A5007374146- HIV/AIDS Research and Interventions
- Global Maternal and Child Health
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- HIV Research and Treatment
- Healthcare Systems and Reforms
- Sex work and related issues
- Primary Care and Health Outcomes
- HIV/AIDS Impact and Responses
- HIV/AIDS drug development and treatment
- Global Public Health Policies and Epidemiology
- COVID-19 epidemiological studies
- Poverty, Education, and Child Welfare
- Health Policy Implementation Science
- Health Systems, Economic Evaluations, Quality of Life
- Chronic Disease Management Strategies
- Intimate Partner and Family Violence
- Child Nutrition and Water Access
- Vaccine Coverage and Hesitancy
- Parasites and Host Interactions
- Interprofessional Education and Collaboration
- Sexual Assault and Victimization Studies
- Tuberculosis Research and Epidemiology
- Food Security and Health in Diverse Populations
- Healthcare Policy and Management
Liverpool School of Tropical Medicine
2015-2024
University of Liverpool
2007-2024
Aintree University Hospitals NHS Foundation Trust
2021-2024
Royal Liverpool University Hospital
2007-2023
Hospital for Tropical Diseases
2006-2021
National Institute for Medical Research
2021
University of the Philippines System
2019
University of the Philippines Manila
2019
Kenya Medical Research Institute
2013
Moving the GoalPosts
2011
Community health workers (CHWs) are increasingly recognized as an integral component of the workforce needed to achieve public goals in low- and middle-income countries (LMICs). Many factors intersect influence CHW performance. A systematic review with a narrative analysis was conducted identify contextual influencing performance CHWs. We searched six databases for quantitative, qualitative, mixed-methods studies that included CHWs working promotional, preventive or curative primary care...
Community health workers (CHWs) have a unique position between communities and the sector. The strength of CHWs' relationships with both sides influences their motivation performance. This qualitative comparative study aimed at understanding similarities differences in how CHWs, sector were shaped different Sub-Saharan African settings. demonstrates complex interplay on trust actors Mechanisms influencing feelings (dis)connectedness, (un)familiarity serving same goals, perceptions received...
Health extension workers (HEWs) in Ethiopia have a unique position, connecting communities to the health sector. This intermediary position requires strong interpersonal relationships with actors both community and sector, order enhance HEW performance. study aimed understand how between HEWs, sector were shaped, inform policy on optimizing performance providing maternal services. We conducted qualitative six districts Sidama zone, which included focus group discussions (FGDs) women men from...
The recent publication of the WHO guideline on support to optimise community health worker (CHW) programmes illustrates renewed attention for need strengthen performance CHWs. Performance partly depends motivation, which in turn is influenced by incentives. This paper aims critically analyse use incentives and their link with improving CHW motivation. We undertook a comparative analysis linkages between motivation based existing datasets qualitative studies six countries. These had used...
The current study identifies young people's preferences for HIV self-testing (HIVST) delivery, determines the relative strength of and explores underlying behaviors perceptions to inform youth-friendly services in southern Africa.A mixed methods design was adopted Malawi Zimbabwe includes focus group discussions, in-depth interviews discrete choice experiments.The conducted during formative phase cluster-randomized trials oral-fluid HIVST distribution. Young people aged 16-25 years were...
Supportive supervision is an important element of community health worker (CHW) programmes and believed to improve CHW motivation performance. A group intervention, which included training mentorship supervisors, was implemented in Ethiopia, Kenya, Malawi Mozambique. In three the countries, this combined with individual and/or peer supervision. mixed-methods implementation study conducted assess effect intervention on CHWs' perceptions motivation-related outcomes. total, 153 in-depth...
South Africa bears the world's largest burden of HIV with over 6.4 million people living virus. The African government's response to has yielded remarkable results in recent years; 13 Africans tested a 2012 campaign and 2 are on antiretroviral treatment. However, an & AIDS STI National Strategic Plan aiming get 80 percent population know their status by 2016, activists public health policy makers argue that non-invasive self-testing should be incorporated into country Counseling Testing...
Effective referral systems from the community to health care facility are essential save lives and ensure quality a continuum of care. The effectiveness in Mozambique depends on multiple factors that involve three main stakeholders: clients/community members; workers (CHWs); facility-based workers. Each stakeholder is dependent other could form either barrier or facilitator within complex system Mozambique. This qualitative study, aiming explore barriers enablers lens adaptive systems,...
BackgroundThe efficacy of daily co-trimoxazole, an antifolate used for malaria chemoprevention in pregnant women living with HIV, is threatened by cross-resistance Plasmodium falciparum to the sulfadoxine–pyrimethamine. We assessed whether addition monthly dihydroartemisinin–piperaquine co-trimoxazole more effective at preventing infection than placebo plus HIV.MethodsWe did individually randomised, two-arm, placebo-controlled trial areas high-grade sulfadoxine–pyrimethamine resistance Kenya...
This study compares client volume, demographics, testing results, and costs of 3 "mobile" HIV counseling (HCT) approaches with existing "stand-alone" HCT in Kenya. A retrospective cohort 62,173 individuals receiving between May 2005 April 2006 was analyzed. Mobile assessed were community-site mobile HCT, semimobile container fully truck HCT. Data obtained from project monitoring data, accounts, personnel interviews.Mobile reported a higher proportion clients no prior test than stand-alone...
A cohort design was used to determine uptake and drop out of 213 HIV-exposed infants eligible for Early Infant Diagnosis (EID) HIV. To explore service providers care givers knowledge, attitudes perceptions the EID process, observations in-depth interviews were conducted. 145 (68%) enrolled after 2 months age. 139 (65%) dropped before follow up 18 old. 60 (43%) outs occurred within enrolment. Maternal factors associated with infant maternal loss (48 [68%] vs. 8 [20%], P < 0.001) younger age...
Community health workers (CHWs) in Mozambique (known as Agentes Polivalentes Elementares (APEs)) are key actors providing services rural communities. Supervision of CHWs has been shown to improve their work, although details how it is implemented scarce. In Mozambique, APE supervision structures and scope work clearly outlined policy rely on supervisors at the facility reference. The aim this study was understand which aspects impact motivation programme implementation.Qualitative research...
Devolution reforms in Indonesia and Kenya have brought extensive changes to governance structures mechanisms for financing delivering healthcare. Community health approaches can contribute towards attaining many of devolution's objectives, including community participation, responsiveness, accountability improved equity. We set out examine two countries at different stages the devolution journey: 15 years postdevolution 3 years.We collected qualitative data across multiple levels system one...
Introduction HIV self‐testing (HIVST) has the potential to increase uptake of testing among untested populations in sub‐Saharan Africa and is on brink scale‐up. However, it unclear what extent HIVST would be supported by stakeholders, policy frameworks are place how variations between contexts might influence country‐preparedness for This qualitative study assessed perceptions stakeholders three countries. Methods Fifty‐four key informant interviews were conducted Kenya ( n =16), Malawi =26)...
Abstract Introduction HIV self‐testing (HIVST) provides couples and individuals with a discreet, convenient empowering testing option. As all testing, potential harms must be anticipated mitigated to optimize individual public health benefits. Here, we describe social (SHs) reported during HIVST implementation in Malawi, propose framework for grading responding harms, according their severity. Methods We report findings from six studies Malawi (2011 2017) that included substudies...
BackgroundLate initiation of antiretrovirals in pregnancy is associated with increased risk perinatal transmission and higher infant mortality. We report the final 72-week postpartum results for efficacy safety dolutegravir-based compared efavirenz-based regimens mothers infants.MethodsDolPHIN-2 was a randomised, open-label trial. Pregnant women South Africa Uganda aged at least 18 years, untreated but confirmed HIV infection an estimated gestation 28 weeks, initiating antiretroviral therapy...
Despite substantial investment in health capacity building developing countries, evaluations of effectiveness are scarce. By analysing projects Africa that had successfully built sustainable capacity, we aimed to identify evidence could indicate was likely be sustainable. Four were selected as case studies using pre-determined criteria, including the achievement capacity. mapping activities each study onto a framework previously used for evaluating research Ghana, able common all projects....