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Research conducted by Professor Nick Mascie-Taylor on the causes and effects of parasitic infection in Bangladesh, and on the effectiveness of different interventions, led directly to changes in government policy, the roll-out of drug and health education campaigns by the World Health Organisation and the World Bank, and ultimately a reduction in the prevalence of infection and an improvement in the health of Bangladeshi poor. For example, based on recommendations from this research, a two-drug strategy for the control of Filariasis commenced in Bangladesh in 2008; by 2010 twelve districts with high prevalence had been treated, resulting in ~27 million individuals receiving treatment. With this approach microfilaremia prevalence had fallen from about 15% to under 1%.
In Bangladesh, 50 million people live in poverty and around 28 million live in extreme poverty. To date, development agencies have focussed almost exclusively on the needs of the poor and ignored those of the extreme poor. Building on years of poverty research in Bangladesh, researchers at the University of Bath have played a key role designing and then developing a £65 million programme, which is the country's first national scale initiative focusing exclusively on extreme poverty. Impacts from the programme include improving the livelihoods of one million extreme poor people; helping NGOs design innovative programmes for the extreme poor; and embedding the discourse around extreme poverty in the polity.
Childhood obesity is an increasing problem in the UK with roughly one in seven school aged children in Scotland and England being classified as obese. The picture is similar in Wales where the prevalence is one in eight. The direct cost of obesity to the NHS is estimated to be £4.2bn a year, with this set to rise if the causes of childhood obesity are not addressed. The contribution of the research described below to tackling this issue is manifold: it has enabled the development and improvement of child health interventions/programmes; it has allowed commissioners and programme leads to make more informed decisions about investment in these interventions/programmes; and it has contributed to the development of regional healthy weight strategies and national guidelines on weight management.
Jacqueline Barnes' evaluations of government initiatives promoting parenting and child development for vulnerable families have directly affected major policy decisions since 2008. Her study of the Home-Start programme demonstrated limited benefits of unstructured volunteer support, and informed recent NICE guidance on early intervention. Her subsequent evaluation of the Family Nurse Partnership (FNP) programme for vulnerable mothers changed government policy. The success of FNP, as demonstrated during the initial evaluation phase, led to ministerial decisions to more than double the provisions of this programme in 2010 and 2013. FNP has now been rolled out widely in England, Scotland and Northern Ireland.
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.
The main impact of this work has been to provide an evidence base to inform practice and policy in relation to nutrition and diet. Through our contribution to the international EURRECA Network of Excellence, we have developed resources accessible to international expert panels as they review micronutrient recommendations. In addition, this work has had a significant impact on the formation of two major new initiatives; BOND and Zinc-Net, both of which address global issues relating to zinc deficiency and human health. Our pioneering research activities in Pakistan are helping to transform nutrition support and quality of life in marginalised communities.
The Regional Hunger and Vulnerability Programme (RHVP) sought to achieve research-based change in policy approaches to food insecurity and famine in southern Africa by investigating a range of policy options and generating debate. The programme's success can be identified in evidence of use, as provided by a post-programme independent evaluation of RHVP; policy response, as observed in social protection policy changes in Malawi, Lesotho, Botswana and Mozambique; and policy outcomes, measured by the impact on beneficiaries of social transfer schemes put in place or expanded in scope due to RHVP influence on social protection policy thinking in southern Africa.
Research conducted at UCL by Professor Orazio Attanasio and his direct engagement with policymakers has been instrumental in the implementation, design and evaluation of conditional cash transfer (CCT) programmes to stimulate the accumulation of human capital in Mexico and Colombia. The research underpinned the design of an innovative pilot, which he also evaluated, in two major cities, Puebla and Ecatepec, with a combined population of around 4 million. In Colombia, an evaluation led by Professor Attanasio led to improvements in and expansions of the CCT programme, with ongoing benefits to 3 million households. The research team also contributed to a child development programme that launched in Peru in March 2013.
For over 20 years, conclusive evidence has existed that folic acid in early pregnancy prevents spina bifida and related birth defects (collectively known as neural tube defects; NTD), leading to folic acid recommendations for women of reproductive age worldwide. However, translating these recommendations into practice remains a significant challenge. This case study is focussed on identifying and addressing the challenges in implementing current folic acid policy into practice in healthy populations, and in parallel investigating newer roles for folate in preventing disease. Our international outputs to date have provided a scientific foundation for developing evidence-based, sometimes controversial, policy in this area and its translation to consumers.
Agreed by world governments in 2000, the UN's Millennium Development Goals established targets for global improvement of poverty incidence, education, health, environmental sustainability and gender equality by 2015. In 2008 Jeff Waage led a consortium of the University of London's Bloomsbury Colleges in a unique project commissioned by The Lancet culminating in The Lancet's publication of a monograph identifying the MDGs shortcomings, with recommendations for future goal setting. Its authority, novel approach and timeliness made a substantial contribution to current discourse on international development and have supported continued research and policy engagement on this critical global policy process.