Global Health Practicum in the time of COVID-19

For most people, myself included, the pandemic upended our way of life, from the way we socialize to the way we work. Currently, I work as a pediatric surgeon, so prior to starting my MPH, I figured that I would have to find a practicum experience that would be flexible with regard to my work schedule; allowing me to meet my clinical responsibilities while fulfilling my practicum requirement. More importantly, I wanted an experience that would allow me to marry my research interest in access to prenatal care and neonatal outcomes in sub-Saharan Africa. For all these reasons, I was extremely excited when I got the opportunity to work with the UNC Gillings Zambia group which focuses on “improving public health, locally and globally.” Specifically, I was selected as a practicum intern for the Antenatal Care/ Postnatal Care Research Collective – Household Survey (ARCH), a multinational collaborative that aims to optimize birth outcomes in low resource settings. I don’t think that I could have asked for a better practicum opportunity, as it aligned perfectly with my interests.

In my role, I will be working to help with study start-up and implementation of a new longitudinal household survey of 5,000 households in Lusaka, Zambia. The goal of this survey is to gain a better understanding of the behavioral and reproductive health of women of reproductive age. Ultimately, the results from the study will provide estimates of the burden of maternal, newborn, and infant disease; and provide information regarding key risk factors and social disadvantages that contribute to adverse maternal and neonatal outcomes. I am excited to be part of this study, albeit in a small way, because I think we know little about factors related to preconception and antenatal care of women in resource-limited areas. This area of research is particularly important because I think better understanding will provide information not only regarding factors affecting maternal health, but also regarding the burden of birth defects and help to inform planning for and improving neonatal outcomes.

During my practicum experience, I will be working to develop training materials for field research staff and recruitment materials for study participants.  Over the last few weeks, I have been working on getting acquainted with the study protocol, and meeting key personnel for the study. I have also started working on some of the participant recruitment materials.  It has been really interesting having meetings on Zoom to discuss the study and its initiation. It has made me long more for in-person meetings, because I think that it would have been great to meet some of the people with whom I’d be working. I also think that it would have been an amazing opportunity to be on ground in Lusaka. I am still hoping that I will be able to visit the Zambia Hub in the future.  In spite of the challenges regarding not being in-person, I have been fortunate to have a preceptor who has been available and easily accessible.

There are number of things that I am looking forward to in my practicum. Firstly. I am looking forward to learning how to carry a research study from a concept, to one that is actualized in practice. I am also looking forward to developing the training schedule and materials that will be instrumental in initiating the study. I feel that this project will allow me to think critically about an important part of research study implementation, in which I have little experience. Lastly, I hope that this experience will provide opportunities to build relationships with researchers who have similar interests, in improving prenatal access to care and neonatal outcomes, in resource-limited settings.  As a physician who is interested in global surgery and research, my involvement will therefore provide me with the skills to develop study management tools, train research staff in international settings, and establish methods to monitor data quality. Given that the study is still in the early stages of implementation and initiation, I believe that I will gain valuable experience regarding the successful implementation of a research protocol.

Although I expect to have a busy summer, I’m planning on making the most of the sunny days by doing as much work as I can outside :).

‘Desola