Health and Systems for Health

Global Environmental Change and Its Health Impacts

The Center has been at the forefront of research on the emerging epidemics of non-communicable disease (NCD) and injuries across Africa even in the face of a continuing high burden of infectious diseases. We have generated
evidence that has led to stronger and more responsive health systems, able to address the specific needs of vulnerable populations. The Center has developed and tested models of service delivery to reduce leakages
across the NCD risk reduction continuum, and to improve quality and access to private sector-provided primary health care among slum residents. Gaps in evidence remain, however, related to mainstreaming chronic disease management, attracting and retaining NCD patients in care, and strengthening skills among low-cost private providers. There is yet to be an increase in research on the epidemiology of, or mitigating strategies for, the rising burden of injury.

The need for evidence on what works to improve awareness of NCD risk factors, linkages to and retention in NCD care programs, and how to integrate NCD care into existing platforms for chronic infectious disease management is acute”. So is the need to understand the systems that generate and sustain health at the community, health system and societal levels, and to test models for strengthening systems to make them responsive to current epidemiological trends.

Generating evidence to drive stronger and more resilient systems for improved health is the overarching goal of this Unit in three programmatic areas:

The signature issue for this Unit will be chronic disease management. We will aim to understand the magnitude, burden and impacts of non-communicable diseases and other chronic conditions (mental health problems and injuries), and the interactions and intersections between infectious and NCDs in order to inform integrated and efficient health system responses to major public health problems. The program will also identify and assess the impact of patient-centered and technology based approaches to improve integrated management of chronic

The Unit will also continue its current initiatives in NCD epidemiology research, expanding the scope to children, adolescents and older people. Interventions to mitigate risk of common NCDs will be developed and tested. A new area of work will develop and test approaches to enhance and/or maintain intrinsic physical and cognitive capacity at older age.

The third program of work will aim to understand and characterize health system needs to end the big epidemics and respond to new global health threats. It will contribute to improved knowledge by understanding the differentiated health needs of vulnerable populations. We will aim to understand the needs of long-term users of antiretroviral treatment and how care for people with HIV/AIDS is integrated into service delivery, including SRHR for young people and NCDs for older adults. The program will also conduct research on health system approaches for integrated care of infectious diseases and NCDs.


Featured Project

Indoor and Outdoor Air Pollution and Their Health Impacts, in Poor Urban Settings in Nairobi

Program: Health and Systems for Health

Air pollution (both outdoor and indoor) is a critical public health challenge especially in the developing world where legislation on emissions control is either weak or non-existent. In these countries, majority of households rely on fuels for cooking and heating that have been classified as high source of pollution.  Studies, such as this one, have documented the negative effects of both outdoor and indoor air pollution on health in other parts of the world but there have been very few such studies in Africa.


The study uses a mixed-methods approach where a qualitative study is conducted to look at the perceptions and attitudes of residents regarding air pollution and a quantitative study that measures levels of both indoor and outdoor air pollution to establish the levels of air pollution and their association with health outcomes. The project is being implemented by two APHRC researchers enrolled in a sandwich PhD program at Umea University.


  • Umea University

Project period

  • March 2012 to February 2014


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