Researchers extend their REACH to South Africa
Eyles, a social geographer, and Birch, a health economist -- both recognized globally for their contributions to the understanding of health inequities -- were awarded a Teasdale-Corti Team Grant allocated up to $1.6 million over four years.
The REACH proposal was one of 13 chosen from more than 250 applications following a stringent peer-review process.
The program funds innovative collaborations between Canadian health researchers and their counterparts in the developing world.
"While South Africa is the richest country in Africa, there are massive disparities in the availability, affordability and acceptability of the health services offered," says Eyles. "There are economic, geographical and cultural barriers that are abiding features of the South African landscape."
The REACH team, comprised of team leaders Eyles, Birch and two South African researchers, will focus on three health interventions: anti-retroviral therapy for HIV/AIDS, tuberculosis care and maternal health.
The grant will also offer the opportunity for graduate students to join the REACH team doing fieldwork in South Africa; provide exchange opportunities for South African students and professors to benefit from the health economic research methods and expertise at McMaster; and direct the careers of the next generation of researchers to problem solve and build the capacity needed to address inequity in the distribution of health and health care.
South Africa has a population of almost 48 million with an estimated 5.5 million people who are HIV-positive.
"The infection rates are still very high, complicated by South African politics and denial. Antiretroviral treatment (such as the AIDS cocktail) needs to be moved out to those who need it," explains Eyles. He adds, "There is also a terrible synergy between AIDS and the emergence of multi-drug resistant tuberculosis."
Besides researching the various facets of access to appropriate health care for the public health threats of HIV/AIDS and tuberculosis, the REACH team will research the extreme inequalities found in maternal health care, where access to basic services has caused an unacceptably high maternal mortality rate, especially among black women who are dying in pregnancy and during childbirth.
The REACH project commences this summer with the South African team leaders selecting four sites, representative of the urban and rural realities in South Africa, choosing two urban and two rural communities.
The REACH team will determine how these communities access health care -- defining access as the 'degree of fit' between users/populations and providers/health system -- to map inequities in utilization. Their in-depth studies will gather statistics, develop methodology, analyze policies, make assessments and provide pieces to the puzzle that will strengthen South Africa's capacity to find practical and sustainable solutions to its health care challenges.
The grants program is named in honour of Dr. Lucille Teasdale and her husband, Dr. Piero Corti. Teasdale was a pioneering Canadian surgeon who died in 1996 after contracting AIDS while operating on patients in Uganda. Teasdale and Corti dedicated their lives to improving health care in Africa, and to building the capacities of African health practitioners.
The grants will be awarded through the Global Health Research Initiative (GHRI), a partnership between the Canadian Institutes of Health Research (CIHR), the Canadian International Development Agency (CIDA), Health Canada and the International Development Research Centre (IDRC).