School of International Development - UEA: Health, Policy and Practice

Good health is a vital dimension of human wellbeing and influences processes of development and change. The School of International Development has established a unique inter-disciplinary health research team, including economists, sociologists, environmental scientists and anthropologists.  Our diverse research activities are linked by a general interest in the ways that development settings and processes influence the health sector, whether at household and community level or in terms of health policy and practice.  We combine policy-relevant research with innovative theoretical scholarship. Over the past 15 years we have focussed strongly on HIV and AIDS, as part of the wider UEA HIV and Development Group. We have extended this expertise into a wide range of health policy and practice themes, including:
 

• Interfaces between health services and households or communities
• The role of the health sector and health services in social protection
• Health sector and environmental hazards
• Human resources for health service delivery
• Reproductive rights and strategies

Email: devresnews@uea.ac.uk
Phone: 01603 592323

Since 2000 the School has expanded its research on international health and development, building on its long standing strength in HIV and AIDS research and investing in new areas of inquiry, notably research on:

• Interfaces between health services and households or communities
• The role of the health sector and health services in social protection
• Health sector and environmental hazards
• Human resources for health service delivery
• Reproductive rights and strategies

Research on the interface between health services and households focuses on access, uptake and health care expenditures, and the socio-economic effects of morbidity on individuals and households.  Studies have been conducted in Sri Lanka (ESRC-funded), South Africa (Wellcome Trust-funded), Ethiopia (SCF-funded) and currently in Burkina Faso and Uganda.  The Burkina Faso research is evaluating the impact of obstetric complications on the economic, social and physical well-being of women and their families, and whether such events lead to sustained impoverishment in the longer term (3-4 years), while research in Uganda is exploring the impact of family and individual ill-health on older people’s well-being.

The role that the health sector can play in social protection is revealed by these household studies, which look at treatment behaviour and the economic burden of illness for households. In Sri Lanka the free public care at the point of delivery, financed through tax-based risk sharing, protected the poor from catastrophic health care expenditures.  In South Africa, recent research findings show the links between illness-related costs and impoverishment over time, and the protection effects of free health services, cash transfers and social networks.  Different degrees of success in drawing on these social protection resources affected household capacity to cope with illnesses and made a considerable difference to whether households sustained their livelihoods, struggled or declined.  Cash transfers combined well with free health care to build resilience among some households.

In Latin America, Peter Lloyd-Sherlock has assessed the equity implications of health sector reforms in Latin America, focusing on the capacity of insurance schemes to protect the most vulnerable groups, including older people.  Lloyd-Sherlock’s work focuses on the impacts of policy change on equity and the most vulnerable social groups. The research is highly critical of the impacts of orthodox health sector reform on the overall effectiveness of health systems on Latin America, arguing that they have reduced efficiency, accountability and capacity to improve population health.

We have also examined health sector responses to disaster risk, especially from climatic hazards such as floods, drought and tropical cyclones. Roger Few has worked in Mexico and Vietnam as part of research funded by ESRC geared to enhancing understanding of how people and institutions in developing countries respond to the health risks posed by extreme climatic events. Health-related response to risk in both countries has been improved through closer cross-sectoral and vertical coordination, though there remains a disjuncture in both countries between national/regional strategy and local-level capacities for response.

Pro-poor or equitable health systems are reliant on motivated health workers who are prepared to work in rural settings.  Focusing on this question of health worker behaviour, Peter Serneels has used insights from behavioural economics and psychology, and combined qualitative and quantitative methods, to examine the labour market choice and on the job behaviour of health workers. The study, now adopted as a model by The World Bank, is being replicated in a number of countries in Africa and Asia and collaboration with WHO.

We also critically examine the discourse of rights-based approaches to reproductive health. Catherine Locke currently leads research on the impact of new opportunities for migration on marriage, child-bearing and child-rearing strategies in Vietnam.

Janet Seeley is involved in a research project on sex workers and their clients in Kampala, Uganda.  Her research focuses on building an ethnography of life and livelihoods in an effort to try to understand more about ways to reduce risk (from disease but also violence).

For a summary of current and recent research projects on health policy and practice at the School of International Development click here.

see Research (above)