A team at King’s College London is building a research network to improve chronic disease care across eight health facilities in South Africa, Ethiopia, Zimbabwe, and Sierra Leone. The problem is that health systems in sub-Saharan Africa were designed for acute infections, not for the long-term management of conditions like depression, tuberculosis, cancer, and pregnancy complications. Patients often fall through gaps between fragmented services, and healthcare workers lack tools to detect and manage multiple conditions at once. The unit, called careSSA, will test integrated care models that combine mental health screening with TB or NCD treatment, embed palliative care into primary clinics, and train staff to identify antenatal depression and violence against women during routine maternal visits. If successful, the research could shift how resource-poor health systems deliver care—from episodic, single-disease visits to continuous, coordinated support for people with complex, long-term needs. The project also funds early-career researchers in implementation science and health economics, aiming to build lasting local expertise rather than relying on short-term external aid.
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KCL Global Health Strategy As a global top 20 University, with strengths in biomedical education and research, KCL recognised a need to cohere its global health (GH) activities, with a solid base and plan for investment and growth. The new King’s GH Institute (KGHI) is a focal point for King’s GH researchers, a mark of our institutional commitment, and a catalyst for a step change in the scale and impact of our research and education. KGHI’s vision is to establish a cutting-edge interdisciplinary research program, strengthening health systems and services to be ‘fit for purpose’ to deliver universal coverage of quality continuing care in resource-poor settings. This relates to KCL’s GH strengths in areas also directly relevant to new UN SDG priorities; health system strengthening/ workforce development; NCDs (mental health, ageing, surgery, cancer care, palliative care, dental health); maternal/newborn health; and environment and health. Recent investment in global affairs (Country Institutes, International Development Institute), policy studies (Policy Institute at King’s) and social science (Dept. of GH & Social Medicine) foster interdisciplinary research and education. Our iBSc in GH, and MScs in GH, Global Mental Health, and GH and Social Justice attract 160 students annually. KCL plays a leading role in the South London CLAHRC (King’s Centre for Implementation Science coordinates implementation and QI research across health themes), and in two NIHR BRCs (GSTT/ KCL and Maudsley; clinical informatics and translational medicine). The KCL NIHR Unit, careSSA, will be a KGHI flagship project, and a first step to achieving our vision. It will support our partnership strategy “to focus on high value partnerships, where there is good research infrastructure and established collaborations with KCL that can be broadened and deepened; but also committing to long-term research capacity building with less developed partners with important need and potential”. careSSA draws on expertise from KCL-wide centres (Global Mental Health, GH and Health Partnerships, Implementation Science, Women’s Health, King’s Health Economics) the Cicely Saunders Institute for Palliative Care, and Dept. of GH & Social Medicine. 14 Professors, 3 Readers, and 8 Senior lecturers, including 2 NIHR professors and 3 NIHR senior investigators will contribute directly to careSSA. The NIHR Unit will fund early career researcher posts dedicated to GH in Implementation Science, Health Economics, Social Science, Palliative Care and Women’s Health, which we aim to sustain beyond the funding period. KCL has invested in KHGI infrastructure; a Director (0.4FTE), two Deputies (2 x 0.2FTE) and FT support for administration, comms and events, and will commit to fund a Chair of Global Healthcare Delivery Science and a 0.5FTE GH lecturer to support the NIHR Unit, with 3 PhD fellowships for its doctoral training program. SCIENTIFIC STRATEGY NOTE: MORE DETAIL ON CARE PLATFORM INTERVENTIONS AND INTERDISCIPLINARY RESEARCH IS PROVIDED IN ‘ADDITIONAL INFORMATION’, INDICATED IN THE TEXT BY # The care that we seek to improve is delivered in 8 settings (determined by local priorities elicited, so far, by consultation with MoH, researchers and providers in each country - see ODA statement and support letters): South Africa (SA): 1. Integrated PHC for depression comorbid with TB, 2. PHC palliative care for chronic progressive conditions, and 3. Maternal care - detection and management of antenatal depression (AND) and violence against women (VAW) Ethiopia (ETH): 1. Integrated PHC for depression comorbid with NCDs, 2. Maternal care - detection and management of AND and VAW, and risk stratification (early detection and management of pre-eclampsia, sepsis, haemorrhage)#, 3. surgical care# Zimbabwe (ZIM): PHC detection and management of depression Sierra Leone (SL): surgical care# Our starting point is that care is, or will be, guideline-based care (GBC). In SA
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