Collaborative Research – Oxford & Kenya

Global Health Informatics

Electronic Medical Records (EMR) Landscape & OpenMRS for Hospitals in Kenya

Investigators: Chris Paton (Oxford), Naomi Muinga (Kenya)

We are conducting a review of EMR systems in use in Kenya. In doing so, we are interviewing medical officers and IT managers in Kenyan public hospitals to establish which EMR systems they are using and to garner feedback on their usefulness. In linked work, we are supporting the WHO and Ministry of Health to evaluate a new hospital EMR system based on the OpenMRS platform as it is implemented in hospitals in Kenya.

Health Services that Deliver: Improving Care for Sick Newborns in Nairobi

This major project involves many additional partners including the Kenya Paediatric Association, The University of Nairobi and Strathmore University all linking with Nairobi City County. In Kenya team leads include: Mike English, David Gathara, Nancy Abuya, Jacinta Nzinga, and Jalemba Aluvaala; In Oxford work is led by Georgina Murphy with Jacob McKnight.

Using a mixed-methods approach, we are evaluating what gaps exist in the delivery of facility-based, nursing care to sick newborns in Nairobi City County and how these gaps might be addressed by task-shifting. There are many phases to this project including: stakeholder analysis; assessment of capacity, utilisation, and needs for newborn care; service delivery and task profiling; illustrative economic modelling; and examination of the organisational, professional and social context. The project is likely to lead to important new methodological developments in evaluation of the quality of neonatal care as well as providing results of immediate value.

The research is being conducted in partnership with local and national policy-makers as part of efforts to provide evidence for long-term policy on service provision. The evidence-based policy approach taken, and research finding that result, will be internationally relevant while also targeting key policy objectives in Kenya. As part of this 4 year programme of research work has already begun in two areas:

The practice of neonatal nursing – An ethnography approach

Principal investigator: Jacob McKnight (Oxford)

The first part of the research will examine the people, policies and organisations that guide professional nursing work in hospitals in order to help us understand the way in which neonatal services, and their perceived weaknesses, are conceptualised by stakeholders. We will explore the experience of the nursing profession and the issues and factors which inform and constrain nursing practice. This project will act as a study of this important area in its own right, but also as an orienting foundation for the related projects.

Nairobi Newborn Study

Principal investigator: Georgina Murphy (Oxford)

We are quantifying and characterising the provision of facility-based inpatient newborn care, in terms of capacity, accessibility, and quality, in Nairobi City Country. We will also estimate the expected demand for inpatient neonatal services in the County so as to identify any gaps between need for and delivery of services. This work aims to provide information needed to guide strategies for improving the accessibility and quality of care for sick newborns in Kenya.

 

Grants

MRC-Wellcome Trust-DFID-ESRC, Health Systems Research Initiative. Exploring the potential of Open Source solutions to deliver Clean, Clear Information for Health Service Improvement. £99,800

Wellcome Trust: MSc Fellowship awarded to Mr. Tim Tuti (Kenya) - Exploring an E-Health strategy for engaging clinical teams in efforts to improve care. £96,500 September 2015 to March 2018

Oxford University – Wellcome Trust Institutional Strategic Support Fund. Harnessing Routine Data for Learning Health Systems in Developing Countries. £435,000, July 2015 to June 2019

Skoll Centre for Social Entrepreneurship: Research Grant for the Health Emergency Learning Platform (HELP) an eHealth game based learning application. £11,640 February to June 2015.

ISSF Public Engagement Award: The Oxford Health Systems Collaboration – A symposium, £15,000. Funds supported a meeting held at Green Templeton College with the Global Health Policy Programme (who provided co-funding) in February 2014. Attended by international speakers and multiple Kenyan investigators with production of multiple podcasts (see below).

ISSF Seed Funding followed by grant from WHO-Kenya: Initial ISSF seed funding (matching value £9,000) supported a one day workshop in Oxford on health informatics and scoping work to develop new projects in this area. This yielded an initial grant to evaluate the implementation of an Open Source Electronic Health Record System in two Kenyan counties awarded by WHO-Kenya (value,$23,000, May 2014 to March 2015).

MRC-Wellcome Trust-DFID-ESRC, Health Systems Research Initiative. Health Services that Deliver – Improving Care for Sick Newborns. £982,000, January 2015 to June 2019. This major grant application is led by Prof. Mike English with co-applicants including: Prof. S. Shepperd, Prof. S. Dopson, Prof. A. Gray, Dr. J. McKnight, Dr. G. Murphy, Dr. S. Molyneux, Dr. C. Jones, Prof. A. Noor, Dr. J. Chuma, Dr. J. Aluvaala, & Prof. F. Were.

Oxford Tropical Network Travel Grants: The OHSCAR team has won additional travel grants for meetings to foster new collaborations between Kenya and Oxford for research in Medical Statistics (February 2014; £4,500) and to development novel game-based learning applications (April 2015, £9,200).

 

DPhil Scholarships competitively awarded and linked to OHSCAR:

Mr Lucas Malla (October 2014 to September 2018) formerly of the KEMRI Wellcome Trust Research Programme (KWTRP)-Nairobi, Lucas won a Clarendon Scholarship to undertake DPhil studies with NDM and is working on applications of comparative effectiveness analyses in Kenya. He is supervised by Prof. Mike English (DoS) and Prof. Rafael Perera and Dr. Emily McFadden (from Medical Statistics Unit, DPC).

Ms Abby Enoch won a NDPHS Scholarship (October 2014 to September 2018) to undertake DPhil studies on the implementation of pulse oximetry in Kenya. She is supervised by Prof. Sasha Shepperd (DoS, NDPH) and Prof. Mike English.

Dr Jalemba Aluvaala (Jan 2015 to December 2018) formerly of the Ministry of Health in Kenya and currently of the University of Nairobi, Aluvaala won a Scholarship from the Oxford Tropical Network to undertake DPhil studies on optimising delivery of inpatient neonatal care services. He is supervised by Prof. Mike English (DoS) and Prof. Jay Berkley (NDM).