Dr Rachel Tolhurst

Reader in Social Sciences in International Public Health

I have 25 years’ experience of research, training and partnership on gender equity and health systems strengthening in Africa and Asia. My research has focused on social drivers of inequities in health and well-being including intersections between gender equity, poverty and disability, with regard to a wide range of health issues, including TB and lung-health, anti-microbial resistance maternal, sexual and reproductive health and gender-based violence. I am the Deputy Director of the Centre for Health Systems Strengthening (CHESS) and co-convenor of the Gender and Health Group.

Research

My research currently focuses on urban health equity, with a particular focus on urban informality, social determinants of health and community-based participatory approaches.

I am joint Principal Investigator for the GCRF Accountability for Informal urban Equity Hub (ARISE)(link is external)(opens in a new tab) (2019-2024), together with Professor Sally Theobald. ARISE aims to address the intractable development challenge of ill-health, inequity and insecurity in informal urban settlements in Low and Middle-Income Countries (LMICs). Our Hub brings together partners with a range of relevant expertise and commitment to work with disadvantaged people living in informal settlements in Bangladesh, Kenya, India, Nepal, Malawi, Sierra Leone, Senegal and Zimbabwe. Our research supports them in claiming their rights to health and to build government accountability and capacity to provide them with security and services, by using a community-based participatory research (CBPR) approach.

I am joint Principal Investigator (with Dr Surekha Garimella at The George Institute for Global Health, India and Dr Lana Whittaker at LSTM) of Urban SHADE (Strengthening Health services Access and Delivery in Extreme Weather Events; NIHR RIGHT 2024-2026), which aims to work with people living in urban informal settlements, health system and other relevant stakeholders to co-develop and implement interventions to improve heath system responses to extreme weather events in Kenya, India and Sierra Leone.

I am a co-Investigator on ReCITE (Research by Communities to Address Inequities Through Expression; UKRI (AHRC/ESRC; 2024-2026) led by Professor Miriam Taegtmeyer, which aims to scale-up and sustain the integration of storytelling into community and health system efforts to address these gaps and promote health equity by building a legacy of trust and collaborative action in Merseyside.

I am the Health, Nutrition and Well-being domain and Gender Cross-cutting theme co-lead for the African Cities Research Consortium(link is external)(opens in a new tab) (2021-2026), which is a Foreign Commonwealth and Development Office (FCDO) funded programme led my the University of Manchester that uses a political settlements and systems analysis approach to generate insights and evidence that will help improve the living conditions, services and life chances of all city residents, particularly for disadvantaged communities, across 8 development domains in 13 African cities.

I am also a thematic expert on GEAR-UP (Gender mainstreaming in AMR), led by Professor Sally Theobald.

Previous research in the last 10 years. I was Social Sciences lead for the NIHR Global Health Research Unit on Lung Health and Tuberculosis in Africa at LSTM (IMPALA) (2017-2021), and for the Drivers of Antimicrobial Resistance (DRUM) consortium (GCRF)(link is external)(opens in a new tab) (2018-2021). I also lead the gender equitable careers theme on the DELTAS Learning Research Programme (2016 – 2020), in collaboration with the Capacity Research Unit and MRC-funded social science research exploring the drivers of child marriage in Sudan (2014-15). I led LSTM’s contributions to two EU-funded consortia – INPAC (2012-2016), which aimed to test an intervention to improve post-abortion family planning in China, and MATIND (20111-2015), which evaluated two demand-side financing approaches to improving maternal health in India.

Other relevant expertise, professional memberships etc.

I am a serving member of the Equity Reference Group on Immunisation, which aims to generate innovative ideas to accelerate progress on equity in immunisation. Operating as an action-oriented think tank, the group is reviewing evidence across health programmes and other sectors and recommending innovative ways to achieve greater equity in immunisation though policies and programming.

Teaching

I co-convene qualitative research on the Masters in International Public Health Research Methods in Public Health Module (TROP 703) and am Deputy Convenor of the Public Health Policy, Programmes and Strategies Module (TROP 703), teaching on social determinants of health, gender and health equity and urban health. I also teach on the DTMH and supervise Masters student dissertations. I have has successfully supervised 8 PhDs.

Current PhD students

Quality of life among people with chronic lung disease in LMICs. Irene Ayakaka

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. Beate Ringwald

Understanding the embodiment of discrimination and stigma among waste picking communities in India, it’s impact on their health and wellbeing and the consequences on agency.Shrutika Murthy

A Critical Assessment of How Urban Development and Relocation Processes Shape Wellbeing of Marginalised People. Smruti Srinivas Jukur

Recent publications:

Selected publications

ARISE Consortium (corresponding author) (2024) Improving Accountability for Equitable Health and Well-being in Urban Informal Spaces: Moving from Dominant to Transformative Approaches. Progress in Development Studies, pp. 1–20 https://journals.sagepub.com/doi/epub/10.1177/14649934231225530

Ringwald B, Taegtmeyer M, Mwania V, Muthoki M, Munyao F, Digolo L, Otiso L, Wangui Ngunjiri AS, Karuga RN, Tolhurst R for the Korogocho ALIV[H]E research team (2023) Power and poverty: A participatory study on the complexities of HIV and intimate partner violence in an informal urban settlement in Nairobi, Kenya. Social Science and Medicine, Volume 336, https://doi.org/10.1016/j.socscimed.2023.116247

Egere U, Shayo E, Chinouya M, Taegtmeyer M, Ardrey J, Mpagama S, Ntinginya N, Ahmed R, Hussein EH, El Sony A, Wingfield T, Obasi A, Tolhurst R, The IMPALA Consortium (2023) Honestly, this problem has affected me a lot”: A qualitative exploration of the lived experiences of people with chronic respiratory disease in Sudan and Tanzania. BMC Public Health, 23(1):485. doi:10.1186/s12889-023-15368-6.

Mangochi H, Tolhurst R, Simpson V. Kwaza K, Chidziwisano K, Feasey NA, Morse T, MacPherson E (2023) A qualitative study exploring hand hygiene practices in a neonatal unit in Blantyre, Malawi: implications for controlling healthcare-associated infections Wellcome Open Research 7:146 (https://doi.org/10.12688/wellcomeopenres.17793.2).

Mangochi H, Tolhurst R, Simpson V. Kwaza K, Chidziwisano K, Feasey NA, Morse T, MacPherson E (2023) A qualitative study exploring hand hygiene practices in a neonatal unit in Blantyre, Malawi: implications for controlling healthcare-associated infections Wellcome Open Research 7:146 (https://doi.org/10.12688/wellcomeopenres.17793.2).

Mankhomwa J, Tolhurst R, M’biya E, Chikowe I, Banda P, Mussa J, Mwasikakata H, Simpson V, Feasey N, MacPherson EE (2022) A qualitative study of antibiotic use practices in intensive small-scale farming in urban and peri-urban Blantyre, Malawi: Implications for antimicrobial resistance, Frontiers Veterinary Science, in press. DOI: 10.3389/fvets.2022.876513

Ringwald B, Tolhurst R, Taegtmeyer M, Digolo L, Gichuna G, Gaitho MM, Phillips–Howard PA, Otiso L, Giorgi E (2022) Intra-urban variation of intimate partner violence against women and men in Kenya: Evidence from the 2014 Kenya Demographic and Health Survey. Journal of Interpersonal Violence. https://doi.org/10.1177%2F08862605221120893

Singh Kakar I, Mallya A, Whittaker L, Tolhurst R and Garimella S (2022) Intersecting Systems of Power Shaping Health and Wellbeing of Urban Waste Workers in the Context of COVID-19 in Vijayawada and Guntur, Andhra Pradesh, India Inayat. Social Sciences 11: 333. https://doi.org/10.3390/ socsci11080333.

Karuga, R, Steege R, Njoroge I, Liani M, Wiltgen Georgi N, Otiso L, Muturi N, Okoth LA, Theobald S, and Tolhurst R (2022). Leaving No One Behind: A Photovoice Case Study on Vulnerability and Wellbeing of Children Heading Households in Two Informal Settlements in Nairobi. Social Sciences 11: 296. https://doi.org/10.3390/socsci11070296.

Dean L, Theobald S, Nallo G, Bettee A, Kollie K, Tolhurst R (2022) A syndemic born of war: Combining intersectionality and structural violence to explore the biosocial interactions of neglected tropical diseases, disability and mental distress in Liberia. PLOS Glob Public Health 2(6): e0000551. https://doi.org/10.1371/journal.pgph.0000551

Ardrey J; Jehan Kate, Desmond, N, Kumbuyo C, & Tolhurst, R (2021) ‘Cooking is for everyone?’: Exploring the complexity of gendered dynamics in a cookstove intervention in rural Malawi, Global Health Action, 14:1, 2006425, https://www.tandfonline.com/doi/full/10.1080/16549716.2021.2006425

Ardrey J, Jehan K, Kumbuyo C, Ndamala C, Mortimer K and Tolhurst R (2021) ‘Pneumonia has gone’: exploring perceptions of health in a cookstove intervention trial in rural Malawi. BMJ Global Health 6:e004596. https://gh.bmj.com/content/6/10/e004