The Role of Development Assistance for Health in Reducing Child Mortality

描述（申请人提供）：拟议的五年培训和研究计划项目将使一名已在全球卫生筹资方面取得成就的初级学者掌握理论、方法，人口统计学和人口研究的方法和技术，并探讨经济和人口方法的结合，以研究卫生发展援助在降低儿童死亡率方面的作用，国家比较研究和卢旺达国家案例研究。拟议的职业发展计划确定了四个培训目标：（1）发展有关衡量儿童死亡率的人口学和人口科学方面的专门知识以及关于儿童死亡率变化原因的理论和模式;（2）获得流行病学背景知识，以了解发展中国家不同年龄组五岁以下儿童的疾病概况;（3）提高时间序列和多层次研究的统计技能;（4）获得研究伦理方面的培训，并发展拨款写作的概念和技能。这四个目标将通过以下四项发展活动来实现：（1）人口学和人口研究、流行病学、统计方法和研究伦理方面的课程工作和指导阅读;（2）人口学领域主要专家的指导（Kenneth Hill和Samuel普雷斯顿），流行病学（梅根·默里），卫生政策（Agnes Binagwaho）和卫生经济学（彼得·史密斯）;（3）参加人口研究和健康的讲习班、研讨会和学术会议并发表研究成果;以及（4）开发一项拨款，以支持一项关于卫生保健融资和人口健康结果的独立研究计划。具体研究目标有三个：（1）对64个进行人口与健康调查的国家的新生儿、婴儿和儿童死亡率水平的年度差异进行时间序列国别估计，并为1996年至2011年的总体DAH、儿童健康DAH和传染病DAH项目生成完整的时间序列国别支出数据集;（2）系统地评估1996年至2011年期间64个DHS国家的总DAH、用于儿童健康的DAH以及用于防治传染病的DAH对儿童死亡率的影响;（3）了解DAH在改善儿童健康和降低儿童死亡率方面的作用，通过使用“国家平台方法”增加儿童保健服务。“K-01奖将为我提供强有力的指导和人口学和人口研究以及流行病学和定性方法方面的专业培训，这将使我能够实现我的长期职业目标，即通过跨学科方法提供严格的科学证据，以设计医疗保健融资战略，有效改善弱势群体的健康结果。 公共卫生相关性：降低儿童死亡率和改善儿童健康是卫生方面的千年发展目标之一。由于在降低儿童死亡率方面进展缓慢，迫切需要提供循证指导，以最有效地利用现有资源。拟议的研究将填补这一知识空白，并为了解低收入国家保健发展援助与降低儿童死亡率之间的关系作出重要贡献。

DESCRIPTION (provided by applicant): The proposed five-year project of training and research plans will enable a junior scholar already accomplished in global health financing to master theories, methodologies, and techniques in demography and population studies and explore the integration of economic and demographic methods for studying the role of Development Assistance for Health (DAH) in reducing child mortality through a cross-country comparative study and a country case-study in Rwanda. The proposed career development plan sets four training goals: (1) to develop expertise in demography and population science concerning the measurement of child mortality and theories and models on the causes of child mortality change; (2) to obtain background knowledge of epidemiology so as to understand the disease profiles of under-five children of different age groups in developing countries; (3) to advance statistical skills for time-series and multilevel studies; and (4) to obtain training in research ethics and develop concepts and skills for grant writing. These four goals will be met with the following four development activities: (1) course work and directed reading in demography and population studies, epidemiology, statistical methods, and research ethics; (2) mentorship from leading experts in demography (Kenneth Hill and Samuel Preston), epidemiology (Megan Murray), health policy (Agnes Binagwaho) and health economics (Peter Smith); (3) participating and presenting research in workshops, seminars, and academic conferences for population studies and health; and (4) developing a grant to support an independent research program on health care financing and population health outcomes. There are three research specific aims: (1) to produce time-series country-specific estimates for the annual difference in the level of neonatal, infant and child mortality rates for the 64 countries with Demographic and Health Surveys and to generate complete time-series country-specific disbursement datasets for overall DAH, DAH for child health, and DAH for infectious disease programs from 1996 to 2011; (2) to systematically assess the effects of total DAH, DAH for child health, and DAH for combating infectious diseases on child mortality rates for the 64 DHS countries between 1996 and 2011; and (3) to understand the role of DAH in improving child health and reducing child mortality in Rwanda through increasing child health care provision using a "national platform approach." The K-01 award will provide me with strong mentorship and specialized training in demography and population studies as well as epidemiology and qualitative methods, which will enable me to carry out my long- term career goal of providing rigorous scientific evidence through an interdisciplinary approach for designing health care financing strategies that will effectively improve health outcomes for disadvantaged populations. PUBLIC HEALTH RELEVANCE: Reducing child mortality and improving child health is one of the health Millennium Development Goals (MDGs). The slow progress in reducing child mortality makes urgent the need for evidence-based guidance for achieving the most efficient use of existing resources. The proposed research will address this gap of knowledge and make an important contribution to understanding the relationship between the development assistance for health and child mortality reduction in low-income countries.