I am a Professor of Health Systems and Policy in the Department of Global Health and Development at LSHTM and Adjunct Professor at Njala University, Sierra Leone, with over 25 years of experience in health systems and policy research in low- and middle-income countries (LMICs). My main expertise is in health systems governance and anti-corruption, effective delivery models and health systems strengthening.
Seeking to ensure research uptake and impact on policy and practice, I have served as an elected board member of Health Systems Global, a professional society for health policy and systems research (HPSR) (2012-18), and co-founder and former co-chair of its Thematic Working Group on Teaching and Learning HPSR. Currently, I co-chair the Thematic Working Group Action on Accountability and Anti-corruption for SDGs (TWG AAA) and sit on the Steering Group of the Global Network for Anti-Corruption, Transparency, and Accountability (GNACTA) in Health Systems convened by the WHO, the Global Fund, and UNDP.
I served as a commissioner on the Lancet Commission on Realigning Child Health in the SDG Era (2019-2020) and was a technical team member on the Lancet Global Health Commission on PHC Financing for LMICs. I am a Senior Editor for BMC Health Services Research and Social Science and Medicine (Health Systems). I sit on a range of funding panels and advisory steering committees.
Affiliations
Centres
Teaching
I have established, and co-lead the LSHTM face-to-face Health Systems module, and advise on the content of the distance-learning version. I have delivered Health Policy and Systems Research (HPSR) training worldwide, currently leading work to accelerate the development of HPSR capacity and the creation of learning networks in the Western Pacific Region.
I currently supervise Research Degree students working on anticorruption strategies in low- and middle-income countries, NCD/HIV comparative policy analysis in Botswana, and people-centred communication applied to NCDs.
Research
I lead a portfolio of anti-corruption research. Within the FCDO-funded Anti-Corruption Evidence (ACE) research consortium in Bangladesh, Nigeria, and Tanzania, the research focuses on providers’ incentives to engage in rent-seeking—informal payments, absenteeism, pharmaceutical market distortion–and on identifying tailored strategies to address these practices. The ‘Accountability in Action’ project funded by MRC HSRI explores ways to address the institutional, structural and social drivers of health sector corruption and distortions at primary health care level in Nigeria and Malawi, identifying feasible solutions.
I have long-term interest in the assessment of health system responses to the growing burden of chronic noncommunicable diseases requiring complex inputs in terms of treatment, follow-up, and care processes (hypertension and diabetes). I served as a deputy PI on the RESPOND project funded by the Wellcome Trust/ Newton Fund-MRC Humanities & Social Science Collaborative Award exploring barriers to hypertension control among poor and underserved populations in Malaysia and the Philippines (RESPOND) using surveys and a digital diary platform, building on previous work on diabetes. The project also involved strengthening the capacity to use evidence and engage in political processes to respond to the needs of these groups.
I have led interdisciplinary multi-method projects involving comparative research on health systems and governance, such as the ‘Good Health at Low Cost 25 years on’ project funded by the Rockefeller Foundation, examining ways in which good governance and accountability have promoted major advances in health and access to services in some LMICs compared to others at a similar level of wealth. Other work has focused on developing effective and equitable primary care models for underserved populations involving community volunteers (Ethiopia, PI/HSRI grant) and building resilient health systems (Sierra Leone, Co-I/HSRI).
Selected Publications
