I have recently completed my practicum and conducted research with a team from UNC and the École des Hautes Etudes en Santé Publique in France. Together, we have worked on a qualitative sub-study based in a semi-rural area of Benin.
Over this summer, I developed a codebook to analyze thirty transcripts on maternal depression and knowledge and behaviors associated with anemia, malaria, and helminth infection among women and children. Additionally, I have learned to use a new qualitative analysis software, Dedoose, to facilitate the analysis process. Through my practicum, I have further developed my qualitative analysis skills and acquired new tools to expand my research scope. Focusing on the experiences of women during their maternal health period has also allowed me to gain a more nuanced understanding of maternal health challenges associated with infectious diseases and mental health. I hope to further these insights in future projects on maternal health, specifically in sub-Saharan Africa. Through my data analysis, I have also gained insight into social and structural factors that impact adherence to treatment plans and health promotion, such as challenges with the affordability of treatment and lack of knowledge surrounding treatment options.
This practicum experience has been incredibly rewarding and informative and has set me on a path toward further exploring maternal and child health!
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].
Accra, Ghana; Photo Credit to Caitlin Williams
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).
Bibimbap at the Beach; Photo Credit to Anamika Devi
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.
* 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.
Enjoying the fresh air while attending a nutrition workshop in Balthali
Hello again, this is Ellina Wood. As the summer is quickly fading and my internship is coming to an end, I have been reflecting on my time spent in Nepal over the past three months. I have the great fortune to complete an incredibly fulfilling and rewarding dietetic internship with Helen Keller International (HKI) on Suaahara II: a project that has been implemented in Nepal since 2016 and partners with local stakeholders to address the health and nutritional status of women and children across 42 key districts.
Green leafy vegetables, pulses, and eggs to be shared at a swasthya aama samuha (health mothers’ group)
I agreed to the internship with the premise that I would engage in cooking demonstrations, analyze the nutrition content of existing recipes, make recipe recommendations to bolster the micronutrient profile, and write success stories to be shared in the annual report. Although some of my time has been spent on these objectives, a larger aspect of my internship has been spent on other tasks. While collaborating with a local dietitian and the Ministry of Health and Population (MoHP), I conducted literature reviews to develop a new national nutritional management protocol to aid in the recovery of moderate acute malnourished (MAM) children using nutrient-dense foods in place of imported formulated supplementary foods. Whilst there is currently no international guidance that endorses the use of local foods for the treatment of MAM, emerging evidence suggests that providing local foods may be comparable to formulated supplementary foods for recovery rate and weight gain so long as quality sources are used for the appropriate duration. In fact, the World Health Organization (WHO) is in the process of developing an international guideline, focusing on locally available food, for the prevention and treatment of moderate wasting in children presenting at health facilities with acute illness. It is the MoHP’s goal that any learning generated through monitoring and evaluation of the rollout of the new nutritional management protocol will be a valuable addition to the evidence base for the WHO guidelines.
Materials used during growth monitoring and promotion pilot testing
I also provided technical support to my team as they conducted pilot testing for an upcoming revision to Nepal’s Growth Monitoring and Promotion (GMP) guideline. The field-testing process meant that I had the opportunity to travel to different regions across Nepal to meet with the municipality-level governments and to support my team in training/ observing health care providers at Outpatient Therapeutic Centres (OTCs) and Non-Outpatient Therapeutic Centres (non-OTCs). Following each GMP pilot test, my team conducted exit interviews and focus groups with participating health care workers and mothers. Our observations and the following discussions ultimately guided our revisions for the GMP protocol and model recommendations for local and national government-decision making. Being able to travel to several districts not only gave me the chance to engage in monitoring and evaluation exercises with various government agencies and communities but it also allowed me to gain a deeper understanding of the region-specific customs and beliefs (trying new foods and getting glimpses of new, breathtaking views was a bonus!). I gained knowledge about the value of adaptability, how to effectively communicate in a culture that differs from my own, and how to be receptive when my worldview is challenged.
Although it is difficult to leave, I do so knowing that I am far better equipped to handle public health challenges. Overall, my internship has left me feeling inspired to continue working in the global health space.
