I have spent the last 30 years researching the economics of health systems in low- and middle-income countries. My major contributions are in the areas of health financing and the private health sector. I chaired the recent Lancet Global Health Commission on Financing Primary Health Care, and have authored key publications on how strategic purchasing can help to improve health system performance. My work on the private sector has contributed to our understanding of the opportunities and limitations of using the private sector to extend access to critical public health interventions and, more recently, to the challenges of regulating healthcare markets. I frequently advise national governments and international organisations on health system and financing issues. I am President of the International Health Economics Association, and Director of the NIHR Global Health Research Programme
Affiliations
Department of Global Health and Development
Faculty of Public Health and Policy
Centres
Centre for Evaluation
Malaria Centre
Centre for Maternal Adolescent Reproductive & Child Health
Health in Humanitarian Crises Centre
Antimicrobial Resistance Centre
Global Health Economics Centre
Teaching
I teach on Economic Analysis for Health Policy a. My research degrees students are studying topics including measurement of financial risk protection and Universal Health Coverage, public sector reforms, and cost-effectiveness of malaria in pregnancy interventions.
Research
My research has focused primarily on the economics of health systems in low- and middle-income countries. I have done research on hospital sector reforms in Uganda and Zambia, focusing on the implications of two-tier pricing for equity of access to hospital services. I am interested in the role of the private sector in health, and in identifying the opportunities and limitations of the private sector in improving the efficiency, quality and responsiveness of health systems. This includes a particular interest in novel approaches to regulation, particularly in relation to market disruptions such as provider consolidation and epharmacy. I am also interested in health financing reforms, particularly how to increase the levels and effectiveness of spending on primary health care.
Research Area
Health care financing
Health policy
Health systems
Selected Publications
Malaria, medicines and miles: A novel approach to measuring access to treatment from a household perspective.
2019
SSM - Population Health
Managing transitions from external assistance: cross-national learning about sustaining effective coverage.
2024
Health policy and planning
Determinants of government spending on primary healthcare: a global data analysis.
2023
BMJ global health
Budget monitoring, accountability practices and their influence on the efficiency of county health systems in Kenya.
2023
PLOS global public health
Designing economic evaluations for transferability: A critical review and practical guide
2023
International Health Economics Association Congress
Evaluating the effectiveness of the National Health Insurance Fund in providing financial protection to households with hypertension and diabetes patients in Kenya.
2023
International journal for equity in health
Examining the influence of health sector coordination on the efficiency of county health systems in Kenya.
2023
BMC health services research