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Sassy Molyneux
kilifi [dot] kemri-wellcome [dot] org Research
Sassy's current main area of research is aimed at producing new thinking, evidence and recommendations around strengthening community accountability in biomedical research and in health delivery in sub-Saharan Africa. Community accountability is increasingly promoted in sub-Saharan Africa; in biomedical research to strengthen research ethics, relevance and acceptability, and in health delivery as a right in itself, and to enhance quality of care, perceived appropriateness, and patient utilisation. Despite the prominence of community accountability in policy and practice, there is little published experience, leading to calls for further research. Sassy's work involves literature reviewing and empirical work, including a series of case studies exploring the implementation and impact of community accountability for different biomedical studies and health delivery activities. The work is aimed at developing and testing a draft theoretical framework, and at feeding into local and international policy and practice.
Sassy's current main area of research builds on two previous bodies of work: around the interface between health systems and households; and the interface between health researchers and communities. Regarding the former, her work began with an interest in maternal mobility, gender relations, health-related decision-making, and treatment-seeking behavior. Her PhD thesis compared maternal migration, mobility and treatment-seeking between a rural and an urban setting on the Kenyan coast. Recognition of the importance of cost, and of the financing policies influencing this, led to post-doctoral research around treatment-seeking behavior, costs and coping at the household level, the role of social resources in supporting coping mechanisms, and implications for policy and practice. These issues were explored using a livelihoods framework, and a study design similar to other micro-level studies being conducted in Sri Lanka, South Africa and Thailand. The generalisability of the findings within the country, and new questions around reaching and protecting the most vulnerable households, were then explored through a mixed methodology study exploring equity in prevention and treatment of malaria in four Kenyan districts (Co-PI with Dr Jane Chuma). Current research includes evaluating the implementation and impact of an innovative financing mechanism for health facilities in Kenya (Co-PI with Dr Catherine Goodman).
Regarding the interface between health researchers and communities, Sassy began work looking at community perceptions and understanding of the activities of the KEMRI-Wellcome Trust Collaborative Research Programme. This work contributed to the development of a large scale communication strategy - including significant community engagement activities and action research - which is on-going (often co-led with Dr. Vicki Marsh). Specifically, Sassy was a PI on an action research study aimed at building a research agenda around the application of ethical principles in practice in low income settings. She is also one of the group of scientists in the Social and Behavioural Research group that currently work alongside community facilitators (Community Liaison Group) to develop, implement and evaluate systematic and innovative approaches to community engagement in health research in Kilifi District in Kenya.
Collaborations
Publications
Publications: peer reviewed journals
Molyneux (in press). Reducing User Fees for Primary Health Care in Kenya: Policy on Paper or Policy in Practice? International Journal of Equity & Health.
Chuma J and CS Molyneux (2009). Estimating inequalities in ownership of Insecticide Treated Nets: Does the choice of socio-economic status measure matter? Health Policy and Planning, 24(2):83-93.
Molyneux CS, Goudge J, Russell S, Chuma J, Gumede T and L Gilson (2009). Conducting health-related social science research in low income settings: ethical dilemmas faced in Kenya and South Africa. Journal of International Development, 21, 309-326.
Chuma J and CS Molyneux (2009). Coping with the costs of illness: the role of shops and shopkeepers as social networks in a low-income community in Coastal Kenya. Journal of International Development, 21, 252-270.
Porter T, Chuma J and CS Molyneux (2009). Barriers to managing chronic illness among urban households in coastal Kenya. Journal of International Development, 21, 271-290.
Goudge J, Russell S, Gilson L, Molyneux S and K Hanson (2009). Journal of International Development Special Issue: Household experiences of ill-health and risk protection mechanisms. Journal of International Development, 21, 159-168.
Gikonyo C, Bejon P, Marsh V, and CS Molyneux (2008). Taking social relationships seriously: Lessons learned from the informed consent practices of a vaccine trial on the Kenyan Coast, Social Science and Medicine, 67(5): 708-720
Kilonzo N; Taegtmeyer M, Molyneux CS; Kibaru J and Theobald S (2008). Engendering health sector responses to sexual violence and HIV in Kenya: Results of a qualitative study. AIDS CARE journal, 20(2): 188-190.
Lairumbi GM, Molyneux, CS, Snow RW, Marsh K, Peshu N and M English (2008). Promoting the social value of research in Kenya: examining the practical aspects of collaborative partnerships using an ethical framework. Social Science and Medicine, 67(5): 734-747.
Marsh V, Kamuya D, Gikonyo C, Rowa Y and CS Molyneux (2008). Beginning community engagement at a busy biomedical research programme: experiences from KEMRI CGMRC-Wellcome Trust Research Programme, Kilifi, Social Science and Medicine, 67(5): 721-733
Molyneux CS and Geissler W (2008). Editorial: Ethics and ethnography in medical research in Africa, Social Science and Medicine, 67(5): 685-695.
Chuma J, Gilson L & CS Molyneux (2007). Treatment-seeking behaviour, cost burdens and coping strategies among low-income rural and urban households in Coastal Kenya: an equity analysis. Tropical Medicine and International Health, 12, 673-686.
Molyneux CS, Gikonyo C, Bejon P, and Marsh V (2007). Checking informed consent understanding using a quiz: lessons learned from a malaria vaccine trial on the Kenyan Coast, Malaria Journal, Nov 10; 6 (1):145.
Molyneux CS, Huchkins B, Chuma J and Gilson L (2007). The role of community-based organizations in household ability to pay for health care in Kilifi District, Kenya, Health Policy and Planning , 22:6: 381-392).
Starling B, Kamuya D, Gilonyo C, Molyneux CS and V Marsh (2007). Utafiti in Coastal Kenya. Science and Public Affairs, June 2007, 10-11.
Bejon P, Jedidah Mwacharo, Oscar Kai, Tabitha Mwangi, Paul Milligan, Stephen Todryk, Sheila Keating, Trudie Lang, Brett Lowe, Caroline Gikonyo, Catherine Molyneux, Greg Fegan, Sarah Gilbert, Norbert Peshu, Kevin Marsh, and Adrian Hill (2006). A phase 2b randomized trial of the Candidate Malaria Vaccines FP9 ME-TRAP and MVA ME-TRAP among children in Kenya, PLoS Clin Trials 1(6): e29. DOI: 10.1371/journal.pctr.0010029.
Bejon P, Peshu N, Gilbert SC, Lowe BS, Molyneux CS, Forsdyke J, Lang T, Hill AV, Marsh K (2006). Safety profile of the viral vectors of attenuated fowlpox strain FP9 and modified vaccinia virus Ankara recombinant for either of 2 preerythrocytic malaria antigens, ME-TRAP or the circumsporozoite protein, in children and adults in Kenya. Clin Infect Dis. 2006 Apr 15;42(8):1102-10. Epub 2006 Mar 14.
Chuma J, Thiede M & CS Molyneux (2006) Rethinking the economic burden of malaria at the household level: Evidence from applying a new analytical framework in rural Kenya. Malaria Journal, 5:76.
Kibe LW, Mbogo CM, Keating J, Molyneux S, Githure JI, Beier JC (2006). Community based vector control in Malindi, Kenya. African Health Sciences, 6 (4), 241-246.
Elsey, H., Kilonzo, N., Tolhurst, R. and CS Molyneux (2005). Bypassing districts? Implications of sector-wide approaches and decentralization for integrating gender equity in Uganda and Kenya. Health Policy and Planning 20 pp.141-149
Molyneux, CS, Peshu N., & Marsh, K (2005). Trust and informed consent: insights from community members on the Kenyan Coast, Social Science and Medicine, 61 (7), 1463-1473.
Molyneux, CS, Wassenaar D., Peshu N., & Marsh, K. (2005) ‘Even if they ask you to stand by a tree all day, you will have to do it!': Community voices on the notion and practice of informed consent, Social Science and Medicine, 61(2), 443-454.
Abuya TO, Molyneux CS, Orago ASS, Were S and V Marsh (2004). Quality of care provided to children presenting to private clinics on the Kenyan Coast. African Health Sciences 4 (3): 160-170.
Molyneux, CS, Peshu N., & Marsh, K. (2004). Understanding of informed consent in a low-income setting: three case studies from the Kenyan Coast, Social Science and Medicine, 59, 12, 2547-2559.
Molyneux CS, Mung'ala-Odera V, Harpham T & Snow RW (2002). Maternal mobility across the rural-urban divide: empirical data from coastal Kenya. Environment and Urbanisation, 14, 1, 203-217.
Molyneux CS, Murira G, Masha J & Snow RW (2002). Intra-household relations and treatment decision making for child illness: a Kenyan case study. Journal of Biosocial Science, 34, 109-131.
Harpham T & CS Molyneux (2001). Urban health in developing countries: a review. Progress in Development Studies 1, 2, 113-137.
Snow RW, Howard SC, Mung'Ala-Odera V, English M, Molyneux CS, Waruiru C, Mwangi I, Roberts DJ, Donnelly CA, Marsh K (2000). Paediatric survival and re-admission risks following hospitalization on the Kenyan coast. Tropical Medicine and International Health, 5 (5) 377-388.
Molyneux CS, Mung'ala-Odera V, Harpham T & Snow RWS (1999). Maternal responses to childhood fevers: a comparison of rural and urban residents in Coastal Kenya. Tropical Medicine and International Health 4 (12): 836-845.
Snow, R. W.,McCabe, E.,Mbogo, C. N., Molyneux, C. S.,Some, E. S.,Mung'ala, V. O.,Nevill, C. G (1999). The effect of delivery mechanisms on the uptake of bed net re- impregnation in Kilifi District, Kenya, Health Policy and Planning, 14 (1), 18-25.
Bull PC, Lowe B, Kortok M, Molyneux C & Marsh K (1997). Parasite antigens on the infected red cell surface are targets for naturally acquired immunity to malaria. Nature Medicine 4 (3): 358-360.
Snow RW, Molyneux CS, Warn PA, Omumbo J, Nevill CG, Gupta S & Marsh K (1996). Infant parasite rates and immunoglobulin seroprevalence as a measure of exposure to plasmodium falciparum during a randomized controlled trial of insecticide-treated bed nets on the Kenyan Coast. Am. J. Trop.Med. Hyg. 55 (2): 144-49.
Snow RW, Molyneux CS, Njeru EK, Omundo J, Nevill CG, Muniu E & Marsh K (1997). The effects of malaria control on nutritional status in infancy. Acta Tropica 65: 1-10.
Snow RW, Omundo JA, Lowe B, Molyneux CS, Obiero JO, Palmer A, Weber MW, Pinder M, Nahlen B, Obonyo C, Newbold C, Gupta S & Marsh K (1997). Relation between severe malaria morbidity in children and level of plasmodium falciparum transmission in Africa. Lancet 1997 349: 1650-54.
Publications: Policy documents and manuals
Opwora A, Kabare M, CS Molyneux and C Goodman (2009).
Haaland A & CS Molyneux (2006). Collecting quality information: Training manual on practical communication skills for field researchers and project personnel, World Health Organisation/TDR.
Kilonzo N, Abuya T, Mutemi W, Were S and Molyneux S (2002). SWAps and gender mainstreaming in Kenya - district level opportunities & challenges. Paper in resource pack on Sector Wide Approaches: Opportunities and Challenges for Gender Equity in Health.
Harpham T & CS Molyneux (2000). Urban health in the context of poverty, inequity and polarization trends in developing countries. Background paper for the third Global Report on Human Settlements, UNCHS 2001.
Molyneux CS & Harpham T (2000). Urban health in developing countries: recognising and responding to a complex reality. Background paper for the US National Academy of Science (NAS), National Research Council Panel on Urban Population Dynamics.