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.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01HD071929-03
Application #
8637102
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
King, Rosalind B
Project Start
2012-04-01
Project End
2017-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
3
Fiscal Year
2014
Total Cost
$137,160
Indirect Cost
$10,160
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
02115
Lu, Chunling; Li, Zhihui; Patel, Vikram (2018) Global child and adolescent mental health: The orphan of development assistance for health. PLoS Med 15:e1002524
Lu, Chunling; Cook, Benjamin; Desmond, Chris (2017) Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda. BMJ Glob Health 2:e000364
Black, Maureen M; Walker, Susan P; Fernald, Lia C H et al. (2017) Early childhood development coming of age: science through the life course. Lancet 389:77-90
Lu, Chunling; Liu, Kai; Li, Lingling et al. (2017) Sensitivity of measuring the progress in financial risk protection to survey design and its socioeconomic and demographic determinants: A case study in Rwanda. Soc Sci Med 178:11-18
Lu, Chunling; Chu, Annie; Li, Zhihui et al. (2017) Assessing development assistance for child survival between 2000 and 2014: A multi-sectoral perspective. PLoS One 12:e0178887
Richter, Linda M; Daelmans, Bernadette; Lombardi, Joan et al. (2017) Investing in the foundation of sustainable development: pathways to scale up for early childhood development. Lancet 389:103-118
Lu, Chunling; Black, Maureen M; Richter, Linda M (2016) Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level. Lancet Glob Health 4:e916-e922
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
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
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

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