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These fuels are typically burned in open fires, often indoors, that emit smoke into the household environment and lead to high levels of household air pollution. Women and children, especially young children, experience high exposures to air pollution in the home; this has been linked to a range of adverse health outcomes including non communicable lung diseases like chronic obstructive pulmonary disease (COPD) and lung cancer in adults and asthma in children. It is now recognised that household air pollution from biomass smoke is the third leading cause of global disability and death with 4 million deaths attributed to this exposure annually. This burden, much of which is represented by non-communicable respiratory disease, falls hardest on poor populations around the world and in countries in sub-Saharan Africa in particular. To build the foundations for work to tackle this issue we have bought together a network of investigators from ten African countries (Cameroon, Ethiopia, Ghana, Kenya, Malawi, Nigeria, South Africa, Sudan, The Gambia and Uganda) underpinned by support from the Pan African Thoracic Society (PATS), American Thoracic Society (ATS) Methods in Epidemiologic, Clinical and Operations Research (MECOR) programme, MRC BREATHE-Africa partnership, Malawi Liverpool Wellcome Trust (MLW), Burden of Obstructive Lung Disease (BOLD) Centre, Spirometry Training Services Africa, Global Asthma Network (GAN), and Collaboration for Applied Health Research and Delivery (CAHRD). This proposal offers an unprecedented opportunity to create a multi-site multi-disciplinary pan-African platform for clinical, epidemiological and applied health research underpinned by regional and international collaborative research and delivery networks that will allow us to conduct research into the causes, prevention and treatment of non-communicable respiratory disease across the life course. By addressing a major cause of morbidity and mortality across the life course of children and adults living in low or middle-income countries in Africa the proposal is fully aligned with the overall principle of Official Development Assistance (ODA) to promote welfare of developing countries. Within the two years of this foundations-building grant we will work hard to create a thriving partnership whilst delivering on two specific research aims: to 1) develop and share methodology for the measurement of non-communicable respiratory disease exposures and outcomes tailored to the challenges of conducting research in resource-constrained African environments and 2) use this methodology to generate and share high quality preliminary data from multiple African sites.","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. 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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. Increasingly, large and expensive prevalence surveys are being used to estimate the number of people with active disease in a population. These estimates are less subject to bias, but measure a different quantity. Little work has explored the best way of combining these three data sources. A major goal of this work is to use mathematical transmission models for burden estimation and provide a unified framework for all data. These models yield the number of new cases, deaths, and also the prevalence of disease. They explicitly represent disease transmission and so introduce a dependence between the number of new cases in different years. These models involve parameters evidenced from previous epidemiological work, but must be calibrated to learn from data on TB reports, deaths and prevalence. Calibration means adjusting imperfectly known model parameters in order to match observed model outputs to the data. 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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They are a diverse group of conditions, not directly caused by infections and are most often long-term and lifestyle-related, such as diabetes, high blood pressure, cancers, asthma and kidney disease. The reasons for the increase in these diseases are complex but include increasing urbanisation, overweight/obesity and lifestyle risk factors, such as smoking tobacco, high alcohol intake and reduced physical activity. The increase in NCD, is occurring alongside a high level of infectious disease (such as HIV and tuberculosis) and under- or mal-nutrition, which often exacerbates these conditions and leads to very poor health outcomes and shortens lives. In Africa, deaths from NCD in adults now exceed deaths caused by infectious diseases. To truly understand the severity and extent of these diseases requires investigations using detailed information from a general population, referred to as population-based research. Population-based research (as opposed to hospital-based research) is particularly important in Africa as relatively few people use formal health services, especially in the early stages of illness. The unique and valuable data collected in repeated cycles of population-based research help us to determine the amount and causes of disease; the risk (or chance) of death from these conditions; how these diseases develop in individuals; and how the disease changes over time (for example, age and sex of people most commonly affected). To understand NCDs in Africa better, and to help inform African policy makers and researchers, we propose an African NCD Longitudinal Data Alliance (ANDLA). ANDLA will bring together population-based research data from multiple partners working in existing study sites across Africa to create large, harmonised datasets that are robust and powerful enough to address important research questions that individual study sites would struggle to answer on their own. ANDLA will provide a dynamic and sustainable platform of population-based data collected over time (longitudinal-data). The data will be standardised and made available in an easily usable form, and will focus on NCD and their risk factors. It will be a unique large-scale data resource for understanding NCD in Africa now and in future decades, to inform and shape effective policy in populations with limited resources and a large and growing amount of these disease.","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","LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE"], "activity_status_code":"4", "activity_date_iso_date":["2017-01-01T00:00:00Z","2017-02-01T00:00:00Z","2018-12-31T00:00:00Z","2019-04-30T00:00:00Z"], "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":["UG","MW","ZA","KE"], "recipient_country_percentage":[25.0,25.0,25.0,25.0], "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"], "budget_type":["1","1","1"], "budget_period_start_iso_date":["2016-04-01T00:00:00Z","2017-04-01T00:00:00Z","2018-04-01T00:00:00Z"], "budget_period_end_iso_date":["2017-03-31T00:00:00Z","2018-03-31T00:00:00Z","2019-03-31T00:00:00Z"], "budget_value":[69238.24,314764.6,152081.96], "budget_value_currency":["GBP","GBP","GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","3","3","3","3","3","3","3","2"], "transaction_date_iso_date":["2019-09-30T00:00:00Z","2018-09-30T00:00:00Z","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","2017-03-31T00:00:00Z","2017-01-01T00:00:00Z"], "transaction_value":[52219.02,69799.08,82282.88,82282.88,81621.74,81621.74,69238.24,69238.24,605883.9], "transaction_value_currency":["GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP"], "transaction_value_date":["2019-09-30T00:00:00Z","2018-09-30T00:00:00Z","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","2017-03-31T00:00:00Z","2017-01-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[64547.84687235029,91169.0401327137,109364.90156846131,114949.85036255438,109407.7987607443,108786.02552333496,88636.51344992509,85394.37148593499,747926.3248313457] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_S004785_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Holistic Approach To Unravel Antibacterial resistance in East Africa (HATUA)"], "description_narrative":["The potential harm that increasing levels of antibacterial resistance (ABR) will have on human health is vast, as a consequence the effects of this will be felt across society and at the economic level. It is predicted that by 2050, 10 million lives per year and a cumulative 100 trillion US Dollars of economic output may be lost worldwide. In order to address this looming problem a co-ordinated global response is required to try and halt the rise of ABR. Efforts are underway to tackle the rise in resistance, however agenda-setting is dominated by High Income Countries (HICs) and may not reflect priorities or needs of Low and Middle Income Countries (LMICs), where the levels of resistance and also the types of disease caused by bacteria may be different. One of the most vulnerable regions to the increase in antibiotic resistance is Africa where, in comparison to other regions of the world, the burden of infectious diseases is highest. The economic, cultural and ethnic diversity of Africa mean that the problems surrounding ABR across African countries are likely be distinct from other regions of the world, and therefore require regional solutions and approaches. For example, the availability of antibiotics can be patchy, and the routes of access to antibiotics are variable (including traditional healers, public and private medical practitioners and over-the- counter antibiotic access). Social, cultural and lifestyle drivers of ABR in Africa also have specific features - closer communal living in cities with variable water/sanitation, and closer animal husbandry in rural communities. This project aims to address ABR in Africa and fill the gaps in knowledge. The research will target three main areas that comprise the problem: the bacteria that are antibiotic resistance and cause disease; the amount of antibiotics that are used to treat disease; and the behaviour of humans that governs how antibiotics are used and supplied. The three elements incorporate epidemiological, economic, cultural and societal factors that interact and contribute to the problem. Bringing together research covering these 3 elements will provide a holistic view of ABR in East Africa. The project will establish a surveillance network across Uganda, Kenya and Tanzania that is comprised of sentinel sites that monitors and characterized the ABR bacteria that cause disease at that location, maps the use of antibiotics in the sentinel hospitals and the surrounding communities, and captures the behaviour and attitudes of humans that is responsible for their use in these setting. The project also recognises antibiotics are not exclusively used for human medicine, therefore our surveillance will also cover the use of antibiotics in veterinary medicine in the linked communities to provide a 'One Health' view. Using a multidisciplinary approach, encompassing, microbiology, genomics, epidemiology, statistics, social sciences and geography, we will seek to explore and describe the relationships between the elements, and identify the drivers of ABR. Using this knowledge, we will identify interventions, such as public health and infection control measures and legislation changes, that can be made to control ABR at national and regional level. At the global level, the output of this project will add to the worldwide picture of ABR. This information will also be of value to global development agencies such as the WHO and FAO, to direct funding into effective interventions critical to the region.","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 OF ST ANDREWS"], "activity_status_code":"4", "activity_date_iso_date":["2018-05-01T00:00:00Z","2018-05-01T00:00:00Z","2022-03-31T00:00:00Z","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":"2", "recipient_country_code":["KE","TZ","UG"], "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","1"], "budget_type":["1","1","1"], "budget_period_start_iso_date":["2018-04-01T00:00:00Z","2019-04-01T00:00:00Z","2020-04-01T00:00:00Z"], "budget_period_end_iso_date":["2019-03-31T00:00:00Z","2020-03-31T00:00:00Z","2021-03-31T00:00:00Z"], "budget_value":[1022036.0,911718.84,919103.82], "budget_value_currency":["GBP","GBP","GBP"], "planned_disbursement_type":["1"], "planned_disbursement_period_start_iso_date":["2022-07-01T00:00:00Z"], "planned_disbursement_period_end_iso_date":["2022-09-30T00:00:00Z"], "planned_disbursement_value":[114887.97], "planned_disbursement_provider_org_ref":["GB-GOV-13"], "planned_disbursement_provider_org_type":["11"], "planned_disbursement_provider_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY AND INDUSTRIAL STRATEGY"], "planned_disbursement_provider_org_narrative_text":["DEPARTMENT FOR BUSINESS, ENERGY AND INDUSTRIAL STRATEGY"], "planned_disbursement_provider_org_narrative_lang":[" "], "planned_disbursement_value_date":["2022-07-01T00:00:00Z"], "capital_spend_percentage":0.0, "transaction_type":["3","3","3","3","3","3","3","3","3","3","3","3","2"], "transaction_date_iso_date":["2022-09-30T00:00:00Z","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","2018-05-01T00:00:00Z"], "transaction_value":[105599.36,114887.98,114887.98,114887.98,113964.86,113964.86,113964.86,113964.86,127754.5,127754.5,127754.5,127754.5,2852858.66], "transaction_value_currency":["GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP","GBP"], "transaction_value_date":["2022-09-30T00:00:00Z","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","2018-05-01T00:00:00Z"], "planned_disbursement_value_usd":[137677.6503736045], "hierarchy":1, "transaction_value_usd":[119514.5179936419,153661.37178531123,148843.58274182474,143859.70427376297,141037.17645758463,149635.4916093788,140871.78066744335,144471.2487596983,168253.32196010352,161951.41896813342,166868.31886086136,169802.73803527525,3846502.4087424753] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_S019170_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["MICA: Development of new agents for the treatment of cryptosporidiosis"], "description_narrative":["A recent clinical study in Africa and South Asia has found that cryptosporidiosis is one of the most significant causes of death and illness from diarrheal diseases amongst children in the developing world. Cryptosporidiosis is caused by a single-celled protozoan parasite; the predominant species infecting humans are called Cryptosporidium hominis and Cryptosporidium parvum. This parasite mainly lives in the cells in the gut wall and has a complex life-cycle. Infection occurs due to consumption of water or food contaminated with the parasites. Parasites are spread from an infected individual through their faeces. In people who are healthy and well nourished, the disease clears naturally within a couple of weeks. However, in people who are malnourished (particularly in young children) and people with an immune system that is not functioning properly (for example HIV/AIDS victims), the disease can have a much more significant impact. It is the major contributor to life-threatening diarrhea in young children, with 2.9-4.7 million cases in children under 24 months in sub-Saharan Africa and the Indian sub-continent, leading to more than 200,000 deaths per year. Cryptosporidiosis is also associated with malnutrition and stunted growth in children and probably causes chronic infections, which last for weeks or months. The only drug registered for the treatment of this disease is nitazoxanide, which is not very effective, especially in those patients who are most severely affected due to a weak immune system and/ or malnutrition. Therefore there is an urgent need for the development of new drugs to treat: (1) children <24 months, especially those that are malnourished and with chronic diarrhea; and (2) immunocompromised children and adults with advanced AIDS and chronic diarrhea. Cryptosporidium may be the cause of as much as 75% of chronic diarrhea in this patient cohort. We have discovered some chemical starting points that can be used for a drug discovery programme. We have a series of compounds that kill the parasites and also are very effective in clearing the parasites from rodent models of cryptosporidiosis. The compounds are thought to work through preventing the parasite making proteins. The aim of this project is to take these starting points and optimise them to make a molecule which has the potential to be a drug. This will require us to optimise multiple features of the molecule: its ability to kill the parasite, its ability to reach the sites in the body where the parasite resides without being broken down, and its safety. At the end of this project we hope to have a \"preclinical candidate\". This is a compound that we think should be suitable to enter human clinical trials. The steps after this project, prior to human clinical trials will be to make the compound on a larger scale under properly defined conditions and to carry out formal safety testing.","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-SC-015096"], "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 DUNDEE"], "activity_status_code":"4", "activity_date_iso_date":["2018-12-01T00:00:00Z","2019-05-01T00:00:00Z","2021-07-31T00:00:00Z","2023-01-31T00:00:00Z"], "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":["BI","KM","ET","KE","MG","MW","MU","MZ","ZW","RW","ER","SO","DJ","SD","SS","TZ","UG","ZM","AO","CM","CF","TD","CG","CD","GA","GQ","ST","ZA","BW","LS","NA","SZ","CV","BJ","GM","GH","GN","GW","CI","LR","ML","MR","NE","NG","SN","SL","SH","TG","BF"], "recipient_country_percentage":[2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123,2.0408163265306123], "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":["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":[943848.8,885292.5], "budget_value_currency":["GBP","GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","3","3","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","2019-12-31T00:00:00Z","2019-09-30T00:00:00Z","2019-06-30T00:00:00Z","2018-12-01T00:00:00Z"], "transaction_value":[179651.53,229893.98,237873.51,237873.53,235962.24,235962.24,235962.24,235962.24,2165959.19], "transaction_value_currency":["GBP","GBP","GBP","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","2019-12-31T00:00:00Z","2019-09-30T00:00:00Z","2019-06-30T00:00:00Z","2018-12-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[248939.80718950738,307480.5939836779,308177.97882575076,297858.9725431336,292014.99550130573,309817.65593052306,291672.5464242103,299125.1818581239,2745736.269544861] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_T017759_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Exploring the potential for using parent experiences of pre-term birth to improve care in LMICs, using video narratives and digital stories."], "description_narrative":["Providing people-centred care is now recognised as a fundamental pillar of high-quality healthcare, and part of the WHO's global health strategy. Empowering and engaging the people at the heart of health systems has the express aim of influencing the ways health services are delivered to individuals, families and communities, enabling health system co-production. Health systems in many countries in sub-Saharan Africa, including Kenya, are frequently characterised as 'weak', lacking human and financial resources and suffering from inadequate management and accountability mechanisms. Taking a people-centred approach is now a central tenet of health systems research and policy that seeks to understand, strengthen and improve these systems. Understanding patient experiences of health systems was identified as a key research priority by the Lancet Global Health Commission's 2018 report, \"High-quality health systems in the Sustainable Development Goals era\". This pilot project is a collaboration between centres of excellence from Kenya (health systems research) and the UK (patients' narratives and applied health research). In high income countries, studies of patients' narratives have been used highly effectively to inform policy and improve services, providing direct patient benefit. To date these approaches have not been applied in low and middle-income countries (LMICs). This project will address the need for people-centred care through a pilot, based on rigorous social science research, that uses mothers' experiences of preterm birth as a pathfinder to explore the potential for using patient experiences to improve care in LMIC settings. The research will explore the experiences of mothers of premature babies in Kenya, and use those experiences in the co-production of people-centred training resources for the multi-professional teams providing newborn care. Premature birth remains a global health priority and a perfect target for our health experience sharing project. In 2013 2.8 million deaths in neonates occurred in LMICs across the world. Improving access and the quality of care for premature babies is central to improving outcomes. In Kenya, 120 in every 1000 babies are born prematurely, nearly 200,000 babies each year. Prior work by this team, in Kenyan capital, Nairobi, estimated the potential burden of illness in this population, identified available care, how mothers access that care, and the quality of existing nursing services. Half of the babies born early or underweight do not access appropriate care. The ratio of nurses to babies is extremely low. While our work reveals mothers are important members of the care team, we know little about their experiences and perspectives in Nairobi or elsewhere in Kenya. Capturing the experiences of mothers of preterm babies is the next step towards improving care for this highly vulnerable population. This project will build on a recently completed longitudinal qualitative study of mother's experience of pre-term birth in two Nairobi hospitals. We will collect additional interviews, to broaden the sample, (audio or video recorded depending on preferences and consent) with mothers of premature babies in two settings (urban and rural). We will analyse these narratives to develop visual resources (video narratives and/or digital stories) and use these in the co-production of training resources for staff. We will work throughout the project with local, regional and national stakeholders to ensure our work can influence policy and change in the health system. We will evaluate the training to understand the impact of patient narratives on staff to produce empathetic and patient and family-centred care, and explore the potential for scale up. Our collaboration will build research capacity in Kenya, allow for mutual learning and, we hope, foster the development of regional health systems research networks that can support the development of people-centred health systems.","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 OF CAMBRIDGE"], "activity_status_code":"4", "activity_date_iso_date":["2020-04-01T00:00:00Z","2020-09-01T00:00:00Z","2022-03-31T00:00:00Z","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":["KE"], "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"], "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":[52195.16], "budget_value_currency":["GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","3","2"], "transaction_date_iso_date":["2021-03-31T00:00:00Z","2020-12-31T00:00:00Z","2020-04-01T00:00:00Z"], "transaction_value":[26097.58,26097.58,197078.08], "transaction_value_currency":["GBP","GBP"], "transaction_value_date":["2021-03-31T00:00:00Z","2020-12-31T00:00:00Z","2020-04-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[36162.93461743824,34905.217613512774,244614.99480580763] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_T020768_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Understanding male engagement in child health and nutrition in urban informal settlements: A formative participatory exploration"], "description_narrative":["Improving child health requires primary prevention, quality health services and community action to address the underlying drivers of health and wellbeing. Whilst there is recognition that the health system encompasses both the suppliers of policy, services, and interventions, and the communities and households intended to benefit from them; in health systems research the focus has primarily been on the supply-side with little attention given to the demand-side of this equation. Gender roles and relations play an important role in child health and nutritional status. In many sub-Saharan African (sSA) settings, childcare and health is predominantly a female domain with men largely absent or only involved in perceived severe or serious cases. Similarly, intentionally or unintentionally, child health programmes in sSA countries predominantly focus on women. While women are perceived as responsible for children, paradoxically they must negotiate decision-making and resources with other family members, including men. By exclusively focusing on women without considering family dynamics or the broader social context, these programmes may inadvertently reinforce harmful gender divisions and practices related to child health and nutrition. Evidence suggests that programmes targeting women might be more effective if men's roles are considered and transformed to affirm more equitable gender relations. For example, in the 'Men in Maternity' programme in New Delhi, India, husbands were encouraged to play an active role in their wives' antenatal and post-natal care with improved outcomes in the intervention compared to the control groups. Similarly, the IMAGE intervention in Limpopo South Africa used a participatory approach to engage men and challenge behaviours in relation to intimate partner violence and HIV transmission; resulting in a significant reduction in the risk of physical and sexual violence by an intimate partner even up to two years after introduction of the intervention. Informal settlements (referred to colloquially as 'slums') house a significant proportion of the world's urban population particularly in low- and middle-income countries; with this number set to rise with increasing urbanization. Throughout their life-course, these populations suffer from disproportionately higher burden of illness compared to the general population. In Kenya where this work will be undertaken, studies show that slums in the capital city of Nairobi have higher child and under-five mortality rates compared to the national, urban and rural averages with long and complex pathways to seeking care; frequently involving the use of informal systems of healthcare prior to, or concurrently with, engaging formal health facilities. Furthermore, following treatment in the formal health system, ill or recovering children are 'discharged back' into their homes and communities. Without proper understanding of the complexities and dynamics operating at the household and community levels, hospital-initiated interventions are likely to be less effective and sustainable. Focusing on the demand-side of the health system, the proposed work seeks to answer if and how participatory approaches can strengthen male involvement in child health and nutrition for better outcomes. Specifically:1) To understand men's and women's perspectives of the actual, desired and perceived role of men in child health, and related barriers and facilitators; and 2) Use an in-depth participatory approach to engage men and other stakeholders in co-creating a context-specific, feasible, and scalable male engagement intervention package for improved and more responsive health service delivery.","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","71"], "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL","ARCH - KWTRP"], "activity_status_code":"4", "activity_date_iso_date":["2020-01-02T00:00:00Z","2020-04-03T00:00:00Z","2022-01-01T00:00:00Z","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":["KE"], "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"], "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":[94554.48], "budget_value_currency":["GBP"], "capital_spend_percentage":0.0, "transaction_type":["3","3","2"], "transaction_date_iso_date":["2021-03-31T00:00:00Z","2020-06-30T00:00:00Z","2020-01-02T00:00:00Z"], "transaction_value":[70915.86,23638.62,189874.97], "transaction_value_currency":["GBP","GBP"], "transaction_value_date":["2021-03-31T00:00:00Z","2020-06-30T00:00:00Z","2020-01-02T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[98266.79747775095,29599.657706923375,248207.28482080434] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_T022078_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["A systems approach to examining health sector responses to cholera epidemics in Kenya"], "description_narrative":["Simple Summary Kenya has experienced an increased disease burden due to cholera outbreaks characterized by continuous transmission in the refugee camp settings of Garissa and Turkana, and sporadic transmission in cities such as Nairobi and Mombasa. However, while inquiry has been made regarding how the health sector has responded to and how populations have been impacted by epidemics such as cholera, not enough attention has been paid to causal relationships between the unique components of the health systems leading to an inadequate understanding of how the building blocks of the health systems interact in disease surveillance and epidemic response. Consequently, this research effort focuses on examining the health sector responses to these epidemics, developing a systems-theory-based description of the said responses, and based on the results, provide recommendations that may help break the epidemic's continuous and cyclical nature. The study will be conducted in Turkana and Garissa in Kenya, as well as in Nairobi. These are counties that have diverse levels of health system sophistication and recent experiences of cholera epidemics. Moreover, the study draws on several systems analytic frameworks to determine the actors and their decisions, as well as their inter-relationships, linkages and dependencies. Thus, the study appropriates systems-oriented research techniques and applies them in a novel fashion to the assessment of health service delivery. The findings of this study are expected to guide interventions aimed at improving disease surveillance and epidemic response. The study will also act as a primer for the research community by assessing the utility of systems-thinking approaches in such settings, and subsequently opening a related research agenda.","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","STRATHMORE UNIVERSITY"], "activity_status_code":"4", "activity_date_iso_date":["2019-10-01T00:00:00Z","2020-05-01T00:00:00Z","2021-07-31T00:00:00Z","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":["KE"], "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":[29014.52,68785.8], "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","2019-10-01T00:00:00Z"], "transaction_value":[22928.6,22928.6,22928.6,-6085.92,29014.52,159840.77], "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","2019-10-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[31771.737558401746,30666.742762094753,29705.239584282033,-7620.628819775398,35906.91005167837,201964.15278990474] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_N01037X_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Unveiling the protein landscape of the African trypanosome cell surface and chasing down potential targets for therapeutic intervention"], "description_narrative":["Neglected tropical diseases are a diverse group of diseases that thrive mainly among the poorest of the world's populations. Three of the World Health Organisation's 10 most significant neglected tropical diseases - African trypanosomiasis (also known as sleeping sickness), leishmaniasis, and Chagas' disease - are caused by closely-related single-celled parasites. Human infection with African trypanosomes is brought about when an infected tsetse fly takes a blood meal. Without treatment the disease progresses through general ill health to coma and death. Current drugs in use against trypanosomes are old, toxic and failing due to emergence of resistance. Urgent new research is needed to identify potential new therapeutic options. An unusual aspect of African trypanosomes is that they multiply in the human blood in full view of the body's defence systems. They do this by periodically changing their cell surface to escape recognition by the host. However, many molecules on the parasite surface perform essential functions and cannot be changed. Trypanosomes place these in a special, protected domain on the cell surface. Identifying surface-exposed invariant molecules and understanding how this protective segregation is maintained are of major scientific interest, as well as of practical utility in uncovering ways in which trypanosomes may be vulnerable to new therapies. Using a combinatorial approach funded by the MRC, I have previously identified the composition of the African trypanosome cell surface. I now aim to exploit this knowledge to single out those invariant surface molecules that are essential to the survival of the parasite during infection. For this, I propose to harness some of the power of modern DNA sequencing technologies to test which cell surface genes, when silenced, cause the parasite to die inside the host. A similar method will be used to identify not only cell surface genes, but any genes that the parasite uses to maintain the cell surface organisation, which is so critical to escaping the host immune attack. Finally, I propose to test those surface-exposed molecules for their potential as vaccines. My pilot experiments show that I can use genetically-modified parasite to screen for molecules on the parasite surface that are accessible to the immune system. I propose to develop this assay and test the most promising candidates in an animal model of human disease. The proposed work will increase our understanding of the fundamental biology of a significant human parasite, and also, by exposing essential surface molecules, provide the first steps in developing new treatments.","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-RC000664"], "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 NOTTINGHAM"], "activity_status_code":"4", "activity_date_iso_date":["2016-02-01T00:00:00Z","2016-08-01T00:00:00Z","2019-07-31T00:00:00Z","2020-01-31T00:00:00Z"], "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":["DZ","AO","BJ","BW","BF","BI","CV","CM","CF","TD","KM","CG","CI","CD","DJ","EG","GQ","ER","SZ","ET","GA","GM","GH","GN","GW","KE","LS","LR","LY","MG","MW","ML","MR","MU","MA","MZ","NA","NE","NG","RW","SH","ST","SN","SL","SO","ZA","SS","SD","TZ","TG","TN","UG","ZM","ZW"], 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"transaction_value_date":["2020-06-30T00:00:00Z","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","2017-09-30T00:00:00Z","2017-06-30T00:00:00Z","2017-03-31T00:00:00Z","2016-12-31T00:00:00Z","2016-09-30T00:00:00Z","2016-02-01T00:00:00Z"], "hierarchy":1, "transaction_value_usd":[35338.544969500836,35383.2671468586,35995.80409605356,37396.3189512501,35995.6454219427,37088.485399767465,37437.42695319532,39349.2479260813,37755.47527085471,37540.9078967279,35768.49465963458,34460.1564476372,34914.78456772723,36714.86174550597,565009.2316840629] },{ "default_currency":"GBP", "default_lang":"en", "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_N015061_1", "reporting_org_ref":"GB-GOV-13", "reporting_org_type_code":"10", "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"], "title_narrative":["Understanding and enhancing approaches to quality improvement in small and medium sized private facilities in sub-Saharan Africa"], "description_narrative":["The private sector is a major and growing source of treatment in low- and middle-income countries (LMIC), but there is considerable concern about the safety and quality of care. Recent years have seen fast growth in small and medium sized private clinics, but their regulation is often poor, and relatively little is known about the effectiveness of interventions to improve the quality of care they provide. This project aims to address this evidence gap. The research takes place in the context of an innovative intervention developed by the international NGO PharmAccess that extends the benefits of clinical standards and stepwise certification to small and medium-sized facilities in LMIC, using standards developed with international accreditation bodies. The PharmAccess model seeks to improve the quality of care that facilities provide as well as to shape the broader healthcare and finance markets and policy environment. There are several components to the model. Health facilities are assessed on a set of \"SafeCare\" structural quality standards, trained on quality improvement and business skills, and assisted in the development of a quality and business improvement plan. They receive regular mentoring visits and are also connected with the PharmAccess Medical Credit Fund, a social investment fund which facilitates access to bank loans to finance implementation of the plan. The aim is to create a series of virtuous circles, with improvements in SafeCare assessment scores signalling improved quality of care to individual and institutional purchasers, thus increasing demand for health services; and improved business performance ensuring further access to credit, and the sustainability of quality gains. The research will begin with an analysis of secondary data collected routinely by PharmAccess in Tanzania and Kenya to date to examine changes in the SafeCare assessment scores over time and factors associated with these changes. We will then undertake a randomised controlled trial to evaluate prospectively the impact on quality of care of the roll out of the PharmAccess model to additional private for-profit and faith-based facilities in Tanzania. The trial will assess the effects of the intervention on the quality of care received by patients through comparison of 120 intervention and 120 control facilities after 2 years of implementation. These data will also be used to assess the relationship between SafeCare assessment scores (which measure availability of inputs such as infrastructure, technology and standard operating procedures) and measures of technical and perceived quality of patient care (which concern the interaction between caregivers and patients). Technical quality will be measured through standardised patients (covert actors) and clinical vignettes (overt role-playing), with perceived quality measured through patient interviews. In addition, in-depth interviews will be conducted in 30 intervention facilities and with 8 implementing staff in Tanzania to assess the perceived benefits and costs of participating in the PharmAccess model, and factors affecting quality improvement and business performance. Finally, 30 national level key informants will be interviewed to explore how the PharmAccess model shapes the market for healthcare and healthcare finance, and the policy environment in both Tanzania and Kenya. The results are expected to make an important contribution to the evidence base on improving private sector care and to the literature on measuring process quality of patient care. The findings will be of substantial benefit to national and international policy makers and programme managers who are interested in private sector healthcare and health systems strengthening more generally, with important implications for all organisations within the health system that require adherence to quality standards (eg, social health insurance programmes, social franchising programmes, regulatory agencies)","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. 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