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Health Economics and Systems Analysis Group (HESA)

We are a group of over 50 staff with internationally recognised expertise in a wide range of disciplines including health economics, policy analysis, public health, epidemiology and social science.

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About us

We are a group of over 50 staff with internationally recognised expertise in a wide range of disciplines including health economics, policy analysis, public health, epidemiology and social science.

About
About HESA

We are a group of over 50 staff have internationally recognised expertise in a wide range of disciplines including health economics, policy analysis, public health, epidemiology and social science. HESA has a strong track record in the production and communication of rigorous, policy-relevant research, conducted through long-term collaborations with Southern research partners. We endeavour to contribute to methodological developments in the disciplines in which we work, and to encourage and support multidisciplinary thinking and analysis.

We also contribute to a vibrant teaching programme in health economics and health systems through supervision of over 25 research degree students, teaching on the LSHTM in-house and distance learning Masters programme, and through providing short courses in health economics and financing for international organisations such as UNICEF and DFID.

Read more about the wide range of health economics research conducted across the School in this brochure.

Key research themes addressed by the group include:

The Communicable Disease Policy Research Group (CDPRG), within HESA, is based in Bangkok, Thailand, and conducts research across the SE Asia region, and beyond on the diverse public health problems associated with communicable disease control.

Research
Research HESA

Governance, organisation, financing and delivery of health systems

A key area of the work of HESA is health systems research, which seeks to generate knowledge about how societies organize themselves to achieve collective health goals. Health systems research is a rapidly growing, multi-disciplinary field. 

Health systems research in HESA addresses the key health systems components of health financing, governance, and human resources. The RESYST Consortium, for example, includes work on these three themes, but also seeks to examine the interactions among health system functions, the factors which influence effective implementation of health system policies, and the role of socio-political contexts at the national and global levels. 

HESA research has also examined how health systems change and innovate over time, for example, exploring health system responses to the growing burden of non-communicable chronic conditions and pluralistic health systems, particularly the role of the private sector. Our research seeks to promote methodological innovation, for example employing multi-method evaluations, action research, and methods for the evaluation of complex health system interventions.

HESA is the focal point for health systems research within the Faculty of Public Health and Policy. HESA staff are involved in international promotion of rigorous health systems research, including support to the first professional society on health systems, Health Systems Global.

List of projects (PI and other HESA staff collaborators):

Resilient and Responsive Health Systems (RESYST) | Kara Hanson (PI); Lucy Gilson (PI); Mylene LagardeCatherine GoodmanJo Borghi | University of Cape Town; University of Witwatersrand; KEMRI Wellcome Trust Research Programme; Indian Institute of Technology Madras; Health Policy Research Group, University of Nigeria (Enugu); International Health Policy Programme; Ifakara Health Institute; Health Policy Systems Institute, Vietnam | Nigeria, South Africa, Tanzania, India, Thailand, Vietnam, Kenya

Universal coverage in Tanzania and South Africa (UNITAS) | Anne Mills (PI); Jo Borghi | University of Dar-es-Salaam; Ifakara Health Institute; Centre for Health Policy; University of Cape Town; University of KwaZulu Natal; Institute of Tropical Medicine Belgium | Tanzania; South Africa

Consortium for Health Policy & Systems Analysis in Africa (CHEPSAA) | Lucy Gilson (PI) | University of Cape Town; University of Dar es Salaam; University of Ghana; Tropical Institute of Community Health & Development Trust; College of Medicine of the University of Nigeria; University of Western Cape; University of Witwatersrand; University of Leeds, Karolinska; Schweizerizches Tropen-UND Public Health Institute | South Africa; Tanzania; Ghana; Kenya; Nigeria

New vaccines: from licensing to adoption | Anne Mills (PI); Sandra Mounier-JackHelen BurchettUlla GriffithsSergio Torres Rueda | Bangladesh (ICDDR,B); Cameroon; Ethiopia; Guatemala; Kenya; Mali; Rwanda; South Africa

Antimalarial drugs: market and supply chain research and policy recommendations (ACTwatch) | Kara Hanson (PI); Catherine GoodmanBen PalafoxSarah TougherEdith Patouillard | Benin; Democratic Republic of Congo; Cambodia; Madagascar; Nigeria; Uganda; Zambia

Good Health at low cost 2010: identifying factors, within health systems and the wider context, which influence health outcomes | Dina Balabanova (PI); Anne MillsBen PalafoxLoveday Penn-Kekana | IITM, India; ICDDRB, Bangladesh; MHRC, Ethiopia; IHPP, Thailand; Health Policy Analysis Group, Kyrgyzstan | India; Bangladesh; Ethiopia; Thailand; Kyrgyzstan

Investigating the role and influence of non-standard economic preferences on health workers' decisions in South Africa | Mylene Lagarde (PI) | Centre for Health Policy | South Africa

Cost-effectiveness of financial and non-financial incentives for the retention of physicians, Malawi | Kara Hanson (PI); Kate Mandeville | College of Medicine, University of Malawi | Malawi

Implications for the NHS of medical tourism | Richard Smith (PI) | York University | Global

Building sustainable capacity for research for health and its social determinants | Jo Borghi (PI); Edith Patouillard | Deutsche Gesellschaft fur Internationale Zusammenarbeit GIZ; IESE Business School; University of the Witwatersrand; University of Nairobi; Ifakara Health Institute; Fundacao Oswaldo Cruz; Instituto Nacional de Salud Publica; Universidad Nacional de Colombia; COHRED Group; University of Geneva | Germany; Spain; South Africa; Kenya; Tanzania; Mexico; Colombia; Switzerland

Donor aid tracking for MNCH (Countdown to 2015) | Jo Borghi (PI); Anne Mills (PI); Catherine PittGiulia GrecoMelisa Martinez Alvarez; Christopher Grollman; Leonardo Arregoces; Paola Vargas Pastor| Global

Evaluation of a pilot P4P initiative in Tanzania | Jo Borghi (PI); Edith PatouillardGiulia Greco | Ifakara Health Institute (IHI) | Tanzania

Evaluation of the impact of the NHIF MCH insurance, Tanzania | Jo Borghi (PI); Edith PatouillardFrida Kasteng | Ifakara Health Institute (IHI) | Tanzania

The role of professional education and training in workforce migration | Richard Smith (PI); Gillian Styles | Ghana

 

IDEAS (Informed Decisions for Action) to improve Maternal and Newborn Health | Joanna Schellenberg (PI); Anne Mills; Neil Spicer; Lindsay ManghamKara Hanson | Last 10 Kilometers, Saving Newborn Lives, The Maternal and Newborn Health in Ethiopia partnership, Ethiopia; Society for Family Health, Nigeria; Better Birth, Manthan, Sure Start, India | Ethiopia, India, Nigeria

Evaluation of financial incentives for maternal health | Timothy Powell-Jackson  (PI) | Nepal

The impact of user fee removal policy in Zambia on health care utilisation, provider choice and out-of-pocket medical expenses | Aurelia Lepine (PI); Mylene Lagarde | Zambia

Financing and delivery of efficient, effective and equitable PHC systems in Ethiopia | Dina Balabanova (PI); Lindsay Mangham; Girmaye Dinsa | Ethiopia

Path to universal health coverage: understanding health system consequences of user-fee exemption | Fred Martineau (PI) | Sierra Leone

Studying health workers' incentives and accountability in Sierra Leone | Maria Bertone (PI); Mylene Lagarde | Sierra Leone

Increasing the uptake of health services in low-income countries: what can we expect from userfee removal & financial incentives | Aurelia Lepine (PI) | Senegal; Nigeria; South Africa

Equitable and sustainable health care financing in Timor Leste and Fiji | Lorna Guinness (PI) | Timor Leste; Fiji

District health management and health service delivery: evidence from India | Timothy Powell-Jackson (PI) | India

Maternal Evaluation Team | Catherine Goodman (PI); Timothy Powell-Jackson, Andreia Costa Santos; Shreya Pereira; Manon HaemmerliRichard Iles, Sarah Tougher

Health systems strengthening in global health in China | Kara Hanson (PI), Melisa Martinez AlvarezDina Balabanova | China

Investigating the determinants of health worker performance | Mylene Lagarde (PI) | Senegal

Evaluation of the implementation, cost and long term impact of P4P of health services in Tanzania | Jo Borghi (PI) | Tanzania

 

Macroeconomic modelling of health and health policy

HESA research into macroeconomics and health focuses on macroeconomic modelling, particularly the Computable General Equilibrium (CGE) approach, but also involves retrospective macroeconomic analysis and research into the areas of growth and development, especially the intersections of macroeconomics, economic development, and health.

Our health-focussed macroeconomic models have been used in various contexts including pandemics and outbreaks, dietary change, greenhouse gas reduction strategies, health reforms and methodological development.  The diseases and health conditions we model are broad including infectious disease (including SARS/Flu, antibiotic resistance and malaria), non-communicable disease (particularly diet and lifestyle related illness) and more general applications to capture health effects on productive labour supply.  Countries and regions modelled include Europe and Sub-Saharan Africa in particular but many other country contexts, together with global modelling applications are undertaken.

As well as tailoring macroeconomic models to specific health applications, we also undertake model development and current projects include the integration of epidemiological, demographic and macroeconomic models into a single framework in order to capture interaction and feedback effects beyond those which can be estimated by means of a partial equilibrium or isolated health or economic model.

List of projects (PI and other HESA staff collaborators):

Methodological development of the macro-economic modelling of malaria control in Africa | Richard Smith (PI); Marcus Keogh-Brown | University of Copenhagen | Ghana; Tanzania; Mozambique

The economic burden of anti-microbial resistance (AMR): paper | Richard Smith (PI) | University of Birmingham | Global

GRACE: Genomics to combat Resistance against Antibiotics in Community-acquired LRTI | Richard Smith (PI); Marcus Keogh-Brown | Global

Reducing chronic diseases: the implications of a ‘healthy diet’ for agriculture, trade and food systems | Marcus Keogh-Brown (PI); Richard Smith | Mexico; Thailand

Macroeconomic burden of Alzheimer's disease in China | Marcus Keogh Brown (PI); Richard Smith | China

Economics of malaria and malaria control

HESA has the largest group of academics who work on economics in malaria, playing a central role in the LSHTM Malaria Centre. We draw on our strengths as a multidisciplinary team of economists, social scientists, clinicians and epidemiologists to apply different methodological approaches to a broad range of policy and programme relevant issues in both Sub-Saharan Africa and Asia. 

We undertake a wide range of cost-effectiveness analyses of malaria control interventions, encompassing diagnostics, drugs, treatment delivery strategies, vector control and prevention in pregnancy in association with the MIP consortium.

Another key focus of our work is the analysis of private markets for malaria-related commodities, including studies of markets for antimalarial drugs, diagnostics and insecticide treated bednets. We are also involved in a number of large-scale field evaluations of interventions to improve access to effective malaria treatment and diagnosis through public facilities, community health workers and the private sector, for example through the ACT Consortium, and the Independent Evaluation of the Affordable Medicines Facility-malaria (AMFm) ACT subsidy programme. Our work also encompasses strategies to contain the development of resistance to antimalarial drugs, in association with WWARN

Qualitative studies are another important area of our work, encompassing research on the social burden of malaria, provider behaviour, design of behavioural interventions, and the realities of participating in malaria research and trials.

Finally we explore the wider implication of malaria and malaria control through macroeconomic modelling.

List of projects (PI and other HESA staff collaborators):

IMPACT 2: Monitoring interventions to improve ACT access and targeting (ACT consortium) | Catherine Goodman (PI); Katia Bruxvoort; Rebecca Thomson | Ifakara Health Institute (IHI); US Centres for Disease Control & Prevention | Tanzania

Artemisinin Resistant Malaria Research Programme | Shunmay Yeung (PI); Philippe Guyant; Harriet Lawford; Marco Liverani; Nayantara Wijayanandana | MORU; LSTM | Cambodia; Nigeria; Bangladesh; Thailand

Malaria in Pregnancy - Economics input | Kara Hanson (PI); Silke Lutzelschwab | The Centre de Recerca en Salut Internacional de Barcelona (CRESIB); Navronga Health Research Centre(NHRC); Papua New Guinea Institute for Medical Research | Brazil; Colombia, Tanzania, Guatemala; Ghana; Papua New Guinea; India; Madagascar; Mali; Nigeria; Papua New Guinea

An equity and cost-effectiveness analysis of alternative strategies for the deployment of ACTs at the community level (ACT consortium) | Virginia Wiseman (PI); Lindsay Mangham-Jefferies | Health Policy Research Group, University of Nigeria (Enugu); University of Yaounde | Nigeria; Cameroon

Antimalarial drugs: market and supply chain research and policy recommendations (ACTwatch) | Kara Hanson (PI); Catherine Goodman; Ben Palafox; Sarah Tougher; Edith Patouillard | Benin; Democratic Republic of Congo; Cambodia; Madagascar; Nigeria; Uganda; Zambia

Independent Evaluation of the Affordable Medicines Facility – Malaria (AMFm) | Kara Hanson (PI); Catherine Goodman, Sarah Tougher, Ben Palafox | ICF International | Ghana; Niger; Madagascar; Nigeria; Uganda; Kenya; Tanzania

Understanding private sector demand for malaria medications in developing countries | Kara Hanson (PI); Ben Palafox | Benin; Madagascar; Nigeria; Uganda; Zambia

A cluster-randomised trial of health worker and community interventions to improve adherence to national guidelines for the use of ACTs in Tanzania | Hugh Reyburn (PI); Clare Chandler | National Malaria Control Programme; National Institute for Medical Research in Tanzania; Kilimanjaro Christian Medical Centre | Tanzania

Introducing malaria rapid diagnostic tests (RDTs) into the private health sector in Uganda: a randomised trial among drug shops to evaluate impact on antimalarial drug use | Sian Clarke (PI); Kristian Hansen (PI), Clare Chandler; Eleanor Hutchinson | Ministry of Health, Uganda; DBL Institute for Health Research and Development, University of Copenhagen | Uganda

An evaluation of the Cambodian Village Malaria Worker programme | Shunmay Yeung (PI); Edith Patouillard | Ministry of Health, Cambodia | Cambodia

Integrated community case management of common diseases of childhood at scale | Betty Kirkwood (PI); Kara Hanson, Anna Vassall, Frida Kasteng | Malaria Consortium | Uganda, Mozambique

Case management versus IPTp for malaria control in pregnant women: provider and user perspectives | Mylene Lagarde (PI) | Ghana

Willingness to pay for malaria rapid diagnostic tests | Shunmay Yeung (PI); Kristian Hansen | Uganda

Working with plantation owners to control malaria and antimalarial drug resistance | Shunmay Yeung (PI); Rebecca Thomson | Cambodia

Malaria rapid diagnostic tests in context | Shunmay Yeung (PI); Catherine Goodman (PI); Clare Chandler (PI); David Bath

Evaluation of complex health system interventions

Researchers in HESA are actively involved in evaluating a range of health systems interventions, from global and national level programmes to localised pilots, in a variety of low- and middle-income country settings. These interventions are often complex, and evaluations reflect the complexity of introducing change into health system settings. The methodological approaches employed and built on by the group include process evaluations, to understand the fidelity, reach and dose of interventions delivered and received, mechanism evaluations, to understand how change occurred and attribution to the intervention, impact evaluations, to assess the intended and unintended impacts of interventions, and economic evaluations, to assess the cost-effectiveness of interventions. These evaluations are undertaken using rigorous study designs, including randomised trials, quasi experimental designs and natural experiments. Our methodological toolkit incorporates quantitative and qualitative fieldwork, the use of theory driven data analysis techniques for both quantitative and qualitative data and the use of systematic reviews on the effectiveness of different health systems interventions.

List of projects:

IMPACT 2: Monitoring interventions to improve ACT access and targeting (ACT consortium) | Catherine Goodman (PI); Katia Bruxvoort; Rebecca Thomson | Ifakara Health Institute (IHI); US Centres for Disease Control & Prevention | Tanzania

IDEAS (Informed Decisions for Action) to improve Maternal and Newborn Health | Joanna Schellenberg (PI); Anne Mills; Neil Spicer; Lindsay Mangham; Kara Hanson | Last 10 Kilometers, Saving Newborn Lives, The Maternal and Newborn Health in Ethiopia partnership, Ethiopia; Society for Family Health, Nigeria; Better Birth, Manthan, Sure Start, India | Ethiopia, India, Nigeria

Independent Evaluation of the Affordable Medicines Facility – Malaria (AMFm) | Kara Hanson (PI); Catherine Goodman, Sarah Tougher, Ben Palafox | ICF International | Ghana; Niger; Madagascar; Nigeria; Uganda; Kenya; Tanzania

Evaluation of a pilot P4P initiative in Tanzania | Josephine Borghi (PI); Edith Patouillard; Giulia Greco | Ifakara Health Institute (IHI) | Tanzania

Evaluation of the impact of the NHIF MCH insurance, Tanzania | Josephine Borghi (PI); Edith Patouillard; Frida Kasteng | Ifakara Health Institute (IHI) | Tanzania

A cluster-randomised trial of health worker and community interventions to improve adherence to national guidelines for the use of ACTs in Tanzania | Hugh Reyburn (PI); Shunmay Yeung; Clare Chandler | National Malaria Control Programme; National Institute for Medical Research in Tanzania; Kilimanjaro Christian Medical Centre | Tanzania

Introducing malaria rapid diagnostic tests (RDTs) into the private health sector in Uganda: a randomised trial among drug shops to evaluate impact on antimalarial drug use | Sian Clarke (PI); Kristian Hansen (PI); Clare Chandler | Ministry of Health, Uganda; DBL Institute for Health Research and Development, University of Copenhagen | Uganda

ACT PRIME: Evaluating the impact of enhanced health facility-based care for malaria and febrile illnesses in children in Tororo, Uganda | Sarah Staedke (PI); Clare Chandler | Infectious Diseases Research Collaboration, Makerere University and University of California San Fancisco | Uganda

ACT PROCESS: Evaluating the process, context, and impact of interventions to enhance health facilities in Tororo, Uganda | Sarah Staedke (PI); Clare Chandler | Infectious Diseases Research Collaboration, Makerere University | Uganda

Perceptions of malaria and antimalarials amongst HIV positive individuals enrolled in an antimalarial drug trial in Tanzania | Clare Chandler (PI); Lasse Vestergaard (PI); Joanna Reynolds | National Institute of Medical Research, Tanzania; DBL Institute for Health Research and Development, University of Copenhagen | Tanzania
 
School-based Treatment with ACT to Reduce Transmission (START): Evaluation of the community impact of intermittent preventive treatment for malaria in Ugandan schoolchildren: a cluster randomised trial  Sarah Staedke (PI); Clare Chandler  | Uganda

GUARD study: Good Use of ACTs and RDTs in Drug outlets. Mixed method study of the quality and use of RDTs and corresponding use of ACTs and artemisinin monotherapies in the private sector in Cambodia  Shunmay Yeung (PI), Clare Chandler  | Cambodia

An evaluation of the Cambodian Village Malaria Worker programme | Shunmay Yeung (PI); Edith Patouillard | Ministry of Health, Cambodia | Cambodia

Millennium Village Evaluation, Ghana | Timothy Powell-Jackson (PI); Arnab Acharya | ITAD, Institute of Development Studies | Ghana

Integrated community case management of common diseases of childhood at scale | Betty Kirkwood (PI); Kara Hanson, Anna Vassall, Frida Kasteng | Malaria Consortium | Uganda, Mozambique

Maternal Evaluation Team | Catherine Goodman (PI); Timothy Powell-Jackson, Andreia Costa Santos; Shreya Pereira; Manon Haemmerli; Richard Iles, Sarah Tougher

Health systems strengthening in global health in China | Kara Hanson (PI), Melisa Martinez Alvarez; Dina Balabanova | China

Investigating the determinants of health worker performance | Mylene Lagarde (PI) | Senegal

Evaluation of the implementation, cost and long term impact of P4P of health services in Tanzania | Josephine Borghi (PI) | Tanzania

Economic evaluation of health interventions

The health economists in HESA have a wealth of experience in economic evaluations of health care interventions in low- and middle-income settings. We are approximately ten staff who work almost solely on economic evaluation. While the majority of our studies have traditionally been focused on interventions against communicable diseases, in particular malaria, HIV/AIDS and vaccine preventable diseases, we have recently gained expertise within non-communicable disease areas, such as eye health and weight management interventions. Our preferred study approach is to design economic evaluations alongside clinical trials or observational studies; often in close collaboration with epidemiologists and disease specific experts.

For more information about this area of work please contact Dr. Ulla Griffiths.

List of projects (PI and other HESA staff collaborators):

Malaria in Pregnancy - Economics input | Kara Hanson (PI); Silke Lutzelschwab | The Centre de Recerca en Salut Internacional de Barcelona (CRESIB); Navronga Health Research Centre(NHRC); Papua New Guinea Institute for Medical Research | Brazil; Colombia, Tanzania, Guatemala; Ghana; Papua New Guinea; India; Madagascar; Mali; Nigeria; Papua New Guinea

Cost-effectiveness of financial and non-financial incentives for the retention of physicians, Malawi | Kara Hanson (PI); Kate Mandeville | College of Medicine, University of Malawi | Malawi

Economic evaluation of Seeing is Believing eye care programme | Ulla Griffiths (PI); Fiammetta Bozzani | ZAMBART; Sightsavers Zambia | Zambia

An equity and cost-effectiveness analysis of alternative strategies for the deployment of ACTs at the community level (ACT consortium) | Virginia Wiseman (PI); Lindsay Mangham-Jefferies | Health Policy Research Group, University of Nigeria (Enugu); University of Yaounde | Nigeria; Cameroon 

District burden and costs of severe pneumonia before and after introduction of pneumococcal vaccine in Malawi | Ulla Griffiths (PI); Fiammetta Bozzani | Institute of Child Health, University College London | Malawi

Global cost-effectiveness of efficacious TB vaccines | Ulla Griffiths (PI); Yoko Laurence | Global

Estimation of the cost of meningitis surveillance in Chad | Ulla Griffiths (PI); Ngozi Erondu | Agence de Médecine Préventive (AMP) | Chad

Integrated community case management of common diseases of childhood at scale | Betty Kirkwood (PI); Kara Hanson, Anna Vassall, Frida Kasteng | Malaria Consortium | Uganda, Mozambique

Reduction of early mortality among HIV-infected subjects starting ART therapy: a randomised trial (REMSTART) | Shabbar Jaffar (PI); Lorna Guinness | Tanzania Ministry of Health, Tanzania National Institute for Medical Research, Zambia Ministry of Health, Zambia Institute for Medical Research and Training | Tanzania; Zambia

A cluster-randomised trial of health worker and community interventions to improve adherence to national guidelines for the use of ACTs in Tanzania | Hugh Reyburn (PI); Clare Chandler | National Malaria Control Programme; National Institute for Medical Research in Tanzania; Kilimanjaro Christian Medical Centre | Tanzania

A cost-effectiveness analysis of introducing malaria rapid diagnostic tests (RDTs) into the private health sector in Uganda: a randomised trial among drug shops to evaluate impact on antimalarial drug use | Kristian Hansen (PI); Siân Clarke (PI); Eleanor Grieve; Sham Lal; Clare Chandler; Eleanor Hutchinson | Ministry of Health, Uganda; DBL Centre for Health Research and Development, Denmark.

A phase III randomised controlled trial of oral fluconazole plus flucytosine versus amphotericin B-based therapy for one or two weeks for initial treatment of HIV-associated cryptococcal meningitis | Shabbar Jaffar (PI); Ulla Griffiths | MRC/DFID joint trials | St Georges; Liverpool School Tropical Medicine, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Ministry of Health (Zambia), University Teaching Hospital Lusaka, University of North Carolina, Kamuzu Central Hospital, University of Paris Descartes; Istitut Pasteur | Zambia; Malawi

Evaluation of the Adolescent Girls Empowerment Programme (AGEP) | Fiammetta Bozzani (PI) | Population Council | Zambia

Cost-effectiveness analysis of the Randomised Evaluation of HIV/FP Service Models (REacH) Program | Fiammetta Bozzani (PI) | Population Council | Zambia

Can mass media campaigns reduce child mortality? | Simon Cousens (PI); Josephine Borghi; Frida Kasteng | Development Media International | Burkina Faso

Economic consequences of maternal morbidity | Tim Powell-Jackson (PI) | Bangladesh

Cost-effectiveness of Hib vaccine | Kim Mulholland (PI); Ulla Griffiths; Anne Mills | Johns Hopkins University, USA | Belarus; India; Uzbekistan

Effectiveness of facility-based audits to improve the responsiveness of West African district hospitals to obstetric emergencies: a three-country cluster randomised controlled trial (AUDOBEM) | Catherine Pitt (PI) | Prince Leopold Institute of Tropical Medicine (ITM), Belgium; East European Institute for Reproductive Health (EEIRH), Romania; Centre de Recherche en Reproduction Humaine et en Demographie (CERRHUD) - Benin; Centre Muraz, Burkina Faso; Ministere de la Sante Publique, Niger; Institute of Tropical Medicine and International Health, Charité, Universitätsmedizin Berlin, Germany | Benin; Burkina Faso 

Intermittent preventive treatment of malaria in children under 5 and bednets (IPTc/ITN trial) | Paul Milligan (PI); Catherine Pitt | Burkina Faso; Mali 

Monitoring and evaluation of the Avahan project in India: impact assessment and cost-effectiveness analyses using enhanced surveillance methods and mathematical modelling of HIV transmission dynamics | Lorna Guinness (PI); Anna Vassall | India 

Assessment of quality of life and societal costs of sequelae from bacterial meningitis in children | Ulla Griffiths (PI) | PATH Senegal | Senegal

The cost-effectiveness of rapid diagnostic tests in home-based management of malaria using artemether-lumefantrine: Cluster-randomised trials in two areas of high and low malaria transmission in rural Uganda | Kristian Hansen (PI); Siân Clarke (PI) | Ministry of Health, Uganda; DBL Centre for Health Research and Development, Denmark.

Cost-effectiveness of four different approaches to malaria diagnosis and treatment in Afghanistan | Toby Leslie (PI); Kristian Hansen; Eleanor Grieve; Amy Mikhail (PI); Mark Rowland (PI)

Assessment of the feasibility to develop, pilot and implement routine unit costing approaches in Kenya | Ulla Griffths (PI); Adrian Gheorghe | Kenya

Economic evaluation of screening & management of hypertension using digital technology in Ghana | Ulla Griffths (PI); Adrian Gheorghe | Ghana

Malaria rapid diagnostic tests in context | Shunmay Yeung (PI); Catherine Goodman (PI); Clare Chandler (PI); David Bath

Nutrition

HESA research addresses the influence of food economics and policy in nutrition and related health.

Specifically, this work relates to food pricing and its influence on consumption, the influence of trade and agricultural policy on nutrition and health, industry influence on trade policy and the management of risks associated with trade agreements, and the influence of social protection schemes on nutrition and health. These are multidisciplinary areas, drawing on our expertise in disciplines including economics, public health, epidemiology and nutrition.

We apply a range of methodological techniques, including both quantitative and qualitative analysis to examining these issues. Staff are closely linked and work in collaboration with colleagues from the Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH).

List of projects

Direct and indirect impact of food taxes and subsidies on food consumption and population health | Laura Cornelsen (PI), Richard Smith

Demand and preference for animal sourced foods in families with young children in peri-urban Nairobi | Laura Cornelsen, Barbara Haesler (RVC), Paula-Dominguez Salas (RVC), Pablo Alarcon (RVC), Eric Fevre (ILRI), Jonathan Rushton (RVC)

Do agricultural input subsidies on staples reduce dietary diversity? | Helen Walls (PI), Deborah Johnston (School of Oriental & African Studies), Richard Smith, Tayamika Kamwanja and Ephraim Chirwa (University of Malawi)

A systematic review of the impact of international food-related trade policy on nutrition and health | Helen Walls, Laura Cornelsen, Sharon Friel (The Australian National University), Richard Smith, Soledad Cuevas

Direct and indirect impact of food taxes and subsidies on food consumption and population | Laura Cornelsen (PI)

Towards a healthier and environmentally sustainable edible oil consumption profile for Asia | Richard Smith (PI); Marcus Keogh Brown | Thailand

Staff
HESA staff

Group Head:  Dr Josephine Borghi
Group Administrator:  Nicola Lord

Henning Tarp Jensen is Associate Professor in Macroeconomics & Simulation Modelling.  His current research is focussed on the construction and application of fully integrated macroeconomic and epidemiological-demographic simulation models for national and multi-regional health policy analysis, and his research spans food and nutrition-related NCDs and Alzheimer’s disease, and infectious diseases such as malaria and HIV/AIDS.
Jo Borghi is the Head of HESA and an Associate Professor in Health Economics and Policy.  Her research interests are the evaluation of health financing reforms, including mechanisms to increase health care coverage and financial protection among the informal sector and supply side incentives such as performance based financing; and the financial implications of these reforms for governments and the population, their equity effects and implementation processes.
Anne Mills is Deputy Director and Provost and Professor of Health Economics and Policy Department of Global Health and Development. Her main research interests are: issues concerned with the financing and organisation of health care in low and middle income countries; the economics of tropical disease control, especially malaria; general issues of how to encourage the use of economic thinking and analysis in decision making; and making economic evaluation techniques accessible to a non-specialist audience.
Richard Smith is Professor of Health System Economics.  His current interests are in the interaction and interface between a nation’s health system and other systems - both within the nation and between different countries through macro-economic modeling of health (care) and economic analysis of the impact of trade and trade agreements.
Tony Barnett is Professor of Social Sciences of Infectious Diseases. In addition to his work on infectious diseases, Professor Barnett also researches FGM in various parts of Africa and has provided expert witness advice in relation to these matters in courts in the UK, USA, Netherlands and Germany.
Richard Coker is Professor of Public Health.  He heads the Communicable Diseases Policy Research Group (CDRPG) based in Bangkok.  His main health systems analysis, planning for emerging infectious diseases, analyses of strategic planning, policy analyses, the development and ranking of indicators to assess performance, and the development of models to support health system functioning.  He is also Visiting Professor at the Saw Swee Hock School of Public Health in Singapore.
Lucy Gilson is Professor of Health Policy & Systems.  Her primary research interests include concerns for: equity in health and health care; governance in health systems; how health care is funded and organised; and how decisions about health and health care are made at policy, managerial and household levels.  She also has an appointment at the School of Public Health and Family Medicine at the University of Cape Town.
Kara Hanson is Professor of Health System Economics.  Her research focuses primarily on the economics of health systems in low- and middle-income countries, and the role of the private sector in health systems, and in identifying the opportunities and limitations of the private sector in improving the efficiency, quality and responsiveness of health systems.
Catherine Goodman is a Professor of Health Economics and Policy.  Her research interests include the role of the private sector in health care delivery, with a particular focus on improving access to malaria treatment; and strategies to improve the provision of services in primary health care facilities, including novel financing approaches and community accountability strategies.
Shunmay Yeung is a Clinical Associate Professor in Health Policy and Economics. Her main research focuses on using economic analysis, mathematical modelling and operational research undertaking community based studies of access to malaria treatment and diagnosis.
Dina Balabanova is an Associate Professor in Health Systems/Policy.  Her main research areas are evaluation of health systems responses to the growing burden of conditions requiring complex inputs in terms of treatment, follow-up and care processes and access to care and its determinants, health system reform in middle and low income countries, informal payments and mechanisms to increase affordability and availability of care in low resource settings.
Marcus Keogh-Brown is an Associate Professor in Economic Modelling. His current research is focused on analysing the macro-economic impact of health disorders and development of macro-economic models in various health-related contexts; and his areas of interest include infectious and communicable diseases such as SARS, influenza, antibiotic resistance and malaria and also non-communicable disease modelling and its implications for agriculture, food, the environment and trade.
Sandra Mounier-Jack is an Associate Professor in Health Policy. Her work includes studying the impact of infectious disease policies on health systems. She has evaluated the effects of introducing new vaccines, as well as HIV and TB donor programmes, on health systems. Her research interests also cover global health. She leads the LSHTM Organisational Management course aimed at clinicians.
Timothy Powell-Jackson is an Associate Professor in Health Economics. His research focuses on health economics issues in developing countries; and he has a keen interest in financial incentives, impact evaluation, the economic consequences of ill health, equity in health financing and, more broadly, the interaction between health and development.
Virginia Wiseman is an Associate Professor in Health Economics.  Her main research is investigating the cost-effectiveness of provider interventions to improve health worker practice in providing treatment for uncomplicated malaria. She is also co-Director of the UNICEF health financing training programme.
Katia Bruxvoort is an Assistant Professor in Epidemiology. Her research focuses on evaluating large-scale interventions in Tanzania to improve access and targeting of artemisinin-based combination therapies (ACTs) for malaria.
Laura Cornelsen is an Assistant Professor in Agri-Health Economics. Her research focuses on the meta-analysis of own- and cross price elasticities for food and the impact of food trade policies on health and nutrition outcomes.
Tom Drake is an Assistant Professor in Health Economics. His work focuses on the economic evaluation of interventions against infectious diseases in low and middle income countries.
Giulia Greco is an Assistant Professor in Health Economics. Her two main areas of interests are the economic evaluation of public health programs in developing countries and the applicability of the capability approach for assessing quality of life.
Mishal Khan is an Assistant Professor in Public Health. She is experienced in epidemiological and operational research and policy analysis. Mishal’s main research areas include gender inequalities, health systems strengthening, public-private partnerships and tuberculosis control and she has led large studies in Pakistan, Bangladesh, China, Myanmar and Cambodia. Her interest is in developing locally appropriate, sustainable interventions and policy measures to improve health.
Catherine Pitt is an Assistant Professor of Health Economics. She coordinates economic evaluation work across the group and pursues both methodological and applied research primarily in cost and cost-effectiveness analysis, but also in tracking and understanding donor aid. Her work focuses on Sub-Saharan Africa, on health issues including malaria, maternal and newborn health, and neglected tropical diseases, and on community health workers, community-level delivery strategies, and public health interventions.
Melisa Martinez-Alvarez is an Assistant Professor in Health System Economics. Her current research projects explore health systems with a specific focus on reproductive, maternal, newborn and child health in China, Tanzania and Malawi.
James Rudge is an Assistant Professor in Infectious Disease Epidemiology. His work focuses on the emergence and spread of infectious diseases in Southeast Asia, and the capacity of health systems to respond and he is interested in using a multi-disciplinary approach to addressing policy-relevant research questions on the epidemiology and control of infectious diseases, particularly zoonoses.
Andreia Santos is an Assistant Professor in Health Economics. She is currently a member of the Merck for Mothers core research team and involved in the randomised controlled trial team that investigates the effectiveness and cost-effectiveness of interventions for the control of malaria in Tanzania.
Aurelia Lepine is an Assistant Professor in Health Economics. Her background is in development economics and applied microeconometrics. Her research is on health financing, intra-household allocation, impact evaluation of health policies and HIV/AIDS.
Helen Walls is an Assistant Professor. Her main research focus is the structural influences on food systems and nutrition, particularly the impact of international trade and agricultural policy. She is also affiliated with the Leverhulme Centre for Integrative Research on Agriculture and Health.
Sarah Tougher is an Assistant Professor in Pharmaceutical Policy and Economics. Her current research focuses on access to medicines for malaria in sub-Saharan Africa.
David Bath is a Research Fellow in Health Economics. His current research focuses on the economic evaluation of rapid diagnostic tests for malaria in both the public and private sectors.
Sadie Bell is a Research Assistant in Public Health Evaluation. She is currently completing a PhD exploring the accessibility and acceptability of HIV services in the UK to adults receiving a positive HIV diagnosis at age 50 years and over. Sadie is working on projects to explore vaccination programme delivery in the UK, with a particular focus on migrant populations.
Tracey Chantler is a Research Fellow with expertise in qualitative research methodologies, ethics and immunisation. Her research focuses on questions related to organisation and delivery of immunisation programmes, vaccine demand and the public interface with research and health technologies.
Soledad Cuevas is a Research Fellow in Macroeconomic Modelling and Health. Her current research is on integrated health, economic and sustainability analysis of food policy and macroeconomic modelling. She is currently completing a PhD on nutritional, economic and environmental aspects of the edible oils sector in India. Her research interests include the study of socioeconomic and structural determinants of health, as well as the integrated analysis of health and sustainability goals in policy making.
Camilla Fabbri is a Research Fellow in Health Economics working as part of the team evaluating the social franchise programme (Matrika) in Uttar Pradesh, India. Her current research focuses on evaluating the use of health information to increase supply and demand for health care services.
Silke Fernandes is a Research Fellow in Health Economics. Her current research is mainly concerned with economic evaluations of malaria in pregnancy interventions in Africa and Papua New Guinea with a particular focus on evaluating the cost effectiveness of new prevention strategies. Her other interests are economic evaluations of maternal and child health interventions, the economic consequences of low birth weight as well as economic evaluation methodology, all with a focus on low and middle income countries.
Meenakshi Gautham is a Research Fellow in Health Systems and Policy Analysis. Her research interests include the private health sector with a special focus on rural health services and informal providers. Her current research is generating evidence for policymaking around the private health sector in maternal health, public private partnerships, and the drivers of antibiotic use in the informal private sector in rural India.
Manon Haemmerli is a Research Fellow in Health Economics within the Maternal healthcare markets Evaluation Team (MET) at LSHTM. She works on the case studies of three social franchises models in India and Uganda, which aim to improve access to and quality of maternal health services in these settings.
Erling Høg is a Research Fellow in Social Science. His research focuses on health culture, rights and politics, rooted in his training in anthropology, ethnography, human rights, bioethics, development studies and social policy. He is primarily interested in anthropology of infectious diseases, currently conducting ethnographical research of poultry value chains and avian influenza.
Frida Kasteng is a Research Fellow in Health Economics.  Her current research focuses on the economic evaluation of initiatives to increase the coverage and quality of integrated community case management (iCCM) of common childhood diseases - malaria, pneumonia and diarrhea - in relation to ongoing scaling up of iCCM in Mozambique and Uganda.
Jessica King is a Research Fellow in Health Economics and Impact Evaluation. Her current research focuses on evaluating a quality improvement programme for private health facilities in sub-Saharan Africa.
Roxanne J. Kovacs is a Research Assistant in Health Economics.  Roxanne holds a Bachelors in Philosophy, Politics and Economics from the University of York and a Masters in International Development from Sciences Po Paris.  Roxanne currently works on issues related to health worker performance in low and middle-income countries. She is interested in a number of research methods including economic experiments, direct clinical observations and standardised patients.
Frederick Martineau is a Research Fellow in Health Systems. He is currently completing a PhD investigating the health system consequences of user fee exemption policies, focusing particularly on Sierra Leone. A medical doctor by background, specialising in paediatrics, he previously worked for the NHS for five years, as well as in Sierra Leone supporting government child health services as a Medical Coordinator for an NGO. His main research interest is in mixed-methods health system research in low and middle income countries, in particular interventions to improve access to health care.
Ben Palafox is a Research Fellow in Pharmaceutical Policy and Economics. His current research areas of interest include pharmaceutical policy and the evaluation of public health interventions.
Matthew Quaife is a Research Fellow in Health Economics. His current research focuses on HIV prevention and maternal & child health, using stated preference and behavioural economic methods.
Diana Quirmbach is a Research Fellow in Health Economics. Her current work focuses on the direct and indirect impacts of diet-related policies such as food taxes and the regulation of portion sizes on food and beverage consumption in the UK. In addition to this, Diana is a specialist in health behaviours, outcomes and policies in the transition countries of Eastern Europe. She has a particular interest in the effect of anti-smoking legislation on cigarette consumption in the Russian Federation.
Neha Singh is a Research Fellow in Health Systems and Reproductive, Maternal, Newborn and Child Health. Her current work focuses on mixed-methods health policy and systems research to improve women’s and children’s health in humanitarian crises settings and in low- and middle-income countries.
Sergio Torres Rueda is a Research Fellow in Health Economics. His research interests include: markets and supply chains for antiretrovirals and antimalarials in sub-Saharan Africa, and the effect of vaccine introductions on health systems in sub-Saharan Africa and Latin America. 
Research Degree students linked to HESA
Research Degree students linked to HESA
Melisa Martinez-Alvarez (completed) 
An evaluation of Development Assistance for Health in Tanzania: aid effectiveness principles, relationships and their influence on health sector financing
Ana Amaya 
Aid (in)dependence? Promoting long term sustainability in the response to HIV/AIDS - the case of the Global Fund in Peru (DrPH project)
Laura Anselmi
Equity and efficiency in health sector public financing: a study of resource allocation in Mozambique
Maria Bertone
The remuneration structure of health workers: effects on incentives, performance and accountability in Sierra Leone
Katia Bruxvoort
Cluster-randomized trial of text message reminders to retail staff of appropriate practices for dispensing artemether-lumefantrine in drug shops in Tanzania: effect on dispenser knowledge and patient adherence
Antonia Dingle
Equity of access to reproductive and maternal health services in Cambodia: status, measures, determinants and interventions
Luke Harman
Voucher subsidy programmes in low-income settings: learning lessons from agriculture and health (working title)
Justine Hsu
Akudo Ikpeazu
Evaluating the effects of Global Fund grants on human resources for health in Nigeria.
Rachel Irwin (completed)
Global health diplomacy and the World Health Organisation: a social drama
Jin Xu
China's policies on combating "Counterfeit" medicines: navigating between economic and public concerns.
Judith Kabajulizi
Macroeconomic implications of health sector reforms: a computable general equilibrium analysis of Uganda
Mahoko Kamatsuchi 
Accelerating targeted child survival interventions through integrated child health events
Yuka Karasawa
Mary Kawonga 
Dominic Kemps
Yoko Laurence
Yoko's PhD will determine the cost-effectiveness of alternative strategies for screening and managing patients with concurrent tuberculosis and diabetes mellitus.
David G. Lugo-Palacios
PhD research: Analysis of the effectiveness of primary care services and hospital efficiency in Mexico
Lindsay Mangham-Jefferies 
Providers’ knowledge, preferences and practices in treating patients with suspected malaria in Cameroon and Nigeria
Christine Michaels
Exploring youth preferences for an integrated package of sexual and reproductive and HIV services in rural Malawi
Corina Monagin (completed)
Case Study: How are perceptions of risk in wet markets informing policy implementation of emerging infectious disease in Guangdong, China
Gemini Mtei (completed)
Health care financing progressivity and household risk protection in the context of health system financing reforms in Tanzania
Minh Nguyen Hoan
Chima Onoka
Economic analysis of the market for health insurance in Nigeria: examining the roles of health maintenance organisations (HMOs) and linked health care providers
Catherine Pitt
Catherine's PhD addresses methodological issues arising in health economic evaluations and is focussed specifically on the challenges around measuring and valuing health worker time use in developing countries. 
Midori Sato
Exploring managers' experiences in implementing the Free Health Care Policy in Nepal: which organisational factors influence the implementation of the user-fee abolition policy?
Gillian Stynes (completed)
The aim of the PhD is to characterise the relationship between professional education decisions and migration decisions amongst pharmacists.
M Ali Syed
Suriwan Thaiprayoon
Health and trade negotiations: a case study of the Thai Ministry of Public Health
Noppakun Thammatacharee
Can a disease management approach facilitate the inclusion of high-cost conditions in a benefit package? The case of renal replacement therapy in Thailand
Benjamin Tsofa
Examining the effects of political decentralization on governance for health sector planning and budgeting in Kenya
Inthira Yamabhai
Health implications of patient protection for pharmaceuticals: a case study of Thailand
May Yeung
Factors associated with uptake of influenza vaccine in people aged 50 to 64 years in Hong Kong: a case-control study