缅北强奸

2024 Global Health Graduate Scholars

Kyla Christianson

MScA candidate, Advanced Nursing degree in the Global Health Concentration

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Dr. Alice Benjamin Global Maternal and Child Health Award

Kyla鈥檚 Project: Feasibility and Acceptability of the Healthy Conversation Skills model among Interdisciplinary Healthcare Providers working to Deliver a Preconception to Early Childhood Obesity Prevention Intervention in Shanghai, China

The effects of childhood obesity are detrimental; it impacts health trajectories over one鈥檚 lifetime, places an increased financial burden on healthcare systems, and is a risk factor for a plethora of health disorders. Given alarmingly increasing childhood obesity rates in China, the Sino-Canadian Healthy Life Trajectories Initiative (SCHeLTI) study is currently being conducted in hopes of preventing obesity in the early childhood period from pre-conception, pregnancy, and early childhood until the age of 5. The Healthy Conversation Skills model (HCS) is used by interdisciplinary healthcare providers to support the adoption of lifestyle and behavior changes among parents, children, and the family unit. While the HCS model is proven to be an effective approach, research is needed to assess its appropriateness, feasibility, and acceptability to allow healthcare providers to perform their role as health promoters. Additionally, this research taking place in Shanghai, China will aim to understand the experience of the healthcare providers who work together in an interdisciplinary team to conduct the HCS while caring for mothers, partners, and families from pre-conception to early childhood to prevent childhood obesity.

Swati Das

PhD candidate, Rehabilitation Science

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Dr. Kenneth Remsen Global Health Award

Swati鈥檚 Project: The role and meaning of evidence in clinical decision-making among occupational therapists in India

Evidence-based practice, although presented as a global healthcare mandate to improve healthcare practices worldwide, falls short with regards to the inclusion of diverse perspectives, including the perspectives of healthcare practitioners from the Global South. My research will address this gap by exploring the role and meaning of evidence from the perspectives of occupational therapy practitioners from India using a participatory approach and interpretive descriptive methodology. I will partner with a senior occupational therapist as a local expert from a government-funded rehabilitation and training institution in Odisha, India. The study will be conducted over a period of 5 months and will involve individual in-depth interviews with occupational therapists in Odisha to understand their experiences of clinical decision-making and their use of different sources of knowledge. I will travel to India for 6 weeks to recruit study participants, strengthen partnerships with the local expert and study participants, and collaboratively develop my research approach. These partnerships will contribute towards creating a mutual learning environment and enhancing the contextual relevance of my research approach and its findings. The proposed work can generate novel insights into Indian occupational therapists鈥� decision-making process within their everyday practices and the sources of knowledge they draw on, including but not limited to evidence.

Hannah Doyle

MSc candidate, Public Health,

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Steinberg Fund for Interdisciplinary Global Health Research Award

Hannah鈥檚 Project: Indigenous Lung Health in North-Central British Columbia (SPIRO Project)

The SPIRO project is focused on understanding factors associated with effective and sustainable implementation of integrated spirometry service and associated respiratory care (Spirometry as Care) for people with COPD. The research team works with various sectors and programs that are working for more equitable access to care in these regions, but are currently missing a respiratory component. This work will be transformational for people with COPD in these communities, and the knowledge gained will support continuous improvement in the study settings as well as other rural, remote, and northern communities across Canada.

My project focuses on understanding the feasibility and health outcomes of Spirometry as Care from patient, community, provider, and health system perspectives. As a practicum student, I work within a collaborative research team and help support research projects occurring within the SPIRO grant, related to rural, remote, and Indigenous Peoples equitable access to diagnostic testing to improve overall patient experiences and outcomes related to lung health.

The main goal of my project is to determine baselines and identify targets for local care improvement plans which will contribute to identifying barriers to accessing spirometry from the patient, primary care providers, and First Nations perspective across studies in the SPIRO project.

颁茅濒颈苍别 Goulart

PhD candidate, Epidemiology

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Scholar Graduate Award

颁茅濒颈苍别鈥檚 Project: Exploring the Impact of Zika Exposure Misclassification, Trimester of Zika Infection, and Racial Inequalities on Congenital Zika Syndrome: A Multi-Country Individual Patient Data Meta-Analysis

Zika (ZIKV), a virus primarily transmitted by mosquito bites can also be transmitted during pregnancy to the fetus, leading to several congenital malformations collectively known as congenital Zika syndrome (CZS). ZIKV was declared a public health emergency in 2016. Today, 89 countries/territories have reported transmission, while gaps in research persist. First, the lack of a standardized ZIKV definition at the onset of the emergency due to limitations in testing led some studies to be at risk of bias due to misclassification of ZIKV exposure. Additionally, the impact of trimester of ZIKV infection on CZS is not fully understood. Further, ZIKV/CZS burden is not evenly distributed across populations, with higher burden among Black or non-white people, though the extent of this disparity is unclear.

The objective of this project is to robustly estimate the effect of misclassification of ZIKV exposure and trimester of infection on CZS, while accounting for racial/ethnic inequalities. The first aim is to examine how ethnic/racial inequalities have been measured in the studies of ZIKV and CZS. The second aim is to estimate the impact of misclassification of ZIKV exposure on estimates of outcome CZS. The third aim is to investigate if trimester of ZIKV infection influences the acquisition and severity of CZS, and if racial/ethnic inequalities exist in these outcomes. Analyses will be completed using an individual patient data meta-analysis, which includes 64 studies from 22 countries. This research will generate novel evidence of inequalities on ZIKV and highlights the importance of accounting for misclassification.

Chanelle Lawson-Lartego

MSc candidate, Public Health

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Ambassador Paul Frazer Travel Award for Global Health and the Steinberg Fund for Interdisciplinary Global Health Research Award

Chanelle鈥檚 Project: Evaluation of Psych Corps Ghana Mental Health Training on Community Mental Health Workers

Globally, there is an ongoing mental health crisis that is affecting all age groups. In Ghana, the challenges faced in this mental health crisis include a lack of sufficient healthcare professionals trained in mental health, low levels of mental health literacy in the general population, and persistent mental health-related stigma in the health system and in the general population. Psych Corps Ghana is a non-governmental organization established to address these challenges by training and equipping mental health psychology graduates to contribute to the expansion of mental health services across the country. This organization trains recent psychology graduates and assigns them to work in various health facilities across Ghana under the supervision of community psychiatry nurses, or other mental health professionals. These graduates aim to bridge the gap in mental health care treatment through tasks like providing lay counseling, engaging in psychoeducation with community members, and conducting home visits with community psychiatry nurses. To date, there has been no formal evaluation of the program鈥檚 impact on trainees; Therefore, my project will focus on assessing the impact of the Psych Corps Ghana鈥檚 3-day training on the mental health knowledge and professional wellbeing of recent psychology graduate students. I will address these research questions using qualitative approaches such as in-depth interviews and focus group discussions.

Fouad Maghamez

MSc(A) candidate, Nursing

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Scholar Graduate Award and the Steinberg Fund for Interdisciplinary Global Health Research Award

Fouad鈥檚 Project: Sustainable Community Initiatives: Evaluating the Elderly Program in Njombe, Tanzania a Decade After Launch

In response to the unique challenges faced by elderly caregivers in Njombe, Tanzania, stemming from the HIV burden affecting the adult generation, the Elderly program was initiated over a decade ago. This collaborative effort, led by Highlands Hope Umbrella (HHU), TANWAT Hospital, and The 缅北强奸 Ingram School of Nursing, has evolved significantly. Originally designed to foster social connections among the elderly, the program has transformed into a robust service provider, addressing both the physical and psychosocial health challenges encountered by this vulnerable demographic.

The current study is dedicated to systematically evaluating the Elderly program's perceived benefits from the perspectives of both users and healthcare workers. The overarching goals include assessing program feasibility and proposing an implementation process for sustained success. Employing a qualitative descriptive design, the research involves interviews and focus groups with program users and healthcare workers, ensuring a comprehensive understanding of the program's impact and feasibility.

This research carries substantial significance for the elderly community in Njombe, providing valuable insights that can inform the development and enhancement of future initiatives tailored to their evolving needs. Furthermore, healthcare workers stand to benefit, as the findings can contribute to improved service delivery and foster collaboration with local initiatives. The ultimate aim of this study is to contribute to the enrichment of global healthcare knowledge, offering lessons that can inform more effective, culturally sensitive, and sustainable healthcare initiatives on a global scale.

Devena Mahabir

MSc candidate, Family Medicine

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Steinberg Fund for Interdisciplinary Global Health Research Award

Devena鈥檚 Project: Empowering Women's Reproductive Health: Investigating barriers to effective policy implementation in Rural South Africa

The COVID-19 pandemic has disproportionately impacted healthcare in South Africa's rural Eastern Cape, particularly affecting sexual and reproductive health (SRH) services. Public healthcare facilities, vital in impoverished regions, face challenges such as overcrowding and prolonged wait times, exacerbating vulnerability to infection. Despite governmental efforts, mistrust persists among rural populations. The IDRC/CIHR-funded project "Ukuvula Isango," aims to document and address the impacts of this collapse on rural communities, with the aim fostering women's empowerment and informing post-pandemic reconstruction. Data-driven policy change for SRH is a key element of this. Under the Ukuvula Isango umbrella, this project aims to investigate the process of policy translation in a resource-limited post-pandemic context, analyzing the barriers and facilitators to policy implementation in the rural Eastern Cape of South Africa. This study integrates previously collected qualitative data, employing ethnographic observations and semi-structured interviews with participants and stakeholders to document and analyze the process of translating data into programming and policy change. Results will be coded using an existing health policy framework, informing policy development for enhanced reproductive health outcomes. Supported by a skilled team and robust infrastructure, this research will engage marginalized communities in co-producing evidence-based policy solutions, offering unique insights to catalyze effective changes in women's reproductive health in under-resourced settings. The project holds significance in exploring strategies for women to emerge from the pandemic with increased resilience and enhanced health protection, while identifying barriers and facilitators to effective data to policy knowledge translation in a resource-poor setting.

Aravind Raj

PhD candidate, Family Medicine

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Steinberg Fund for Interdisciplinary Global Health Research Award

Aravind鈥檚 Project: Implementing Diabetes Programs for South Asian Canadians

South Asians (SAs) are the largest visible minority population in Canada representing 7.1% (2.6 million) of the total population and are projected to reach over 5 million by 2041. SAs have an increased prevalence of diabetes compared with European Canadians, which is often undiagnosed or lately diagnosed and poorly controlled. This can partly be attributed to provider and system-level barriers including a lack of cultural awareness in recommending diabetic diets and exercise guidance, and a lack of diabetes educational services offered in non-official languages. Culture is a factor affecting diabetes care and a social determinant of health, raising the importance of culturally sensitive diabetes programs. However, challenges remain in implementation of such programs and in delivering culturally competent care. The aim of this study will thus be to improve implementation outcomes of culturally sensitive diabetes programs for SA Canadians by reviewing the implementation science literature, conducting a policy analysis of diabetes policy in Canada, and conducting a realist evaluation case study of a culturally relevant diabetes program for SA Canadians.

Meena Ramachandran

PhD candidate, PhD in Rehabilitation Science

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Scholar Graduate Award

Meena鈥檚 Project: An ethnographic exploration of inequities in health and social care for people living with dementia in India

Inequities in accessing and utilizing health and social care services for people living with cognitive decline and dementia have been documented in different global contexts, including the Global South, and have often been studied from macro and third-person perspectives. My research will use a first-person experience-near approach to understand how people living with cognitive decline or dementia in Chennai, India access and navigate health and social care services, specifically focusing on their experiences of service-related inequities. Partnering with a non-profit organization that provides dementia care services, I will conduct ethnographic research involving open-ended interviews and participant observations with people living with dementia, their family members, and service providers. Data collected through this ethnographic fieldwork will help understand the local and organizational context and trajectory of care for individuals living with cognitive decline and dementia in the community. By foregrounding first-person perspectives of those experiencing service-related inequities, the findings of this project can help understand how services can be tailored to meet the unique needs of each individual living with dementia. The study findings will also be used to develop resources that can be integrated into the curriculum and training for future health and social care professionals working with people living with dementia.

Nicole Shaw

MSc candidate, Human Nutrition

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Steinberg Fund for Interdisciplinary Global Health Research Award

Nicole鈥檚 Project: Nexus of Women鈥檚 Empowerment, Dietary Diversity, Food Security, and Water Security among Mangrove Food Gatherers in Brazil

This project addresses the fundamental link between women鈥檚 empowerment, food security, and health in Brazilian mangrove communities, focusing on Marisqueiras鈥攚omen who harvest shellfish. While dietary diversity and water security are recognized food security indicators, they are often overlooked in women鈥檚 empowerment studies. The project employs exploratory mixed methods and uses the Women鈥檚 Empowerment in Agriculture Index (pro-WEAI), a robust tool endorsed by the United Nations, to assess women鈥檚 empowerment. The study pioneers assessing water security within the pro-WEAI framework, addressing a literature gap with validated instruments. Collaborating with the University of Sergipe and local organizations, 480 Marisqueiras will be surveyed to establish their empowerment level. Internationally validated instruments, including the Women Dietary Diversity Score (WDDS), Food Insecurity Experience Scale (FIES), and Individual Water Insecurity Experience Scale (IWISE), will assess dietary diversity, food security, and water security, respectively. In-depth interview and focus groups will be employed to adapt Pro-WEAI and then surveys will be distributed.

Anticipated correlations between women鈥檚 empowerment and higher dietary diversity, improved household food security, and enhanced water security suggest increased decision-making power and resource allocation within households. This comprehensive understanding of relationships aims to inform policies promoting gender equality, sustainable resource management, and improved health in Brazilian mangrove communities. This study represents an initial step toward positive change in the region, marking the first examination of these relationships among Marisqueiras.

Luz Villa Castillo

MSc candidate, Epidemiology

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Steinberg Fund for Interdisciplinary Global Health Research Award

Luz鈥檚 Project: Incidence of Tuberculosis meningitis in children less than 5 years-old with meningitis of unknow etiology in Bangladesh. A collaborative work with the Children Health Research Foundation (CHRF) for improving the diagnosis of TB meningitis in Bangladesh

Title: Incidence of Tuberculosis meningitis in children less than 5 years-old with meningitis of unknow etiology in Bangladesh. A collaborative work with the Children Health Research Foundation (CHRF) . Introduction: Bangladesh, a middle-income South Asian country, faces a significant public health challenge due to TB, contributing 3.6% to the global TB burden. Children, especially those under 5, are highly susceptible to TB and its extrapulmonary forms, including meningitis. The CHRF, a non-profit organization, aims to improve child health in Bangladesh through research. They have observed that infectious diseases are the leading causes of meningitis in young children, yet TB meningitis often goes undiagnosed due to financial barriers and lack of access to WHO-recommended molecular testing. Methods: The study hypothesizes that many children with TB meningitis remain undiagnosed due to these challenges. To address this, CHRF has created a biobank of samples from children whose meningitis etiology remains unclear after traditional diagnostic methods. The study will use WHO-recommended molecular tests to analyze these samples, aiming to better understand the incidence of TB meningitis in this demographic. The study involves a diagnostic evaluation of 8,550 Cerebrospinal fluid samples from 2015 to 2022 across four hospitals in Bangladesh. Additionally, a one-year prospective surveillance will be conducted in Mirzapur, a semi-urban region, to compare with the incidence of pediatric TB meningitis in that area. Relevance: The study's outcome is critical for TB diagnosis, prevention, and treatment in children, particularly in low and middle-income countries (LMICs). Accurately assessing TB meningitis incidence using WHO-recommended tests will inform TB policies at both national and global levels. This is vital given the challenges in diagnosing extrapulmonary TB and the severe consequences of TB meningitis in children, aligning with the United Nations Sustainable Development Goal of ensuring healthy lives.

Sacha Williams

PhD candidate, Experimental Surgery / Surgical and Interventional Sciences

Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Steinberg Fund for Interdisciplinary Global Health Research Award

Sacha鈥檚 Project: The Impact of Gender on Pediatric Surgical Care in Africa

Background: Currently 1.7 billion children lack access to surgical care globally. A significant proportion of these children live in Africa, resulting in a high surgical disease burden. Yet, surgery remains under-utilized, despite its potential to reduce death or disability. An important social determinant of health is gender, characteristics, roles, and behaviours attributed to masculinity and femininity. Gender inequities have fuelled social/structural barriers negatively impacting females, including adverse surgical outcomes in women. Recently we reported, among children affected by sex-neutral conditions, surgery was performed 3.6 times more often on boys, while girls鈥� mortality was 1.6 times greater.

Objectives:

1. Determine the priorities, perspectives, customs of African parents/caregivers, healthcare professionals regarding gender equity in pediatric surgical care.
2. Validate our gender disparity findings.
3. Elucidate barriers to gender equity.
4. Develop a mitigation plan.

Methods: Mixed-methods approach. Objective 1 (Priority-setting) will involve community participatory focus groups. Objective 2 (Validation of previous study findings) will encompass parent/caregiver surveys incorporating the Three Delays to Surgery model, comparing experiences by patient gender. Objectives 3 and 4 (Identifying barriers, Potential solutions) will include stakeholder surveys and focus groups. Trained local facilitators will assist recruitment during clinic visits and via referrals (Snowball method). English and applicable local languages will be used for enrollment, participant communication, and data collection. Data will be analyzed through descriptive statistics, and regression models, as applicable.

Significance: This work will facilitate south-north partnership, provide a novel, sustainable blueprint for reducing gender disparities, and contribute to improving the long-term surgical care of African children.

2023 Global Health Graduate Scholars

Fio Vialard

MSc Epidemiology,聽Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Fio鈥檚 Project: Designing a digital risk score assessment tool from an app-based Multiplexed testing program to screen two sexually transmitted and blood-borne infections for key populations in India.

"Every day, 1 million people worldwide contract one or more sexually transmitted or blood-borne viruses including hepatitis B (HBV), and human papillomavirus (HPV). In India, these infections are inadequately documented, and occur more in certain populations. Women from rural and peri-urban communities face stigma and discrimination when accessing healthcare services, leading to limited education about risk, and testing for these infections.

To combat testing inequity, multiplex tests that detect multiple co-infections simultaneously can be combined with digital applications for rapid communication to healthcare providers and patients, improving patient care and decreasing transmission. Digital applications can also document patient information to create risk scores to improve testing programs through patient education and engagement. Few studies on these strategies have been conducted in middle-income countries like India.

We therefore aim to develop a risk score assessment tool from a primary study to evaluate an app-based multiplexed testing program for HPV and HBV for at-risk populations in India. We will collect clinical, socio-economical, demographic, perception-related, and behavioral information related to 1250 participants offered a connected multiplex testing strategy at community-based clinics in Mumbai. These measures will be stored in our digital application and used to develop a risk score for HPV and HBV to help determine why certain individuals are more at-risk, improving prevention efforts.

This study will be the first in India to generate a risk-score for HPV and HBV in key populations and to support World Health Organization recommendations and will guide policy makers to improve global health of key populations."

Isabel Munoz Beaulieu

MSc Family Medicine, Global Health concentration, Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Isabel鈥檚 Project: What are communities and humanitarian鈥檚 roles in ensuring sustainability during project closure in the Philippines?

Humanitarian project closures become inevitable when an emergency situation abates. This closure can harm local communities by stopping services that they now depend on for survival. Understanding the needs of communities beyond closure might help organizations minimize harms and advance justice for those affected. Thus, my project, conducted in partnership with the Center for Disaster Preparedness (CDP) in the Philippines, will explore the roles and responsibilities communities and humanitarian organizations have to ensure sustainability during and after humanitarian project closure. I will draw on literature on locally-led approaches, humanitarian responsibility, and the theoretical framing of the 鈥榚thics of the temporary鈥欌�攚hich draws attention to the temporariness of humanitarian action and invites a wider temporal scope in thinking about humanitarian鈥檚 past, and how it affects its present and future. These sources will be used to consider findings from an ongoing empirical study and to investigate notions of sustainability following project closure: What does it mean for humanitarian aid to be sustainable? And what are the obligations to sustain it in avoiding harms and advancing justice for communities? The empirical study informing my thesis was led by CDP and a Community Advisory Board (CAB). Data includes twenty-five key informant interviews and seven focus groups. Currently, we are analyzing this data through an inductive framework analysis. Findings will support normative analysis on communities' understanding of sustainability. Additionally, it will inform training material for communities and humanitarian organizations on how to close humanitarian projects ethically and sustainably鈥� developed collaboratively with the CDP and CAB.

Vibhuti Dikshit

Masters of Law, Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Vibhuti鈥檚 Project: A study of the factors that influenced the passage of the Surrogacy (Regulation) Act, 2022 and its ground level impact.

This project has dual purpose. Firstly, I hope to study the factors that influenced the passage of the Surrogacy (Regulation) Act, 2021 in India after over a decade of deliberation. Secondly, I want to study the recorded impact of the law on the lives of those who perform surrogacy and whether that impact measures up to the reasons the law passed in the first place.

Yasmine Elmi

MSc, Family Medicine, Global Health concentration, Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Yasmine鈥檚 Project: Youth-led Research Action Participation in Senegal.

Child marriage is a major violation of children's rights, and due to gender inequality, girls are most often the victims of this phenomenon. In 2018, an estimated 29% of young women in Senegal were married before the age of 18. Youth-led Research Action Participation (RAP) is an innovative approach to positive youth research and development that goes beyond youth advocacy or youth participation in program planning. This project will use RAP to understand the links between child marriage and other GBV and SRHR issues and develop locally relevant interventions to address gender inequalities and reduce child marriage. Action research is needed to provide insights into programs with an emphasis on the importance of adolescent participation in this research and in developing programs targeted to their group. My project will contribute to this cutting- edge research into participatory methods and their impacts.

Cherinet Osebo

PhD Candidate, Global Surgery Stream Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Mary A Metcalf International Travel Fund.

Cherinet鈥檚 Project: Building Partnership_ Implementing National Trauma Registry in Tanzania.

Trauma and injury represent the leading causes of death worldwide. There are more annual injury-related deaths than from HIV, malaria, and tuberculosis combined. Disappointingly, over 90% of injury-related deaths and disabilities are disproportionally housed in low- and middle-income countries (LMICs). This disparity resulted from poorly designed trauma care systems and the absence of trauma registries. The trauma care system is an organized, coordinated effort in a defined location that delivers comprehensive care for all injured patients and integrates the trauma registry with the local public health system. The trauma registry is a database that collects prospective data regarding patient demographics, injury epidemiology, trauma care, and clinical outcomes and helps to design evidence-based preventive strategies where the injury is considered a 鈥榟otspot.鈥� Tanzania is among the LMICs with significant injuries leading to death and disability. Although the injury is a significant public health crisis, Tanzania lacks well-designed national trauma registries. This project bridges the gap and provides new insights into the trauma care system by deploying a synchronized, novel electronic trauma registry.

Cyntia Kraichati

PhD Candidate, Anthropology Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Cyntia鈥檚 Project: Watershed Lives: An Ethnography of River Infrastructure and Ruination in Lebanon

Bridging anthropology and global health, my doctoral dissertation traces the fraught histories of infrastructural development and decline in Lebanon; and examines their implications for public health and inequalities. My research explores the gradual erosion of the Litani river dam in Lebanon 鈥攁 hydropower and irrigation project implemented between 1950 and 1970 and funded by the Lebanese state鈥檚 first loan from the World Bank. Declining infrastructural projects like the Litani dam have become a synecdoche of the Lebanese state鈥檚 divestment from responsible public service provision. Initially conceived as the country鈥檚 most important investment in technological modernity, the heavily polluted Litani is now provoking the 鈥渟low deaths鈥� of people, communities, and landscapes in the rural region of the Bekaa through which it flows (Nixon 2011). When it was first built, the dam flooded fertile agricultural lands and transformed farmers to power plant workers. More recently, it has become a sink for the dumping of waste and sewage with neighboring communities blaming the river for rising rates of cancer, respiratory illnesses, and allergies. Combining archival and ethnographic research in West Bekaa where the dam is located, my research explores the institutional discourses of infrastructural development and their refraction in the quotidian lived experience of those affected and on their health. My research attends to way the gaps and tensions between these two entwined scales have become invested with local politics. It ultimately foregrounds the creative ways communities address broader health, socioeconomic and ecological fallouts.

Ruben Valle

PhD candidate, Mental Health, Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Mary A Metcalf International Travel Fund

Ruben鈥檚 Project: Evaluation of the technical guidelines for caring of individuals with FEP in Peru: Perspective of service user, families, and health providers.

Introduction: As part of national mental health reforms, Peru鈥檚 Ministry of Health (MINSA) began producing a Technical Guideline for the care of individuals with first-episode psychosis in 2022. The guideline, being developed by mental health experts, is based on psychosis literature and existing guidelines from high-income countries. Including the perspectives of service users, their families and healthcare providers is crucial to the appropriate design and effective implementation of health interventions. In Peru, where early intervention is not yet integrated into psychosis care, refining and operationalizing the new guideline with stakeholder perspectives will ensure its local relevance and cultural sensitivity. Objectives: This study aims to assess the experiences and insights of service users, family members and mental health staff with respect to current mental health care provision, and their perspectives on Peru鈥檚 new early psychosis services guideline. Methodology: We will conduct a qualitative study, following the experience-based co-design approach. The study will entail three rounds of in-depth interviews. Interview recordings will be transcribed and subjected to thematic analysis. Discussion: The study will complement the expert knowledge that has gone into the development of preliminary guideline with the knowledge of people with lived experience and clinical expertise. Key authorities involved in developing the technical guideline have endorsed the need for this study and agreed to facilitate it. Information produced in this work will be shared with mental health authorities from MINSA so that they can integrate it into the technical guideline. Regional dissemination will also inform mental health policy across Latin America.

Tamara Ajeeb

PhD candidate, Human Nutrition Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Joseph I. Wolfsdorf Fund for Global Child Health

Tamara鈥檚 Project: Human Milk Microbiome: Role of Maternal Diet and Infant Growth

In 2020, UNICEF reported that 149 million children (1 in 5) under five years of age were stunted, and 45 million suffered from wasting; these children were largely from LMICs, where exclusive breastfeeding (EBF) predominates. Breastfeeding is a major protective factor against child malnutrition and contributes to the maturation of healthy gut microbiota. Human milk microbiome (HMM) contributes significantly to infant gut microbiomes; aids in nutrient digestion, energy harvesting, and storage; and may play an overlooked role in infant growth.

Maternal diet affects both the HMM and its major source, the maternal gut microbiome. To date, no studies have examined the potential effects of HMM on infant growth mediated by maternal diet.

Guatemala is a developing country with high EBF rates (76%), where more than 90% of Indigenous mothers breastfeed beyond six months. Nonetheless, Guatemala has the highest prevalence of stunting in the Americas, with Mam-Mayan Indigenous communities disproportionately affected, where stunting emerges during the 3rd month of life among breastfed infants.

The primary objectives of my study are to (1) assess the relationship between HMM and infant growth, (2) evaluate if these associations are mediated by maternal dietary intakes, and (3) evaluate the influence of maternal dietary intake on the EBF infants鈥� growth parameters among mother-infant dyads in the Mam-Mayan Indigenous population of Guatemala.

This research may inspire nutritional interventions involving maternal diet and microbiota-targeted therapies to improve early-life microbial exposures in an endeavor to optimize child growth and decrease the malnutrition-related burden of noncommunicable diseases.

2022 Global Health Graduate Scholars

Virginie Combet

Masters of Science in Public Health - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Dr. Stephen Corber Global Health Travel Award

Virginie's project: Practicum with the Respiratory Epidemiology and Clinical Research Unit of the Centre for Outcomes Research and Evaluation of the Research Institute of the 缅北强奸 Health Centre

"I will work with Dr. Faiz Khan, Associate Professor of the Department of Medicine, 缅北强奸, Respirologist and Director of TB Clinical Services at the Montreal Chest Institute at the 缅北强奸 Health Centre, and Associate Director of Clinical Research of the 缅北强奸 International TB Centre, and his team to coordinate the launch of a research project based in Nunavik which aims to develop resilient responses as part of Nunavik鈥檚 health and housing services to mitigate the impacts of climate change on lung health in Nunavik and is part of the principal investigator鈥檚 research program addressing improvement of lung health within the region."

Christine Ha

PhD candidate,聽Human Nutrition - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Christine's project: Cree youth gaining traditional food literacy within the Eeyou Istchee traditional food system

"The Cree of Eeyou Istchee in northern Quebec have identified that promoting youth engagement in traditional food practices is a priority because it is central to Cree identity, health and well-being. It is important to better understand the processes that support Cree youth to gain the knowledge and skills to carry on traditional food practices. Cree communities have identified that despite environmental and socio-cultural changes that impede opportunities for youth to learn about traditional food practices, intergenerational knowledge exchange through oral traditions and practicing Cree culture with Elders/knowledge holders sustains Cree ways of life. This project proposes to identify ways where youth are enabled to navigate the Eeyou Istchee food system for carrying on traditional food practices, by engaging them in community-led traditional food-related activities. Food literacy is a concept to explain how people gain the collective awareness, knowledge, skills and empowerment to access food systems for improved nutrition and well-being. We recognize that food literacy is a western concept, however it will be a useful guiding concept in this project. This is the first project that adapts the concept of 鈥渇ood literacy鈥� as a bridge to collaboratively examine the dimensions of this concept that is cultivated within the distinct Cree traditional food system in Eeyou Istchee. The purpose of the research will focus on how traditional food literacy in Eeyou Istchee is gained through the process of Cree youths鈥� experiences of engaging with the environment and knowledge holders within the traditional food system for knowledge and skills acquisition."

Elizabeth Hern谩ndez Castellanos

PhD candidate, Human Nutrition - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Elizabeth's project: Nutrition Learning Community: nutritional status, dietary diversity, food security, and food waste in Mexican women participating in the Food Bank of Tepatitl谩n

"Food security (FS) is defined as: 鈥渨hen all people, at all times, have physical and economic access to sufficient, safe, and nutritious food that meets people鈥檚 dietary needs and preferences and allows them to live an active and healthy life鈥�. M茅xico faces the double burden of malnutrition (obesity coexisting with undernutrition), which is more common in women with a low level of education and food insecurity. The prevalence of overweight or obesity in female participants of Food Banks in Jalisco was 75%. More than half of the Mexican population (55.5%) reported some level of Food Insecurity in 2018.

Food products that do not reach human consumption generate an economic burden and increase operative costs in terms of water, soil, and energy. The reduction in food loss has a great potential impact on the decrease of hunger and poverty. Thus, this project aims to assess the nutritional status, dietary diversity, food security, and food waste in Mexican women in the Food Bank of Tepatitl谩n before and after participating in a Nutrition Learning Community (NLC).
Learning Communities (LC) posit that learning is a continuous process in the community through the social connections within the group. The NLC will be led by women, the FB, and the research team to build knowledge and practice about nutrition-sensitive topics and the community鈥檚 needs.
The following measurements will be taken at baseline, 3, and 6 months: the nutritional status, dietary diversity, food security status, and food waste. Water access will only be reported at the baseline."

Melody Lynch

PhD Candidate, Geography - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Melody's project: Growing Safe? - Food in the World Health Organization鈥檚 Healthy City of Kuching, Malaysia

"While urban agriculture can potentially increase food security for city dwellers and support the development of healthy cities, it might also yield negative consequences for communities. For instance, in developing Asia, the contamination of urban-grown foods is concerning as pollution from some of the world鈥檚 largest emerging economies is difficult to regulate. Additionally, research has shown that policies aiming to promote urban agriculture may actually serve to exclude the most vulnerable groups. Urban agriculture scholarship has been occurring in silos, with environmental, social and health research on urban agriculture being largely examined separately. Through a mixed-method, interdisciplinary approach entailing mapping, interviewing, soil and vegetable toxicity testing, as well as photovoice, the aim of my research is to examine under what conditions, in what places, and for which communities can urban agriculture provide safe foods in the World Health Organization-designated healthy city of Kuching, Malaysia. This research bridges the gap between environmental, social and health research on urban agriculture by contextualizing toxicity levels of vegetables and soils within historical processes of colonialism and urban development. It integrates a justice perspective by examining inequalities through an intersectional lens to reveal ethnic, gendered, class and generational differences in access to safe foods. The outcomes of this work will inform policies for supporting healthy city strategies involving urban agriculture in ways that are safe, sustainable, and just."

Nicole Nguenha

MSc, Family Medicine - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Mary A Metcalf International Travel Fund

Nicole's project: Examining the Perspectives of National and Subnational Stakeholders Regarding Multisectoral Coherence for Tobacco Control Regulation in Mozambique

"My study will examine the perspectives of policy makers at the national and subnational levels on the tensions between tobacco as an economic commodity and the implementation of tobacco control regulation in Mozambique. With many Low to Middle Income Countries (LMICs) such as Mozambique having increased tobacco leaf production considerably in the past 20 years, east Africa now accounts for over 90 percent of tobacco leaf production in the continent. In the case of tobacco control in tobacco producing LMICs, health sectors are often focused on implementing the comprehensive tobacco control measures to reduce tobacco use, while economic sectors are concerned with the livelihoods of tobacco farmers, as well as the macroeconomic factors associated with revenue generation and foreign exchange earnings. The tension between economic and health sector goals has been known to create barriers to tobacco control in tobacco producing LMICs. In order to explore the tensions, challenges and opportunities associated with tobacco policy, I plan to conduct interviews with different stakeholders across sectors.The main aim of this project is to identify and explore the factors that shape policy (in)coherence in relation to tobacco in Mozambique. "

Jingyi Tian

Masters of Science in Public Health - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Ambassador Paul Frazer Travel Award for Global Health

Jingyi's project: Parental income, educational expectations, and the fertility desire of Chinese adolescents.

"My research aims to study the state鈥檚 current response to the low fertility desire in its policies in light of the demographic realities. Instead of simply examining the magnitude of its effect or forecasting the population growth, this research attempts to understand how parental socioeconomic status affects the fertility desire of their children through the expectation of educational achievement.

This short project attempts to identify the mechanism that shapes the low fertility trend in contemporary China and observes the trend in perceiving fertility desire concerning the socio-cultural structure. By analyzing data from China Family Panel Studies, my research found that parental socioeconomic status does have an impact on the fertility desire of the second generation, but the expectation of educational achievement is not the main factor that mediates this effect. But the result does show that the fertility desire is much lower than the fertility preference in the 1960s, which is a new pattern that policymakers to work with, not a problem to work against.

The research aims to engage in academic conversations with demographic studies, anthropology of policies, and China studies. It also attempts to inform the quantitative discussions in demography with a qualitative understanding of the cultural dynamics in a different population."

Sydney Timmermans

MSc, Family Medicine - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Sydney's project: Unpacking Northern Ontario鈥檚 sexual assault evidence kits: a mixed methods approach to understanding the barriers preventing justice and care for survivors

"Sexual assault evidence kits (SAEKs) are used to gather forensic evidence from survivors after assault. Justice is hindered without this physical evidence, resulting in a dependence on traumatizing survivor narratives. Sexual assault can affect anyone, but it unfortunately disproportionately affects women and members of the queer community. Despite high rates of sexual violence in these groups, 41% of hospitals do not have SAEKs available or staff trained to use them. Most of these deficits fall in remote Northern areas, forcing survivors to travel great distances to receive care. Research on sexual assault care is limited, but it is known that a 鈥渏ustice gap鈥� exists, whereby individuals in rural and socioeconomically marginalized communities have poorer access; Northern and Indigenous communities are known to especially lack access to sexual assault care. This lack of resources results in poor survivor mental health, increased chronic health disorders, substance abuse and violence perpetuation, placing further strain on health services.

I plan to gain the perspectives of healthcare providers about access to sexual assault resources in their communities, as well as barriers they face in providing care. My mixed methods research will involve surveys and interviews with healthcare providers in Thunder Bay, Kenora and Sioux Lookout.

Findings of my research aim to alleviate the stress placed on care providers in resource-poor regions, and increase access to care for those who seek aid in regions lacking adequate healthcare infrastructure. "

Ziyue Wang

PhD Candidate, Family Medicine and Primary Care - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Ziyue's project: Understanding the health-seeking behaviours in primary care settings among cardiometabolic disease (CMD) patients in rural China: a mixed methods study

"Each year, more than 20 million people died from diabetes, stroke, and other cardiometabolic diseases (CMD). Today, three-fourths of these deaths occurred in low- and middle-income countries (LMICs) and more than one fourth of CMD patients live in China. This significant burden has disproportionately affected patients living in China鈥檚 rural areas. Compared to a rich body of literature focusing on the barriers related to health delivery system, the barriers related to patients鈥� behavioural factors such as attitudes, beliefs, and mental models towards primary care have not been explored in depth. This project aims to understand how complex social, institutional, and cultural factors can shape patients鈥� mental models and influence their health-seeking behaviours with respect to CMD in rural China. We will conduct a mixed-method study in three counties in Eastern, Central, and Western China. For the quantitative component, we will collect variables on patients鈥� mental models, socioeconomic/health status, clinical indicators, and health-seeking behaviours. For the qualitative component, we will explore patients' perceptions in their care-seeking journey previous health-seeking experiences, their personal life history, and the features of local primary care settings. Based on both qualitative and quantitative results, we will create a patient journey map to describe how mental models interact with different touchpoints while patients navigate through in their care journeys. Our findings will also help to improve CMD care practice for researchers, clinicians, and policy makers. Ultimately, our findings will lead to a better quality of life for patients living with CMDs in China and other LMICs."

Jolian Wong

MSc, Nutrition - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Jolian's project: A mixed methods realist evaluation of FEHNCY Community Engagement and Mobilization for knowledge translation: towards supporting cultural safety and integrating Indigenous knowledge systems

"Community-based participatory research is recognized as a respectful way to do research with Indigenous peoples by equitably involving and engaging communities throughout the research process and represents a shift from research on Indigenous peoples. Food, Environment, Health and Nutrition of First Nations Children and Youth (FEHNCY) will collect data from 60 First Nations communities across Canada to promote changes in policies and programs addressing First Nations鈥� health needs. While previous research has highlighted the need for engaging communities, the impact of community engagement on the conditions for applying findings of health research has not been studied. This study examines how FEHNCY Community Engagement Component (CEC) activities support the conditions needed to translate study findings into action. We hypothesize that valuing Indigenous knowledge in community engagement will improve participation and create conditions favorable for knowledge application. This mixed methods study will collect in-depth interviews and modified Talking Circles to understand community and study team perspectives on community context, CEC implementation, and outcomes, while process evaluation will describe the extent and reach of CEC activities. Interviews, modified Talking Circles and statistics will be analyzed together to understand how the CEC activities work, for whom, and in what circumstances. This research will contribute to understanding how community engagement impacts knowledge translation of representative health surveys like FEHNCY. Further, this research will develop a theory on how to effectively and meaningfully engage First Nations communities in health and social science research and translate findings into action to address health inequities."

Alexandra Zimmer

PhD candidate, Epidemiology - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Spencer-Hick Family Global Heath Education and Training Fund

Alexandra's project: Smartphone-based Artificial Intelligence Cough Analysis for Tuberculosis and COVID-19 Screening in Lima, Peru

"Cough is a key symptom of respiratory diseases including tuberculosis (TB) and COVID-19; however, patients tend to have poor recall on symptom duration and severity. Prior studies and AI models have shown that AI can identify human coughs from ambient sounds (cough detection) and can differentiate coughs caused by different diseases (cough classification). For example, there is a promising smartphone application named Hyfe Research that uses AI to detect human cough, with more than 96% accuracy. Such AI models can be used on smartphones, allowing for non-invasive, easy to use tools, especially in resource-limited settings. In this study, we will use the Hyfe Research app to record coughs and develop AI models to differentially screen COVID-19 and TB patients in Lima, Peru. Participants presumed to have TB and/or COVID-19 will record five solicited coughs at the facility. A subset of participants will be given a smartphone with Hyfe Research to passively record spontaneous coughs for 7 days. A cough database will be generated and annotated with diagnosis, demographic, and clinical data. The AI algorithms鈥� cough classification performance will be evaluated against laboratory reference standards. We will also qualitatively assess the acceptability and feasibility of using smartphone-based AI cough screening by conducting in-depth interviews with healthcare staff and through a patient survey. This study will contribute to a global database of TB and COVID-19 cough sounds. The development of a reliable AI algorithms for cough detection could help streamline confirmatory testing, reducing diagnostic delays and limiting transmission."

2021 Global Health Graduate Scholars

Emmanuelle Batisse

PhD Candidate, Epidemiology - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Emmanuelle's project: Exposure to Household Air Pollution and Immune Function Among Rural South African Children participating in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE).

"In South Africa, more than 40% of the rural population still uses solid fuels for indoor cooking. These practices result in critically high exposure to household air pollution (HAP), specifically to fine particulate matter (PM2.5), with women and children being particularly at risk. PM2.5 penetrates deeply into the lung and enters the bloodstream contributing to systemic inflammation and oxidative stress, which have been shown to alter antibody response to response to vaccines. However, no human study has investigated whether exposure to HAP inhibit immune response to vaccines in children. The objectives of my doctoral research are to characterize the levels, sources, and determinants of exposure to HAP in rural South African children and to determine whether exposure to HAP is associated with altered immunologic response to vaccines between age 6.5 and 8 years. This study is based on the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), a cohort of 752 South African mothers and children. Using personal-level exposure to PM2.5 and black carbon, I will characterize children鈥檚 levels, sources and determinants of exposure. I will use generalized linear models to investigate the association between exposure to HAP and immunity function for three classes of vaccine. This research project represents the largest and newest study exploring the potential adverse effects of HAP on children's immune response to vaccines anywhere in the world. In these poor areas where infectious diseases account for almost half of the disease burden among children, these results will have major repercussions for vulnerable populations."

Morgen Bertheussen

Masters of Arts, Geography - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Morgen's project: What household and community-level SDH are associated with more favorable health outcomes across communities in Nunavik

"Inuit perception of health is multidimensional, emerging from the interaction and interrelation of many social and environmental factors. Because of this, health and well-being can vary significantly depending on the extent to which protective factors are available at the household and community-levels. Social determinants of health (SDH) represent these conditions that go beyond individual-level risk factors in shaping population health outcomes. There is a consensus in the literature that the SDH play a major role in influencing physical and psychosocial health of Indigenous Peoples. However, previous quantitative studies examining these associations seldom define health holistically. Rather, health is measured using univariate outcome indicators, failing to capture Indigenous holistic conceptualizations of health, and further reinforcing western biomedical principles that tend to treat health issues separately. Hence, because Indigenous perception of health is multidimensional, a holistic measure of health is required to better understand how the SDH influence Inuit health and well-being. Therefore, my thesis aims to answer the following question: What household and community-levels SDH are associated with favorable health outcomes across communities in Nunavik? This project will be integrated within the scientific activities of the Community Component of Qanuilirpitaa?, the 2017 Nunavik Health Survey, and will apply the conceptual framework developed in the former to operationalize a holistic indicator of Inuit health and well-being, and link holistic health to household and community-level factors. Understanding how SDH relate to the principle of holistic health has the potential to inform, promote and support public health interventions, services, and programming in the Arctic."

Andrea D'Addario

Masters of Management, International Health Leadership - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Spencer-Hick Family Global Health Education and Training Fund

Andrea's project: The Impact of COVID-19 on Remote Health Care Provider Wellness: A Northern Territory Lens

"Recently, a system wide staff wellness survey carried out in January 2021 by an operational team in an NWT health authority (D鈥橝ddario, 2021) suggests that frontline and management teams are experiencing significant psychological distress, loss of professional autonomy, fatigue, and burnout. Despite the relatively low numbers of positive COVID-19 cases in the NWT, the survey highlights trends of the intensifying impacts on health care practitioner wellbeing. Additionally, the feedback alludes to the increased potential of workforce loss as a result of poor workplace support and leadership. Review of practitioner narratives suggested that staff wellness may be mitigated by the presence of supportive and responsive supervision and leadership.

This research project aims to understand if the anecdotal evidence highlighted in the preliminary qualitative survey is supported by more robust quantitative research methods. Through partnerships with the Northwest Territories Health and Social Services Authority (NTHSSA) and the Territory of Nunavut (NT), the research aims to better understand the psychological impact on the northern health care workforce, specifically health and social services staff and health management personnel, and, to evaluate how health leadership style is associated with improved outcomes for health care workers living and working in remote northern communities during the lifecycle of the pandemic. Additionally, this research project endeavours to provide Territorial policymakers and executive leadership with meaningful organizational insight and interventions at the frontline and health care leadership levels to protect and sustain the longevity of a skilled health care work force across the Northern Territories."

Minnie Horace

PhD Candidate, Nursing - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Joseph I. Wolfsdorf Fund for Global Child Health

Minnie's project: Exploring Liberian nurses and midwives鈥� individual and shared experience with using The World Health Organization Safe Childbirth Checklist to improve maternity care practice in Liberia: An interpretive phenomenological study

"Approximately 830 women worldwide die every day from preventable causes related to pregnancy and childbirth (WHO, 2019). Many of these deaths could be prevented by providing evidence-based care. To address the issue of preventable maternal deaths and to assist skilled birth attendants in remembering and adhering to evidence-based practices, the World Health Organization Safe Childbirth Checklist (WHO-SCC) was developed by WHO in 2008 (Spector et al., 2012). The SCC was introduced in Maryland county, Liberia in 2018, with little known of the acceptability of using this tool by nurses and midwives who attend births. This project, to be conducted under the supervision of Dr. Anita Gagnon of the Ingram School of Nursing (ISoN), is meant to begin to fill this knowledge gap. An interpretive phenomenological study will be conducted to explore and understand the lived experiences and perception of nurses, midwives, and other health professionals likely to be implicated with the use of the SCC."

Lavanya Huria

MSc, Epidemiology - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Lavanya's project: Patient pathways, individuals鈥� care seeking behaviours, delays, and costs of care

"As a direct cause of the COVID-19 pandemic, compared to 2019, the reported number of people who were diagnosed with tuberculosis (TB) between January and June dropped by 25-30% in Indonesia. The pandemic is an additional burden on the already fragmented health sector of both these countries, and private providers are struggling to accommodate individuals seeking care for TB. The private sector administers approximately 50% of TB treatment in Indonesia. However, decreasing case notifications are evidence that the nationwide lockdowns during both waves has had devastating impacts on the TB patient pathway. Additionally, little is known about the additional financial burden this is putting on individuals with TB. The primary objective of my research project is to explore the impact of the COVID-19 pandemic on individuals seeking to access care for TB from the private sector. Surveys are currently being conducted with consenting individuals in Bandung, Indonesia to gather information regarding the steps individuals with TB took while seeking care (screening, diagnosis, treatment), delays that they are facing due to the pandemic, and out-of-pocket costs. This will allow me to empirically analyze the current situation and investigate the true double burden of COVID and TB. To address the disruptions in care that the pandemic has caused, we must ascertain the nature and location of these delays. I hope to gather evidence to eventually guide strategies that engage private healthcare providers and accelerate the delivery of care to those most burdened by this pandemic. "

Lilian Lopez Leyva

PhD Candidate, Human Nutrition - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Joseph I. Wolfsdorf Fund for Global Child Health

Lilian's project: The importance of the human milk microbiome, and its relationship with subclinical mastitis and their impact on infant growth in an indigenous population of Guatemala

In my proposed project I am interested in further investigating the association of the milk micronutrient composition (minerals and trace elements), the human milk microbiota and subclinical mastitis, which this latter one may be a consequence of micronutrient deficiencies and microbiota dysbiosis. Finally, I will analyze the impact on infant growth of human milk microbiota changes induced by subclinical mastitis and milk nutrient composition (mineral and trace elements), all this using biobanked milk samples that have been previously collected by our research group. However, with the help of the Global Health Scholars and a visit to Guatemala I will be able to obtain more information on infant feeding practices, as currently we only have data of the maternal diet intake.

A second objective in travelling to the research site in Guatemala is to collect water and soil samples in order to analyze if any environmental bacteria might be associated to the milk microbiome. I am interested in acquainting myself with the culture and traditions of the community and interviewing the Mam-Mayan mothers in order to better understand the infant feeding practices. Finally, by being in Guatemala and as Spanish is my mother tongue, I will be able to give back to the team members at CeSSIAM by sharing my recent findings and work collaboratively on solutions that improve the current breastfeeding practices and the nutritional and microbial composition of the human milk."

Enriqueta Lucar Figueroa

MSc, Experimental Surgery - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Enriqueta's project: Evaluation of epilepsy surgery program development in low-and-middle income countries (LMIC) and creation of a Delphi-consensus epilepsy database

"This project consists of two parts with the goal of improving epilepsy care in LMIC by creating tools to better help define the disease burden of epilepsy and to improve epilepsy program development. The first part of this project consists of a scoping review assessing established epilepsy programs in LMIC. Each building block of the WHO health system framework will be evaluated based on its strengths, weaknesses, opportunities, and threats/barriers. The goal is to identify gaps in epilepsy care systems in LMIC. The second part of this project is to create an epilepsy database for LMIC based on epilepsy experts鈥� opinion with a modified Delphi method consensus. Participants will be both national and international epilepsy experts from several disciplines dedicated to epilepsy patient care. Epidemiological, clinical and administrative variables will be assessed. The goal is to create a database to help define the epilepsy disease burden in LMIC which can then serve both for epidemiological and research purposes. After completion of the database, follow-up studies will be conducted through retrospective internal and external validation of the proposed database."

Karen Paul

PhD Candidate, Social Work - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students

Karen's project: 鈥淕ood Social Work Practice鈥� in Settings of Armed Conflict: A Study of Syria

"My research explores perspectives on what constitutes 鈥済ood social work practices鈥� in the midst of the complex emergency in areas of Northwest Syria. My research focuses on the perspectives of community members, national and international practitioners who perform or receive social work functions. It also explores their views on useful forms of support for Syrians who perform these functions and recommendations for 鈥済ood social work practices鈥� in other complex emergencies. Within the social work profession, best practices may be defined as 鈥渞ecommendations regarding the practices most appropriate for routine use in service systems with particular populations and problems鈥� (Mullen et al., 2008, para 4). 鈥淕ood practices鈥� are those that are proven to be useful and create good results, and are thereby recommended as models (FAO, 2016). Yet, conceptions of good practice may differ across culture and contexts. Existing social work research explored effective practices for working with survivors of human trafficking globally (Steiner et al., 2018), perspectives on local forms of social work in post-conflict Sierra Leone (Doucet & Denov, 2012), and post genocide Rwanda (King et al., 2017). Yet, there is a lack of research exploring perspectives on 鈥済ood social work practices鈥� within complex emergencies and in Syria. Using an online collaborative method, my research uses constructivist grounded theory to develop a framework on what constitutes 鈥済ood social work practices鈥� in the midst of the Syrian context. This framework will offer insights for recommendations on good social work practices in other complex emergencies and effective forms of support for local practitioners."

Angelina Sassi

MSc, Epidemiology - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Ambassador Paul Frazer Travel Award for Global Health

Angelina's project: COVID Effect on TB (COVET) project [focus on Indonesia data]

"Tuberculosis (TB) is one of the top ten causes of death globally. Ensuring that high-quality health care is accessible and available to all people at risk for TB is a crucial step in the fight to end TB. This project will contribute to the goal of engaging private healthcare providers for TB by assessing the extent to which the COVID-19 pandemic has disrupted private healthcare markets in Indonesia.

The goal of the COVID Effect on TB (COVET) project is to enrich our understanding of how the COVID-19 pandemic has impacted private healthcare markets in three countries with high burden of TB and dominant private health sectors (India, Indonesia, and Nigeria). My thesis will specifically assess the extent to which the COVID-19 pandemic has affected the quality of TB services in the private health sector in Indonesia. In partnership with local research organizations, we will collect quantitative, comparative data on how the COVID-19 pandemic has changed private health markets as compared to pre-COVID markets. The standardized patient methodology for assessing quality of TB care has been previously validated and a detailed manual and toolkit have been published for wider use. By limiting standardized patient surveys to just one case 鈥� the classic, 鈥減resumed鈥� TB patient who will present with typical TB symptoms 鈥� comparisons can be easily made to standardized patient data that were collected in Indonesia before the COVID-19 pandemic began. We will complete 250 actual standardized patient interactions with 200 providers in each site."

Khandideh Williams

MSc, Family Medicine - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Khandideh's project: A qualitative study exploring the relationship between race and primary healthcare accessibility within socially vulnerable populations in Montreal

2020 Global Health Graduate Scholars

Loloah Chamoun

PhD Candidate, Human Nutrition,聽Global Food Security - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Ambassador Paul Frazer Travel Award for Global Health

Loloah's project: The use of palm weevil larvae as a livelihood strategy and a food fortification approach for women of reproductive age in Ghana.

"The research project aims to gain a better understanding of Ghanaian women of reproductive age鈥檚 (WRA) beliefs regarding the acceptability of palm weevil larvae (akokono) for consumption and sale purposes, as well as evaluate the barriers and facilitators associated with its marketability within selected communities in the Ashanti region. Moreover, this study aims to evaluate WRA鈥檚 dietary intake to develop anakokono-fortified food product that is specific to the communities鈥� nutritional needs (mainly in terms of iron), that is highly nutritious, cost-effective, accessible and accepted organoleptically by WRA.Ultimately, I am trying to understand whether akokono could be harnessed as a source of income for WRA in peri-urban communities in the Ashanti region, and as a food fortification approach to treat iron-deficiency anemia among WRA."

Gabriel Schnitman

MSc Candidate, Experimental Surgery (Global Surgery stream) - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Gabriel's project:聽 Feasibility of the application of multimedia animations as preoperative guides for urgent abdominal surgeries in public hospitals in Brazil

"With a need for better communication tools, this study aims to evaluate the feasibility and impact of standardized pre-surgical multimedia guides for patients. Utilizing routinely updated, peer-reviewed medical literature, short-animated videos can be developed to focus on holistically educating patients on what to expect when undergoing surgical procedure, preoperative information, overview of their treatment, what to expect during their hospital stay and postoperative recovery details. The main objective of this study is to evaluate feasibility and impact of standardized pre-surgical animation guides for patients subjected to emergency surgical procedures in public hospitals in a low/middle income country."

Giorgia Sulis

PhD Candidate, Epidemiology - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Giorgia's project: Mystery clients to assess inappropriate antibiotic use in India

Global antibiotic consumption has increased dramatically over the past few decades, contributing to the development and spread of antimicrobial resistance (AMR), which is now a public health emergency worldwide. As highlighted by our previous work with standardized (simulated) patients (SPs), even in countries like India where the burden of infectious diseases is high, antibiotics are excessively used. Besides prescription in the absence of clinical indication (such as common cold or self-limiting watery diarrhea), it is likely that antibiotics are prescribed inappropriately in terms of drug choice, dosage and duration to patients who need an antibiotic treatment. For instance, certain antibiotic classes such as quinolones that have a high potential for selecting resistance and should be therefore used with great caution, are disproportionately prescribed and dispensed in India, suggesting a poor adherence to treatment guidelines among health professionals. Private providers substantially contribute to the high levels of antibiotic use in the country. Since about three quarters of outpatient visits in India take place in the private sector, a better understanding of prescription practices among private primary care practitioners is extremely important. We will conduct a SP study in India with the aim ofassessing the extent and pattern of inappropriate antibiotic prescribing/dispensing to patients with prespecified infectious illnesses that are commonly encountered in primary care settings in India and for which antibiotics are required.

Juan Pimentel

PhD Candidate, Family Medicine - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Juan's project: Impact of Co-Designed Game Learning on Cultural Safety in Colombian Medical Education: a Randomized Controlled Trial

"Cultural safety encourages health practitioners to examine how their own culture shapes their clinical practice; it proposes they should respect patient worldviews. Lack of cultural safety in health care is linked to stigma and discrimination towards culturally diverse patients. As part of an effort to bridge the cultural divide between Western health services and the cultural preferences of the society, we developed a medical curriculum to promote respect for traditional medicine users in multicultural Colombia. A challenge facing cultural safety education in a setting like this is that health professionals are seldom motivated to interact with traditional health practices. Game jams, collaborative workshops to create and play games,have recently shown effectiveness and engaging potential in university-level education. No published medical education research has explored the role of co-designed game learning in medical training. My trial aims to determine whether medical student participation in a game jam to design an educational game on cultural safety is more effective than a conventional lesson on cultural safety in terms of change in students鈥� self-reported behavior."

Tristan Supino

Msc Candidate, Psychiatry - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Spencer-Hick Family Global Heath Education and Training Fund

Tristan's project: School Mental Health Promotion for Indigenous Youth

"Background: In the Division of Social and Transcultural Psychiatry, my project will evaluate the implementation of a school-based mental health promotion program for Indigenous youth. Indigenous populations in Canada have been subjected to colonialism and cultural oppression, leading to many Indigenous groups having higher rates of youth suicide and drug abuse than non-Indigenous counterparts. Health promotion programs that build upon resilience are one strategy to address this inequity. Directed by Dr. Kirmayer, Listening to One Another to Grow Strong (LTOA) originates as a family-based mental health promotion program developed in partnership with First Nations communities that aims to enhance the well-being of Indigenous youth, their families, and their communities. A unique feature of the program is that each First Nation adapts the program to their culture to increase cultural appropriateness and community uptake. To increase program reach, the LTOA team developed a shortened and more flexible school-based program. Although the school-setting can scale-up a family program to reach a larger population, the evaluation of the implementation of a school-based mental health programs in Indigenous communities in Canada remains an under-studied area.

Research Objectives: In partnership with Nlaka鈥檖amux Health services,a First Nations Health Organization in British Columbia, the research objectives are: (1) identify implementation strategies used to successfully deliver the LTOA school-based program;(2) assess the students鈥� experiences in the program.To have positive outcomes, interventions need to be properly implemented while considering the context of the implementation. The specific objective is to evaluate the local implementation process of the school-based intervention, with the goal of improving program delivery."

Joy Nyamiaka

Masters of Science in Public Health - Participant in the 缅北强奸 Global Health Scholars Program for Graduate Students supported by the Soe-Lin-Hecht Global Health Graduate Award

Joy's project: Tailoring Cervical Cancer Screening Services for Inuit Women of Nunavik

"Being informed about HPV and its association with cervical cancer is crucial for women to understand and take full advantage of cervical cancer prevention and detection strategies. The level of awareness and knowledge about HPV among Inuit women is quite low. A study by Cerigo et al.(2010) found that only about 31% of Inuit women have heard about HPV with most of them hearing about it from their health care provider, the radio, or female lay health workers. Therefore, under the supervision of Dr Brassard, I will be working with health care workers in Nunavik, Quebec to identify ways to implement HPV self-sampling as a way to increase access to regular screening among Inuit Women. Specifically, in collaboration with these health professionals, I will develop educational tools to inform women about cervical cancer, HPV related cancers, and the importance of cervical cancer screening and prevention. This project aims to identify convergence and divergence between Inuit women and non-Inuit health care workers to define implementation strategies for cervical cancer screening that are in accordance with Inuit values and practices.Since primary care in Nunavik is provided by non-Inuit professionals, understanding how Nunavummiut see the issue is fundamental to developing realistic screening strategies. Cancer screening coverage can be increased by self-sampling however, implementation strategies must be contemporaneous with an education campaign on the importance of screening and the link between HPV and CC."

2019 Global Health Graduate Scholars

Kathryn LaRusso

PhD Candidate, Experimental Surgery, Global Surgery Track - Kathryn is a Jean-Martin Laberge Global Pediatric Surgery Research Fellow in the Department of Pediatric Surgery at Montreal Children鈥檚 Hospital. She has always been drawn to global work and completed her undergraduate degree at Georgetown University in International Health. She subsequently obtained an MPH from Boston University in International Heath and Health Policy after living and working in Dakar, Senegal with the World Bank Group. She worked on HIV and TB projects in Togo, DR Congo, and Gabon before attending medical school at Michigan State University. She is currently a general surgery resident at UT Health in San Antonio and interested in completing a pediatric surgery fellowship. Her PhD work is focused on improving surgical care for children and currently based in Uganda

Kathryn's project: Measuring pediatric risk-adjusted surgical outcomes in low-resource settings using the National Surgical Quality Improvement Program for Pediatrics database

Parnor Madjitey

PhD candidate, Family Medicine - Parnor is a biochemist and a bioethicist trained at the Center for Biomedical Ethics and Law at the Katholieke Universiteit in Leuven, Belgium and at the Joint Centre for Bioethics at the University of Toronto, Canada. He has many years of research experience working with a team of scientists on a multidisciplinary case-control study of malaria in a Ghanaian local community. He worked as the team leader at both the field site and in the malaria project laboratory. He has also been involved in non-communicable disease research in various locations in Ghana and taught public health ethics courses at the School of Public Health, University of Ghana, Legon, Ghana. The focus of his Doctoral thesis is on the 2014 Ebola pandemic outbreak in Liberia, Sierra Leone and Guinea. He has an interest in exploring how to promote health equity at the intersection of primary health care, global health and public health ethics.

Parnor's project:聽 An investigation of ethical tensions faced by health workers during Ebola outbreaks in resource-poor settings

Erin Muyres

Masters of Science in Public Health - Erin is a Registered Nurse with a BScN from MacEwan University in Edmonton, Alberta. Following practical experience, primarily in maternity and pediatric environments, she volunteered for two years as an RN with Mercy Ships in Benin and Madagascar. During this time she also acquired a Diploma of Tropical Nursing at the Liverpool School of Tropical Medicine in the UK. Erin is passionate about capacity building and improving health systems globally which led her to pursue a Masters of Science in Public Health at 缅北强奸.

Erin's project: Developing training materials for health workers for the Smart Discharges Program in Uganda to decrease post-discharge mortality in children

Raissa Passos dos Santos

PhD Candidate, Nursing - Raissa is a PhD Candidate at Ingram School of Nursing. She graduated with a Masters Degree in Nursing Science from the Federal University of Santa Maria, Brazil. Her masters thesis was focused on the moral experiences of nurses caring for children with complex needs. Raissa is the recipient of the 2016 David McCutcheon Pediatric Palliative Care. She is part of the VOICE team (Views On Interdisciplinar Childhood Ethics) as a research trainee. In 2018, she was awarded the Doctoral training scholarship from the Fonds de recherche Sant茅 do Quebec (FRQ-S). Her research interests include Health Care for Children with Medical Complexity, Pediatric Palliative Care, Global Health, Ethics and Bioethics in Pediatrics and Nursing Ethics and Practice.

Raissa's project: Advancing ethical care for children with medical complexity in Brazil: a global health qualitative study

Talia Sternbach

Msc Candidate, Epidemiology - Talia holds a BA in Environmental Science and Urban Systems from 缅北强奸 and is pursuing her MSc in Epidemiology, focusing on global environmental health and policy evaluation. She is interested in leveraging scientific evidence and interdisciplinary collaborations to inform health and social policies and address environmental exposures that are harmful to human and planetary health.

Talia's project: Assessment of air pollution and indoor temperatures in peri-urban Beijing to inform the Beijing Household Energy Transition (BHET) policy evaluation.

Anita Svadzian

PhD Candidate, Epidemiology - Anita first joined the 缅北强奸 International TB Centre as a research assistant. As an RA, she was working on various projects through 缅北强奸鈥檚 agreement with UNOPS 鈥� Stop TB Partnership 鈥� TB REACH. Though Anita holds an honours B.A. in Art History and History, she has always had a strong interest in medical fields having worked in clinical research for the Cedar鈥檚 Breast Centre at the MUHC for the majority of her undergraduate studies and thereafter. This formative experience inspired her to seek formal training and consequently, she completed her M.P.H. from Boston University with a focus on Epidemiology. She is extremely interested in the social determinants of health and as such her somewhat unorthodox background has helped her in understanding the interdisciplinary dynamics of health research.

Ran van der Wal

PhD Candidate, Family Medicine and Primary Care - Ran is a Vanier Scholar with a background in law and public health. With nearly a decade of global health practice (M茅decins Sans Fronti猫res and Premi猫re Urgence Internationale), she has been involved in global health research since 2013. Her current PhD project involves participatory research in a structural HIV prevention trial in Botswana. Her fieldwork supports stakeholder-led improvements of social support programs to leverage resources and capabilities for HIV prevention.

Ran's project: HIV-sensitive social protection in Botswana: vulnerable young women improve their access to social support programs

Mercedes Yanes Lane

Masters of Science in Public Health - Mercedes is a bicultural Mexican-British family doctor, passionate about infectious diseases and finding ways to reduce the social inequities that can lead to them. She graduated from the Autonomous University of San Luis Potosi Mexico and has since worked in the Mexican National Public Health Institute as a research assistant in the Tuberculosis unit and as program coordinator for the infectious diseases and maternal health and well-being programs of the Medical Specialties Hospital of San Luis Potosi.

Mercedes' project: Sustainability and impact of interventions from the Enhancing the Public Health Impact of Latent Tuberculosis Infection Diagnosis and Treatment study (ACT 4) in Rio de Janeiro, Brazil

Michele Zaman

Masters of Science in Public Health - Michele completed her Bachelor's of Science at McMaster University. Through her previous work with intergovernmental organizations, she has became passionate about child and maternal health issues, particularly the relationship between nutrition and social determinants of health and how these interactions affect the etiology of obesity and other child health outcomes. Her research focuses on the promotion of early childhood development through nutrition, education and gender empowerment.

Michele's project: A global systematic review and meta analysis of responsive feeding exposure and effects on child development and health outcomes

2018 Global Health Graduate Scholars

Emily MacLean

PhD Candidate, Epidemiology - Emily completed her BSc in Biology at Simon Fraser University, and her Masters in Microbiology & Immunology at 缅北强奸, where her research focused on cutaneous leishmaniasis. Expanding upon her interest in infectious disease beyond the molecular level, she joined Dr Pai and his team at the 缅北强奸 International TB Centre as an RA and is now pursuing her PhD in epidemiology.聽

Emily's project: "Childhood TB is difficult to diagnose because the symptoms are very general, making it difficult to distinguish from other diseases, and existing diagnostic tests are not tailored for use in children. Both the most widely used diagnostic test, smear microscopy, and the most accurate modern test, GeneXpert MTB/RIF, require sputum samples, which young (<7 years) children cannot actually produce. My research project is concerned with evaluating the diagnostic accuracy of an updated GeneXpert test, GeneXpert Ultra, with an alternative sample for childhood use. In collaboration with NGOs FIND and Jan Swasthya Sahayog, we will conduct a field study of Xpert Ultra in Ganiyari, India, a rural village in central India. We will determine how well Xpert Ultra, performs using stool samples, which are much easier to obtain from children than sputum. Stool will be sampled using a sample collection and purification tool that will ensure samples are of minimal biohazard risk, and that samples to be processed will be standardized before being run in the Xpert Ultra test. Additionally, we aim to determine the impact of other medical conditions on Ultra performance. It is critical to understand test accuracy in people living with severe comorbidities, which are unfortunately common in children at risk for TB."

Emmanuel Chilanga

PhD Candidate, Social Work - Emmanuel holds a Master of Science degree in Geography from University of Western Ontario and a Bachelor鈥檚 degree in Education from University of Malawi. Emmanuel is a member of the Centre for Research on Children and Families (CRCF) at 缅北强奸 and a Malawian collaborator of Consuming Urban Poverty (CUP2) research group based at Wilfrid Laurier University in Canada.

Emmanuel's project: Applying the Intervention Mapping Protocol to develop a Community Based Household Food Security and Dietary Diversity Promotion Program in Mzuzu city, Malawi

"The aim of my study is to develop a household food security and dietary diversity promotion program by using an Intervention Mapping Approach in Mzuzu city, Malawi. The proposed nutritional intervention program protocol will act as a blueprint that will guide Mzuzu city Council and its development partners to successfully implement a theory and evidence based nutrition intervention that can mitigate the negative impacts of severe food insecurity and low dietary diversity. The protocol was designed for health promotion but it can also be used in any situation in which behavior change is desirable. Intervention mapping framework is based on three perspectives. The first is a social ecological approach whereby the framework recognizes that health is a function of individuals and of the environments in which individuals live. Secondly, the intervention mapping protocol recognizes the importance of collaboration among various stakeholders in development, implementation and evaluation of health promotion program. Inclusive community participation is important in designing a health program because it ensures that the intervention reflects the needs of the local community, brings a greater breadth of knowledge, skills, and expertise that improve the external validity of the intervention. Lastly, the intervention mapping is based on the use of theory and evidence based data in order to develop, implement and evaluate a health program."

Icoquih Badillo-Amberg

Masters of Science in Public Health - Icoquih received her Bachelors of Arts聽in Psychology, minoring in聽Biology at 缅北强奸. She聽is currently completing her masters in聽Public Health as a Queen Elizabeth Scholar聽at the same institution.聽聽Icoquih is very passionate about maternal and child health 聽issues.Her research focuses聽on the promotion of health service access and health equity among聽women and children in North-Eastern Kenya. In addition to generating scientific evidence, Icoquih and her team聽work to聽inform聽decision making and policy聽for effective and sustainable responses to critical health聽issues facing vulnerable聽women and children in this region.

Icoquih's Project: "My research project seeks to utilize data from the African population Health Research Center (APHRC) to determine the impact of culturally appropriate interventions on maternal health service utilization in women aged 15-49 in Garissa, Kenya and seeks to study the socio-cultural barriers that preclude women from accessing healthcare in this region. It is a project that may contribute to the efforts of improving maternal and child health globally by generating evidence for the effectiveness of a culturally sensitive maternity intervention.聽 In addition to writing the report of my own project, I will conduct epidemiological analysis in collaboration with APHRC research scientists and will also contribute to writing the final report of the intervention study, which will be submitted November 2018."

Kariane St-Denis

Masters of Science in Public Health, Global Health Option - Kariane completed a Bachelor's in Arts and Science with a double major in Molecular Biology and International Development Studies. In the past, she has worked with an NGO focusing on issues of reproductive health among school-aged girls in regions of rural Uganda.

Kariane's project: Validating first trimester pregnancy status in adult women to inform implementation of deworming programs

"The aim of this study is to validate the use of a questionnaire, consisting of a minimum set of parsimonious questions with high predictive potential, in assessing the pregnancy status of women in Iquitos, Peru. A study population of 1000 adult women聽 will be recruited from a catchment area of peri-urban communities around Iquitos. These communities are known to be endemic for worm infections and would be included in the national deworming program. Both a questionnaire and a urine-based pregnancy rapid test will be administered to the study population. The validity of the questionnaire will be assessed by comparing the results of the questionnaire to the results of the pregnancy rapid test, which will serve as the gold standard. One or more questions with the greatest predictive capacity (those for which the answers show a consistent pattern of agreement with the binary outcomes of the pregnancy result) will be identified using quantitative biostatistical methods. To complement this comparative analysis, the value and applicability of the questionnaire as perceived by the respondents themselves will be assessed through focus group discussions. The focus group discussions will聽 contextualize and inform the interpretation of the data and provide guidance during the rolling out of the deworming program."

Katherine Pizarro

PhD Candidate, Psychiatry - I am a PhD student in Transcultural Psychiatry with a background in public health and evaluation research. I have mixed-methods training and have conducted formative and evaluation聽research in Peru, Ethiopia and the US.聽My doctoral research is focused on the evaluation of mental health promotion programs for at-risk youth.

Katherine's Project: "My PhD will focus on developing and evaluating a community-led intervention for addressing the social determinants of fathers鈥� wellbeing and engagement in promoting maternal and child health (MCH) in marginalized indigenous聽 communities in Guatemala. The current project will be the first step in this larger effort and aims to: 1) explore the knowledge and perceptions of fathers, mothers, indigenous healers and local health center staff about the local determinants of paternal wellbeing and involvement in MCH, and 2) measure the prevalence of these determinants and their聽 relationship to men鈥檚 wellbeing and involvement in MCH). The fieldwork will take place in two rural regions with a high burden of maternal and child morbidity: Cuilco, Huehuetenango and Santiago Atitlan, Solol谩. Taking a participatory approach, I seek to build a culturally safe, collaborative environment to generate community engagement in promoting men鈥檚 involvement in MCH. I will form a community advisory committee (CAC) of interested stakeholders in each of the two regions, which will contribute to intervention design, ensure the appropriateness of methods, identify and recruit participants, and interpret findings."

Sophie Huddart

PhD Candidate, Epidemiology - Sophie Huddart received a BSc in Immunology and Infectious Disease from Penn State University and a MSc in Biostatistics from the University of Glasgow as a Fulbright Scholar. She has conducted research in immuno-parisitology and statistical clustering methodology but has always been an epidemiologist at heart. In addition to being the team鈥檚 number cruncher, Sophie works on diagnostics and patient mortality in the Indian TB epidemic.

Sophie's Project: "A key component of the WHO End TB Strategy is improving the quality of TB care. Case fatality is an important marker of care quality as prompt diagnosis and appropriate treatment should prevent deaths during and after treatment. The End TB Strategy calls for a 95% reduction in TB deaths by 2035 relative to 2015 rates and improving this metric requires accurate measurement of fatality. This project, which will form the central paper in my manuscript-based PhD thesis, will estimate the case fatality rate among TB patients treated in the largely unregulated Indian private healthcare sector. Currently, very few studies in the literature that assess the mortality of Indian TB patients consider privately treated patients because weak recordkeeping systems make these patients very difficult to follow using administrative databases. In this project, I will collaborate with PATH and World Health Partners (WHP) to survey cohorts of privately treated TB patients in Mumbai and Patna, India. I will estimate the rate of fatality and recurrent TB in this understudied patient group and identify predictors for fatality and recurrence."

Sara Ferwati

Masters of Science in Public Health - I am a biochemist by training. I have completed a previous MSc in cancer research, but realized I spent a lot of my spare time studying policies and understanding the impact of social inequities on health. Thus, I decided to pursue a MScPH as a way to consolidate my health science background and interest in social determinants of health.

Sarah's Project: "The primary objective of this study is to design interventions to address the cost period before and after the diagnosis and the associated social costs of childhood cancers in India. To do so we will conduct: 1) A scooping review of literature addressing interventions to combat treatment costs of聽 chronic diseases in LMIC, specifically in South Asian communities. 2) Interviews and focus groups to assess the applicability of the designed interventions at a cultural and political level; this will be carried out in New Delhi. The interviews will be designed and conducted under the guidance of Dr. Ramandeep Aror, the on-site supervisor. Our research team has extensively mapped the sources of families鈥� costs and availability of support prior and following their child鈥檚 cancer diagnosis. This study will design and evaluate targeted interventions to alleviate the costs associated with a child鈥檚 cancer, with the goal of reducing the rates of treatment abandonment in India."