devinitorg/iati-policy-markers huggingface dataset:
E-MhGAP Intervention guide in Low and middle income countries: proof-of-concept for Impact and Acceptability (Emilia project) Layperson summary  The context for the Emilia proposal is the 'mental health treatment gap'. This is the difference between the number of people with mental illness needing treatment and care, and the number who actually receive help. At present this gap is huge. Over 80% of people with severe mental disorders in low and middle income countries (LMICs) receive no treatment at all. The aim of the Emilia project is to assess if it is possible to produce a version of the World Health Organisation (WHO) Mental Health Global Action Programme Intervention Guide that is easily usable on smart phones and tablet devices, for use in this project by primary care staff in Nepal and Nigeria. We intend to assess if this electronic form of guidance is suitable for use in other LMICs, where over 85% of the world's population live.  We will compare the training, support and supervision given to primary health care using the paper version and the electronic version of the WHO Mental Health Global Action Programme Intervention Guide (mhGAP IG). We will assess if the electronic version is more practical to use (ie more feasible) by answering the following questions. Is the electronic version more feasible to use in terms of:  1. greater staff acceptability 2. more often leading to an evidence-based intervention 3. a greater proportion of patients with depression are identified by primary care staff 4. being affordable and cost-effective 5. delivering better clinical support and supervision to primary care staff 6. leading to less stigma related to people with mental illness among primary care staff The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
African critical care registry network for pandemic surveillance, clinical management and research. MRC GECO COVID award looking at the African critical care registry network for pandemic surveillance, clinical management and research. Our group of LMIC based co-investigators and project partners from established critical care and pandemic networks aims to address the knowledge gaps that exist regarding the natural history and clinical course of COVID-19 related critical illness in seven African countries - Ethiopia, Kenya, Namibia, Sierra Leone, South Sudan, Tanzania and Uganda. COVID-19 The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
Trans-national cohorts of nephrotic syndrome - a unified approach to a global chronic disease Kidney disease in Low and Middle income countries is under recognised and severely under resourced. The reasons include lack of clinical expertise, diagnostic capabilities, and even if recognised the means to treat chronic, remitting disease without specialist drugs and technology is rarely possible. The incidence of one of the commonest types of renal disease (in adults and children), idiopathic nephrotic syndrome (INS), appears considerably higher in LMICs than in the developed world. This is likely contributed to by a combination of infectious triggers and genetic background, though other factors remain unknown.  The biological understanding of glomerular disease has been revolutionised in recent years by study of the glomerular podocyte, the specialised cell type that is the primary target of damage in INS. The potential therefore is to use compelling biological advances to develop technologically sophisticated laboratory assays that can rapidly be tested on large local populations of patients in different LMIC settings. This will lead to directly applicable classification of disease according to new molecular and genetic findings, and hence targeted and more effective health care.  This proposal brings together different groups of researchers with different strengths, and will enable knowledge transfer between all partners. The host laboratory in the UK is a world leader in podocyte biology and INS population genetics, and has well-established links with key leaders in nephrology in several LMICs. In the UK we have established in nephrology a national patient registry (www.rarerenal.org) and biorepository, with widespread clinician and patient buy-in that is recognised as innovative This proposal aims to extend this concept internationally, to build a vibrant and cohesive network of academic centre leads in three LMICs with the UK centre as a hub. Each centre will be helped to build the infrastructure and expertise required to carry out biomarker and clinical trials studies on large and currently poorly understood cohorts of patients. The downstream benefits will be (i) establish a team of LMIC centres trained consistently in laboratory research/diagnostic techniques and clinical database/biobank establishment (ii) transfer of cutting edge translational biology advances from the UK laboratory (and elsewhere) to establish novel laboratory assays locally (iii) share clinical trials methodology that will maximise impact of laboratory findings from large cohorts of patients. Links to Bristol will then facilitate definitive analysis of large scale molecular data. in this carefully curated population, with a pipeline of sustainable skills development in each centre. The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
Bridging the Mental Health Treatment Gap through Tele-psychiatry - 'REACH' a Formative Research Project from Goa, India. India has a significant burden of mental illness with almost 70 million people having some form of mental illness. This problem is compounded by an acute shortage of trained specialist manpower to provide mental healthcare to those who require it. The existing manpower can only provide care for one third of the mental health needs. Furthermore, 70% of this manpower is inequitably concentrated in urban areas while 70% of the Indian population lives in the villages. This mismatch is a great public health challenge and there is an urgent need to look at innovative ways to overcome this barrier to access. Affordable technology, which is easily accessible in India today, might provide the turning point in the field of mental healthcare delivery. In this project we plan to use videoconferencing technology to provide mental healthcare for patients attending primary care clinics. We plan to discover whether such an innovation is feasible and safe to deliver, acceptable to the various stakeholders and has a positive impact on the mental health of the people. Videoconferencing facilities will be established between District Hospital and Primary Health Centres, where most patients access health care. Patients with Depression, Alcohol use disorders and Severe mental illness will be identified by research workers, who will be offered consultations with a psychiatrist based in the District Hospital via videoconferencing. Medication and follow up services will be provided in the primary health centres. Before-after assessment will measure change in symptoms and disability level. Since the service is delivered in the community we expect better compliance rates. In-depth interviews will be conducted with all stakeholders including service delivery agents, patients and their families to determine the acceptability of tele-psychiatry. Demonstrating that delivering mental health care through tele-psychiatry is feasible and acceptable has significant policy implication. Tele-psychiatry can then play a transformational role in mental health delivery in low resource settings. The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
Determining the persister populations in sputum during tuberculosis therapy. A supplementary study to the RIFASHORT trial. IIB  Research Boards May/Jun 2016  RM 2017 award to  add value to a clinical trial testing a shortened treatment of TB by studying the ability of tests to predict treatment failure in Botswana The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
COVID-19 Neurological Disease: a Global Meta-Analysis and Prospective Case Control Study in Brazil, India and Malawi. MRC GECO COVID-19 Neurological Disease award: a Global Meta-Analysis and Prospective Case Control Study in Brazil, India and Malawi
 COVID-19 The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
Factors affecting childhood exposures to urban particulates (FACE-UP) GCRF Health and Context award looking at factors affecting childhood exposures to urban particulates (FACE-UP) in Indonesia and Nepal The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
Enabling rapid conversion of antigen to vaccine, applied to multi-stage malaria vaccination MRC IIB award to enable rapid conversion of antigen to vaccine, applied to multistage malaria vaccination The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
The Bangladesh D:CLARE Project (Diabetes: Community-Led Awareness, Response and Evaluation) We recently completed a population health experiment in rural Bangladesh where we found that a diabetes-focused participatory community mobilisation intervention whereby ordinary community members themselves identify, prioritise and address threats to their health reduced the burden of diabetes and the risk of diabetes (known as 'intermediate hyperglycaemia') in these villages by more than 60% relative to villages where no intervention took place. Furthermore, among individuals who were at higher risk of developing diabetes, those living in community mobilisation villages were almost 60% less likely to develop the disease over two years compared to those who lived in villages where no intervention took place. These findings and our robust methods of evaluation give us confidence that exposure to the community mobilisation intervention caused this reduction in the burden of intermediate hyperglycaemia and diabetes. Furthermore, the low-cost, social intervention is cost-effective and can lead to savings in health care expenditure. Based on these findings, we wish to scale-up our intervention to cover a much larger population. Working with the Diabetic Association of Bangladesh, who will implement the intervention across a population of 215,000 people, UCL will apply epidemiological, economic, social and implementation science methods to better understand the processes, costs and impact of implementation at such a large scale. Further, we will evaluate the sustainability of groups when direct intervention from the Diabetic Association of Bangladesh is withdrawn and evaluate whether observed improvements in health last over a period of three years. Finally, a core component of our project will be engagement with governmental and non-governmental stakeholders in Bangladesh and globally to share our findings and to explore opportunities for longer-term, larger-scale implementation of the intervention. The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
InterTxt2Heart pilot: A trial to evaluate efficacy of text message to improve adherence to cardiovascular medications in secondary prevention. In less developed countries cardiovascular diseases (heart diseases and stroke) have a vast deleterious impact at individual and society level.   Patients with cardiovascular diseases can benefit from affordable and effective medications, but only a minority of patients takes the medications, and strategies tested in the past to improve taking of these medications have failed.   Mobile phones are becoming an essential instrument in daily life of people living in less developed countries and therefore have become an ideal "instrument" to deliver interventions to change behaviours, such as taking medications. Previous successes of studies using mobile text messages to improve adherence to HIV-medications provides a strong precedent that this success could be translated to cardiovascular diseases. However, to achieve this, it requires a carefully work on understanding the reasons why people stop taking medications that also considers the local-context.   To date, there are no studies in cardiovascular disease that full fill these criteria. Our long-term aim is to conduct the largest study to evaluate if mobile text messages can be helpful to increase adherence to life-saving cardiovascular medications. As a first step (current proposal), we will be studying reasons for poor adherence to cardiovascular medications using "state of art" psychological strategies co-developed by some of the co-applicants. Then, we will convert this knowledge, on reasons for poor adherence, into short-text messages tailor to the specific needs of patients in order to increase adherence of cardiovascular medications. In a second step (not included in this proposal) we will test under controlled experimental conditions (known as randomized trial) if mobile text messages are useful to increase adherence to cardiovascular medications that decrease blood pressure and the bad-cholesterol as well as making the blood thinner to avoid occlusion of arteries in the heart, brain and extremities.   The study will take place in Colombia, Ghana, and India, representing major geographical areas with different stage of economic development and health care systems. We expect that our wide-coverage of less-developed countries will facilitate a rapid adoption of our intervention (if successful) to other less-developed countries. Our study will inform the World Health Organization initiative on uses of mobile text phone interventions to improve management of chronic conditions such as cardiovascular diseases The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
Long-term health after malnutrition: the role of the pancreas With current global changes in diet and lifestyle, even low- and middle-income countries are experiencing the 'double burden' of undernutrition and overweight. Both conditions can be found within communities, families and even individuals at different times over their life course. It is well established that malnutrition in pregnancy, resulting in an infant born with low birth weight, can increase the risk of diseases such as diabetes, heart disease and cancer in adulthood. However, the consequences of malnutrition after birth are much less studied. Severe acute malnutrition in childhood, indicated by extreme thinness, remains common in Africa and Asia. In addition, substantial numbers of adult patients with tuberculosis or HIV, diseases which are common in Africa and Asia, may become severely malnourished. We are interested in diabetes, which in Africa and Asia affects people at younger age and lower weight than in Europe. There is evidence from epidemiological studies that severe malnutrition in childhood and possibly in adulthood increases the risk of later diabetes but there is little information as to the mechanisms involved. We wish to focus on the pancreas which is a key organ in digestion and metabolic processes, especially in relation to diabetes. We will investigate pancreas size, microscopic structure, hormone and digestive enzyme production, and the body's response to these hormones among groups of people in Tanzania, Zambia, India and the Philippines. These groups have participated in the research team's previous studies of malnutrition and were severely malnourished before birth, as children, or as adults. They now live in places with a wide range of access to foods high and fat and sugar which could affect their risk of diabetes. We will use modern clinical methods to compare their pancreas function to that of never-malnourished controls at each site. We will use advanced statistical methods to understand the links between early malnutrition and later diabetes, taking into account the factors often associated with diabetes such as current overweight and high intakes of fat or sugar.  The research will lead to improved understanding of both the long-term consequences of malnutrition and the presentation and underlying metabolism of diabetes in Africa and Asia. Thus, it will lead to improved health care for both malnourished and diabetic people even if we find no important link between early malnutrition and later diabetes. The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
Tuning the immune response in tuberculosis Tuberculosis (TB) is an important infectious disease which affects nine million people and causes two million deaths every year. The human immune system can protect against TB but is also responsible for causing the tissue damage that may result from TB disease. I aim to increase our understanding of the parts of the immune system that influence the balance of beneficial and harmful responses to TB infection in order to identify new targets for more effective treatments and vaccines. To do this I will combine experiments in a fish model that closely resembles human TB with experiments in patients with active TB disease. Initially, I will focus on the role of a specific part of the immune system called interleukin (IL)10 because this is a key mediator that controls the immune system during its response to infections. Thus far the role of IL10 in TB has almost exclusively been evaluated in mouse models that provide incomplete information because they do not accurately reflect human TB disease. In addition, I will take advantage of the massive increase in genetic data that has become available, in order to discover new components of immune responses to TB which vary most between people. I postulate that variable immune responses cause differences in outcome of TB infection. I will test this theory by investigating the effects of deficiency or excess of potential new regulatory factors that I identify in people with TB, using the fish model of TB infection. I hope to gain new insights that help to develop novel interventions that will significantly shorten the length of anti-TB treatment, which will be important to reduce spread of TB and minimise development of drug resistance. I anticipate that my work may also lead to design of new vaccines that prevent TB disease altogether. The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
MICA: The third, Intensive care bundle with blood pressure reduction in acute cerebral haemorrhage (INTERACT3) trial The context of the research Acute intracerebral haemorrhage (ICH) is the most severe type of stroke, which affects millions people in the world each year. The incidence of ICH is high in low- and middle- income countries (LMICs), particularly because prevalence of hypertension is high. ICH has a grave prognosis, with at least two thirds of the patients either dying or left with disability. Given the complex and serious nature of ICH, reliable evidence is required to guide health care delivery and policy making. However, the progress has been slow in established clear evidence of benefit for specific management strategies in this condition. However, there is good pre-clinical and observational data indicating that outcomes can be improved through early strict management of several key physiological parameters. Moreover, audits of hospital administrative data for stroke indicate there is widespread poor adherence to many evidence-based recommendations.   Aims and objectives INTERACT3 (The third, INTEnsive care bundle with blood pressure Reduction in Acute Cerebral haemorrhage Trial) is an investigator initiated and conducted, international, multicentre, randomised cluster clinical trial.  The study aims to determine the effectiveness of early intensive care bundle (BP lowering, glycaemic control, treatment of pyrexia, and reversal of anticoagulation).  The overall objectives include: (i) to solve persistent uncertainties of the most appropriate medical management of acute ICH; (ii) to understand the patterns of usual care for ICH in LMIC, in particular in relation to the use of local protocols, pathways and implementation of current national and international guidelines; (iii) to explore the barriers to implementation and adherence to a complex intervention; and (iv) to explore how best to adopt and integrate evidence-based recommendations into routine health care practice in LMICs.  Potential applications and benefits This study will provide reliable evidence on the acute management of ICH and assist decision makings by professionals, service developers, and policy makers in health sectors. Reliable data on ICH management and outcomes could improve quality of care and reduce the high burden of ICH in LMIC. Clinical practice in the care of stroke patients, particularly those with ICH, and adherence to guidelines, could improve outcomes through participation in a high quality clinical trial conducted across multiple hospitals in LMICs.  Moreover, the result could have a widely generalizable benefit, since evaluation of the intervention will be in a broad range of patients, including those severe ICH and/or who undergo surgery, who have been excluded from conventional individual patient randomised trials to date. The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.