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In 2015, WHO estimated there were 9.6 million TB cases and 1.5 TB deaths. Nearly 500,000 of these cases were resistant to two or more of the main drugs used to treat TB. New drugs, and combinations of drugs, are being developed to treat tuberculosis, as are new vaccines that may protect against disease in adults. Quantifying the burden of TB is fundamental to understanding its global epidemiology and for making appropriate resource allocation decisions. Most estimates of new TB case numbers each year rely strongly on the number of cases reported by countries in that year to WHO. Unfortunately, one in three TB cases are thought to go either undetected or unreported, so the number of cases reported underestimates the number of new cases. While one can correct for this, it is hard to know exactly how much to adjust the reported numbers. Some countries have good systems for recording causes of deaths, which can be used to estimate the number of deaths caused by TB. 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This process provides a model that may be used to make predictions about burden, but may also teach us something about the underlying processes. Many of the parameters concerning the epidemiology and disease course of TB are quite uncertain, and this uncertainty is rarely represented fully in models needing calibration, but will be done in this project using statistical techniques that also allow comparison of different models' performance. TB burden estimation and calibration of transmission models are almost always carried out on a country-by-country basis. Many parameters describing disease progression are likely to be similar in different countries, even if their exact values differ for unknown reasons. Hierarchical modelling techniques allow such parameters to be correlated between countries. This can improve precision, particularly for countries with little data, as estimates can be informed by data from neighbouring countries. I will explore these techniques for the transmission model, and also in statistical modelling aiming to account for the observed patterns of drug-resistance. The transmission model will ultimately be extended to include different types of drug resistance. As new treatments and vaccines emerge, those with responsibility for public health will want to understand the potential impact these new technologies can have in terms of gains in health, and changes in spending. Producing cost-effectiveness and budget impact evidence requires a model that includes transmission, in order to account for indirect benefits accrued by avoiding secondary cases. We will use our model to provide guidance to decision-makers seeking to maximise health gain with limited resources. 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"transaction_value_date":["2021-03-31T00:00:00Z","2020-12-31T00:00:00Z","2020-09-30T00:00:00Z","2020-06-30T00:00:00Z","2020-03-31T00:00:00Z","2019-12-31T00:00:00Z","2019-09-30T00:00:00Z","2019-06-30T00:00:00Z","2019-03-31T00:00:00Z","2018-12-31T00:00:00Z","2018-09-30T00:00:00Z","2018-06-30T00:00:00Z","2018-03-31T00:00:00Z","2017-12-31T00:00:00Z","2017-07-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[34277.811891821475,33085.65789962546,31790.79651222293,30726.313493867852,30367.46441002311,32218.813365784412,30088.155364169204,30856.949189838262,32057.522890347744,30856.81316845746,31538.163858177744,32092.769989425527,33731.65480970169,32365.412965582185,637552.8941929804] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_T003960_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Enhancing brain development by early iron supplementation of African infants: An enabling pilot study"], "description_narrative":["Iron is crucial for brain development and early deficiencies during infancy can cause irreparable damage. Figures from the latest Global Burden of Disease analysis estimate that iron deficiency is more common than all other micronutrient deficiencies combined. This burden is concentrated in sub-Saharan Africa and South Asia. Breast milk contains very little iron, so babies draw upon iron stores laid down in their liver during late foetal life. However, the babies of iron deficient mothers are born with a limited endowment of iron and can rapidly develop iron deficiency. We have recently shown that, by 5 months of age, almost 95% of rural Gambian infants have circulating iron levels below the lower limit of the US reference range. This indicates that these babies are profoundly iron deficienct. The American Academy of Pediatrics (AAP) recommends iron supplementation in exclusively breastfed infants beginning at 4 months of age. AAP also recommends that babies born prematurely start supplementation at 2 weeks. Yet prior and on-going trials of iron supplementation in low-income settings have commenced supplementation much later (eg 8-9m in a large on-going trial in Bangladesh). Our data suggest that this will be too late to prevent early iron deficiency from impairing brain development. We therefore propose a large randomised controlled trial of early iron supplementation starting at 6wks of age. In preparation for such a trial we need to conduct preliminary studies addressing the following questions: Can we effectively enhance circulating iron levels in early infancy by giving daily iron drops? Can we achieve this without undermining duration of exclusive breast feeding? Might the iron alter the balance of the babies' gut microbial flora and thereby cause diarrhoea? Might iron supplementation impair the absorption of zinc and copper and hence require a triple supplement? These questions will be tested in a small enabling study that will inform the design of the intended full trial.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."], "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346"], "participating_org_role":["1","2","3"], "participating_org_type":["10","15","15"], "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL"], "activity_status_code":"4", "activity_date_iso_date":["2020-01-01T00:00:00Z","2021-02-01T00:00:00Z","2021-06-30T00:00:00Z","2022-07-31T00:00:00Z"], "activity_date_type":["1","2","3","4"], "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"], "contact_info_department_narrative":["General enquiries"], "contact_info_email":["enquiries@odamanagement.org"], "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"], "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"], "activity_scope_code":"3", "recipient_country_code":["BD","GM"], "recipient_country_percentage":[50.0,50.0], "sector_code":["12182"], "sector_vocabulary":["1"], "policy_marker_code":["1","5","6","7","8","10","11","12"], "policy_marker_significance":["0","0","0","0","0","0","0","2"], "policy_marker_vocabulary":["1","1","1","1","1","1","1","1"], "collaboration_type_code":"1", "default_flow_type_code":"10", "default_finance_type_code":"110", "default_aid_type_code":["D02"], "default_tied_status_code":"5", "budget_status":["1"], "budget_type":["1"], "budget_period_start_iso_date":["2020-04-01T00:00:00Z"], "budget_period_end_iso_date":["2021-03-31T00:00:00Z"], "budget_value":[9553.95], "budget_value_currency":["GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","2"], "transaction_date_iso_date":["2021-03-31T00:00:00Z","2020-01-01T00:00:00Z"], "transaction_value":[9553.95,200968.24], "transaction_value_currency":["GBP"], "transaction_value_date":["2021-03-31T00:00:00Z","2020-01-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[13238.732065895538,262708.5665141422] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_M019624_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Policy and peeR mentOr intervention proGrams on cardiovasculaR disEase at workSites in 3 South Asian countries."], "description_narrative":["We propose a feasibility study and a survey conducted at 6 sites - 2 in India, 2 in Srilanka, and 2 in Bangladesh. 1. The feasibility study will be conducted to understand the feasibility of peer-mentored interventions at the operational, research and policy levels to improve CVD health. At the operational level, we will identify 6 worksites in Bangladesh (2), India (2) and Sri Lanka (2), obtain acceptance from the management, identify the appropriate personnel as peers to carry out interventions and identify areas at worksites to implement interventions (café, physical exercise, stress reduction, tobacco environment). At research level, we will choose the best methods to identify individuals at risk for interventions, measure risk factor levels identify & train the peer mentors, design the most appropriate interventions, determine the training goals for the peer mentors, select the training methods, and develop the intervention tools. At policy level, we will, in discussion with the worksite management and the concerned State Government departments (health and labour departments) determine the need, methods and outcomes of the interventions. This strategy ensures that we have useful insights on the interventions as well as the agreement and investment of key stake-holders in relevant departments 2. A qualitative study will be conducted to understand the priorities for policy level changes to improve the CVD environment at worksites in each country, at the Central and Regional levels; to understand the common barriers for an optimal CVD environment at worksites; and to understannd the most acceptable peer mentor-based interventions for employees to improve CVD health. We will survey at least three levels of management staff per site on the CVD environment at the workplace. Specifically this will include tobacco policy, food at workplace, opportunities for physical activity, medical care if any provided at worksites, policy on chronic care for employees, barriers for optimal care and possible interventions to improve CV health. We will survey 5 management staff at each level or 15 per worksite for a total of 120 at 8 sites. We will conduct focussed group discussions and in-depth interviews among management staff and employees to better understand policy issues, barriers for CVD care and acceptable interventions to improve CV health. If peer mentor mediated interventions prove to be effective in reducing cardiovascular risk factors, such interventions could be scaled up globally. As adults can spend upto 60% of their time at workplaces, interventions such as these could prove to be effective in reducing cardiovascular risks and reap rich dividends by reducing cardiovascular deaths, thus helping to achieve World Hearth Federation's goal of 25 by 25.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."], "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346"], "participating_org_role":["1","2","3","4"], "participating_org_type":["10","15","15","80"], "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL","CBCI SOCIETY FOR MEDICAL EDUCATION"], "activity_status_code":"4", "activity_date_iso_date":["2014-12-01T00:00:00Z","2015-01-01T00:00:00Z","2016-05-31T00:00:00Z","2017-10-31T00:00:00Z"], "activity_date_type":["1","2","3","4"], "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"], "contact_info_department_narrative":["General enquiries"], "contact_info_email":["enquiries@odamanagement.org"], "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"], "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"], "activity_scope_code":"2", "recipient_country_code":["IN","LK","BD"], "recipient_country_percentage":[33.333333333333336,33.333333333333336,33.333333333333336], "sector_code":["12182"], "sector_vocabulary":["1"], "policy_marker_code":["1","5","6","7","8","10","11","12"], "policy_marker_significance":["0","0","0","0","0","0","0","0"], "policy_marker_vocabulary":["1","1","1","1","1","1","1","1"], "collaboration_type_code":"1", "default_flow_type_code":"10", "default_finance_type_code":"110", "default_aid_type_code":["D02"], "default_tied_status_code":"5", "budget_status":["1","1"], "budget_type":["1","1"], "budget_period_start_iso_date":["2014-04-01T00:00:00Z","2015-04-01T00:00:00Z"], "budget_period_end_iso_date":["2015-03-31T00:00:00Z","2016-03-31T00:00:00Z"], "budget_value":[22679.8,90866.18], "budget_value_currency":["GBP","GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","2"], "transaction_date_iso_date":["2018-03-31T00:00:00Z","2014-12-01T00:00:00Z"], "transaction_value":[3141.8,136372.76], "transaction_value_currency":["GBP"], "transaction_value_date":["2018-03-31T00:00:00Z","2014-12-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[4389.120068100112,213364.9611412918] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_T003928_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Efficacy and safety of chlorhexidine cleansing in reducing bacterial skin colonisation of hospitalised low birthweight neonates:a pilot trial (NeoCHG)"], "description_narrative":["This is a pilot study to work out the best way to apply an antiseptic called chlorhexidine to the skin of low birth weight newborn babies who are admitted to hospital. We want to do this because these babies have bacteria living on their skin, just like older children and adults, but in very small babies these bacteria can more easily get into the blood and make them seriously unwell. This study will work out the best strength of the antiseptic, as well as how often it should be applied, and whether or not it should be combined with a skin softener (called emollient), that could be tested in a larger study in the future. This future study would aim to reduce deaths in these newborns, but at the moment we don't know what type of skin cleansing would have the best chance of doing this. So in this pilot study, we will look at how much the different methods reduce counts of bacteria on the skin. We will also look at the newborns skin every day to make sure it is safe. The antiseptic chlorhexidine has been shown to reduce the risk of dying from infection when it is applied to the umbilical cord in newborns at home in regions with high rates of newborn deaths. However it is still uncertain whether applying chlorhexidine to the body could reduce the risk of infection and death in newborns who are in hospital and also at high risk of infection due to other factors such as low birth weight. In addition, skin softeners, which are often in the form of oils such as sunflower oil, have been shown in some studies to reduce infections, although a recent review was inconclusive. The effect of combining both skin softeners and an antiseptic may have additional undiscovered benefits but has not been adequately tested, therefore this study will also assess this combination. The trial will be conducted in 2 hospitals, one in Bangladesh, and the other in South Africa. Chlorhexidine wipes will be applied to the skin of the body of newborn babies, starting at from 2 days of age and either daily (Monday-Friday) or three times a week (Monday, Wednesday and Friday) thereafter. In addition, half of each group will receive a skin softener as well. Swabs will be taken from various areas of the skin of the newborns, and we will count the number of bacteria growing from these swabs. In addition, we will monitor the skin of the newborns closely for any signs of reaction to the chlorhexidine. In this way, the study will provide information on the balance between how good the different methods are at reducing bacterial counts, whilst remaining safe. The best concentration and frequency of application, with or without skin softener, will then be chosen to be tested in the larger trial in the future. The larger trial would be able to test whether applying chlorhexidine to the skin of hospitalised low birth weight newborns reduces their risk of getting serious infections, and whether this improves their survival.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."], "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346"], "participating_org_role":["1","2","3","4"], "participating_org_type":["10","15","15","80"], "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL","ST GEORGE'S UNIVERSITY OF LONDON"], "activity_status_code":"4", "activity_date_iso_date":["2020-01-01T00:00:00Z","2020-04-01T00:00:00Z","2021-12-31T00:00:00Z","2022-03-31T00:00:00Z"], "activity_date_type":["1","2","3","4"], "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"], "contact_info_department_narrative":["General enquiries"], "contact_info_email":["enquiries@odamanagement.org"], "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"], "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"], "activity_scope_code":"3", "recipient_country_code":["BD","ZA"], "recipient_country_percentage":[50.0,50.0], "sector_code":["12182"], "sector_vocabulary":["1"], "policy_marker_code":["1","5","6","7","8","10","11","12"], "policy_marker_significance":["0","0","0","0","0","0","0","0"], "policy_marker_vocabulary":["1","1","1","1","1","1","1","1"], "collaboration_type_code":"1", "default_flow_type_code":"10", "default_finance_type_code":"110", "default_aid_type_code":["D02"], "default_tied_status_code":"5", "budget_status":["1"], "budget_type":["1"], "budget_period_start_iso_date":["2020-04-01T00:00:00Z"], "budget_period_end_iso_date":["2021-03-31T00:00:00Z"], "budget_value":[37447.94], "budget_value_currency":["GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","3","3","3","2"], "transaction_date_iso_date":["2021-03-31T00:00:00Z","2020-12-31T00:00:00Z","2020-09-30T00:00:00Z","2020-06-30T00:00:00Z","2020-01-01T00:00:00Z"], "transaction_value":[7742.71,12772.34,12080.85,4852.04,235964.03], "transaction_value_currency":["GBP","GBP","GBP","GBP"], "transaction_value_date":["2021-03-31T00:00:00Z","2020-12-31T00:00:00Z","2020-09-30T00:00:00Z","2020-06-30T00:00:00Z","2020-01-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[10728.930249156636,17082.86006341483,15651.393614602444,6075.596764121615,308455.56526842277] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_T023562_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["The Bangladesh D:CLARE Project (Diabetes: Community-Led Awareness, Response and Evaluation)"], "description_narrative":["We recently completed a population health experiment in rural Bangladesh where we found that a diabetes-focused participatory community mobilisation intervention whereby ordinary community members themselves identify, prioritise and address threats to their health reduced the burden of diabetes and the risk of diabetes (known as 'intermediate hyperglycaemia') in these villages by more than 60% relative to villages where no intervention took place. Furthermore, among individuals who were at higher risk of developing diabetes, those living in community mobilisation villages were almost 60% less likely to develop the disease over two years compared to those who lived in villages where no intervention took place. These findings and our robust methods of evaluation give us confidence that exposure to the community mobilisation intervention caused this reduction in the burden of intermediate hyperglycaemia and diabetes. Furthermore, the low-cost, social intervention is cost-effective and can lead to savings in health care expenditure. Based on these findings, we wish to scale-up our intervention to cover a much larger population. Working with the Diabetic Association of Bangladesh, who will implement the intervention across a population of 215,000 people, UCL will apply epidemiological, economic, social and implementation science methods to better understand the processes, costs and impact of implementation at such a large scale. Further, we will evaluate the sustainability of groups when direct intervention from the Diabetic Association of Bangladesh is withdrawn and evaluate whether observed improvements in health last over a period of three years. Finally, a core component of our project will be engagement with governmental and non-governmental stakeholders in Bangladesh and globally to share our findings and to explore opportunities for longer-term, larger-scale implementation of the intervention.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."], "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346"], "participating_org_role":["1","2","3","4"], "participating_org_type":["10","15","15","80"], "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL","UNIVERSITY COLLEGE LONDON"], "activity_status_code":"4", "activity_date_iso_date":["2019-08-01T00:00:00Z","2019-09-01T00:00:00Z","2022-07-31T00:00:00Z","2021-03-31T00:00:00Z"], "activity_date_type":["1","2","3","4"], "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"], "contact_info_department_narrative":["General enquiries"], "contact_info_email":["enquiries@odamanagement.org"], "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"], "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"], "activity_scope_code":"4", "recipient_country_code":["BD"], "recipient_country_percentage":[100.0], "sector_code":["12182"], "sector_vocabulary":["1"], "policy_marker_code":["1","5","6","7","8","10","11","12"], "policy_marker_significance":["0","0","0","0","0","0","0","0"], "policy_marker_vocabulary":["1","1","1","1","1","1","1","1"], "collaboration_type_code":"1", "default_flow_type_code":"10", "default_finance_type_code":"110", "default_aid_type_code":["D02"], "default_tied_status_code":"5", "budget_status":["1","1"], "budget_type":["1","1"], "budget_period_start_iso_date":["2019-04-01T00:00:00Z","2020-04-01T00:00:00Z"], "budget_period_end_iso_date":["2020-03-31T00:00:00Z","2021-03-31T00:00:00Z"], "budget_value":[113213.0,227343.1], "budget_value_currency":["GBP","GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","3","3","3","3","2"], "transaction_date_iso_date":["2021-03-31T00:00:00Z","2020-12-31T00:00:00Z","2020-09-30T00:00:00Z","2020-06-30T00:00:00Z","2020-03-31T00:00:00Z","2019-08-01T00:00:00Z"], "transaction_value":[57065.03,57065.03,56606.52,56606.52,113213.04,1369590.37], "transaction_value_currency":["GBP","GBP","GBP","GBP","GBP"], "transaction_value_date":["2021-03-31T00:00:00Z","2020-12-31T00:00:00Z","2020-09-30T00:00:00Z","2020-06-30T00:00:00Z","2020-03-31T00:00:00Z","2019-08-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[79073.9581536737,76323.83118555952,73336.80375742316,70881.19424823073,140106.7618543083,1663527.9306398393] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_P004105_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Creating responsive health systems: improving the use of feedback from service users in quality assurance and human resource management in Bangladesh"], "description_narrative":["This project aims to improve the responsiveness of the health system in Bangladesh. This addresses an issue of high interest to the country's policymakers. Effective interaction and engagement between the health service users and practitioners and policymakers is an important attribute of responsive health systems. Central to this concept is the opportunity for users to provide feedback on their experiences engaging with the health system, and vitally the ability of the health system to respond to users' suggestions. This project focuses on Bangladesh, a low income Asian country where the Ministry of Health and Family Welfare (MOHFW) is implementing a program allowing service users to send feedback via SMS texts. The texts from the whole country are aggregated in a web portal, which is monitored by the MOHFW staff, who are then expected to follow up each issue with both a sender and local authorities. Service users can also provide feedback directly to health management committees at Upazila level, and through suggestion boxes in each health facility. However, it is unclear how issues received directly at the Upazila level are followed-up and by whom. . The AIM of this project is to assist the policymakers in designing a comprehensive health systems intervention to make Bangladesh's health system more responsive. Specific project OBJECTIVES are to work closely with national and local decision-makers to: 1. Develop an in-depth understanding of the nature and contents of, and key reasons for, feedback received from health service users at Upazila level; 2. Analyse the processes of collecting and responding to service users' feedback at Upazila level, as well as the key contextual facilitators and constraints influencing these processes; 3. Assess the approach to, and processes of, service quality assurance and human resource management, focusing specifically on the use of feedback from service users at Upazila level; 4. Using results of objectives 1-3, develop a comprehensive health systems intervention to improve the use of feedback from service users in quality assurance and human resource management processes at Upazila level. This 18-months project will analyse the national-level user feedback data and collect more detailed qualitative information in one district in Bangladesh. Within the district, we will focus on two Upazila Health Complexes (UHC) which, being the first level referral services from the primary health care, are the backbone of the health system. We will implement a multi-method health systems research using realist evaluation. Qualitative and quantitative data will be collected using combinations of: 1) in-depth interviews with purposefully-identified service users and gender and age-specific focus groups with communities to explore their knowledge of and use of feedback systems; 2) in-depth interviews to explore views of purposefully-selected service providers and managers at the UHC about the user feedback systems; 3) analysis of country-level secondary data on user feedback from the government web portal, to understand types of issues, their location and gender and age of users who initiated issues; 4) non-participant observation of: feedback environment in the district, health management committee meetings and UHC routine quality assurance and staff management practices; 5) review of key documents (e.g. feedback to users and actions taken, meeting minutes, quality assurance guidelines, staff performance appraisal and supervision records). Throughout the project, we will work closely with decision-makers, to facilitate the shared understanding, adoption of results into policy and practice and achieving its highest impact. Project results will be communicated widely through policy briefs, presentations at management meetings, development of newsletters and press-releases, to ensure their uptake in policy and practice in Bangladesh and wider.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."], "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346","GB-COH-RC000658"], "participating_org_role":["1","2","3","4"], "participating_org_type":["10","15","15","80"], "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL","UNIVERSITY OF LEEDS"], "activity_status_code":"4", "activity_date_iso_date":["2017-01-07T00:00:00Z","2017-01-09T00:00:00Z","2018-07-06T00:00:00Z","2018-07-08T00:00:00Z"], "activity_date_type":["1","2","3","4"], "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"], "contact_info_department_narrative":["General enquiries"], "contact_info_email":["enquiries@odamanagement.org"], "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"], "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"], "activity_scope_code":"4", "recipient_country_code":["BD"], "recipient_country_percentage":[100.0], "sector_code":["12182"], "sector_vocabulary":["1"], "policy_marker_code":["1","5","6","7","8","10","11","12"], "policy_marker_significance":["0","0","0","0","0","0","0","0"], "policy_marker_vocabulary":["1","1","1","1","1","1","1","1"], "collaboration_type_code":"1", "default_flow_type_code":"10", "default_finance_type_code":"110", "default_aid_type_code":["D02"], "default_tied_status_code":"5", "budget_status":["1","1"], "budget_type":["1","1"], "budget_period_start_iso_date":["2016-04-01T00:00:00Z","2017-04-01T00:00:00Z"], "budget_period_end_iso_date":["2017-03-31T00:00:00Z","2018-03-31T00:00:00Z"], "budget_value":[16902.25,66998.85], "budget_value_currency":["GBP","GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","3","3","3","3","3","2"], "transaction_date_iso_date":["2018-09-30T00:00:00Z","2018-03-31T00:00:00Z","2017-12-31T00:00:00Z","2017-09-30T00:00:00Z","2017-06-30T00:00:00Z","2017-03-31T00:00:00Z","2017-01-07T00:00:00Z"], "transaction_value":[3655.82,5593.33,11018.4,8453.41,5634.08,5634.08,100681.12], "transaction_value_currency":["GBP","GBP","GBP","GBP","GBP","GBP"], "transaction_value_date":["2018-09-30T00:00:00Z","2018-03-31T00:00:00Z","2017-12-31T00:00:00Z","2017-09-30T00:00:00Z","2017-06-30T00:00:00Z","2017-03-31T00:00:00Z","2017-01-07T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[4775.100191836015,7813.9273507245525,14769.33583951267,11266.763928571174,7212.5635732212995,6948.742782911244,124284.63615142056] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_P017037_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Sustainable day-care for 1-4 year olds in disadvantaged urban communities in Dhaka, Bangladesh"], "description_narrative":["Our partners, CIPRB, have shown, through a natural experiment, that community day-care for 1-4 year old children in rural areas is effective in reducing risk of all-cause mortality by 44%, drowning by 82% and injuries by 88%, compared to children not in day-care [9]. We wish to adapt this model so it can be appropriately, feasibly and sustainably delivered to benefit urban disadvantaged communities. Low-income countries (LICs) are experiencing rapid and uncontrolled urbanisation. This can clearly be seen in Dhaka, Bangladesh with an annual urban population growth of 3.6% [6], and an estimated 4 million inhabitants living in slums. Urbanisation is changing gender dynamics: 22% of women in Dhaka now work outside the home (11% non-slum) [9]. With limited extended family support in slums, women must either leave children with elder siblings - often sisters who then drop-out of school - or neighbours. This limited supervision contributes to high rates of injuries, poor hygiene and limited nutrition, resulting in 50% of slum children suffering stunting (33% non-slum). Child day-care presents a holistic solution, allowing women to work whilst knowing their children are safe, cared-for and have opportunities for early childhood development (ECD). Our partners, CIPRB, have extensive experience of delivering day-care in rural Bangladesh [9]. Building on CIPRB's rural model we plan to develop and refine a sustainable day-care model based on principles of ECD and improving nutrition and hygiene for 1-4 year olds. Financial sustainability is key for longevity and scale-up. We plan to place day-care centres adjacent to slums so services at a suitable fee can be provided to parents in non-slum neighbourhoods. This approach is designed to promote integration between the two communities, potentially facilitating social mobility for slum children. Objectives and methods, to: 1) Understand the extent and nature of demand for day-care we will survey 200 households with children under 5 from slum and non-slum communities, and conduct qualitative interviews to understand perceptions of childcare among women, carers, men and community leaders. 2) Co-produce a proto-type integrated, self-sustaining, child day-care model we will establish a technical working group of childcare experts, community representatives, local government officials, donors and (I)NGOs. The group will draw on CIPRB's, (I)NGO models and findings of a systematic review being conducted by UWA (not included in this proposal) to develop a prototype model and all materials required. The group will also develop a draft theory of change to guide the evaluation. 3) Test and refine an integrated self-sustaining model, we will implement the day-care model for six months. During this time, we will facilitate a group of day-care users and staff to reflect on how the model is working and make changes for improvement. Our qualitative researchers will observe the process, and interview users to understand how to further improve the model. We will assess model costs and the extent that fees from non-slum day-care users can support sustainable delivery. 4) Inform the design of a pilot study for a larger evaluation to assess the cost-effectiveness of the day-care model, we will assess the feasibility and then refine methods for recruitment, assessment and follow-up among day-care users and a potential comparator group. This will involve repeating the survey among the same sample of 200 households. We will also assess children when they start at day-care and six months later. We will use our overall analysis to refine our theory of change. Throughout the study we will engage closely with local government and donors to understand and influence plans to scale up day-care across Dhaka, targeting the urban poor. We will identify the most appropriate outcome measures from our theory of change and discussions with policy makers. We expect these will include ECD, stunting and injuries.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."], "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346","GB-COH-RC000658"], "participating_org_role":["1","2","3","4"], "participating_org_type":["10","15","15","80"], "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL","UNIVERSITY OF LEEDS"], "activity_status_code":"4", "activity_date_iso_date":["2017-01-03T00:00:00Z","2017-03-01T00:00:00Z","2018-07-02T00:00:00Z","2019-02-28T00:00:00Z"], "activity_date_type":["1","2","3","4"], "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"], "contact_info_department_narrative":["General enquiries"], "contact_info_email":["enquiries@odamanagement.org"], "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"], "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"], "activity_scope_code":"4", "recipient_country_code":["BD"], "recipient_country_percentage":[100.0], "sector_code":["12182"], "sector_vocabulary":["1"], "policy_marker_code":["1","5","6","7","8","10","11","12"], "policy_marker_significance":["0","0","0","0","0","0","0","2"], "policy_marker_vocabulary":["1","1","1","1","1","1","1","1"], "collaboration_type_code":"1", "default_flow_type_code":"10", "default_finance_type_code":"110", "default_aid_type_code":["D02"], "default_tied_status_code":"5", "budget_status":["1","1"], "budget_type":["1","1"], "budget_period_start_iso_date":["2017-04-01T00:00:00Z","2018-04-01T00:00:00Z"], "budget_period_end_iso_date":["2018-03-31T00:00:00Z","2019-03-31T00:00:00Z"], "budget_value":[102081.04,24214.94], "budget_value_currency":["GBP","GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","3","3","3","3","3","2"], "transaction_date_iso_date":["2019-06-30T00:00:00Z","2018-06-30T00:00:00Z","2018-03-31T00:00:00Z","2017-12-31T00:00:00Z","2017-09-30T00:00:00Z","2017-06-30T00:00:00Z","2017-01-03T00:00:00Z"], "transaction_value":[15384.35,24214.94,25520.26,25520.26,25520.26,25520.26,150510.88], "transaction_value_currency":["GBP","GBP","GBP","GBP","GBP","GBP"], "transaction_value_date":["2019-06-30T00:00:00Z","2018-06-30T00:00:00Z","2018-03-31T00:00:00Z","2017-12-31T00:00:00Z","2017-09-30T00:00:00Z","2017-06-30T00:00:00Z","2017-01-03T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[19502.469935524554,32184.878915105986,35652.010092664255,34207.987607246214,34013.5808881573,32670.19596014551,185796.40311540163] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_P022626_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["VACCINE - Development of novel picornavirus virus-like particle vaccines"], "description_narrative":["The strategy of the Medical Research Council is to improve the progress of international health research worldwide. Vaccination has had an enormous impact on human and animal health and is therefore one of the most important and effective medical interventions. However, there are still many examples of diseases for which we do not have effective vaccines. Furthermore, much of our current vaccine production involves the production of disease-causing agents (e.g. viruses) which are subsequently inactivated during the production process. In their simplest terms, viruses can be thought of as protein containers that protect the viral genetic material inside. The container is inert - it is the viral genetic material inside which is responsible for causing disease. However, the container (capsid) is of key importance in the process of developing immunity through vaccination. Here, the body's immune system recognises the capsid proteins and generates antibodies to these, which then give the body protection against the disease. Therefore, production of just the capsid as a virus-like particle (VLP) should elicit a protective immune response, yet be totally safe. Furthermore, such production could be undertaken under low containment, which is both easier and cheaper, thus making such virus-like particle vaccines more accessible to developing countries. However, there are problems to be overcome, as many VLPs are unstable. We have a large amount of proof-of-principle data with the production of VLPs for poliovirus and have generated stabilised VLPs that offer better protection than the current polio vaccine (in animal models). We now we wish to apply our strategy to other viruses, focussing on the causative agents of hand, foot and mouth disease. This is a disease of growing concern due to outbreaks particularly in the SE Asia region, associated with hospitalisation and death. According to the World Health Organisation, this affected 1,520,274 people by the end of July in 2012 in China, with 431 reported deaths, and outbreaks are now reported in Europe.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."], "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346","GB-COH-RC000658"], "participating_org_role":["1","2","3","4"], "participating_org_type":["10","15","15","80"], "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL","UNIVERSITY OF LEEDS"], "activity_status_code":"4", "activity_date_iso_date":["2017-09-01T00:00:00Z","2017-10-01T00:00:00Z","2020-08-31T00:00:00Z","2022-05-31T00:00:00Z"], "activity_date_type":["1","2","3","4"], "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"], "contact_info_department_narrative":["General enquiries"], "contact_info_email":["enquiries@odamanagement.org"], "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"], "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"], "activity_scope_code":"4", "recipient_country_code":["BD"], "recipient_country_percentage":[100.0], "sector_code":["12182"], "sector_vocabulary":["1"], "policy_marker_code":["1","5","6","7","8","10","11","12"], "policy_marker_significance":["0","0","0","0","0","0","0","0"], "policy_marker_vocabulary":["1","1","1","1","1","1","1","1"], "collaboration_type_code":"1", "default_flow_type_code":"10", "default_finance_type_code":"110", "default_aid_type_code":["D02"], "default_tied_status_code":"5", "budget_status":["1","1","1","1"], "budget_type":["1","1","1","1"], "budget_period_start_iso_date":["2017-04-01T00:00:00Z","2018-04-01T00:00:00Z","2019-04-01T00:00:00Z","2020-04-01T00:00:00Z"], "budget_period_end_iso_date":["2018-03-31T00:00:00Z","2019-03-31T00:00:00Z","2020-03-31T00:00:00Z","2021-03-31T00:00:00Z"], "budget_value":[149839.78,300893.24,303330.48,152277.02], "budget_value_currency":["GBP","GBP","GBP","GBP"], "planned_disbursement_type":["1","1"], "planned_disbursement_period_start_iso_date":["2021-10-01T00:00:00Z","2022-10-01T00:00:00Z"], "planned_disbursement_period_end_iso_date":["2021-12-31T00:00:00Z","2022-12-31T00:00:00Z"], "planned_disbursement_value":[76138.51,76138.51], "planned_disbursement_provider_org_ref":["GB-GOV-13","GB-GOV-13"], "planned_disbursement_provider_org_type":["11","10"], "planned_disbursement_provider_org_narrative":["Department for Business, Energy and Industrial Strategy","DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "planned_disbursement_provider_org_narrative_text":["Department for Business, Energy and Industrial Strategy","DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "planned_disbursement_provider_org_narrative_lang":[" "," "], "planned_disbursement_value_date":["2021-10-01T00:00:00Z","2022-10-01T00:00:00Z"], "capital_spend_percentage":0.0, "transaction_type":["3","3","3","3","3","3","3","3","3","3","3","3","2"], "transaction_date_iso_date":["2022-12-31T00:00:00Z","2020-06-30T00:00:00Z","2020-03-31T00:00:00Z","2019-12-31T00:00:00Z","2019-09-30T00:00:00Z","2019-06-30T00:00:00Z","2019-03-31T00:00:00Z","2018-12-31T00:00:00Z","2018-09-30T00:00:00Z","2018-06-30T00:00:00Z","2018-03-31T00:00:00Z","2017-12-31T00:00:00Z","2017-09-01T00:00:00Z"], "transaction_value":[23423.4,76138.51,76138.51,76138.51,75526.73,75526.73,75526.73,75526.73,74919.89,74919.89,74919.89,74919.89,906340.53], "transaction_value_currency":["GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP"], "transaction_value_date":["2022-12-31T00:00:00Z","2020-06-30T00:00:00Z","2020-03-31T00:00:00Z","2019-12-31T00:00:00Z","2019-09-30T00:00:00Z","2019-06-30T00:00:00Z","2019-03-31T00:00:00Z","2018-12-31T00:00:00Z","2018-09-30T00:00:00Z","2018-06-30T00:00:00Z","2018-03-31T00:00:00Z","2017-12-31T00:00:00Z","2017-09-01T00:00:00Z"], "planned_disbursement_value_usd":[104301.7536495019,85993.83560628377], "hierarchy":1, "transaction_value_usd":[28593.599313467836,95338.63797104749,94225.18897568576,99969.61672445002,93358.46982209441,95743.90735737814,99469.08499727062,95743.4853059821,97857.65740964629,99578.50764788433,104663.69364658887,100424.47328735089,1207976.9927645863] }] } }