Internship – Duty station: The Hague, The Netherlands

 

Internship opportunity at KNCV Tuberculosis Foundation

 

KNCV Tuberculosis Foundation
KNCV Tuberculosis Foundation is an international non-profit organization dedicated to the fight against tuberculosis (TB), and related health problems like HIV, antimicrobial resistance, and COVID-19. Tuberculosis is the deadliest infectious disease in the world after COVID-19. Being an international knowledge center, KNCV promotes effective, efficient, innovative and situation specific strategies and solutions to eliminate TB and related health problems in a national and international context.

Our multidisciplinary team of passionate professionals covers a broad range of expertise such as quantitative and qualitative research; programmatic prevention and management of TB and related health problems; new diagnostics, drugs, and regimens; clinical management, patient support and stigma reduction; laboratory technologies and networks; education; mobile and digital health solutions and surveillance; strategic planning and advocacy; communication and project management.

For over a century KNCV worked tirelessly to improve the lives of those affected by TB, with a leading role in the successful fight against TB in the Netherlands, exchanging knowledge and expertise with other countries. KNCV is a global network organization, consisting of our global office in The Hague, the Netherlands, eight branch offices and four country based KNCV entities in East, South and Central Asia and Africa. KNCV raises funds from private, institutional, corporate and government sources.

On the journey towards TB Elimination, in 2020 KNCV has defined nine innovation pathways and pursues the development, demonstration and scale-up of innovations as well as existing strategies that can accelerate elimination of TB and related health problems around the world. To do so, KNCV generates evidence, supports global and in-country policy making as well as strategic planning and supports the development of supportive systems.

 

Title Internship
Assess improvements in the collaboration between National TB programs (NTPs) and pharmacovigilance systems in four sub-Saharan African (SSA) countries

Research question
What (tangible and intangible) improvements have been made in the pharmacovigilance systems in four SSA countries after fortifying the collaboration between Public Health Programs (PHPs) and National Medicine Regulatory Agencies (NMRAs), including the relationship between the NTPs and the NMRAs?

Scientific background
Pharmacovigilance is key to better understand the safety of medicines with the aim to prevent or minimize adverse drug reactions (ADRs), a major cause of morbidity and mortality. In Sub Saharan Africa (SSA), public health programs (PHPs) play a key role in providing treatment for poverty-related infectious diseases including HIV/AIDS, malaria, and tuberculosis (TB), but traditionally had little interest and involvement in the conduct of pharmacovigilance. At the same time, innovative medicines that are not yet approved by the NMRA, such as medicines for shorter, all-oral treatment for multidrug resistant TB, are being used by thousands of difficult-to-treat TB patients, often under programmatic conditions, with limited resources for close patient monitoring. These new medicines and regimens are being introduced globally through NTPs with the help of the Global Drug Facility (GDF) providing for quality assured medicines. In PHPs there has been ample attention for the management of ADRs in individual patients caused by anti-TB medicines, but until recently there has been no attention to the importance of reporting ADRs to the NMRA to improve medicine safety on a population level. This lack of safety monitoring can pose a serious risk to public health as countries cannot solely rely on safety data produced from the populations in which the medicines were developed, due to heterogeneity. The Pharmacovigilance Africa (PAVIA) project aims to strengthen pharmacovigilance systems in four SSA countries by fortifying the collaboration between PHPs and NMRAs, starting with the relationship between the NTPs and the NMRAs. To be able to measure improvements during the course of the project, baseline assessment and endline assessments are used. This internship is part of the endline assessment.

 

More details about the PAVIA project can be found on the project website: https://pavia-project.net/

Research design
Mixed-method research design

Methods

Setting
The four sub-Saharan countries participating in the PAVIA project: the Kingdom of Eswatini, Ethiopia, Nigeria, and Tanzania.

Data collection
The data collection for this end line assessment is planned for January-June 2022 (6 weeks per country, four countries in total). The data collected is both quantitative (through a pre-structured endline assessment tool) and qualitative (through interviews and observations). For this study, the intern will be involved in the data collection and management and analyze both quantitative and qualitative data for one specific country. Depending on the start date of the intern, the intern might also assist in designing data collection tools.

 

Quantitative data
A pre-structured endline assessment tool with pharmacovigilance indicators will be developed to collect quantitative data on indicators addressing health system, policies, laws and financing, pharmacovigilance processes, capacity and infrastructure including training needs, stakeholder environment and communication/ dissemination opportunities, and the total number of patients on MDR-TB treatment, on new medicines and regimens, and included in active pharmacovigilance schemes. The tool also assessed the collaboration with the national pharmacovigilance authorities, flow of ADR reports, and roles and responsibilities for assessing the ADRs including causality assessment.

Qualitative data
A short interview guide is developed to guide the semi-structured group and individual interviews with stakeholders in the four participating countries. The qualitative data will be used as verification and explanation of the quantitative data.

 

Work to do and competences
The intern will be processing and analyzing the collected data for one country. The quantitative data needs to be processed into a dataset for analysis. The qualitative interviews need to be transcribed, by using the transcription software “Otter”. After data is prepared for analysis, the interns will perform data analysis.  Quantitative data will be analyzed (by SPSS, STATA, or R) by using descriptive statistics and statistical methods to compare baseline and endline data. Qualitative data will be analyzed (by NVivo) by using a thematic approach: interviews will be coded using both a deductive and inductive method and consequently categorized in themes. Finally, analyzed data will be reported in a manuscript for publication in a peer-reviewed journal.

 

Time schedule
The length of the internship is a minimum of 5 month, with a start date between January and April 2022.

Supervision
The interns will receive daily supervision from drs. Ineke Spruijt (TB consultant and epidemiologist) and bi-weekly supervision from dr. Edine Tiemersma (senior epidemiologist and project lead of KNCV work package of the PAVIA project).

Medical ethics committee
Necessary (exemption of) approval from relevant medical ethics committees is already obtained, as this internship is part of an ongoing project.

Expected result

  • MSc thesis;
  • Presentation in English for the university and internally in the organization;
  • Draft manuscript for scientific publication (a collaboration between different interns working on the various countries).

Application and information

You can apply for this position, via the form below before 31 October 2021. If you have any questions, feel free to contact drs. Ineke Spruijt, TB consultant and epidemiologist (ineke.spruijt@kncvtbc.org) our HRM Team in The Netherlands: +31(0)70-41672222 or mail to recruit@kncvtbc.org.

 

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