FUNDING ORGANIZATION	RESEARCH ORGANIZATION	PROGRAM	DIRECTOR	CITY	COUNTRY	ABSTRACT
	EC	UNIVERSITY OF MALAWI	AFRICAN REGIONAL CAPACITY DEVELOPMENT FOR HEALTH SYSTEMS AND SERVICES RESEARCH	KUMWENDA, NEWTON	ZOMBA	MALAWI	View
This project will add new research training capacity at Sub Saharan African (SSA) universities, for health systems and services strengthening. The focus is doctoral and post doctoral training, institutional strengthening for education, financial and administrative research management, and South-South network building. Novel capacity building approaches will reduce brain-drain, be more climate friendly and encourage gender equity with south based training. Internet mounted downloadable modules in quantitative (e.g., epidemiology), qualitative (e.g., anthropology) and economic methods will support excellent interdisciplinary courses. Our EU and African partners have many successful previous collaborations, e.g., web based training modules; joint PhD degree with Uganda. Health systems strengthening is research intensive, incremental improvement to service delivery, implementation and evaluation. Therefore SSA countries need to grow their own health services and systems research (HSSR) capacity: interdisciplinary, rigorous and relevant. ARCADE-HSSR will support evidence informed service delivery by producing a stream of well trained young HSSR scientists, the next generation of health system leaders and researchers in SSA. Activities will be aimed at individuals, institutions and at the network. Makerere University(MU) and Stellenbosch University (SU) are two strong SSA universities with HSSR focus. They will act as hubs in a South-South network including MU, SU, and initially, Muhimbili (MUH) and Malawi (MA). Working with strong northern HSSR institutions (Karolinska Institute KI, Sussex University Institute for development Studies, IDS, and Norwegian Knowledge Centre for Health Services KS) this region-wide approach will draw skills, resources and students to a new south-south HSSR capacity development network. We will expand our unique north-south joint PhD degree programme (KI-MU: 20 Ugandan graduates), to south-south joint PhD degrees (MU-SU).
	EC	UNIVERSITY OF MALAWI	CLINICAL OFFICER SURGICAL TRAINING IN AFRICA	BORGSTEIN, ERIC	ZOMBA	MALAWI	View
Obstetrical and abdominal emergencies, and trauma, much of it affecting children, represent a major and neglected part of Africa’s burden of disease. Countries cannot train and retain sufficient specialist surgeons (doctors) to address these priorities. We propose a surgical training intervention targeted at Clinical officers (COs), who are trained non-physician clinicians that form the backbone of Africa’s district hospital services. Lacking medical degrees, COs have fewer opportunities for emigration. Surgical training of non-clinician physicians has been tried and reportedly worked well in African countries. It has never been rigorously evaluated, nor been subject to economic and population impact assessments. Two different 2 year training models are proposed: district hospital in-service training in Malawi and centralised training in Zambia. Before-and-after and randomized controlled trial evaluations are planned. The latter is the strongest study design for evaluating an intervention. Outcomes will include direct health benefits to patients, including morbidity and mortality averted; improved provider knowledge, skills and performance; direct (surgical) and indirect (management and other services) improvements in district hospital performance. Cost-effectiveness analyses and population impact assessments will be conducted. Clinical Officer training has for long been a feasible and acceptable model to African national policy makers; and COST-Africa has already elicited high level expressions of support. There will be an ongoing interaction with national stakeholders in both countries to ensure attractive career paths, salaries and retention strategies are in place for the graduates. A proven model for training and retaining a new cadre of non-physician surgical officers has the potential to provide a standard of life-saving surgical care often denied to African populations; tackle major rural:urban inequities; and transform district hospital care. Without such a resource, Africa has no hope of reaching MDG 5 on maternal mortality; and reduced hope for MDG 4 on childhood mortality.
	EC	UNIVERSITY OF MALAWI	ENABLING UNIVERSAL AND EQUITABLE ACCESS TO HEALTHCARE FOR VULNERABLE PEOPLE IN POOR RESOURCE SETTINGS	MUNTHALI, ALISTER	ZOMBA	MALAWI	View
Healthcare can be neither universal nor equitable if it is less accessible to some sections of society than it is to others. EquitAble’s focus on activity limitations brings recent thinking on disability, public health and health policy together to provide data that is crucial to enable universal and equitable access to healthcare in resource poor settings. EquitAble is a four-year collaborative research programme comprised of both leading and upcoming researchers, from two European and four African countries. Each of the African partner countries represent distinct challenges in terms of equitable access to health care in contexts where a large proportion of the population has been displaced (Sudan); where the population is highly dispersed (Namibia); where chronic poverty and high disease burden compete for meagre resources (Malawi); and where, despite relative wealth, universal and equitable access to health care is yet to be attained (South Africa). Documentary analysis of international and country-level health policy will identify health policy aspirations and challenges; along with opportunities for alignment and harmonisation, between different stakeholders. Intensive qualitative interviews and case studies, along with behavioural observations will explore the experiences of healthcare users, non-users and providers, and feed into the development of a household survey instrument. The extensive quantitative household survey will allow us to test models of access to healthcare, taking into account how the relationship between activity limitations and healthcare access is mediated by, or interacts with, cultural, contextual and systems variables. These work packages will constitute a much needed evidence base for health policy and practice in resource poor areas. EquitAble also goes beyond the provision of information and addresses how to ensure that research evidence affects policy and practice; both within the EU and Africa.