Diseases have no borders. A disease anywhere in the world may become a health threat everywhere. It takes less than 36 hours for an outbreak to spread from a remote village to any major city in the world, therefore, the most effective – and cost effective – way to protect people from such health threats i.e measles, cholera and COVID-19 is to stop them before they spread to others and cross borders. Here comes the role of public health surveillance. Public health surveillance is the continuous, systematic collection, analysis and interpretation of health-related data. An effective disease surveillance system is essential to detecting disease outbreaks quickly before they spread, cost lives and become difficult to control. Digital technologies can improve the ability to both detect and respond to disease outbreaks by sharing data swiftly thus helping us to understand how and where diseases are spreading. This information is crucial for deciding what health policies and strategies to make and follow. Significance of this research is not limited to one country but it has global health dimensions. It can help to address the critical issue of global health security by evaluating the impact of digital technologies on public health surveillance. Low and middle income countries (LMICs) including Pakistan have fragile health systems therefore the risk of spreading diseases, even beyond their borders, is high. Disease surveillance system in Pakistan has largely been outdated and paper based, frequently leading to delayed detection of measles, cholera and other communicable disease outbreaks. In 2017, Ministry of Health Pakistan, with support of World Health Organization (WHO), launched Integrated Disease Surveillance and Response (IDSR) system which uses electronic health information system (District Health Information System – DHIS-2) as a platform for rapid and near real time reporting for selected diseases. From 2017 to 2022, the new system was implemented in 52 districts of the country while remaining 104 districts are still using paper based system. The dual existence of different reporting systems presents a unique opportunity for a comparative analysis, allowing for insights into the effectiveness of the digital transition. As a doctoral researcher, I will conduct an evaluation to address the existing knowledge gap regarding the effectiveness of transitioning from traditional paper-based disease data reporting systems to new digital systems. Specifically, my research will focus on evaluating the impact of Integrated Disease Surveillance and Response (IDSR) and District Health Information System 2 (DHIS-2) initiatives in Pakistan. This evaluation aims to assess the effectiveness of new electronic infectious disease surveillance system in enhancing the country's health system capabilities. I aim to conduct a comparative analysis of the performance between DHIS-2, an electronic system, and traditional paper-based systems through cross sectional study, evaluate the effectiveness of the Integrated Disease Surveillance and Response (IDSR) framework and the District Health Information System 2 (DHIS-2) through a comprehensive assessment and explore the determinants influencing the adoption of electronic surveillance systems through a mix method study. The local research infrastructure is well-established, with the National Institutes of Health (NIH) Pakistan under Ministry of Health serving as a central data hub for disease surveillance and public health information. The presence of this infrastructure is vital for the success of the research project, as it provides access to comprehensive and up-to-date data on disease surveillance, outbreaks, and response efforts across Pakistan. The NIH website hosts weekly epidemiological IDSR reports. These reports serve as a rich source of information, forming the foundation for the research and ensuring the reliability and relevance of the data collected. Furthermore, the International Doctoral Programme in Epidemiology and Public Health at Tampere University, drawing on its expertise and research strength, will help to improve the quality and depth of the research findings. Together, these elements of the research infrastructure will contribute to the robustness of the study. The research project is feasible as IDSR implementation, led by Ministry of Health Pakistan, is already in progress with support of WHO. I have five years of practical experience, as a public health expert, in disease surveillance, monitoring and evaluation with World Health Organization, US Centers for Disease Control and Prevention (CDC), and UK Health Security Agency. My previous role as the Training Coordinator in the Integrated Disease Surveillance and Response (IDSR) project has been very relevant. Research will be implemented in phased manner starting from kick off meetings, ethical approvals to data collection, data analysis, reporting and dissemination and finalization and publications. The results of this study may help to improve global health security by examining how well digital health information systems detect and respond to diseases quickly. In Pakistan, the findings might help strengthen the healthcare system, providing useful guidance to policy makers and contributing to practical strategies for better public health monitoring. My research is in line with the European Union's recent Global Health Strategy, which is a cornerstone of the EU's external policy. Addressing and mitigating health threats, particularly pandemics, is highlighted as a key priority within this strategy. Through my research, I aim to contribute to this overarching goal by examining the effectiveness of infectious disease surveillance systems, ultimately working towards a healthier and more resilient global community.

Team

Land is a powerful asset, but it also has a social function. Its economic and social aspects are central in advancing gender equality. Legal control of land as well as legal and social recognition of women’s uses of and rights to land, can also have catalytic effects of empowerment, increasing women’s influence and status in their homes and communities. During past decades changes in the Chinese land tenure rights and practices have brought important incentives for rural developments including farmer income and living standards. However, rural women’s land rights are still not adequately implemented. Despite modernization, China is administratively and socially very hierarchical. Foucault's idea of power provides a better starting point for looking at the use of power at the grassroots level than the hierarchical conception of power. Although the Communist Party has significant hierarchical power, at the village level, there are several parties involved in the exercise of power with different motives and perceptions. Regarding to methodology, many researchers have utilized government and other official material to explain certain phenomenon. This research is mainly based on interviews because they can provide an insight that might otherwise be invisible in official documents. This research uses an intersectional approach to qualitative content analysis. It allows the exploration of numerous intersection themes simultaneously. For example, according to this research, age, marital status, location, and gender play an important role in women’s equality situation.

Team

This study explores inequalities in access to housing. In the light of the premise "Leave no one behind", the case study on occupations and struggle against evictions in social housing estates of Lisbon metropolitan area (LMA) draws the attention to the groups of population that are excluded from access to housing. In particular, gendered and racialised aspects of housing exclusions are examined. In addition, the role of civil society in contesting housing exclusion is analysed.

Team

Saila-Maria Saaristo

This research concerns socio-technical issues for providing solar electricity into rural India. Several solar pico-grid systems have been implemented in villages accompanied with comprehensive data collection, field-trips, interviews, and analysis. Research questions have included behavioural aspects with use of solar electricity in the rural context, system reliability, and system optimisations. Key results include observations that reliability need more attention and local training, i.e. strengthening frugality aspects; demand response of the rural population showed less correlation with access to solar electricity.

Team

Sini Numminen, Semee Yoon, Johannes Urpelainen

The doctoral research project targets to understand the relevance of frugal and affordable energy innovations in sustainable energy transitions among low-income communities in emerging economies. The target technology is solar micro-grids in India. The various related sustainability challenges are studied as well as the role of distributed energy in the country's energy mix among rural energy users. Key methods include field trials, interviews, data analysis and sustainability and reliability assessments.

Team

The overall aim of the project is to improve productivity, livelihoods, nutrition and household wellbeing in Ghana and Uganda, while counteracting environmental degradation and mineral depletion caused by monocultures. The study will address both the individual farm level and the rural community level. Introducing the use of biofertilizers through a participatory process can highlight the potential of location-based resources, and empower the community more widely.

Team

Sumelius John (Project manager, Lindström Kristina (Principal investigator), Benjamin Ahiabor, John Baptist Tumuhairwe, Åsa Frostegård, Aserse Aregu (Participant), Vihinen Hilkka (Project manager), Sell Mila (Project manager), Sipiläinen Timo (Participant), Bäckman, Stefan, (Participant) Rosengren, Linda (Other)

We are proposing a three component intervention including health education, a take-home reminder card and a shopping voucher aimed at reducing heavy lifting/carrying among pregnant women in Ghana.The purpose is to reduce the incidence of preterm Birth (less than 37 weeks) and low birthweight (less than 2500 g) which are currently high in the country. Access to funding to implement the intervention on a larger scale promises some solutions to the soaring numbers of adverse pregnancy outcomes in low and middle income countries.

Team

Professor Kimmo Räsänen, Dr. Jos Verbeek, Emma Kwegyir-Afful, Dr Lydia Aziato, Professor J.D. Seffah.

This research focuses on FBOs (World Vision, Fida International and Free Pentecostal Church of Tanzania) and their development projects by employing the capability approach and examining how the faith base influences assessments of valued functionings as aspects of good life, capabilities, and freedoms. Research is based on fieldwork in several regions in Tanzania.

Team

We are looking at how fish farming affects the socio-economical status of women in Nepal, the challenges they face and mitigation measures available. In addition we are also looking at how women establish their businesses and work together in cooperatives. We are also looking the impact of fish farming on food and nutrition security in communities in 3 districts.

Team

Sunila Rai

Marketing channels of agricultural surplus is important for improving food security in most African countries. The cooperative business form offers one way for smallholder and intermediate size farmers to sell their surplus. Twelve Tanzanian cooperatives were studied by semi-structured interviews to find out if the cooperative business model can reduce poverty and address food security. Four types of cooperatives were identified: traditional cooperatives, reforming cooperatives, new cooperatives and co-operatives with some innovations. Both cases of poorly working unions and more recent success stories were found. Features characterizing good cooperative work in Tanzania were identified. Recommendations on policy level how to support cooperative action is given.

Team

John Sumelius; Faustine K. Bee; Suleman A. Chambo; Shimelles Tenaw; Stefan Bäckman,