Internships

Internship Vacancy description

for a Bachelor student BMW or Master HTA/Epidemiology, with interest in Global health, Sub-saharan Africa, Health financing.
Special requirement: ability to read French.

1. Name and address of institute/organization: NICHE Group, ELG - Radboudumc, Nijmegen

2. Title of research project: Assessment of differentials in health sector performance among districts in Burkina Faso; analysis of determinants of service coverage and health outcomes, in particular infrastructure, adequacy of staff and level of funding.
3. Name of staff member who will serve as your supervisor: Dr Leon Bijlmakers

4. Background: Burkina Faso has established a routine of conducting annual health sector reviews, which involve an assessment by the Ministry of Health and its development partners of the extent to which targets set in the country’s strategic plan for the health sector (Programme national de développement sanitaire, PNDS) have been achieved. In early 2014, it was the 5th time in succession that an annual health sector review was conducted and Radboudumc had one scientist- consultant (LB) who played a central role in this exercise. As part of the review a large database was compiled, consisting of the types and level of funding of all the activities that were conducted in all (63) health districts of the country in 2013 under the auspices of the Ministry of Health, as well as that of the supervisory and support activities conducted at the Central (MoH) and intermediate (13 regions) levels.
A report of the health sector review and its finding is available (in French) and has already been adopted by the Government of Burkina Faso. The report is rather descriptive in the sense that it provides an overview of the state of 48 key indicators that are being used to monitor PNDS implementation. These include input, process, coverage/output and health outcome indicators. A partial breakdown of these indicators by district is provided in the report, but there is scope for some more in-depth analysis and linking service output and health outcomes to available inputs/resources, such as physical infrastructure, adequacy of staffing levels and health financing. For some of the variables a further breakdown by district is yet to be obtained through the country’s newly installed electronic health management information system (ENDOS).

5. Research question / aim: What are the trends in health sector performance at the district level and what are the key determinant? What proportion of the variation between health districts can be explained by quantifiable inputs such as infrastructure, personnel and finance? What would be other possible determinants of poor performance that might require further exploration, for instance through qualitative research methods.
The secondary aim is to build a model through which district health sector performance can be described and possibly predicted, based on multiple criteria.
A third aim could be to propose a method to set priorities in planning health interventions for use by district health managers.

6. Research design and methods:
a. Literature study. Identify determinants of health system performance from the international literature and document how these can be analysed in a systematic manner at the country level.
b. Quantitative research. Conduct a multi-level analysis of district health performance in Burkina Faso, based on the existing database: analysis of trends, identification of determinants and correlations, possible confounding factors.
c. Qualitative research.
Assess whether the set of key PNDS indicators would need to be refined (in terms of their definition, source/level/frequency of data collection), so as to allow timely identification of shortfalls/gaps and more efficient monitoring of progress.

7. Task at hand:
• Literature study
• Inventory of existing data base
• Analysis
• Reporting

8. Expected result: Paper/article in English (or French) ready for submission to a scientific journal.

9. Time schedule: Start a.s.a.p. Duration 3 to 4 months.

10. Competences required:
• Knowledge of statistical methods, esp multi-level analysis
• Familiar with Excel and SPSS (or another statistical package)
• Interest in the dynamics of national health systems in Sub-Saharan Africa
• Interest in determinants of health
• Writing skills (proven), good communication skills.

11. Other relevant information:
Office space will be available at the ELG/NICHE department (Studiegebouw). International health environment, with exposure to foreign PhD students.