Reflections on My Summer Practicum with The UNC Water Institute

It has been a few weeks since my practicum ended with the UNC Water Institute. I am grateful that I was given this opportunity to explore the field of water and sanitation hygiene (WASH) in health care facilities (HCFs) and was able to connect with several organizations and WASH professionals during the practicum.

The key activities that I completed during this practicum included a grey literature sorting, systematic reviews of documents and document extractions, nine interviews (11 participants) of international WASH in healthcare facility professionals, and an analysis of the website. These activities guided my practicum products, which included a mini study and report of the website, and a compilation of WASHFIT modules on sanitation related studies.

One of the most interesting parts of the practicum were the interviews. The interviews conducted were to find out training and capacity development needs in HCFs internationally, and questions asked in the interview were based on the eight practical steps identified by the WHO and UNICEF to reach universal access to WaSH in healthcare facilities, such as conducting situation assessments, establishing national standards, implementing infrastructure, and monitoring. I found that many HCFs, with the support of local and national governments had accomplished situational assessments and established at least a national standard, with some HCFs developing individual standards for HCFs or within a specific community. A large barrier to moving forward with implementation, monitoring, and community engagement were resources available to be allocated to hardware and software needs. As the WASH sector grows and the need for services becomes more apparent, resources will need to be prioritized in such a way that they sustain HCF abilities to carry through the eight practical steps.

These interviews also shaped our practicum team’s perception of what tools and guidelines are necessary for advancing services in several domains of WASH and helped us create the WASHFIT modules. The modules included a summary of an intervention or study, the findings and outcomes, and any other information that was important to note about the intervention. The modules also included a visual of where each intervention was conducted, the details of the area, which included type of healthcare facility, geographic makeup (urban or rural), and included icons to symbolize what WASH components were included in the intervention. Once published and shared, WASH professionals may use these modules to guide interventions in their own HCFs and advance within the eight practical steps.


Navigating the Path to Impact: My Summer as a Research Lead for Qualitative Analysis with FHI 360’s TQLA Team

Embarking on a journey as a research fellow with FHI 360’s Total Quality Leadership and Accountability (TQLA) team has been full of learning. As the research lead for the qualitative analysis of TQLA’s impact over the years, I have uncovered not only the transformative power of their work but also the wide array of skills I continue to gather for my future endeavors.

Before delving into the invaluable skills I have gained, let me provide some context. FHI 360’s TQLA framework is a transformative and innovative managerial strategy in global health, championing quality improvement and accountability in HIV programs in several countries globally. My task over the year is to supplement TQLA’s quantitative evaluation by assessing the qualitative impact of TQLA’s work, a responsibility that comes with great anticipation and many opportunities to learn as an early career professional in global public health work.

First, I have had the opportunity to sharpen my data analysis skills. This includes developing a comprehensive interview guide for staff at all levels of the TQLA team. This process involved several iterations and that for me foreshadowed the needed patience in developing valuable and sustainable tools for assessing public health impact. Additionally, I quickly learned the importance of effective communication. I needed to collaborate with colleagues in Nigeria to ensure the analysis aligned with TQLA’s goals. The ability to convey the goals and objectives of our mixed-methods approach in a clear and concise manner is a skill that will undoubtedly serve me well in future projects. Being a point person for such a substantial project continues to teach me the art and science of project management. I continue to hone my ability to organize and execute projects efficiently.

FHI 360 prioritizes the professional growth and development of its employees. Through training programs, mentorship opportunities, and access to a wealth of resources, I have been able to further enhance my skills and knowledge, which will undoubtedly benefit my future career in public health. This summer, I had the opportunity to chat with FHI’s Chief Operating Officer, who shared career insights and encouraged me to build relationships over the year. Additionally, FHI organized a workshop for all interns and fellows that discussed what development work looks like and the skills in high demand. To put this into practice while I am on the team and to leverage my skills for my project, I am currently enrolled in a Project Management course sponsored by FHI.

My practicum was just the beginning of what I believe will be a year full of worthwhile challenges as I continue to build relevant skills. Onwards and Upwards!

Acknowledgements: Thank you to my team in Nigeria, especially Dr. Charles Odima for your support on this project.

-Sena Kpodzro

Occupational and Environmental Preventative Public Health Workshop in Conde, Bahia Brazil

My name is Jaquayla Hodges, and I am an approaching second-year MPH student at UNC Gillings School of Global Public Health in the Applied Epidemiology concentration. Within my public health career, my main foci are health inequities that exist across the African Diaspora, Latinx, and rural communities.

My last update of my practicum in Salvador, Bahia Brazil centered the work completed by myself and the Entre Mares Research Group while stationed in the city. The second half of my practicum moved the team to a town three hours north of Salvador, Sítio do Conde.

Fishing boats in the mangrove near Conde
Fishing boats cruising through the mangroves along Conde and neighboring towns.

This trip was not originally planned for my participation during the practicum, but my practicum preceptor saw this as a great experience for me to connect my data analysis to reality. Afterall, the principal of epidemiology is the use of participant data from real people to improve health conditions and outcomes. My work involved data analysis of responses collected from a questionnaire distributed by the research team of fellow UNC and Universidade Federal da Bahia professors and students. I analyzed both quantitative and qualitative data including variables such as household income for each municipal city in Southern Bahia with the use of R Studio and Excel. Most of this work was remote, so it was nice to meet the people in my dataset. Members of the team from other parts of Brazil, including Pernambuco and indigenous towns, came along for this workshop as well.

Members of the research group and Condo residents smile and pose on the beach
Members of the Entre Mares Research Group and a few Conde residents following the first day of the workshop.

The motive of this workshop was to relay the health impact of the 2019 oil spill, connect the residents to the team’s progress, and assess the knowledge of preventative methods and behaviors for future environmental crises. We used data analyzed from the team to provide fishing communities knowledge and reasonable personal protective equipment (PPE) tips according to what everyone found accessible. For example, most people in the area wore shorts and flip flops daily. Something as simple as wearing long sleeved shirts and pants contributed to better protection during the cleaning processes. Alternatives to expensive store products were also discussed, acknowledging the reality of accessibility of costs for PPE. There were games like “Facto ou Mito (Fact or Myth)”, where participants would break into two teams and answer whether the statement on the screen about preventative environmental disaster behaviors were a fact or myth. None of the teams answered incorrectly! Both teams ended up winning prizes at the end of the game.

Conde residents are seated indoors playing Facto ou Mito
Residents of Conde and neighboring cities in the workshop, playing Facto ou Mito.
A handwritten flowchart depicts how the fishing colony was impacted by the oil spill disaster
A flowchart created by the participants shows how the fishing colony is affected by the disaster. This organizes the event and its real-life effect according to those impacted.

The team’s analyses, along with a few other studies on oil disasters around the world, aided in providing statistics for the workshop. Analyses are key to protecting communities from future occupational and environmental disasters through the workshops our team developed over the summer. The Entre Mares Research Group has grown to observe, engage and protect fishing communities in Salvador, and other affected communities in northeastern Brazil. I took over 300 photos and videos (see below), with community permission, for use of advocacy in future text or social media posts and the creation of a banner to be displayed in the fisher’s post in Conde. Future workshops with the team will focus on fisher’s occupational health and aims to expand to other important health outcomes for those living across northeastern Brazil.

Small, clear bottles feature the logo Jaquayla designed
Materials for participants with the logo I designed!
A close up shot of colored pencils, part of a pair of scissors, and colorful pieces of paper on a table
Free childcare was provided with games that increased their awareness of the environment and their importance as families who fish to support the economy and themselves. 
A shot from behind a boy who holds a fish net nera the shore
The son of the leader of the fishing site shows us his fish net making skills.
A man holds a fish out to the camera
A proud fisher shows me his catch of the day.