Health Demographics & Global Health

Thanks to the field of health science, we have today a multitude of strategies designed to prevent, diagnose and treat a wide range of global diseases. However, the cost effectiveness and effect of these strategies are highly dependent upon how the strategies are implemented and in which health care system.

The aim of global-health research is therefore to address global health challenges of political and economic significance. The health of populations in a global context is the focal point of our research, and improved health for all, reduction of inequalities, and safeguarding against global threats are at the top of the agenda.

Global-health research addresses questions like:

  • What are the most pressing global health challenges and how can they be measured?
  • Which factors affect global health?
  • Which interventions should be applied to improve global health?
  • How should healthcare systems be designed to be as cost effective as possible?

We look at specific treatment strategies, the design and financing of healthcare systems as well as factors outside the healthcare system. These include climate issues, education, nutrition and economic growth. We envisage that this will enable us to, for example, identify target groups for intervention and to inform decision-making on the priority of health initiatives, both within and outside the conventional health care system.

In our research, we constantly try to cope with the fact that what may be the best solution to health challenges in one country may not necessarily prove a good solution in other countries. For example, we work in regions with healthcare systems of a very poor standard and no vital registration systems. Consequently, it may be quite difficult to diagnose diseases or describe their impact at population level as you do not even know the base population. Therefore, we are trying to develop simple tools as, for example, a clinical score to determine the stage of disease of a tuberculosis patient without using advanced laboratory analyses, and we are attempting to establish population-based registers within so-called Demographic Surveillance Sites. Further, we look at summary measures which can be used to describe the overall health status of a population, be used for comparative analyses between countries and population groups, and be used as an effect measure in health-economics analyses.

Who are the users of a healthcare system, how do they use the system, and which services are provided? The answers to these questions are all influenced by the design of a healthcare system. Further, in communities where resources are extremely scarce, disease poses a considerable financial threat which may have devastating consequences for the individual member of the community. We are therefore striving to find the most suitable financing mechanisms in a given context. In a study of health insurance in Ghana and Tanzania we are examining how different kinds of health insurance affect health behaviour, the access to the healthcare system, the choice of treatment, the quality of healthcare services, and the financial risk of the users. Not least, our endeavours seek to determine whether health insurance ultimately affects the health of the population at large.

Projects

  • Health insurance in Ghana and Tanzania: Increasing access and equity
  • Cost effectiveness of vaccination strategies (sequence and bundling) and Vitamin A supplements for children
  • Economic consequences of the rising number of elderly people and increasing incidence of chronic diseases
  • Multi-site studies by the INDEPTH Network of risk factors for tuberculosis and of the clinical treatment of tuberculosis suspects
  • IRIPT – Isoniazid or Rifampicin/isoniazid as Preventive treatment for Tuberculosis, a randomized clinical trial
  • PIONA – Protease Inhibitor Or NNRTI as first line HIV treatment in a West African population, a randomized clinical trial
  • Primary health care reform in Palestine
  • Introduction and evaluation of family and community medicine as a post graduate specialty in Rwanda 

Methods

We pursue an interdisciplinary approach by focusing on the needs of under-privileged populations where capacity-building elements play a vital role. We conduct culture-sensitive population-based studies in collaboration with local partners.

Interdisciplinary approach

  • Randomised controlled clinical trials
  • Cross-sectional, case-control, and follow-up studies
  • Quasi-experimental designs
  • Survey design and design of questionnaires
  • Qualitative studies
  • Demographic models
  • Epidemiology
  • Health-economics analysis of costs and effects of interventions