LONDON SCHOOL OF HYGIENE & TROPICAL MEDICINE
UNIVERSITY OF THE PHILIPPINES – MANILA, COLLEGE OF MEDICINE
Lead Researcher in Social Science
The project will provide the knowledge needed to overcome health system barriers to optimal management of hypertension in Malaysia and the Philippines. This is important because it is a major cause of disability and premature death yet is easily detected and treated. Moreover, such knowledge can inform policies to improve management of all chronic diseases. Yet although evidence on its clinical management is universal, to overcome the health systems barriers, especially those faced by the poor, local knowledge is needed. This, in turn, requires local capacity in health systems research and knowledge transfer.
This project brings together all these elements in a partnership between leading research institutions in Malaysia, the Philippines and the UK. The project will use mixed methods to understand barriers to hypertension control faced by low-income households over 12-18 months. We will use innovative open-source mobile technology to capture participant-generated content (video, audio, text, etc.) on their lived experience, coupled with assessment of formal and informal providers. The project will generate analytical and methodological insights of relevance to Malaysia and the Philippines, and the global community, specifically low and middle income countries seeking to implement patient-centred and pro-poor responses to the growing burden of non-communicable disease (NCD).
The project aims to improve management of hypertension in Malaysia and the Philippines and, in doing so, build capacity to mitigate the rapidly increasing health and economic burden of NCD, now disproportionately affecting the poor in those countries. This project focuses on hypertension, first because it is a leading contributor to cardiovascular disease (CVD) and other NCD burden, and, second, because it is a “tracer” condition (common, with effective management requiring a broad range of health system building blocks) whose study can reveal wider health system barriers to management of any chronic disorder.
The project has three interlinked objectives:
- Objective 1 (research on access to hypertension care): Produce robust and compelling evidence on the barriers to hypertension control faced by low-income households in Malaysia and the Philippines;
- Objective 2 (capacity building): Building on a longstanding collaboration among the partners, strengthen health systems research capacity in Malaysia and the Philippines and develop models and approaches that can be used in other low and middle income countries
- Objective 3 (impact and communication): Promote uptake of evidence — within study countries and regionally — to inform the development of pro-poor responses to hypertension and, by extension, other common chronic diseases.
For the research component in objective 1, the project applies quantitative and qualitative elements to ask: What happens when one is diagnosed with hypertension? What are the pathways and key stages of care? What care/type of provider is accessed and what are the costs at each stage? Are there differences among population groups in seeking, obtaining and adhering to care (socioeconomic, ethnic, rural/urban, marital status) and what explains these (e.g. lack of resources, distance, lack of family support or local facilities). What are the major barriers to continuous access to care and medication?
Quantitative elements include:
- Creation of panels of 600 households in each country, from 30 low-income urban and rural communities, each household with at least one member with hypertension, followed up over 18 months;
- Embedded micro-costing study among 5 hypertensive individuals in each community
Qualitative elements include:
- Recruitment of 20 people with hypertension in each of 2 communities in each country, with in-depth interviews at recruitment and 12 months and completion of audio/video/text diaries in interim describing health seeking behaviour
- Focus group discussions in 6 different communities in each country (mix of urban/rural)
- Structured assessments of selected health facilities
This preferably full time or near full time post provides an exciting opportunity for the successful candidate to develop their research portfolio in the area of patient experience and access to care for non-communicable disease. The post-holder will be able to contribute to the design and conduct qualitative research, including data collection, and analysis, as well as lead on writing papers with guidance from the UK collaborator team (London School of Hygiene and Tropical Medicine). The post-holder will be prepared to take a high degree of responsibility for their own work, in return for the flexibility and freedom we offer within the project to develop their own ideas. We will support the successful candidate to achieve her/his academic goals and provide mentoring and guidance where needed. We aim to provide an intellectually challenging environment, with high-quality, stimulating research, which builds theory and improves policy and practice.
The principal work within this post will be to pursue independent, primarily qualitative research, with a specific focus on patient experience and pathways to hypertension care, and the barriers to optimal management of faced by poor and vulnerable households. The research design will involve qualitative interviews, and developing and using a new mobile technology platform to collect longitudinal qualitative data. The post holder will lead or be actively involved in all stages of the research: study design drawing on the relevant theoretical and empirical literature, country situation analysis, seeking ethics approval, analysis, write-up and communication of the research. The post-holder will conduct fieldwork, and train and supervise other team members (e.g. data collectors). This will require periods of time travelling to project sites. Data analysis and drafting journal articles and national and international dissemination jointly with project partners are among key responsibilities of post.
The work will also involve coordinating across other project components, such as the quantitative cohort study of households and individuals living with hypertension and a rapid assessment of providers of hypertension care. The post-holder will also ensure that these components draw on the qualitative study findings. The project also includes opportunities for individual capacity building in qualitative research methods including participatory methods, and in research communication skills and stakeholder engagement (e.g. policy makers, the public).
The appointment is for 3 years covering a substantial part of the project duration. Salary will be Php 50,000.00 per month inclusive of all applicable taxes. The successful candidate will be placed on the scale according to relevant qualifications. The post will be based in Manila/Kuala Lumpur, with frequent travel to project sites.
The post holder will be accountable to Drs. Dans and Palileo-Villanueva at the UP Manila College of Medicine for operational and logistical aspects of the project. S/he will also work closely on technical and broader project deliverables with Drs McKee, Balabanova, Renedo and Palafox at the London School of Hygiene and Tropical Medicine.
The post-holder will be responsible for the following tasks, all of which will involve collaboration, frequent exchanges across all project partners, and specifically with the social scientist and the health system researchers at the LSHTM.
- Conduct literature review of the relevant theoretical and empirical literature on chronic illness related to barriers faced by poor, vulnerable and hard-to-reach households, capturing the role of institutional and personal barriers but also local culture and social context in shaping patient experiences and pathways to hypertension care.
- Conduct situation analysis on user experience in seeking care for noncommunicable disease and barriers to accessing effective treatment (jointly with the researcher working on the quantitative analysis). Contribute to developing an analytical framework of access to care. Contribute to a national stakeholder analysis
- Lead the country-specific qualitative research design, drawing on the literature and situation analysis. This will include development of the nationally adapted protocol and preparation of data collection instrument(s), as well as management of qualitative study logistics, obtaining local ethics approval, access permission and other aspects of study preparation.
- Lead and participate in data collection, contributing to the selection of research fieldwork sites, engaging and recruiting target communities (with support from data collectors) to facilitate long-term project buy in, training and supervising data collectors, quality control.
- In collaboration with other team members, lead the development of digital diaries co-produced with research participants, and suitable local production teams. Manage diary submissions and share co-produced digital stories.
- Enter the data in Nvivo or other appropriate platform. Drawing on the analytical work develop a coding frame and conduct thematic qualitative data analysis with guidance from the LSHTM team.
- Write up a narrative report reflecting key findings (structure to be agreed with the LSHTM team so that it can be used as a basis for writing papers). Communicate with the project partners in Malaysia and the broader team to ensure comparative analysis and publications.
- Write peer reviewed articles based on the qualitative studies, and contribute to such articles led by other team members.
- Liaise with the broader project team in relation to study design, analysis and dissemination, e.g. provide regular feedback on progress.
- Participate in regular analytical and writing workshops/supervisory sessions run by the LSHTM team, as well as annual collaborator meetings, bi-weekly conferences, and ad hoc meetings as required.
- Contribute to national dissemination and communication, outputs and activities to maximise project impact, e.g. contribute to policy briefs and public engagement events to communicate research findings, attend international conferences.
- Collaborate on other components of the research, and contribute as co-author on project-wide publications.
- Liaise with other University staff members, outside the immediate project team, as well as with research collaborators at other institutions to help build interest and capacity related to the project focus of research. Participate in peer-to-peer mentoring.
- Undertake research training relevant to the project aims, including health systems research, and further training in research project management, media and public engagement, and policy engagement.
- Take on necessary tasks of an administrative nature in support of the project, as required by the Country Lead investigator.
- Excellent masters degree grades in social science (human sciences, history, geography, anthropology, social psychology etc.)
- Knowledge of and familiarity with applying social science approaches in health, methods and instruments for study design and analysis.
- Evidence of experience in collecting and analysing qualitative data
- Excellent and demonstrable writing skills, including writing-up findings from qualitative research for scientific journals
- Proven ability to work independently/with minimal guidance
- Excellent interpersonal skills and ability to communicate appropriately with a wide range of team members and stakeholders, including good presentational skills. This will include the ability to communication respectfully with vulnerable respondents
- Interest in research into patient experience and/or patient-centred care
- Willingness to develop own portfolio of research and establish a career in social science /health systems research.
- Good organisational and administrative skills
- Doctorate in social science (human sciences, history, geography, anthropology, social psychology etc.)
- Experience of independent research, particularly among poor and/or marginalised groups
- Interest in working with poor and/or marginalised groups
- Publications in peer-reviewed journals commensurate with time spent in research
- Previous research experience in patient experience and/or patient access to care.
- Comfortable using a variety of Information and Communications Technology applications
- Experience of teaching, mentoring and capacity building
- Proven ability to work in a team
The post-holder will be responsible to Drs. Dans and Palileo-Villanueva at the UP Manila College of Medicine, and ultimately to the LSHTM PI Prof.McKee and co-PI, Dr.Balabanova.
Salary and conditions of appointment
The appointment will be for 3 years.
Salary will be Php 50,000.00 per month inclusive of all applicable taxes.
Applications should consist of:
- Application form explaining how you meet the essential and (where applicable) desirable requirements of the post. These are set out in the person specification above. Please ensure your answers are self-contained and do not require reference to other documents (e.g. please do not write ‘see CV’). Note that your application form will be used to score your application in a shortlisting process. Please address each question directly and be succinct.
- Curriculum vitae, including a list of publications (including those “submitted” or “in press”). Duplication of some material from the application form is inevitable and acceptable.
- A sample of your academic writing. This should be written solely or principally by the applicant (e.g. as first author if piece is multi-authored). Possible samples include academic essays, thesis chapters, unpublished or published journal articles.
- Names of two referees who may be approached immediately.