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Health Care Delivery in Low Resource Setting

Health care delivery in low resource settings remains a challenge. There is increasing prevalence of long term conditions such as diabetes and hypertension and their complications along with the continuing challenges from HIV, TB, malaria and other infectious disease. Health systems in low and middle income countries lack capacity in terms of skilled health professionals and management. We work with colleagues from sub-Saharan Africa and South Asia to explore and innovate in health care delivery taking into account the ethical and social dimensions of how new services are provided.

Current projects include:

Implementing comprehensive, integrated, community-based health care for under-served, vulnerable communities in South Africa: A practical, evidence-informed model – the Batlhokomedi (Carers) study:

South Africa is currently shifting from multiple NGO-led, donor-funded Community Health Worker (CHW) programmes to a national government programme, and is intending to scale up teams of CHWs to provide comprehensive, integrated, community-based care. In this study, we are developing an evidence-informed CHW service model based on the key elements of the South African CHW policy, local circumstances and constraints with particular reference to affordability, and an understanding of the literature on barriers and facilitators. We are implementing and evaluating this model (before and after design) in two pilot sites in the Sedibeng Health District, Gautang, South Africa. The findings of the study will provide practical lessons for implementing a CHW programme at scale in South Africa and similar settings in other low and middle income countries. This study is funded by the UK Medical Research Council. Research is led by Jane Goudge, Centre for Health Policy, University of the Witwatersrand and Frances Griffiths, Warwick Medical School.

NIHR Global Health Research Unit on Improving Health in Slums at the University of Warwick

We are mapping access to healthcare in slums of Nigeria, Kenya, Bangladesh and Pakistan. From these findings we will develop innovation in healthcare provision to improve health in slums, taking account of social and ethical implications.

Healthcare workers’ perceptions and experience on using mHealth technologies to deliver primary healthcare services: qualitative evidence synthesis

Review registered with the Cochrane Effective Practice and Organisation of Care Group. Review findings have been used in the WHO Digital Health Interventions Guidelines 2019.

Selected recent publications:

Watkins, Jocelyn, Goudge, Jane, Gómez-Olivé, F. Xavier, Griffiths, Frances. 2018. Mobile phone use among patients and health workers to enhance primary healthcare : a qualitative study in rural South Africa. Social Science & Medicine, View

Anstey Watkins, Jocelyn, Goudge, Jane, Gómez-Olivé, F. Xavier, Huxley, Caroline J., Dodd, Katherine, Griffiths, Frances. 2018. mHealth text and voice communication for monitoring people with chronic diseases in low-resource settings : a realist review. BMJ Global Health, View

Taylor C, Griffiths, F, Lilford R, 2017 The affordability of comprehensive Community Health Worker programmes in rural sub-Saharan Africa. BMJ Global Health. 2017 Sep 25;2(3):e000391. doi: 10.1136/bmjgh-2017-000391. eCollection 2017.

Anstey Watkins, J., Wagner, F., Gómez-Olivé, X. Wertheim, H., Sankoh, O., and Kinsman, J. (2019). Rural South African Community Perceptions of Antibiotic Access and Use: Qualitative Evidence from a Health and Demographic Surveillance System Site. American Journal of Tropical Medicine and Hygiene. 100(6): 1378-1390. (DOI: https//