FLIA’s work on health has shown how lessons learnt in Africa can be applicable to other situations around the world. Our work on Ebola pandemics helped to set the foundations for further research into Covid-19 in the UK, while other research has examined the structure of healthcare provision across the continent.

Health systems

In areas of sub-Saharan Africa, public health practitioners are part of a larger global health system. While these are largely devised and financed by external agents, the information and evidence needed for effective decision-making at the national and sub-national levels had not been extensively studied. The LEAD Project focused on the transmission and control of schistosomiasis and soil-transmitted helminths around the African Great Lakes Region, with fieldwork in Kenya, Malawi, Tanzania and Uganda.

In April 2023, the World Health Organisation (WHO) initiated an agenda to tackle multiple health threats, by suggesting that response to health crises should not be left to the health sector alone. The WHO recommended that sectors including health, agriculture, and the environment must work together. What was not fully understood was how the siloed sectors would work together in an authoritarian regime like Uganda. FLIA research looked at how this operated at the village level across the country.

FLIA conducted an empirical investigation into the market for public and private primary care services in Soweto, Johannesburg. It focused on provider performance on the one hand and the demand for private services from uninsured cash-paying patients on the other. The study provided important information on whether the private primary care market can contribute to better health system access, quality and efficiency. The results are relevant to many low- and middle-income countries trying to expand healthcare within mixed healthcare systems.

Covid-19

PERISCOPE was a large-scale research project involving a consortium of 32 European institutions to investigate the social, economic, behavioural and mental health-related aspects of the Covid-19 pandemic.

The project gathered data on the broad impacts of Covid-19 and developed a comprehensive reference tool: the Covid Atlas. PERISCOPE also developed guidance for policymakers to enhance Europe’s preparedness for future similar events and proposed reforms in the multi-level governance of health.

A CPAID research team has explored how the rhetoric of ‘trust-building’, which was built during the pandemic has ultimately served to silence experiences of racism and exclusion which function through encounters in the UK health system. This project explored legacies of mistrust in the post-Covid world centred around the Ugandan diaspora living in Newham in East London.

The Stigma in a post-Covid world project undertook ethnographic and participatory research with Roma communities in the UK, perceived as having greater difficulties than other migrant groups in accessing and using healthcare services. The study interrogated the impact of public health interventions during the Covid-19 crisis and how the pandemic affected perceptions of stigma, institutional trust, feelings of belonging, and structures of self-empowerment amongst Roma groups.

Ethnographies of (Dis)Engagement explored perceptions towards Covid-19 vaccines among social groups who have reported some of the lowest rates of uptake across the G7, and the world. The research was based on Roma collectives living across Italy, migrants in Rome and at Italy’s border, and African diaspora communities in Canada.

Ebola

During the 2014-16 Ebola outbreak and resultant state of emergency, the family was a primary unit of care and material support. Yet, the crisis demonstrated complex interactions between the everyday workings of the family, the state and humanitarian and NGO actors. It revealed both the ‘public’ character of the family and the ‘private’ and intimate reach of the state and global actors. A CPAID project examined family-based public authority in Sierra Leone, which was widely misunderstood, particularly in its contemporary form, often written off as ‘corrupt’, ‘patrimonial’, or ‘customary’.

'Living the Everyday' principally addressed how social relations and everyday life affected knowledge and the management of sickness during the Ebola outbreak. The research was conducted on the borders of Uganda-Democratic Republic of Congo and Uganda-South Sudan. These borders have come to the attention of international experts, under the guise of Ebola-preparedness efforts, following the spread of the epidemic from North Kivu, DRC. Little was known about everyday social relations, movement and health-seeking in and across these spaces and their impact on the local population’s health.