Greetings from Ghana…and Togo?

MAZA tricycles at the Bunkpurugu Health Center.
MAZA tricycles at the Bunkpurugu Health Center.

One of my biggest motivations in pursuing a public health career and degree is the opportunity to contribute to the existing efforts across the country to improve maternal, infant, and child health in the nation. MAZA has afforded me this opportunity with this summer practicum. MAZA is a social enterprise that provides safe, accessible, affordable and reliable transportation for urgent and emergency health care needs in remote rural areas of Ghana, with a focus on pregnant women and sick infant. They lease motorized tricycles to local drivers at a discounted price in exchange for their being on call for urgent/emergency health care transportation twice a week. For the other five days of the week, the drivers use the tricycles as taxis to earn a living and pay a weekly fee to MAZA. After two years, they own the tricycles outright. MAZA’s service is available 24 hours a day, seven days a week through a toll-free number or by direct contact with the local drivers.

A community in the Bindi Subdistrict of the Bunkpurugup Yunyoo District.
Another community in the Bindi Subdistrict of the Bunkpurugup Yunyoo District.
A community in the Bindi Subdistrict of the Bunkpurugup Yunyoo District.
A community in the Bindi Subdistrict of the Bunkpurugup Yunyoo District.

MAZA has been in the Bunkpurugu-Yunyoo District for a year now and has provided transportation during emergency/urgent health care needs for over 200 passengers since. My practicum is a field assessment focused on exploring the geographical limits of MAZA’s intervention in the Bunkpurugu-Yunyoo District. My first week in the Northern Region was spent in the field in Bunkpurugu-Yunyoo collecting location data of MAZA drivers and passengers to investigate the distance between drivers commute to pick up passengers and take them to a health care center during emergencies. Working in this part of Ghana – rural, open, bright, unlike what I’m used to in the capital city of Accra – has been nothing short of exciting.

about to cross the river behind me into Togo. The river acts as a physical boundary between Ghana and Togo in one of the communities in Bunkpurugu.
About to cross the river behind me into Togo. The river acts as a physical boundary between Ghana and Togo in one of the communities in Bunkpurugu.

Little did I know there are communities in this part of the country, that have existed for decades, are now divided by superficial international border lines delineating Ghana from Togo. There are literally families living in the same community with one family’s house in Togo and the other in Ghana. Wild right? That’s one of the most fascinating things I’ve encountered here. As such, there are families technically living in Togo that have benefited from MAZA’s services because they are a part of a community that is also Ghanaian and visit the health facilities in Ghana.

This week, I go back to the rural areas for the second part of the project – community assessment. Looking forward to sharing those experiences with you all.

 

-Edith

Muli bwanji?

Lone tree in the fields in the edge of town
Lone tree in the fields in the edge of town

Muli bwanji? In Malawi you hardly ever have an exchange without asking the other person how they are, and you can be sure you’ll always be asked back. The country is known as “The Warm Heart of Africa,” and all who visit have the opportunity to confirm this statement. Since 1990, it has hosted the UNC Project-Malawi (UNCPM), a collaboration between UNC Chapel Hill and the Malawi Ministry of Health. It is located on the campus of Kamuzu Central Hospital in the capital city of Lilongwe. The project’s mission is to identify innovative, culturally acceptable, and affordable methods to improve the health of the people of Malawi, through research, capacity building, and care. The scope of activities has diversified since then.

Lake Malawi on a Monday afternoon
Lake Malawi on a Monday afternoon
UNCPM New Annex Building
UNCPM New Annex Building

Before I moved to North Carolina and started the MPH program in the department of Health Behavior, I lived in Lilongwe from 2013 to 2016, working for the Brazilian Ministry of Foreign Affairs. In 2015, I met my wife when she was working at UNC Project-Malawi and because of her research in pediatric oncology we have kept in contact with the project since we moved. This summer I was fortunate enough to join the project to work on a research study called, “Mother Infant Retention-Promoting Mother Infant Retention along the HIV Care Continuum: A Comparative Effectiveness Evaluation of Three Models for Community Facility Linkage.” The study’s goal is to characterize widely adopted community-facility linkage models and assess the impact on mother-infant pair care retention and the Prevention of Maternal-to-Child Transmission (PMTCT) of HIV under “real world” conditions in Malawi.

Panoramic View of the Area 25 District Health Center
Panoramic View of the Area 25 District Health Center

My participation in the study involves a literature review describing issues of HIV linkage to care during the Universal Test and Treat area in Sub-Sharan Africa and other high-burden settings. The review should be published in a special supplement about linkage to care in the AIDS and Behaviour journal, and I will be included as one of the co-authors of the article. For the past week, I have been accompanying the study team during their last data collection activities in two sites near Lilongwe, before they move to other sites in the north of the country. For the rest of my practicum I will be working with an epidemiologist to conduct an interim data analysis and the study’s coordinator to prepare an interim report for the study funder, USAID/PEPFAR, and for key Malawian policymakers.

That’s me making sure I spell names properly
That’s me making sure I spell names properly
Part of the study team in Area 25 (L-R: Nicole Carbone, Blessings Chisunga and Godfrey Banda)
Part of the study team in Area 25 (L-R: Nicole Carbone, Blessings Chisunga and Godfrey Banda)

 

 

 

 

 

 

 

-Rigo

 

Greetings from Uganda!

My name is Kirsten Miner and I’m a first year MPH student in the Maternal and Child Health department. I’m passionate about reproductive health and family planning, particularly for those women who live at the “last mile” – women who live and work in rural areas for whom access to health care is a challenge. I’m interested in learning about novel ways the global health community is tackling this challenge, and I couldn’t have found a better internship to explore this interest than my current practicum: the Sayana® Press project under PATH Uganda!

The evaluation team waits under a mango tree at Amwa Health Center II. (From left: Happy Johnson Byamugisha, Chloe Morozoff, Paul Kimwumwe)

Sayana®  Press is an all-in-one injectable contraceptive offering three months of pregnancy prevention. It is similar to Depo-Provera, another injectable contraceptive that is widely popular across Sub-Saharan Africa. However, Sayana® Press is unique in that it doesn’t require a trained health professional to administer it. Lay health workers such as Community Health Workers, and even women themselves, are qualified to inject with appropriate training. This makes Sayana®   Press an excellent solution for women living in rural areas: they can access training through their health center and then take home enough units to use for up to a full calendar year, preventing frequent returns to the clinic to access contraceptive services.

Amwa Health Center II facing an impending rain storm.

For my practicum, I joined PATH’s Advancing Contraceptive Options project which is the major driver for Sayana®   Press introduction in Uganda and has been training Ugandan women in four districts to self-inject with the drug. This week (my first week on the project!) the team launched Phase I of their evaluation of self-injection in order to determine best practices and cost-efficacy. I was able to join the evaluation team on a site visit to Oyam District in northern Uganda to support the launch and learn the ins and outs of the evaluation process.

 

The Kampala evaluation team and Oyam District research assistant team finalize their work for the week. (From left: Chloe Morozoff, Oliva Edonga, Kirsten Miner, Bernard Okella, Harriet Aduk, Paul Kimumwe. Photo credit: Chloe Morozoff)

I’m excited to continue participating in the evaluation and learning about the project!

-Kirsten