London School of Hygiene & Tropical Medicine

HSR2020: Presentations, posters, sessions

Researchers from the Department of Global Health and Development are participating at the 6th Global Symposium on Health Systems Research. 

• View the full HSR2020 programme

Sunday 8 November

Using standardised patients to measure quality of care in low- and middle-income countries 

Time: 9:00-11:30am Gulf Standard Time (GMT +4)

Type: Skills Building session

Presenters: 

• Virginia Wiseman (London School of Hygiene & Tropical Medicine, UK; Kirby Institute, University of New South Wales, Australia)
• Ada Kwan (University of California, Berkeley & University of California, San Francisco, USA) 
• Jessica King, London School of Hygiene & Tropical Medicine, UK)
• Ronelle Burger (Stellenbosch University, South Africa) 
• Duane Blaauw (University of the Witwatersrand, South Africa) 
• Peter Mugo (Kenya Medical Research Institute, Kenya) 
• Xiaohui Wang (Lanzhou University, China)
• Luh Putu Lila Wulandari (University of New South Wales, Australia) 
• Kara Hanson (London School of Hygiene & Tropical Medicine, UK)
• Mylène Lagarde (London School of Economics, UK) 
• Roman Xu (Sun Yat-sen University, China)
• Jishnu Das (Georgetown University, USA)

Summary: In this session, we will introduce the standardised patient (SP) methodology, which is the current state-of-the-art method to assess quality of care in low- and middle-income country settings. Through presentations, quizzes, work sessions, and a panel, we will engage participants to think through the current state of the method, as well as its research advantages and implementation challenges.  

Policy and systems research

Time: 3:30pm-5:30pm Gulf Standard Time (GMT +4)

Type: Skills building session

Presenters: 

• Dr Gina Teddy
• Prof Lucy Gilson
• Dr Dina Balabanova
• Dr Zulkarnain Karim
• Dr Meike Schleiff
• Dr Ayat Abu-Agla
• Prof Anthony Zwi
• With the HSG Thematic Working Group Teaching and Learning Health Policy and Systems Research (HPSR)

Summary: The ‘Teaching & Learning Clinic’ will focus on strategies to leverage innovative HPSR models of educational practice and promote capacity strengthening, including: a) interactive teaching approaches for HPSR, b) accelerating national HPSR development: adapting HPSR competency frameworks, c) educational research for HPSR; and d) innovative student assessment practice.

Managing global health research collaborations

Time: 6:00-9:00pm Gulf Standard Time (GMT +4)

Type: satellite session, organised session, oral, poster

Presenters: 

• Sassy Molyneux (KEMRI-Wellcome Trust)
• Nadia Tagoe (KEMRI-Wellcome Trust)
• Sam Kinyanjui (KEMRI-Wellcome Trust)
• Justin Pulford (Liverpool School of Tropical Medicine)
• Joanna Raven (Liverpool School of Tropical Medicine)
• Bassirou Bonfah (Centre Suisse de Recherches Scientifiques en Cote d’Ivoire)
• Lucy Gilson (University of Cape Town)

Summary: Managing research collaborations requires navigating complex challenges, including aligning diverse interests and maintaining essential relationships. This session will provide a forum for participants to share experiences and resources, and to explore underlying influences.  Participants will build skills in developing strategies to resolve managerial challenges and to negotiate the multiple dimensions of collaboration management.

Monday 9 November

Meet the editors 2020: Exploring conflict of interest in academic publishing of health systems research

Time: 4:00-6:00pm Gulf Standard Time (GMT +4)

Type: Organised session

Chair: 

• Kara Hanson (LSHTM)

Presenters: 

• Virginia Wiseman (LSHTM)
• Seye Abimbola (University of Sydney)
• Zoe Mullen (Lancet Global Health)
• Ala Lorena Ruano (International Journal for Equity in Health)
• Stephen Hodgins (Global Health: Science and Practice)
• Michael Reich (Health Systems & Reform)
• Margaret Saunders (Health Affairs)

Summary: Conflict of interest (COI) declaration is an important part of publication. Purposeful failure to disclose COI is a form of misconduct and different journals and scientific communities will have their own ways of dealing with this. These can range from re-reviewing a paper through to its complete withdrawal. Financial relationships are the most easily identifiable COI and the most likely to threaten the credibility of the journal and the authors. However, conflicts can occur for many other reasons such as personal or working relationships, academic competition, etc. COIs are not always clear cut and sometimes authors, reviewers and editors fail to fully recognise and in turn, disclose them. In this session we seek to provide more clarity around COI in academic publishing including the different COI policies and any gaps that need to be addressed to improve the trustworthiness and transparency of health systems research.

Tuesday 10 November

How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations

Time: 8:05-8:50pm Gulf Standard Time (GMT +4)

Type: Poster

Presenter: 

• Tim Chege

Co-authors:

• Francis Wafula
• Eric Tama
• Irene Khayoni
• Dosila Ogira
• Gilbert Kokwaro
• Njeri Mwaura
• Catherine Goodman

Summary: Kenyan has piloted a set of innovative regulatory reforms, including a joint health inspection checklist incorporating standards from eight regulatory agencies, increased inspection frequency, and public display of inspection results. We analysed the full economic costs of the development, implementation and scale-up of these innovations.

Wednesday 11 November

Sharing health data and information across borders: lessons from Southeast Asia

Time: 5:45pm-7:00pm Gulf Standard Time (GMT +4)

Type: Oral presentation

Presenter: 

• Marco Liverani

Partners:

• Dr Teng Srey (Ministry of Health, Cambodia)
• Dr Le Minh Sat (Ministry of Science and Technology, Vietnam)

Summary: Based on fieldwork in Cambodia and Vietnam, this presentation will discuss factors that may affect the transfer, exchange, and use of public health data and expertise across borders for infectious disease surveillance.

Engaging social, economic and environmental forces (2) – Analyzing immunization equity dimensions in supply chain design in Pakistan

Time: 7:05-7:50pm Gulf Standard Time (GMT +4)

Type: Poster

Presenter: 

• Mariam Zameer

Authors:

• Mariam Zameer (VillageReach)
• Nora Philips-White (VillageReach)
• Dr Olamide Folorunso (UNICEF)
• Rachel Belt (Gavi, the Vaccine Alliance)
• Dr Hamidreza Setayesh (Gavi, the Vaccine Alliance)
• Naeem Asghar (Pakistan EPI, Federal Ministry of Health)
• Dr Arshad K. Chandio (Pakistan EPI, Federal Ministry of Health)

Summary: Distribution of vaccines and supply chain design is often based on cost efficiency; however, this paper presents illustrates applying an equity lens to design. It describes how equity was considered during an immunization supply chain design in Pakistan, by analyzing 114 districts with 6,400 health facilities, and how a similar approach would be useful for COVID-19 vaccine.

Thursday 12 November

Journal launch of HPP special issues: Early-career women mentorship

Time: 1:05-1:50pm Gulf Standard Time (GMT +4)

Type: Networking session

Presenters: The session will be co-moderated by Aku Kwamie (the Alliance) and Nanuka Jalaghonia (HSG Secretariat). Virginia Wiseman will be taking part on the panel.

Summary: In July 2019, HSG and the Alliance for Health Policy and Systems Research (the Alliance), in partnership with Health Policy and Planning, launched the Women Mentorship program. This follows the Alliance’s initial mentorship program to increase the numbers of early-career women based in low- and middle-income countries working in HPSR, who are interested to publish their research for the first time and in need of guidance to successfully navigate the manuscript submission and acceptance process.

Innovations in implementation research: launch session of journal special issue

Time: 1:05-1:50pm Gulf Standard Time (GMT +4)

Type: Launch session

Presenters: 

• James Hargreaves (LSHTM, supplement editor)
• David Peters (JHU, Board Chair Alliance HPSR)
• Kabir Sheikh (AHPSR, supplement editor)
• Jeanette Vega (UC Christus)
• Soumya Swaminathan (Chief Scientist, WHO)
• Ilona Varallyay

Summary: Innovations in Implementation Research in Low- and Middle-Income Countries” showcases innovations in implementation research that are enhancing its value, shaping its development, and fueling the growth of the field. Specifically, it focuses on innovations in LMIC contexts - where IR has the greatest potential to have impact. The supplement is a joint production of Health Policy and Planning and the Alliance for Health Policy and Systems Research.

Deconstructing the Patient Pathway to (In)Effective Care for Hypertension: an Application to the Philippines

Time: 1:05-1:50pm Gulf Standard Time (GMT +4)

Type: Poster session: Engaging technological, data and social innovations

Presenter: 

• Dina Balabanova (LSHTM, on behalf of the RESPOND project)

Summary: From the politics, corruption and corporate interference track. 

Does profit drive the provision of unnecessary care? A cross-sectional analysis of overprovision in for-profit and faith-based Tanzanian health facilities

Time: 1:05-1:50pm Gulf Standard Time (GMT +4)

Type: Live poster

Presenter: 

• Jessica King

Co-authors:

• Tim Powell-Jackson
• Christina Makungu
• Catherine Goodman

Summary: We developed a framework to conceptualise the major harms of unnecessary care: economic, public health and clinical. Using standardised patients, we measured overprovision in 227 Tanzanian private health facilities. Contrary to our hypothesis, profit status was not universally associated with overprovision.

Posters: Sunday 8 November - Thursday 12 November

Fostering sustainable scalability of technological innovations in India and Nigeria

Presenters: 

• Neil Spicer
• Deepthi Wickremasinghe
• Yashua Alkali Hamza
• Nasir Umar
• Tanya Marchant
• Joanna Schellenberg

Summary: A qualitative study exploring sustainable scale-up of donor-funded maternal and newborn health technological innovations targeting rural populations in Uttar Pradesh, India and Gombe, Nigeria. The poster explores: innovation attributes contributing to sustainable scale-up; actions promoting sustainable scale-up of the innovations; contextual factors enabling and inhibiting sustainable scale-up.

Enhancing the social purpose and values of healthcare providers: A case study of appropriate antibiotic use in Pakistan and Cambodia

Presenters: 

• Mishal Khan
• Sonia Rego
• Rumina Hasan
• Johanna Hanefeld
• Sovanthida Suy
• Sothavireak Bory
• Anna Durrance-Bagale
• Zia Sultana
• Vonthanak Saphonn

The presenters are from LSHTM, Aga Khan University (Pakistan), University of Health Sciences (Cambodia). 

Summary: We analysed the professionalism of healthcare providers (HCP) and how this relates to their professional education, using inappropriate dispensing of antibiotics as a case study, in two LMIC with high antibiotic consumption: Pakistan & Cambodia. We found that qualified HCP were not always more responsible gatekeepers of access to antibiotics than unqualified HCP. We identified 4 areas in which strengthening HCP professional education is critical.

Adaptive work in the primary health care response to domestic violence in occupied Palestinian Territory: exploring the role of context

Presenters: 

• Loraine J. Bacchus (main presenter)
• Abdulsalam Alkaiyat
• Amira Shaheen
• Ahmed S. Alkhayyat
• Heba Odwa
• Rana Halaseh
• Ibrahim Jeries
• Gene Feder
• Rihab Sandouka
• Manuela Colombini

Summary: HERA (Healthcare Responding to Violence and Abuse) trained providers in two primary health care clinics in the West Bank to identify and respond to women experiencing domestic violence. The evaluation explored intervention-context interactions that affected fidelity to the intended HERA model. Providers and women negotiated contextual constraints through adaptive work.

Leaving no one behind: Identifying the social and material factors influencing retention among community health workers in Ethiopia

Presenters: 

• Nikita Arora
• Kara Hanson
• Neil Spicer
• Dorka Woldesenbet Keraga
• Abiy Seifu Estifanos
• Matthew Quaife

Summary: Poor motivation and retention of community health workers (CHWs) remains a challenge in Ethiopia. Using qualitative methods, we identified a number of material and social motivational factors driving their labour market choices in Ethiopia. In addition to material incentives, our findings report that CHWs are socially motivated workers and thus policy interventions that also appeal to their social needs could represent a more cost-effective way of improving their retention.

Resilience under occupation in Palestine: a qualitative study of mental health responses in the Gaza Strip and the West Bank

Presenters: 

Main presenter and co-authors, including partners: 

• Rosalyn Hoppe (LSHTM, Department of Global Health and Development, UK)
• Samah Jabr (Mental Health Unit, Ministry of Health, Palestine)
• Natasha Howard (LSHTM, Department of Global Health and Development, UK) (National University of Singapore, Saw Swee Hock School of Public Health, Singapore)

Summary: Examines mental health responses in the Gaza Strip and the West Bank (occupied Palestinian territories).

Implementing pro-poor universal health coverage: is quality of care a game changer?

Presenters: 

• Manon Haemmerli
• Augustine Asante
• Hasbullah Thabrany
• Virginia Wiseman

The presenters are from London School of Hygiene and Tropical Medicine (London, UK), University of New South Wales (Sydney, Australia), University of Indonesia (Jakarta, Indonesia). 

A qualitative examination of health system governance and adaptation under three areas of military control in Syria

Presenters: 

• Dr Yazan Douedari

Co-authors:

• Mervat Alhaffar
• Mohamed Twaish
• Samer Jabbour
• Aula Abbara
• Natasha Howard

Summary: Health system governance support in one or more area of military control in Syria could start by strengthening accountability and participation, preferably led by local health authorities as these remain the most legitimate governance actors in all areas. Support efforts should start now, to nurture burgeoning governance initiatives that could mature post-conflict.

The choices and consequences of seeking care for chronic conditions for disadvantaged populations in Malaysia and the Philippines

Time: 8:05-8:50pm Gulf Standard Time (GMT +4)

Type: Poster session: Engaging Social, Economic and Environmental forces

Presenter: 

• Benjamin Palafox (LSHTM, on behalf of the RESPOND project)

Summary: From the accountability and social voice track. 

Wednesday 25 November

Achieving progress on anti-corruption and accountability: towards policy options that recognise power and politics

Time: 7:00-9:00pm Gulf Standard Time (GMT +4)

Type: Skills building session

Presenters: 

• Dr Dina Balabanova
• Prof Martin McKee
• Prof Mushtaq Khan
• Dr Eleanor Hutchinson
• Blake Angell
• Dr Nahitun Naher
• Mir Raihanul Islam
• Prof Syed Masud Ahmed
• Dr Peter Binyaruka
• Mary Ramesh
• Prof Obinna Onwujekwe
• Prince Agwu
• Chukwudi Nwokolo
• Rachel Cooper
• Transparency International
• Dr Pallavi Roy
• Dr Ntuli Kapologwe

Summary: Corruption and poor accountability undermine UHC and social justice, however good governance approaches have had limited success. We explore the individual, institutional and structural drivers of absenteeism and informal payments in Bangladesh, Tanzania and Nigeria. We discuss anti-corruption policy options aligned with provider choices (in discrete choice experiments) and political and power configurations.

Wednesday 9 December

Addressing quality in private facilities – an RCT of the impact of SafeCare on clinical quality in Tanzania

Time: 5:00-6:15pm Gulf Standard Time (GMT +4)

Type: Oral

Presenter: 

• Catherine Goodman

Co-authors:

• Jessica King
• Timothy Powell-Jackson
• Christina Makungu
• Abdallah Mkopi
• Nicole Spieker

Summary: The SafeCare model aims to improve service delivery across healthcare facilities, using a standards-based approach, comprising assessments, mentoring, training and access to loans.  We evaluated the impact of SafeCare on clinical quality of care, using a cluster randomised controlled trial covering 237 faith-based and for-profit private facilities in Tanzania.

Does management matter for quality of care? Evidence from Tanzania’s private healthcare sector

Time: 5:00-6:15pm Gulf Standard Time (GMT +4)

Type: Oral

Presenter:

• Jessica King

Co-authors:

• Timothy Powell-Jackson
• Christina Makungu
• Catherine Goodman
• Matthew Quaife

Summary: We measured quality of care and management in 227 Tanzanian private health facilities, and found better managed facilities were more likely to provide correct treatment in accordance with guidelines and comply with IPC practices. This provides the impetus to develop management interventions and evaluate their effects on health service delivery. 

Wednesday 10 February

Do health facility performance scorecards encourage accountability? A process evaluation of an innovative public reporting mechanism in Kenya

Time: 1:00-2:15pm Gulf Standard Time (GMT +4)

Type: Oral

Presenter: 

• Irene Khayoni

Co-authors:

• Francis Wafula (Strathmore)
• Eric Tama (Strathmore)
• Tim Chege (Strathmore)
• Dosila Ogira (Strathmore)
• Gilbert Kokwaro (Strathmore)
• Njeri Mwaura (World Bank)
• Catherine Goodman (London School of Hygiene and Tropical Medicine)

Summary: Public reporting mechanisms on facility performance seek to empower patients and enhance accountability, but are rarely used in the global south. Kenya has piloted an innovative system of Joint Health Inspections, which included display of performance scorecards at healthcare facilities. We explored the implementation and perceived impact of these publicly displayed scorecards.

Posters: Dates TBC

Prevalence of poor mental health among health workers in low- and lower-middle income countries: A scoping review

Presenters: 

• Julia Lohmann
• Denny John
• Aso Dzay

Summary: In trying to estimate the impact of COVID on the mental health of health workers, researchers in most low- and lower-middle income countries face challenges regarding high-quality baseline data. This review highlights availability and gaps as well as methodological strengths and weaknesses in the current literature.

Does Performance-based Financing erode health workers’ intrinsic motivation? Findings from Malawi and Burkina Faso

Presenters: 

• Julia Lohmann
• Adamson Muula
• Jean-Louis Koulidiati
• Serge Somda
• Paul Jacob Robyn
• Manuela De Allegri

Summary: A frequently discussed but yet little researched potential unintended consequence of Performance-based Financing is “intrinsic motivation crowding out”. In Malawi and Burkina Faso, we found no evidence that PBF negatively impacts intrinsic motivation overall. We present qualitative findings as to the likely reasons.