Maurice Bloch Seminar: Professor Till Baernighaussen

We are pleased to invite you to:

The Institute of Health and Wellbeing Maurice Bloch Annual Lecture Series 2016/17

Title: Quasi-experiments in health systems research: Value, uses, limitations

Presenter: Professor Till Baernighausen

Date: 28 March 2017

Time: 3pm tea/coffee will be served 30mins beforehand

Venue: Sir Charles Wilson Lecture Theatre

Chair: Professor Sally Wyke

Abstract:

Quasi-experimental designs are gaining popularity in epidemiology and health systems research – in particular for the evaluation of health care practice, programs and policy – because they allow strong causal inferences without randomized controlled experiments. I will describe the concepts underlying five important quasi-experimental designs: Instrumental Variables, Regression Discontinuity, Interrupted Time Series, Fixed Effects, and Difference-in-Differences designs. I will describe the assumptions required for each of the designs to ensure valid causal inference and discuss the tests available to examine the assumptions. I will then illustrate each of the designs with examples from health systems research and discuss future potential uses and limitations of quasi-experiments in generating generalizable knowledge for health policy.

Biography

Till Bärnighausen is Associate Professor at the Department of Global Health and Population, Harvard T.H. Chan School of Public Health. He also serves as Program Director for Health Systems and Impact at the Wellcome Trust Africa Centre for Health and Population Studies in South Africa, one of the Trust’s four Major Overseas Programmes. He is also a faculty affiliate at the Harvard Center for Population and Development Studies.

Till works on health care access, transformation of health services, and the causal impacts of HIV treatment and other global health priority interventions on population health, economic, social and behavioral outcomes.

Till and his team have established the population impact of HIV treatment – delivered under the real-life conditions of a public-sector health system in rural Southern Africa – on mortality and life expectancy, employment an educational attainment, and health seeking and sexual behavior. They have also shown that in a rural Southern African community with high HIV prevalence and incidence neither sexual partner concurrency nor large age gaps between young girls and their male partners are important drivers of the HIV epidemic. Finally, Till has introduced several methods innovations for applied, population-based HIV research: new approaches to estimate HIV incidence using cross-sectional data on recent HIV infection; Heckman selection models to remove selection bias from HIV prevalence estimates; regression discontinuity for causal inference in clinical an population-based cohorts; and novel approaches to use geographical information system data to determine distance and exposures.