1. COMDIS-HSD Addressing national government priorities
Embedded within government systems
Nuffield Centre for International Health & Development, UK (Lead)
Malaria Consortium, UK & elsewhere
Association for Social Development, Pakistan
Health Research and Social Development Forum, Nepal
Advancement through Research and Knowledge Foundation, Bangladesh
Centre for Global Health, China
Centre for Global Health Research, Ghana
Good Shepard Hospital, Swaziland

2. Implement and evaluate the intervention
Purpose
Research to improve delivery of basic health services in low-income countries.
Embedded R and D – leading to policy and practice change
Stage 1
Design and develop service delivery package in line with MoH national priorities
Stage 2
Pre-test and pilot package (e.g. guidelines, materials and research tools)
Stage 3
Implement and evaluate the intervention
Stage 4 Support both policy and practice change (RU) nationally and internationally

3. Improving community health care

4. Community Clinics in Bangladesh. Objectives
Setting
Community Clinics in Bangladesh.
Objectives
to develop improved training for community health care providers
to assess quality of care provided by CHCPs.
Results
Of 1490 children examined, 90% were correctly diagnosed, 86% correctly treated and 99% received a correct referral decision
89% of consultations resulted in correct use of antibiotics.
e.g. 70% to be reached on key indicators, particularly around antibiotic prescription and referral

5. Curriculum and training adopted nationwide.
Policy implications
Community clinics (or similar) can be an effective way of delivering basic care and referral services, if curriculum and training are appropriate
Research demonstrating the effectiveness of better curricula and training can influence MoH to adopt such methods.
Impact
Curriculum and training adopted nationwide.
e.g. 70% to be reached on key indicators, particularly around antibiotic prescription and referral

6. Urban health care

8. Setting
Nepal, and urban primary health centres in Kathmandu.
Objectives
Originally planned to be intervention development and assessment
Major delays due to the policy environment
Major opportunities to support policy development.
Progress
Project has already had a major impact on policy
Now working with MoHP to develop urban health plan: expected to complete by end 2016
Intervention development and assessment ongoing.

9. Policy implications
The process of developing urban health care policy is political and difficult
With dedicated input and goodwill on all sides, it is possible to advocate for policy development
Major technical and organisational input is needed to support/lead the process.
Impact
Policy developed and voted into law
Practical implementation should be research-informed.

10. Embedded research has major potential for impact
Conclusion
Embedded research has major potential for impact