We use multi- and interdisciplinary global health research to help address the gross inequalities in health between and within countries. By combining expertise in the fields of the social and political sciences, economics, public health and epidemiology, health care sciences, and parasitology and virology, we currently advance global health research in the following areas:
RGHI participants at Erasmus MC excel in the areas such as ViroScience (prof. M. Koopmans, prof. Eric van Gorp), microbiology and infectious diseases (prof. Annelies Verbon and prof. Hubert Endtz), NCDs, bioinformatics (prof. Peter Van der Spek), genetics, gastro-enterology (prof. Maikel Peppelenbosch), integrated primary care. A shared interest across the biomedical and clinical participants in RGHI pertains to the desire to enhance the clinical and systemic effectiveness of interventions, particularly in challenged environments. This is – for instance – demonstrated by cross-cutting Erasmus-based research on disaster/epidemics preparedness, linking basic science and clinical innovation to health systems strengthening.
Health systems financing & management
Good evidence on health care financing interventions that aim to extend coverage of health care services and ensure that effective medical care can be accessed without threatening household financial security can quicken the pace of progress toward Universal Health Coverage (UHC). Prof. dr. van Doorslaer has lead several large projects evaluating policies with these goals in a range of Asian and African countries (see also Impact evaluation).
Research on health services management & organisation is lead by Dr. Jeroen van Wijngarden and Dr. Isabelle Fabbricotti and covers the full width of the health care sector, from hospital care to child welfare. To a large extent, research is carried out in or close to the primary process. Examples of recent projects include the evaluation of disease management programmes, research into care pathways, patient safety and ICT in health care
At the start of the 21st century profound health inequities persist globally between countries and between social groups within countries. The Department of Public Health and Erasmus School of Health Policy & Management are internationally renowned for their health inequalities research. Prof. dr. Mackenbach (Dept. Public Health, head of department) and Prof. dr. van Doorslaer (Erasmus School of Health Policy & Management) are authorities in international comparative health inequalities research. They and colleagues have led large projects including HEFPA, Demetriq, EquiNaM, and REI-UHC. They have done extensive research on the factors that contribute to health inequalities, on how to reach the poor and vulnerable.
With over half of the world’s population living in cities, and megacities springing up in many parts of the globe, the wide array of challenges which particularly uncontrolled urban sprawl poses are also at the core of RGHI research. Rotterdam is among the top innovative cities in Europe. The Department of Public Health in collaboration with the Municipal Health Council of Rotterdam is leading in urban health innovation and instrumental in setting up Academic ‘Innovation Labs’, studying the health and equity implications of urban development. The Institute of Housing and Urban Development is the most specialized Urban Development research center in the country, involved in research on housing and urban planning, slum development, urban-rural interactions, and informal labour in urban centers. RGHI participants at the Institute of Social Studies such as dr. Joop de Wit are leading in the field of new empirical studies of slums (in India and other parts of Asia), and urban governance.
No sustainable health systems development can occur without good governance. RGHI partners have an outstanding track record regarding specialized research on science-policy-practice relations in healthcare settings. Both at ISS and ESHPM, governance research is well established. Prof. Wil Hout (ISS) is actively engaged in researching the governance landscape surrounding key international development agencies and institutions such as the UN agencies At ESHPM, the team prof. Roland Bal, with researchers such as Maarten Kok study processes of ‘building governance’ and deliberative democracy, using mixed methodologies and participatory action research strategies. In the context of the REI research on Universal Health Coverage, they study the ‘governance construction’ in the drafting of sustainable health finance and service delivery.
Prof. dr. van Doorslaer has extensive experience with robust impact evaluations of health care financing reforms in low and middle-income countries. Using both household and health care facility data, the distributional effects of reforms such as i) health insurance, ii) performance based financing and iii) voucher schemes are being evaluated. These evaluations use both existing publicly available data and data specifically collected in relation to the intervention. Econometric techniques are applied to ensure robust impact estimates in settings where a randomized control trial is not feasible.
Prof.dr. Jan Hendrik Richardus and dr. Sake de Vlas at the Dept. Public Health lead research into the health and socio-economic consequences of infectious diseases and the cost-effectiveness of their control. The core activity is the development of simulation models describing the transmission and natural history of infectious diseases, and application of these models to predict the impact of control measures. The team collaborates with scientific, governmental and non-governmental organisations worldwide, and contributed to the evaluation and development of control programs for infectious diseases in different settings. Infectious diseases covered include amongst others HIV, TB, neglected tropical diseases such as onchocerciasis, leprosy and leishmaniasis.
In a series of policy evaluations prof. Arjun Bedi and colleagues at the International Institute of Social Studies have evaluated the impact of Ethiopia’s community-based health insurance scheme on household welfare and health.