As PIVOT builds a model evidence-based health system, we are committed to improving our understanding of how health system strengthening can break cycles of poverty and disease. Our extensive, data-driven monitoring and evaluation (M&E) operation is helping to guide our clinical intervention and our health system strengthening programs. Our implementation research is informing health programs and producing data for replicating and scaling-up of the model. In addition, the population-level and basic science research that we are supporting is contributing to the critical international debate on how comprehensive health system strengthening can effectively break cycles of poverty and disease.
Our research agenda and activity is expanding rapidly.
The following papers have been published since September 2015:
Rist CL, Ngonghala CN, Garchitorena AS, Naharimahefa A, Brook C., Miller AM, Ramananjato RH, Rabeza RV, Randrianarivelojosia M, Wright PC, Gillespie TR, Bonds MH. 2015 “Modeling the Economic Burden of Livestock Disease in the Ifanadiana District of Madagascar” One Health, 1:60-65.
Bodager JR, Wright PC, Rasambainarivo FT, Parsons MB, Roellig D, Xiao L, Gillespie TR. 2015. “Complex epidemiology and zoonotic potential for Cryptosporidium suis in rural Madagascar.” Veterinary Parasitology. 207:140-143.
Bublitz DC, Wright PC, Bodager JR, Rasambainarivo FT, Gillespie TR. 2015. “Pathogenic Enterobacteria in Lemurs Associated with Anthropogenic Disturbance.“ American Journal of Primatology. 77:330–337
Rist CL, Ngonghala CN, Garchitorena AS, Gillespie TR, Bonds MH. 2015 “The burden of livestock diseases on the poor” Trends in Parasitology. 31:527-530.
Garchitorena A, Ngonghala CN, Guegan JF, Texier G, Bellanger M, Bonds MH, Roche B. “Economic inequality caused by feedbacks between poverty and the dynamics of a rare tropical disease: the case of Buruli ulcer in sub-Saharan Africa.” Proc Roy Soc B
A number of manuscripts are being prepared including:
Garchitorena A, Miller AC, Cordier L, Ramananjato R, Rafaralahy VR, Cripps A, Hall L, Velo O, Rabemampionona A, Murray M, Farmer P, Rich M, Rakotozafy G, Randriantsimaniry D, Gikic D, Bonds MH. “Evaluating the impact of reducing barriers for utilization of health care services in rural Madagascar”. Expected submission March 2016.
Miller AC, Ramananjato RH, Rafaralahy VR, Gikic D, Cordier L, Cripps A, Rahaniraka Razanadrakato HT, Randriamanambintsoa M, Garchitorena A, Alexandre JR, Murray M, Farmer P, Razanavololo S, Rich M, Bonds MH. “Population-based impact evaluation for district level health system strengthening: Ifanadiana Madagascar”. Expected submission date April, 2016
Bonds MH, Gikic D, Hall L, Cordier L, Cripps A, Miller AC, Garchitorena A, McCarty M, Loyd T, Adriamihaja B, Gillespie T, Murray M, Wright P, Farmer P, Herrnstein R, Herrnstein J, Rich M. “Advancing a Science for Sustaining Health in Madagascar”. Expected submission date May 2016.
In November 2015, a 3-day internal PIVOT Research Retreat was held in Ifanadiana, Madagascar to discuss PIVOT’s research priorities, process for reviewing and approving research projects, pending papers, and future research directions. PIVOT’s co-CEO, Country Director, Medical Director, Research Advisor, Research Manager, M&E Manager, Administrative Director and Boston Program Manager discussed and determined strategies for PIVOT’s future research needs.
One of the main projects to come out of the Research Retreat is to design a longitudinal cohort study, which will play a critical role for measuring impacts of PIVOT’s programs on the community over space and time. We will continue our successful partnership with the Madagascar Institute of Statistics (INSTAT) to conduct yearly surveys of the individuals in the same households, which will allow us to measure the impact of PIVOT’s intervention in the District on individuals’ health seeking behaviors, health indicators, and survival. We expect to begin data collection in April of 2016.
More to come on this topic in the coming months.