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UCT RESEARCH REPORT 2012
at achieving universal health coverage in South Africa and
Tanzania. The project will undertake monitoring mainly
at the district level, with some monitoring and evaluation
at the national level. It aims to support implementation
processes and will establish an ‘early warning system’ of
implementation difficulties. It is a collaborative, EU-funded
project with 2 other South African institutions, a Tanzanian
institution and 2 European institutions.
The Global Network for Health Equity (GHNE) continued
in 2012 and will enable comparative and collaborative work
across three continents to advance equitable universal
health coverage. It draws on 3 existing networks: EQUITAP
(Equity in Asia-Pacific Health systems, an Asia-Pacific
Research Partnership); LANET (The Latin American and
Caribbean Research Network on Financial Protection
and Health Observatory); SHIELD (Strategies for Health
Insurance for Equity in Less Developed Countries, an
African network that the HEU co-ordinates). It is funded by
the IDRC.
The HEU completed work undertaken in Kenya, Uganda
and Zambia that critically evaluated patterns of health care
financing and benefits from the use of health services, to
provide an evidence base for promoting equitable health
systems in these countries. The project was funded by
the International Development Research Centre (IDRC)
for Uganda and Zambia; and funding for Kenya came
from the Wellcome Trust. The HEU worked with the
following partners on this project: the Kenyan Medical
Research Institute, HealthNet Consult in Uganda and the
Department of Economics at the University of Zambia.
The main role of the HEU is was to provide research and
technical support.
The DST/National Research Foundation South African
Research Chairholder in Health and Wealth focuses on the
inter-play of health and wealth in the South African context
and the impact of a range of government policies on
health. Researchers contextualised the social determinants
of health within an African context to increase awareness
about this issue and to take into account health equity
issues to address the root causes of socioeconomic
health inequalities. Another key area of research relates to
providing a strong evidence base to contribute to current
policy debates on health care financing reform.
The Researching Equity in Access to Health Care (REACH)
project ended in 2012. It focused s on how health systems
could contributemore effectively to achieving development
goals by actively promoting equitable access to health
care. This was explored through the case of South Africa’s
health system, focusing on three tracer health interventions
of particular relevance to the Millennium Development
Goals (MDGs) and which were crucial to addressing the
burden of ill-health in South Africa. The tracers were
maternal health services, tuberculosis and HIV care. The
HEU collaborated with the Centre for Health Policy at
the University of Witwatersrand, the Africa Centre at the
University of KwaZulu-Natal and McMaster University in
Canada.
The XTEND study evaluates the impact and cost-
effectiveness of Xpert MTB/RIF in the investigation of TB
and its impact on patient and programme outcomes and
transmission at a population level, and thus informs policy
on the scale up of Xpert MTB/RIF in low- and middle-
income countries. The XPHACTOR project focuses on
the Xpert MTB/RIF for people attending HIV clinics. It will
identify an evidence-based algorithm, which is feasible to
implement within HIV clinics, to guide the utilisation of TB
investigations. The results will complement the XTEND
study, and provide evidence to guide the rational use of
Xpert MTB/RIF in national roll-out in South Africa and other
settings where HIV and TB are both prevalent. The project
runs until 2014 and the HEU is partnering with the London
School of Hygiene and Tropical Medicine, the Aurum
Institute, the World Health Organisation, and the National
Health Laboratory Services. The Gates Foundation is
funding this project.
The HEU also worked on four short-term research projects
in 2012. First, a cost-effectiveness analysis of the MVA85A
vaccine. This project focuses on estimating the potential
cost-effectiveness of adding the MVA85A vaccine to the
BCG vaccine in HIV negative children from the perspective
of the South African government. It is funded by the Oxford-
Emergent Tuberculosis Consortium (OETC). Second, a cost
analysis of an integrated community-based approach for
drug-resistant tuberculosis care. This study aims to estimate
the cost of decentralized drug-resistant TB management
model developed by the MSF in partnership with the
City of Cape Town and the Provincial Government of the
Western Cape. Costs will be estimated from both the health
services perspective and a societal perspective. The study
is funded by the MSF. Third, an implementing and scaling
up a community health policy in Kenya project focuses
on community health policy in Kenya; the HEU is working
with Japanese Aid and the Kenyan Ministry of Health to
analyse issues related to implementing a health promotion
programme with Community Health Workers. The project
will run until the end of January 2014. Finally, the retaining
health professionals in Mozambique’s public health sector
project. The HEU is working on a multi-partner project
funded by the EU that is using Discrete Choice Experiment
methodologies to elicit health professionals’ preferences
for staying on in the public health sector of Mozambique.
The project runs until the end of March 2013.