Updated on Sep 13, 2023 | AIGH
AMPATH Nepal recently hosted its first strategic planning workshop with stakeholders from the Icahn School of Medicine at Mount Sinai, Dhulikhel Hospital-Kathmandu University Hospital (DH-KUH), Kathmandu University School of Medical Sciences, AMPATH Kenya partners, and members of the AMPATH Secretariat. This process strengthened a shared vision and defined strategic priorities for work together over the next five years.
Rachel Vreeman, MD, MS, Chair of the Department of Global Health and Health System Design and Director of the Arnhold Institute for Global Health at Icahn Mount Sinai, led us in an exercise to envision together how the partnership can indeed bring “quality health care for all.” We reviewed AMPATH’s vision: “a global partnership to ensure health for all,” which aligns well with DH-KUH’s vision of “quality health care for all.”
Our connection related to care stood out for all of us: Ampath’s motto of “leading with care” and DH-KUH’s motto of “we care” makes care the center of all we do within our partnership. To reach quality health care for all, we wanted to consider together in each of our priorities how to think across the health system from the community to the referral hospital and across the lifespan of the population to holistically address the health needs of the populations we serve.
Leading up to the strategic planning workshop, we identified priorities in care, education, and research based on burden of disease in Nepal, strengths of all partners, and priorities of our Nepal institutional partners and communities. This led us to prioritize noncommunicable diseases (NCDs), attributing to more than 70 percent of deaths in Nepal. Our work over the next five years will start in the community to develop a comprehensive care model to screen, link, treat, and retain patients with NCDs and incorporate guidelines for referrals. With this, we recognize the need to provide the highest quality subspecialty care within DH-KUH to care for those with complications from NCDs.
A drawing Rachel Vreeman, MD, MS, made during the strategic planning meeting in Nepal
Another care priority includes women’s and child health. While there has been success related to antenatal care and increasing institutional births, we still recognize gaps within ongoing postnatal care and child health. We hope to expand some of the Institute’s prior work using the community health worker model in Dolakha to improve outcomes in these areas. Additionally, as DH-KUH develops high-risk pregnancy services, we will work together to support increasing the number of normal deliveries in community facilities, screening for high-risk pregnancies, and guidelines for referrals. The partnership will also include important women’s health issues beyond reproductive health, such as cervical and breast cancer screening and treatment.
The education team meet in Nepal to discuss multilateral exchange programs.
Over the next five years, we will develop adolescent friendly health services to support the needs of adolescents in the communities served by DH-KUH. AMPATH Nepal is already supporting a population-based needs assessment among adolescents. With this data and input from adolescents, we will support trainings and development of adolescent friendly services in the community and at DH-KUH. This will complement the work AIGH is doing globally related to adolescent health.
For each of these care priorities, we need education and research to support their progress and inform future direction. Both our education and research teams worked together to consider how to grow the infrastructure to support multilateral exchanges, workforce development, and research training and capacity.
We not only strengthened our shared vision and defined priorities for the next five years, but also continued to build relationships and trust. We learned from one another and will always remember the wise words from our AMPATH Kenya colleagues—words of encouragement, reminders that, “Sometimes we will win and sometimes we will learn,” and of course, “If we want to walk fast, walk alone; if we want to walk far, walk together.” So, as we consider the first of many strategic plans, more than anything, we are committed to a long-term partnership of walking together to ensure health for all.
Rose House, MD, MS, an Associate Professor of Emergency Medicine and Pediatrics, has served as Nepal Partnership Director since September 2022. She works alongside Nepal colleagues to develop and support our global health partnership between Mount Sinai, Kathmandu University School of Medicine, and Dhulikhel Hospital in Nepal. She also provides education and clinical care in emergency medicine and pediatric emergency medicine.
Aug 21, 2023 | AIGH
Shurnette Henry
Shurnette Henry is a Senior Finance Manager 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. In her role, she provides financial portfolio management and assists investigators with all aspects of pre-award proposal development, finance, and post-award grants management. She has worked for the Institute for four years. She previously worked at Columbia University Irving Medical Center.
In this Q & A, she discusses her career journey and what inspired her to work in global health.
Can you tell us a little bit about yourself and your background?
I came to New York in 2000 from Toronto and began a career in finance as a stockbroker. I continued in various financial roles over the next 20 years, serving both corporate and individual clients with a broad spectrum of financial products and managing corporate financial portfolios. Over time, I found myself gravitating toward the relationships and aspects of my career that helped people on a personal level.
What inspired you to make a change in your career?
As I progressed through my career, I found that my personal interests for adding value to people’s lives was misaligned with the corporate demands of building wealth. The incentive for wealth generation was more advantageous for the institutions I worked for than for the individuals I wanted to help. Therefore, I left corporate finance and began looking for opportunities that were better aligned with my desire to help people who perhaps didn’t have access to essential information or tools to help themselves. I came onboard to fulfill the Institute’s need to find a grants and finance professional who could develop its inter-departmental grants process and financial management of accounts, and I was looking to work with a team that shared my care for people, and desire to impact people’s lives in a personal way.
What do you like most about working at the Institute?
I love that what we do at the Institute as it affects the lives of people locally and internationally, especially individuals who represent underserved demographics. It’s also an added bonus that the team within Global Health consists of a collection of talented people who all share a common goal of working from a place of mutual respect and appreciation, and work collaborative to make an impact.
What led you to work in global health and what do you like about it?
I’ve always been fascinated with macroeconomics and understanding how different socioeconomic systems affect different people’s lives. Therefore, when I was approached with the opportunity to work in global health, I loved learning about the Department’s mission and the steps it was taking to achieve it. Global health is a field that focuses on improving the well-being and health of people around the world. It goes beyond borders, races, and cultures, aiming to ensure that everyone has access to quality health care, regardless of their socioeconomic status.
The impact that we’re making at the Institute can be transformative as we work with our domestic and international partners to establish health systems, reduce suffering, and improve the quality of life for numerous people. We bring together professionals from diverse disciplines, governments, non-governmental organizations, and communities to find innovative solutions to complex health problems. The contribution that I bring to the team at the Institute allows me to fulfill my desire to contribute positively to the world, make a meaningful difference in people’s lives, and work towards a more equitable and healthier world. It makes me feel really good that I’ve added value in a small way toward a greater goal.
What are some of the most challenging aspects of your career?
One of the most challenging aspects of my career includes dealing with the complexities of funding and budgeting in a constantly evolving and unpredictable environment. Our projects often operate with finite resources, and we are constantly competing within the global marketplace for funding. As a global health department, we regularly collaborate with institutions in other countries that have their own set of financial regulations and compliance requirements. Ensuring adherence and managing cross-border transactions can sometimes present challenges. During these times, it becomes essential for me to work on a deeper level with individuals at our collaborating institutions. This also makes the challenging parts of what I do that much more enjoyable because, depending on the situation, I’ll find myself speaking with dynamic people who are half way across the world.
Finance is undeniably a crucial and necessary part of any business or body of research, and it is true that many people may find it intimidating or overwhelming. I personally believe that, in many ways, the budget informs the important research work that is done, therefore I make it my goal to work with our Principal Investigators to build strong budgets that will support the important work that they do.
What is some advice you would give someone looking to go into finance and grants?
I would encourage anyone seeking a career in finance and grants to pursue relevant training and education in finance, accounting, economics, and business administration, since it touches all of these skill sets. Develop your financial analytical skills, including modeling, budgeting, and forecasting; and stay relevant on shifting trends. Communication is also key because you are continually creating and translating budgets to people who don’t necessarily manage budgets on a regular basis. Finally, try to always be adaptable and resilient so that you can successfully navigate through changes, overcome obstacles, and always be open to learning something new.
Updated on Aug 15, 2023 | AIGH
Peer navigators play an integral role in connecting adolescents with clinical care at the AMPATH Rafiki clinic, but what happens to peers as they transition from adolescence to young adulthood and beyond?
The peer navigator program has immense benefits; it provides many young people with a first job that is fulfilling and rewarding, with opportunities for skills building and learning, as well as career exploration. However, peer navigators eventually age out of the program, as it is only for so long that they are of a similar age as the adolescents they are supporting. These peer navigators are trained and perfectly poised to continue their important work at AMPATH in another capacity.
To maintain involvement in AMPATH and transfer and grow skills, some former peer mentors/navigators turn to getting involved in health and HIV-related research at AMPATH as peer researchers or as part of the Adolescent and Youth Research Advisory Board (AYRAB).
Some peer mentors aspire to become investigators who may lead their own research portfolio. On this path, some peer mentors have transitioned to the role of peer researcher to gain experience and build new skills that will support their career development.
Several of the peer navigators at the AMPATH Rafiki clinic have contributed to research being conducted, and have co-authored several papers with Mount Sinai researchers on topics such as sources of perceived stigma, the impact of multimedia teacher trainings on HIV related stigma, and the prevalence of COVID-19 infection among HIV-infected youth during the pandemic.
Dennis is a peer navigator turned peer research assistant whose first contact with AMPATH was as a patient. He became a peer navigator in 2016, and in 2021 transitioned to being a peer researcher after he aged out of the program.
Dennis has very strong relationships in the community, making him excellent at youth recruitment for studies. He has a pulse on the activities at the Rafiki Centre, as well as in the broader Eldoret community, which also helps to inform our study ideas and procedures. As a peer research assistant, Dennis is also very helpful in picking up on the needs of our participants, and the best ways to engage them. His research focuses on engaging children and adolescents living with HIV, and he has co-authored publications concerning adolescent stigma and ethics.
He sat down with Lonnie Embleton PhD, MPH, an Adolescent Health Advisor at the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, and Assistant Professor, Department of Global Health and Health Systems Design, to discuss peer mentors and peer researchers at the Rafiki clinic.
Tell me about what a peer mentor does and your role at Rafiki and AMPATH as a young person?
My role as a peer mentor is linking adolescents to clinicians, especially finding out the things that are hard for the adolescent to tell people, like in school and to other adults. These are topics like stigma in schools, relationships, positive health, dignity, prevention, and how to adhere to medication. The role of a peer mentor is to help them tackle challenges to adherence. Because I’ve walked through the same journey, I have tricks up my sleeves about how to survive and can share those. At the AMPATH facility, we can talk about advocacy, an adolescent’s personal role in their care, and resource mobilization.
So now you’ve transitioned from being a peer mentor to researcher?
Yes. As a peer researcher, I am engaged in recruiting participants, consenting/assenting, and evaluating. In this specific study, we are evaluating and doing interviews with adolescents, and scheduling them for research visits. I also do some data entry, storage, and visualization, mostly within the sphere of research.
What does it mean to be an adolescent/youth peer mentor in Kenya?
During [a community level stigma reduction study study], we trained teachers on how to impact stigma reduction in schools, and created training modules with school teachers. We taught them how, if they find an adolescent living with HIV in the school, they can create a safe environment in the classroom where students feel free to talk about the challenges they face, their relationships, and even feel comfortable enough to disclose their status.
It means a lot that the peer mentors are a part of the research process. Involvement of young people in medical research, such as the introduction of injectable drugs for HIV, often doesn’t happen. Having a peer navigator involved in research allows for that perspective to be present in the development process.
[Another study] looked at some of the challenges that adolescents are facing throughout the COVID-19 pandemic. As a peer researcher, adolescents feel free talking to me; during the pandemic adolescents would open up to me about lacking food or transport and couldn’t travel [to clinic], etc. So being a peer researcher, I understand the challenges that adolescents face easier than a clinician who is checking their viral loads, for example. I bring friendliness to the adolescent, and they are more honest with me with their thoughts than with the others.
What does the day in the life of a peer mentor or researcher working with adolescents living with HIV look like?
We get to impact a person’s HIV care at the clinic, affecting their treatment adherence and their status from not being virally suppressed to being suppressed. It’s satisfying for a young person to go through that journey with the adolescents and find solutions. Just assisting with an adolescent through the journey, helping an adolescent stay negative, who is already infected, is enjoyable.
Nothing about us without us. Working at Rafiki, I get to understand the needs of the adolescents and channel those concerns forward. Whenever the researchers are making policies or programs, they can see what the adolescents need. With this knowledge, we can create adolescent services to fill their unique needs. So, that is most enjoyable. There is also an advocacy aspect—I get to interact with the outside population and understand and correct myths and misconceptions [about HIV].
How has being a peer mentor and researcher changed your life?
I got to learn a lot about how research is done and some of the priorities I need to make for my own future career. I was mentored on how to write an abstract and manuscript, and I got to travel to the 2019 International Conference of AIDS and STIs in Africa to discuss my work and learn from others. It is interesting and empowering to sit down with policymakers at a summit and tell people what would work, and what would not, and what should be prioritized, based on my experience and knowledge. The journey is great, and is helping me figure out which line of medical research I want to work with. I am currently interested in mental health.
What do you envision in your future career?
I am interested in research and, as a peer in research, I want to answer some of the questions and knowledge gaps I see. I think research will empower me to answer questions I have myself. Research tells us why and how we can improve. I am early in my education, and much more interested in those young people, who have not yet graduated with degrees, and how they can implement innovative ideas they have.
What is one thing that you wish people knew about the role of youth peer mentors?
That it’s hard. It is not as simple as it seems to be a peer mentor. You have to understand mental health, medications, BMI and nutrition; you are partly a social worker for adolescents one-on-one to understand what is going on at home. You are a mini-bit of every role in the facility.
People think peer mentorship is simply a young person talking to another young person. But you have a role in everything. With viral load, for example, you know the person’s value and we have to understand what this means; how this pattern reflects the client’s health. Because we do, we can figure out if they need to see a clinician, nutritionist, or a social worker. So, you need to understand all of the aspects of care for a young person to know how to support them and help link them to the care they need when they confide in you.
What are some of the challenges of being a peer mentor?
The challenges are lack of training. In the world of HIV, information is constantly changing. We get stuck with the old recommendations and need updated information. Young people have to look for the information themselves. We need a structured way to get the most up-to-date information as quickly as possible, and a structured way of training. If you are not constantly looking for updates, you will get stuck with the old information because there is no standardized reporting tool. For example, nevirapine [a medication to treat HIV] is still there, but in the process of being phased out.
What motivates you as a peer mentor?
Getting to walk on the journey with young people, because I’ve been there myself. Getting to assist a young person, it feels good to have impacted someone’s life for the better. Now I have networks, and networking with other people gives me insight into what is currently going on, and what I can do in the facility to get on that level and help. Most of the peer mentors are in the community, but we are in the facility, so we are limited in engaging with what other organizations are doing. I’m also motivated by the linkages to attend conferences and HIV workshops–funded by AMPATH.
Outside of being a peer mentor/researcher, what do you like to do?
I play chess, I play football, I like going on trips, taking walks, and long road trips. I enjoy engaging with community-based organizations and other organizations to see what is being initiated and what can I do to facilitate programs that will work in our facility. Some examples include safe spaces, mental health spaces, safe environments for young people, new [treatment] drugs being rolled out, etc. I am also passionate about using digital platforms to empower young people to advocate for healthy behaviors.
A lot of my interests circulate around health. I am also passionate about creating an adolescent camp. It would be interesting; a peer mentor adolescent camp/club, where we could engage for a week or four days outside of the clinic and talk about their challenges. It would be great to have the chance to debrief among peer mentors—we hear and see a lot, but who sees us?
What are three words that best describe you?
Enthusiastic. Self-driven. Creative!
What do you want the world to know about young people and young people in Kenya?
They have the push and the drive to find solutions for themselves. Kenya is a competitive country, every young person has something unique about them. They have grit. Young people are mostly self-driven, with an explosion of ideas to implement. Getting the ability to implement them is a challenge, figuring out how to take their ideas to fruition, so they can make a difference in the community.
Lonnie Embleton, PhD, MPH, is an Adolescent Health Advisor and Assistant Professor, Department of Global Health and Health System Design.
Ava Boal is an Associate Researcher, Arnhold institute for Global Health and Department of Global Health and Health System Design.
Jul 28, 2023 | AIGH
Attending the conference at Mount Sinai are, from left: Raymond Aborigo, PhD, Helen McGuire, MHSc, David Heller, MD, MPH, and Engelbert Nonterah, MD, PhD.
Since 2017, I’ve been privileged to collaborate with Ghana’s Navrongo Health Research Centre (NHRC) to explore and develop new care models to treat chronic diseases like high blood pressure and depression.
We work in rural communities where there is often no doctor. Our hope is to create and refine programs that improve primary care access worldwide, including in the rural United States, by training nurses and health workers to diagnose and manage these conditions through door-to-door home visits.
I’ve benefited enormously from the research expertise of my colleagues at NHRC, who for more than 30 years have worked tirelessly on countless such studies to close the health gap between urban and rural Ghana—on subjects ranging from malaria to safe childbirth to COVID-19.
Rachel Vreeman, MD, MS, addressing the conference.
Recently, our Mount Sinai partnership in Ghana underwent a major change. With support from the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, my partnership co-director Raymond Aborigo, PhD, a senior social scientist at NHRC, and I convened a week-long conference at Mount Sinai. This conference was aimed at expanding this collaboration from a discrete research project centered on our own adult chronic disease efforts to a bilateral institutional partnership welcoming all the best research minds at Mount Sinai to collaborate with NHRC across all aspects of rural primary care. And since both Mount Sinai and NHRC see research as but one of the three core aims of health leadership, we also mapped out avenues for collaborations for the other two: teaching the next generation of health providers and scholars, and directly providing health care itself informed by novel research and rendered by excellent trainees.
From June 5 through June 9, the Arnhold Institute hosted not only Dr. Aborigo but also Engelbert Nonterah, MD, PhD, a physician and heart disease researcher, and NHRC’s institutional director, Patrick Ansah, MS, MPH. Through meetings with department heads and deans for fields ranging from obstetrics to environmental health to medical education, we mapped out more opportunities to expand the Ghana partnership than we could have imagined—for the benefit of Mount Sinai as much as NHRC. We’re now discussing strategies to send young Mount Sinai scholars to Navrongo, Ghana, to study the impact of pollution on cardiovascular health, researching the genetic causes of heart disease and expanding access to obstetric care.
NHRC offers unique resources and opportunities. NHRC is the premier research agency of the government of Ghana, and when its programs succeed they can be implemented as national health policy. Their research in the 1990s on sending nurses and health volunteers to remote regions to provide door-to-door care cut deaths in half in children under five, and this “Navrongo Experiment” subsequently became the standard of care across Ghana. Further, NHRC completes a census at least twice a year of more than 150,000 people in the local community, allowing precise, up-to-date health data to both guide and measure health interventions by tracking the burden of disease.
But perhaps most importantly, NHRC is universally respected by their community for engaging in ethical, compassionate health research targeted directly at areas of greatest local need. For this reason, Dr. Ansah told us, not only does NHRC rarely struggle to recruit participants for new vaccine trials or other studies, but persons deemed ineligible for these programs sometimes appeal to the Centre to let them into the study anyway.
NHRC also shares Mount Sinai’s core values and that of the Arnhold Institute: conducting cutting-edge research to close health disparities and protect the vulnerable, and ensuring that this work leads to, and learns from, excellence in medical teaching and improving patient care. Moreover, a new university, the C. K. Tedam University of Technology and Applied Sciences, founded in 2020 a mile from NHRC, already boasts a public health school, with a medical school to follow in a few years.
Mount Sinai’s partnership in Ghana has never been stronger, and the possibilities revealed to Dr. Aborigo and me this past month alone have exceeded the greatest expectations we had. With the research and teaching talent of Mount Sinai and NHRC—coupled with our complementary resources and shared values—we have the capacity to build together an alliance to change how primary care is delivered in Ghana and beyond.
David Heller, MD, MPH, is an Assistant Professor at the Arnhold Institute for Global Health and the Department for Global Health and Health System Design and co-director of the Arnhold Institute’s global partnership in Ghana.
Updated on Jul 7, 2023 | AIGH
Madeleine Ballard, PhD
Madeleine Ballard, PhD, Assistant Professor 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, designs and studies interventions to improve the performance of community health workers (CHWs) in low- and middle-income countries.
Dr. Ballard is also lead author of the World Health Organization/UNICEF implementation support guide on CHWs and COVID-19 vaccination and co-author of the UNICEF/Global Fund implementation support guide on national georeferenced CHW master lists. She served on the guideline review committee for the first World Health Organization guideline on community health worker programs.
Dr. Ballard serves as Executive Director of Community Health Impact Coalition (CHIC), a network of CHWs and aligned health organizations in 40+ countries making professional community health workers the norm worldwide by changing guidelines and funding.
In this Q&A, Dr. Ballard discusses the inspiration behind the founding of the CHIC and her work at the Institute.
Can you tell us a little bit about yourself and your background?
I live in London, and I’m originally from Montreal. I’ve moved to countries five times in between. I’m fired up about health care for all—particularly the role of technically right and morally sound collaborations to get us there. I dig exercise but have an addiction to bubble tea. I am fascinated by the challenges of post-religious cultural contexts.
What was the inspiration behind the founding of Community Health Impact Coalition?
Community Health Impact Coalition is making professional community health workers (proCHWs) the norm worldwide. We research to equip international norm setters with evidence to create proCHW guidelines. We advocate to influence global financing institutions to increase proCHW funding. We activate in-country networks to win national proCHW policy.
The inspiration for CHIC came from the recognition that large-scale national community health worker (CHW) programs were struggling to replicate the success of smaller, targeted interventions. We saw the immense potential of CHWs in improving population health, but there was a need for a collaborative effort to address the challenges of delivering effective community health programs at scale. CHIC was founded on the principle of collective action and radical collaboration, bringing together CHWs and aligned health organizations with extensive experience in providing high-quality care.
How has working at the Institute influenced your work, and what do you like about working for the Institute?
Working at the Institute has had a profound impact on my work. I appreciate the Institute’s emphasis on integrating evidence-based practice and health equity into long-term partnerships of solidarity. The opportunity to collaborate with and learn from experts from diverse backgrounds has enriched the shared work of the Coalition and influenced my approach to leadership.
How does your work differ from other academic professionals?
What sets my work apart from other academic professionals is my focus on bridging the gap between academia and practice. While academic research is vital, it is equally important to translate research findings into policies that shape the lives of communities every day. I strive to bring together the best of both worlds by leveraging evidence-based practices and collaborating closely with practitioners, policymakers, and other stakeholders to shorten the evidence to action pipeline.
Can you describe the work you did in Liberia and how that impacted your work?
As the founding Program Manager for Last Mile Health, I worked with community health workers to achieve universal access to health care in some of the most remote parts of the Liberian rainforest—where it took up to 14 hours to reach the nearest clinic and the average age of death was younger than the med students we teach. This experience reinforced my belief in the importance of investing in community health delivery and the role of CHWs as key agents of change. Regions like the ones we lived in were plagued not only by lack of services, but also by the assumption that the people living there are too inaccessible, too difficult, and too expensive to treat. My entire career is devoted to busting these types of “immodest claims of causality.”
Do you have any advice you would like to offer anyone who is thinking of going into the global health field?
Take the time to figure out what you believe is important and have courage to live your values. There are a lot of pre-fabricated notions about how we should approach problems or what constitutes “success”; it’s worth reflecting deeply on whether they reflect your own instincts about what’s meaningful.
Updated on Jun 5, 2023 | AIGH
At the end of 2022, AMPATH Nepal launched the Nepal Pilot Projects grant opportunity to accelerate the development of collaborative work between the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, Dhulikhel Hospital, and Kathmandu University School of Medical Sciences. This academic partnership seeks to build enduring collaboration across care, education, and research domains to improve the health and well-being of the populations we serve.
The grant serves to support the formation of counterpart teams that will develop collaborative projects to improve quality or access to care, establish training programs, or promote research that will address key challenges and priorities in the health system.
We received many competitive applications. We are excited to announce that we will be supporting the following four proposals:
Cervical Cancer Prevention Program in Rural Nepal: “Expanding reach through Community Health Workers” by Sunila Shakya, MBBS, MD, PhD and Sheela Maru, MD, MPH
Cervical cancer is the most common gynecological cancer in Nepal with high incidence and mortality. Nevertheless, cervical cancer can be detected at its precancerous phase with high performance screening tests and timely appropriate treatment of precancerous lesions. Low public awareness, geographical challenges and limited resources are the major challenges in cervical cancer prevention in Nepal.
This pilot project offers home-based, cervical cancer screening through self-sampled HPV testing and linkage to care through Community Health Workers. The project aims to train and evaluate knowledge and skills of cadre of health care worker on cervical cancer prevention; provide cervical cancer screening and treatment through community health workers; and evaluate screening and treatment program implementation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework for replication or scale up.
A population-based adolescent health needs assessment in Dhulikhel, Nepal, by Lonnie Embleton, PhD, MPH, and Shrinkhala Shrestha, MPHM, PhD
Evidence suggests adolescents aged 10 to 19 years old in Nepal experience a significant burden of communicable and non-communicable diseases and injuries, but several data gaps exist to fully depict adolescent health needs and priorities nationally and at the provincial and municipal levels. To address this significant gap in data, the collaborative team of adolescent health experts from Dhulikhel and New York will co-design and pilot a mixed methods, population-based adolescent health assessment in Dhulikhel municipality with local stakeholders and collaborators.
When adolescent-friendly services are designed using contextually relevant data, services will be responsive to local adolescent health needs. Adolescents will then be more likely to access health services and will ultimately see improvements in their health and well-being. It is anticipated this foundational work will be the first step towards establishing a longitudinal population-based adolescent health assessment that can inform planning, monitor progress, and capture inequalities in adolescent health at the provincial and municipal levels.
Training of Trainer on Simulation Based Education by Jyotsana Twi Twi, MS, BSN; Laly Joseph, DVM, DNP, CNE, RN, C, MSN, APRN, ANP, FNAP; and Sarla Santos, DNP, MS, NPD-BC, CCRN
Simulation-based Education (SBE) is still a new concept in medical education in Nepal. SBE can help develop health professionals’ knowledge, skills, and attitudes, while protecting patients from unnecessary risks, and it can be a valuable tool in learning to mitigate ethical tensions and resolve practical dilemmas.
SBE techniques, tools, and strategies can be applied in designing structured learning experiences, as well as be used as a measurement tool linked to targeted teamwork competencies and learning objectives.
Kathmandu University School of Medical Sciences has a simulation lab that is the first of its kind in Nepal. However, educators require SBE training to effectively utilize the facility. In this project, faculties from different educational institutions will be introduced to SBE and will be trained in providing simulation-based instruction.
Global IMPACT (Improving Emergency Medical Preparedness And Childhood Treatment) by Morgan Bowling, DO, FAAP, and Anish Joshi, MBBS, MD
Children living in areas with limited resources face numerous challenges, including the lack of access to specialized pediatric care. Nepal has shown significant improvement in child mortality; however, the rate remains higher than other nations.
This project will first conduct a needs assessment using a modified version of the National Pediatric Readiness Assessment (NPRP), with the goal of evaluating overall pediatric readiness in the Emergency Department at Dhulikhel Hospital. Second, to improve pediatric morbidity and mortality in the hospital community, it will certify a pilot group of doctors, nurses, and paramedics in the American Heart Association’s Pediatric Advanced Life Support (PALS) program, and then credential local providers to become PALS instructors so the program is self-sustaining.
Finally, to further foster a comprehensive PEM training program, it will develop and implement an in-situ multi-disciplinary simulation program in relevant pediatric clinical vignettes. This project seeks to deliver feasible and sustainable methods to improve the care of critically ill and injured children in Nepal. These pilots have the potential to prevent cancer, advance an adolescent health agenda, improve health care education, and be better prepared to treat children in any emergency or disaster.
