Health systems can be considered as the products of human relationships: between patients and health workers, managers and policy makers, communities and governments. As a whole, these relationships establish norms of who is eligible for care and what can be expected from the health system. In poor countries where health services are weak and under-funded, care that is unaffordable and unavailable can become socially normal. Communities and health workers have substantial knowledge of these norms and interactions and how health policy is 'brought alive' through them. Their voices are often overlooked in the routine design and delivery of services however. The project will address this situation by institutionalising processes to: (1) strengthen systems to record and report on deaths, their causes and circumstances; (2) enable the voices of people excluded from access to health systems on their needs and priorities for action, and; (3) act on this information with health workers, managers, planners and policy makers. The process will collect data, analyse, plan and act, and demonstrate an ability to bring about change in partnership with those for whom the situations are most directly relevant. Practical research that is understood and 'owned' by end users in an action-oriented process will strengthen relationships between patients, health workers and policy makers to support and sustain positive change. The research builds on development work providing actionable health information for poor and rural groups in South Africa. Rural villages in South Africa represent many settings in the region, with deeply entrenched poverty, inequality, avoidable illness, and weak health systems where many deaths go undocumented and uncounted. The development work has adapted Verbal Autopsy, a method used in many poor countries to establish the causes of death for people who die without a doctor present. The research has introduced a system to record new information in Verbal Autopsy on factors such as transport and hospital admissions. In developing countries these processes can play a critical role in survival, and documenting them provides important information for health service provision. The development work has also tapped into local knowledge on long standing health problems by building partnerships with communities. Using Participatory Action Research, we have developed understandings of the social issues affecting health, and how these affect people's interactions with care. Participatory Action Research provides a route to involve those in the greatest need in health services. This can empower disadvantaged groups to have more of a say in health systems, in turn strengthening people's abilities to protect and promote their health. We have worked with the health authority throughout, considering what the data are telling us, and how changes can be implemented to respond to the issues identified. The project will extend the development work into an ongoing system of collaborative problem solving, taking data to those who organise and provide services, and working at different levels to understand and enable what is required for change. The work will strengthen existing partnerships with communities, policy makers and planners, and develop new relationships with health workers and clinic managers to act on the evidence towards shared goals. The research will embed a partnerships culture to generate and use information on the realities of health workers and patients to improve care, strengthening access to the health system, achieving improved outcomes and fostering equity in health. The work has been done with a research centre in South Africa established for over 20 years. A team of researchers and policy makers from universities and health authorities in developing and developed countries who have shaped health research and policy in Africa for over 25 years have come together to lead the five year programme.

Intergenerational relations involve the exchange of material, instrumental, and emotional support across the life course. Parents are sources of support to their children but can become recipients of support, especially at older age. Older parents around the world rely most often on their adult children for financial support and care, and adult children increase contact and even become co-resident when parents experience losses, such as widowhood, or illhealth. Amidst dramatic changes in family structure and residential mobility, the extent to which this family lifecycle of intergenerational support is realized is uncertain. Economic uncertainty and the relative absence of public safety nets in poor settings in the global south heighten the policy relevance of addressing these issues. This proposed ESRC-funded series of three cyberseminars will enhance the contribution of family demography to understanding intergenerational relationships and support in low- and middle-income countries. Designed to facilitate the maximum amount of international participation, three interrelated but stand-alone cyberseminars will be conducted in 2012-2014. Using a 'virtual' forum that facilitates knowledge exchange between the north and south, the cyberseminars will bring together academic researchers and students from demography and other allied disciplines, practitioners in family-centered programmes, and people involved in the collection of family data in resource-poor settings. Seminar 1: Building consolidated concepts and methods for the study of intergenerational relationships and support in demographic research Seminar 2: How are family dynamics in low- and middle-income countries affecting intergenerational support and can policies promote positive support in resource-poor settings? Seminar 3: New directions in the demographic study of intergenerational networks and the health and wellbeing of families in low- and middle-income countries Key objectives of the seminars also relate to i) promoting interest and knowledge about contemporary topics in family demography internationally; ii) creating greater awareness of the strength, scope and opportunities for family demography in Asia, Africa, Latin America and Oceania, and iii) fostering interdisciplinary academic networking and collaboration involving demographers from different regions. The cyberseminars will be hosted by the University of Southampton with scientific and technical assistance from the Centre for Research on Ageing, the ESRC Centre for Population Change and the Worldwide University Network (WUN). The co-applicants for this ESRC cyberseminar series are drawn from major academic institutions involved in population studies: Victoria Hosegood (Africa Centre for Health and Population Studies & Southampton), Sara Randall (UCL), Kathryn Yount (Emory), Sureeporn Punpuing (Mahidol), Jacques Alioune (Malawi/Liverpool), Maria Evandrou, Sabu Padmadas, and Jane Falkingham (Southampton). This team has three project partners who will add considerable value to this ESRC cyberseminar series: The University of Southampton, the International Union for the Scientific Study of Population (IUSSP) and the INDEPTH Network. The seminars are also supported by the Population Council.