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Institute for Global Health and Development - Staff Profiles

Professor Sophie Witter, ReBUILD Programme, IGHD

Contact Sophie

Areas of interest

  • Health financing, policy and health systems in low and middle income countries
  • Improving financial access to care, with a focus on maternal and child health
  • Human resources for health and provider incentives
  • Health sector development in post-conflict and fragile settings
  • Mixed methods evaluations of systemic interventions


Sophie Witter is a health economist specialising in health financing policy and health systems research in low and middle income countries. She has 25 years’ experience in these areas, working first in development agencies and then in the universities of York, Aberdeen and QMU Edinburgh. She is currently a Professor at IGHD working on health systems research and the ReBUILD programme in particular (funded by DFID, and focussing on health systems development in post-conflict areas, 2011-17). She has extensive experience of health financing research, using mixed methods, as well as providing technical advisory services for Ministries of Health and development partners and teaching at post-graduate level.


Sophie is leading research into health worker incentives and the evolution of HRH policy post-conflict, within the ReBUILD programme. She is also working on a number of other specific research projects, including a systematic review for WHO of paying for performance and family planning, developing guidance for national health financing strategies (with WHO), health labour markets studies in Timor Leste (World Bank), evaluating the impact of insurance for displaced populations in Darfur (World Bank), and leading an evaluation of the Free Health Care Initiative in Sierra Leone (DFID), as well as demand-driven evaluation programmes (DFID).


Funded Projects

ReBUILD - Research for building pro-poor health systems during the recovery from conflict.

The ReBUILD Consortium is an international research partnership working for improved access of the poor to effective health care and reduced health costs burdens, through the production and uptake of a coherent body of high quality, policy-relevant new research on health systems financing and human resources for health in post-conflict countries. ReBUILD is led in the UK by the Liverpool School of Tropical Medicine and Queen Margaret University, Edinburgh, working with partner research organisations in Cambodia, Sierra Leone, Uganda and Zimbabwe. ReBUILD is funded by the UK Department for International Development.

Systems resilience in UNRWA health provision to Palestine refugees displaced by the Syria crisis

This research will focus on the key vulnerabilities of UNRWA health systems in the face of disruptions associated with the displacement of Palestine refugees registered in Syria (PRS).

This research project is funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. Visit for more information.

The R2HC programme is funded equally by the Wellcome Trust and DFID, with Elrha overseeing the programme’s execution and management.



Sophie teaches on health financing, human resource for health, performance-based financing, and complex evaluation approaches.



Sophie welcomes applications from those interested in pursuing a PhD in health systems research, especially in: health system reforms, health financing, and human resources for health.

She is currently supervising:

Dr Fatima Bajwa - How does governance influence the implementation of health workforce policies in Pakistan?

Andrew Ocero - Equity in Maternal Health Care Services in post-conflict Northern and non-conflict East-Central Uganda: A Comparative Mixed Methods Multi-case study

Usar Iornumbe – An economic analysis of retail pharmaceutical markets in Nigeria: towards access expansion and policy  

Constance Shumba - Human resource retention strategies: Analysis of the factors affecting retention in Uganda’s Private-Not-For-Profit hospitals

A selection of recent publications:

Witter, Sophie and Boukhalfa, C and Cresswell, Jenny A. and Daou, Z and Filippi, Veronique and Ganaba, Rasmané and Goufodji, S and Lange, Isabelle and Marchal, Bruno and Richard, Fabienne (2016) Cost and impact of policies to remove and reduce fees for obstetric care in Benin, Burkina Faso, Mali and Morocco. International Journal for Equity in Health, 15 (1). pp. 123-142. ISSN 1475-9276 See article on eResearch:

Bertone, Maria P, Lagarde, Mylene and Witter, Sophie (2016) Performance-based financing in the context of the complex remuneration of health workers: findings from a mixed-method study in rural Sierra Leone BMC Health Services Research DOI: 10.1186/s12913-016-1546-8

Namakula, Justine and Witter, Sophie and Ssengooba, Freddie (2016) Health worker experiences of and movement between public and private not-for-profit sectors—findings from post-conflict Northern Uganda. Human Resources for Health, 14 (1). ISSN 1478-4491

Ganaba, Rasmané and Ilboudo, Patrick G. C. and Cresswell, Jenny A. and Yaogo, Maurice and Diallo, Cheick Omar and Richard, Fabienne and Cunden, Nadia and Filippi, Veronique and Witter, Sophie (2016) The obstetric care subsidy policy in Burkina Faso: what are the effects after five years of implementation? Findings of a complex evaluation. BMC Pregnancy and Childbirth, 16 (1). ISSN 1471-2393

Wurie, Haja R and Samai, Mohamed and Witter, Sophie (2016) Retention of health workers in rural Sierra Leone: findings from life histories. Human Resources for Health, 14 (3). ISSN 1478-4491

Ensor, Tim and So, Sovannarith and Witter, Sophie (2016) Exploring the influence of context and policy on health district productivity in Cambodia. Cost Effectiveness and Resource Allocation, 14 (1). ISSN 1478-7547

Vaughan, Kelsey and Kok, Maryse C and Witter, Sophie and Dieleman, Marjolein (2015) Costs and cost-effectiveness of community health workers: evidence from a literature review. Human Resources for Health, 13 (1). ISSN 1478-4491

McPake, Barbara and Edoka, Ijeoma P and Witter, Sophie and Kielmann, Karina and Taegtmeyer, Miriam and Dieleman, Marjolein and Vaughan, Kelsey and Gama, Elvis and Kok, Maryse and Datiko, Daniel and Otiso, Lillian and Ahmed, Rukhsana and Squires, Neil and Suraratdecha, Chutima and Cometto, Giorgio (2015) Cost–effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya. Bulletin of the World Health Organization, 93 (9). 631-639A. ISSN 0042-9686

McPake, Barbara and Witter, Sophie and Ssali, S and Wurie, H. and Namakula, J and Ssengooba, F (2015) Ebola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone. Conflict and Health, 9 (1). ISSN 1752-1505

Bertone, Maria Paulo and Witter, Sophie (2015) The complex remuneration of human resources for health in low-income settings: policy implications and a research agenda for designing effective financial incentives. Human Resources for Health, 13 (62). ISSN 1478-4491

Witter, Sophie and Falisse, J-B and Bertone, M. P. and Alonso-Garbayo, A and Martins, J S and Salehi, A S and Pavignani, E and Martineau, T (2015) State-building and human resources for health in fragile and conflict-affected states: exploring the linkages. Human Resources for Health, 13 (33). ISSN 1478-4491

Witter, Sophie and Wurie, H. and Bertone, M. P. (2015) The free health care initiative: how has it affected health workers in Sierra Leone? Health Policy and Planning. ISSN 0268-1080

Bertone, M. and Witter, S. (2015) An exploration of the political economy dynamics shaping health worker incentives in three districts in Sierra Leone. Social Science and Medicine, volume 141, pp56-63.

Bertone, M. and Witter, S. (2015) The complex remuneration of Human Resources for Health in low income settings: policy implications and a research agenda for designing effective financial incentives. Forthcoming with Human Resources for Health.

Witter, S., Benoit, J-B, Bertone, M, Alonso-Garbayo, A., Martins, J., Salehi, A., Pavignani, E., Martineau, T. (2015) State-building and human resources for health in fragile and conflict-affected states: exploring the linkages. Human Resources for Health special edition on investing in HRH.

Witter, S., Wurie, H. And Bertone, M. (2015) The Free Health Care Initiative: how has it affected health workers in Sierra Leone? Health Policy and Planning journal, 1-9

Graham, W. and Witter, S. (2014) Counting what counts. The Lancet, Vol 384, September 13, 2014, pp.933-935.

Namakula, J. and Witter, S. (2014) Living through conflict and post-conflict: experiences of health workers in northern Uganda and lessons for people-centred health systems. Health Policy and Planning special edition on People-Centred Health Systems.

Bertone, M., Samai, M., Edem-Hotah, J. and Witter, S. (2014) A window of opportunity for reform in post-conflict settings? The case of Human Resources for Health policies in Sierra Leone, 2002-2012. Conflict and Health , 8:11.

Marchal, B., Van Belle, S., De Brouwere, V. And Witter, S. (2013) Studying complex interventions – from theory to practice: designing the FEMHealth evaluation of fee exemption policies in West Africa and Morocco . Health Services Research, 13 : 469 .

Cometto, G. And Witter, S. (2013) Tackling health workforce challenges to universal health coverage: setting targets and measuring progress. WHO Bulletin special edition on HRH and UHC, vol. 3;91:881–885.

Bertone, M., Meessen, B., Clarysse, G., Hercot, D., Kelley, A., Kafando, Y., Lange, I., Pfaffmann, J., Ridde, V., Sieleunou, I. and Witter, S. (2013) Assessing Communities of Practice in health policy. A conceptual framework as a first step towards empirical research. Health Research Policy & Systems, 11:39.

Witter, S., Toonen, J., Meessen, B., Kagubare, J., Fritsche, G. and Vaughan, K. (2013) Performance-based financing as a health system reform– mapping the key dimensions for monitoring and evaluation. BMC Health Services Research, 13:36.

McPake, B., Witter, S., Ensor, T., Fustukian, S., Newlands, D., Martineau, T. (2013) Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources. Human Resources for Health, 11(1):46.

Richard F., Antony M., Witter S., Kelley A., Meessen B., Sieleunou, I. (2013) Fee exemption for maternal care in Sub-Saharan Africa: a review of 11 countries and lessons for the region. Global Health Governance, special edition on universal health coverage, vol. 6, no. 2

Witter, S., Jones, A., Ensor, T. (2013) How to (or not to)...measure performance against the Abuja target for public health expenditure. Health Policy and Planning doi: 10.1093/heapol/czt031

Chirwa, Y., Witter, S., Munjoma, M., Mashange, W., Ensor, T., McPake, B., Munyati, S. (2013) The human resource implications of improving financial risk protection for mothers and newborns in Zimbabwe. BMC Health Services Research 2013, 13:197

Zou, G., Wei, X., Witter, S., Yin, J., Walley, J., Liu, S., Yang, H., Tian, G. and Mei, J. (2013) Incremental cost-effectiveness of improving treatment results among migrant TB patients in Shanghai. International Journal of Tuberculosis and Lung Disease, Vol. 17, no. 8, pp 1056-1064 (9)

Witter, S., Garshong, B, Ridde V. (2013) An exploratory study of the policy process and early implementation of free NHIS coverage for pregnant women in Ghana. International Journal for Equity in Health, 12:16.

Fox, S., Witter, S., Wylde, E., Mafuta, E., Lievens, T. (2013) Paying for performance in a fragmented, fragile state:reflections from Katanga Province, Democratic Republic of Congo. Health Policy and Planning. doi: 10.1093/heapol/czs138

Witter, S., Cometto, G., Zaman, R., Sheikh, M., Wibulpolprasert, S. (2013) Implementing the Agenda for Global Action on human resources for health: analysis from an international tracking survey.  Journal of Hospital Administration, vol. 2, no. 1, p. 77-87.

Witter, S. (2012) Health financing in post-conflict states: what do we know and what are the gaps? Social Science and Medicine, vol. 75, p.2370-2377.

Witter, S, Khalid, K, Abdel-Rahman, M, Hussein, R., Saed, M.  (2012) Removal of user fees for caesareans and under-fives in northern Sudan: a review of policy implementation and effectiveness.  International Journal of Health Planning and Management.

Fretheim, A., Witter, S., Lindahl, A., Olsen, I. (2012) The evidence-base for performance based financing in low- and middle income countries: still more questions than answers. WHO Bulletin, 90:559–559A.

Related blogs:

Witter, S., Fretheim, A., Kessy, F., Lindahl, A.K. (2012) Paying for performance to improve the delivery of health interventions in low and middle-income countries. Cochrane Database of Systematic Reviews, Issue 2.

Witter, S., Khadka, S., Nath, H., Tiwari, S. (2011) The national free delivery policy in Nepal: early evidence of its impact on health facilities. Health Policy and Planning (special edition on user fee removal) vol. 26, pp.ii84–ii91.

Witter, S., Zulfiquar, T., Javeed, S., Khan, A., Bar, A. (2011) Paying health workers for performance: a district-based case study in Pakistan. Human Resources for Health journal, 9, 23.

Witter, S., Ha, B.T., Shengalia, B., Vujicic, M. (2011) Understanding the ‘four directions of travel’: qualitative research into the factors affecting retention of doctors in rural Vietnam. Human Resources for Health, 9, 20.

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