Health systems research

Philip Ayieko

Dr Philip Ayieko works for SIRCLE, a Consortium for National Health Research, collaboration between KEMRI - Wellcome Trust Research Programme, the University of Nairobi, College of Health Sciences and the Ministry of Medical Services. SIRCLE aims to build capacity for high quality health services and implementation research, and promote clinical excellence by engaging trainee researchers in policy relevant research.

The KEMRI-Wellcome Trust research programme

The KEMRI-Wellcome Trust Research Programme is a major Wellcome Trust’s overseas programmes. Its work has had a major influence on national and international health policy. Research spans a wide variety of topics and disciplines including research on malaria and bacterial and viral infectious diseases, work to map disease risk and intervention coverage and work on research ethics and health systems strengthening.

Philip Ayieko: Child health interventions

My background is in epidemiology. I have been working in health system research for the last eight years. My basic training was in nursing which has really enhanced my practice of epidemiology.

On average every 1 in 10-15 children who are admitted in to Kenyan hospitals die during admission so my current research is involved with monitoring the type of care that is provided within hospitals in low income countries.

This area is important because the outcome for children admitted in to hospital in low income countries is very poor and this type of outcome can be improved by basic intervention, so there is a wide scope for improving these outcomes.

Basically I apply basic epidemiological concepts and statistical methods of analysis to monitor quality of care. Part of the challenge of working in this area is that we do not have metrics for quantifying the performance of hospitals and that is part of the work that I do.

The tools that I apply basically are drawn from statistical modelling, using basic statistical approaches to analysis of large data sets gathered from hospitals.

To a large extent, the type of studies we do are impacting on the care that children receive in hospitals. For example there was a study that we just concluded that demonstrated that basic training of health workers and provision of support supervision improves the type of care that is provided within hospitals.

The area that we work with is very interesting in that the care that is provided depends on what the health workers are informed about. There are many challenges in our setting in terms of care provision - there are places where there is no basic equipment, such as incubators, for newborn care. Research shows that provision of alternative forms of care like skin-to-skin contact between the mother and the child for prolonged periods of time can improve survival by up to 40%. So the challenges are just bringing such information to the health workers so that they can improve the type of care that they provide and also monitoring to ensure that these things are being implemented.

My advice to young researchers is to find an area that you are interested in. That is very key to sustain the type of work that you are going to do. Once you find the area then identify the mentors who can mentor you in this area. Finally I would develop critical skills to ask good questions and find good answers.