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 THE GRANTGrand Challenges in Global Health is a family of grants programs focused on one unifying purpose: To overcome persistent bottlenecks in creating new tools that can radically improve health in the developing world. The Bill & Melinda Gates Foundation Principal Investigator:Population Health Metrics Research Consortium ProjectA project currently underway to address Gates Grand Challenge in Global Health #13Critical information on population health is needed to inform planning, resource allocation, program implementation, monitoring and evaluation. Currently, there are major gaps in the available measurement methods and technologies to yield this information, making it difficult to address health inequities through effective policy. The Population Health Metrics Research Consortium Project is funded by the Bill and Melinda Gates Foundation as part of its Grand Challenges in Global Health program. This project aims to address Grand Challenge #13: Develop technologies that permit quantitative assessment of population health. The PHMRC project pursues a creative and bold approach by wedding epidemiology, biomedical research, and population health assessment to:
CollaboratorsThe PHMRC project team represents a wide array of research interests and areas of expertise. Collaborating scientists include physicians, epidemiologists, health economists, demographers, mathematicians, biologists, and social scientists from the following institutions.
Project Highlights
Develop methods to measure mortality where vital registration systems are incomplete.Survey Analysis Methods: The PHMRC project is currently implementing a household survey that incorporates innovative ways of gathering accurate information on mortality, effective coverage of key interventions, and causes of death from four international sites. The project team previously completed a census at research sites in Tanzania, India, and the Philippines to establish mortality rates against which the results of the household survey will be measured. New methods to analyze existing census data have also been developed. Most notably, we have developed better methods to gauge mortality based upon sibling survival questions. Develop methods to measure cause-specific mortality in populations with incomplete or inadequate cause-of-death coding.Verbal Autopsy instruments: The principle of verbal autopsies (VA) is that key conditions relating to major causes of death can be reliably recalled by relatives after a family member’s death. In this method, field interviewers speak with the next of kin, using a VA questionnaire to collect information about the symptoms of the deceased, demographic characteristics, possible risk factors (such as tobacco use), and other potentially contributing characteristics. The data are then aggregated to estimate population-level patterns of the major causes of death using the recently developed Symptom Pattern Method. Currently, the PHMRC project team is collecting data in hospital and clinical environments where the causes of death are known. Cases that meet the project criteria are followed up with blinded VA interviews with a relative of the deceased. This allows the new methods to be validated against gold standard data. The validated VA tool has been incorporated into the household survey to assess verbal autopsy results from community datasets where causes of death are unknown. This will allow for estimation of cause-specific mortality in areas that lack complete vital registration systems. The PHMRC goals include developing a standardized and concise VA instrument that can be easily used in resource-poor settings and developing straightforward and cost-effective methods to analyze them. Statistical methods to correct for selection bias in hospital deaths: Deaths recorded in hospitals are not a random sub-sample of all deaths in the community, but are still a valuable source of population health information. The PHMRC project team has developed a statistical method that estimates population level cause-of-death profiles using regional vital registration data to overcome the selection bias of hospital death data. The PHMRC is currently applying and advancing this new method using datasets from both the developed and developing world. Develop methods to measure the prevalence and incidence of major diseases.Proteomics research: The PHMRC project team is working to develop methods that will allow for effective population screening for diseases based on complementary sets of biomarkers, or molecular barcodes, found in human blood samples. The diseases being investigated include tuberculosis, HIV, malaria, and diabetes.. The PHMRC project team collected plasma samples from a research site in the Philippines and is currently collecting plasma and sputum samples in two research sites in Tanzania. The samples are processed and analyzed by the Broad Institute for potential biomarker patterns. If this approach is found to be effective, it could be used in conjunction with population censuses to better understand the prevalence of key conditions. Serum Immunoglobulins for Enteric Pathogens: The PHMRC project team is endeavoring to validate serological assays for representative bacterial, viral and parasitic causes of diarrhea in developing countries and then prospectively evaluate these serological assays in field areas. Improve measurement of effective delivery of priority health interventions.Physical measurement and dried blood spot analysis: The household survey incorporates a novel tool for evaluating the prevalence of chronic diseases in the population. This information will provide an indication of how the health care system is helping the community. The survey instrument utilizes a biometric assay to collect direct data from adults on diabetes, cholesterol, and tetanus immunization (in women with children), and immunization history of tetanus, diphtheria, and measles, mumps, and rubella in children. It additionally collects height, weight, and blood pressure of selected respondents. Further, the instrument collects verbal responses on health behaviors, risk factors, and symptoms of the respondents. For more information, please contact: gc13@healthmetricsandevaluation.org |
