Research axis
Global Health inequities

Overall motivation

Health inequities (presence of unfair, avoidable or remediable differences in achieving optimal health and well-being among people) are persistent and urgent challenges globally and locally [Tangcharoensathien, 2023]. Certain population groups are disproportionately affected by some diseases, bear a greater burden of ill-health, have less access to quality health services and experience shorter life expectancies. Reducing health inequalities highly depends on the efforts made towards reaching universal health coverage and Sustainable Development Goal (SDG) 3.8, which seeks to ensure that all people, whatever their circumstances, have access to quality healthcare without facing the risk of financial impoverishment. The roots of health inequalities are deep and entangled between historical, structural, social, economic and environmental factors. Consequently, both research into health inequalities and the policy actions to reduce them are complex and diverse, and require holistic multisectoral effort.

The objective of this axis is to conduct interdisciplinary research on Global Health inequities and poverty related diseases (PRDs), including through large-scale intervention studies and contribute to the transfer into policies of the research findings and the comprehensive, complex, multifactorial evidence-based interventions assessed.

Integrated activities

Several founding members of IPORA from different disciplines were already engaged in global health research. Building on their complementary expertise and collaborations with academic partners, NGOs and ministries of health, they developed a medium-term research agenda focusing on three interconnected challenges: tuberculosis, under-five mortality and severe acute malnutrition.

Tuberculosis (TB) remains the leading infectious disease killer worldwide and is closely linked to poverty and inequality. Countries with lower income levels tend to experience higher TB incidence, and within countries, people living in poverty face a greater risk of infection and more limited access to care.

Under-five mortality is another key indicator of global health inequalities. Many deaths among young children are caused by poverty-related diseases such as HIV, tuberculosis, malaria, diarrheal diseases and respiratory infections, often compounded by undernutrition and poor living conditions.

Severe acute malnutrition (SAM) affects more than 13 million children under five worldwide. It is both a consequence and a marker of poverty, associated with fragile food systems, environmental shocks and limited access to healthcare. SAM also increases the risk of severe infections and poor treatment outcomes.

Academic validation

During the first cycle of IPORA funding, the Global Health Inequalities (GHI) axis generated significant research outputs and strengthened interdisciplinary collaboration. Researchers co-published 11 scientific articles based on projects that benefited from IPORA’s interdisciplinary networking during the analysis phase. The team also implemented one IPORA-funded seed project, prepared and secured external funding for four new research projects, and initiated four PhD projects.

These activities also contributed to the creation of JEAI SPADE-KZ (Strengthening the fight against Poverty-related Diseases in Children), a research initiative funded by the IRD. The project aims to strengthen the capacities of the University of Zambia (UNZA) Paediatric HIV and TB Clinical Research Unit in public health, epidemiology, social sciences and health economics.

Developed in partnership with the GHiGS team at the University of Bordeaux, the Zambian Ministry of Health, and the National Tuberculosis and Leprosy Programme, the initiative supports interdisciplinary research on poverty-related diseases affecting children. By reinforcing research capacity and partnerships, the project will help prepare future large-scale intervention studies aimed at reducing under-five mortality and poverty-related diseases in Zambia and across the southern African region.

Associated projects

Community Health Workers. Strengthening a proximity strategy in rural areas (PROXISANTE)

Community Health Workers. Strengthening a proximity strategy in rural areas (PROXISANTE)

This three-year project in Côte d’Ivoire aims to strengthen rural healthcare access by training and supporting Community Health Workers to implement innovative community-based strategies for the prevention, screening, and management of HIV, malaria, and tuberculosis.

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Improving the use of economic evaluation data for priority setting in a multi-donor environment in resource-limited countries: The case of tuberculosis and other poverty-related diseases among children in Zambia, Mozambique and Côte d’Ivoire

Improving the use of economic evaluation data for priority setting in a multi-donor environment in resource-limited countries: The case of tuberculosis and other poverty-related diseases among children in Zambia, Mozambique and Côte d’Ivoire

This project aims to develop and test new methodological tools to help health policymakers in resource-limited countries use economic evaluation data more effectively to set priorities and allocate resources for tuberculosis and other poverty-related diseases.

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NutriVax-Measles: Increasing measles vaccination coverage through supplementation with an SQ-LNS incentive in children aged 6-23 months

NutriVax-Measles: Increasing measles vaccination coverage through supplementation with an SQ-LNS incentive in children aged 6-23 months

Explore NutriVax-Measles: a study in Northeast Nigeria on increasing measles vaccine coverage in children 6-23 months by combining it with SQ-LNS supplementation to break the vicious cycle of malnutrition and infectious diseases.

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Validation of treatment decision algorithms for childhood tuberculosis at low levels of healthcare in high burden countries – effectiveness, implementation, and integration into policy and practices (Decide TB)

Validation of treatment decision algorithms for childhood tuberculosis at low levels of healthcare in high burden countries – effectiveness, implementation, and integration into policy and practices (Decide TB)

Evaluating algorithms for childhood TB treatment in high-burden countries to improve diagnosis at primary healthcare levels, informing effective implementation and policy integration, aligned with the End TB Strategy for global TB eradication by 2035

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Wakobo ti Kodro: A quasi-experimental study aimed at strengthening the identification and follow-up of pregnant women at risk of obstetric complications in the community by traditional birth attendants in the Central African Republic

Wakobo ti Kodro: A quasi-experimental study aimed at strengthening the identification and follow-up of pregnant women at risk of obstetric complications in the community by traditional birth attendants in the Central African Republic

This quasi-experimental study in the Central African Republic evaluates whether training and digitally supporting traditional birth attendants, and integrating them into the health system, can improve the identification of high-risk pregnancies and increase safe deliveries in health facilities.

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