Research Programme Consortia (RPC) Contracts Awarded: Health

Theme 1 - Health Systems, Economics and Financing

HD105: Consortium For Research On Equity And Health Systems (CREHS)

CREHS aims to produce new knowledge on how to strengthen health system policies and interventions in ways which preferentially benefit the poorest people of the world. It will also strengthen the capacity of consortium partners to support local and global policy development through relevant, high quality, timely and well communicated research, and to develop as regional hubs of expertise.

Research will focus on four themes - recent health sector reform experiences, protection against the financial risks of ill-health, performance of the health workforce, and expanding coverage of high priority policies and interventions (scaling up). It will employ analytical frameworks drawn from economics and policy analysis.

Research questions and projects will be developed through researcher/policy-maker interaction, in order to identify and respond to demand for knowledge from research users. Research will focus on both policy design and the factors influencing policy change and implementation, and will be fed into the policy-making processes in partner countries and globally through a range of communications approaches.

Cross-country comparative analysis in the different settings of consortium countries will help to assess the extent to which research findings from one setting apply to other settings, and to help judge what policies and implementation approaches are likely to be effective in different contexts.

Consortium countries and members are:

• India: Indian Institute of Technology (Madras)
• Kenya: Kenya Medical Research Institute Centre for Geographic Medicine Research - Coast
• Nigeria: University of Nigeria (Enugu)
• South Africa: Centre for Health Policy, University of Witwatersrand and Health Economics Unit, University of Cape Town
• Tanzania: Ifakara Health Research and Development Centre
• Thailand: International Health Policy Programme, Bangkok
• UK: Health Economics and Financing Programme, London School of Hygiene and Tropical Medicine.

Director: Anne Mills, (Kara Hanson from 1 September 2006), London School of Hygiene and Tropical Medicine

HD106: Future Health Systems: Making Health Systems Work for the Poor

The consortium's aim is to create knowledge and shape future health systems that will benefit the world's poor. The RPC will bring policy-makers from influential developing countries together with leading public health and development research institutions to test strategies in three main areas:

• Ways in which the financing of health care can reduce peoples' risk of poverty;
• Ways to improve access to health services in settings where the relationships between government, the private sector, health providers, civil society and the public are changing rapidly; and
• Ways in which health systems research can influence policy and programs to promote the interests of the poor.

Consortium partners are based in countries that are critical to meeting the Millennium Development Goals -- Bangladesh, China, India, Nigeria, and Uganda. The RPC will work in these countries as well as Afghanistan, where it is important to learn about the transition out of conflict. The lead agency is Johns Hopkins University Bloomberg School of Public Health (USA), which along with Institute of Development Studies (UK), will play key facilitating roles in working with the RPC partners, national stakeholders, DFID, and other international agencies.

The partners and principal researchers are:

• Johns Hopkins University Bloomberg School of Public Health (JHBSPH), Baltimore, USA
• Institute of Development Studies (IDS), Brighton, United Kingdom. Centre for Health and Population Research (ICDDR,B), Dhaka, Bangladesh
• Chinese Health Economics Institute (CHEI), Beijing, China
• Indian Institute of Health Management Research (IIHMR), Jaipur, India. The Institute of Public Health (IPH), Makerere University, Kampala, Uganda
• University of Ibadan (UI), College of Medicine, Faculty of Public Health, Ibadan, Nigeria.

Director: David Peters, Johns Hopkins University

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Theme 2 - Communicable Diseases: Vulnerability, Risk and Poverty

HD205: Team for Applied Research to Generate Effective Tools and Strategies -TARGETS Consortium

The main aim of TARGETS will be to improve the health of the poor and vulnerable through effective communicable disease control. The research will build on more than a decade of productive DFID-funded research by consortium members into the control of tuberculosis and malaria. Initial work will focus on those two diseases, but will be gradually extended to other communicable diseases including meningitis, diarrhoea and acute respiratory infections.

TARGETS will conduct research to develop new tools to diagnose, prevent and treat communicable diseases, but will also develop and test new strategies to implement those tools sustainably at national scale, and to improve effective access to them by the poor and vulnerable.

The Consortium, led by the London School of Hygiene & Tropical Medicine, comprises 7 other partners:

• The Centre for Health Research and Development, Pune, India
• Ifakara Health Research and Development Centre, Tanzania
• INDEPTH Network of Demographic Surveillance Systems, Accra, Ghana
• KNCV Tuberculosis Foundation, The Hague, Netherlands
• Makerere Medical College, and its Infectious Diseases Institute, Uganda
• Swiss Tropical Institute, Basle
• ZAMBART, the Zambian AIDS-related Tuberculosis project, Lusaka, Zambia.

Most of TARGETS' research work will be focused in the five developing countries where partners are based; Ghana, India, Tanzania, Uganda and Zambia. One partner, INDEPTH, is a network of 33 potential study sites throughout Africa, Asia, Central America and Oceania. Additional research and dissemination activities will be carried out elsewhere when appropriate; for example, some of our research will be in situations of complex emergency, natural disaster, or post-conflict.

Director: Sandy Cairncross, London School of Hygiene and Tropical Medicine

HD206 Communicable Diseases: Vulnerability, Risk and Poverty (COMDIS)

Co-directors John Walley and James Newell, University of Leeds

The aim of the communicable disease ("COMDIS") research programme consortium is to ensure access to effective interventions on a far greater scale and reaching vulnerable people. COMDIS will research and develop feasible and affordable interventions for TB, malaria and HIV care. It will investigate patient and provider issues and evaluate approaches to improve utilisation, delivery and quality of interventions together with health systems issues. A key strategy will be to anchor research within operational programmes, so that knowledge will be rapidly incorporated into policy and practice at scale in partner countries and elsewhere.

The partners are:

Malaria Consortium, UK and Africa.

Bangladesh Rural Advancement Committee (BRAC), Dhaka, Bangladesh.

Association for Social Development (ASD), Islamabad, Pakistan.

Beijing National and Guangxi Provincial Centres for Diseases Control.

Department of Clinical Medicine, Makerere University, Kampala, Uganda.

School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.

The Health Research and Social Development Forum, Nepal.

The Good Shepherd Hospital/ Lubombo regional health, Swaziland.

The national tuberculosis and malaria control programmes in the partner countries (in Uganda also AIDS and IMCI programmes) are key collaborators with COMDIS.

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Theme 3 - Reproductive Health and HIV

HD3: Research and capacity building in reproductive and sexual health and HIV/AIDS in Developing Countries

The purpose of this consortium is to support a research programme that will strengthen the evidence base to:

• enable policy makers to identify and prioritise interventions that will improve reproductive and sexual health and reduce HIV incidence among economically poor populations in Africa and Asia;
• ensure that the results of the research are made available to policy makers at national and international levels in an intelligible and relevant form;
• strengthen research capacity in partner institutions in developing countries to ensure that the programme is sustainable.

The RPC will be co-ordinated by the London School of Hygiene and Tropical Medicine (LSHTM), and will be a collaboration with the following institutions:

• National Institute for Medical Research (NIMR), Mwanza, Tanzania
• Navrongo Health Research Centre (NHRC), and School of Medical Sciences of Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
• Reproductive Health and HIV Research Unit (RHRU), University of Witwatersrand, Republic of South Africa
• Medical Research Council's Social and Public Health Sciences Unit (MRC SPSHU), Glasgow, UK
• International Planned Parenthood Federation (IPPF)
• Population Services International (PSI).

The RPC will focus mainly on Tanzania, Ghana, and South Africa representing various levels of the HIV epidemic in Africa, and on India and Cambodia, where there are more concentrated epidemics but large numbers of people at risk.

The greatest strength of this new Consortium is its ability to bring a wide range of disciplines, including epidemiology, health economics, modelling, social, clinical and microbiological sciences, to bear on a particular problem. The inclusion of two major international NGOs will ensure that the results of the research will be translated into policy and practice on a global scale.

Director: David Mabey, London School Hygiene and Tropical Medicine

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Theme 4 - Sexual Reproductive Health and Rights

HD4: Realising Rights: improving sexual and reproductive health for poor and vulnerable populations

Good sexual and reproductive health (SRH) is increasingly recognised as essential both to human wellbeing and to efforts to reduce poverty. Improving access to high quality SRH services and enabling poor people to claim their rights to SRH are a necessary step towards meeting the Millennium Development Goals (MDGs).

Poor SRH is a source of enormous suffering for millions of the world's poorest people. It accounts for a high proportion of the global burden of ill health, particularly for reproductive age women. Yet it is a largely invisible burden in many countries.

Despite two decades of sustained effort, progress on improving SRH has remained slow and SRH rights are often not understood or remain unrealised in practice. As well as being a denial of human rights, denial of SRH and rights affects physical security, bodily integrity, health, education, mobility, and economic status.

This programme brings together researchers from several disciplines to focus on populations in sub-Saharan Africa and South Asia with the greatest access and entitlement problems in SRH: the very poor, young people - especially girls and young women, and other hard-to-reach groups such as migrants and those most vulnerable to stigma.

The main objectives of the programme are to:

• Improve the evidence base on the high levels of SRH morbidity, mortality and unmet need among poor and vulnerable populations and communicate it to policy and advocacy audiences;
• Find innovative ways to improve access to existing and new low cost SRH technologies and services by poor women and men;
• Improve knowledge of how SRH rights can be translated into reality in locally appropriate and sensitive ways;
• Build capacity to put sexual and reproductive health and rights onto national and local policy agendas.

Some of the work of the RPC will be concentrated in RPC partner countries of Ghana, Kenya and Bangladesh but geographical coverage will be much wider and take advantage of the international and regional research and service delivery sites and networks of the consortium partners.

The members of the RPC Consortium are:

• Institute of Development Studies, University of Sussex, UK
• African Population and Health Research Center, Nairobi, Kenya
• BRAC, Dhaka, Bangladesh
• EngenderHealth, New York, USA
• INDEPTH Network, Accra, Ghana
• London School of Hygiene and Tropical Medicine, UK.

Director Hilary Standing, Institute of Development Studies

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Theme 5 - Maternal, Neonatal and Child Health

HD5: Achieving MDGs 4 and 5: Strategic research to develop the evidence base for policy for mother and infant care at facility and community level

A new research consortium has been launched on maternal, neonatal and infant health with funding from DFID.

The objectives of the consortium are:

• To explore opportunities for improving integrated mother and infant care delivery through preparatory research and consultation with policymakers in partner countries;
• To provide population-based evidence on interventions to improve the survival of women and infants through (i) community interventions and (ii) health services delivery;
• To provide the evidence base for policy making by documenting the contexts in which these integrated service and community interventions work.

The consortium will manage projects in Burkina Faso, Ghana, Nepal, Malawi and Bangladesh with the purpose of improving maternal and infant survival in poor countries, by integrating disparate evidence, generating new knowledge in key areas, and communicating research findings effectively.

The consortium comprises a number of experienced organisations worldwide and is coordinated by the Institute of Child Health and the London School of Hygiene and Tropical Medicine.

• Institute of Child Health, UK
• London School of Hygiene and Tropical Medicine, UK
• International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B)
• Perinatal Care Project (PCP), Diabetic Association of Bangladesh (DAB)
• Centre MURAZ, Burkina Faso
• Kintampo Health Research Centre (KHRC), Ministry of Health/Ghana Health Services
• Maimwana project, Lilongwe Central Hospital, Malawi
• Mother and Infant Research Activities (MIRA), Nepal
• The Florence Nightingale School of Nursing and Midwifery, Kings College London, UK
• National Perinatal Epidemiology Unit, University of Oxford, UK
• Aga Khan University, Pakistan.
  

Director: Anthony Costello, Institute of Child Health

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Theme 6 - Mental Health

HD6: Mental health policy development and implementation in Africa: breaking the cycle of mental ill-health and poverty

The research programme consortium aims to provide new knowledge regarding comprehensive multi-sectoral approaches to breaking the negative cycle of poverty and mental ill-health. The programme will undertake an analysis of existing mental health policies in African countries, provide interventions to assist in the development and implementation of mental health policies in those countries, and evaluate the policy implementation over a 5-year period.

The programme will be conducted in four countries that represent a variety of scenarios in mental health policy development and implementation: Ghana, South Africa, Uganda and Zambia.

Strategies for making mental health care accessible to poor communities will be documented, for instance through primary health care and non-health sectors, with an emphasis on promoting mental health and providing care for those who most need it and can least afford it.

Capacity will be built in mental health research, policy making, service planning and service delivery. The RPC will provide a coherent body of high quality policy relevant new knowledge to assist other developing countries to break the cycle of poverty and mental ill-health.

The consortium will be led by the Department of Psychiatry and Mental Health at the University of Cape Town and will include:

• Department of Mental Health and Substance Dependence, World Health Organisation (WHO), Geneva
• African Regional Office of WHO, Brazzaville
• Nuffield Centre for International Health and Development, University of Leeds
• University of KwaZulu-Natal, Durban
• Human Sciences Research Council, Durban
• Institute of Psychiatry, King's College, London
• Kintampo Health Research Centre, Accra
• Makerere University Medical School, Kampala
• University of Zambia, Lusaka.

In addition to the consortium partners, we have received support for the proposal and indication of willingness to participate from the relevant government departments in the study countries.

Director: Alan Flisher, University of Cape Town

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Theme 7 – HIV and AIDS

HD 12: Social Context of HIV and AIDS (Addressing the Balance of Burden on AIDS – ABBA)

This RPC is helping DFID to drive forward its strategy for assisting countries to tackle HIV and AIDS. The goal is to improve the effectiveness of efforts to reduce poverty and to achieve the Millennium Development Goals by lessening people’s vulnerability to HIV.

HIV threat is uneven across a population, and impacts differently on individuals, households and communities. Country policies sometimes ignore this unevenness. Although funding for HIV has increased dramatically, it has produced unequal benefits, and there is a danger of efforts at prevention being disconnected from those for treatment. HIV also threatens civil and government institutions (e.g. the health service, agricultural production and formal education sectors) necessary for poverty reduction, with consequent implications for development.

We assist governments in Africa to use research evidence about factors that influence the impact of HIV and AIDS on poor and vulnerable groups in order to provide greater benefits from programmes to tackle HIV in health, education and other sectors.

One important body of such evidence concerns the social, economic and institutional factors that place the livelihoods of vulnerable and neglected groups at increased threat from HIV and AIDS, and identify which institutions and programmes are best placed to alleviate those threats. Another, concerns the way in which HIV affects the very institutions and programmes that tackle HIV and other health problems.

The RPC agenda is to improve use of this evidence by policy makers, local programme implementers, representatives of vulnerable groups, and researchers so that better policies and programmes can be implemented for improving benefit to the poor and the vulnerable.

The countries the RPC will cover are Ghana, Nigeria, Kenya, Ethiopia, South Africa, Swaziland and Uganda.

The RPC Partners are:

• Dr Dave Haran Liverpool School of Tropical Medicine (lead partner)
• Prof Alan Whiteside Health Economics and HIV/AIDS Research Division (HEARD), South Africa
• Dr John Gyapong Health Research Unit (HRU), Ghana
• Dr Kelly Hallman Population Council, New York

• Dr John Mwesigwa Regional AIDS Training Network (RATN), Kenya
• Ms Bertha Nhlema Simwaka Research on Equity and Community Health (REACH), Malawi

Director: Dr Dave Haran, Liverpool School of Tropical Medicine

Last updated 21 July 2006

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