Category: Amy T.

Though this summer is coming to an end and my amazing practicum experience with it, rather than coming to a full stop, I feel like my work in public health is moving full steam ahead. Transportation references aside, my practicum this summer focused on the qualitative analysis portion of an implementation science evaluation of the national scale up of a midwife-led Obstetric Triage Intervention Package (OTIP) in high-volume hospitals in Ghana [1].

The final stretch included analyzing and interpreting all the transcribed interviews and synthesizing the data into a report and presentation targeted toward a general policymaking audience. I had expected the most challenging aspect of the practicum to include the process of developing a codebook for the interviews and the subsequent coding process, but I was surprised by the work that came after—what did all of this data mean? How would this translate into something practical and applicable? There was a lot of floundering and panic on my part, but the process of creating this “results” report was an ultimately rewarding one—I learned so much more about qualitative research, maternal and child health, and implementation science, and more importantly, how much I still have to learn. I look forward to making the connections between what I learned during this practicum experience and the classes I will be taking in the Fall (I’m looking at you HBEH 784 – Implementation Science in Global Health).

Once again, this hybrid/remote practicum model has allowed me the opportunity to explore more of my new home. My last summer trip included a visit to the Outer Banks Beach area. As a Florida native, I thought I knew beaches but this trip was definitely a learning experience. All of my invertebrate biodiversity class experiences seemed to pay off – I had a great time examining all of the Mollusca specimens in between some nice beach naps.

Finally, thank you to my preceptors, Stephanie Bogdewic, MPH and Caitlin Williams, MSPH for all your patience and mentorship this summer! And thank you to our partners at the Kybele-Ghana organization and the Ghana Health Service for your collaboration and inspiring work in improving the health and well-being of mothers* and children in this project.

– Amy T.

* The author acknowledges and respects the lived experiences of birthing individuals with gender identities not exclusive to cisgender female identities. However, for the purposes of data collection/analysis and recognizing Ghanian cultural values and norms, individuals that give birth have been referred to with traditional binary terminology, including women, females, and mothers.

[1] Williams CR, Bogdewic S, Owen MD, Srofenyoh EK, Ramaswamy R. A protocol for evaluating a multi-level implementation theory to scale-up obstetric triage in referral hospitals in Ghana. Implement Sci. 2020;15(1):31. Published 2020 May 12. doi:10.1186/s13012-020-00992-2

I am Amy Tran, a student in the Global Health concentration who is moving steadily towards the second year of the MPH program. My public health interests primarily revolve around issues of maternal and child health, particularly in low-resource settings, though I am also interested in aspects of data analysis, both quantitative and qualitative, and the applications of GIS in public health.

For my summer practicum experience (to which I was introduced by my former faculty advisor, Dr. Rohit Ramaswamy), I am working with a joint team of UNC Gillings researchers and the Kybele-Ghana organization. My preceptors are also Ph.D. students here at Gillings—Stephanie Bogdewic, MPH, and Caitlin Williams, MSPH. This collaboration is centered on the scale-up of the midwife-led Obstetric Triage Implementation Package (OTIP) in Ghanian hospitals and tertiary health facilities, which was developed in 2013 and since 2019, has been scaled up to a national level to be implemented in six other high-volume hospitals [1].

This obstetric triage intervention is aimed at reducing maternal mortality by addressing the third delay in referral hospital settings, or the delay in a patient receiving the appropriate health care once it has been sought [1, 2]. Midwives are central to the OTIP intervention, as they are the ones responsible for assessing mothers* once they arrive at the delivery facility with green, yellow, and red bands that indicate the risk level of the pregnancy [1]. At this stage, the research team is concerned with assessing the “know-do” gap in regards to implementation theory, as well as the leadership dynamics and development tied to the program.

I have limited “professional” experience working in global public health settings, generally relegated to a Peace Corps volunteer experience that is more aptly described as a community health outreach “stint”, that ultimately motivated me to pursue formal education and qualifications here. Therefore, being able to work with a research team on a project with clear and direct practical applications to maternal health has given me an extremely valuable opportunity to look at a public health issue and intervention from a different perspective. In addition, my responsibilities include the development of an interview guide for a series of in-depth qualitative interviews with leadership in the OTIP intervention, as well as the qualitative data analysis and presentation of findings to a specialized stakeholder audience. I’m thankful for the introduction to qualitative research methods I received from Dr. Suzanne Maman and the teaching team in HBEH 753 Qualitative Methods in Health Behavior (highly recommend!), in addition to the other synthesis/interprofessional skills introduced in other core courses. My preceptors have been nothing but supportive and accommodating—they are great motivating mentors and I look forward to the rest of this practicum experience!

As an added note, due to the hybrid/remote nature of this practicum experience, I have been able to benefit from the freedom to better explore the local sights. Recently, I have taken a trip to Asheville, including the iconic Biltmore Estate, as shown (above). As a Florida native, I am excited for this opportunity to explore a brand new place!

-Amy T.

* The author acknowledges and respects the lived experiences of birthing individuals with gender identities not exclusive to cisgender female identities. However, for the purposes of data collection/analysis and recognizing Ghanian cultural values and norms, individuals that give birth have been referred to with traditional binary terminology, including women, females, and mothers.

[1] Williams CR, Bogdewic S, Owen MD, Srofenyoh EK, Ramaswamy R. A protocol for evaluating a multi-level implementation theory to scale-up obstetric triage in referral hospitals in Ghana. Implement Sci. 2020;15(1):31. Published 2020 May 12. doi:10.1186/s13012-020-00992-2

[2] Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med. 1994;38(8):1091–110.