This PhD opportunity is being offered as part of the LSTM and Lancaster University Doctoral Training Partnership. Find out more about the studentships and how to apply.
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Abstract |
Malawi, like many low-income countries, faces multiple shocks and stressors that are impeding health outcomes. In the aftermath of the COVID-19 pandemic, the country was hit by a prolonged cholera outbreak in 2023. In March in the same year, a tropical cyclone led to extensive flooding, with thousands of people being displaced. These simultaneous shocks occurred in a context of an already constrained health system, high inflation and increased costs of living. Achieving universal health coverage and equity in health becomes increasingly difficult in such a context of polycrises.
It is important to learn from what happened in 2023, because infectious disease outbreaks and climate-related disasters will continue to happen. In fact, they are semi-predictable, occurring in the rainy season in years with high predicted rainfall or extreme weather events. This PhD project is part of the work of the Institute of Resilient Health Systems, that focuses on health system research to enhance the preparedness, response and transformation of health systems in the face of shocks and everyday stressors. The PhD will contribute to the Institute’s research in Malawi, that aims to understand how communities prepare and respond to polycrises, and how such learnings can be used to enhance resilience at the community and primary health care (PHC) level.
Many communities across Malawi have active citizens who work together in community development committees, village health communities, mother groups and other community structures. Such existing structures are often involved in preparing and responding to crises, even before support from government and non-governmental organisations is in place. The research will focus on such existing community structures, in addition to other community stakeholders, such as traditional leaders, representatives of community-based organisations, and community health workers. Included communities are selected based on their exposure to multiple crises in the past two years.
Phase 1 of the research aims to provide insights into communities’ ways of self-organisation in the context of polycrises, with a focus on improving health outcomes and health equity. For example, what local actions are taken to prevent infectious diseases? What community initiatives enhance food security? How is access to routine health care maintained? How do communities provide health-related support for the most vulnerable? How are risks communicated at community level? The outcomes of this formative phase will provide the base for the co-reaction of an intervention that will shape community preparedness and response teams, connected to the PHC facility level in research intervention areas in Malawi (phase 2). The outcomes of the intervention will be evaluated over time, particularly during new (predicted) times of polycrises (phase 3).
The PhD is proposed to be embedded in the formative phase of the research. A qualitative approach will be used to understand how communities view shocks and stressors, which ones are perceived to particularly influence health and wellbeing, and how community self-organisation looked like. A stakeholder mapping will map all key community and PHC stakeholders that had a role in preparedness and response. The PhD student will conduct a mixed-methods social network analysis as part of the formative phase.
Social network analysis is a method that is used to provide insights into relationships between groups, people and institutions. It can, for example, focus on communication, information flow, community actions, and resource mobilisation. It can reveal (power and) positions of stakeholders, and levels of trust between stakeholders. |
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Where does the project lie on the Translational Pathway? |
T3 - Evidence into Practice
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Expected Outputs |
It is expected that this PhD project will result in at least two scientific publications. The project also contributes to capacitating community key stakeholders and PHC providers in preparing and responding to shocks in Malawi.
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Training Opportunities |
Training opportunities for PhD students within LSTM and MLW will be available for the student.
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Skills Required |
Basic quantitative and qualitative data collection and analysis skills. Ability to work in constrained contexts, conduct multiple stakeholder processes and community-level field work.
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Key Publications associated with this project |
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