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The Global Research Professorships programme funds research leaders, with a track-record of applied health research in low- and middle-income countries (LMICs), to promote effective translation of research and to strengthen research leadership at the highest academic levels. Funding of up to £2m over up to 5 years is awarded to Professors working in close partnership with a research institution in an LMIC.. By the end of the award, NIHR Global Research Professors will be expected to: \n\n1) Have demonstrated research leadership at a national and/or international level.\n2) Have been developed and protected by their institutions, including being relieved of administrative tasks.\n3) Enhance existing and establish new research collaborations in low- and middle-income countries (LMICs).\n4) Have supported training and capacity strengthening/mentorship within LMIC and UK (if applicable) institutions that enhances research capacity for future global health and care research.\n \n ID: GB-GOV-10-RP_05_302394\nTitle: NIHR GRP: Healthy Ageing in Sub-Saharan Africa\nDescription: The NIHR Global Research Professorship (GRP) scheme is open to all professions and all Higher Education Institutions (HEI), based in UK and low-and-middle-income-country (LMIC), to nominate health researchers and methodologists with an outstanding research record of clinical and applied health research and its effective translation for improved health. Global Research Professors are required to have existing strong collaborations or links with collaborators or partners in institutions in countries on the OECD DAC list and the award should plan to strengthen these/support training and capacity development/mentorship in these partners.\n\nThanks to advances in health and sanitation, around the world people are living longer than ever before, with the greatest changes happening in Africa. In these added years of life, older people understandably want health and wellbeing, that is ‘healthy ageing’. However, currently many African countries, with challenged healthcare services and limited resources, are struggling to provide for their rapidly ageing populations, meaning older people are more likely to be living with disability and dependence. The World Health Organization (WHO) describes healthy ageing as an older person’s ability to walk, see and hear, and function mentally within the place they live. As countries develop health services to meet the growing needs of ageing populations, there is an opportunity now to proactively plan innovative ways of providing healthcare to help people age well. I have an established research network across The Gambia, South Africa and Zimbabwe on which to build this research programme. I want to understand why some people age healthily and some ‘unhealthily’ in these three very different countries, and then develop a ‘Healthy Ageing Check-up’, run by nurses and therapists in local communities, where older people can be assessed and offered practical management to maintain health as they age. Initially my team and I will analyse information collected from 5030 older adults across the three countries, to understand how commonly people are ageing healthily (and unhealthily), and how this influences quality of life. We will then look at what diseases particularly pre-dispose someone to unhealthy ageing, which we should address in our healthy ageing check-ups. State-of-the-art blood tests for molecules reflecting how our bodies work, will help us understand the underlying processes behind how these diseases affect the way we age.\n\nWe will then work with a range of stakeholders, healthcare experts and older people themselves, to develop a health check-up for people aged 65 years and older, that we will test in Zimbabwe. The check-up will assess for example, walking, balance, nutrition, memory, mood, eyesight, and hearing. We expect most older people will have problems in several areas. When we identify a problem we will offer advice, practical solutions and if needed arrange specialist referral. We will test how well the roll-out of this system of health checks works, for example how often we identify a health problem, how often we can offer a solution and, when we follow them up again after 4 months, how frequently the older person has taken up the recommendations. In theory access to public healthcare is free to older people in Zimbabwe. As well as calculating how much it costs to provide the health check-ups and care, we will see if people experience extra ‘out-of-pocket’ costs because of the health checks, and if so, the reasons for this. \nFinally, working with the WHO, we will develop a ‘Healthy Ageing Intervention Toolkit’ to guide the structured, comprehensive, person-centred assessment and management of older people, ready for scale-up across sub-Saharan Africa.\nOver the 5 years, I will grow a highly-skilled and experienced Global Health and Ageing Research team to ensure positive impacts on older people’s health for many years to come.. 1. To evaluate ‘healthy ageing’ in three diverse settings in sub-Saharan Africa (The Gambia, Zimbabwe, South Africa):\na. Quantifying healthy ageing and generating T-Scores to enable rural-urban and inter-country comparisons.\nb. Understanding associations between healthy ageing and key outcomes including health-related quality of life (HRQoL), food insecurity and household wealth\nc. Determining drivers of ‘unhealthy ageing’, particularly multimorbidity clusters that associate with adverse ageing profiles\nd. Describing the metabolomic ‘signatures’ of healthy and unhealthy ageing in these three diverse populations.\n\n2. To develop a healthy ageing screening and intervention programme for community-dwelling older adults which addresses challenges to functional ability.\n\n3. To determine the feasibility, acceptability, effectiveness and costs of introducing community-based health checks of functional ability for older people in Zimbabwe.\n\n4. Through community engagement and involvement (CEI), co-design and implement community-based healthy ageing peer-to-peer support groups, to promote and maintain functional ability by facilitating self-management.\n\n5. To develop a ‘Healthy Ageing’ Intervention Toolkit guiding a structured, comprehensive, person-centred approach for non-specialist assessment and management of functional ability in older people living in sub Saharan Africa.\n \n ID: GB-GOV-10-RP_05_302418\nTitle: NIHR GRP: Calling time on avoidable morbidity from asthma in African children\nDescription: The NIHR Global Research Professorship (GRP) scheme is open to all professions and all Higher Education Institutions (HEI), based in UK and low-and-middle-income-country (LMIC), to nominate health researchers and methodologists with an outstanding research record of clinical and applied health research and its effective translation for improved health. Global Research Professors are required to have existing strong collaborations or links with collaborators or partners in institutions in countries on the OECD DAC list and the award should plan to strengthen these/support training and capacity development/mentorship in these partners.\n\nVision: All children and adolescents with asthma in Africa having equitable access to affordable and effective care.\n\nAims: My overall aim is to improve access to effective and affordable care for children and adolescents with asthma in Africa.\n\nAround 1 in 10 children and adolescents have asthma and mortality from asthma in some African countries is 100 times that in the UK. Medications to reduce suffering and death have been available for over half a century, but these have largely been unavailable in Africa. Quality data on prevalence and cost of care are largely unavailable resulting in low prioritisation by policymakers. These inequities warrant urgent intervention. A recent change in asthma management recommends against use of asthma relievers (reliefs airways obstruction) inhaler therapy alone based on disproportionately high deaths associated with their excessive use. Combination inhalers which include both a controller (treatment to prevent airway swelling) medication usually corticosteroids and fast-acting relievers (β2-agonist) are now widely accepted and endorsed as the first step in the treatment ladder, but are inaccessible in Africa.\n \nDesign and methods:\nIndividually randomised controlled trial of the clinical-and cost-effectiveness of a pragmatic single inhaler-based approach to asthma management in poor rural South African setting.\nPopulation: Children and adolescents 6-18 years, who have had ≥1 asthma attack in the last 12 months. A total of 2028 will be included with equal numbers in the intervention and the control group.\n\nIntervention: An easy to use strategy of an inhaled corticosteroid/ fast-onset β2-agonist (ICS/LABA) inhaler for symptom relief (reliever) as well as for maintenance (controller) therapy. \n\nControl: Local standard asthma care \n\nPrimary outcome: Severe asthma attack defined as any asthma attack that requires medication with oral or intravenous corticosteroids.\n\nTime: 12 months’ follow-up.\nI will conduct a multi-country cross-sectional study to determine the prevalence and risk factors for asthma in children and adolescents in three African countries, with a view to create an African Asthma Observatory.\nI will collect data with standardised tools Global Asthma Network (GAN) methodology with a self-administered written and video questionnaire on symptoms of asthma, allergic rhinitis, eczema and environmental questions. In addition, a list of questions on risk factors tailored for the African setting will be included.\n\nPatient Public Involvement:\nPilot work from focus groups with patients and carers of the NIHR Global Group Achieving Control of Asthma in Children in Africa (ACACIA) informed the research. Half of the asthmatics experienced severe symptoms which affected participation in sport, school and leisure activities. Asthmatics also expressed a need for effective, easy to use inhalers. A pilot on the prevalence of asthma in the uMkhanyakude community with the Vukuzazi health camp by Africa Health Research Institute where I propose to perform the clinical trial found than only 55% of adolescents with asthma symptoms had a diagnosis. I will adapt the NIHR INVOLVE information for participation in clinical trials to isiZulu to ensure equitable participation. Community stakeholders and service-users will be engaged throughout the project.\n. 1. To determine the clinical and cost effectiveness of ICS/LABA compared to standard asthma care\n2. The determine the prevalence and risk factors for asthma in adolescents in Africa\n3. To create an observatory for asthma for Africa\n4. To establish opportunities for early career researcher in Africa to strengthen research capacity\n5. To advocate for access and effective medications for asthma for African children and adolescents.\n \n ID: GB-GOV-10-RP_05_302421\nTitle: NIHR GRP: Advancing Research to Reduce Alcohol Related Harms - Policy, Practice and Sustainable Development in India\nDescription: The NIHR Global Research Professorship (GRP) scheme is open to all professions and all Higher Education Institutions (HEI), based in UK and low-and-middle-income-country (LMIC), to nominate health researchers and methodologists with an outstanding research record of clinical and applied health research and its effective translation for improved health. Global Research Professors are required to have existing strong collaborations or links with collaborators or partners in institutions in countries on the OECD DAC list and the award should plan to strengthen these/support training and capacity development/mentorship in these partners.\n\nProblem drinking affects large numbers of individuals and their families across the world. It also leads to social harm through violence, loss of work, and increased direct law enforcement and healthcare costs. As India and other similar countries become more affluent, drinking is becoming more common. Furthermore, the harms related to drinking are disproportionately affecting the poorest in society. Despite this burden of problem drinking, only one out of ten such drinkers has any access to appropriate care in India. This is due to the inability of our health systems to successfully integrate and scale-up effective treatments in a sustainable manner. Through my programme I aim to bridge this gap between 'what works' and 'how to make it work at the population level' by developing contextually-relevant strategies to guide the translation of such research evidence in low resource settings.\n\nI will do this by using the lessons learnt in a series of research studies conducted in India. In one study I will first develop and then test a contextually relevant and scalable intervention that caters to the various levels of severity of problem drinking and also engages the families of those with drinking problems to enhance entry into and adherence to the treatment. In the other study I will test how engaging communities in care allows greater engagement in care and consequently better outcomes in those with depression. While investigating if these interventions work in real-world settings, I will also examine the various strategies required to prepare the health-systems for efficiently and sustainably integrating these interventions into routine healthcare delivery.\n\nAll these studies will include a systematic engagement with a range of community stakeholders including service users, their families, clinicians, community leaders, and policy makers. All these stakeholders will be equal partners in the research and will actively contribute to the design and implementation of the studies. The studies will be designed so that they are responsive to inputs of the stakeholders and felt needs of the communities in which they will be implemented. In parallel with all these studies, I will coordinate a systematic process, involving various stakeholders, through which I will consolidate the lessons learnt from the individual studies to develop a guidance document to aid the efficient scaling-up of psychosocial interventions in low resource settings.\n\nThe short-term impact of the programme will be the benefits accrued by the study participants receiving the psychosocial interventions, and contextually relevant knowledge generated about ‘what works’ i.e. psychosocial interventions for problem drinking. The long-term benefits beyond the duration of the programme, and also beyond India, will be through the knowledge generated on how to sustainably scale up effective programmes so that they are easily accessible to those who need them.. Study 1 (Development of Alcohol Problems Treatment Plus (APT+)): Using systematic and evidence-based intervention development processes I will integrate interventions developed in the study setting into a single integrated intervention (APT+). The process will include consultations with various stakeholders such as expert clinicians, individuals with drinking problems, and family members; followed by evaluation of acceptability and feasibility through treatment cohorts using process evaluation and in-depth interviews with the various stakeholders.\nStudy 2 (Integrated Care for Alcohol Problems): hybrid effectiveness-implementation RCT with two arms comparing treatment as usual (TAU) with APT+.\nStudy 3 (IMPRESS): hybrid implementation cluster RCT which will compare two task-sharing models for delivering a psychological intervention by non-specialist health workers, i.e. as a stand-alone intervention in public-sector primary care clinics versus being integrated with an evidence-based community intervention delivered by community based agents aimed at increasing demand for care and improving treatment adherence and effectiveness.\nStudy 4 (Bench to Bedside-B2B): I will systematically review lessons learnt from ICAP and IMPRESS and consolidate them into strategies using a systematic process which includes triangulation of data from nested qualitative studies and process data from the two studies, Delphi process with implementation science experts, and semi-structured interviews with key stakeholders, including policymakers.\n\nCommunity engagement/Dissemination\nA range of community stakeholders will actively contribute to the intervention development and/or implementation and testing as equal partners. Through rapid feedback loops integrated into the study design; and involving participatory research and dissemination through various channels, we will ensure that the study outputs are responsive to inputs and felt needs of the communities in which they will be implemented.\n \n ID: GB-GOV-10-RP_05_302422\nTitle: NIHR GRP: Increasing newborn survival: harnessing real-time data, digital innovation and community engagement \nDescription: The NIHR Global Research Professorship (GRP) scheme is open to all professions and all Higher Education Institutions (HEI), based in UK and low-and-middle-income-country (LMIC), to nominate health researchers and methodologists with an outstanding research record of clinical and applied health research and its effective translation for improved health. Global Research Professors are required to have existing strong collaborations or links with collaborators or partners in institutions in countries on the OECD DAC list and the award should plan to strengthen these/support training and capacity development/mentorship in these partners.\n\nVision: to improve the health of newborns and children by building equitable institutional partnerships through which global learning and innovation can flourish. The scientific gap I will address is how to improve newborn care in health facilities in low-resource settings. Every year, around two thirds of the 2.4 million deaths occurring within the first month of life and half of the 2 million stillbirths are likely avoidable by ensuring that the most generalisable (already-well-described) clinical pathways are delivered.\n\nOver the last 7 years I have been working with: families, healthcare providers, software developers, data scientists and the Ministries of Health in Zimbabwe, Malawi and the UK, to co-develop a data driven quality improvement system for hospital-based newborn care. Neotree is a tablet-based application developed with and for nurses and doctors to give better care to newborns, especially in low-resource settings where most newborn health care is delivered by those with little or no training in newborn health. The app guides the healthcare provider through clinical history taking and examination for sick and small babies, providing educational messaging and prompts. This straightforward combination of the key data, education and guidelines is incredibly powerful: not just because it can improve the result for each individual baby, but also because the data can be sent onward to local and national data stores allowing doctors and nurses to look at data for their own population and then improve the guidelines. \n\nNeotree is open source, and all data captured by the system are owned locally. As of 19/11/2021 the Neotree has been used in two countries to assist the care of ~16,000 newborns by more than 350 healthcare professionals and has been shown to improve quality of care (e.g. more targeted and evidenced based prescription antibiotics). Plans and funding applications for larger scale testing to assess impact on mortality are underway (out of scope for this application).\n\nThrough this Professorship I will extend Neotree to the care of the mother and baby during birth and the care of babies born in rural primary care clinics in Zimbabwe. In addition, I will substantially improve two existing areas: how to use data from the Neotree to improve guidelines, and how we work with families and parents to create partnerships in care - in particular we will find out how best to involve parents in feeding babies and keeping them warm.\n\nI will increase the number of African researchers who are able to conduct research in digital innovation, newborn care and community engagement through (i) supervision and mentorship of African PhD and Masters students and clinicians; (ii) ensuring the Neotree data are curated, easily accessible and reusable and (iii) delivering a 2-year programme in engaging families and communities in newborn research and care. The latter will build on work we have conducted over the last 6 months with families and ArtGlo Africa, a Malawian based participatory arts group, to empower families as active participants in healthcare and research and to strengthen community engagement in newborn care in Malawi and Zimbabwe. I will also mentor a junior researcher in UK-focused community child health.. 1. Extend Neotree to new outcomes (quality of perinatal care) and populations (rural health clinics) to help with the care of over a million babies and mothers annually in Zimbabwe and Malawi.\n2. Substantially improve neonatal outcomes in communities already using Neotree by optimising clinical care pathways for thermoregulation, convulsions, low birth weight, prematurity, hypoglycaemia, HIV, respiratory distress, neonatal encephalopathy, sepsis, syphilis, jaundice and congenital abnormalities.\n3. Actively and explicitly involve families in newborn care research and also in the co-creation of family centred clinical pathways.\n", "_version_":1862221875111788544 }] } }