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.