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Abstract |
The UKRI GCRF Accountability for Informal Urban Equality Hub, led by LSTM, aims to address the intractable development challenge of ill-health, inequity and insecurity in informal urban settlements in Low- and Middle-Income Countries. ARISE brings together eleven partner institutions and people from a variety of backgrounds and disciplines who work together in Sierra Leone, Bangladesh, Kenya and India. The Hub uses participatory action research to support precarious and marginalised people to claim their rights to health and build government accountability and capacity to provide them with security and services. The Hub’s research will support them in claiming their rights to health and well-being and works to build governmental accountability and capacity to provide them with security and key health services. By sharing experiences across four countries the aim is to shape national and global policies and best practices through evidence-based advocacy. LSTM also has a new forthcoming grant on Strengthening responsiveness of health services provision to extreme weather events for urban marginalised people which is co-led by LSTM and the George Institute in India. This also uses Community Based Participatory Research to better understand and respond to extreme weather events in different informal settlements in Kenya, Sierra Leone and India. NIHR204854 - The PhD Candidate will build on findings from ARISE and the forthcoming extreme weather events grant. Health systems are shaped by their context and are inherently relational. A deeper understand of how health systems function within urban informal spaces, and for the urban marginalized is of paramount importance given the increasing numbers of people living and working in urban informal spaces globally. Community health workers are a key provider of healthcare in such spaces and are residents of these spaces themselves. They form critical link to the health system and have embedded knowledge of these underserved and evolving communities. Working within urban built environments presents unique challenges as ARISE research has shown they are often serving 10x the amount of recommended households. The landscape in which they operate is also changing in response to a changing climate, influx of residents and changing laws and legislature around their work globally. Dialogue with partners will be required to further shape the focus of this PhD to explore emerging research gaps related to the interface between health systems and service provision in a changing urban built environment. Due to the rapidly changing research environment the PhD student will work with partners to identify key health challenges and gaps to confirm the shape of the research project. An in-country supervisor will also be identified once the scope of the PhD is finalised.
This research aims to shape national and global policies and best practices through evidence-based work done in partnership with disadvantaged people in informal settlements.
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Where does the project lie on the Translational Pathway? |
T3 Evidence into Practice T4 Practice to Policy / Population |
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Expected Outputs |
• Publications: A minimum of 3 key publications related to the nexus of urban health systems, health service provision, urban built environment and informal urban spaces and practices with a focus on community health workers and equity • Impact: An improved understanding of how health systems operate and adapt within informal urban settlements and the critical role of CHWs in these settings. • Funding: Identification of further funding opportunities in relation to urban health thematic areas identified as relevant to CHWs during the PhD project. |
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Training Opportunities |
The PhD candidate will have access to: • LSTM research methods courses • Varied training opportunities (research methods, data management, academic writing etc.) targeted at the wider ARISE Hub and broader funding networks. • Training opportunities jointly identified with the supervision panel. |
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Skills Required |
The applicant will have strong qualitative skills; sound understanding of quantitative skills; well-developed communication skills; experience or interest in applied field work in LMICs; a good understanding of social determinants of health and health systems concepts; experience working with communities to generate research for action. |
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Key Publications associated with this project |
Steege, R., M. Taegtmeyer, R. McCollum, K. Hawkins, H. Ormel, M. Kok, S. Rashid, L. Otiso, M. Sidat, K. Chikaphupha, D. G. Datiko, R. Ahmed, R. Tolhurst, W. Gomez and S. Theobald (2018). "How do gender relations affect the working lives of close to community health service providers? Empirical research, a review and conceptual framework." Social Science & Medicine 209: 1-13. |
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Kimani J., Steege R., Makau J., Nyambuga K., Wairutu J., Tolhurst R. (2021). Building Forward Better: Inclusive Livelihood Support in Nairobi’s Informal Settlements. IDS Bulletin, 52(1) DOI: 10.19088/1968-2021.104 |
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Karuga, R.; Steege, R.; Njoroge, I.; Liani, M.; Wiltgen Georgi, N.; Otiso, L.; Muturi, N.; Okoth, L.A.; Theobald, S.; Tolhurst, R. Leaving No One Behind: A Photovoice Case Study on Vulnerability and Wellbeing of Children Heading Households in Two Informal Settlements in Nairobi. Soc. Sci. 2022, 11, 296. |
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Raven, J., Wurie, H., Idriss, A. et al. How should community health workers in fragile contexts be supported: qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo. Hum Resour Health 18, 58 (2020). https://doi.org/10.1186/s12960-020-00494-8 |
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Steege, R., Taegtmeyer, M., Ndima, S. et al. Redressing the gender imbalance: a qualitative analysis of recruitment and retention in Mozambique’s community health workforce. Hum Resour Health 18, 37 (2020). https://doi.org/10.1186/s12960-020-00476-w |