The George Institute for Global Health is launching a new course, Introduction to Randomised Clinical Trials (RCTs), to build capacity and strengthen evidence-based approaches to global health challenges.

RCTs are considered to produce the highest quality of evidence on the effects of interventions because of their ability to minimise bias. Critical to successful generation of high-quality evidence through RCTs is the knowledge and skills to properly design, conduct, analyse and report them.

“RCTs are extremely important in medical research and we’re very proud to be offering this course to equip the next generation of researchers with the knowledge and tools they need to contribute to future advances in global health” - Helen Monaghan, Director, Global Project Operations, Centre for Operational and Research Excellence, The George Institute, Australia

The 12 to 13 week online course beginning on 07 June 2022 will be delivered by experienced researchers and trial managers at The George Institute. It will provide early career researchers (The George Institute staff, consultants, students, visiting fellows, collaborators, and partners) with a comprehensive introduction to the fundamentals of RCTs, including effective trial management.

This course will harness the knowledge gained and skills developed over more than 20 years of ground-breaking RCTs carried out at The George Institute. After completing this course, participants will have understanding of the strengths and limitations of RCTS and how they can be applied to have real world impact and improve people’s health.” - Niveditha Devasenapathy, Lead, Better Treatments, The George Institute, India

Contact

Abdul Salam
The George Institute for Global Health
researchtraining@georgeinstitute.org

Kate Ballard
The George Institute for Global Health
researchtraining@georgeinstitute.org

Open letter to Australia’s next government, 16 May 2022

Ahead of the 2022 Federal election, The George Institute for Global Health calls on all political parties to commit to developing a clear and explicit implementation plan for the National Preventive Health Strategy’s ‘Blueprint for Action’ in the first 100 days of government.

The National Preventive Health Strategy 2021-2030 (NPHS) is an important milestone and a credible and evidence-based strategy that will, if properly funded and implemented, deliver a healthier, more equitable Australia. Australian governments, the health sector and community members have worked together to develop the strategy. To date, no political party has committed to funding the implementation of this strategy during the 2022 election cycle.

Commitment to the goals of the NPHS, coupled with appropriate investment, is urgently needed to reverse the spiralling growth in disease burden and to help protect the health of all Australians.

Nearly half of all Australians have one or more chronic condition, such as cardiovascular disease, cancer or type 2 diabetes. Yet, Australia’s per capita expenditure on preventive health ranks in the bottom half of OECD countries.

As Australia heads to the ballot box, we call on all political parties to commit to a concrete plan for implementing the NPHS ‘Blueprint for Action’ in the first 100 days of government.

Key priorities for action in the NPHS include:

• Invest in prevention by committing 5% of health expenditure to prevention.
• Launch an independent, expert-led governance process to advise on prevention priorities and the use of the prevention fund.
• Futureproof the public health workforce by developing and enhancing expertise and capacity, including digital training and improved health systems infrastructure.
• Improve health literacy by creating a national health information platform to empower consumers.
• Link prevention with primary care by aligning the Blueprint for Action with the Primary Health Care 10 Year Plan and the National Aboriginal and Torres Strait Islander Health Plan.
• Develop evidence-based preventive health mechanisms by investing in a robust research sector.
• Strengthen health equity by ensuring an equity lens underpins preventive health, prioritising Aboriginal and Torres Strait Islander people and other communities experiencing vulnerability.
• Build innovative partnerships and develop consumer engagement between and within sectors, using the National Consumer Engagement Strategy 2021-2030.
• Boost action in target focus areas such as anti-smoking, healthier diets and environments to deliver early wins in reducing the burden of disease at population level.

Australia’s healthcare system enables citizens to enjoy world-class treatments and programs, underpinned by a robust research sector. But effective governments don’t just invest in treating health problems – they invest in preventing them, especially for the most at-risk communities. Every dollar spent on prevention leads to better outcomes and significant health-system savings.

Return-of-service schemes - which fund the education of health sciences students provided they return to work in their local communities for a period of time after qualifying - have been used to address healthcare worker shortages across South Africa.

But are they a good investment? A team of researchers from The George Institute and UNSW, Sydney, set out to try and answer this question by seeking the insights of key policymakers from the country’s provincial health departments. Their findings have now been published in PLOS Global Public Health.

According to lead author Sikhumbuzo Mabunda, Africa - especially sub-Saharan Africa - has the highest burden of disease in the world, the second largest population, and also the biggest shortage of health professionals.

“The country’s public health sector has only 33 medical practitioners per 100,000 people compared to the global average of 176 per 100,000 population and its primary care facilities are serviced by less than a third of the professional nurses and midwives that are actually needed,” he said.

“The main reasons driving this shortage are a limited capacity to train health professionals and the tendency for them to move to urban centres or to the private sector once qualified or even move overseas to work in more developed countries.”

But despite the adoption of several policies by governments in selected African countries in the south of the continent - like mandatory service in public sector for the duration of government-funded training - the inequitable distribution of resources persists.

To obtain on-the-ground insights into what is and isn’t working well, the George Institute research team conducted semi-structured, qualitative interviews with 16 key South African policymakers from eight of its nine provinces.

“They did feel that RoS schemes played an important role in increasing the pool of skilled health professionals and said they helped rural and disadvantaged South Africans secure academic qualifications and jobs in the health sector,” said Sikhumbuzo.

“But these benefits were undermined by lack of long-term planning, lack of transparency in the selection of some recipients, poor monitoring and coordination, and deliberate breaches of contract.”

Despite the high costs of the bursaries - reported to account for one quarter of the health worker training budget in Gauteng province, for example - no formal evaluations of the impact of RoS schemes were reported.

“We identified a number of areas where RoS schemes could be improved, such as better monitoring and enforcement of fines when contracts are broken, and policies to better support beneficiaries to fulfil their contracts,” said Sikhumbuzo.

“Given that these schemes represent a significant expenditure in an already resource constrained health system, ongoing monitoring and evaluation is important to ensure they are meeting population needs” he added.   

The George Institute continuing its journey in the mental health space is proud to announce another initiative supporting the psychosocial needs of the frontline workforce. The institute is leading the Psychosocial Support for Front Line health Workers (FLWs) component (in partnership with Engender Health) as a part of the USAID funded project titled - MOMENTUM Safe Surgery in Family Planning and Obstetrics and Gender-integrated Responses to COVID-19 Priorities in India, launched in Bengaluru, Karnataka on April 25, 2022.

The launch event was inaugurated and attended by Dr K Sudhakar, Hon’ble Minister for Health & Family Welfare & Medical Education, Government of Karnataka, Sri Achar Halappa Basappa, the honourable Minister for Women & Child Development & Empowerment of Differently Abled & Senior Citizens, Government of Karnataka, Dr Arundhanthi Chandrashekhar, Director, National Health Mission – Karnataka along with other senior government officials and relevant stakeholders.

The MOMENTUM project aims to prevent future and current pregnancy-related mortality and morbidity in India by promoting awareness of equitable access to high-quality care for voluntary and consented safe surgeries. It intends to provide a gender-integrated response to the emerging COVID-19 priorities in India, including for Gender-Based Violence (GBV) and psychosocial support for the FLWs.

The George Institute has been leading the mental health space for years through various flagship programmes. In this component, the team is leveraging extensive learnings and experiences from the India Health Accelerator Program and Digital health Innovations for psychosocial Support to FLWs – Accelerated response (DISHA) project. The DISHA project aims to co-create a basket of solutions (combination of online and offline) packaged as an intervention to be implemented in 25 districts across six states, namely: Assam, Chhattisgarh, Jharkhand, Karnataka, Madhya Pradesh, and Odisha. The identified interventions will respond to psychosocial issues faced by FLWs (including increasing reported incidents of stress, burnout, violence, and stigma) and build their knowledge, capacity, and resilience by promoting effective responsiveness in the future.

The hon’ble minister - Dr Sudhakar, highlighted the need for psychosocial support through digital technologies and the potential to integrate Tele-Manas programme like initiatives into the response intervention. Other partners and senior officials present at the launch event acknowledged the urgency to respond to the psychosocial needs of the FLWs and highlighted the positive impact this component holds. Collective action towards designing effective strategies can influence and strengthen the overall outcomes of the MOMENTUM project. Dr Ajay Khera, India Country Representative, Engender Health, appreciated the value of association with The George Institute and other partners to address this primary component of the project.

Following the launch event, the team undertook a preliminary field visit to the Tumkur district in Karnataka to implement the activities planned under the project. They met the District Mental Health Programme (DMHP) and visited Nagavalli Primary Health Centre (PHC) and Kuripalaya Urban PHC. They interacted with the PHC staff, Auxiliary Nurse Midwives (ANMs), Accredited Social Health Activists (ASHAs), Medical officers and DMHP team members to understand the psychosocial needs of FLWs, current coping strategies for dealing with work-related stress and interventions aimed at improving the scenario of mental health and its services provided by the DMHP team.

Moving forward, The George Institute will conduct a series of co-creation workshops in six districts to assess the FLWs’ psychosocial needs in detail and incorporate the learnings to design a final package of intervention to pilot in these six districts and then roll out in the remaining 25 Districts over next 18 months.