Health

Individuals, communities and societies face a number of health challenges associated with rapid and accelerating social, economic, demographic and ecological change. These have been manifested in major outbreaks of infectious diseases, a growing problem of chronic, non-communicable disease and the continued existence of large numbers of people living in poverty and vulnerable to a wide variety of potential shocks. There is the growing realisation that the world's population is interconnected and health challenges are faced by rich and poor countries alike.

A home care worker from the Mulanje Mission Hospital, Malawi, crushes antibiotics before applying them to the tumour on Patrick Mandeule's leg. Credit
Kieran Dodds / Panos

IDS research and knowledge activities to address these challenges on health revolve around resilience, accountability, urbanisation and digital innovation for health system transformation.

1. Resilience

The speed of economic, social, technological and ecological change is likely to accelerate in the future. This will make the contribution of the health sector to social resilience increasingly important. The Ebola epidemic in West Africa and Zika in Latin America have demonstrated the importance of an effective and resilient health system in protecting people against catastrophic health shocks. The transmission of infections from animals to humans and the growing challenge of resistance to antibiotics demonstrate the need to take into account the wider social and ecological challenges in designing intervention strategies to build resilient health systems.

2. Accountability

Health inequities - that is, unfair and avoidable difference in health associated with poverty, gender inequalities and other factors that marginalise large numbers of people. Innovative approaches are needed that recognise changing roles of states, private actors and community and social organisations, and the interaction between local, national and global levels. If existing weaknesses in governance and accountability arrangements are not tackled, the effort to achieve Universal Health Coverage as part of the fairer world envisaged in the UN's 2030 Agenda for Sustainable Development is unlikely to be achieved.

3. Urban

With more than half of humanity now living in urban areas, and with the urban population in South Asia and sub-Saharan Africa, two of the world's poorest regions, set to double in the next two decade, there is an urgent need for strategies that enable people to live safely in these rapidly growing cities. These include the provision of decent hygiene and sanitation, context-appropriate forms of disease containment, measures to ensure access to safe, effective and affordable medical care and the recognition of the peri-urban poor as legitimate citizens.

4. Digital innovation

Information and Communication technologies (ICTs) are going to have a major impact on health and health systems in the near future. To ensure that everyone (including the very poor) benefits from this new technology, it is vital that those designing new applications, people responsible for health systems and social researchers come together to explore the opportunities and potential challenges, especially for low- and middle-income countries (LMICs).

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Photo of Alex Shankland, IDS Research Fellow More details

Photo of IDS researcher Amber Huff More details

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Aparna John, DPhil Candidate, Health and Nutrition Cluster, Institute of Development Studies More details

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Photo of Cathérine Müller, Vulnerability and Poverty Reduction research team More details

Photo of Catherine Holley,  Information Officer for the Human Development Resource Centre (HDRC) in IDS Knowledge Services. More details

Photo of Gerry Bloom, Research Fellow of the Knowledge Technology and Society team More details

Photo of Hayley MacGregor More details

Photo of Henry Lucas from Knowledge Technology and Society Team More details

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Photo of Jackie Shaw, Research Fellow in the Participation research cluster More details

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Leah Murphy is the Health and Education Convenor with the Knowledge Services More details

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Photo of Nick Nisbett, IDS Research Fellow in the Vulnerability and Poverty Reduction team More details

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Accountability for Health Equity Programme

Since the publication of the 2004 World Development Report a range of different attempts have been made to make the design, prioritisation and delivery of health services more accountable to different stakeholders. However, complex politics and power dynamics can limit or skew people's abilities to access services or hold them to account, particularly for poor and marginalized people. More details

AllAfrica and IDS development reporting initiative

IDS and AllAfrica have teamed up to produce and distribute compelling multi-media content on critical issues for Africa’s future, as part of a development reporting initiative. More details

Assessing the Impact of Conflict and the Effects of WFP Humanitarian Interventions on Moderate Acute Malnutrition and Other Developmental Outcomes in Mali

This project is a multidisciplinary research partnership involving IFPRI, PCD, IDS and WFP which builds on a unique pre-crises baseline conducted in early 2012 to provide rigorous evidence for policymakers on the effects of humanitarian interventions by WFP on child malnutrition in in Mali. More details

Bridging the Gap Evaluation

This is a mid-term evaluation of the Bridging the Gaps Programme a global program operating in 16 countries across all the main key populations at-risk for HIV. More details

Changing health and welfare in China and the UK

The project looks at the changing role of state and non-government actors in providing social services in China’s rapidly evolving welfare regime, and aims to promote mutual learning between officials and researchers in China and the UK. Despite historical, social and institutional differences, there is a degree of similarity in strategies emerging. More details

Childhood Vaccination in West Africa

Vaccines for children are currently high on international policy, aid and funding agendas, as a major promised means to meet the Millennium Development Goals. Yet major challenges have emerged in ensuring effective coverage and dealing with public anxieties. More details

Childhood Vaccination: Science and Public Engagement

Vaccines for children are currently high on international policy, aid and funding agendas, as a major promised means to meet the Millennium Development Goals. Yet major challenges have emerged in ensuring effective coverage and dealing with public anxieties. More details

China Health Development Forum

The China Health Development Forum is an informal association coordinated by the Chinese Health Economics Institute (CHEI) and IDS. More details

Citizen Engagement Programme (CEP)

An empowerment and accountability programme aimed at improving the quality of health and education services in Mozambique. More details

Dynamic Drivers of Disease in Africa Consortium

A STEPS-led consortium of researchers aiming to advance understanding of the connections between disease and environment in Africa, focusing on animal-to-human disease transmission.. More details

Ebola: Lessons for development

IDS researchers argue that there is an urgent need to look beyond the immediate, on-the-ground concerns of disease control and containment to consider the bigger and broader questions about international development. More details

Ensuring Health Care for the Rural Poor: alternative approaches in China and Vietnam

A comparative study of rural health care services undertaken in collaboration with partners in Vietnam and China. More details

Final External Review of the Cross-Cutting Disability Research Programme

This independent external review aimed to determine the extent to which the three year Cross-Cutting Disability Research Programme (CCDRP) in Nepal, India, Zambia, Uganda, and Kenya, has met its expected impact, outcome and outputs. More details

Future Health Systems Research Programme Consortium

Future Health Systems is a research consortium working to improve access, affordability and quality of health services for the poor. More details

Health Systems Global Communications

IDS is working with Health Systems Global (HSG) to develop communications, share messages and engage with its members and the global community. More details

Human Development Innovation Fund

The Human Development Innovation Fund (HDIF) identifies and supports innovations that have the potential to create social impact in education, health and WASH (water, sanitation and hygiene) across Tanzania. More details

Independent Evaluation of the Reduction of Maternal and Neonatal Mortality in Kenya Programme

An evaluation of a programme in Kenya to avert maternal and neonatal deaths through nationwide life saving skills training for health professionals, and integrated health system strengthening in selected counties. More details

Interactions Eldis Website

Interactions is an IDS-hosted interactive online resource on Empowering Women and Girls, featuring real-time research and analysis. The website features up-to-the minute research findings and policy analysis on gender-based violence, urban health and unpaid care work from IDS and partners More details

Livestock, Livelihoods and Health

Livestock, Livelihoods and Health is an interdisciplinary research programme exploring diseases that can be transmitted from wild or domesticated animals to people (known as zoonoses). More details

Myanmar Pig Partnership

The Myanmar Pig Partnership is focusing on the risks of zoonotic disease emergence associated with the rapid growth and intensification of livestock production in Myanmar in recent years. More details

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IDS publications on international development research

How is Perceived Community Cohesion and Membership in Community Groups Associated with Children’s Dietary Adequacy in Disadvantaged Communities? A Case of the Indian Sundarbans

BMC Health Services Research 16 (2016)

Membership in community groups and a sense of community cohesion may facilitate collective action in mobilizing resources towards better health outcomes. This paper explores the relationship of these factors, along with individual level socio-economic variables, to dietary adequacy among children below 6 years of age, a proximate determinant of child malnutrition. More details

IDS publications on international development research

How Can Health Systems Research Reach the Worst-Off? A Conceptual Exploration

BMC Health Services Research 16 (2016)

Health systems research is increasingly being conducted in low and middle-income countries (LMICs). Such research should aim to reduce health disparities between and within countries as a matter of global justice. For such research to do so, ethical guidance that is consistent with egalitarian theories of social justice proposes it ought to (amongst other things) focus on worst-off countries and research populations. More details

IDS publications on international development research

Exploring Pathways for Building Trust in Vaccination and Strengthening Health System Resilience

BMC Health Services Research 16 (2016)

Trust is critical to generate and maintain demand for vaccines in low and middle income countries. However, there is little documentation on how health system insufficiencies affect trust in vaccination and the process of re-building trust once it has been compromised. We reflect on how disruptions to immunizations systems can affect trust in vaccination and can compromise vaccine utilization. More details

IDS publications on international development research

Synergies, Strengths and Challenges: Findings on Community Capability from a Systematic Health Systems Research Literature Review

BMC Health Services Research 16 (2016)

Community capability is the combined influence of a community’s social systems and collective resources that can address community problems and broaden community opportunities. We frame it as consisting of three domains that together support community empowerment: what communities have; how communities act; and for whom communities act. More details

IDS publications on international development research

Comparison of Social Resistance to Ebola Response in Sierra Leone and Guinea Suggests Explanations Lie in Political Configurations not Culture

Critical Public Health 01.27 (2016)

Sierra Leone and Guinea share broadly similar cultural worlds, straddling the societies of the Upper Guinea Coast with Islamic West Africa. There was, however, a notable difference in their reactions to the Ebola epidemic. As the epidemic spread in Guinea, acts of violent or everyday resistance to outbreak control measures repeatedly followed, undermining public health attempts to contain the crisis. More details

This is the cover of the book ''A Practical Guide to Implementation Research on Health Systems'.

A Practical Guide to Implementation Research on Health Systems

This is an open access resource targeted primarily at post-graduate students intending to undertake field research on health systems interventions in resource-poor environments. More details

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The Effect of New Cooperative Medical Scheme on Catastrophic Health Expenditure and Impoverishment from Tuberculosis Care

International Journal for Equity in Health (2016)

This article assesses the effect of New Cooperative Medical Scheme (NCMS) on relieving catastrophic health expenditure (CHE) and impoverishment from TB care in rural China. More details

IDS publications on international development research

Strands of Struggle: Dealing with Health and Citizenship in the Aftermath of Asbestos Mining

Journal of Southern African Studies 42.5 (2016)

Asbestos mining is banned in many parts of theworld, and promoted in others. This article examines the effects of asbestos mining in South Africa, 30 years after the mines closed. Focusing on mining communities, it explores the political struggles that the communities have engaged in to address environmental threats, rehabilitate land, and secure compensation for their ill-health. More details

IDS publications on international development research

Towards the Just and Sustainable Use of Antibiotics

Journal of Pharmaceutical Policy and Practice 31.9 (2016)

The emergence and spread of antibiotic resistant pathogens poses a big challenge to policy-makers, who need to oversee the transformation of health systems that evolved to provide easy access to these drugs into ones that encourage appropriate use of antimicrobials, whilst reducing the risk of resistance. More details

IDS publications on international development research

Strengthening Capacity to Enhance Delivery: Implementation of Payment Reform in China

Future Health Systems Stories of Change 5 (2016)

In 2002, China launched a voluntary health insurance scheme to provide financial protection to people affected by disease-related illness. Future Health Systems (FHS) work in Hanbin County, western China, has drawn on innovative methods from implementation and participatory research to train and support local policymakers, managers and health professionals in the evidence-based implementation of the scheme. More details

IDS publications on international development research

Applying Systems Thinking to Strengthen Health Systems

Future Health Systems Stories of Change 2 (2016)

Systems thinking represents a unique theoretical and practical contribution. It facilitates ways to cross disciplines, and brings previously unused tools and approaches to tackle global health implementation differently. Future Health Systems (FHS) has played a major role in applying and advocating for the approach as a means to holistically understand health systems in low- and middle-income countries, as well as adaptation and scale-up of the project’s interventions. More details

IDS publications on international development research

Saving Money, Saving Lives: Community Saving Groups Lead to Improvements in Maternal and Newborn Health Care in Uganda

Future Health Systems Stories of Change 6 (2016)

Future Health Systems (FHS) work on maternal and newborn health in the poorest districts of eastern Uganda has contributed to a story of community empowerment where people have learnt to prioritise, prepare and save money for childbirth. This increases the likelihood of delivery in a health facility, and therefore the chances of a healthy pregnancy and safe childbirth under skilled care. More details

IDS publications on international development research

Enhancing Social Accountability for Health Care in Afghanistan

Future Health Systems Stories of Change 3 (2016)

In the United States and parts of Africa and Asia, community scorecards (CSCs) have improved accountability and responsiveness of services. Work supported by Future Health Systems (FHS) sought to evaluate CSC feasibility in a fragile context (Afghanistan) through joint engagement of service providers and community members in the design of patient-centred services, to assess impact on service delivery and perceived quality of care (QOC). More details

IDS publications on international development research

Through the Lens: Empowering Women in Vulnerable Communities to Voice their Concerns

Participatory Action Research (PAR) methodologies can help empower marginalised groups to capture and articulate their experiences and concerns to decision-makers. Future Health Systems (FHS) has worked with women in the Sundarbans of West Bengal to use Photovoice – a PAR method using photographs and narrative – to raise awareness of the challenges the women face to access health care. The initiative has led local policymakers and health workers to prioritise, and take steps to address, the issues. More details

IDS publications on international development research

Consequences and Futures of Inequalities (an introduction to Part II)

If we continue on the pathway of growing inequality, what will the consequences be? What are the possibilities of alternative pathways which take us to a fairer world? What will be the critical tipping points along the way? More details

IDS Policy Briefing 123 Front Cover

Towards Mutual Learning with the Rising Powers

IDS Policy Briefing 123 (2016)

Mutual learning is emerging as a new way of talking about the ‘how’ of development cooperation, particularly in contexts of rapid change, with countries increasingly recognising that they have much to learn from each other’s experience. More details

Independent Evaluation of the Reduction of Maternal and Neonatal Mortality in Kenya Programme - Overview

This brief provides an overview of the Independent Evaluation of the Reduction of Maternal and Neonatal Mortality in Kenya Programme. More details

IDS publications on international development research

Galvanising Gender Analysis and Practice in Health Systems

Future Health Systems Key Message Brief 4 (2016)

Gender analysis is an important component of health systems research (HSR) as it reveals how power relations create inequalities in health system needs, experiences, and outcomes among women, men, and people of other genders. Various challenges must be overcome to successfully mainstream gender into health systems practice and research. More details

IDS publications on international development research

Working with Health Workers to Improve Maternal Health Services

Poor quality of maternal and newborn health services in Uganda have resulted in low maternal health service utilisation and high newborn mortality rates, both at home and at health facilities. The support Future Health Systems (FHS) provided to health workers to improve maternal health service delivery illustrates how a package of interventions that equips health workers with the necessary knowledge, skills and equipment, supplies and other non-financial incentives can improve the quality of maternal and newborn health service delivery. More details

Front cover of IDS Evidence Report 202

Building Mutual Learning between the Rising Powers

IDS Evidence Report 202 (2016)

This Evidence Report provides a summary account of the Mutual Learning research initiative at the Institute of Development Studies, carried out from 2012 to 2014 as part of the Rising Powers in International Development programme. More details