IHI overview - CORE · 2017. 12. 5. · IHI Circle of Fellows Technology Branches: Ifakara,...
Transcript of IHI overview - CORE · 2017. 12. 5. · IHI Circle of Fellows Technology Branches: Ifakara,...
IHI overview
50+ years of health development research
Governing Bodies and Organization
SWISS GOVERNMENT TANZANIAN GOVERNMENT
SDC Swiss
TPH COSTECH NMAIST NIMR MoH
BOARD OF GOVERNORS
ALL BoG MEMBERS PRIVATE CIVIL
SOCIETY ESRF
BOARD OF TRUSTEES
DIRECTORATE & MANAGEMENT COMMITTEE
IHI-SUPPORT DEPARTMENTS AND RESEARCH THEMATIC GROUPS
Founder Members
Associate Founder
Members
RMOs
4
Sentinel Panel of Districts (District Observatory)
Research Infrastructure Development
• BSL II labs Ifakara and Bagamoyo
• BSLIII lab Bacteriology and virology Bagamoyo
• Clinical Trial facility: Bioequivalence, drug & vaccines, food sup
• Expansion of entomology screen houses
• Entomological labs Cat 3 in Bagamoyo
• Population and facility based surveillance (SPD)
• Validated data management and storage facilities
• Training facilities for clinical and research studies
• Office and support centers in 7 location in Tanzania
Capacity Building
Translation of Research Results into Policy
Strategic Objectives
Organization of research and support structures
1. Biomedical Science
2. Environmental Health and Ecological Science
3. Interventions
4. Health System Science
5. Impact Evaluation
6. Policy Delivery
Operations Knowledge People Finance
Organisational Support
Clie
nt
an
d R
es
ea
rch
Ou
tco
me
s
Laboratory discovery /
development
Developing ideas to work
in practice
Testing in the field
Matching interventions to
the real world
Measuring outcomes: did
the intervention work
Taking it to scale within
reality and public policy
Research Lifecycle
Improved
population
health
EXHIBIT 2
Organization structure
8
Chief Research
Officer
Chief Financial
Officer
Chief of Professional
Development
Chief Knowledge
Officer
Chief Operations
Officer
IHI Circle of Fellows
Technology Branches:
Ifakara, Bagamoyo,
Dar, Rufiji, Kigoma,
Dodoma, Mtwara Internal Audit /
Compliance
Research Quality
Assurance
Board of Governors / Board of Trustees / Board Committees
Chief Executive Director / Deputy
Organisational structure
Biomedical Science
Environmental Health
& Ecological Science
Interventions
Health Systems
Science
Impact Evaluation
Policy Delivery
Data & Analysis
Centre
Personnel
Administration
Training & Prof.
DevelopmentCommunications
Knowledge Bank
Procurement
Transport Chief Accountant
Grant Support
Legal
Development &
Partnerships
Facilities
EXHIBIT 3
Vaccine
Malaria prevention using Insecticide Treated Nets
Exploratory studies in ‘95-7 Social Marketing in 1997 Long term effects-’99-2004 National scale 2001 National M&E 2002 GF Voucher scheme 2003 Universal coverage campaigns 2010
Policy relevant analysis: Use of Sulphurdoxine Pyrethamin for treatment of malaria
6%
Mkuzia
Mlimba
11.4%
12%
6.4%
21%
32.%
19.%
28
%
19.4
%
55
.2%
19.4
%
6%
19.2
% 5
0.7
%
16
.40
%
80
.3%
11.9
%
2.4
%
5.5
%
18.6
%
45.8
%
23.7
%
11
.9%
19.3
%
5.3
%
12%
40.2
%
47.8
%
4.1
%
32.3
%
13.4
%
54.3
%
3.4
%
10.2
%
86.4
%
Butimba
Kyela
22.5%
0%
95.9
%
Masasi
13.7
0%
75.4
%
0%
5%
10%
15%
20%
25%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
year
severe cases following operational failure (CQ regimen)
IP admissions following operational failure (CQ regimen)
severe cases following operational failure (SP regimen)
IP admissions following operational failure (SP regimen)
2006: Coartem introduced as National policy
In children 5–17 months of age during 12 months of follow-up
• Vaccine efficacy against clinical disease: 55.8% (97.5% CI: 50.6-60.4)
• Vaccine efficacy against severe disease: 47.3% (95% CI: 22.4-64.2)
October 18, 2011
In children 6–12 weeks of age during 12 months of follow-up
• Vaccine efficacy against clinical disease: 31.3% (97.5% CI: 23.6-38.3)
• Vaccine efficacy against severe disease: 36.6% (95% CI: 4.6-57.7)
November 9, 2012
The DMF outlines information and processes required for timely and informed
decisions when an approved malaria vaccine becomes available – [ A tool to
aid systematic planning ]
Need for early country-level planning
Introduction of a Malaria Vaccine
Decision Making Framework
Molecular epidemiology
Immunology
…other research questions
Clinical trials on new
TB treatment regimens
or new TB vaccines
-Training (2010: 4PhD 4MSc started) -Public health service
Evaluation of new
TB diagnostics
&
Tuberculosis Research at IHI
Tuberculosis Research future direction
• Clinical TB vaccine and drug development – phase II and III trials • Supported by EDCTP, TB Alliance and probably Aeras/GSK (TB vaccine
phase II-III
• Early Bactericidal Activity studies • Evaluate new anti-TB drugs (compounds) if they have activity against
TB - TB Alliance
• Interrelation TB – Diabetes Mellitus • Epidemiology, Pharmacokinetic, Immunology, Mtb genetic background
Strengthening health system: equitable access to quality health systems
Inter-linked and mutually dependent key themes:
Delivery of essential and quality health services
Financial - increase the understanding of health insurance mechanisms in promoting health system equity and addressing the needs of vulnerable groups
Human resources – improving productivity of health workers & getting services closer to the people (through task shifting/ sharing, community health workers & use of cell phone technology)
Governance and decision-making – strengthening of health facility governing boards to increase accountability
Health facility assessment & health information system
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Tool 3
Clinical skills
Tool 4
Management
Tool 2
Job expectations
Tool 1 Infrastructure &
Equipment
Tool 6
Client satisfaction
• Implementation research in population of over 1 million
• Innovations • Volunteer community intervention designed for scale-up in Tanzanian
context
• Paid community health workers with accredited curriculum ready for scale up
• Community-linked supervision & support
• Foot size proxy for birth weight
• Cluster-randomized controlled evaluation
Human resource: Community health workers for MNCH
Health accounts for resource allocation
• District Health Accounts tool and PlanRep2 Maps district budgets and expenditures in relation to burden Helps align spending with priorities Improves transparency and accountability
20
Social Determinants of Health – early stages
• Strengthening systems and building research capacity in researching for SDH in LMIC ; potential for future collaboration with FIOCRUZ
• SDH conceptualization and ‘contextual’ analysis integrated and embedded in ongoing institutional priority research areas
• Monitoring Equity in Tanzania (part of a regional initiative led by EQUINET)
21
Gap areas for future focus
• Strategies for promoting accountability for improved quality of health care for all in need at all levels of the system
• Global influences and their impact on national health systems
• Contextualizing lessons learned- what works and what does not under which circumstances – SDH and innovation.
• Impact of changing demographics and fragile systems – needs of elderly, double burden of disease, urbanization.
Knowledge Forums
23
• April : Malaria Control Forum 2011, 2012
• Oct 2011: Monitoring & Evaluation SPD
Dissemination of INESS & Malaria Vaccine trial results
Knowledge Products and Policy
Training activities
• Partnership with universities
• Skills training for stakeholders
• Platform for MSc and PhD
• 33 MScs, 30 PhDs, Post doctoral training
• A unique programme in the region to be offered under NM-AIST, Arusha
• 2 year academic/research programme
• Strong involvement of internationally renowned subject experts
• Dissertation and a publishable scientific paper manuscript
• Use of problem based learning
• Practical hands on training using IHI research platforms
• Three streams of specialization
Training: Masters in Public Health Research
National
MDG 4
Possible
Latest point is
within the forecast