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Using system dynamics modelling for collaborative, evidence-based design of interventions to reduce tuberculosis transmission in South African health facilities
Investigator(s): Prof Alison Grant (LSHTM), Dr Justin Parkhurst (LSE), Prof Anna Vassall, Dr Fiammetta Bozzani, Dr Aaron Karat (all LSHTM)
Amount Awarded: £199,997

We will investigate system dynamics modelling (SDM) as a method to bring together policymakers, practitioners, and researchers to design and prioritise new interventions to interrupt tuberculosis (TB) and drug-resistant TB (DR-TB) transmission in healthcare facilities. We will evaluate SDM as a way to enable transparent evidence-based decision-making.

SDM was developed in engineering and management sciences to map and mathematically model complex systems; there is increasing interest in applying SDM to health systems. Understanding health systems constraints and enablers is pivotal to designing feasible, acceptable interventions.

We will facilitate SDM workshops with national and provincial policymakers, diverse public health professionals (particularly in DR-TB) from two South African provinces, and researchers. Participants will create ‘causal loop’ diagrams depicting systems relating to DR-TB infection prevention and control in health facilities. These models will be used alongside qualitative, quantitative, and conventional disease models from the Umoya omuhle study (a multidisciplinary study taking a ‘whole systems’ approach to interrupting TB transmission in health facilities) to allow policy makers to incorporate a wide range of evidence in intervention design and prioritisation.

Other study activities will include a literature review of the use of SDM in knowledge exchange and policy development and in-depth interviews with workshop participants, particularly policymakers. We will combine the findings of the literature review, observations and outputs from the SDM workshops, and interviews with workshop participants, to assess the utility of SDM as a method for exchanging knowledge and enabling evidence-informed decision-making for infectious disease control.

Research team:

Prof Alison Grant, Professor of International Health, LSHTM
Dr Justin Parkhurst, Associate Professor in Global Health Policy, LSE
Prof Anna Vassall, Professor of Health Economics, LSHTM
Dr Fiammetta Bozzani, Research Fellow, LSHTM
Dr Aaron Karat, Research Fellow, LSHTM

Co-investigators at Queen Margaret University, Edinburgh:
Dr Karina Kielmann, Reader, QMUE
Dr Karin Diaconu, Research Fellow, QMUE

Co-investigator at the University of Sussex:
Dr Hayley MacGregor
, Fellow in the Institute of Development Studies, Sussex.

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