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Dr Sunil Amrith's research has enhanced understanding of the historical roots of many contemporary policy problems, making him a leading expert on the history of public health in South and Southeast Asia. The critical success of his monograph Decolonizing International Health, and its positive reception among non-academic specialists in the field, led to his involvement in dialogues with policymakers in international NGOs and invitations to contribute a historical perspective to discussions about public health issues in the developing world. His work has influenced policy development and shaped capacity building programmes.
Globally, there are around 290,000 maternal deaths per year, 83,000 of them in South Asia. Post-partum haemorrhage [PPH] is a major contributor to maternal mortality. Currently, oxytocin is advocated as a key life-saving drug for arresting/preventing PPH when administered immediately after birth. Edinburgh University research on home deliveries in India exposed one important but largely unacknowledged and unquantified risk-factor for maternal mortality: widespread misuse of oxytocin during labour to speed up the process. These and other findings in relation to the supply and unregulated use of pharmaceuticals in South Asia have been brought to the attention of advocacy groups and international donors, thus helping frame pharmaceuticals policy debate, e.g. by highlighting the need to reduce the diversion of oxytocin for dangerous use during labour. The research has also increased recognition of the importance of ethnographic research in facilitating evidence-based public-health policy-making and enhanced the capacity of advocacy groups to provide evidence-led input on crucial policy questions.
The `People in Public Health' (PIPH) study and related research on health trainers, health champions and volunteers has brought together evidence on rationales for lay engagement, effectiveness and models of support. Dissemination activities, supported by a Department of Health grant, have achieved reach into various policy arenas and national networks. At the same time there is evidence of research utilisation in public health practice. One of the impacts has been the establishment of `Active Citizens for Health', a national network of partner organisations to bring together evidence and learning that has been hosted by Leeds Metropolitan University.
Empirical evidence generated by UEL research has directly influenced the reform of health financing in two Indian states with total populations of 154 million through changes to provider behaviour, the organisation and use of funds, and treatment verification processes and package rates. The impacts of this work have been commended by the UK Department for International Development (DFID) and the World Bank, and attracted interest from states with similar healthcare schemes. More widely, it has helped policymakers in India and the UK recognise the importance of including high quality comprehensive primary care in India's strategic planning for universal health care, and the benefits to the UK in prioritising primary care collaboration with India.
Professor Mark Jackson's research on the history of allergy and asthma, carried out in the Centre for Medical History, University of Exeter, has been successful in enhancing clinical, commercial and policy understandings of the social, political and cultural, as well as biological, determinants of allergic diseases in the modern world. It has also helped to raise public and patient awareness of historical trends in asthma and allergies and to increase public understanding of evolving methods of diagnosis, prevention and treatment through focused collaboration with the charity Asthma UK as well as through various outreach and engagement activities. Professor Jackson was appointed to the Centre of Medical History at Exeter in 1998.
Public financing of health services in low income countries was challenged by the World Bank's Agenda for Reform in 1987, which advocated increased roles for private sector, private insurance and user fees. This was followed by a wave of reforms implementing this approach. McPake has been involved in researching the implications of this shift since this period and has published a series of influential articles that have had a demonstrable impact on this debate. Removal of user fees for all, or selected, services or for selected population groups has occurred in many countries, including 28 of 50 countries with the highest maternal and child health mortality included in a recent survey (http://bit.ly/17FUiDM). Witter is the lead researcher who has examined country level experiences of removing fees and it is demonstrable that her work has been applied in specific countries to shape the details of policy and has also had a major influence on the global debate.
Health inequalities are recognised as a critical UK policy issue with life expectancy gaps of up to 28 years between the least and most deprived areas. This case-study demonstrates how Durham University research has led to: (a) changing health service commissioning (with County Durham and Darlington Primary Care Trust [PCT]): (b) influencing NHS funding policy (by generating Parliamentary debate); as well as (c) contributing to the development of the new public health system in England and Wales (as part of the Strategic Review of Health Inequalities in England post-2010 [Marmot Review]).
This case study highlights a body of research around health Research Priority Setting (RPS) that assists policy makers in effectively targeting research that has the greatest potential health benefit. Empirical research on RPS led to organizational changes, and new policies within the Cochrane Collaboration along with new training resources and new RPS exercises. A research gap on inequalities in the risk of oral cancer in the English South Asian population led to an evidence synthesis exercise being carried out by the National Institute for Health and Care Excellence (NICE) and the formulation of a new public health guideline.
Research by the University of Southampton into maternal and child health in the developing world has contributed significantly to the design of better health policies by governments, international agencies, and non-governmental organisations. The research broke new ground in identifying the urban poor in developing countries as among the groups most at risk of poor maternal and child health. Its findings have informed policy and funding priorities at national and international organisations including the Department for International Development (DFID) and the United Nations; influenced health practitioners in Africa and Asia; and led to better health care outcomes in countries which were the focus of the research.
Durham University's Centre for Public Policy and Health (CPPH) has worked closely with the World Health Organisation's (WHO) Regional Office for Europe to help design the European Action Plan for Strengthening Public Health Capacities and Services. The European Action Plan (EAP) draws extensively on three major CPPH research projects on the nature and governance of the public health system in England. The EAP, endorsed by all 53 WHO Member States in September 2012, is a main pillar for the implementation of the WHO's policy framework — Health 2020 — also endorsed by Member States.