Gillings Around the globe – Page 36 – Local is Global. Global is Local.

Health and Access in the Himalayas

Posted on July 13, 2022July 8, 2022 by

My view from work in the Kathmandu valley, overlooking the southern hills

Hello! My name is Abby, an incoming second-year MPH student at UNC in the Global Health concentration. For my practicum, I wanted to experience public health work in the field. It was my priority to utilize my newly learned skills in public health to the benefit of my practicum site, while still being challenged and gaining skills that I could use in my career. I had the privilege of ending up in Kathmandu, Nepal. Having grown up here, I was all the more excited to return home and experience Nepal in a professional setting with the Nick Simon Foundation International in partnership with the Nick Simons Institute (NSI). NSI is a Nepali run NGO that works to innovate solutions in rural healthcare through training and hospital support and advocacy with the Ministry of Health and Population of the Nepali government. I will be assisting the Research, Advocacy, and Monitoring and Evaluation (RAM) team with Dr. Ruma Rajbhandari and Dr. Suresh Tamang.

This summer, I will be evaluating the qualitative and quantitative data for NSI’s Advanced Skilled Birth Attendant (ASBA) training program, culminating in a policy brief for the Nepali government. The ASBA training works to enhance the clinical skills of obstetric emergencies, specifically focusing on cesarean sections, in medical officers. The training has been designed in partnership with the National Health Training Center to fulfill the shortage of specialized human resources in rural Nepali hospitals where transportation in an emergency is often limited due to geography, infrastructure, and cost. Ultimately this work will inform government policy and the potential scaling-up of the program and the deployment of ASBA graduates.

Most days I come to the Kathmandu office, but I also had an opportunity for a field visit to Janakpur to observe the Minimum Service Standards (MSS) of a Secondary B hospital. It was an insightful experience that showed the differences between program plans and implementation. Although further work has not been finalized, I may assist in the development of a logic model for future monitoring and evaluation of NSI’s large Curative Service Support Program (CSSP) for the RAM team at NSI.

A full Thali plate with rice, lentils, veggies, ghee, aachar, and dahi

In my spare time I am catching up with family friends, eating all my favorite street food, refreshing my (very rusty) Nepali, and enjoying the heavy rains of the monsoon.

-Abby

Digital Health Interventions in Sichuan, China, continued

Posted on July 12, 2022July 8, 2022 by

It has been only five weeks since my last blog post, but it feels like it’s been months. To recap: my practicum project involves interviews in rural China with community health workers, supervisors (for the community health workers), and caregivers (who are either pregnant or caring for a baby 0-18 months old) who receive home-based educational lessons on topics like breastfeeding, maternal and baby nutrition, injury prevention, maternal mental health, and hygiene. When I last wrote, I was working on the interview guides. Since then, I have recruited interviewers, held an interview training session, managed the interviewers as they conducted my interviews, transcribed the recordings, and translated the transcripts.

In many ways, this practicum has felt like my own mini research project (a project within a project, if you will) – mine to manage and lead to the charge on, with mentors to offer guidance when needed. The first thing I have learned so far is that my expectations regarding timing were unrealistic: The interview guides were an iterative process, but that also meant that they took nearly twice as long to complete. I still am translating transcripts and haven’t gotten to coding or analyzing anything yet, even though I should be in my last week. The second thing I have learned is that logistical problems are impossible to predict. For example, I never suspected the difficulties that would come with using a Chinese transcription service when you don’t have a Chinese cell phone number or a Chinese bank account. I’ve also discovered the difficulties in managing a team of people in a different time zone, and the importance of clear, written communication. Through reading the interviews, I have learned about Chinese culture like newborn practices and childrearing customs.

Marten Van Purren the best practicum helper I’ve ever had!

My next step for this practicum is to finally (after almost two weeks!) finish translating the interviews and begin coding. I suspect that coding will be easier since I feel as if I know all the transcripts by heart after double checking the transcription and translations line by line. Once the analysis is complete, I will compile it all into a report, which I will present to Stanford’s Rural Action Education Program (REAP). I hope that my findings will help inform future steps in this program, which nearly every interviewee enjoys immensely and finds extremely helpful with childrearing. Though the intervention is scheduled to end soon, I think the findings from both this small project and the larger intervention could have larger impacts on rural families all throughout China.

-Sam

The Little Things and Practicum Mid-Point

Posted on July 11, 2022July 7, 2022 by

Hello blog readers!

My name is Maria Esposito and I am a rising second year MPH student in the Global Health Concentration. I am almost two months into my summer practicum working with UNC Professors, Dr. Audrey Pettifor and Dr. Tonia Poteat, through the UNC-Wits Reproductive Health and HIV Institute (RHI) partnership based in Johannesburg, South Africa. My practicum is focused on an implementation science research study, which will examine differentiated care models for transgender people in South Africa with regard to their HIV care.

Before starting my MPH at Gillings, I was working in USAID’s Office of Population and Reproductive Health as an Administrative Program Assistant. Most of my work consisted of project and financial management for international family planning projects. Beyond that, for most of my public health career, I have conducted and contributed to a range of research projects on global and local reproductive health issues, menstrual equity, qualitative analysis, and engaging with community stakeholders.

While looking for a practicum, I knew I wanted to explore different aspects of reproductive health, specifically outside of family planning. After a lot of reflection, I realized I had never been involved in the initial stages of a study. I see my practicum with the UNC-Wits RHI as an opportunity to build upon this, my interests, create deliverables for the study (a clinic checklist and an interview guide), while also learning significantly more about global HIV inequities, transgender care, and implementation science research in Johannesburg, South Africa. Ultimately, I am thankful to be given this practicum opportunity and be tangibly closer to UNC-Wits RHI’s research work.

Rho (gray cat on the left) and Taylor (senior dog on the right) are the two pets that I have taken care of this summer. They have both been great companions while I recovered from COVID

With that being said, the first few weeks of my practicum were challenging. I was recovering from back to back COVID infections and a pulled nerve in my back, which has made adjusting to a schedule difficult. Thankfully, I have fully recovered and I have been able to catch up with some friends, pets like my friend’s cat (Rho) and a senior dog (Taylor), and I made friends with an Eastern Bluebird fledgling. With that being said, I am still trying to build structure in the same way that classes and working provided me, but for my practicum workflow instead. This is still a work in progress!

I certainly did not see all of the unexpected hurdles when I started my practicum, but I continue to try to find the little things that keep me energized when it comes to my practicum work.

Cheers to finding the little things this summer!

-Maria

Mildred Blueberry - the Eastern Bluebird fledgling that flew directly up to my roommate and I. And he made himself at home for 4 days before flying off my balcony. Truly the highlight of my summer so far! — Mildred Blueberry – the Eastern Bluebird fledgling that flew directly up to my roommate and I. And he made himself at home for 4 days before flying off my balcony. Truly the highlight of my summer so far!