Mobilizing stakeholders to build trust in public health systems in post-pandemic West Africa

The goal of this project is to contribute to ongoing public health response to the COVID-19 pandemic and governments’ strategies for building inclusive and cohesive recovery societies in sub-Saharan Africa. The project objectives are to: 1) document drivers of mistrust in public health response to COVI-19 across three countries with contrasting public health systems, levels of economic growth and political stability, and pandemic preparedness experience and levels; 2) examine patterns of trust in the three countries and the relationships between trust and specific COVID-19 behavioral outcomes; and 3) explore and identify strategies for sustaining or building trust in public health institutions.

A related project seeks to provide innovative strategies for building inclusive and cohesive community level zoonotic disease surveillance among nomadic pastoralists in West Africa. Our objectives are to:

This community-engaged project is designed to mobilize community level resources to build trust as a proactive tool for enhanced surveillance for zoonotic diseases (i.e., infectious diseases of animal origin) in pastoral communities in sub-Saharan Africa (SSA).

This community-engaged project is designed to mobilize community level resources to build trust as a proactive tool for enhanced surveillance for zoonotic diseases (i.e., infectious diseases of animal origin) in pastoral communities in sub-Saharan Africa (SSA).

Empowerment and social protection

This gender transformative action-oriented research aims to enhance evidence-informed policymaking and practice to promote the health, wellbeing and economic empowerment of extremely poor women in a pandemic recovery world in a pandemic recovery world in sub-Saharan Africa (SSA), using Ghana as a case study. The overall goal is to use gender equality and health equity lenses to understand the impact of cash transfers, particularly the Ghana Livelihood Empowerment Against Poverty Program, and complementary water services on the work life and health of extremely poor women. The project is implemented in collaboration with the Ghana Livelihood Empowerment Against Poverty Program and three districts in the Upper West Region of Ghana. This research area will provide evidence, policy options, and strategic direction on how to better align cash transfers and complementary services to meet the strategic needs of women in a COVID-19 recovery environment.

Funder(s): New Frontiers in Research Fund (NFRF)

Water insecurity, equity and climate resilience

We are collaborating in the REACH-WISER (Water InSecurity Equity and Resilience) team to assessment empowerment and its connection to water insecurity, seasonality, and climate resilience. REACH is an international, collaborative project led by Oxford University (OU), financially supported by FCDO, to improve water security for the poor in Ethiopia, Kenya and Bangladesh. REACH-WISER (Water InSecurity Equity and Resilience) focuses on interactions between water security and inequalities across communities in Ethiopia, Kenya and Bangladesh. There is a novel focus on understanding household and intra-household dynamics of water security and inequalities, including gendered power relations and decision-making related to water, which have been under-researched in relation to WASH. Dr. Sarah Dickin and Dr. Elijah Bisung are collaborating through the use of the Empowerment in WASH Index in REACH-WISER, and its connections to a range of other outcomes being investigated by the larger team.

Founders: REACH-WISER & FCDO

Women's empowerment and climate change

There is growing interest in climate resilient WASH in many regions that are impacted by climate hazards such as floods, droughts and sea level rise that all affect delivery of these services. In many cases these impacts threaten to further exacerbate gender inequalities related to WASH. Within this context we are studying the missing links between empowerment and climate adaptation in Bangladesh, in collaboration with Simavi, a WASH NGO focused on the rights to water and sanitation for women and girls with a strong emphasis on social and climate justice. When decisions needs to be made to prepare for climate impacts or to recover, it is important to consider who is empowered in these decisions at all levels from the individual, household or community. The findings from this work will have important implications for just adaptation and resilience building.

Funders: Social Sciences and Humanities Research Council and the Science Foundation for Africa.

Non-Communicable Diseases, Climate Change and Health

Climate change and noncommunicable diseases (NCDs) are considered the 21st Century’s major health and development challenges. Both planetary and public health problems pose a disproportionate burden on low- and middle-income countries that are unprepared to cope with their synergistic effects. These two challenges pose risks for achieving many sustainable development goals (SDGs). Solutions to this combined threat needs to consider social inequities and participatory approaches that center women voices. Building on an existing interdisciplinary research network and working collaboratively with researchers from across seven universities, we are investigating how participatory methods can be used to develop NCD prevention and climate change adaptation strategies in Malawi and Ghana. The overarching aim of this research program is to assess the awareness, knowledge and understanding of climate change, its effects on food production, dietary choices, and links to risk of NCDs as well as how climate impacts NCDs management and coping strategies. The research will provide evidence to inform policy decisions designed to address climate change and prevent NCDs. Three graduate students will be supported through this award to respectively conduct research on themes: 1) urban agriculture, dietary diversity and NCD management; 2) knowledge of climate change and its impacts in relation to food production, dietary choices, and diet related NCDs: 3) climate change, food and water insecurity, and women’s empowerment.

Funder: The Bruce Mitchell Fund

Changing food environments, diabetes risks and management in resource poor settings

Diabetes is a major leading cause of death in the world and the daily demands of living with diabetes take an emotional toll on people living with diabetes (PLWDs). Uncontrolled diabetes is associated with increased risk for severe health complications. The high burden of NCDs on the global front has been recognized and included in the United Nations’ Sustainable Development Goals. Goal 3 of the UN SDGs is focused on health with target 3.4 aimed at reducing by one-third premature mortality from NCDs through prevention and treatment and promotion of mental health and wellbeing. Despite the recognition of the challenges posed by NCDs, they remain underfunded and less prioritized and healthcare systems are not re-oriented to deal with NCDs in most low-to-middle-income countries (LMICs). Managing diabetes is dependent upon the availability of resources including access to screening and information, peer and social support, and the socio-political environment. The overall objective is to examine the lived experience of managing diabetes and effective ways of co-creating and co-developing interventions in resource poor settings in Ghana and Belize. We are working collaborative with hospital-based diabetes programs in 3 underserved communities in northern Ghana, 3 communities in Belize and with people living with diabetes and Diabetes organizations  to address diabetes risk and management transparently and collaboratively.

Funders: CIHR (Canadian Institutes of Health Research), Queen’s Global Engagement Grant

Maternal and child health in sub-Saharan Africa

Maternal mortality remains a critical public health challenge globally. The causes of maternal mortality include a complex web of cultural, social, political, and individual factors that influence the risk of a woman dying during or shortly after childbirth. Regrettably, more than half of the maternal deaths occur in low to middle income countries, especially in sub-Saharan Africa (SSA). Women’s access to and control over economic resources and participation in economic activity is not only a potential pathway to reducing gender inequalities but can also create a trajectory that leads to reduction in maternal mortality risk. Working collaboratively with local gatekeepers and researchers in Ghana, we aim to enhance community-health system communication and knowledge improvements for pregnancy and newborn care using AI tailored solutions (ENCOMPAS). The ENCOMPAS project will develop two digital systems (E-platform and Preg-App). The two digital platforms will be integrated to improve the lived experiences  of pregnant women enrolled onto the study in the Wa West district (WWD) and the Mamprugu Moagduri District (MMD) in the Upper West and North-East Regions of Ghana, respectively. Specifically, this project will examine pregnant women experiences along the referral pathway (pregnancy to childbirth), assess treatment outcomes during pregnancy, shared experiences during childbirth, postpartum care received, early timing and utilization of required ANC services by pregnant women, continuum of care and satisfaction ratings of maternal health service quality.

Funder: Grand Challenge Canada

Promoting Black Children Health and Development in Canada

The availability and utilization of quality and culturally responsive support systems are crucial in shaping children and youth’s physical, cognitive, social, and behavioral development. However, for racialized and immigrant Canadians, these essential services are either not designed to address their unique circumstance or are out of their reach. The intersection of race/ethnicity, poverty and the COVID-19 pandemic have elevated the risk of poor health outcomes for racialized children in Canada and may contribute to widening existing racial opportunity and achievement gaps. The first strand of the project is focused on identifying and mobilizing resources to promote early learning and childcare equity in Kingston and London Ontario. The second strand aims to adopt a community-based research partnership approach to co-create a community-health systems partnership that creates supportive environments to enhance perinatal and newborn health.

Funders: Social Sciences and Humanities Research Council.