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.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Scientist Development Award - Research & Training (K01)
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Pediatrics Subcommittee (CHHD)
Program Officer
King, Rosalind B
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Brigham and Women's Hospital
United States
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Lu, Chunling; Mejía-Guevara, Iván; Hill, Kenneth et al. (2016) Community-Based Health Financing and Child Stunting in Rural Rwanda. Am J Public Health 106:49-55
Mejía-Guevara, Iván; Hill, Kenneth; Subramanian, S V et al. (2015) Service availability and association between Mutuelles and medical care usage for under-five children in rural Rwanda: a statistical analysis with repeated cross-sectional data. BMJ Open 5:e008814
Gilbert, Barnabas J; Patel, Vikram; Farmer, Paul E et al. (2015) Assessing development assistance for mental health in developing countries: 2007-2013. PLoS Med 12:e1001834
Cohen, Ted; Jenkins, Helen E; Lu, Chunling et al. (2014) On the spread and control of MDR-TB epidemics: an examination of trends in anti-tuberculosis drug resistance surveillance data. Drug Resist Updat 17:105-23
Lu, Chunling; Tsai, Sandy; Ruhumuriza, John et al. (2014) Tracking rural health facility financial data in resource-limited settings: a case study from Rwanda. PLoS Med 11:e1001763
Binagwaho, Agnes; Farmer, Paul E; Nsanzimana, Sabin et al. (2014) Rwanda 20 years on: investing in life. Lancet 384:371-5
Drobac, Peter C; Basinga, Paulin; Condo, Jeanine et al. (2013) Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership. BMC Health Serv Res 13 Suppl 2:S5
Yan, Xin; Shen, Hua; Loh, Charles et al. (2013) A longitudinal study about the effect of practicing Yan Xin Qigong on medical care cost with medical claims data. Int J Econ Res 10:391-403
Lu, Chunling; Liu, Qing; Sarma, Aartik et al. (2013) A systematic review of reported cost for smear and culture tests during multidrug-resistant tuberculosis treatment. PLoS One 8:e56074
Lu, Chunling; Chin, Brian; Lewandowski, Jiwon Lee et al. (2012) Towards universal health coverage: an evaluation of Rwanda Mutuelles in its first eight years. PLoS One 7:e39282