Dr Meenakshi Gautham
Health Systems and Health Policy
15-17 Tavistock Place
My research is aimed at designing models of governance for the private health sector, with a special focus on the complex challenge of antibiotic resistance. I have a special interest in informal markets that are a key source of primary care and antibiotics for the poor in many low and middle income countries. These markets are difficult to regulate due to multiple social and economic interdependencies between health care providers, pharmaceutical suppliers, health and regulatory systems and consumers of healthcare, and stewardship interventions have to first ensure proper access to reduce excess. My study teams include the UKRI/HSRI funded One Health Antibiotic Stewardship in Society (OASIS) study group in India, and the UKRI/GCRF funded AGRI/AMU cluster with collaborators from Asia, Africa and South America. We are working with the private health sector and pharmaceutical industry to co-design antibiotic behaviour change interventions, including self-regulation, targeting informal and formal primary care providers, marketing and supply chain actors and the public.
I also lead the MESH study aimed at designing a novel integrated approach for more precise detection and management of Reproductive tract/sexually transmitted infections (RTIs/STIs) among women care seekers in rural India. We are testing a new protocol that integrates Point of Care tests and mental health screening into syndromic management guidelines.
I joined LSHTM in 2012 as the India Country Coordinator of IDEAS, a 5-year Gates Foundation funded measurement, learning and evaluation project in maternal, newborn and child health, implemented by LSHTM in Ethiopia, India (Uttar Pradesh and West Bengal) and North East Nigeria. In 2015 I joined the Merck for Mothers study team at LSHTM, researching the private health sector in maternal healthcare in Uttar Pradesh. From 2016-18 I led an HSRI study exploring the social, economic and behavioural drivers of antibiotic use by informal private healthcare providers in West Bengal, India. Prior to working with LSHTM I was a post-doctoral fellow (2008-2012) with the Institute of Health Policy and Management, Erasmus University, Netherlands, and the Micro Insurance Academy in New Delhi. I completed my PhD at LSHTM (Public Health and Policy) in 2006. Before that I worked as India Programme Manager with Intrahealth International (1997-2001).
I am deputy module organiser of the Health Policy, Process and Power (PHM 109) module. I also teach on the One Health M.Sc (joint M.Sc with RVC) and contribute to the AMR short course. I supervise student dissertations from several M.Sc courses including Public Health, Control of Infectious Diseases and One Health, co-supervise PhDs, and provide students with opportunities to conduct fieldwork on my field sites.
My research interests include the private health sector, informal sector, drivers of antibiotic use and AMR, antibiotic stewardship, and multi-stakeholder approaches to complex intervention design and private sector governance. I am particularly interested in the politics of interdependencies between ‘street medicine’ and the formal health sector and in exploring the potential of participatory methodologies and policy entrepreneurship in inclusive and complex policy design. I also have a growing interest in digital interventions and in user centred design to harness technologies as behaviour change tools.