COMDIS-HSD

Description

COMDIS-HSD is a Research Programme Consortium, working with partner NGOs in low- and middle-income countries (LMICs). We have researched and developed improvements to the delivery and quality of prevention and care services for communicable and non-communicable diseases, as well as making these services easier for people to access, especially in underserved populations. Though the existing round of funding ended in December 2018, the research and service development partners continue to work together on follow on and other projects (with other funding sources). We are currently bidding for the next round of funding for COMDIS. 

For further details visit our website http://comdis-hsd.leeds.ac.uk

Communicable Diseases Health Service Delivery research programme consortium

Health services are generally very poor in LMICs and the very poor, women and disadvantaged groups receive particularly bad service. It is vital that strategies to deliver health services are feasible for the context, are sustainable and can be scaled up to the whole country.

Aim & Objectives

To develop and test locally-appropriate strategies for delivery of health services (including care and/or control of communicable and non-communicable diseases) in LMIC countries, and to support development of operational plans, tools and training methods and materials to enable and encourage large scale implementation of successful strategies by partner governments and other health service providers. The main diseases to be addressed are tuberculosis (TB), malaria, neglected tropical diseases, sexually transmitted infections, HIV/AIDS, diabetes, hypertension, asthma and COPD, malaria and non-malaria fever – and reducing overuse of antibiotics and antimalarials, to minimise antimicrobial drug resistance

Particular issues to be addressed are: encouraging appropriate demand for services; improving access to services; improving primary care; developing community-based initiatives; improving services in urban areas, particularly slums; maintaining and improving quality of services and avoiding development of drug resistance.

Methods

We have an approach where the research is embedded and conducted within the ministry of health programmes, such as TB and malaria programmes. See the http://comdis-hsd.leeds.ac.uk/wp-content/uploads/2018/12/The-Embedded-Approach.pdf. This includes a series of research, service development, evaluation and support to scale-up approaches, typical approaches are as follows:

Strategy development: quantitative and qualitative operational research methods, working with local populations and health providers to identify needs, constraints, opportunities etc.

Strategy assessment: including randomised controlled trials, district implementation cohort studies and comparisons of outcomes before and after implementation and qualitative methods (generally together with individual interviews and focus group discussions and costing studies) to better understand the outcomes.

Encouraging large-scale implementation: participatory workshops involving government and other partners throughout the development and implementation of the research, to produce operational plans, tools and training methods and materials, and encourage ownership, commitment and scale-up.

Results

Development of many proven strategies, including strategies to:

• deliver community-based care for multi-drug resistant TB
• integrate screening (eg for chronic cough and diabetes) and interventions in South Asia
• expand community-based networks for onchocerciasis elimination to include mass drug administration for other major neglected tropical diseases
• implement public–private partnerships for health service provision for TB and other diseases in urban areas where public provision cannot be improved
• contextually adapt and institutionalise the use of evidence-based guidelines, enhanced supervision and performance monitoring for better quality care – which have been scaled up across countries and provinces
• provide basic health services for residents of slums
• to contain antibiotic, antimalarial and insecticide resistance.

For more results visit our website www.comdis-hsd.leeds.ac.uk

Partners & Collaborators at the University of Leeds with

Bangladesh – National Tuberculosis Control Programme, BRAC, ARK
Nepal – National Tuberculosis Control Programme, HERD
Pakistan – National Tuberculosis Control Programme, ASD
Eswatini (formerly called Swaziland) – Good Shepherd Hospital and Lubombo region
UK, Uganda, Mozambique etc – Malaria Consortium

COMDIS-HSD team at the University of Leeds

Research: James Newell and John Walley (Co-Principal Investigators/ Directors), Rebecca King, Helen Elsey and Joe Hicks

Operations:  Libby Clark, Debi Greaves and Polly Spooner

Research Communications and Uptake: Nilam Ashra-McGrath and Alistair Quaile

Impact

We worked closely with partner NGOs in low- and middle-income countries, our aim was to improve the quality of prevention and care services for communicable diseases, as well as making these services easier for people to access, especially in underserved populations. We also worked closely with ministries of health and policymakers in our partner countries to design and carry out research and share evidence needed to improve the way national agencies deliver health services to their populations. To read more about our work and our impact download our impact summary here. See resources for our research and policy briefs, guides and tools, e.g. the packages of care for noncommunicable diseases.