Health and Wellbeing

Project duration: 2024-25

Academic Staff:

• Dr Lucia D'Ambruoso (PI)
• Maria Van Der Merwe (Co-I)

Funder: Medical Research Foundation

Project Summary:

Community participation is recognised as a key, enabling mechanism to achieve 'health for all'. Knowledge of how to operationalise the concept is limited, however. Based in rural South Africa, the Verbal Autopsy with Participatory Action Research (VAPAR www.vapar.org) project has developed an intervention supporting Community Health Workers (CHWs) to build competencies in community mobilisation. We have trained over 100 CHWs in a rural sub-district (population 500,000), improving functionality and capacity for local decision-making. We now plan to respond to demand from the provincial health authority to adapt the intervention for implementation across the province (population 4.4 million).

In South Africa, the health system faces many challenges: entrenched health inequalities, resource shortages, and multiple health crises. CHW roles are crucial but hindered by inadequate training and support. Our intervention has been rigorously developed and tested responding to local needs and priorities, and is endorsed by health officials. We now seek to expand its application, building on its success in improving CHW capabilities and connecting them with communities to better understand and address health disparities. We plan to embed practical solutions for community participation across practice settings, and share learning at provincial and national levels to facilitate policy and strategy commitments to participation in health.

Project duration: 2022 - 2026

Academic Staff:

• Professor Pamela Abbott (Joint PI), Dr Lucia D'Ambruoso, Dr Abraham Getaneh, Professor Paul McNamee, Jane Negrych, Niamh Bruce, Dr Rachel Shanks, Isabel Stanley - University of Aberdeen.
• Professor Wences Nzabalirwa (Joint PI), Ali Kaleeba Bakali, Ivan Gahima, Prof Darius Gishoma, Assoc Prof Clementine Kanazayire, Emmy Ndagijimana, Francois Nkurunziza, Boniface Ntahobavukira, Emmanuel Mwizerwa, Professor Laetitia Nyirazinyoye, Dr Eric Remera, Dr Clarisse Simbi, Dr Dorothy Tukahabwa - University of Rwanda.
• Dr Tsion Hailu (Co-Lead), Dr Mahlet Yared (Co-Lead), Isayas Wubshet Alemu, Dr Semere Gebremariam Baraki, Meron Birle, Wakgari Tasisa Duressa, Dr Kibur Engdawork, Dr Girma Motti Geletu, Dr Awoke Mihretu, Dr Elias Sebsibe - Addis Ababa University.

Funder:

• National Institute for Health Research (NIHR), NIHR Global Health Research Units and Groups Programme

Partners:

• University of Rwanda
• Addis Ababa University

Project Summary

The "NIHR Global Health Research Group on promoting children's and adolescent's mental wellbeing in sub-Saharan Africa" is a four-year project with the overall aim of identifying, developing, implementing and evaluating an affordable, effective, equitable and trusted strategy for promoting the mental wellbeing of children and adolescents in sub-Saharan Africa. The project will be delivered in Rwanda and Ethiopia, working with researchers, community members, children and adolescents, parents, and teachers to co-design and deliver a culturally appropriate mindfulness intervention.

Project duration: 2022 - 2027

Staff:

• Prof Justine Davis (PI), Prof Karla Hemming, Prof Tony Belli, Laura Quinn, Prof Richard Lilford, University of Birmingham
• Dr Jean Claude Byiriniro, University of Rwanda
• Dr Lucia D'Ambruoso, University of Aberdeen

Funder:

• National Institute for Health Research (NIHR), NIHR Global Health Transformation (RIGHT) Programme

Partners:

• University of Birmingham
• University of Rwanda

Project Summary

Delays in getting injured patients to hospital in a timely manner result in avoidable death and disability. is particularly the case in low- or middle-income countries (LMICs), where even when ambulance systems are available, communication between ambulance systems, patients, and hospitals is inefficient. To overcome these difficulties, a local software firm designed Rwanda912, a novel electronic tool for use in low resource settings. Rwanda912 uses an ambulance Destination Decision Support Algorithm (DDSA) which regularly collects information from hospitals on availability of staff and equipment, and from the ambulance crew on patient status; it uses this information to match the patient with the nearest able hospital. has been endorsed by the Rwandan Ministry of Health (MoH) and won local innovation awards.

In collaboration with MoH, Rwandan ambulance services, and local and international academics, this project will test whether Rwanda912 reduces time from injury to arrival at hospital and improves clinical outcomes such as death and length of stay in hospital. We will ensure Rwanda912 is acceptable to users and failsafe in the field before deploying it in ambulances and testing whether it improves patient outcomes in a major urban and rural district in Rwanda. We will also test "user friendliness", whether it is being used as intended, and cost-effectiveness.

Project duration: 2022 - 2026

Staff:

• Prof Justine Davis (Co-Director), Dr Agnieszka Ignatowicz, Dr Alice Sitch, Prof Antonio Belli, Prof Richard Lilford, University of Birmingham
• Prof Kathryn Chu (Co-Director), Dr Lungiswa Nkonki, Stellenbosch University
• Associate Prof Jean Claude Byiringo, University of Rwanda
• Dr Theophile Dushime, Ministry of Health - Rwanda
• Prof Abebe Bekele, University of Global Health Equity
• Prof Junaid Razzak, Weill Cornell Medicine
• Prof Laura Bojke, University of York
• Dr Lucia D'Ambruoso, University of Aberdeen
• Prof Sameen Siddiqi, Aga Khan University
• Prof Stephen Tabiri, University for Development Studies

Funder:

• National Institute for Health Research (NIHR), NIHR Global Health Research Units and Groups Programme

Partners:

• University of Birmingham
• Stellenbosch University
• University of Rwanda
• University of Global Health Equity
• Ministry of Health - Rwanda
• Weill Cornell University
• University of York
• Aga Khan University
• University for Development Studies

Project Summary

The World Health Organisation has stated that strong health systems that provide quality care for people who are injured are urgently needed to prevent death and disability due to injury. However, evidence that could lead to reduced delays in access of quality care after injury is lacking.

In this project, we will build on partnerships in Ghana, South Africa, Rwanda, and Pakistan. Together we will use the three delays framework which looks at both access to and quality of care provided - to ask what are the delays to equitable access of quality care after injury and how can these be overcome to reduce death or disability? We will collect information on delays and their effects on patient outcomes. We will then develop a visual model to show where to intervene to reduce delays suffered after injury and produce maximum health benefits. By partnering with stakeholders in each country we will develop solutions for future study in these, and other similar, countries.

Project duration: /

Staff:

• Prof Pamela Abbott, Prof Claire Wallace, University of Aberdeen

Funder:

• University of Aberdeen

Partners:

• School of Social Sciences, University of Aberdeen

Project Summary

The University has followed all of the children born in Aberdeen in 1921, 1936, and 1950-1956 as they grow and age. Collectively these groups are known as the ABERDEEN BIRTH COHORTS, and are a jewel in the crown of Scottish health research and have helped to advance our understanding of aging well. In primary school these children sat tests of reading and mental ability. Over the years, researchers have linked the results from these tests to health and social information.

The linked data has been used to answer questions like:

• Does being born very small affect mental health later in life?
• Is the risk of dementia related to childhood intelligence?
• What influences quality of life in old-age?

Project duration: 2015 - 2016 (18 months)

Staff:

• Prof Peter Byass (Co-PI), University of Umeå, Sweden
• Dr Lucia D'Ambruoso (PI), University of Aberdeen;
• Jennifer Hove, Prof Kathleen Kahn, Denny Mabetha, Dr Stephen Tollman, University of the Witwatersrand
• Nombuyiselo Nkalanga, MRC/Wits Agincourt Research Unit
• Prof Sophie Witter, Queen Margaret University
• Maria Van Der Merwe
• Dr Barry Spies, University of the Free State, South Africa

Funder:

• Health Systems Research Initiative from Department for International Development (DFID)
• Medical Research Council (MRC)
• Wellcome Trust
• Economic and Social Research Council (ESRC)

Partners:

• Mpumalanga Department for Health
• MRC/Wits Agincourt Unit
• University of the Witwatersrand, Johannesburg
• University of Umeå
• University of Aberdeen
• Queen Margaret University, Edinburgh

Project Summary

Dr Lucia D'Ambruoso leads of programme of research supported by the Health Systems Research Initiative from the MRC, ESRC, Welcome Trust. The research addresses recent estimates that two-thirds of the world's deaths pass unrecorded, by improving systems to record and report on deaths that occur outside clinics or without registration. Through improved data, the work aims to improve the ability health systems to respond to the needs of vulnerable and excluded populations through partnership approaches with communities and researchers.

Project duration: 2017

Staff:

• Dr Lucia D'Ambruoso, Prof Pamela Abbott, Flora Douglas, Centre for Global Development, University of Aberdeen
• Emma McPherson, Aberdeen City Council
• Emmanuel Okpo, National Health Service (NHS) Grampian

Funder:

• Charities Aid Foundation of America from the Robert Wood Johnson Foundation Donor-Advised Fund

Partners:

• Shaping Health programme led by the Training and Research Support Centre (TARSC)

Project Summary

In Aberdeen City, Scotland, people who are 'working poor', unemployed, dependent on state welfare or homeless are at greater risk of food poverty that others in the community. A 2015 Community Empowerment Act (Scotland) mandates co-determination involving communities in all sectors.

This case study presents the work of two social enterprises involving those affected by food poverty as peers and volunteers: in pathways to employment in a café and community food outlets; in training activities to support employment; and in providing spaces for 'social suppers' to eat, meet and obtain skills and support for benefit claims, housing and healthcare. Two rounds of participatory budgeting by the local council provide community grants for such initiatives and generate participatory decision-making around these resources.

Project duration: 2020 - 2021

Staff:

• Prof Lesley Anderson (PI), Dr Lucia D'Ambruoso, University of Aberdeen;
• Other Coinvestigators: Dr Joao Camanda, Dr Francisco Antonio Macongo Chocolate, Dr Ruben Buco, Dr Lynne Lohfeld

Funder:

• University of Aberdeen GCRF Institutional Pump Priming Fund (IPPF)

Project Summary

A nine-month project evaluating opportunities and barriers to establishing an autonomous and functional sickle cell anaemia (SCA) unit in Cabinda, Angola

Project duration: 2020 - 2022

Staff:

• Prof Peter Byass (Co-PI), University of Umeå, Sweden
• Dr Lucia D'Ambruoso (PI), University of Aberdeen
• Jennifer Hove, Prof Kathleen Kahn, Denny Mabetha, Dr Stephen Tollman, University of the Witwatersrand
• Nombuyiselo Nkalanga, MRC/Wits Agincourt Research Unit
• Prof Sophie Witter, Queen Margaret University
• Maria Van Der Merwe
• Dr Barry Spies, University of the Free State, South Africa

Funder:

• Health Systems Research Initiative from Department for International Development (DFID)
• Medical Research Council (MRC)
• Wellcome Trust
• Economic and Social Research Council (ESRC)

Partners:

• Mpumalanga Department for Health
• MRC/Wits Agincourt Unit
• University of the Witwatersrand, Johannesburg
• University of Umeå
• University of Aberdeen
• Queen Margaret University, Edinburgh

Project Summary

The VAPAR platform creates a space through research that is being employed to connect people and services in a mutually supportive learning-and-action engagement to expand the knowledge base on health equity. The process combines longitudinal data with narratives and visual images, generating analysis and interpretations of practical relevance in communities and health systems. The aims of the work are to develop inclusive knowledge partnerships, evaluate change, and build sustainability.

Project duration: 2017 - 2023

Staff:

• Prof Peter Byass (Co-PI), University of Umeå, Sweden
• Dr Lucia D'Ambruoso (PI), University of Aberdeen
• Jennifer Hove, Prof Kathleen Kahn, Denny Mabetha, Dr Stephen Tollman, University of the Witwatersrand
• Nombuyiselo Nkalanga, MRC/Wits Agincourt Research Unit
• Prof Sophie Witter, Queen Margaret University
• Maria Van Der Merwe
• Dr Barry Spies, University of the Free State, South Africa

Funder:

• Health Systems Research Initiative from Department for International Development (DFID)
• Medical Research Council (MRC)
• Wellcome Trust
• Economic and Social Research Council (ESRC)

Partners:

• Mpumalanga Department for Health
• MRC/Wits Agincourt Unit
• University of the Witwatersrand, Johannesburg
• University of Umeå
• University of Aberdeen
• Queen Margaret University, Edinburgh

Project Summary

The VAPAR platform creates a space through research that is being employed to connect people and services in a mutually supportive learning-and-action engagement to expand the knowledge base on health equity. The process combines longitudinal data with narratives and visual images, generating analysis and interpretations of practical relevance in communities and health systems. The aims of the work are to develop inclusive knowledge partnerships, evaluate change, and build sustainability.