Global Health

Global health is a focal research theme of the AIID. It is a broad term for the field of study, research and practice aimed at improving health and health equity. In our research on global health we closely collaborate with anthropologists, public health experts and medical researchers of the Amsterdam Institute for Global Health and Development (AIGHD) and local partners – we jointly collect and analyze data. The combination of our joint socioeconomic, biomedical, and public health expertise allows us to study global health issues from a broader perspective. Our research covers areas such as sexual and reproductive health, maternal and child health, HIV/AIDS and Violence against Women and Girls.

Universal Health Coverage

Much of AIIDs research is aimed at Universal Health Coverage (UHC). UHC is currently on top of the international Global Health agenda. Its goal is to enable all people to obtain the quality health services they need without suffering financial hardship paying for them. UHC is seen as a crucial element in poverty reduction and economic development: the poor are especially vulnerable to health shocks, but have limited resources to cope with high medical expenditures which may further push them into poverty. We aim to generate knowledge to advise policy-makers and break this vicious cycle. Our UHC research focuses on health insurance and mHealth.

Health Insurance

Health insurance is an important channel through which to achieve universal health coverage. Since 2004 AIID has been involved in evaluating the impact of micro health insurance programs in four sub-Saharan Africa countries (Namibia, Nigeria, Tanzania, Kenya). Together with AIGHD impact is evaluated on both biomedical and socioeconomic indicators, such as healthcare utilization and out-of-pocket expenditures. Next to measuring impact we advise implementers how to improve their program. The research uses both quantitative methods (household surveys, diaries) and qualitative methods (in-depth interviews and focus group discussions).

Research staff:

Jacques van der Gaag, Chris Elbers, Wendy Janssens, Emily Gustafsson-Wright, Zlata Tanović, and Marijn van der List.

Sexual and Reproductive Health

AIID has conducted several studies in the field of Sexual and Reproductive Health and Rights (SRHR) in various African countries and Indonesia. As a member of ShareNet International, the AIID aims to contribute to the policy debate with high-quality scientific evidence.

AIID studies SRHR-related topics by using a mixed-methods approach. We believe that understanding the context of a SRHR program is crucial for the interpretation of studies findings. We therefore complement and strengthen our quantitative data-collection (based on household surveys, diaries and behavioural experiments), with deep qualitative insights gathered via focus group discussions, in-depth interviews and other qualitative methods.

Research staff

Marije Groot Bruinderink, Wendy Janssens, Menno Pradhan.

Projects

Current projects

· Family planning and women’s sexual and economic empowerment – RCT of a family planning training programme in the outskirts of an urban agglomeration in Maputo Mozambique.

Previous projects

· Evaluation of projects of Yayasan Pelita Ilmu (YPI) – Comprehensive Sexuality Education for senior high school students in Indonesia. Part of Joint MFS II Evaluations at country level: Indonesia.

· Male Views on Female Condoms – A Study of Male Acceptance of Female Condoms in Zimbabwe, Cameroon and Nigeria

Publications

Scientific publications

Koster, W, M. Groot Bruinderink and W. Janssens, (2015), “Empowering women or pleasing men? Analyzing Male Views on Female Condom Use in Zimbabwe, Nigeria and Cameroon”, Forthcoming in International Perspectives on Sexual and Reproductive Health.

Project reports

Koster W, Groot Bruinderink M L, and Janssens, W., ‘Male views on female condoms: A Study of Male Acceptance of Female Condoms in Zimbabwe, Cameroon, and Nigeria’, 2012, http://femalecondoms4all.org/wp-content/uploads/2014/10/Male-Views-on-Female-Condoms-A-Study-of-Male-Acceptance-of-Female-Condoms-in-Zimbabwe-Cameroon-and-Nigeria-UAFC-Joint-Programme-20120410.pdf

Koster W, Groot Bruinderink M L, ‘Next to natural’: A qualitative study of male acceptance of female condoms in Greater Harare, Zimbabwe, 2012, http://condoms4all.org/wp-content/uploads/2014/10/Next-to-natural-UAFC-Joint-Programme-Country-Report-Male-Views-on-Female-Condoms-Zimbabwe-20120409.pdf.

Koster W, Groot Bruinderink M L, Effective prevention without side-effects: A study of male acceptance of female condoms in Lagos, Nigeria, 2012, http://condoms4all.org/wp-content/uploads/2014/10/Effective-Prevention-Without-Side-Effects-UAFC-Joint-Programme-Country-Report-Male-Views-on-Female-Condoms-Nigeria-20120409.pdf

Koster W, Groot Bruinderink M L, Dual protection, with different sexual partners: A qualitative study of male acceptance of female condoms in Cameroon, 2012, http://condoms4all.org/wp-content/uploads/2014/10/Dual-Protection-with-Different-Sexual-Partners-UAFC-Joint-Programme-Country-Report-Male-Views-on-Female-Condoms-CAMEROON-20120410.pdf

HIV/AIDS

HIV/AIDS has been an important topic of AIID already since 2004. AIID has published several peer reviewed scientific papers on the topic, and has organized annual international workshops on “The Economic Consequences of HIV/AIDS” from 2006 to 2010 in Amsterdam, attended by top HIV/AIDS economists and medical experts. It has worked closely with the Amsterdam Institute for Global Health and Development (AIGHD), a research institute founded and headed by world renowned HIV/AIDS researcher Joep Lange, housing many HIV/AIDS experts in the medical field.

Even though individuals who are infected with HIV can now live long and relatively healthy lives when on treatment, HIV/AIDS research is still important. In a recent Lancet paper, Piot et al. (2015) urgently call for a scaling up of HIV prevention and funding, to stop the still rising global HIV prevalence and to expand access to HIV treatment.

In a recently published paper in the journal Demography, AIID researchers investigated possible estimation errors in the percentage of individuals who live with HIV, that can arise when individuals who refuse to be tested for HIV in the scope of a population representative survey are more (or less) likely to be infected than those who do participate in the test.

Currently, AIID is working on the effect of socioeconomic status on new HIV infections, which is potentially very important in HIV prevention targeting. If prevention methods can be targeted on easily observable characteristics such as socioeconomic status, then more HIV infections can be prevented at a smaller cost.

Reference:

Piot, P., Karim, S. S. A., Hecht, R., Legido-Quigley, H., Buse, K., Stover, J., Resch, S., Ryckman, T., Møgedal, S., Dybul, M., Goosby, E., Watts, C., Kilonzo, N., McManus, J., Sidibé, M., on behalf of the UNAIDS–Lancet Commission (2015), Defeating AIDS—advancing global health, Lancet, 386, 171-218. http://dx.doi.org/10.1016/S0140-6736(15)60658-4.

Research staff:

Jacques van de der Gaag, Wendy Janssens, and Zlata Tanović.

Work-in-progress:

Tanović, Z. (2015). In search of socioeconomic drivers of HIV incidence in sub-Saharan Africa: Panel versus cross section and the case of Namibia. Work-In-progress.

Projects
Previous projects
– Longitudinal study on health insurance and HIV/AIDS in Namibia
– The Economic Consequences of HIV/AIDS

Publications

Scientific publications

Janssens, W., van der Gaag, J., de Wit, T. F. R., & Tanović, Z. (2014). Refusal bias in the estimation of HIV prevalence. Demography, 51(3), 1131-1157. doi: 10.1136/bmj.c6323

Janssens, W., de Beer, I., Coutinho, H. M., van Rooy, G., van der Gaag, J., & Rinke de Wit, T. F. (2010). A cautious note on household surveys in poor settings. BMJ, 341. doi: 10.1136/bmj.c6323

Aulagnier, M, W. Janssens, I. de Beer, G. Van Rooy, E. Gaeb, C. Hesp, J. van der Gaag and T.F. Rinke de Wit (2011), “The Incidence of HIV in Windhoek, Namibia: Demographic and Socio-Economic Associations”, PLoS ONE ¸ Vol.6(10): pp. 1-9 (e25860), doi:10.1371/journal.pone.0025860.

Lammers, J. (2008). HIV/AIDS, risk and intertemporal choice Tilburg: Tilburg University Press.

Böhnke, Lene (2013), “HIV/AIDS: The Role of Risk Perception in Explaining Risky Sexual Behavior”, MSc thesis, VU University Amsterdam.

Tanović, Z. (2013), “The effect of poverty on HIV incidence in Namibia” MSc thesis, University of Amsterdam.

mHealth

M-Pesa, Kenya’s booming mobile money platform, allows its users to send money from one mobile phone to another. This makes it easy to bridge large distances, in a country where few people have bank accounts and banks are scarce, especially in remote rural areas. Why not use M-Pesa to strengthen healthcare financing?

The Dutch NGO PharmAccess is developing a health wallet where people can save and pay for healthcare expenses via M-Pesa. By earmarking these funds for healthcare, donors can directly transfer money to their target population (saving on administrative costs), and can be sure that it will be spent for healthcare. AIID is currently developing a research agenda with PharmAccess to improve targeting (e.g. through poverty mapping techniques) and to experiment with various designs in order to enhance effectiveness. An attractive and innovative feature of the research program will be the analysis of big data.