There are big differences in health and access to healthcare around the world. In many low and middle-income countries, households are a high risk of illness and when does fall ill, they often can’t afford the care they need. Progress towards making healthcare available for everyone has been uneven.
For example, in Central African Republic, resources are limited, there is state fragility, and many women do not have access to trained doctors or nurses during childbirth. There are high numbers of mothers dying—about 692 out of 100,000 live births in 2023. In comparison, in the Netherlands, it is 4 mothers. Some low-income countries have shown tremendous success in addressing maternal mortality – for example Ethiopia has seen a fourfold decrease in maternal deaths over the last twenty years, in parts due to improvements in access to maternal health services.
This shows the unfair and uneven distribution of global healthcare but also opportunity to study and find solutions. Where individuals lives—and countries allocate limited resources —can make a huge difference in whether they fall ill and get the care they need.
News
Events
No event items found.
How ESHPM is making a difference
That’s why at ESHPM, through our cross-cutting Global Health Theme, we work to improve health systems, understand economic and behavioural determinants of health, and reduce inequalities. We do this through engaged teaching and research, always in close collaboration and in response to priorities of partners around the world.
Our expertise
We bring together expertise in global health economics, behavioural economics, econometrics & policy evaluation, health technology assessment, and governance. With our expertise, we aim to help shape smarter policies and practical solutions that move us closer to fair and accessible healthcare for everyone—both in the Netherlands and across the globe.
What we focus on
At ESHPM, we want to help build a healthier world—especially in places where healthcare is hard to reach and resources are limited. We are driven by research, real-world challenges, and a strong commitment to finding practical and scalable solutions. Here are some of the key areas we focus on:
- Stronger Health Systems: We look at how healthcare can be made available to everyone, without causing financial stress. Our goal is to support systems that are fair, effective, and robust.
- Health Behaviours in Real Life: Through our Global Health Behaviours Lab, we study how people make health decisions. We run real-world experiments in low-resource settings to test what actually works to support healthier choices and outcomes.
- Health and the Economy: We explore how poverty, income, and social conditions affect people’s health—and how better health can support economic progress in return.
- Changing Health Needs: We tackle today’s big health challenges in times of transition, like the rise in certain chronic and non-communicable diseases (diabetes, cardiovascular diseases, cancer) in low and middle-income countries, while also addressing long-standing issues like malnutrition and infectious diseases.
- Smart Use of Technology: We explore how digital tools and new technologies can improve the way healthcare is delivered—especially in places with limited resources and at scale.
- Knowledge Translation: We experiment with new ways of generating and sharing knowledge in more equitable ways.
Global Health and the SDGs
Our Global Health projects help shape real-world policies and interventions that improve access to healthcare and reduce health inequalities, in low- and middle-income countries. Our projects link to the United Nations Sustainable Development Goal for Good Health and Well-being (SDG 3).
We don’t look at health challenges in isolation—we connect them to wider issues like poverty and inequality. By understanding how poor health is linked to economic hardship and social disadvantage, our work also contributes to SDG 1 (No Poverty) and SDG 10 (Reduced Inequality).
Through research, education, and collaboration with global partners, we aim to create lasting impact where it’s needed most.
Our Global Health experts
Prof.dr. Matthias RiegerProfessor and Theme Chair Global Health
Focus: Global Health Behaviours, Field & Natural Experiments, Health and Economic Development
dr. Igna BonfrerAssociate Professor Global Health Economics and Director Rotterdam Global Health Initiative
Focus: Health Systems
dr. Hedwig BlommesteinAssociate Professor Health Technology Assessment
Focus: Cost Effectiveness, Cancer
dr. Robert BorstAssistant Professor
Focus: Health Policy, Governance, Knowledge Translation, Dutch Caribbean
Sean RichardsonPhD Researcher
Focus: Health Behaviours, Tuberculosis, South Africa
Ninza MwenesongolePhD Researcher
Focus: Healthcare Financing in Low and Middle-Income Countries
Relevant publications
Sambodo, N. P., Bonfrer, I., Sparrow, R., Pradhan, M., & van Doorslaer, E. (2023). Effects of performance-based capitation payment on the use of public primary health care services in Indonesia. Social Science & Medicine, 327, 115921.
Bonfrer, I. (2022). Dying to know: does performance-based financing reduce mortality?. Health Policy and Planning, 37(3), 416-417.
Nam, P. K., Restrepo, B. J., Rieger, M., & Wagner, N. (forthcoming). Can Information Enhanced with Nudges Mitigate the Rise of Childhood Obesity in the Global South? Journal of Human Resources.
de Vries Mecheva, M., Rieger, M., Sparrow, R., Prafiantini, E., & Agustina, R. (2021). Snacks, nudges and asymmetric peer influence: Evidence from food choice experiments with children in Indonesia. Journal of Health Economics, 79, 102508.
Giuntella, O., Rieger, M., & Rotunno, L. (2020). Weight gains from trade in foods: Evidence from Mexico. Journal of International Economics, 122, 103277.
Brindley, C., Van Ourti, T., Bonfrer, I., & O'Donnell, O. (2025). Association of socioeconomic inequality in cardiovascular disease risk with economic development across 57 low-and middle-income countries: Cross-sectional analysis of nationally representative individual-level data. Social Science & Medicine, 365, 117591.
Dieteren, C., Sarkar, S., Saharan, S., & Bonfrer, I. (2022). Effects of a smartphone application on maternal health knowledge and dietary diversity among pregnant women in India: a randomized single center pilot study. Journal of Global health reports, 6, e2022057.
Borst, R. A., Wehrens, R., & Bal, R. (2023). “And when will you install the new water pump?”: disconcerted reflections on how to be a ‘good’Global Health scholar. Globalization and Health, 19(1), 19.
Borst, R. A., Wehrens, R., Bal, R., & Kok, M. O. (2022). From sustainability to sustaining work: What do actors do to sustain knowledge translation platforms?. Social Science & Medicine, 296, 114735.
Join us
ESHPM is dedicated to leading in global health through strategic partnerships, cutting-edge research, and education. Explore how you can join our mission to create a healthier, more equitable world.