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Understanding and enabling ’Learning Health Systems’: connecting science with service delivery to support everyday resilience


Project Description

Learning Health Systems are defined as systems in which: “science, informatics, incentives, and cultures are aligned for continuous improvement and innovation, with best practices seamlessly embedded in the delivery process and new knowledge captured as an integral by-product of the delivery experience” (Institute of Medicine 2015). The learning health systems approach provides important entry points to connect science with service delivery to improve the practical relevance of research by co-producing research with and for health systems. The approach was also endorsed by the World Health Organization (WHO) in 2012, affirming: “research [that] is sensitive and responsive to the knowledge needs of decision-makers, health practitioners, citizens and civil society, who are responsible for the planning and performance of national health systems” (WHO, 2012). The WHO aim to change the way research is conducted, embedding it more completely in policy-making and implementation, and encouraging active engagement between researchers and policy/decision-makers.

The project will work with a new health policy and systems research (HPSR) initiative in rural South Africa that supports the public, policy makers, researchers and planners to engage and learn by generating local data of practical relevance (https://www.vapar.org/). The student will work with the School of Public Health, University of the Witwatersrand, which hosts the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) Health and Socio-Demographic Surveillance System (HDSS) (https://www.agincourt.co.za/). HDSSs are geographically defined areas that monitor population health. Established in 1992, Agincourt is the oldest and most developed HDSS in South Africa collecting longitudinal information on births, deaths, migration and socioeconomic status. The area is densely populated, with 116,000 people in 18,500 households in 31 villages covering 420 square kilometres; 30% of the population comprises former Mozambican refugees. There is little formal sanitation and electricity is available but affordable only to a minority. 84% of the population is below the poverty line and a significant number of households rely on social grants for survival.

The study will also work with the Aberdeen Centre for Health Data Science (ACHDS), a partnership between the University of Aberdeen, the National Health Service (NHS) Grampian and NHS Research & Development North Node (https://www.abdn.ac.uk/achds). ACHDS is a centre of excellence for health research and state of the art data science methodologies, collaborating internationally including with partners from the University of Sao Paulo, Brazil. A core principle of ACHDS is to engage and involve the population across Aberdeen City, Aberdeenshire, Grampian and the North bringing together experts in health and health care, health informatics, and data science with patients and the public. Research also be conducted in Grampian region, Scotland, which has a population of 500,000 with 50% living in Aberdeen City. The region is relatively affluent with pockets of deprivation. Of 30 communities among the 20% most deprived in Scotland (areas of multiple deprivation), 22 are in the City of Aberdeen, with 8% of the City’s population living in them. While the Grampian region generally has better health indicators than the Scottish average, the more deprived areas have poorer health outcomes.

Working in different world regions and health systems contexts, the project will examine learning health systems adopting socio-technical and realist perspectives to draw key insights and learning on how new data and data processes can capture and respond to everyday practicalities of policy implementation as well as on community-identified priorities, and on issues of digital maturity. The project will examine policy processes, and the role of evidence in these processes to develop understandings of the impacts of data, how they are produced, in which circumstances, and leveraging which impacts. The work will develop new knowledge on how partnerships between communities, researchers and practitioners can build cultures of demand-driven research responsive to the needs of those who organise, deliver and use public services. More generally, the project will develop key insights into how governance contexts characterised by ’top-down’ policy and planning can be supported to be more relevant to local contexts, needs and situations, supporting everyday resilience and more distributed forms of leadership.

APPLICATION PROCEDURE:
This project is advertised in relation to the research areas of APPLIED HEALTH SCIENCE. Formal applications can be completed online: https://www.abdn.ac.uk/pgap/login.php. You should apply for Degree of Doctor of Philosophy in Applied Health Science, to ensure that your application is passed to the correct person for processing.

NOTE CLEARLY THE NAME OF THE SUPERVISOR AND EXACT PROJECT TITLE ON THE APPLICATION FORM. Applicants are limited to applying for a maximum of 3 applications for funded projects. Any further applications received will be automatically withdrawn.

Funding Notes

This project is funded by a University of Aberdeen Elphinstone Scholarship. An Elphinstone Scholarship covers the cost of tuition fees only, whether home, EU or overseas.

For details of fees: View Website

Candidates should have (or expect to achieve) a minimum of a First Class Honours degree in a relevant subject. Applicants with a minimum of a 2:1 Honours degree may be considered provided they have a Distinction at Masters level.

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