Final Report: 2019-2021 RELIGHT Research Groups

The three following groups were awarded funding from the Centre for Global Health (CGH) for the 2019-2021 period to assist with advancing their global health agenda through project development support. The Digital Health Promotion in the Global South project led by Josef Noll, The Child, Nutrition and Development (CHNUDEV) project led by Per Ole Iversen, and The Politics of Global health Security project led by Katerini Storeng. Each year the research groups have shared their progress and we are now excited to present their final report below, which outlines the success and accomplishments of the first RELIGHT cohort. 

Project: Digital Health Promotion in the Global South – (ProDHP)

Introduction

The project ProDHP addresses digital health promotion (DHP) in the Global South as an effective way to strengthen the health care systems in the global south by empowering the people. The project is based on a global collaboration, involving multi-disciplinary partners across Europe, USA and Africa.  

The goal of ProDHP for 2021 was to extend the set of DHP messages with the two new domains being antimicrobial resistance (AMR) and sexual violence, and through this process verify the methodology for digital health promotion. Given the methodology and the practical examples covering a range of diseases, ProDHP establishes a global network and identify project opportunities. 

This report covers the year 2021 whereby, Co-PI Christine Holst, PI Josef Noll, Co-PI Wisam Mansour, Britt Nakstad, Kristian Rødland and Cynthia Wagamati have all contributed to the progress and finalisation of the ProDHP. Kathe Arnesen at Nordic Media has had the main responsibility for the AMR animation production, while the sexual violence animation will be produced in Kenya.

Activities in 2021

Ongoing work throughout 2021 included the promotion of the DHP processes and outcomes, especially (i) applying the methodology with story, script and animation creation of two more videos, (ii) the promotion of the health messages, and (iii) the involvement in project and proposal work addressing DHP. 

1. The methodology for storytelling, translation into a script, and the creation of the AMR video was successfully applied for. The video was delivered in Q4 of 2021 and simple updates need to be carried out by the producer. The production of the animation on sexual violence turned out to be more cumbersome. Though the story and the script production went well, the translation into an animation made the cultural sensitivity of violence against women visible. We expect a first version in Q1 of 2022.
2. The promotion of DHP has reached out both nationally and internationally, with i) contribution in 6 conferences and workshops, ii) bi-directional meetings and iii) project proposals and engagements.
3. In September, the Digital Global Health Crosscutting Theme was launched at Centre for Global Health (CGH). The webinar focused on DHP, and both Josef Noll and Christine Holst participated.

Status animation creation

The team has focused on finalizing the two animations under production:  

• Sexual violence – Meeting with NGO based in Kenya and the animator in June, with a revision of the script right afterwards. The final script tells the story about Atieno from Kenya, a victim of child sexual abuse. The aim is to share the animation on television and via smartphones with the possibility of presenting the work on the radio. The first version of the animation is expected to be finished in Q1 of 2022.

• AMR - The animation is completed after several rounds and revisions. The story is about Prisha from India and AMR. The story, as well as the animation, was reviewed in India. Due to some minor issues, the publication of the final version is expected in February of 2022.

These two additional animations contribute to the set of videos available at DigitalGlobalHealth.eu, and form the invitation for worldwide collaboration on DHP. DHP has been discussed with various actors including the Norwegian Institute of Public Health and the World Health Organization, as well as national entities in developing economies. Though the benefits are obvious, the burden on developing economies to produce these animations, as well as the missing access for most people, are seen as the biggest hindrance for take-up. 

The animations, besides being used in project proposals and research projects, support the strategy of the CGH, i.e 

• “to be a hub for capacity development in research based global health education,” where the methods and results of DHP can easily be adapted to novel themes and countries/regions. Results from the DigI Project underline that knowledge uptake and refresh through digital animations, provided free of charge to the community, demonstrates a tremendous knowledge increase, as well as a 12-month knowledge retention.

• “to act as a facilitator of community engagement, knowledge-based dialogue, and public opinion formation,” where provision of health messages in a digital way leads to better community engagement and knowledge-based dialogue around health topics, as confirmed through the PhD work by Christine Holst.

Conclusion

The project ProDHP has delivered according to expectations, based on a global collaboration and the involvement of multi-disciplinary partners across Europe, USA and Africa. The goal of ProDHP was to extend the set of DHP messages with the two new domains being AMR and sexual violence, and through this process, verify the methodology for digital health promotion. The DHP videos are prepared according to plan, with minor delays. Results in the field show an extraordinary effect of the animated videos in terms of attention and knowledge uptake.  

Given the methodology and the practical examples covering a range of diseases, ProDHP establishes a global network, brought the topic of DHP into project proposals and established three new projects. Furthermore, DHP has reached high visibility and attention out in the world. The visibility is reflected in the invitations to high-level events, e.g. the Lancet Commission on Digital Health.  

Digital Global Health has become a Crosscutting Theme at the Centre for Global Health, UiO. The goal is to invite the academic network through The Guilt and ARUA to create digital animations in health topics. The animations are a convincing argument of why access to information on health should be free of charge. Besides the academic work, the Basic Internet Foundation has taken up the health videos as part of the school connectivity projects in Tanzania and Kenya. In Kenya, 45 schools were connected in Q4 of 2021, while Tanzania started with 10 schools in 2021, aiming at 200 schools in 2022. 

Project: The Child, Nutrition and Development (CHNUDEV)

Introduction

Further to the allocation letter in 2019, CHNUDEV again expresses their gratitude of being awarded this funding. As also expected in this funding year, the pandemic has markedly impacted this project in various ways, such as fieldwork, data collection, progress of PhD students, and writing of scientific reports/manuscripts.

Data collection and analyses

As notified in previous reports, the CHNUDEV team completed the first half of the planned follow-up study of the mother/child pairs in 2019. Due to the pandemic, they are still waiting for the possibility to resume fieldwork to complete the next half of this follow-up study. Uganda is now gradually opening, and they plan to do this in the first half of 2022.

However, they have completed the analyses of anthropometric and body composition data collected in the first phase, and they have been published or submitted for publication - see below.

Published

Kakwangire, P., Moss, C., Matovu, N., Atukunda, P., Westerberg, A.C., Iversen, P.O. & Muhoozi, G. The association between dietary diversity and development among children under 24 months in rural Uganda: Analysis of a cluster-randomized maternal education trial. Publ Health Nutr 24: 4286-4296, 2021.  

Iversen, P.O., Ngari, M., Westerberg, A.C., Muhoozi, G. & Atukunda, P. 
Child stunting concurrent with wasting or overweight: A 6-year follow-up of a randomized maternal education trial in Uganda. Nutrition 89: 111281, 2021.  

Atukunda, P., Ngari, M., Chen, X., Westerberg, A.C., Iversen, P.O. & Muhoozi, G. Longitudinal assessments of child growth: A six-year follow-up of a cluster-randomized maternal education trial. Clin Nutr 40: 5106-5113, 2021.  

Atukunda, P., Eide, W.B., Kardel, K.R., Iversen, P.O. & Westerberg, A.C 
Unlocking the potential for achievement of the UN Sustainable Development Goal 2 – “Zero Hunger” - in Africa: Targets, strategies, synergies and challenges. Food Nutr Res 65: 7686, 2021.  

In addition, one other manuscript is currently being reviewed.

One Ugandan female master student in nutrition (at Kyambogo University in Kampala, Uganda) is preparing her master thesis based on their data.

Project: The Politics of Global Health Security

Since first receiving the RELIGHT allocation in September 2019, the Global Health Politics Research Group at the Centre for Development and the Environment (SUM) has used this support to strengthen capacity in the area of global health politics, contributing to salary support (frikjøp) and activities.  

Here are the activities undertaken in 2021 that contribute directly to RELIGHT aims by increasing the competence, capacity, visibility and research output of the group, led by Katerini T. Storeng.

Although RELIGHT support has been important to these activities, the primary financing for these efforts comes from three grants awarded by the Research Council of Norway, as outlined below.

Project development and funding

The PANPREP project was scoped out with the support of RELIGHT buy-out (frikjøp) of Katerini T. Storeng and funded by the Norwegian Research Council. It began on 1 September, 2020 and will last for 3 years. 

• Felix Stein remains employed as a post-doctoral fellow, and Aurelia Neumark was recruited as a research assistant across PANPREP and all other key areas of the Global Health team, working full-time throughout 2021. A new Master’s stipendiat, Marit Bye Gjermshus, has been appointed for 2022. Her thesis will focus on Norway’s position with regards the proposed TRIPS waiver during the Covid-19 pandemic, and what factors impacted Norway’s initial, and later, stances.
• Despite the withdrawal of their partner, The Norwegian Defence Research Establishment, in 2021 due to lack of relevant capability within the team (withdrawal and new plan for 2022 approved by the NFR in late 2021), the project is well underway. Multiple project meetings have been held, two international advisory board meetings assembled, and numerous academic articles and blogs and newspaper articles have been published. See the project website for full details of all our outputs to date.

The Smartcovid project was also scoped out with the support of RELIGHT buy-out (frikjøp) of Katerini T. Storeng, and funded by the Norwegian Research Council. It began in May 2020, and will be completed in May 2022.

• In addition to the core project members – from SUM, Sierra Leone, Myanmar, Canada, the US, the UK and Japan – the group awarded a one-year stipend to UiO Masters student, Eirik Jacobsen, who has been writing his thesis on Tawain’s response to COVID-19, with a particular focus on mobile applications. 

• They have published numerous articles and dissemination pieces and plan for a final workshop to be held in Oslo in June 2022 for all partners, Covid-19 permitting. See the project website for full details. 

• The RELIGHT support has also contributed to the research group’s ability to attain SAMEVAL network support funding from the Norwegian Research Council in 2021, to support further project development, capacity strengthening and two national PhD courses in 2022 and 2023 related to the theme of global health security/pandemic preparedness (see above description for the first 2022 course). This network support has enabled the development of a new PhD course at SUM, entitled “Bits, bytes and bodies: Digitalisation, health and society,” which will be held in June 2022. The aim of this interdisciplinary course is to explore how processes of digitalisation and datafication are transforming health systems, experiences and outcomes across the world.

Buy-out (“frikjøp”) of staff to participate in the writing of proposals

RELIGHT funding in 2021 contributed to the buy-out of staff to work on three different, but related proposals submitted to the Norwegian Research Council: 

• “mHEALTH-INNOVATE: exploring how healthcare workers’ informal and innovative uses of mobile phone messaging apps are shaping service delivery and governance in LMICs”, led by Simon Arnold Lewin, Global Health Team, Folkehelseinstituttet, submitted in February 2021 to The Research Council’s call for Projects for Scientific Renewal (funding granted in June 2021)   

• “Vax-Trust: Vaccine policy, communication and consequences,” led by Prof. Øyvind Ihlen, Department of Media Studies, University of Oslo, submitted in February 2021 to The Research Council’s call for large interdisciplinary projects (Fellesløftet IV - Stort tverrfaglig forskerprosjekt) (shortlisted but unfortunately not funded; a further project proposal will be submitted to the Norwegian Research Council in February 2022) 

• “EQUITABLE INNOVATION: An interdisciplinary study of the regulatory, economic and political conditions for successful innovation in pursuit of global public health equity,” led by Prof. Inger Berg Ørstavik, submitted to UiO:Life Science Convergence Environment call, June 2021 (not awarded) 

• Young Talent Grant for Global Health Politics group team member Tom Neumark in 2021 (unfortunately not funded, although it received excellent marks). He will apply for a Scientific Renewal Grant in 2022 (to be submitted February 2022)

Supervision

• Antoine de Bengy Puyvallée was awarded PhD funding to begin his project, ‘The politics of epidemic response: new actors in global health security,’ in 2019. This project ties in with the team’s broader research agenda on public-private partnerships for global health security and is incorporated into the PANPREP project. Katerini is the primary supervisor on the project. 

• Katerini also closely supports the UiO Masters’ stipendiats (Eirik Jacobsen in 2021 and Marit Bye Gjermshus in 2022) through inviting them to relevant project meetings and commenting on their work and providing supervision to Gjermshus’ project.

Outreach / dissemination

• Throughout 2021, the team has participated actively in public debate, as commentators on Urix, Nyhetsmorgen, TV2 and NRK among other media outlets. Based on their commentary on Covid-19, Antoine de Bengy Puyvallée and Katerini Storeng have contributed to interviews and articles in both national and international media as well as having an active social media presence. Team members have also contributed to podcasts including Pandemipodden, Universitetsplassen and In Pursuit of Development. For more details including a list of all the interviews its team members have participated in, see the research group’s website.

Networking

• The research group continues to host the Network for Social Sciences in Norwegian Global Health Research, which has around 220 members 

• The group has also restarted the new series of Global Health Unpacked, a seminar series that aims to foster critical discussions on the politics of global health, with insights from social sciences and humanities. (First new event with Adam Kamradt-Scott, Professor at the European University Institute, on pandemic law-making, was held 04.11.21; unfortunately, due to the pandemic, they were unable to host their second event in December 2021.) 

• The group has played an active role in forming The Collective for the Political Determinants of Health, an international and interdisciplinary group of around 50 scholars and practitioners interested in the political determinants of health, that came out of the Independent Panel on Global Governance for Health. This included formation of the group, advisory council, website, social media account and a quarterly newsletter, as well as a series of fortnightly blogs written by members. The first Advisory Council meeting and first AGM of The Collective held in September 2021, with agreement on future activities.

The group is delighted to have been successful in the most recent RELIGHT call for 2022-2024 (100,000 NOK per year). This will enable it to continue their well-regarded research to become global leaders in the field of global health by increasing the competence, capacity, visibility and research output of its team, contributing directly to RELIGHT aims.