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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 a 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).


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

ReBUILD’s overall purpose is to contribute towards 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 in post-conflict countries.

It is an international partnership funded by the UK Department for International Development (DfID) between 2011-2017 (£6,000,000).

Partnerships with:

Makerere University School of Public Health, Uganda,

Biomedical Training and Research Institute, Zimbabwe,

College of Medicine and Allied Health Sciences, Sierra Leone,

Cambodia Development Resource Institute, Cambodia,

Liverpool School of Tropical Medicine, UK.

Directors Barbara McPake and Tim Martineau.

IGHD Researchers: Barbara McPake, Sophie Witter, Suzanne Fustukian, David Newlands


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:

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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