Economic evaluation of community-centred cardiovascular risk management strategies in rural sub-Saharan Africa

Reference Number: PhD Project 03/2026

Director of Studies: Edwine Barasa

Names of co-supervisors: Stacey Orangi, Benjamin Tsofa and Anthony Etyang

Country: Kenya

 

BRIEF DESCRIPTION OF THE PROJECT

Background and Introduction

Cardiovascular diseases (CVD), driven largely by poorly controlled hypertension and other modifiable risk factors, represent one of the fastest-growing causes of premature mortality in sub-Saharan Africa (SSA). Despite the availability of effective interventions, coverage of diagnosis, treatment initiation, and long-term control remains extremely low, particularly in rural settings. Health systems in SSA operate under severe resource constraints, making it essential that new interventions are not only clinically effective but also affordable, cost-effective, and scalable.

Both the IHCoR-Africa and the cardiovascular disease risk reduction in sub–Saharan Africa CARIsSA projects focus on community-centred approaches to improve hypertension and overall cardiovascular risk management through task-sharing, improved diagnostic strategies, digital decision-support tools, and simplified treatment pathways. However, robust local evidence on the costs, cost-effectiveness, and budgetary implications of these approaches is limited. Policymakers therefore lack the economic evidence needed to prioritize and sustainably scale such interventions within constrained health budgets.

This PhD will address this critical gap by generating high-quality economic evidence to inform resource-allocation decisions for cardiovascular risk-reduction strategies in rural SSA, directly aligned with WP2 of IHCoR-Africa and WP3 of CARIsSA.

 

Purpose and aim of the studentship

The overall aim of the PhD is to evaluate the costs, cost-effectiveness, and budget impact of alternative community-centred strategies for diagnosing and managing hypertension and cardiovascular risk in rural Kenya and The Gambia.

 

OVERALL RESEARCH QUESTIONS

The PhD will answer the following research questions.

  1. What are the health system and patient-level costs of community-centred cardiovascular risk management interventions compared with standard facility-based care?
  2. How cost-effective are alternative diagnostic, risk-stratification, and treatment strategies for hypertension and high cardiovascular risk when delivered through community-centred models?
  3. What is the budget impact and affordability of scaling up these interventions within county and national health systems?
  4. How do cost-effectiveness results vary across population sub-groups, intervention components, and implementation scenarios?

 

Specific objectives

  1. Costing
    • Estimate the full economic costs of delivering community-centred cardiovascular risk management interventions, including diagnostic strategies, treatment, follow-up, supervision, and digital tools.
    • Quantify patient and household costs (out-of-pocket expenditure, time costs, productivity losses).
  2. Cost-effectiveness analysis
    • Evaluate the incremental cost-effectiveness of alternative diagnostic and treatment strategies, including combinations of blood pressure measurement approaches and cardiovascular risk stratification tools.
    • Estimate cost per Disability-Adjusted Life Year (DALY) averted from both health system and societal perspectives.
  3. Economic evaluation
    • Conduct economic evaluations to estimate short-term cost-effectiveness using observed CARIsSA cluster randomized controlled trial outcomes.
  4. Budget impact and policy relevance
    • Assess the financial implications of scaling up effective interventions at county and national levels under realistic budget constraints.

 

SCOPE OF SUPPORT

This is a three-year PhD studentship to be based at KWTRP. The selected candidate will be supported in applying for and registering for a PhD at the Open University - UK. The candidate will be supervised by Edwine Barasa, Stacey Orangi, Benjamin Tsofa and Anthony Etyang, research scientists at KWTRP. The selected candidate will receive a stipend, medical insurance, and financial support to cover tuition, academic-related fees, travel expenses, and research expenses.

 

METHOD OF APPLICATION

Interested applicants are required to submit the following.

  1. One-page application letter.
  2. An updated curriculum vitae with a contact email address and telephone number.
  3. A copy of the highest degree and a certified copy of an academic transcript.
  4. One-page personal statement stating the preferred area of research, reasons for selecting the area, and future career ambitions.
  5. A letter of support from an academic referee stating the potential of the candidate to succeed in a research career. 

 

SELECTION PROCESS

Shortlisted candidates will be invited to an interview, either in person or via videoconference. The successful candidate in the interview will be offered PhD training support.

 

NOTE: ONLY ONLINE APPLICATIONS will be accepted. 

STARTING DATE: May 2026.

APPLICATION DEADLINE: March 18, 2026

NOTE: Only shortlisted candidates will be contacted

 

Click here to apply