Projects

The HEU carries out policy-relevant health economics and health systems research. See brief outlines of long-term and short-term projects below.

Long-term projects

Global Network for Health Equity

The Global Network for Health Equity (GHNE) will enable comparative and collaborative work across three continents to advance equitable universal health coverage. It draws on 3 existing networks: EQUITAP (Equity in Asia-Pacific Health systems, an Asia-Pacific Research Partnership);  LANET (The Latin American and Caribbean Research Network on Financial Protection and Health Observatory); SHIELD (Strategies for Health Insurance for Equity in Less Developed Countries, an African network). It is funded by the IDRC. 

Universal coverage in Tanzania and South Africa: monitoring and evaluating progress (UNITAS)

The UNITAS project will focus on monitoring and evaluating policy formulation and implementation processes aimed at achieving universal health coverage in South Africa and Tanzania. The project will undertake monitoring mainly at the district level, with some monitoring and evaluation at the national level.  It aims to support implementation processes and will establish an ‘early warning system’ of implementation difficulties. The project runs from 2011 to 2015 and is funded by the European Union. It is a collaborative project with partners from the London School of Hygiene and Tropical Medicine, Ifakara Health Institute (in Tanzania), Institute of Tropical Medicine Antwerp (in Belgium), Centre for Health Policy, University of Witwatersrand and the Africa Centre in South Africa.

Consortium for Health Policy & Systems Analysis in Africa

The Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA) is an African-European network that supports capacity development in the field health policy and systems analysis. Activities include curriculum development, staff development and engagement with policy makers in national and regional levels, as well as building a network among the organisational partners. CHEPSAA builds on earlier activities funded by the Ford Foundation. It brings together 11 organisational partners from South Africa, Tanzania, Ghana, Kenya, Nigeria, UK, Sweden and Switzerland for the period 2011 to 2014, and is funded by the European Commission.

Resilient and Responsive Health Systems (RESYST) Consortium

Resilient and Responsive Health Systems (RESYST) is a Consortium that is undertaking health policy and systems research (with a focus on financing, health workers and governance) in a set of African and Asian settings, including India, Kenya, Nigeria, South Africa, Thailand, Tanzania and Vietnam. Funded by DfID, the consortium began in 2011 and will run until 2016.

NRF – National Research Foundation South African Research Chair in Health and Wealth

This programme of research is funded by the Department of Science and Technology and administered by the National Research Foundation’s South African Research Chair Initiative over the period 2008-2011. The overall research focus of the Chair is on the inter-play of health and wealth in the South African context and the impact of a range of government policies on health.

REACH – Researching Equity in Access to Health Care

This integrated program of research, capacity building and knowledge translation focuses on how health systems could contribute more effectively to achieving development goals by actively promoting equitable access to health care. This will be explored through the case of South Africa’s health system, focusing on three tracer health interventions of particular relevance to the Millennium Development Goals and which are crucial to addressing the burden of ill-health in South Africa. These are maternal health services and tuberculosis and HIV care. The HEU collaborates with the Center for Health Policy at the University of Witwatersrand and McMaster University in Canada in this Teasdale-Corti funded project which runs from 2007 to 2012.

Financing and benefit incidence analysis in Uganda and Zambia

The main aim of the research is to critically evaluate patterns of health care financing and benefits from the use of health services in Uganda and Zambia, to provide an evidence base for promoting equitable health systems in these countries. The project was implemented in 2010 and will continue until 2012 with funding by the International Development Research Centre (IDRC). The HEU will work with 2 other partners: the HealthNet Consult in Uganda and the Department of Economics at the University of Zambia. The main role of the HEU is to provide research and technical support.

EQUINET – Regional Network for Equity in Health in East and Southern Africa

The Health Economics Unit has been involved in EQUINET (the Regional network for Equity in health in east and southern Africa) since soon after its establishment in 1998. EQUINET is a network of health professionals, civil society members, academics, policy makers, state officials and others within the region who have come together as an equity catalyst, to promote and realise shared values of equity and social justice in health. The HEU has particularly contributed to work around equitable financing of health systems and equitable allocation of health care resources. Over the years, we have worked with countries such as Namibia, Tanzania, Zambia, Zimbabwe and more recently Mozambique, to develop resource allocation strategies based on the relative need for health care in each district.

Strengthening health policy analysis research and training through a focus on approaches to comparative and synthesis analyses

Professor Lucy Gilson coordinates this project to develop the methods for synthesising health policy analysis work, and existing empirical studies around key themes. The project runs from 2009 to 2011 and is funded by the Alliance for Health Policy and Systems Research.

Health Policy Analysis capacity development in Africa

The aim of this project is to strengthen health policy analysis training in Africa and involves curriculum development and short courses training in partnership with six research organisations in Africa. Professor Lucy Gilson is the leader of the first phase of this programme of work that runs from 2008 to 2011, with funding from the Ford Foundation.

Short-term Projects

Eliciting public preferences in relation to health systems changes in South Africa

A project on public engagement in health care systems change in South Africa has been launched by Black Sash (a South African civil society organisation) in collaboration with the Health Economics Unit (HEU) at the University of Cape Town and the Health-e News Service. Each of South Africa’s nine provinces will play host to a 2-day consultation workshop with civil society groups to consider public views on the values communities would like to underpin the South African health system and key issues that need to be addressed in restructuring the health system. The HEU is involved in documenting and critically assessing the deliberation processes occurring in the workshops in order to draw methodological implications for public engagement in health care policy. In the second phase of the project, the HEU will undertake a discrete choice experiment (DCE) to elicit the community’s preferences in health care delivery. The results of the DCE study will contribute to the design of policy for health system change in South Africa. The project runs from 2010-2011.

For more information about the project please contact: Elroy Paulus (elroy@blacksash.org.za).

The cost of scaling up the integrated cervical cancer prevention programme in South Africa

The aim of the research is to estimate future resource requirements for adding the human papillomavirus vaccine (HPV) to the existing screening programme to prevent cervical cancer in South Africa. Edina Sinanovic is the Principal Investigator on this project funded by PATH.

Economic analysis of an increased access to TB and HIV diagnosis, treatment and adherence support

This study aims to estimate cost and cost-effectiveness of integrated versus non-integrated community-based adherence support for patients on TB treatment and antiretroviral therapy (ART) in South Africa. The project is funded by PEPFAR. Edina Sinanovic is the Principal Investigator.

HIV/AIDS cost-effectiveness

Currently, two cost-effectiveness projects are underway.

• The first evaluates the cost-effectiveness of public, private and public-private partnerships in the delivery of antiretroviral treatment to HIV-infected adults in South Africa. Collaborators include the Division of Clinical Pharmacology, Department of Medicine, UCT; Aid for AIDS and Broadreach.
• The second assesses the cost-effectiveness of doctor versus nurse-based delivery of antiretroviral treatment to HIV-infected adults in South Africa. We work with the Desmond Tutu HIV Centre, UCT and AURUM Health Research.

Recently completed projects

SHIELD – Strategies for Health Insurance for Equity in Less Developed Countries

The SHIELD project aimed to identify the major equity challenges in the health systems of three African countries (Ghana, Tanzania and South Africa) through an understanding of financing and benefit incidence. The project was implemented from 2006 to 2010 and was partly funded by the International Development Research Centre (IDRC) and the European Union. Knowledge generated will form the basis for considering alternate approaches to health insurance within these countries as a mechanism for addressing health system equity challenges and contributing to the achievement of the Millennium Development Goals. See the SHIELD research output.

CREHS – Consortium for Research into Equitable Health Systems

The HEU was part of a consortium of research groups from South Africa, Nigeria, Kenya, Tanzania, India and Thailand under the leadership of the London School of Hygiene and Tropical Medicine with funding from the United Kingdom Government Department for International Development. The consortium aimed to increase knowledge on how to strengthen health systems in ways that preferentially benefit the poorest and to strengthen the capacity of partners to support local and global policy development. Work under the four themes of health sector reform, financial risk protection, workforce performance and scaling up began in 2005 and continued until 2010. See the CREHS website.

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