Global collaboration could mean better primary care for people in poorer areas

Ensuring a healthy future for all - priorities to advance Universal Health Coverage

In 2019, world leaders agreed to the most comprehensive and ambitious political declaration on health in history at the inaugural United Nations High-Level Meeting (UN HLM) on Universal Health Coverage (UHC). Yet across the world people are struggling to access high-quality, patient-centric, integrated health services, when and where they need them and without incurring financial hardship. The most recent global monitoring report on UHC re-affirms that we are way off track to achieve 2023 targets.

Ahead of the Multistakeholder Hearing and High-Level Meeting on UHC in 2023, The George Institute urges governments to prioritise the following in pursuit of a healthy future for all:

  1. Identify, develop, and formalise opportunities for social participation in UHC, including governance and decision-making roles for communities and civil society across policies, programmes, and resource allocation.
  2. Prioritise the routine collection and analysis of data disaggregated by sex, gender, and other intersecting characteristics to track progress towards targets and identify and address barriers that impede women, girls and other groups experiencing marginalisation from accessing health promotion, prevention, diagnosis, treatment, and care.
  3. Put patients at the centre, integrating NCD prevention and care within existing health services to address multiple health conditions, including at primary care level, and prevent catastrophic out-of-pocket costs by putting health insurance programmes in place.

All UHC efforts must be underpinned by core values including a focus on equity and inclusivity, good governance, cross-sector collaboration, support and protection for healthcare workers, and attention to local context, all in a broader framework of human rights and social protection.

Spotlight: Social participation to ensure a healthy future for all

Social participation, sometimes referred to as citizen engagement or community action for health, has become an integral part of health systems strengthening since it was recognised in the Alma Ata declaration on “Health for All” in 1978. Recognition is growing that people’s voices and actions must influence how domestic resources are used to deliver quality health services for all and hold governments accountable. The need to establish platforms and partnerships to enable this was embedded in the Political Declaration of the UN HLM in 2019.

The George Institute is delighted to be involved in the project Social Participation for Health: Engagement, Research, and Empowerment (SPHERE), a partnership with the Civil Society Engagement Mechanism for UHC2030, the World Health Organization, and national partners in countries including Vietnam, Kenya, and Argentina. Over a four-year period, SPHERE will document experiences of advancing social participation for health, collaborate with communities to promote and evaluate context-specific implementation approaches, and draw lessons to advance the broader UHC agenda.

Take Action

  1. Follow us on Twitter @GeorgeInstitute, @GeorgeInstUK or @GeorgeInstIN and join us to say #People4UHC #HealthForAll and amplify #UHCDay
  2. Join our #UHCDay fire-side chat with researchers and practitioners who – based on their involvement in research, advocacy, and action related to citizen engagement – will share perspectives, learnings, challenges, and the way forward for Social Participation for health (SPH) in their country contexts and deliberate on the role of SPH within the UHC discourse.
  3. Learn more about the SPHERE project.
 

National Hypertension Taskforce takes on the silent killer of uncontrolled blood pressure in Australia

Media release

The Australian Cardiovascular Alliance (ACvA) and Hypertension Australia (formerly the High Blood Pressure Research Council of Australia) have joined forces to establish a National Hypertension Taskforce with the ambitious goal to double Australia’s rates of controlled blood pressure from 32% to 70% by 2030.

Professor Anushka Patel appointed new Chief Executive Officer of The George Institute

The George Institute for Global Health is pleased to announce the appointment of Professor Anushka Patel as its new Chief Executive Officer.

Professor Patel will be replacing Professor Robyn Norton AO and Professor Stephen MacMahon AO, who announced earlier this year they would be stepping down in December 2022 for new leadership and new ideas to continue the growth of the Institute.

Professors Norton and MacMahon co-founded the Institute in Sydney, Australia in 1999 to address the escalating global burden of non-communicable diseases and injury. Today, the Institute is internationally recognised as one of the world’s leading global health research institutes, with over 1,100 people across four regional offices and more than 245 active projects across 50 countries.

“We are delighted to welcome Anushka to lead the Institute during this exciting new phase of organisational growth,” said David Armstrong, the Chair of The George Institute’s Board of Directors. “Anushka brings a wealth of experience and an inspiring vision to the Institute that will ensure it continues to deliver on its mission to improve the health of millions of people worldwide.”

Professor Patel is clinician scientist with a distinguished academic career and extensive senior leadership experience, including most recently as Vice-Principal Director and Chief Scientist at The George Institute. Externally, Professor Patel has held numerous senior academic and professional roles with government agencies, non-government organisations and multilateral organisations, in Australia and globally. Professor Patel is also an active cardiologist in Sydney. She will begin her new role at the end of January 2023.

“It is a great honour to follow in the footsteps of such visionary founders, who have presided over an organisation that has seen extraordinary growth and impact globally,” said Anushka. “We are entering a period of heightened global uncertainty, with rapid social, environmental, economic, technological and geopolitical shifts that will inevitably influence the strategy of any ambitious organisation, particularly one focused on global health.

“This uncertainty also brings opportunities to further grow our impact. I very much look forward to the challenges ahead, building on the strengths of the organisation, our partnerships and our incredibly talented teams across the Institute and George Health.” 

Event

How do we build the world we want? Multi-Country Perspectives on Social Participation for Universal Health Coverage

Health Equity Network India’s 20th Equilogue

Social participation or citizen engagement has become an integral part of health systems strengthening since its rise in prominence as part of the Alma Ata declaration on “Health for All” in 1978. Evidence linking social participation to improve health outcomes and health systems is emerging and acting as a critical tool for advocacy around the policy imperative for governments to institutionalize and strengthen social participation as part of health programs. History bears testimony to the central role that the civil society has been playing in advocating for and facilitating citizen engagement in health. There have been numerous attempts globally at institutionalising and operationalising citizen engagement in health programs. Several of these experiences in countries have been documented whereas for many such documentation is emerging.

Mark your calendars for 16th December 2022 | Friday | 1530-1700 IST

About the Equilogues

The Civil Society Engagement Mechanism (CSEM) for UHC2030 is partnering with The George Institute for Global Health as part of a project entitled “Social Participation for Health: Engagement, Research, and Empowerment (SPHERE)” to document experiences of social participation and community action in health and support advocacy efforts of civil society partners in Argentina, Vietnam and Kenya towards advancing citizen engagement and social participation for health linking up to UHC. With Universal Health Coverage (UHC) occupying the central stage in policy and advocacy related to health systems governance and the delivery of health services, such documentation offers lessons and opportunities for cross-learning on how social participation could be leveraged for progressively achieving UHC.

The 20th Equilogue of the Health Equity Network India (HENI) will bring together researchers and practitioners who – based on their involvement in research, advocacy, and action related to citizen engagement – will share perspectives, learnings, challenges, and the way forward for Social Participation for health (SPH) in their country contexts and deliberate on the role of SPH within the UHC discourse.

Format: The webinar will begin with a team from The George Institute for Global Health India showcasing its documentation work on the history of institutionalising community participation and action in health under India’s National Health Rural Mission (NRHM) using the oral history methodology of a Witness Seminar.  

This will be followed by a fireside chat hosted by Dr David Peiris from The George Institute with representatives from the civil society deeply involved with work encompassing social participation and movement-building on UHC and strengthening community led action for health reform.  

Speakers

  • Hari Sankar

    Research Fellow, Health Systems and Equity, The George Institute for Global Health, India 

    Dr Hari Sankar D is a qualitative research fellow at the George Institute for Global Health India. He has a Master’s in public health and a Bachelor’s degree in Ayurveda. He has worked for more than six years in health systems and operation research focusing on primary health care. He is trained in disease surveillance and later gained field experience in implementation research. His current research interest is focused on developing a monitoring framework for tracking health system performance indicators and underlying inequalities in the health system of Kerala.

    Hari Sankar
  • Misimi Kakoti

    Research Officer, The George Institute for Global Health, India 

    Misimi Kakoti is currently working as a Research Officer (RO) at The George Institute, India. Her research interests lie in the intersection of gender, rights, and equity in health policy and systems. She has been primarily involved with the documentation work on community action in health in India with the method of Witness Seminar, piloting the 8Quity checklist tool, and the CEDAW implementation review project at TGI. She has previously worked with the Rapid Evidence Synthesis Unit at The George Institute. She also supports the Secretariat of the Health Equity Network India (HENI). Prior to this, she has worked with the Tata Institute of Social Sciences and ActionAid India. 

    Misimi Kakoti
  • Abhijit Das

    Founder and Managing Trustee, Centre for Health and Social Justice, India 

    Dr Abhijit Das is the Founder and Managing Trustee of the Centre for Health and Social Justice, a policy research and advocacy institution on health and human rights, and gender equality. Dr Abhijit is a medical doctor with 35 years of experience in grassroots work, training, research and policy advocacy in the field of public health. He is the founder member of MenEngage, a global alliance of NGOs working with men and boys on gender equality, and Co-Convenor of COPASAH (Community of Practitioners on Accountability and Social Action in Health), a global health rights and social accountability network, and member of the Advisory Group on Community Action (AGCA). He is Clinical Associate Professor, Department of Global Health, University of Washington.  

    Abhijit Das
  • Smitha Sadasivan

    Disability Rights Practitioner

    Smitha Sadasivan is a social activist passionate about accessibility and inclusivity of persons with disabilities at all domains including civil political socio cultural, financial legal and administrative contexts. She is a member of the Civil Society Engagement Mechanism for UHC 2030, while also serving on the Steering Committee of the UHC 2030 initiative overall. In her native state of Tamil Nadu, she serves on the State Advisory Board for Persons with Disabilities under the Rights of Persons with Disabilities, the Disability Rights Alliance. At the national level, she is a member of the Multiple Sclerosis Society of India and the Election Commission. Smitha has degrees in English Literature and Psychology.

    Smitha Sadasivan
  • Nguyen Thuy Linh

    Deputy Director, Center for Supporting Community Development Initiatives (SCDI), Vietnam

    The Centre for Supporting Community Development Initiatives (SCDI) is a Vietnamese NGO, well-known for its leading role in advocacy for marginalized populations’ access to health and fostering national networks of key populations and other community networks in Vietnam. 

    In 2015, Linh joined SCDI to develop the Children and Youth program, and has led various interventions and advocacy efforts on drug harm reduction and HIV prevention for young drug users, sexual and reproductive health and rights for young women and adolescent girls, building resilience, increasing access to health and education for disenfranchised children. She also provides supervision for Harm reduction and Addiction Treatment program and the Communication and Social Mobilization team. 

    Before SCDI, Linh sat in the core team laying the stepping stones for the first Global Fund supported project on HIV/AIDS led by civil society in Vietnam, facilitating capacity building of community-based organizations and key populations networks and their engagement in advocacy for enabling environment for civil society participation in the HIV response. 

    Nguyen Thuy Linh
  • Justin Koonin

    Co-Chair, UHC2030 Steering Committee; President, AIDS Council of New South Wales 

    Justin is co-chair of the Steering Committee of UHC2030, the international multi-stakeholder partnership for universal health coverage, and is a member of multiple WHO expert panels. At a national level, Justin is president of ACON (AIDS Council of New South Wales), Australia’s largest community organisation dedicated to HIV/AIDS prevention, care and support, as well as to the health of sexuality and gender diverse people more broadly. He is Distinguished Fellow and Honorary Professorial Fellow at The George Institute and Adjunct Associate Professor in the Faculty of Medicine and Health at the University of New South Wales, as well as a Fellow of the Australian Institute of Company Directors. Justin's training is in the field of pure mathematics, and he currently works as an investment analyst.

    Justin Koonin
  • David Peiris - Fireside chat host

    Director, Global Primary Health Care Program; Co-Director, Centre for Health Systems Science, The George Institute for Global Health

    David is Director of the Global Primary Health Care Program (Better Care) and Co-Director of the Centre for Health Systems Science.

    He is a Professor in the Faculty of Medicine, UNSW Sydney and works clinically as a GP in Sydney. David joined the Institute in 2006 and leads the Better care program at the Institute. This program focusses on SDG 3 - especially SDGs 3.4 and 3.8. The goal is to overcome the challenges of delivering affordable, high-quality health services and programs to communities across the globe. It is underpinned by health systems science, a dynamic and emerging discipline that includes health services research, health policy and systems research and implementation science. David has published extensively in areas related to health systems research and leads several grants testing innovative strategies to improve access to high-quality primary health care with a particular focus on under-served populations. He was the 2015-2016 Australian Harkness Fellow in Healthcare policy, based at Harvard School of Public Health where he conducted a national study of the changes to health care delivery systems associated with President Obama's reforms. He has been a board member with the Royal Australian College of General Practitioners National Faculty of Aboriginal and Torres Strait Islander Health and sits on several government, non-government and research advisory committees. He was the elected co-chair of the Global Alliance for Chronic Diseases committee for hypertension control from 2012 to 2015.

Six ways to manage migraine without drugs

We’ve all heard of the crushing headache pain that comes with migraine but did you know that one in every seven people experience them, three in every four people with migraine are females, and migraine is the number one cause of disability in young people?

With so many people affected worldwide, you’d think modern medicine would have developed a solution by now but unfortunately there’s still no definite cure for migraine.

Event

Seminar: Adolescent and Child Injury

Burn Injury

Injury is the number one cause of death among children.

Join us to hear experts from India, Bangladesh, the United Kingdom and the United States, who will highlight the various challenges and opportunities for child and adolescent injury prevention. Our speakers bring together technical and operational expertise, as well as links to local context and capacity. 

Speakers

  • Prof. Geetam Tiwari, Department of Civil Engineering, Indian Institute of Technology, Delhi

    Prof. Geetam Tiwari is an international authority on transportation planning and safety, who serves as MoUD Chair Professor for Transport Planning at the Department of Civil Engineering, Indian Institute of Technology, Delhi. She has extensive research experience in dealing with transportation issues of special relevance to low-income countries, including development of safer and more efficient bus systems and road designs, with a particular focus on traffic and transport planning related to pedestrians, bicycles, and bus systems. With degrees from the University of Roorkee (BA, architecture) and the University of Illinois, Chicago (MA, urban planning and policy; Ph.D., transport planning and policy), Prof. Tiwari has served as Adlerbertska Guest Professor for sustainable urban transport at the Chalmers University of Technology, Sweden (2007–2010).

    Geetam_Tiwari
  • Dr. Mathew Varghese, Transportation Research and Injury Prevention Programme, Indian Institute of Technology,

    Dr. Mathew Varghese is a graduate and a post-graduate in orthopedic surgery from Maulana Azad Medical College at the University of Delhi. He is an expert on injury control, epidemiology of injuries, pre-hospital care and emergency care of trauma patients. Dr. Varghese is the co-author of the book 'When someone has hurt' a first aid guide that has been translated into five languages and 'Prehospital Trauma Cam Systems’ published by the WHO. He is also an associate faculty at the Transportation Research and Injury Prevention Programme, a WHO collaborating center at the Indian Institute of Technology, Delhi.

    Mathew_Varghese
  • Dr. Aminur Rahman, Director, International Drowning Research Centre, Bangladesh (IDRC-B)

    Dr. Aminur Rahman is a renowned child drowning prevention expert. He is a Director at the International Drowning Research Centre-Bangladesh (IDRC-B), which is part of the Centre for Injury Prevention and Research, Bangladesh (CIPRB). After graduating in medicine from Dhaka University in 1986, Dr. Rahman completed his Diploma in Community Medicine in 1991 from Dhaka University. He completed Masters in Medical Education in 1997 from Dundee University, UK. In 2010 he completed his PhD from the Public Health Science Department of Karolinska Institute, Sweden.

    Aminur_Rahman
  • Assoc. Prof. Kavi Bhalla, Department of Public Health Sciences of the Biological Sciences Division, University of Chicago

    Assoc. Prof. Kavi Bhalla works in the Department of Public Health Sciences of the Biological Sciences Division at the University of Chicago, and Affiliated Faculty at the Harris School of Public Policy. His research aims to develop transport systems that are safe, sustainable and equitable, with a central focus on road safety in low- and middle-income countries. His recent work has focused on the development of analytical tools for improving estimates of the incidence of injuries in information-poor settings using available data sources. Assoc. Prof. Bhalla co-led the injury expert group of the 2010 Global Burden of Disease Project. He is formally trained as a mechanical engineer and his PhD (Cornell, 2001) thesis research focused on the mechanics of material failure, which he later applied to the study of injury biomechanics and vehicle crashworthiness. He is broadly interested in the design of products, environments, and systems that are safe and have positive health impacts

    Kavi_Bhalla
  • Prof. Julie Mytton, University of the West of England, Bristol

    Prof. Julie Mytton is a Professor of Child Health at the University of the West of England, Bristol. She is co-lead for Training and Capacity Building, supporting the development of understanding, using and producing evidence of local researchers and practitioners. Prof. Mytton is co-Director for the NIHR Global Health Research Group on Nepal Injury Research and UWE Director for the Centre for Academic Child Health. Her research interests are in injury prevention and global health.

    Julie_Mytton
  • Dr. Margie Peden, Head of Global Injury at The George Institute for Global Health and Co-director of the WHO Collaborating Centre on Injury Prevention

    Dr. Margie Peden currently holds academic positions at Imperial College London and the University of New South Wales and an honourary position at Johns Hopkins University. She is Head of Global Injury at The George Institute for Global Health and Co-director of the WHO Collaborating Centre on Injury Prevention. Dr Peden’s academic interests include identifying and evaluating appropriate interventions to prevent child injuries in low-income settings and implementing frameworks to improve nurses’ efficacy in emergency and accident units. She is particularly interested in using participatory methodologies to develop good practices for the most vulnerable in society. While road injuries are the biggest issue, Dr Peden's work also canvases other significant problems of drowning, burns and falls, and identifies interventions that could save lives. Her research looks at what works, specifically in developing countries.

    Margie
  • Dr. Joanne Adrienne Vincenten, Child Injury Prevention Health Programme, UNICEF

    Dr. Joanne Adrienne Vincenten leads the Child Injury Prevention Health Programme at UNICEF and brings on decades of experience for child and adolescent injury prevention, particularly across road safety and drowning

    joanne-adrienne_vincenten
  • Prof Rebecca Ivers, Honorary Professorial Fellow, The George Institute

    Professor Rebecca Ivers is head of the School of Population Health, UNSW. Recognised for her expertise in studying injury, trauma care and falls prevention, Professor Ivers designs and leads large observational studies and randomised trials focusing on injury prevention and trauma care in Australia and in low- and middle-income countries in Asia.

Tamara_Mackean

New funding to address institutional racism in Australia’s healthcare system

Associate Professor and Waljen woman Tamara Mackean from the Guunu-manaa (Heal) Aboriginal and Torres Strait Islander Health Program at The George Institute has been successful in securing funding for a five-year project to reform the development and delivery of hospital care for Aboriginal and Torres Strait Islander peoples by addressing implicit bias and institutional racism within Australian hospitals.

The Australian Government’s NHMRC Synergy Grants round supports outstanding multidisciplinary teams of investigators to work together to answer major questions that cannot be answered by a single investigator with funding of $5million over five years.

Associate Professor Mackean is leading the collaboration between Aboriginal and Torres Strait Islander and non-Indigenous researchers to understand and address the complex dynamics of racism, implicit bias and colonisation which significantly impact the health and wellbeing of Aboriginal and Torres Strait Islander people and families.

In recent decades, racism has been clearly identified as a determinant of health and wellbeing for Aboriginal and Torres Strait Islander people. Not only does racism cause detrimental impact on health and wellbeing it also significantly affects access to, and quality of health care services.

Inequities in health outcomes and access to hospital care are persistent, with Aboriginal and Torres Strait Islander people experiencing 2.3 times the rate of disease burden compared to non-Indigenous Australians.

Data on hospitalisations between July 2015 and June 2017 showed there were also as many as 69 preventable hospitalisations per 1,000 Aboriginal and Torres Strait Islander people compared with 26 per 1,000 non-Indigenous Australians.

The impacts of racism are severe and traumatic, not only for Aboriginal and Torres Strait Islander patients and families, but also for staff working in Australian hospitals.

The project centres Indigenous ways of knowing, being and doing and combines multiple theories, including decolonisation, cultural safety, quality care and implementation science, to determine how Local Health Networks and Districts (LHN&D) in Australia can cultivate anti-racists hospitals.

It will provide much needed new knowledge on assessing change readiness in Local Health Networks and Districts to undertake actions to redress racism in hospital care. The project will also provide much needed evidence on the implementation of hospital service and hospital organisational actions aimed at improving health care quality and access for Aboriginal and Torres Strait Islander people and communities.

“This project is focussed on structural reform as a necessary part of healing for Aboriginal and Torres Strait Islander people and families who have suffered ongoing trauma and injustice within the health system,” said Tamara.

“Our diverse team will contribute to the development of research that acknowledges and respects working at the knowledge interface by bringing Aboriginal and Torres Strait Islander knowledge of health and healing alongside Western biomedical knowledge to produce new meaning based on mutual respect,” she added.

 

nigeria-migration-social-networks

How do social networks influence Nigerian health workers’ intentions to migrate?

The emigration of skilled health workers (SHWs) from low- and middle-income countries (LMICs) to high-income ones has been on the rise. In 2000, an estimated 415,936 doctors migrated from LMICs to countries belonging to the Organisation for Economic Development (OECD). By 2015, this number had risen to 716,432 – an increase of over 70 percent in 15 years.

This trend has led to a spike in the clinical workload of those who choose to remain, decreasing the quality of health services, and negatively impacting their job satisfaction and wellbeing. Migration of SHWs has also negatively impacted LMIC health systems by reducing the pool of health educators available to train future SHWs, limiting the ability to respond to future health workforce needs.

Like many other LMICs, Nigeria’s health system has been affected by SHW migration. Our new study finds that the social networks of skilled health workers (SHWs) in Nigeria can have considerable influence on their intentions to migrate to other countries. These networks – including policy makers, colleagues, peers, friends, family, and others that share common ties – can be leveraged to improve the country’s response to health worker migration.

“Our paper does not recommend preventing SHWs from migrating. But there is a need to improve migration governance,” explains lead author Dr. Kenneth Yakubu, Co-Lead of The George Institute’s Initiative for Partnerships in Africa.

Migration governance refers to how norms, laws, procedures, and organisational structures regulate or facilitate a state’s response to migration.

“Governments respond to SHW migration based on expert advice or formal regulatory systems that they are conversant with, but there are informal systems of thinking and behaviour that impact migration behaviour too,” he adds.

“Our paper aims to provide evidence on one such informal system - health workers’ social connections - on moulding migration intentions.”

Yakubu interviewed 22 SHWs living or working in Nigeria on their interactions within networks regarding migration and their intent on moving out of the country. Half the participants wanted to migrate, while half intended to stay and practice in Nigeria. Those looking to move had larger social networks and their discussions centred on information on migration opportunities and support from social networks (family, friends) to aid decision-making. While those planning to stay also participated in conversations about migration opportunities, they were also interested in engaging their networks in improving health services in the country and mitigating the negative effect of migration.

“Health worker migration is a complex issue requiring collaboration among multiple stakeholders. Our study shows SHWs can serve as links across various networks, raising awareness about SHW migration,” adds Dr Yakubu.

“It also highlights the agency and leadership potential of health workers to influence how their colleagues and other stakeholders perceive factors related to SHW migration.”

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Bitesize: Why is eating less salt important for heart health

Why is eating less salt important for heart health? This is probably a question many of us have asked of ourselves as we spot the amount of salt in a packaged snack or are adding salt to a meal.

In this bite size episode, Director of the World Health Organization Collaborating Centre on Population Salt Reduction at The George Institute, Jacqui Webster, unpacks the link between salt and heart health, and outlines steps you can take to reduce your salt consumption.