Health and Systems for Health

Health and Systems for Health

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


Food Choices Project: Dietary transitions in African Cities

Program: Health and Systems for Health

Driven in part by the increasing migration of individuals to cities in many African countries, a change in dietary habits has been observed, with increasing consumption of unhealthy foods that are high in calories and low in nutrients. This change in dietary practices has resulted in increasing levels of obesity in cities, with higher rates among women. Policy responses have also lagged behind this growing concern, with any in existence having limited success so far since they are mostly influenced by evidence from higher income countries and are less relevant to the African context.

There is also little known about the factors that drive food consumption in African cities, particularly the role that people’s social networks play (e.g. family or peer groups), the neighborhoods that they live in (e.g. access to fast food outlets), and economic factors, among others.

This project will explore the factors that are associated with food consumption patterns (what people eat) and practices (how, where, when and with whom they eat) within two African cities (Nairobi and Accra). We will undertake novel approaches for collecting data on food consumption patterns and practices and the factors associated with them. The different approaches will entail the use of existing scientific evidence, as well as capturing the views of local communities and stakeholders in identifying solutions to the problem of unhealthy dietary practices. To do this, we will:

  • review the extent of evidence in published research, and through analyzing existing information on dietary behaviors;
  • interview people about the kinds of food they eat and how they eat it;
  • use photography with a local community to explore the factors that influence food choices; and,
  • map the food environment in the same local neighborhood (e.g. location and type of food outlets) to explore how characteristics of the environment might influence people’s food choices.

Based on the results of the above, we will identify the range of factors associated with dietary patterns and practices. With the support of local experts and policymakers, we will then compare these factors to current policy approaches in these settings to assess which gaps may require addressing, and identify interventions that may be useful.

The proposed research will strengthen existing partnerships, build new ones, and enhance capacity in research. This will pave the way for the development of new interventions that are more likely to be effective. We will also share our results more widely with experts and policymakers from other African cities via webinars, social media, and regular project website updates.

Read about the project on this blog. Please also visit the project website for more information.


Project period

  • Start date: April 2017
  • End Date: March 2019



Project Funders

  • GCRF Concept_v4 ...


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