By Claire Turner, Communications Coordinator, iDSI, Global Health and Development Group
As the new academic year commences we take a look back at some of the work conducted by early career researchers as short research projects in the Centre for Health Policy, which they presented on this summer. Below is a summary of the work that was presented.
PBO bed nets – A Case for Comparative Effectiveness for Innovative Tools in Vector Control
Debra Ten Brink, MD. MPH candidate at Imperial College London, UK
Supervised by Professor Kalipso Chalkidou, Francis Ruiz and Mohamed Gad (Global Health and Development Group)
- What was the most interesting or significant thing you found through your research?
Vector tools are a complex group of health technologies, as there is no standard approach to preventing malaria and other vector borne diseases. Tools are used in combination or separately, for example, long lasting insecticide nets are used in combination with indoor residual spraying in some countries while others only use insecticide nets. As the use is very context specific, this makes the comparison of clinical effectiveness of new products difficult. Secondly, economic evaluation of new products is not yet incorporated into the process when it comes to the appraisal of new health technologies in vector tools. First, because it is a difficult endeavour due to the lack of the aforementioned golden standard. Secondly, in the global health community, there seems to be a reliance on economies of scale to drive down prices. An alternative process could be a standard operating procedure of economic evaluation, where countries themselves can decide whether a more expensive product might be worth the investment. All interviewed stakeholders agreed that economic evaluation could be very valuable, but there appears to be a lack of data as well as an absence of consensus as to how this might be done. - What were the challenges?
The evaluation of vector tools is being discussed at the World Health Organisation at the moment, hence interviewing key stakeholders surrounding the decision-making process was challenging. Most stated confidentiality issues as a reason, even though results will be anonymised. - Why did you choose to work with Imperial?
I chose to study at Imperial College because the Global Health stream of the MPH focusses on low and middle income countries and the challenges and opportunities to strengthen their health systems. - What is next for you?
I hope to continue in health policy, working in organisations that focus on country-centred approaches to solving health issues in low and middle income countries.
Data Sharing for direct and non-direct purposes
Anna Fugard, PPE candidate at University of Exeter, UK
- What was the most interesting or significant thing you found through your research?
Through my research it became clear that transparency in communication is paramount to a successful policy around data sharing. Good communication is needed to gain the trust of the public, as without trust people will feel insecure about sharing personal information and to protect themselves they will often opt out, even if the data policy is sound. It was interesting to see how many professionals within the medical world were unclear about what data sharing entailed. Whereas, I was expecting that they would have the best knowledge about data sharing policies: confirming that there were significant gaps in knowledge and communication. - What were the challenges?
Writing up reports was challenging; choosing the correct wording was key to ensure that reports were informative but not perceived as critical towards the different bodies involved e.g The Department of Health. It became clear that different organisations have different angles and perspectives that needed to be taken into consideration and respected. - Why did you choose to work with Imperial?
I am interested in medical ethics and am interested in going into medical politics or law. - What is next for you?
I am going into my final year of studying Politics, Philosophy and Economics at the University of Exeter.
DFID’s Value for Money Framework: A Practical Approach for Development Assistance in Health
Yihui Liang, MPH candidate at Imperial College London, UK
Supervised by Professor Kalipso Chalkidou, Francis Ruiz and Mohamed Gad (Global Health and Development Group)
- What was the most interesting or significant thing you found through your research?
A significant takeaway, is the difficulty and complexity of developing an algorithm or method for ex-ante and ex-post value for money analysis and decision making, for any scale that is larger than a small population for a very specific health outcome. Although it may be possible, it would require an immense amount of theoretical modelling upfront. A few features which could quantify and improve the DFID value for money approach in health however, are a combined ex-ante and ex-post method of implementation rather than only ex-post, the integration of a mathematical model using outcome-specific indicators (including cost effectiveness analysis), and a ranking or traffic light system for funding decisions. I also found a complete re-orientation of defining value for money as four layers of efficiency in health economic terms, to be a better representation than the process-chain model currently used by DFID.
- What were the challenges?
Without a longer working timeframe, and more in-depth mathematical modelling, actually providing a framework or model containing necessary indicators was a challenge. The biggest component to this, was addressing the quantification and comparison of health impact across so many different health areas. An understanding of DFID’s own internal objectives and health priorities would be a next step in pursuing targeted health indicators. - Why did you choose to work with Imperial?
I decided to study at Imperial for its focus on quantitative practicals, and the choice to specialise in the Global Health stream, which was my primary interest.
- What is next for you?
My interests lie with non-governmental organisations which specialise in global health policy, either in program implementation in local settings, or evaluation work which draws connections between work done, and set standards of quality.
Research Tracker Portal
Charles Masson, Health Information Technology candidate at Polytech Grenoble, France
Joshua Symons (Big Data and Analytical Unit (BDAU))
- What was the most interesting or significant thing you found through your research?
The most interesting part of my project was the technical creation of the programme: which allowed researchers to be connected online in new ways.
- What were the challenges?
I did not know the technical part used to create the software so I had to teach myself. Moreover, I did not know the medical system of the UK and I had to do research to understand it.
- Why did you choose to work with Imperial?
It was a great opportunity to do such an internship at a well renowned university. The big data area interested me a lot and the project is an important innovation of the department; that links researchers with medical staff. - What is next for you?
I will keep studying to finish my engineering school and then will look to obtain a 6-month-internship. I would also like to complete my studies at a business school to develop my skills in other areas and then I may create my own start-up.
‘Close, but No Cigar’: A Preliminary Review of Global Antimicrobial Stewardship Efforts
Niisoja Torto, Public Policy and Global Health candidate at Duke University, USA
Didi Thompson (Institute for Global Health Innovation)
- What was the most interesting or significant thing you found through your research?
I was surprised to find out about the scale of inappropriate use of antimicrobial drugs in health systems around the world. With this in mind, it is striking that despite the wide recognition of the effect of this misuse of drugs on the emergence of antimicrobial resistance (AMR), global progress to combat this misuse has been slow and collective action has been largely absent. - What were the challenges?
It was difficult to reconcile both the relative abundance of information on antimicrobial stewardship and the simultaneous lack of data/variability of important aspects of stewardship programs, such as regarding provider compliance and the effectiveness of specific interventions. - Why did you choose to work with Imperial?
With the encouragement of one of the professors at my home institution, I decided that the opportunity to explore the field of health policy here was an opportunity I had to seize. While CHP at Imperial is a leading health policy centre in itself, its connection to WISH provided a unique opportunity that I could not necessarily have had in the US. Additionally, the prospect of coming to London, a city unlike any I have ever visited, also served as encouragement. - What is next for you?
I hope in the future to go into the field of global health policy, combining my interests in health, social justice, and policy. While I am still unsure of the exact angle I will take or the health issues I am most interested in, I hope by the time I have finished my undergraduate degree in three years that I will have focused my interests.