HEARD is celebrating the graduation of one of our students, Dr Murphy Kajumi, who was supported in his studies through the HEARD PhD Scholarship Programme. Below are a few insights on Dr Kajumi’s PhD journey.

Thesis topic: My thesis title was “HIV and AIDS Service Delivery (In)efficiency in Malawi: A Transaction Cost Economics Analysis of the Antiretroviral Programme.

What inspired me to start a PhD: During my consultancy work, I found myself increasingly collaborating with health researchers. My interest in health economics research was sparked while working on a multidisciplinary independent review team of Malawi’s National AIDS response from 2007 to 2011. That experience revealed the crucial role of evidence-based decision-making in health service delivery. I then found myself enrolling for the global health PhD at HEARD generously supported by the Swedish International Development Agency.

The main findings of  my PhD: I applied transaction cost economics governance theory to the ART programme to determine its overall technical efficiency ART programme in Malawi for the fiscal year 2018/19, and the types of inefficiency it displayed. I found that the governance design of Malawi’s ART programme aligns with Transaction Cost Economics (TCE) theory, although the programme remains technically inefficient, with an overall efficiency score of 92%—suggesting that ART output could be increased by 8% with the same resource volumes. Additionally, scale inefficiencies are present, with 69% of ART facilities showing they are too large to operate efficiently and 23% are too small to be efficient. In the face of retreating development aid for HIV/AIDS these insights raise important questions about how we design and manage HIV service delivery systems to reduce administrative costs, and how ART facilities are allocated.

What are my plans for the future: Surely, “I did not come this far only to come this far”, as the graduation mantra affirmed. I hope to ride on the guidance of my academic mentors and continue with health research. I am committed to continuing in health research, with a focus on improving the efficiency and equity of health systems—because better data and smarter decisions can save more lives.

A quotation of my own or another that resonates with me: There are many inspirational words, but I would go with the Biblical quote from John 12 verse 24 (NIV)-“…. unless a kernel of wheat falls to the ground and dies, it remains only a single seed. But if it dies, it produces many seeds.” This verse captures the essence of what I experienced during my PhD journey—true growth often requires sacrifice. I saw this principle lived out by my wife Zindaba  and children, and the remarkable team at HEARD, from Thembi to the Executive Director. Their willingness to support me—and undoubtedly others—with such selflessness made a lasting impact. Their quiet sacrifices helped me press on through challenges, and I’m deeply grateful.