Ms Thomasena O’Byrne

Biography

Thomasena O’Byrne is a Postdoctoral Research Associate based at the Malawi-Liverpool-Wellcome Programme, where she leads the One Health and Health Systems Associate Group. As a global health systems researcher and implementation scientist, Thomasena has worked in Sub-Saharan Africa for over 17 years, with a particular focus on how to strengthen healthcare systems to improve quality of care and tackle health challenges like antimicrobial resistance. Her current research, funded by the National Institute for Health and Care Research, tackles healthcare-associated infections and antimicrobial resistance by supporting the adaptation and implementation of World Health Organisation infection prevention and control guidelines in secondary and tertiary healthcare facilities in southern Malawi.

Thomasena has a strong background in qualitative and implementation research and her earlier work focused on health-seeking behaviours and primary care systems in low-resource settings, grounding her approach in equity and community engagement. Alongside research, she is passionate about capacity strengthening and mentoring. She supervises PhD and master’s students and supports global training initiatives through the Health Systems Global Thematic Working Group on Teaching and Learning.

Her work bridges research, policy and practice. She is an appointed member of the Malawi Ministry of Health’s Quality Management Technical Working Group and actively contributes to the Malawi-Liverpool-Wellcome Programme’s social science and health systems and infection biology themes. Beyond academia, Thomasena is an International Coaching Federation accredited leadership coach and mentors early-career researchers and professionals.

 

Research interests

Thomasena’s research focuses on the intersection of health systems strengthening, antimicrobial resistance, and infection prevention and control. She is interested in how to apply systems thinking and implementation science to design practical, scalable solutions that improve the quality and safety of care in different contexts.

Through her current work on improving infection prevention and control practices, her team is supporting the implementation and evaluation of the World Health Organisation’s evidence-based infection prevention and control framework in healthcare facilities in Malawi. This involves working closely with frontline health workers, hospital managers, housekeeping staff, patient carers, patients, and other key infection prevention and control stakeholders to embed sustainable improvements across the health system.

A key focus is One Health integration, linking human, animal, and environmental health to address antimicrobial resistance holistically. For example, the group’s Wellcome Trust-funded work used community dialogues to amplify public understanding of drug-resistant infections. Thomasena is also involved in optimising antibiotic usage to mitigate antimicrobial resistance, a major National Institute for Health and Care Research funded programme. This includes policy-level engagement, behaviour change interventions and exploring the realities of clinical decision-making in resource-constrained environments.

More broadly, she is passionate about understanding and improving the health workforce. Her work explores how leadership, supervision, and management can be strengthened to build more resilient health systems. She uses qualitative, mixed methods, and participatory methods – centring local stakeholders, from policymakers to patients – to capture lived experiences

Selected research publications

An assessment of infection prevention and control implementation in Malawian hospitals using the WHO Infection Prevention and Control Assessment Framework tool – Journal: Infection Prevention in Practice – Published: 22nd August 2024

Child acute illness presentation and referrals at primary health clinics in Malawi: a secondary analysis of ASPIRE – Journal: BMJ Open – Published: 25th April 2024

Applying systems thinking to understand the process of decentralization: A malawi case example: A malawi case example – Published: 22nd December 2022

The health policy response to COVID-19 in Malawi – Journal: BMJ Global Health – Published: 18th May 2021

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