BMJ Global Health Grant: Winners
Meet 2022's winner
Olatunde Olayinka Ayinde, MBBS; MS (Int’l Hlth Policy & Mgmt), FWACP (Psychiatry)
Lecturer, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria & Honorary Consultant Psychiatrist, Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
Could you tell us something about yourself and your research? I completed my basic medical training at the university of Ibadan, Nigeria in 2005 and obtained a Master of Science degree in International Health Policy and Management at Brandeis University, Waltham, USA in 2014. I had additional training in Global Mental Health, Implementation Science and Project Management in Global Health. In the course of study and work, I received several scholarships and awards, including the Joint Japan/World Bank Scholarship and the Andrej Marusic Prize. I wear three hats at work. First, in the last 7 years, I have worked as a psychiatrist in Nigeria. Second, I teach psychiatry at both undergraduate and postgraduate levels. Third, I am an investigator with the WHO Collaborating Centre for Research and Training in Mental Health, Neuroscience, Drug and Alcohol abuse, University of Ibadan. Nigeria is a country with considerable burden of mental disorders, large treatment gaps for these conditions as well as severe scarcity of human resources for mental health. All my activities are therefore directed towards reducing the burden of mental disorders in Nigeria through clinical service provision, generating research evidence for advocacy and policy, and upskilling human resources for mental health service. In the last 5 years, along with working with a group of international collaborators to study the epidemiology of psychoses in diverse settings, I have had a special interest in the design and evaluation of task sharing approaches for treating perinatal depression in primary care settings, using randomised control trial and implementation science methodologies. My overarching career goal is to become an independent clinical researcher and a leader in developing effective interventions for scaling up mental health services in resource-constrained settings through the integration of mental health into routine primary care. Why did you undertake this research? Perinatal depression is a disabling mental disorder among women of childbearing age and is commoner among mothers in low- and middle-income countries (LMIC). Our group had previously demonstrated that the prevalence of perinatal depression among adolescent mothers is twice that in adult mothers in our setting. In addition, there is now strong evidence that perinatal depression is associated with serious maternal and infant adverse outcomes, including elevated rates of obstetric complications, impaired infant cognitive and emotional development, and elevated levels of psychopathologies in infants of depressed mothers up till the age of 14 years. These adverse effects are worse among adolescent mothers. Previous work by our team has shown that although interventions designed for adult mothers with perinatal depression can alleviate depressive symptoms among adolescent mothers, they do not lead to improvement in parenting skills and infant outcomes among this group of mothers. In addition, adolescents receiving care in adult treatment settings report negative attitude and hostility from maternal care providers, leading to reluctance to engage with service. There is therefore a need for interventions that are tailored to the peculiarities of adolescent mothers with perinatal depression.
The majority of adolescent mothers reside in LMIC, where they are more likely to come from marginalised communities characterised by poverty, lack of education and employment opportunities, which are the same factors that often drive perinatal depression. In addition, it so happens that it is in these same countries that there is severe scarcity of mental health resources, leading to large treatment gaps for perinatal depression. Young persons make up more than half of the population in many LMIC. Therefore, adolescent pregnancy and its accompanying social and economic consequences, which are worsened by perinatal depression, could lead to intergenerational transmission of socio-economic disadvantages to children of millions of adolescent mothers in these countries, with implications for national economic prosperity. So, it is my belief and that of my co-workers that the design and scale up of interventions for perinatal depression is an endeavour that need to be given top priority. What do you think will be the main benefits of winning the grant? To our knowledge, this is the first time that an intervention that addresses the unique features of adolescent perinatal depression has been designed and shown to be effective in reducing depressive symptoms and improving parenting skills among adolescents in a low resource setting. Winning this grant gives me the opportunity to share the findings from our work with researchers and policy makers who work with adolescents from diverse settings. I hope that this work stimulates further research in this largely neglected area. For example, future research needs to expand on the policy implications of our findings by including an evaluation of the cost-effectiveness of the approach. I also hope that the findings would influence adolescent mental health policy in diverse settings. How do you think this opportunity will contribute to your research The opportunity to present this work at the Seventh Global Symposium on Health Systems Research to such an accomplished audience will no doubt be a boost to my career as an early career investigator from a low middle-income country. It should give me an opportunity to meet and network with leaders in global health and researchers from other parts of the world who work with adolescents. Such encounters may provide a fertile ground for building collaborations and exploring funding opportunities to move my work in this area forward.
Read about past winners
Jason V. Alacapa, MD, MBA, MPH(Econ), MHM
Chief Executive Officer, Innovations for Community Health, Inc.
Chief Executive Officer, metaHealth Insights and Innovations, Inc.
Dr Alacapa is a medical and public health professional with business, health management, and health economic evaluation qualifications. He has more than seven years of progressive work experience in health systems strengthening, health economics and financing, and health management, both in the Philippines and abroad. Furthermore, Dr Alacapa is the Chief Executive Officer and Founder of the Innovations for Community Health, an NGO implementing sustainable and scalable market and private-sector oriented health system innovations in tuberculosis care; and of metaHealth, the first health technology assessment-focused firm in the country. On the side, he is also doing consultancies with local and international agencies. Currently, he is also taking a DrPH in Implementation Science, a predominantly part-time and distance professional doctorate, at the Johns Hopkins Bloomberg School of Public Health.
Could you tell us something about yourself and your research? My recent work in public health practice and research focuses on driving private-sector engagement with health technology assessment (HTA) and tuberculosis (TB). Through my work in the NGO Innovations for Community Health, we deploy social enterprise one-stop DOTS facilities to find the "missing cases" of tuberculosis seen by private physicians. These cases are "missing" because they are not registered in the National TB Program (NTP), and their outcomes are not tracked. Often, these patients don't receive quality care, and they don't complete the six months of treatment. Thus, fueling the country's intractable epidemic. In this context, my implementation research utilized an interrupted time series analysis to provide effective evidence for an innovative model of healthcare delivery that connects a network of private providers (the "spokes") to the NTP resources through an intermediary one-stop DOTS (the "hub"). This hub-and-spoke model has sustainability at its core by maximizing national healthcare insurance reimbursements. Why did you undertake this research? Newer models of care are needed to solve the Philippine's TB problem, which is one of the top ten high burden countries globally. To date, an effective private sector intervention to find the "missing cases" is yet to be scaled-up in the Philippines. This research provides evidence to support the scale-up of a promising solution.
What do you think will be the main benefits of winning the grant? Innovations are often met with strong resistance. Attending an international conference would allow us to gain a broader audience for the work that we do, which could potentially increase our credibility and legitimacy. We also plan to publish our findings in a highly-respected peer-reviewed journal. These two factors could help us increase buy-in from our local stakeholders for adoption and broader implementation. After all, good evidence should be front and centre in policy and decision-making. How do you think this opportunity will contribute to your research? As an individual professional, this grant provides me with a platform to showcase the work that I have done. Furthermore, as a young researcher from a developing country, this boosts my confidence and inspires me to do more. I am looking forward to the networks and connections that could be established when I attend the conference. These scholars and researchers could spur collaboration that could build on our current work.
Dickson Lwetoijera, MSc, PhD
EHES and Training Departments, Chief Research Scientist, Ifakara Health Institute (Tanzania)
Dickson Wilson Lwetoijera is Chief Research Scientist at Ifakara Health Institute (IHI), an Adjust Professor at Nelson Mandela African Institution of Science and Technology (NM-AIST), and a Wellcome Trust International Intermediate Fellow (2020-2024). He graduated with a PhD in Medical Entomology from Liverpool School of Tropical Medicine in 2016. With 12 years of experience in malaria vectors control research, he has made notable contributions to the field, some of which include, 30 peer-reviewed publications, participated in the fundraising of 4.9 million USD; and reviewed over 31 research manuscripts submitted for publication on international peer-reviewed journals. Dr Lwetoijera is also an Editorial Board Member of the journal Frontiers in Sustainable Cities and the Deputy Head of the Training and Capacity Building department at IHI. His research interest focuses on alternative vector control tools with the potential to target mosquitoes outdoors. Specifically, he focuses on auto dissemination, mosquito-assisted larviciding and genetic-based technologies for mosquito control. Find out more about Dr Lwetoijera's research.