COMDIS-HSD Addressing national government priorities Embedded within government systems Nuffield Centre for International Health & Development, UK (Lead) Malaria Consortium, UK & elsewhere Association for Social Development, Pakistan Health Research and Social Development Forum, Nepal Advancement through Research and Knowledge Foundation, Bangladesh Centre for Global Health, China Centre for Global Health Research, Ghana Good Shepard Hospital, Swaziland

Implement and evaluate the intervention Purpose Research to improve delivery of basic health services in low-income countries. Embedded R and D – leading to policy and practice change Stage 1 Design and develop service delivery package in line with MoH national priorities Stage 2 Pre-test and pilot package (e.g. guidelines, materials and research tools) Stage 3 Implement and evaluate the intervention Stage 4 Support both policy and practice change (RU) nationally and internationally

Improving community health care

Community Clinics in Bangladesh. Objectives Setting Community Clinics in Bangladesh. Objectives to develop improved training for community health care providers to assess quality of care provided by CHCPs. Results Of 1490 children examined, 90% were correctly diagnosed, 86% correctly treated and 99% received a correct referral decision 89% of consultations resulted in correct use of antibiotics. e.g. 70% to be reached on key indicators, particularly around antibiotic prescription and referral

Curriculum and training adopted nationwide. Policy implications Community clinics (or similar) can be an effective way of delivering basic care and referral services, if curriculum and training are appropriate Research demonstrating the effectiveness of better curricula and training can influence MoH to adopt such methods. Impact Curriculum and training adopted nationwide. e.g. 70% to be reached on key indicators, particularly around antibiotic prescription and referral

Urban health care

Setting Nepal, and urban primary health centres in Kathmandu. Objectives Originally planned to be intervention development and assessment Major delays due to the policy environment Major opportunities to support policy development. Progress Project has already had a major impact on policy Now working with MoHP to develop urban health plan: expected to complete by end 2016 Intervention development and assessment ongoing.

Policy implications The process of developing urban health care policy is political and difficult With dedicated input and goodwill on all sides, it is possible to advocate for policy development Major technical and organisational input is needed to support/lead the process. Impact Policy developed and voted into law Practical implementation should be research-informed.

Embedded research has major potential for impact Conclusion Embedded research has major potential for impact