Professor Miriam Taegtmeyer

Head of Department of Clinical Sciences

Miriam Taegtmeyer is a Professor of Global Health at the Liverpool School of Tropical Medicine, where she heads the Community Health Systems Research Group.  The group consists of staff and doctoral students with a research portfolio of over £8 million (2018), spanning 11 countries across Africa and Asia.  Our vision is to create a world where your health is not dictated by who you are, where you are born or where you live. We conduct robust and innovative global health implementation research on community health systems. We engage and partner with communities, practitioners and policy makers and our research is used to strengthen and sustain high quality community health systems for underserved communities 

As a public health researcher, practicing NHS consultant physician and qualified teacher Miriam focuses on implementation research that bridges disciplines.  Her research in the complementary areas of HIV testing and counselling, community health systems and quality improvement has directly impacted public health and informed global and national policies and guidelines.  She is particularly interested in progress to universal health coverage and improved health equity in resource poor settings.  Using mixed methods research she has designed and tested approaches to the scale-up of community health programmes that are both cost effective and of high quality, leading to over 90 peer reviewed publications in JAMA, AIDS, JAIDS and the WHO Bulletin among others.  Through her unique approach to combining research with implementation her work is responsive to local needs, solution-based and builds on local capacity and priorities thus ensuring policy uptake and creating resilience in health systems.  In 2015 Miriam was included in the Graduate Institute list of 300 Women Leaders in Global Health.

The REACHOUT network, for which she is PI, is respected internationally as an example of excellence in community health systems research.  REACHOUT hosts the Thematic Working Group on Close-to-Community Providers under Health Systems Global – a community of practice bringing together over 250 key players in health systems.  The work of REACHOUT has been quoted in UK parliament and its approaches to quality improvement of community health programmes have influenced national and regional policy in Kenya, Malawi, Mozambique and Ethiopia.  Findings from Miriam’s research in HIV have been taken up in national policy through her involvement in the Kenya VCT committee (2001 – 2004); the Kenyan national ARVs task force (2002-2004), the Namibian national HTC guidelines (2010) and operational plan for HIV (2011) and the Tanzanian quality improvement framework for HTC.  She was a member of the WHO HTC guidelines development group (2007-2015) and member of the WHO consolidated ART guidelines (2010 – 2014).

Miriam was the founder of LVCT Health, an indigenous Kenyan NGO which was established out of an operational research project on HIV testing and counselling in 2000.  This work was cited as an example of best practice in the 2004 National Audit Office Report due to its cost-effective health impact.  LVCT Health has now grown into a successful, internationally-recognised, indigenous organisation that provides HIV tests and services to millions of Kenyans, trained over 3000 health care workers and provided technical assistance to Ministries of Health in Ethiopia, Ivory Coast, Botswana and Tanzania, creating a large platform for implementation research.  It is a great privilege for Miriam to continue to have joint research projects with LVCT Health. Miriam has also provided technical assistance in HIV counselling and testing in Nigeria, DRC, Kenya, Tanzania, Mozambique and Namibia.

Teaching

Prof Taegtmeyer is a qualified teacher and teaches both undergraduate and post graduate medicine.  She has written curricula and training manuals for HIV counselling and testing in numerous settings.  She developed the highly praised Masters module in HIV (Trop 974), bringing together global experts in clinical and public health aspects of HIV management in resource poor countries.  Currently she teaches on the Diploma in Tropical Nursing, Masters in International Public Health, Masters in Tropical and Infectious Disease, Masters in Tropical Paediatrics and Diploma in Reproductive Health.

Current PhD students

Lynne Elliot

Primary supervisor

Year 3

Functionality and sustainability of quality improvement teams for community health systems in Kenya

Meghan Bruce

Primary supervisor

Year 3

Costs, finances and decision-making for community health programmes

Charlotte Hemingway

Primary supervisor

Year 2

Digital gaming and HIV knowledge, testing and linkage among adolescent MSM in the Philippines

Stephen Mulupi

Primary Supervisor

Year 2

Decision-making and priority setting for lung health in a devolved Kenyan community health system 

Beate Ringwald

Secondary Supervisor

Year 2

Exploring opportunities for addressing intimate partner violence in the context of community-based HIV services in Kenya and steps toward testing interventions at community-level

Dr Helen Barsosio

Secondary Supervisor

Year 1

Investigating promising malaria chemoprevention strategies for HIV-infected women in Sub-Saharan Africa

Current Research Grants

Principle Investigator

Funder

Dates

Value

Title and aims

Role

MRC PHIND

2019-2020

 

£150,000

 

4byFour Pilot

 

PI

 

USAID

2016-2019

$1.8m

SQALE Integration of quality improvement in community health in Kenya

PI – coordinated development of research idea, wrote proposal, leading grant from LSTM

MRC Newton Foundation

2015-2018

£560,000

HIV GET pilot study that links gaming to HIV rapid testing in the Philippines

PI and HTC technical lead.

EC FP7

2013-2018

€5.8m

REACHOUT a 6 country mixed method health systems research study on the equity effectiveness and efficiency of close to community providers

PI - coordinated development of research ideas, led proposal writing, leading whole grant 


Co-Investigator

Funder

Dates

Value

Title and aims

Role

NIHR

2017-2020

£7m

IMPALA unit for research in TB and lung disease

Health systems discipline lead

UNITAID

2017-2019

$73m

STAR Initiative – scale up of HIV self-testing in 6 countries in Africa

Deputy research director, lead regulatory pathway development; qualitative research network and policy influence

UNITAID

2016-2020

$5.5m

DOLPHIN2: RCT evaluating Dolutegravir (antiretroviral drug) in pregnancy

Co-applicant and Qualitative Research Lead

 

UNITAID

2015-2017

$33m

STAR Clinical Trial on impact of HIV self-testing

Co-PI, deputy research director, leads regulatory pathway development; qualitative research network

Gates Foundation

2013

$1m

HIV self-testing prototype evaluation for HIV in Malawi, Kenya and South Africa developing video methods

LSTM PI coordinating inter country analysis

CDC

2010-2015

$1.8m

HIV and Malaria Cooperative Agreement

Co-Applicant supporting national and international policy in HIV testing and counselling

 

Involvement in WHO HIV working groups 

  1. Consolidated ARV Guidelines.  Core writing group (2007-2015)
  2. Guide for choosing approaches to national HTC delivery (2012): Service Delivery Approaches to HIV testing and counselling (HTC): A strategic HTC programme framework. 
  3. Home-based HIV testing and counselling (2012): Planning, implementing and monitoring home-based HIV testing and counselling.  A practical handbook for sub-Saharan Africa. 
  4. Guide for monitoring and evaluating national programmes for HIV testing and counselling (2011). National indicators for monitoring and evaluating HIV testing and counselling programmes.  
  5. Policy on the window period in HIV testing (2010): Delivering HIV test results and messages for re-testing and counselling in adults.
  6. WHO Handbook for improving HIV testing and counselling services Nov 2010. http://www.who.int/hiv/pub/vct/9789241500463/en/index.html  
  7. Primary Health Care Centre Manual (2008): Operations manual for delivery of HIV prevention, care and treatment at primary health centres in high-prevalence, resource-constrained settings. 

Selected publications

  • Five papers with public health impact

    Marum E, Taegtmeyer M. Chebet K. Scale up of voluntary HIV counselling and testing in Kenya. JAMA 2006;296:859-62.Comprehensive description of operational models, approaches and quality assurance mechanisms based on my data from first 33 testing sites. It has had considerable impact on research and strategy in this field.

    Grabbe KL, Menzies N, Taegtmeyer M, Emukule G, Angala P, Mwega I, Musango G, Marum E. Increasing access to HIV counseling and testing through mobile services in Kenya: strategies, uptake and cost-effectiveness. J Acquir Immune Dedic Syndr  2010 Jul 1; 54 (3):317-23 First costing study to compare costs of various approaches, showing the importance of community outreach in reaching couples and first time testers for HIV. Cited 79 times. 

    Taegtmeyer M, Davies A, Mwangome M, Van der Elst EM, Graham SM, Price MA, Sanders EJChallenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya PLOS One 2013; 8(6):e6452 Findings influenced counsellor training for MSM friendly sites in Kenya, leading to the testing of over 20,000 MSM and it has been cited 20 times in 2 years. 

    Peck RB, Lim JM, van Rooyen H, Mukoma W, Chepuka L, Bansil P, Knight LC, Muturi N, Chirwa E, Lee AM, Wellhausen JD, Tulloch O, Taegtmeyer M. What Should the Ideal HIV Self-Test Look Like? A Usability Study of Test Prototypes in Unsupervised HIV Self-Testing in Kenya, Malawi, and South Africa. AIDS Behav 2014 Jul;18 S 4:422-32. First paper to describe video methods for assessing HIV self testing and one of few papers on HIV self-testing prototypes. Cited 15 times in 18 months.

    Kok M, Dieleman M, Taegtmeyer M, Broerse JEW, Kane S, Ormel H, Tijm MM, de Koning K. Which intervention design factors influence performance of Community Health Workers in low and middle income countries? A systematic review. Health Policy Plan 2014 doi: 10.1093/heapol/czu126 First systematic showing factors affecting CHW performance.