Nov 20, 2024 | AIGH, Community
Rt. Honorable Prime Minister KP Sharma Oli, during his visit to New York for the 79th United Nations General Assembly, made a notable stop at The Mount Sinai Hospital to acknowledge the critical work being done through AMPATH Nepal.
In his address, Prime Minister Oli emphasized the challenge of health inequity that exists across the globe. He pointed out how, despite advancements in science and technology, many resource-limited countries like Nepal struggle to provide equitable healthcare services. Due to financial constraints and limited infrastructure, millions of people in poorer countries are denied access to essential and quality health care. The Prime Minister called for greater international cooperation and partnerships to bridge this gap, noting that access to quality health services should not be a privilege limited to wealthy nations.
“Despite gradual improvement in Nepal’s health sector with the implementation of Sustainable Development Goals, the partnership of the international community is necessary for modern and infrastructure-equipped health services,” he said. “I would like to thank Mount Sinai Hospital for its collaboration with Kathmandu University and Dhulikhel Hospital in training, research, and resource mobilization to support Nepal’s health sector.”
AMPATH (Academic Model Providing Access to Healthcare) Nepal plays a pivotal role in addressing these challenges. With partners such as Mount Sinai, Dhulikhel Hospital, and Kathmandu University School of Medical Sciences, AMPATH Nepal is leading the way to improve care and strengthen health care systems, advance research, and enhance training for healthcare professionals.
Biraj Karmacharya, PhD, Administrative Director of Dhulikhel Hospital (DH) and Co-Director of AMPATH Nepal, expressed enthusiasm for the Prime Minister’s recognition. “The government of Nepal has always been one of the strongest allies of Dhulikhel Hospital. The visit of PM Oli is a testament to the fact that the government support to the endeavors of DH and this partnership is unwavering. We will continue to harness this unique support to enhance our impact at a larger national level.”
Rajeev Shrestha, Chief of Research and Development Division at Dhulikhel Hospital, also echoed the Prime Minister’s sentiments, noting that AMPATH’s efforts are bolstering Nepal’s ability to manage and treat chronic illnesses. By expanding specialist services and bringing international expertise to local health care settings in Nepal, AMPATH is helping to address significant unmet needs in the population. AMPATH’s work in Nepal includes specialized treatment programs focused on non-communicable diseases like heart disease, kidney disease, and cancer—critical areas of need given that more than 70 percent of deaths in Nepal are attributed to these conditions.
This visit by Prime Minister Oli highlighted the importance of collaborative efforts in health care. Nepal’s commitment to universal health care, combined with the support of international partners like Mount Sinai, is paving the way for sustainable improvements in the country’s health system.
The partnership reflects a model for global cooperation, where academic health centers and governments work together to deliver high-quality health care, train the next generation of health professionals, and ensure that no one is left behind in the pursuit of health and well-being. Prime Minister Oli’s recognition of these efforts serves as a reminder of the power of global partnerships in building a more equitable health care system for all.
Rose House, MD, MS
AMPATH Nepal Partnership Director
Associate Professor, Arnhold Institute for Global Health
Department of Global Health and Health System Design
Icahn School of Medicine at Mount Sinai
Oct 4, 2024 | AIGH
Since 2021, a global-local collaboration between Mount Sinai and NYC Health + Hospitals called the NYC Partnership has funded pilot projects that address health inequities faced by communities in Queens. These Pilot Project Awards encourage investigators at Mount Sinai, NYC Health + Hospitals/Elmhurst, and NYC Health + Hospitals/Queens to collaboratively consider health challenges and design research investigations, care interventions, and/or trainings to address them.
The collaborative nature of these awards has benefited previous recipients. Eyal Shemesh, MD, a 2023 awardee investigating a cardiology care engagement intervention, noted, “The grant was instrumental in allowing us to set-up and maintain a new and successful research partnership between the two institutions, a relationship that will now not be limited to the specific project related to the grant but, rather, will move forward with other initiatives.” Dr. Shemesh is a Professor of Pediatrics, and Psychiatry at the Icahn School of Medicine at Mount Sinai and directs the behavioral precision medicine program at The Mindich Child Health and Development Institute.
The community benefits as well. Deborah Reynolds, MD, Co-Principal Investigator with Dr. Shemesh, noted, “Our patients were absolutely thrilled with the project. According to their own testimonies, it made them feel like they are participating in a community effort to help our providers learn how best to improve support—not just for the participants, but for others who receive care at the cardiology clinic.” Dr. Reynolds is an Assistant Professor, Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai.
This is the spirt of these awards. The NYC Partnership aims to continue to meet the needs of these communities through these awards and is pleased to announce the recipients of the 2024 NYC Partnership Pilot Project Awards. A 23-member Selection Committee conducted an NIH-style review of 20 applications. The Committee selected five projects for funding of up to $25,000.
Improving Inpatient Care for the Transgender Population in Queens, NYC: Joan Curcio-Williams, MD, Jessica Lichter, MD, and Guangdong Liu, MD
Transgender people experience significant health disparities and often receive substandard care. Many clinicians have not been trained to provide evidence-based, culturally competent care for this population, and operate in health care systems designed from a cisgender framework. There have been interventions to better address the health needs of transgender patients in the outpatient setting, but few have focused on inpatient hospitalizations. To address this gap, this project at NYC Health + Hospitals/Elmhurst aims to educate clinicians on providing optimal care for transgender patients in the inpatient setting and develop guidelines that safeguard the needs and dignity of this vulnerable population during acute hospitalizations.
Characterizing Children in Street Situations in New York City: A Mixed Methods Study: Lonnie Embleton, PhD, MPH
New York City’s migrant crisis has resulted in children in street situations selling candy and other items in the subway and begging on the streets with their families. Children in street situations rely on the street to live and/or work by themselves or with friends or family. These children often face social, health, and economic disparities and human rights violations. Their presence in NYC requires attention and interventions to ensure their well-being. This necessitates accurate data on these children’s social, economic, and health circumstances. This project will characterize the circumstances of children in street situations aged 5 to 17 years through a field-based survey of these children; a cross-sectional survey of a sample of these children, who will also receive a well child checkup at NYC Health + Hospitals/Elmhurst and be enrolled in NYC Care or Child Health Plus; and in-depth interviews with a sample of parents of these children.
Impact of a Virtual Healthy Lifestyle Intervention for Children and Adolescents with Obesity: Joan Han, MD and Thaina Rousseau-Pierre, DO, MS
In the United States, pediatric obesity affects 20 percent of children and adolescents, with higher rates among Hispanic and Black youth. The 2023 American Academy of Pediatrics (AAP) guidelines for childhood obesity treatment recommend intensive health behavior and lifestyle treatment (IHBLT) to improve nutrition and physical activity habits. Virtual IHBLT programs reach a larger population than in-person programs, but efficacy data are lacking and needed. Since 2021, the Pediatric and Adolescent Clinics at NYC Health + Hospitals/Elmhurst have been piloting a virtual 18-week IHBLT program developed and led by Larissa Polanco, MD, that meets AAP standards for patients age 8-17 years. This project will assess the impact of this program on physical and mental health outcomes and aims to improve the program through surveys, focus groups, and semi-structured interviews of past participants. Based on these data, the IHBLT program will be expanded to the Healthy Lifestyle Clinic for pediatric obesity treatment at Mount Sinai Hospital.
Assessing Barriers to Health Care and Enhancing Health Care Access for Latinx Immigrant Workers: Homero Harari, ScD, Adina Valceanu, MD, and Laura Sirbu, MD
Nearly 75 percent of Latinx immigrants in New York City work in occupations that deem them “essential workers,” however these jobs can put them at higher risk for occupational injury. Many of these workers do not receive health insurance or paid sick leave and are unaware how to address their injuries and health needs. Through a collaboration between the Mount Sinai Selikoff Centers for Occupational Health (SCOH) and NYC Health + Hospitals (H+H)/Queens, this project aims to assess this gap in care through focus groups of workers, semi-structured interviews with SCOH and NYC H+H/Queens employees and key community stakeholders, and a survey of workers from different occupational sectors. Based on these results, a referral system between NYC H+H/Queens and SCOH will be created to address the occupational injuries of this population, with the goal to expand this pilot project to all ambulatory NYC H+H sites.
Digital Inclusion and Risk Communication to Improve Blood Pressure Control in the Emergency Department (ED) (INCLUD-ED): Phase 1 Planning: Kimberly Souffront, PhD, RN, FNP-BC, FAAN
Elevated blood pressure detected during an emergency department (ED) visit can be a predictor of chronic uncontrolled hypertension. There is variability in hypertension management in the ED. This project will develop a novel intervention that will use electronic health records to identify patients in the ED at NYC Health + Hospitals/Elmhurst with sustained asymptomatic hypertension and provide them a tailored risk communication intervention led by an ED nurse. These patients will be referred to a digitally inclusive remote patient monitoring program that does not require Wi-Fi and is supported by clinical pharmacists for up to 12 months, regardless of insurance status, to further manage their hypertension.
The NYC Partnership congratulates the award recipients and looks forward to working with them to address the needs of communities in Queens.
The NYC Partnership is a collaboration between the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, the Global Health Institute at NYC Health + Hospitals/Elmhurst, NYC Health + Hospitals/Elmhurst and NYC Health + Hospitals/Queens. The NYC Partnership Pilot grant program aims to stimulate innovative, collaborative, and multidisciplinary projects to improve the health of our community.
Payal Ram is the Research Program Coordinator for the New York City Partnership at the Arnhold Institute for Global Health and the Department of Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai and the Global Health Institute at NYC Health + Hospitals/Elmhurst.
Updated on Sep 12, 2024 | AIGH
Building off our inaugural summit in January 2023, the Mount Sinai Adolescent Health Team gathered in Eldoret, Kenya, to host the second AMPATH-Kenya Adolescent Health Summit.
More than 200 participants attended the three-day event, where adolescent health care specialists, researchers, government officials, peer navigators, and health-minded youth gathered to learn, share, and connect with colleagues in the field. Activities included educational sessions, workshops, interactive roleplay, and strategic planning for the coming year. The event was held Monday, June 17, to Wednesday, June 19.
Faculty from the Arnhold Institute for Global Health at Mount Sinai, as well as Moi Teaching and Referral Hospital, kicked off the summit with presentations on the state of adolescent health at AMPATH across the domains of reproductive health and mental health, among others.
Salim Bakari, a founding youth peer mentor in the AMPATH program in western Kenya and senior researcher in the AMPATH pediatrics program, led a youth panel discussion focused on the theme of innovations in adolescent health across AMPATH
Lonnie Embleton, PhD, Co-Chair of the AMPATH Adolescent Health Working Group (AHWG) and an Assistant Professor in the Department of Global Health and Health Systems Design at the Icahn School of Medicine at Mount Sinai, presented on the state of adolescent- and youth-friendly health services in Uasin Gishu County. Salim Bakari, a founding youth peer mentor in the AMPATH program in western Kenya and senior researcher in the AMPATH pediatrics program, led a youth panel discussion focused on the theme of innovations in adolescent health across AMPATH.
Day one concluded by highlighting AMPATH innovations in adolescent health, including projects led by Edith Apondi, MBChB, Mmed, who is the Consultant Pediatrician and founder of the Rafiki Centre of Excellence in Adolescent Health at MTRH and works with the Kenyan Adolescent HIV Implementation Sciences Alliance (KAHISA), and Florence Jaguga, MBChB, Mmed, who is the Consultant Psychiatrist at MTRH and works on screening and brief interventions for youth substance use disorders.
The second day of the summit focused on education. It began with a keynote address from Sabrina Kitaka, MD, PhD, founding president of the Society of Adolescent Health in Uganda and Senior Lecturer and Adolescent Health Specialist at Makerere University, who discussed founding adolescent health in Uganda. Then, faculty and youth awardees of the 2024 Mount Sinai RFA presented on their planned work. In the afternoon, summit participants split up to attend small-group education sessions. Topics included adolescent contraception, mental health, structural and social determinants of health, adolescent development, transitions from pediatric to adult care, and engaging youth as meaningful partners in research.
Day three of the summit began with a keynote address from Mary Ott, MD, MA, Professor of Global Health and Pediatrics and Associate Director for Youth Health Programs at the Arnhold Institute for Global Health. Dr. Ott spoke on Human Rights and Adolescent Health. Then, Dr. Ott moderated a panel of six adolescent health specialists discussing strategies for effectively communicating with young people.
Panelists included Dr. Apondi; John Steever, MD; East African specialist Njeri Karianjahi, MBChB, MmEd, consultant pediatrician at the University of Nairobi and Gertrude’s Children’s Hospital; Katherine MacDonald, MD, and Dr. Kitaka. After the panel, participants broke into small groups to practice, with youth participants playing the role of adolescents, and conference attendees practicing interview skills.
Rachel Vreeman, MD, MS, Chair and Professor in the Department of Global Health and Health System Design and Director of the Arnhold Institute for Global Health, facilitated an interview-based role play session
After the formal closing of the summit by Rachel Vreeman, MD, MS, Director of the Arnhold Institute for Global Health, and Dr. Apondi, AMPATH consortium members stayed after lunch for an afternoon of strategic planning for the coming year, across the domains of sexual and reproductive health, mental health, peers and youth participation, and adolescent and youth-friendly services and community advocacy.
After a long and productive week in Eldoret, attendees filled out a feedback form about the summit. More than 90 percent reported that the summit helped them develop new project ideas, presented knowledge relevant to their work, improved their knowledge and skills related to adolescent health, and facilitated collaboration with their colleagues in the field of adolescent health. We are so grateful for everyone’s participation and cannot wait until the next summit.
Ava Boal is an Associate Researcher at the Arnhold Institute for Global Health and the Department of Global Health and Health System Design.
Updated on Jun 27, 2024 | AIGH, Community, Featured
Since 2021, the Emergency Medicine Global Health Division at Mount Sinai has partnered with the Indian Health Service to provide physician and physician assistant staffing, operational assistance, and educational support at the Cheyenne River Health Center in Eagle Butte, South Dakota.
This remote, critical access hospital comprises an emergency department, a 10-bed inpatient unit, and community outpatient center. The Emergency Department serves about 30 patients daily from the local population on the Cheyenne River Sioux Reservation.
“The partnership has evolved from a few intermittent weeks of staffing to the point where we now expect to provide nearly 28 weeks of full-time attending physician staffing this year,” says John Rozehnal, MD, MS, Assistant Professor, Emergency Medicine, who leads the partnership with Indian Health Services.
John Rozehnal, MD, MS
Mount Sinai Emergency Medicine physicians and other health care providers who participate are given the opportunity to manage a wide range of emergency medical concerns and provide comprehensive critical intervention while developing knowledge of the indigenous culture to enhance their care. Other health care providers include physician assistants and residents, including four Emergency Medicine 2024 graduating residents who supported the partnership.
Recently, the team was successful in assisting with the implementation of a new point-of-care ultrasound (POCUS) equipment and programming, including training that has begun with an education project on the placement of ultrasound-guided IV lines, the performance of regional anesthesia, and the use of bedside diagnostic studies helping to assess pregnancies. Without these new services, patients would often require transfer to a hospital more than an hour away.
The growing partnership between Mount Sinai and Indian Health Services includes a variety of quality improvement projects, such as implementing clinical protocols and improving cultural competencies and quality and safety initiatives.
“We look to further integration with the local team at Eagle Butte and to help develop area-wide initiatives to further both teach and learn from the facilities and patients in the Great Plain Area,” says Dr. Rozehnal.
Updated on Mar 21, 2024 | AIGH
Ashley Chory, MPH, and Dennis Munyoro
The International AIDS Society (IAS) focuses on advancing HIV care and helping those living with or affected by HIV. The 12th biennial IAS Conference on HIV Science presented critical advances in basic, clinical, and operational HIV research that move science into policy and practice. The mission of the conference is centered around supporting polices of stigma reduction and to use evidence based data to inform attitudes, decisions and actions.
Dennis Munyoro is a peer researcher at the MTRH-Rafiki Centre for Excellence in Adolescent Health at AMPATH who was awarded a scholarship opportunity to attend the IAS conference in Brisbane, Australia. His work on engaging children and adolescents living with HIV and serving as a co-author on publications concerning adolescent stigma and ethics made him the perfect candidate to attend this conference. He became a peer navigator in 2016, and in 2021 transitioned to being a peer researcher after he aged out of the program. He discussed his experience at the conference with Ashley Chory, MPH, Global Youth Health Senior Program Manager, and Sakshi Sawarkar, MPH, Associate Researcher.
If you could describe your experience at the IAS conference in one word what would it be and why?
Amazing! Attending the conference opened my mind to new ideas in the field of HIV adolescent care. I was able to understand what the needs of adolescents are in different parts of the world compared to my country (Kenya) and what innovations could work best in my setting. For example, the use of technology to deliver information or linkage to care for people living with HIV.
What did you find to be the conference’s highlight?
The highlight of conference for me was a session titled “How to write a research manuscript: Publish or perish.” Since my interest is more focused on writing and publishing, this session was an eye opener for me as a young person venturing into the research world with the aim of finding solutions to gaps in care and treatment of HIV, especially for adolescents and young adults. Even though as young people we do so much in this area, we do not publish our work or findings.
What was your main takeaway from the conference?
I was very interested in the research aspect of the conference, particularly how to write a good abstract and proposal. This has been a significant help in advancing my career since it has provided me with valuable advice on how to draft strong proposals.
Did you meet other researchers who also work in the field of adolescents living with HIV? If so, could you share any insight into their findings that you found most fascinating? Were there any concepts you could apply into your own research?
Getting the story and telling it right is another area that fascinated me while interacting with the other researchers in the conference. There are a lot of untold stories that could give valuable lessons in terms of success stories or gaps, and if told right it could inform others on how to better implement programs in different dynamics and cultures. There was a concept of embracing and integration of eHealth in the care of HIV. I am more focused on adolescents and young adults, and the introduction and adoption of eHealth and social media platforms would be beneficial to this population since a significant number of them live in the digital world. If they get their information on the internet, it would be the right place to disseminate information to this population.
What was it like connecting with others who are just as passionate about helping adolescents living with HIV?
Attending the conference provided me with a unique opportunity to interact with various young people from different countries and cultures just as passionate as I am in the fight against HIV. Exchanging information with others in this field gave me a good insight on trying out different approaches in delivering care, especially exploring the use of tele-medicine and social media to demystify misconceptions in the community, which will have a great impact in stigma reduction.
Were there any presentations that helped you expand your knowledge about HIV outside of the context of adolescents?
There was a presentation on opportunistic infections being underdiagnosed until it is too late, for instance tuberculosis. The introduction of regular screening in the care unit would change this which will help the client get treatment early enough to contain the infection before it’s too late.
Was there a specific poster, abstract, or study that had a significant impact on you?
Yes, there were a lot of interesting posters in the conference that were intriguing. But the one I found most interesting was a study conducted in the southern part of Africa, where the researchers set up safe-like centers to dispense medications for potentially life-threatening illnesses, such as AIDS. When a client registers, they are notified of the passcode for the safe box their medication is in, and it can be picked up any time. The purpose of adding these medications to this program was to avoid stigmatization in the community. I believe with the right approach in my community, this program would be of value, especially to stable adolescents attending school while living with HIV.
What kind of opportunities did you get from attending this conference?
I had the opportunity to meet with the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) organizers where I was able to secure an online scholarship to attend the conference in Zimbabwe in December 2023. Participating in the conference provided me with an opportunity to network with young people along with various organizations at the conference.
What was your favorite part of your trip outside of the conference?
I really enjoyed my interactions with different organizations in the expo booths. It was refreshing getting to know the different technologies organizations are using to provide better access to HIV management and care. Outside the conference, I enjoyed the environment in Brisbane, the people, food, and culture. The city is one of the best I have ever visited and it was a great experience overall.
Ashley Chory, MPH, is Senior Program Manager, Global Adolescent Health for the Kenya partnership at the Arnhold Institute for Global Health and for the Department of Global Health and Health System Design.
Sakshi Sawarkar, MPH, is an Associate Researcher, Arnhold Institute for Global Health and Department of Global Health and Health System Design
Updated on Mar 20, 2024 | AIGH
Doulas providing information about doula care at a National Council of Negro Women, Inc. (NCNW) Power of Pregnancy Event. Top row: Christine, left, and Sora. Bottom row, from left: Harriet, Denise, and Donna.
Have you heard about doulas? Wondering who doulas are and what they do?
Doulas are trained coaches who provide non-judgmental, educational, emotional, and physical support during pregnancy, labor and birth, and the postpartum period.
Traditional doulas can provide strategies for self-care during pregnancy and for post-natal healing. They can provide hands-on pain-management techniques (such as breathing, positioning, massage) during birth, and they can assist their clients with communicating their questions, preferences, and values to their health care team. They also assist with strategies for newborn sleeping, breastfeeding, and overall assistance with transitions into parenthood.
Community-based doulas go even further by providing support beyond pregnancy and postpartum care. They connect their clients with additional resources such as food, clothing, baby supplies, mental health services, legal and immigration services, and anything else they may need. These doulas are from the communities they serve. They speak the same languages, and share backgrounds with the clients they serve; this makes it easier for individuals to connect with and access culturally appropriate and culturally competent care.
“If a doula were a drug, it would be unethical not to use it.” – John Kennell, MD, noted pediatrician and researcher at Case Western Reserve University in Cleveland known for support of doulas
From 2011 to 2018, there has been an alarming rate of pregnancy-related death, which is eight times higher for Black women than white women, and the rate for Hispanic and Asian women is twice that for white women. Additionally, COVID-19 has worsened this crisis, with minority pregnant women becoming infected at a higher rate than white pregnant women and having higher rates of death from COVID-19.
Doula care can help mitigate these health inequalities. Research has shown that having a doula can improve a person’s birthing experience, and increase their ability to initiate and continue breastfeeding. Additionally, doula care can contribute to shortening the length of labor, reduce the need for epidural and analgesics, decrease the incidence of cesarean sections, and reduce the risk of postpartum depression.
The Arnhold Institute for Global Health NYC Partnership is excited to share its efforts to increase doula care through “Helping Promote Birth Equity through Community-Based Doula Care” or HoPE, which is a program that has been developed in partnership between Mount Sinai the Icahn School of Medicine at Mount Sinai, NYC Health + Hospitals, NYC Health, Ancient Song Doula Services, and Caribbean Women’s Health Association.
The HoPE program provides community-based doula care and support free of cost, to anyone who is pregnant, giving birth, or gave birth recently at either Elmhurst Hospital or Queens Hospital. HoPE is made possible by our generous funders which include Robin Hood and the New York Health Foundation.
You may have seen some of our HoPE doulas in the waiting rooms at Elmhurst or Queens hospital, at community baby showers, resources fairs, and other local events focused on maternal health, health education, and health equity.
On average HoPE doulas provide four to eight prenatal visits, are present during the entire duration of labor, and provide 8-18 postpartum visits up to one year after birth. HoPE doulas are from the Queens community and speak many languages including Spanish, Bangla, Urdu, Punjabi, Hindi, Nepali, Haitian Creole, and Twi. HoPE doulas are advocates for the patients they serve. To better serve our Queens community, the HoPE program is working towards providing further specialized doula care and support to birthing persons experiencing housing insecurity or homelessness as well as justice-involvement or incarceration. Our work with homeless individuals and incarcerated birthing people is made possible by our funder, The Leona M. & Harry B. Helmsley Charitable Trust.
If you are giving birth at Elmhurst Hospital or Queens Hospital and are interested in working with a HoPE doula, request doula services by speaking with your health care team at your next visit or by calling 646-619-6721 and requesting a referral to the HoPE Doula Program.
Kanwal Haq, MS, is the Program Manager for the New York City Partnership at the Arnhold Institute for Global Health and the Department of Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai.
