Mishal Khan
Dados Biográficos
| ID | 3582197 |
|---|---|
| NOME | Mishal Khan |
| PRENOMES | Mishal |
| SOBRENOME | Khan |
| ASSINATURA | KHAN M |
| AFILIAÇÕES | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0002-8967-1761 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 46 |
| TOTAL DE CITAÇÕES | 16 |
| TOTAL COMO AUTOR | 45 |
| TOTAL COMO EDITOR | 1 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2015 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 3 |
Democratizing computational skills
Background Public health is undergoing a digital transformation, with increasing reliance on data-driven decision-making that requires proficiency in computational tools. However, traditional curricula often emphasize theoretical knowledge over applied technical skills, contributing to gaps in workforce readiness. This study evaluated a pilot remote, asynchronous microlearning course designed to expand access to digital skills–specifically R and …
Navigating power hierarchies in the “field”
Despite increasing focus on the broad topic of power hierarchies within research partnerships, scholarly analysis and guidance within global health tends to focus on partnership-building, governance structures and authorship, while the interactions occurring between researchers in settings where a project or community are located, often referred to as the “field”, remains a neglected topic. This study applies an intersectional lens to explore how…
Exploring a One Health approach to sustainability with international One Health and Global Health Security experts – differences, similarities and trade-offs between sectors
Sustainability in global health remains inconsistently defined and operationalised across human, animal, and environmental health sectors. As the One Health approach gains global traction—particularly in addressing complex, ‘wicked’ health problems such as pandemics, antimicrobial resistance, and ecosystem degradation—there is a growing need for shared conceptualisations of sustainability to support cross-sectoral collaboration and ultimately, lo…
Without Critical Consciousness, How Could you Move on?” Qualitative Assessments of an Intervention to Reduce Substance Use Among Formerly Incarcerated Men
Background People with a history of substance use disorder who live in marginalized communities (e.g., large minoritized populations, low income, high crime rates) endure disproportionately high incarceration rates, premature death, and infectious disease incidence. Individuals released from incarceration often return to marginalized communities burdened by socially and structurally determined health inequities. Interventions grounded in critical…
Doctors taking bribes from pharmaceutical companies is common and not substantially reduced by an educational intervention
INTRODUCTION: Incentive-linked prescribing, which is when healthcare providers accept incentives from pharmaceutical companies for prescribing promoted medicines, is a form of bribery that harms patients and health systems globally. We developed a novel method using data collectors posing as pharmaceutical company sales representatives to evaluate private doctors' engagement in incentive-linked prescribing and the impact of a multifaceted educati…
The impact of a multi-faceted intervention on non-prescription dispensing of antibiotics by urban community pharmacies in Indonesia
Introduction Non-prescription antibiotic dispensing is prevalent among community pharmacies in several low- and middle-income countries. We evaluated the impact of a multi-faceted intervention to address this challenge in urban community pharmacies in Indonesia. Methods A pre-post quasi-experimental study was carried out in Semarang city from January to August 2022 to evaluate a 7-month long intervention comprising: (1) online educational session…
Educational priorities of low-and middle-income country medical diaspora organisations
Rising global migration levels have led to growing diaspora populations. There has been interest in the role of diaspora healthcare professionals (HCPs) from low- and middle-income countries (LMICs) in development aid to their origin countries, although there has been comparatively less focus on their educational activities. This study examined the stated educational priorities of LMIC medical diaspora organisations, with a particular focus on th…
Healthcare consumers’ perceptions of incentive-linked prescribing
Incentive-linked prescribing (ILP) is considered a controversial practice universally. If incentivised, physicians may prioritise meeting pharmaceutical sales targets through prescriptions, rather than considering patients’ health and wellbeing. Despite the potential harms of ILP to patients and important stakeholders in the healthcare system, healthcare consumers (HCCs) which include patients and the general public often have far less awareness …
Integration of dental therapists in safety net practice increases access to oral health care in Minnesota
Integrating DTs at CDS improved access by expanding mobile clinics, increasing patient volume, and redistributing procedures, while demonstrating a positive return on investment. Results suggest that adopting the DT model may be a promising practice for other organizations seeking to improve access to dental care, increase operational efficiency, and boost the dental care team's ROI
Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan
Pharmaceutical marketing through financial incentivisation to general practitioners (GPs) is a poorly studied health system problem in Pakistan. Pharmaceutical incentivisation is seen to be distorting GPs prescribing behaviour that can compromise the health and well-being of patients. We draw on a conceptual framework outlined in the ecological system theory to identify multiple factors linked with pharmaceutical incentivisation to GPs in Pakista…
Antiracism in leading public health universities, journals and funders
INTRODUCTION: Two years since the murder of George Floyd, there has been unprecedented attention to racial justice by global public health organisations. Still, there is scepticism that attention alone will lead to real change. METHODS: We identified the highest-ranked 15 public health universities, academic journals and funding agencies, and used a standardised data extraction template to analyse the organisation's governance structures, leaders…
Incentivisation practices and their influence on physicians’ prescriptions
Focus on profit-generating enterprise in healthcare can create conflicts of interest that adversely impact prescribing and pricing of medicines. Although a global challenge, addressing the impacts on quality of care is particularly difficult in countries where the pharmaceutical industry and physician lobby is strong relative to regulatory institutions. Our study characterises the range of incentives exchanged between the pharmaceutical industry …
After the Railways Are Built
This article focuses on an incident involving a series of evictions experienced by a group of Makrani laborers who made their living by earning daily wages at the Hyderabad railway station in early twentieth century Sindh. In this piece I critically analyze two imperial projects: first, the construction of the Indian railways and second, the promotion of “free” wage labor by the colonial regime in the aftermath of the abolition of slavery. By cri…
The healthcare field as a marketplace
Incentivisation of general practitioners (GPs) by pharmaceutical companies is thought to affect prescribing practices, often not in patients' interest. Using a Bourdieusian lens, we examine the socially structured conditions that underpin exchanges between pharmaceutical companies and GPs in Pakistan. The analysis of qualitative interviews with 28 GPs and 13 pharmaceutical sales representatives (PSRs) shows that GPs, through prescribing medicines…
How conflicts of interest hinder effective regulation of healthcare
BACKGROUND: There has been insufficient attention to a fundamental force shaping healthcare policies-conflicts of interest (COI). We investigated COI, which results in the professional judgement of a policymaker or healthcare provider being compromised by a secondary interest, in relation to antimicrobial use, thereby illuminating challenges to the regulation of medicines use more broadly. Our objectives were to characterise connections between t…
“We face the same risk as the other health workers”
In many countries, community pharmacies have played an important role during the COVID-19 pandemic, providing essential medicines and personal protective equipment (PPE), disseminating information on disease prevention and management, and referring clients to health facilities. In recognition of this, there are increasing calls for an improved understanding of the challenges and experiences faced by these providers during the COVID-19 pandemic, w…
Committing to anti-racism reforms? Three critical building blocks for global health organizations
Independent reviews of racism in organisations working to improve global health and justice are piling up. In 2021, a report on abuse and discrimination at Doctors Without Borders was published In
Assessing the potential of wearable health monitors for health system strengthening in low- and middle-income countries
Wearable health monitors are a rapidly evolving technology that may offer new opportunities for strengthening health system responses to cardiovascular and other non-communicable diseases (NCDs) in low- and middle-income countries (LMICs). In light of this, we explored opportunities for, and potential challenges to, technology adoption in Cambodia, considering the complexity of contextual factors that may influence product uptake and sustainable …
Anna Suranyi. Indentured Servitude
Improving National Intelligence for Public Health Preparedness
The COVID-19 epidemic is the latest evidence of critical gaps in our collective ability to monitor country-level preparedness for health emergencies. The global frameworks that exist to strengthen core public health capacities lack coverage of several preparedness domains and do not provide mechanisms to interface with local intelligence. We designed and piloted a process, in collaboration with three National Public Health Institutes (NPHIs) in E…
Stark choices
OBJECTIVES: COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios. METHODS: We used country-specific epidemiological projections from a dynamic transmission model to dete…
Prevalence and determinants of inappropriate antibiotic dispensing at private drug retail outlets in urban and rural areas of Indonesia
INTRODUCTION: The aim of this mixed-method study was to determine the extent and determinants of inappropriate dispensing of antibiotics by licensed private drug retail outlets in Indonesia. METHODS: Standardised patients (SPs) made a total of 495 visits to 166 drug outlets (community pharmacies and drug stores) between July and August 2019. The SPs presented three clinical cases to drug outlet staff: parent of a child at home with diarrhoea; an …
Decolonising global health in 2021
Decolonising global health was a hot topic in 2020. It was the subject of more than 50 academic articles between January and December 2020, appeared as a new area covered in numerous conferences, and featured in public statements by leaders of global health organisations. Although its aims have not been formally defined, we see ‘decolonising global health’ as a movement that fights against ingrained systems of dominance and power in the work to i…
Abolition as a Racial Project
The abolition of slavery in the British Empire demanded a complete transformation of the global legal and political order. Focusing on British India, this chapter argues that this restructuring was, in and of itself, a vital racial project that played out on a global stage. Examining these dynamics over the nineteenth century, I trace how this project unfolded from the vantage point of the Bombay Presidency and the western coast of India, tightly…
A qualitative study of the barriers and enhancers to retention in care for pregnant and postpartum women living with HIV
Retention in care is a major challenge for pregnant and postpartum women living with HIV (PPHIV) in the prevention of mother-to-child HIV transmission (PMTCT) continuum. However, the factors influencing retention from the perspectives of women who have become lost to follow-up (LTFU) are not well described. We explored these factors within an enhanced sub-cohort of the East Africa International Epidemiology Databases to Evaluate AIDS Consortium. …
How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan
Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, …
Methodological gaps and opportunities for studying multisectoral collaboration for health in low- and middle-income countries
The current body of research into multisectoral collaborations (MSCs) for health raises more questions than it answers, both in terms of how to implement MSCs and how to study them. This article reflects on current methodological gaps and opportunities for advancing MSC research, based on a targeted review of existing literature and qualitative input from researchers and practitioners at the 2018 Health Systems Research (HSR) Symposium in Liverpo…
LMICs as reservoirs of AMR’
Antimicrobial resistance (AMR) has recently emerged as a salient global issue, and policy formulation to address AMR has become a contested space, with various actors sharing competing-and sometimes contradictory-explanations of the problem and the range of possible solutions. To facilitate national policy setting and implementation around AMR, more needs to be done to effectively engage policymakers in low- and middle-income countries (LMICs). H…
What are the barriers to implementing national antimicrobial resistance action plans? A novel mixed-methods policy analysis in Pakistan
Despite political commitment to address antimicrobial resistance (AMR), countries are facing challenges to implementing policies to reduce inappropriate use of antibiotics. Critical factors to the success of policy implementation in low- and middle-income countries (LMIC), such as capacity for enforcement, contestation by influential stakeholders and financial interests, have been insufficiently considered. Using Pakistan as a case study represen…
Large funding inflows, limited local capacity and emerging disease control priorities
There are numerous challenges in planning and implementing effective disease control programmes in Myanmar, which is undergoing internal political and economic transformations whilst experiencing massive inflows of external funding. The objective of our study-involving key informant discussions, participant observations and linked literature reviews-was to analyse how tuberculosis (TB) control strategies in Myanmar are influenced by the broader p…
Engaging for-profit providers in TB control
There has been a huge expansion in the private health-care sector over the past two decades, particularly in South Asia, resulting in over 80% of patients seeking care from private health providers. Despite concerns about the quality and equity of private sector service provision, most government public health bodies recognize that the private sector reaches individuals that public institutions cannot cater to, thereby being important in moving c…
Financial barriers and coping strategies
Financial constraints were identified by TB and MDR-TB patients and health care professionals as the most pervasive barrier to care. Barriers appeared to be magnified for ethnic minorities and patients coming from rural areas, especially those with MDR-TB. To reduce financial barriers and improve treatment outcomes, there is a need for further research into the total costs of seeking and accessing TB and MDR-TB care. This will enable better asses…
Large funding inflows, limited local capacity and emerging disease control priorities
There are numerous challenges in planning and implementing effective disease control programmes in Myanmar, which is undergoing internal political and economic transformations whilst experiencing massive inflows of external funding. The objective of our study-involving key informant discussions, participant observations and linked literature reviews-was to analyse how tuberculosis (TB) control strategies in Myanmar are influenced by the broader p…
Are global tuberculosis control targets overlooking an essential indicator? Prolonged delays to diagnosis despite high case detection rates in Yunnan, China
Delay in treating active tuberculosis (TB) impedes disease control by allowing ongoing transmission, and may explain the unexpectedly modest declines in global TB incidence. Even though China has achieved TB control targets under the global Directly Observed Treatment, Short course (DOTS) strategy, TB prevalence in western provinces, including Yunnan, is not decreasing. This cross-sectional study investigates whether prolonged delay in identifyin…
Preventing emergence of drug resistant tuberculosis in Myanmar's transitioning health system
Multidrug-resistant tuberculosis (MDR-TB) is a particular threat to the populations of resource-limited countries. Although inadequate treatment of TB has been identified as a major underlying cause of drug resistance, essential information to inform changes in health service delivery and policy is missing. We investigate factors that may be driving the emergence of MDR-TB in Myanmar, a country where investment and health system reforms are ongoi…
Optimising routine surveillance systems for informing tuberculosis control policies in China
Are scientific research outputs aligned with national policy makers’ priorities? A case study of tuberculosis in Cambodia
With funding for tuberculosis (TB) research decreasing, and the high global disease burden persisting, there are calls for increased investment in TB research. However, justification of such investments is questionable, when translation of research outputs into policy and health care improvements remains a challenge for TB and other diseases. Using TB in Cambodia as a case study, we investigate how evidence needs of national policy makers are add…
A strong TB programme embedded in a developing primary healthcare system is a lose-lose situation
As exemplified by the situation in Cambodia, disease specific (vertical) health programmes are often favoured when the health system is fragile. The potential of such an approach to impede strengthening of primary healthcare services has been studied from a health systems perspective in terms of access and quality of care. In this bottom-up, qualitative study we investigate patient and community member experiences of health services when a strong…
How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan
Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, …
Strong, vertical TB programme embedded in a developing primary healthcare system
Health Policy and Planning, doi: 10.1093/heapol/czx079. The authors would like to indicate that the address for the Saw Swee Hock School of Public Health was incorrectly given in the original manuscript as ‘0808 Rivergate, 97 Robertson Quay, Singapore 238257, Singapore’. This has now been corrected online to ‘Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore 117549, Singapore’.
Patient-centredness versus achieving public health targets
What can motivate Lady Health Workers in Pakistan to engage more actively in tuberculosis case-finding
This study indicated that interventions in addition to, or instead of, financial incentives could be used to increase LHW engagement in tuberculosis case-finding. Our finding about the strong role of internal motivation (intrinsic, religious) in Pakistan suggests that developing context-specific strategies that tap into internal motivation could allow infectious disease control programmes to improve engagement of community health workers without …
Methodological gaps and opportunities for studying multisectoral collaboration for health in low- and middle-income countries
The current body of research into multisectoral collaborations (MSCs) for health raises more questions than it answers, both in terms of how to implement MSCs and how to study them. This article reflects on current methodological gaps and opportunities for advancing MSC research, based on a targeted review of existing literature and qualitative input from researchers and practitioners at the 2018 Health Systems Research (HSR) Symposium in Liverpo…
LMICs as reservoirs of AMR’
Antimicrobial resistance (AMR) has recently emerged as a salient global issue, and policy formulation to address AMR has become a contested space, with various actors sharing competing-and sometimes contradictory-explanations of the problem and the range of possible solutions. To facilitate national policy setting and implementation around AMR, more needs to be done to effectively engage policymakers in low- and middle-income countries (LMICs). H…
"For how long are we going to take the tablets?" Kenyan stakeholders' views on priority investments to sustainably tackle soil-transmitted helminths
Using critical information to strengthen pandemic preparedness
COVID-19 has demonstrated that most countries’ public health systems and capacities are insufficiently prepared to prevent a localised infectious disease outbreak from spreading. Strengthening national preparedness requires National Public Health Institutes (NPHIs), or their equivalent, to overcome practical challenges affecting timely access to, and use of, data that is critical to preparedness. Our situational analysis in collaboration with NPH…
What steps can researchers take to increase research uptake by policymakers? A case study in China
Empirical analysis of the connections between research and health policymaking is scarce in middle-income countries. In this study, we focused on a national multidrug-resistant tuberculosis (TB) healthcare provider training programme in China as a case study to examine the role that research plays in influencing health policy. We specifically focused on the factors that influence research uptake within the complex Chinese policymaking process. Qu…
What are the barriers to implementing national antimicrobial resistance action plans? A novel mixed-methods policy analysis in Pakistan
Despite political commitment to address antimicrobial resistance (AMR), countries are facing challenges to implementing policies to reduce inappropriate use of antibiotics. Critical factors to the success of policy implementation in low- and middle-income countries (LMIC), such as capacity for enforcement, contestation by influential stakeholders and financial interests, have been insufficiently considered. Using Pakistan as a case study represen…
Implementation research in LMICs—evolution through innovation
Major global health gains can be achieved by strengthening the delivery of public health policies and programmes in low-and middleincome countries (LMICs). The population impact of evidencebased technologies and interventions such as drugs, vaccines and health know-how can only be maximized where programmes optimally identify and reach target populations and support them to take up and sustain their effective use. Examples include significant gap…
Improving National Intelligence for Public Health Preparedness
The COVID-19 epidemic is the latest evidence of critical gaps in our collective ability to monitor country-level preparedness for health emergencies. The global frameworks that exist to strengthen core public health capacities lack coverage of several preparedness domains and do not provide mechanisms to interface with local intelligence. We designed and piloted a process, in collaboration with three National Public Health Institutes (NPHIs) in E…
Stark choices
OBJECTIVES: COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios. METHODS: We used country-specific epidemiological projections from a dynamic transmission model to dete…
Prevalence and determinants of inappropriate antibiotic dispensing at private drug retail outlets in urban and rural areas of Indonesia
INTRODUCTION: The aim of this mixed-method study was to determine the extent and determinants of inappropriate dispensing of antibiotics by licensed private drug retail outlets in Indonesia. METHODS: Standardised patients (SPs) made a total of 495 visits to 166 drug outlets (community pharmacies and drug stores) between July and August 2019. The SPs presented three clinical cases to drug outlet staff: parent of a child at home with diarrhoea; an …
Decolonising global health in 2021
Decolonising global health was a hot topic in 2020. It was the subject of more than 50 academic articles between January and December 2020, appeared as a new area covered in numerous conferences, and featured in public statements by leaders of global health organisations. Although its aims have not been formally defined, we see ‘decolonising global health’ as a movement that fights against ingrained systems of dominance and power in the work to i…
Abolition as a Racial Project
The abolition of slavery in the British Empire demanded a complete transformation of the global legal and political order. Focusing on British India, this chapter argues that this restructuring was, in and of itself, a vital racial project that played out on a global stage. Examining these dynamics over the nineteenth century, I trace how this project unfolded from the vantage point of the Bombay Presidency and the western coast of India, tightly…
A qualitative study of the barriers and enhancers to retention in care for pregnant and postpartum women living with HIV
Retention in care is a major challenge for pregnant and postpartum women living with HIV (PPHIV) in the prevention of mother-to-child HIV transmission (PMTCT) continuum. However, the factors influencing retention from the perspectives of women who have become lost to follow-up (LTFU) are not well described. We explored these factors within an enhanced sub-cohort of the East Africa International Epidemiology Databases to Evaluate AIDS Consortium. …
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