Verbal Autopsy with Participatory Action Research (VAPAR): expanding the knowledge base through partnerships for action on health equity

Lead Research Organisation: University of Aberdeen
Department Name: Sch of Medicine, Medical Sci & Nutrition

Abstract

Health systems can be considered as the products of human relationships: between patients and health workers, managers and policy makers, communities and governments. As a whole, these relationships establish norms of who is eligible for care and what can be expected from the health system. In poor countries where health services are weak and under-funded, care that is unaffordable and unavailable can become socially normal. Communities and health workers have substantial knowledge of these norms and interactions and how health policy is 'brought alive' through them. Their voices are often overlooked in the routine design and delivery of services however.

The project will address this situation by institutionalising processes to: (1) strengthen systems to record and report on deaths, their causes and circumstances; (2) enable the voices of people excluded from access to health systems on their needs and priorities for action, and; (3) act on this information with health workers, managers, planners and policy makers. The process will collect data, analyse, plan and act, and demonstrate an ability to bring about change in partnership with those for whom the situations are most directly relevant. Practical research that is understood and 'owned' by end users in an action-oriented process will strengthen relationships between patients, health workers and policy makers to support and sustain positive change.

The research builds on development work providing actionable health information for poor and rural groups in South Africa. Rural villages in South Africa represent many settings in the region, with deeply entrenched poverty, inequality, avoidable illness, and weak health systems where many deaths go undocumented and uncounted. The development work has adapted Verbal Autopsy, a method used in many poor countries to establish the causes of death for people who die without a doctor present. The research has introduced a system to record new information in Verbal Autopsy on factors such as transport and hospital admissions. In developing countries these processes can play a critical role in survival, and documenting them provides important information for health service provision.

The development work has also tapped into local knowledge on long standing health problems by building partnerships with communities. Using Participatory Action Research, we have developed understandings of the social issues affecting health, and how these affect people's interactions with care. Participatory Action Research provides a route to involve those in the greatest need in health services. This can empower disadvantaged groups to have more of a say in health systems, in turn strengthening people's abilities to protect and promote their health. We have worked with the health authority throughout, considering what the data are telling us, and how changes can be implemented to respond to the issues identified.

The project will extend the development work into an ongoing system of collaborative problem solving, taking data to those who organise and provide services, and working at different levels to understand and enable what is required for change. The work will strengthen existing partnerships with communities, policy makers and planners, and develop new relationships with health workers and clinic managers to act on the evidence towards shared goals. The research will embed a partnerships culture to generate and use information on the realities of health workers and patients to improve care, strengthening access to the health system, achieving improved outcomes and fostering equity in health.

The work has been done with a research centre in South Africa established for over 20 years. A team of researchers and policy makers from universities and health authorities in developing and developed countries who have shaped health research and policy in Africa for over 25 years have come together to lead the five year programme.

Technical Summary

Health systems are increasingly considered in terms beyond 'building blocks' models, as complex, adaptive, human and relational. Despite the conceptual advances, people-centered health systems research methods remain underdeveloped. The proposed work will connect two issues: the lack of information on the health of people excluded from access to health systems, and the low utilisation of research evidence by health systems stakeholders. The proposal is to institutionalise a process to strengthen data on mortality registration, combine with local knowledge, and interpret, plan and act on this basis in the health system at different levels. The method combines Verbal Autopsy (VA) with Participatory Action Research (PAR). VA is a method to determine levels, causes and circumstances of deaths. In PAR, communities organise evidence for action. 3 phases are proposed. In Phase 1, a series of 3 reflection and action cycles will be conducted to generate evidence, analyse, plan and act. Data will be generated on levels, causes and circumstances of deaths (using VA) and on health needs and priorities for action (using PAR) with communities. Data will be analysed with provincial level policy makers, action plans will be developed and implemented by district-level practitioners, and progress will be re-assessed in subsequent cycles. In Phase 2, participants and researchers will evaluate the process using realist and political economy methods to understand changes in care, outcomes and progress towards health equity. In Phase 3, sustainability and transferability will be developed with authorities, research and technical groups, health systems stakeholders and communities in the study site, and to the public. The output will be a process based on international standards, that is contextually relevant in health systems at different levels, and capable of translating local priorities into actionable agendas for health systems strengthening as a means towards health equity.

Planned Impact

The main beneficiaries will be people systematically and unfairly excluded from access to health systems. The process will routinely produce information on their needs and priorities for equity-informed decision-making. Generating and embedding this information in an action-oriented process at different levels of the health system will achieve impact through inclusive knowledge production and exchange, fostering trust and cooperation towards common goals, and strengthening service organisation and delivery to improve health outcomes and health equity.

The process will benefit health systems at different levels by fostering engagement and ownership in research. Beneficiaries will be health workers, facility managers and community workers at the 'coalface' of the system who make daily decisions about eligibility and access in resource-scarce, demand-intensive environments. Empowering practitioners to be involved in policy creation, implementation and evaluation with communities they serve and stakeholders at higher levels will acknowledge and employ these realities for positive change. At higher levels of the system, the process will build cultures of HPSR to provide clear information on what is to be done by whom, with which means and within what constraints, informing the prioritisation of interventions and policy directives enabling assessment of and advocacy for resources.

A further major intended impact is the provision of a sustainable process. The research will generate and use co-constructed evidence of practical relevance for equity-informed systems strengthening on an ongoing basis. The methods and choices of topics will be led by participants and during the project, the process will shift from a research-based to a country-led endeavour. This will foster ownership for sustainability, address disconnects between policy and implementation, integrate research across sectors, and provide practical approaches to deal with the complexities of implementation that limit data and action. The process will be grounded in the needs of end users to illuminate and harness implementation in an integrated and sustainable system of change.

The research will strengthen capacity for health policy and systems research (HPSR). HPSR is a relatively new field, viewing health systems as complex adaptive systems, using relativist enquiry paradigms, value-based approaches, and intersectoral collaborations with a commitment to action. Despite its relevance for resilient and equitable health systems, methods remain underdeveloped. Building and serving practitioner networks is a further intended impact in this context. Teaching and training resources for health systems practitioners and researchers will be developed and disseminated to build communities of practice and encourage collaboration between communities, service providers and researchers.

Impact will be realised by developing methods and capacities for use within and beyond the study setting. A range of engagements with governments, health systems, research networks, HPSR practitioners, civil society and public engagement groups outside the study setting are planned to promote collaborative HPSR for equity in health systems. Interest in the research to date from research groups, the media, communities and health system stakeholders suggests demand for these.

Multi-faceted engagement, fostering collaboration where actors are united by overall goals and values will accommodate different perspectives and extend impacts overall. The work will build on partnerships with targeted activities throughout. New forms of engagement will also be explored by reaching out to others without prior exposure to the work, including the public, politicians and the media. We will innovate with digital technologies, online and social media, social networks and face-to-face engagement. Targeting these groups with these activities will maximise collaborative opportunities and impacts.

Publications

10 25 50
 
Description Giving evidence to Ministerial Committee
Geographic Reach National 
Policy Influence Type Gave evidence to a government review
 
Description PhD (2017/18 entry) nested in VAPAR Programme, entitled: The role of community participation in Health System Strengthening in South Africa
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
Impact Student nested in VAPAR for her PhD fieldwork Jennifer Ngwarai is nested in the VAPAR project for the duration of her PhD at the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. The title of her PhD is "The role of community participation in Health System Strengthening in South Africa".
 
Description Placement projects (n=2 2017/18) linking University of Aberdeen postgraduate students to MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), South Africa
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
Impact No impacts as yet
 
Description Fostering policy support for child and family wellbeing - Learning from international experience, 2017-20
Amount £65,600 (GBP)
Organisation Robert Wood Johnson Foundation 
Sector Charity/Non Profit
Country United States
Start 04/2017 
End 06/2020
 
Description REF2021 Impact Support Award (RISA) University of Aberdeen
Amount £9,944 (GBP)
Funding ID Extending verbal autopsy: developing routine field surveillance methods to measure and understand burden of disease in low and middle income countries 
Organisation University of Aberdeen 
Sector Academic/University
Country United Kingdom
Start 11/2018 
End 10/2019
 
Description Wellcome Trust Institutional Strategic Support Fund (University of Aberdeen)
Amount £9,996 (GBP)
Funding ID Developing an international collaborative network to extend the sustainability and transferability of health systems research methods in Africa 
Organisation University of Aberdeen 
Sector Academic/University
Country United Kingdom
Start 01/2019 
End 12/2020
 
Description Women's Health Outcomes Improvement for West Africa Initiative Global Challenge Research Fund (GCRF) Scottish Funding Council, 2018
Amount £9,940 (GBP)
Organisation Government of Scotland 
Department Scottish Funding Council
Sector Public
Country United Kingdom
Start 01/2018 
End 07/2018
 
Title Health Policy and Systems Research (HPSR) in Mpumalanga 
Description Through the VAPAR programme it has been possible to develop a postgraduate taught course on Health Policy and Systems Research (HPSR) which is currently delivered at the University of Aberdeen, and regularly provides content to the international membership body Health Systems Global where the University of Aberdeen is a featured providers of PG training in this area 
Type Of Material Improvements to research infrastructure 
Year Produced 2017 
Provided To Others? Yes  
Impact The intention is for more locally relevant research and research capacity 
URL http://courses.healthsystemsglobal.org/courses/363
 
Title Participatory Action Research (PAR) to gain local knowledge on health and illness, including Photovoice 
Description The method aims to develop community partnerships to co-construct and act on new knowledge on health in rural settings. The method provides a means to engage with communities in a participatory process to review mortality data and extended COD classifications from Agincourt HDSS, to further amplify these data with local knowledge, to set priorities for local services, and explore the potential for benefits related to empowerment and social inclusion. The method has been developed as part of the Verbal Autopsy with Participatory Action Research (VAPAR) methodological development work (DFID/MRC/Wellcome Trust/ESRC Health Systems Research Initiative (MR/N005597/1) ), Phase 2. 
Type Of Material Model of mechanisms or symptoms - human 
Year Produced 2016 
Provided To Others? No  
Impact - PAR process with local communities: Using the new VA outputs in a deliberative process with village-based groups, new insights have been gained on specific mechanisms through which health risks are accumulated and access to services is limited. Issues identified include transactional sex, harmful traditional practices, alcohol/substance abuse and debt, compounded by denial of treatment, insensitive staff and poor confidentiality in clinics. Photovoice was also used to explore participatory photography - Partnerships: the process has been developed with Mpumalanga provincial health authority and local communities in Agincourt. The partnerships are evidenced in a paper, conference abstract and the current application co-authored by health authority representatives and researchers. The health authority also plans to initiate a community health forum responding to needs expressed in the PAR element. 
 
Description Department of Global Health and Development, London School of Hygiene and Tropical Medicine 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Country United Kingdom 
Sector Academic/University 
PI Contribution Project supervision
Collaborator Contribution Project supervision
Impact Thomas LM, D'Ambruoso L, Balabanova D (2018). Verbal autopsy in health policy and systems: a literature review. BMJ Global Health;3:e000639. Thomas LM, D'Ambruoso L, Balabanova D (2018). The use of verbal autopsy and social autopsy in humanitarian crises. BMJ Global Health;3:e000639.
Start Year 2017
 
Description NHS Grampian Public Health 
Organisation NHS Grampian
Department Public Health
Country United Kingdom 
Sector Public 
PI Contribution With colleagues from NHS Grampian, the PI developed and executed the following research study, exploring issues of community participation in health: D'Ambruoso L (PI University of Aberdeen), Abbott P (Deputy-PI University of Aberdeen), Douglas F (Co-I University of Aberdeen), Okpo E (Co-I NHS Grampian), McPherson E (Co-I Aberdeen City Council). Learning from international experience on approaches to community power, participation and decision-making in health. Training and Research Support Centre, Shaping Health: Exchanging on social power in health 2016 - 2018 | GBP 16,000
Collaborator Contribution Input on specific initiatives, programmes and approaches to community power, participation and decision-making in health in NHS Grampian
Impact Loewenson R, Coelho VS, Calandrini A, Waisbich LT, Frenz P, Alfaro T, Mazzei M, Sgombich X, Ndetei DM, Musyimi CW, Musau AM, Matoke LK, Mutiso VN, Matheson D, Matheson K, D'Ambruoso L, Abbott P, Douglas F, McPherson E, Okpo E, Beznec P, Maucec G, Nemeš S, Nemeš D (2017). Experiences of social power and participation in local health systems-Volume 2: Key features of the deep scan case studies, Training and Research Support Centre: Harare. D'Ambruoso L, Abbott P, Douglas F, McPherson E, Okpo E (2017). Case Study: Empowerment approaches to food poverty in NE Scotland in the Shaping Health programme on Learning from international experience on approaches to community power, participation and decision-making in health. Training and Research Support Centre: Harare. Available at: http://ssrn.com/abstract=3027083
Start Year 2017
 
Description Royal College of Physicians of Edinburgh (RCPE) 
Organisation Royal College of Physicians of Edinburgh
Country United Kingdom 
Sector Academic/University 
PI Contribution Organising Committee Member Royal College of Physicians of Edinburgh (RCPE), University of Edinburgh Global Health Symposium in February 2018
Collaborator Contribution Organising Committee Member Royal College of Physicians of Edinburgh (RCPE), University of Edinburgh Global Health Symposium in February 2018
Impact VAPAR PI Dr Lucia D'Ambruoso participated on the organising committee and VAPAR Co-I Professor Stephen Tollman gave the keynote address "Syndemics and chronic disease in South and sub-Saharan Africa" at the Royal College of Physicians of Edinburgh (RCPE) Global Health Symposium held on Wednesday 21 February 2018.
Start Year 2017
 
Description Scottish Parliament Cross Party Group on Improving Scotland's Health: 2021 and Beyond 
Organisation Scottish Parliament
Country United Kingdom 
Sector Public 
PI Contribution VAPAR PI Dr Lucia D'Ambruoso joined the Cross Party Group in 2017 to provide inputs from international and local research. The purpose of the group is: (1) To take a solutions-oriented focus on how to improve the health of the people of Scotland by reducing the health harms caused by alcohol, tobacco, poor diet and obesity and (2) To join up knowledge and learning, and to identify positive ways forward, with a range of stakeholders committed to improving public health and to preventing and reducing non-communicable diseases for the next generation.
Collaborator Contribution Participation in meetings
Impact Participation in meetings
Start Year 2017
 
Description Scottish Parliament Cross Party Group on International Development 
Organisation Scottish Parliament
Country United Kingdom 
Sector Public 
PI Contribution VAPAR PI Dr Lucia D'Ambruoso joined the Cross Party Group in 2017, bringing inputs from international research. The purpose of the group is to ensure liaison between MSPs and organisations working in Scotland on international aid and development issues. To further raise awareness in Scotland of these issues and to provide a Scottish forum for discussion, while also promoting stronger links between Scotland and international aid and development agencies. The group will also seek to promote development education in Scotland, to support Scottish organisations working in international aid and development programmes and where appropriate facilitate regular visits to Scotland by representatives of the international humanitarian agencies while engaging with minority residents in Scotland to encourage their involvement in the work of the group.
Collaborator Contribution Participation in meetings
Impact Participation in meetings
Start Year 2017
 
Description Training and Research Support Centre (TARSC) 
Organisation Training and Research Support Centre
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Insights around social participation in health, and health policy and systems research, have informed productive discussions and collaborative activities with the Training and Research Support Centre (TARSC). The collaboration has been advanced considerably and is evidenced in two research awards from TARSC in November 2017, and in 2018 with the VAPAR PI and TARSC from the Robert Wood Johnson Foundation.
Collaborator Contribution As above
Impact Two grant awards as follows: 1. D'Ambruoso L (PI), Abbott P (Deputy-PI), Douglas F (Co-I), Okpo E (Co-I), McPherson E (Co-I). Learning from international experience on approaches to community power, participation and decision-making in health. Training and Research Support Centre, Shaping Health: Exchanging on social power in health 2016 - 2018 GBP 16,000; 2. Loewenson R (PI), D'Ambruoso L (Co-I). Fostering policy support for child and family wellbeing - Learning from international experience. Robert Wood Johnson Foundation 2018 - 2020 GBP 65,600
Start Year 2017
 
Description Complex Systems Thinking and NCD Prevention Symposium London School of Hygiene and Tropical Medicine Thursday, 14 September 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact VAPAR PI, Dr Lucia D'Ambruoso participated in the above mentioned event organised by LSHTM (https://www.eventbrite.co.uk/e/complex-systems-thinking-and-ncd-prevention-registration-33988673036) with two postgraduate students from the University of Aberdeen. The meeting was an excellent networking opportunity at which links with LSHTM academics working in health policy and systems research were developed.
Year(s) Of Engagement Activity 2017
URL https://www.abdn.ac.uk/iahs/research/global-health/complex-system-thinking-and-noncommunicable-disea...
 
Description Giving evidence to Ministerial Committee: Verbal Autopsy with Participatory Action Research (VAPAR): expanding the evidence base through partnerships for action on health equity. Ministerial Committee on Mortality and Morbidity in Children Under-5, Department of Health, Republic of South Africa 14 February 2019. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact D'Ambruoso L (2019). Verbal Autopsy with Participatory Action Research (VAPAR): expanding the evidence base through partnerships for action on health equity. Ministerial Committee on Mortality and Morbidity in Children Under-5, Department of Health, Republic of South Africa 14 February 2019.
Year(s) Of Engagement Activity 2019
 
Description Invited talk and panel discussion Whose reality counts? Participation and coproduction in global health research. Institute of Applied Health Research Seminar Series, University of Birmingham, 24th January 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact D'Ambruoso L (2019). Whose reality counts? Participation and coproduction in global health research. Institute of Applied Health Research Seminar Series, University of Birmingham, 24th January 2019.
Year(s) Of Engagement Activity 2019
 
Description Invited talk and panel discussion Whose voice counts? Science communication in multi-level, intersectoral collaborations, National Research Foundation/Department of Science and Technology Graduate Student Network: Selling Your Science Selling Yourself 16th-20th September 2018 Limpopo, South Africa. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact D'Ambruoso L (2018). Whose voice counts? Science communication in multi-level, intersectoral collaborations, National Research Foundation/Department of Science and Technology Graduate Student Network: Selling Your Science Selling Yourself 16th-20th September 2018 Limpopo, South Africa. http://gsn.dirisa.org/indibano/2018
Year(s) Of Engagement Activity 2018
URL http://gsn.dirisa.org/indibano/2018
 
Description Keynote address Royal College of Physicians of Edinburgh (RCPE) Global Health Symposium 21 February 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The keynote address "Syndemics and chronic disease in South and sub-Saharan Africa" at the Royal College of Physicians of Edinburgh (RCPE) Global Health Symposium held on Wednesday 21 February 2018 was given by VAPAR co-investigator Professor Steve Tollman of Wits University and MRC, South Africa, and INDEPTH Network, Accra, Ghana
Year(s) Of Engagement Activity 2018
URL https://www.rcpe.ac.uk/college/symposium-global-health
 
Description Maternal Death Surveillance and Response Action Network (MDSR) Publication, published 6 March 2017 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact VAPAR PI Dr Lucia D'Ambruoso wrote the piece: "Local knowledge to reduce under-five mortality: Initiating participatory action research in rural South Africa" to describe using participatory approaches to strengthen mortality surveillance and reporting systems. The process addresses deaths of children under five years of age, which includes newborn deaths. The approaches can be applied to surveillance of perinatal mortality.
Year(s) Of Engagement Activity 2017
URL http://mdsr-action.net/publications/local-knowledge-to-reduce-under-five-mortality/
 
Description Maternal Death Surveillance and Response Action Network (MDSR) Publication, published 7 September 2017 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact VAPAR PI Dr Lucia D'Ambruoso wrote the piece: "Improving data improving health: Verbal autopsy for health systems strengthening" for the Maternal Death Surveillance and Response Action Network following the VAPAR dissemination event at University College London (UCL) 'Improving Data, Improving Health: Verbal Autopsy for Health Systems Strengthening'. The event was organised by the University of Aberdeen's Centre for Global Development and UCL's Institute for Global Health. The half-day event in October 2016 featured six speakers from the World Health Organization, Umeå University, UCL, Malaria Consortium, University of Aberdeen and the Africa Health Research Institute.
Year(s) Of Engagement Activity 2017
URL http://mdsr-action.net/publications/improving-data-improving-health-verbal-autopsy-for-health-system...
 
Description Measuring progress: what is a fact? University of Aberdeen International Development Week 23 February 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact VAPAR Pi Dr Lucia D'Ambruoso gave the talk: 'Measuring progress: what is a fact?' As part of the University of Aberdeen International Development Week 23 February 2017.
Year(s) Of Engagement Activity 2017
URL https://www.abdn.ac.uk/cgd/news/10428/
 
Description Oral presentation and panel discussion - Wariri O, D'Ambruoso L, Byass P, Kahn K, Spies B, Tollman S, Twine R, Van Der Merwe M, Witter S Rethinking collaboration: developing knowledge partnerships to address under-5 mortality in Mpumalanga province, South Africa. Fourth Global Symposium on Health Systems Research, Liverpool 8-12 October 2018. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Wariri O, D'Ambruoso L, Byass P, Kahn K, Spies B, Tollman S, Twine R, Van Der Merwe M, Witter S Rethinking collaboration: developing knowledge partnerships to address under-5 mortality in Mpumalanga province, South Africa. Fourth Global Symposium on Health Systems Research, Liverpool 8-12 October 2018.
Year(s) Of Engagement Activity 2018
URL http://healthsystemsresearch.org/hsr2018/wp-content/uploads/2018/10/OralAbstractBook-Final.pdf
 
Description Organising Committee Royal College of Physicians of Edinburgh (RCPE), University of Edinburgh Global Health Symposium in February 2018 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This symposium examined some of the issues related to the introduction of vaccines into national programmes and discussed key progress in malaria control. In the context of the increasing recognition of the importance of considering multiple disease burdens in developing countries, the symposium will feature talks on syndemics (particularly in relation to non-communicable diseases and mental health), planetary health and the key challenges in global health over the next decade. This symposium was developed to have a broad appeal to those with an interest in global health - medical students, general practitioners, general physicians of all grades and stages of training, and public health professionals.
Year(s) Of Engagement Activity 2018
URL https://www.rcpe.ac.uk/college/symposium-global-health
 
Description Photovoice Exhibition - Mabetha D on behalf of the VAPAR Programme. 'It destroys families and communities: alcohol and drug abuse in rural South Africa. Photovoice Exhibition Fifth Global Symposium on Health Systems Research, Liverpool 8-12 October 2018. http://healthsystemsresearch.org/hsr2018/photovoice/it-destroys-families-and-communities-alcohol-and-drug-abuse-in-rural-south-africa/ 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Mabetha D on behalf of the VAPAR Programme. 'It destroys families and communities: alcohol and drug abuse in rural South Africa. Photovoice Exhibition Fifth Global Symposium on Health Systems Research, Liverpool 8-12 October 2018.
Year(s) Of Engagement Activity 2018
URL http://healthsystemsresearch.org/hsr2018/photovoice/it-destroys-families-and-communities-alcohol-and...
 
Description Poster presentation - Cowan E, D'Ambruoso L, Ameh S, Byass P, Twine R, Wagner RG, Witter S. Understanding non-communicable diseases: combining routine surveillance data with local knowledge in rural South Africa. Fourth Global Symposium on Health Systems Research, Liverpool 8-12 October 2018. 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Cowan E, D'Ambruoso L, Ameh S, Byass P, Twine R, Wagner RG, Witter S. Understanding non-communicable diseases: combining routine surveillance data with local knowledge in rural South Africa. Fourth Global Symposium on Health Systems Research, Liverpool 8-12 October 2018.
Year(s) Of Engagement Activity 2018
URL http://healthsystemsresearch.org/hsr2018/wp-content/uploads/2018/10/Poster-Abstract-book-v2.pdf
 
Description Poster presentation - Thomas LM, D'Ambruoso L, Balabanova D (GHM 16/17 Centre for Global Development, University of Aberdeen): Verbal Autopsy in Health Policy and Systems: A LITerature Review. Fourth Global Symposium on Health Systems Research, Liverpool 8-12 October 2018. 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Thomas LM, D'Ambruoso L, Balabanova D (GHM 16/17 Centre for Global Development, University of Aberdeen): Verbal Autopsy in Health Policy and Systems: A LITerature Review. Fourth Global Symposium on Health Systems Research, Liverpool 8-12 October 2018.
Year(s) Of Engagement Activity 2018
URL http://healthsystemsresearch.org/hsr2018/wp-content/uploads/2018/10/Poster-Abstract-book-v2.pdf
 
Description Poster presentation: Understanding non-communicable diseases: combining health surveillance with community based research in rural South Africa at Wits School of Public Health Research Day Public Health for Sustainable Development in Africa 27 November 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Poster at the University of the Witwatersrand's School of Public Health Research Day
A Masters graduate from the Univesrity of Aberdeen, Eilidh Cowan had a poster displayed at the School of Public Health Research Day on the 27th November 2017. The title of the poster was "Understanding non-communicable diseases: combining health surveillance with community based research in rural South Africa".
Year(s) Of Engagement Activity 2017
 
Description RCUK GCRF regional engagement event, University of St Andrews, 26 September 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Approximately 50-100 delegates attended a RCUK GCRF regional engagement event on the 26 September 2017 at St Andrews University on GCRF strategy, current and upcoming opportunities and to share best practice and lessons learned from other ODA-related activities, including the Collective Fund Growing Research Capacity and Capability call. VAPAR PI gave the following oral invited presentation: D'Ambruoso L (2017). Verbal Autopsy with Participatory Action Research (VAPAR): expanding the evidence base through partnerships for action on health equity. RCUK GCRF Interdisciplinary Research Hubs Event. University of St Andrews 26th September 2017.
Year(s) Of Engagement Activity 2017
 
Description Trends and transitions: Mortality findings and their applications. SA-Medical Research Council On-site Review with Wits University, 14-16 November 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact The presentation was given as part of an institutional review of the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt). The MRC reviews are done every 5 years to improve health of people through quality research and offering support to the accredited MRC sites. During the review, project managers and coordinators presented about the work they do on various studies emphasising the relevance, success and outcomes of the studies. The event was attended by the South African Medical Research Council (MRC) Review panel consisting of 7 MRC committee members and 3 members from two universities in South Africa. VAPAR was presented highlighting the aims, objectives and significance of the study linking to mortality and verbal autopsy data. The panel was updated on data collection methods used, outcomes and on partners, funders and participants of the study. After the presentation, the panel showed interest on the topics that the villages found to be of importance (lack of water and alcohol and drug abuse). One of the panel members further highlighted the importance of involving and building partnership with health economists in health policy and systems research.
Year(s) Of Engagement Activity 2017
 
Description Who counts? The value of empowerment approaches in research on maternal and child health in resource poor settings. Grand Challenges Lecture, Institute of Global Health and Development, Queen Margaret University, Edinburgh, UK 7 March 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact VAPAR PI, Lucia D'Ambruoso, gave the final seminar of the Institute of Global Health and Development (IGHD), Queen Margaret University, Grand Challenges Seminar Series of the 2016-2017 session. The session was given to a group of academics and postgraduate students at QMU and also delivered as a web-cast whereby people could watch and ask questions online. The discussions afterwards reflected interest and engagement in the topics covered
Year(s) Of Engagement Activity 2017
URL https://www.eventbrite.co.uk/e/who-counts-the-value-of-empowerment-approaches-in-research-on-materna...