Gillings Global Health Blog

Students and global health experts share their experiences working with communities.

Staying Connected

Melissa in a field of sunflowers at the NC Museum of Art.

Enjoying the colorful sunflowers, cosmos and zinnas at the NC Museum of Art.

As I was driving a familiar route on I-40, admiring the lit up American Tobacco Trail bridge against the various hues in a beautiful Carolina sunset.  I wondered, “What does a sunset over Lusaka, Zambia look like?” if I were there for my practicum.  I have only heard of my colleagues and friends’ experiences as they lived and traveled there.  I understood it to be a place that drew someone I admired and respected back so many times that when we ordered her retirement party cake, it had the colors of the Zambian flag on it.  I searched for images online, and as I scanned the landscapes, buildings, and people in photographs, in that moment, I wished that I could be there experiencing a universal, cyclic sunset that is familiar yet different everywhere you experience it. When I applied for this practicum, I knew that it would be understandably remote as we are still in a pandemic, but I still wished I could travel and meet with my colleagues in person.  The past year has been a roller coaster ride of emotions through the challenges and opportunities while being remote pursuing an MPH with a concentration in Nutrition at the UNC Gillings School of Global Public Health and working full-time as a project coordinator also at UNC.

Prior to becoming an MPH candidate and returning to work in global health, I earned my culinary arts degree in New York City and worked as a line cook and sales account manager. I also have bachelor’s degrees in Anthropology and East Asian Studies from the University of Virginia.  My partner and I moved to Chapel Hill, North Carolina so I could be an assistant cheesemaker and cheesemonger.  It has been a long journey leaning on my support system of family, friends and mentors to get where I am today able to pursue my passion and studies in global health nutrition.

For my UNC Gillings Zambia Hub practicum, I am part of a qualitative research study funded by the UNC Center for AIDS Research (CFAR).  The study examines the feasibility and acceptability of engaging male partners, grandmothers, and other family members to support HIV-positive mothers in Lusaka, Zambia, to practice recommended infant care and feeding practice and adhere to antiretroviral therapy. The data collectors are trained in Trials of Improved Practices (TIPs), which is a formative research technique, and they counsel women and their families.  Data are collected during a series of three interviews with HIV-positive women, and two interviews with the women’s male partners or family members. TIPs is a consultative methodology that focuses on understanding what is adaptable and feasible for HIV-positive mothers and their partners and families to improve infant feeding and care, bridge the gaps between knowledge, and put improved health for mothers and infants into practice.  I am particularly interested in learning from the Zambia-based team and my preceptor about conducting interviews and using TIPs as a research method and technique to give participants a voice in program planning.  It is vitally important to understand the context and practice cultural humility with stakeholders, which assists with sustainability.  I also like how the participants try out the agreed upon practice and I am eager to learn more about the support system of these women and its impact on their and their infants’ nutrition and prevention of mother-to-child transmission of HIV. During my practicum experience so far, I am learning how to use Ona, an online platform using Open Data Kit (ODK) to collect data and summarize participant characteristics and responses. I have also given feedback on the interview guides and written transcripts.  I look forward to working with the team to create a codebook and code transcripts in Atlas.ti. and synthesizing what we will learn. I also continue to learn from the team on how to conduct qualitative research effectively in interviews and be faithful in translations while maintaining the dignity and privacy of the participants.

My summer days have been flying by as I started a new job within UNC Carolina Population Center (CPC) at the end of May and continued to work full-time in addition to my practicum.  I meet virtually with my preceptor, Dr. Stephanie Martin, and a fellow student every week, and with the Zambia-based team frequently, which keeps me connected and moving forward. I am appreciative and grateful for the team that I work with for their flexibility and understanding. The silver lining that I have found in a remote practicum and hybrid work schedule is I am able to do both. Similarly, to what others have said in this blog space, I reflect upon my current situation daily and strive to change my mindset/perspective by practicing gratitude one day at a time.  I recently watched Chef’s Table: BBQ featuring the James Beard Award winner, Rodney Scott on Netflix.  He said, “Every day is a good day. It doesn’t always go as smooth as we want, but life is what you make it.” “My glass is going to be half full each time.” “What did I do yesterday that I can improve on today?” These words and his approach resonated with me to apply this to life and my practicum experience of doing qualitative research in a pandemic. All research activities in Zambia involving direct contact with participants were temporarily suspended for over a month due to the increase in COVID cases and only recently resumed on August 4.  We have what we planned in the theoretical sense, and then we had to face real-life implementation.  The safety and well-being of those in Zambia were most important. I learned more about communication and how to move forward even during these most challenging times.  Due to the delay in completing data collection and changing timelines in project implementation, my practicum was slightly extended, and I will continue to work with Dr. Martin and the team through an independent study this fall.

Beekeeping boxes.

Backyard beekeeping

Picture of a bunch of different vegetables picked from the garden.

Proud of the harvest from our garden.

In addition to a busy work and school schedule, I am finding respite by taking care of our four beehives and mini homestead garden with my partner, Michael.  I am also spending time with my co-worker and cat daughter, Honey. She reminds me to get up and move away from my computer to pay attention to her and what is going on outside.

Brown, tan, white and grey cat sitting on a chair.

Honey, our amazing and wonderful cat


Learning practical data analysis for strong sanitation programs in India

Picture of Katie in a kayak on a lake.

Enjoying my summer kayaking whenever I got the chance.

I worked with Gram Vikas (GV), an Indian NGO, based in Bhubaneswar, Odisha, India for my practicum this summer. GV has been working in the Odisha state for the past 50 years. GV partners with rural communities to enable them to lead a dignified life by building their capabilities, strengthening community institutions, and mobilizing resources. Gram Vikas has been working to understand and expand access to piped water supply and sanitation in the communities it reaches, as well as to understand and strengthen the institutional systems for community ownership and management of water, sanitation, and hygiene (WaSH) systems since 1993.

Gram Vikas recently completed a sustainability assessment survey capturing data on water and sanitation access, functionality, and management status for over 40,000 households in areas of India where Gram Vikas has worked between 1993 – 2020. Household survey data were collected between August 2018 to January 2020 covering a total of 10 districts across the Odisha state. The sample frame for the survey was a census of communities served in these districts (n = 41,586), meaning that GV attempted to collect data from each household in each community across these districts in which GV had worked.

Working with this dataset from GV has been an incredible learning experience. I have been able to learn Stata in a way that I could not have been able to otherwise. Using data collected by GV across a diverse geographic region, in combination with additional publicly available secondary data, we undertook additional analyses to support GV’s efforts to better understand what variables and factors influence service delivery, service quality, access and use, and sustainability, to strengthen service delivery, enhance equity, and expand access to sanitation across the Odisha state

Some of the challenges that came up from working with this data included my learning curve using Stata in an applied way for the first time and determining how to clean up the variables to get an accurate read. My previous class experience taught me the basics of how to use Stata, but this dataset allowed me to learn in an applied way. Using some of the resources from those classes, the expertise of Cathy Zimmer from the UNC Odem Institute, and assistance from my team I was able to get the support I needed to tackle this dataset. Some of the variables in the dataset needed to be edited to provide the best possible outcome. For example, each household answered a question what type of phone they had, but the outcome of no phone was not included in this variable. It was important that I combine them to have the full picture of what type of phone outcome each household had. I will be grouping this variable with other variables in order to create a wealth quintile in the coming months to see how wealth impacts households ability to have a toilets and bathing rooms in their home and other sanitary dependent variables.

Gorgeous sunset during my vacation to Hilton Head Island

Gorgeous sunset during my vacation to Hilton Head Island.

I have been given the opportunity to continue working on this data in the fall semester and look forward to learning more about what impacts sanitation and how GV’s interventions are helping to close these gaps.


“On my feet” Adaptation Skills

A Tableau map we constructed from geotagging ourselves once in each of the 35 surveyed villages.

A Tableau map we constructed from geotagging ourselves once in each of the 35 surveyed villages.

Hello again!

I hope everyone’s summer went well. Ours was … honestly… a bit chaotic, but it taught me a lot of patience and “on my feet” adaptation skills! While I was always safe and cautious, we did encounter some challenges with COVID-19 during our Sickle Cell Awareness Survey and Community Needs Assessment in Western Uganda. The national policies on travel were changed a few times, and usually with little notice – which made planning our daily work nothing short of challenging.

– However-

I’m really really proud of the work that we did and am very thankful for the help and support that I had along the way!

We [surprisingly] were able to interview ALL 35 villages in the sub-county. This ended up being a little over 200+ individual household interviews. It was not an easy feat but was extremely important, as we wanted to establish the baseline awareness of sickle cell in the area. So far, we are finding an unexpected spatial distribution of sickle cell awareness, which will be interesting to dig into later.

To estimate the current burden of disease, and service utilization in the nearby municipality we visited the records department of four different hospitals and mapped the five-year trend of in-patient, out-patient, and laboratory visits for sickle cell – a bit of grunt work, digging through a lot of loosely-organized dusty papers, and broken binders, but the recovered information is really going to give us some great insight into the current situation in the area.

Most importantly, we got a good look at the service availability and challenges for families with sickle cell from 19 family interviews, and visits with local and national stakeholders in sickle cell care. We looked more deeply into resource availability by surveying 23 area drug shops and traditional healers.  And identified some gaps in provider knowledge and awareness of sickle cell, areas for improvement, through 51 health provider surveys.

Overall, the last three months have been really busy – but really rewarding – because I know the efforts of that work won’t end here. We expect this Community Needs Assessment will lay the groundwork for a future monthly clinic day dedicated exclusively to sickle cell. A day where individuals in this sub-county can come to test for sickle cell and where those with Sickle Cell Disease or Sickle Cell Trait can receive regular health visits and support within their own community.


With goal-motivated fun, time flies

I have been privileged to work on a hugely satisfying and rewarding practicum with the Gillings Zambia Hub. It is qualitative research to assess the acceptability and feasibility of engaging male partners and other family members to support HIV-positive mothers to practice the recommended Infant feeding practices and Anti-Retroviral Therapy (ART) adherence.

My drive and interest in HIV research and the prevention of mother-to-child transmission stem from seeing the hardship faced by people living with HIV. Hence, I was glad for the opportunity to work on a subject matter I find interesting and relevant, so I have had no problem finding my footing or staying motivated, especially with the practicum being a virtual one.

For the project, we use the Trials of Improved Practices (TIPs), a formative participatory research technique developed by the Manoff group to pretest and improve the recommended practices on a small scale before introducing them broadly. Trained interviewers discuss current feeding practices and ART adherence with study participants in individual interviews. In addition, study participants are encouraged to identify home supporters. Subsequently, there is counseling on the recommended practices, and with the interviewer’s help, each study participant decides on specific practices to be adopted over a trial period. In follow-up meetings, the interviewer asks questions to assess the uptake of the recommended practices. By taking this approach, we draw from the experience of the study participants, who are members of our target population, to pilot test our recommendations. This approach enables us to recognize and determine the practicability or limitations of recommended infant feeding practices in the context of the local communities. Furthermore, using TIPs makes it possible to identify possible challenges that might impact the uptake of our proposed recommendations, provide solutions to these challenges, eliminate or modify practices that are not feasible.

As an intern, I support the team by reviewing the transcripts of the focused interviews and providing feedback. I also use Ona to assess and summarize the data and ATLAS.ti for qualitative data analysis. In addition, I am working on a secondary analysis of already coded data to determine the role of social support systems and couples’ joint decision-making in preventing mother-to-child transmission of HIV. Through my interactions with the research team, I am learning to be perceptive of cultural differences, be humble and respectful while giving feedback, and be open to responses that challenge my worldview and perspective. The opportunity to work on a diverse team has also afforded me a better appreciation of the interaction between individual social identities and power dynamics in a research ecosystem.

Sometimes, things do not go according to plan. A little over a month ago, the project had a slight hiccup when the Zambian government had to suspend all hospital-based research because of another wave of the COVID-19 pandemic. Data collection had to stop temporarily, affecting our deadlines for specific points in the study. Thankfully, the COVID-19 cases are dwindling, the suspension was lifted a week ago, and data collection has commenced again. Overall, I would say that this summer has been productive and a lot of fun. Through meeting other students,  I expanded my Gillings community. I also explored more of North Carolina. Most of all, I am thankful for a fantastic opportunity to learn and grow my skills through the Gillings Zambia Hub. Now, my only grudge is the swift passage of time because it feels like I started the practicum a day ago, yet it’s been three months and more. Indeed, time flies.

While spending a summer day at Ft. Macon State Park, I couldn’t resist taking a picture of these lovely seagulls.


Barreling Towards The End

My last practicum blog post, I expressed the slow-build experience making connections and forming relationships with the collaborators and community we were bringing together to support my practicum agency, Pitkin County Public Health, in executing deliverables for a grant addressing health inequities for the Latinx population of Roaring Fork Valley in Colorado exacerbated by COVID-19. Since that last post, I feel like the summer’s flown by, as our team of collaborators and stakeholders has barreled forwards towards the grant deadline next week. The experience has been both exhilarating and thought provoking, providing me many experiential lessons I will take forward into my second year of my MPH program and beyond.

First, I gained a greater appreciation for the challenge of balancing community-driven approaches that prioritize human relationships and creating shared spaces, with the logistical pressures and timelines of working within the institutional norms of grant-based financial infrastructure. For example, to support the Spanish Mental Health Media Campaign funded by the grant, we formed a Strategic Planning and Marketing Committee comprised of various community leaders interested and passionate to address the burden of mental wellbeing challenges in the area. While my preceptor and I prioritized ensuring that all members of the group were properly compensated for their time, as the grant deadline drew nearer, I felt the implicit pressure to increase the number of weekly meetings, and expectation for deliverables for the group to complete all campaign materials by the end of the grant period. I feel it can be so easy working within groups seeking to make a positive impact, and united by common values, to take advantage of these positive qualities. My practicum experience has left me reflecting on how easy it can be in the field of public health to succumb to prioritizing white supremacist norms, such as perfectionism, timeliness, and a sense of urgency, in the pursuit to fulfill the requirements of entrenched institutional standards.

However, my practicum experience also helped me gain a greater appreciation for how the field of public health can (and likely should) intersect with a broad range of other disciplines in its application. While I had the opportunity to participate in perhaps more traditional elements of public health work, such as delivering presentations to the state Board of Health, and developing monitoring and evaluation plans, I also was forced to step out of my comfort zone into other disciplines to properly support the efforts I was involved in. For example, I gained a crash course in budgeting and contract development for media campaigns, working with a county marketing specialist to solicit media purchase estimates from radio stations, public bus lines, and Internet spaces. Once our marketing committee had selected its primary forms of delivering the Mental Wellbeing Media Campaign, I coordinated directly with radio management and talent, and local social media influencers, to draft Scope of Work contracts; process media buys, and manage limited grant funds. There were several hiccups in this process, especially learning to navigate county rules around payment structures for contracted work, to be able to properly reimburse the media talent and campaign designers. I feel like I gained a lot of practical knowledge from these experiences, and I was reminded that in the gap between conceptual public health knowledge and the implementation of health promotion interventions and activities, there’s a variety of practical skills and leadership capacities that can be highly relevant. The varied experiences and skills I’ll take from my practicum have reinforced three lessons for me for my future public health practice: 1) to stay creative about the way public health can be combined with other disciplines 2) to continue developing varied skillsets not immediately incorporated in academic training 3) to seek out and value the knowledge and input of “expertise” from non-traditional sources and community leaders.

Also, I feel inspired to continue bringing my guiding value of creativity into my global health practice. I had the chance to bring my visual eye to my practicum in several respects, by creating logos and visuals for the campaign messaging that had been created by the Marketing Committee, and by building the formatting for resource guide for Immigrants and other Latinx families in the area.

It was a joy to help foster a creative space within the Marketing Committee meetings, cultivating an environment where everyone was sharing ideas and building messaging and campaign materials relevant to their own community. This Marketing Team developed a vision for a three-armed campaign, focusing on a local radio station, a local interview show, and social media pages on Facebook created during the pandemic, to direct limited campaign funding to the mediums with greatest reach and impact for the intended audience. I can confidently say these would not have been the mediums chosen by Pitkin County if left to their own devices, and are another example of the power of tapping into the expertise of community knowledge. I was very inspired to see the demographic-specific messaging the group devised for women, men, the older aged, and adolescents, as well as the compelling radio ads they drafted and moving video testimonials they produced. The unifying feature of the campaign the group devised utilized the imagery of a stoplight to encourage destigmatization, preventative action, and seeking help around mental wellness challenges. I honestly think this idea is super clever, and I can’t look at a stoplight now without being reminded to stop and check-in on my own mental wellbeing.

I also met with a myriad of community leaders, service providers, and other stakeholders, to conceptualize and produce a format for a community resource guide that would be inviting, useful, and accessible. Based on this input I devised a system using visual icons to aid in navigation of the guide and decrease the extent to which literacy is a barrier to access, also highlighting key potential barriers to accessing the services in the guide such as cost and documentation status.


Most of all though, the biggest thing I’ll be taking with me from my practicum experience are the positive memories, connections, and relationships I was able to form (albeit remotely) with so many wonderful individuals. I feel incredibly lucky to have had the opportunity to meet and become friends with the incredibly talented individuals in the Marketing Committee we formed, and I’m so excited to see all the positive work they produce in coming years.  It was difficult to say goodbye, it was a both a valuable reminder of the importance of the human element of public health work, and refreshing validation of my interest in pursuing a career in global health.


Three takeaways from my summer on TB

A map of North Carolina on a laptop in Jaclyn's backyard.I finished my practicum last week with the Tuberculosis (TB) Control Program at the North Carolina Department of Health and Human Services (NC DHHS) and wanted to share a few final reflections.

  1. Practica will inevitably change and evolve throughout the summer – but that’s not a bad thing! I originally thought I would be using surveillance data to estimate the prevalence of latent TB infections in the state. However, I was able to come up with a better strategy after consulting with the TB epidemiologist at DHHS. She illuminated some of the issues with the data reporting system we currently have and encouraged me to consult other estimates from the literature. This new direction allowed me to redirect my efforts to interpreting and assessing the quality of available estimates, which is ultimately an important skill for me as a budding “applied” epidemiologist.
  2. Practica can be a great opportunity to network and meet people outside of your normal circles. I got the chance to meet with some health departments from other states that had already done a similar educational outreach project around latent TB infections. It gave me the chance to see how other health departments structure their programs and often collaborate across states. I also got to peak into some of the case-level work that TB nurses do in North Carolina and how that feeds into the larger population-level work at the health department.
  3. Getting creative and taking initiative can help you get what you want out of your practicum. Part of my project involved compiling a list of doctors (called civil surgeons) that are active in providing medical exams for people seeking immigration status adjustment. I wanted to get some practice creating maps and my preceptor was on board, so I took some time to train on Tableau and then create a map of all active practices. This map was useful in presentations I gave to show where these doctors were concentrated, potentially helping to prioritize hotspots for the educational intervention. This map also illuminated that there were “deserts” in the state, where people might have trouble finding a nearby doctor and potentially get discouraged in the status adjustment process.

Overall, the practicum gave me an interesting look into the work that goes into planning an intervention at the state health department and learning how to use my knowledge and interests to potentially add value in unique ways. I am grateful for the opportunity to get some exposure to the government sector and practice some of the skills I’ve learned in the first year of the MPH.


The End signals the Beginning of Something New

Summer has faded fast. The official end of my practicum with Colectivo Amigos Contra el SIDA (CAS) approaches, sooner than I might like – a gentle reminder that things outside the academia’s confines do not always obey the metronome of a school calendar. I began the summer preoccupied with how I might contribute from afar, in the virtual world, to CAS’s mission, carried out from their clinic in Guatemala City, to provide stigma-free sexual health services to gay and bisexual men. Yet as the summer has worn on, the virtual aspects of my practicum have become less significant. It’s not clear that anything would have been gained, for anyone, by me being present in Guatemala this summer, aside from frequent flier miles. Instead, the great reward – and challenge – became calibrating my expectations of what was feasible in the abbreviated course of this summer.

As I commented in my earlier blog post, CAS maintains a longstanding relationship with Gillings researchers, a collaboration whose current focus is understanding the provision and uptake of HIV pre-exposure prophylaxis (PrEP), a daily medication which is highly effective at preventing the establishment of HIV infection in those exposed to the virus. In Guatemala, CAS is the only provider of PrEP, which it offers free of charge – and remarkably, CAS has greatly expanded its pool of clients using PrEP since the onset of the pandemic. The original design of my practicum focused on developing and implementing data collection instruments, a survey for CAS’s clients and in-depth interviews with providers, that would inform the creation of a mobile app to share health information and coordinate services for CAS’s PrEP program. With delays in the Institutional Review Board (IRB) approval for this phase of the study, my focus shifted to analyzing and preparing to share qualitative and quantitative data from an earlier phase of the research partnership – that is, the dissemination of results.

Before coming back to UNC, I had been exposed to a variety of organizations in the nebulous patchwork that is “international development,” from small NGOs to government agencies. None had the commitment to research that CAS has, to cultivating and producing knowledge to better advance their mission. The accompanying ethical procedures, like IRB approvals, exist for the essential purpose of protecting the human subjects of this research. If anything, given its sometimes-troubled history, stringent ethical standards ought to be at the forefront of global health research and practice. Though I have had to be flexible in my practicum’s immediate aims, my core objective of striving to contribute to CAS’s mission, however modestly, has not wavered. Maybe this reflects my own inexperience in public health research, but I have gained a richer appreciation for the harmony of such community-based, action-oriented research partnerships.

Comparing PrEP users with non-users in the analysis of older study data has revealed differences between each group in the factors influencing PrEP uptake, differing perceptions of the stigma associated with its use, and differing reliance on technology to seek health information. The results of such comparisons will, hopefully, provide insight into how CAS might develop new initiatives to expand the reach of its PrEP program, including via a mobile app. Working through how to best share these results has presented the fresh challenge of how to integrate quantitative and qualitative data sets – and how to do so in such a way that proves most useful to the workings of a fast-paced organization with multiple programmatic objectives. With a keener appreciation for the value of such mixed methods research to public health programs, this is a process I would hope to replicate in future endeavors.

More immediately, I plan to continue as part of the CAS-UNC research collaboration beyond the official end of my practicum. Coming up are results to be shared and interviews to be conducted, both of which hopefully can coexist alongside my coursework commitments. Ten weeks may be a flash in time, but it’s certainly long enough to feel immersed in a project. And this seems only right to me. Exercising humility and creating relationships both call for, among other things, an investment of time. In my own practice, I aspire to be oriented by precisely these values, the foundation of lasting transnational ties that define global health at its best.


Ending with evidence-based decision making

One of the biggest takeaways from my first year as an MPH student was the importance of using evidence to inform the design and implementation of public health interventions – but what happens when there just isn’t enough evidence to make a concrete decision? This was a major practicum challenge that I didn’t anticipate. After sorting and screening and rereading titles and abstracts for hours upon hours, our article search process that started with nearly 700 publications narrowed down to only 11 – and among these, the majority only included child feces disposal practices nested as one small part of larger sanitation interventions. My research focused on the Asia-Pacific region, which has among the highest rates of open defecation globally, so I was surprised to find so few interventions targeting this behavior. Though perhaps this is due to the widespread perception that child feces aren’t as harmful as adults’.

Even large-scale sanitation interventions, like India’s Total Sanitation Campaign, have been notoriously unsuccessful at improving child health outcomes. Programs like these have focused mainly on providing hardware or subsidies for individual households to construct their own sanitation hardware (think toilets, pour-flush latrines, bathrooms) without actually working toward behavior change. Behavior-Centered Design is a new approach to solving environmental health problems and has been a major area of World Vision’s research, which is super exciting to be a part of! So maybe I didn’t find all the statistically significant effect sizes, confidence intervals or p-values that I was initially looking for to prove that yes, giving people toilets = safe child feces disposal = improved public health. But I did come across some rich qualitative data on what real communities perceive as their barriers to improved sanitation, why they engage in certain behaviors, and what they would prefer from a public health intervention. Using these determinants is the next step in designing an intervention that communities actually want.

It seems like I just blinked and the summer is gone and my practicum experience is wrapping up. Looking back to May, I now feel so much more prepared to work on real-world public health problems instead of just practicing in a classroom (but I am looking forward to being back in the classroom this fall semester to see everyone in person!). Even though I felt like my work wasn’t going as I originally planned, I learned even more than I thought I would.


Communication, communication, communication

My practicum with NARAL Pro-Choice North Carolina was to take place over 10 weeks, the last of which began on August 2nd. I expected to enjoy my time with NARAL NC, but my practicum has surpassed my anticipations dramatically.

I believe my good experience centers around the way the staff treats me. They speak to me as an equal, not just as a student who needs supervision. While my preceptor helped me identify a few deliverables that I could work on at the beginning of my practicum, she was flexible and supportive when our goals shifted throughout the summer, allowing me to amend my deliverables as needed.

My last deliverable has been my favorite by far. In short, I have been working on a report on a specific public health problem that is meant to be consumed by the public. I started this project by receiving an abundance of raw data that needed to be analyzed, which allowed me to practice my STATA skills. I was able to take some of that raw data and turn it into an ArcGIS map, which I believe will be a valuable addition to the report. Lastly, I’ve been able to practice my graphic design skills by designing the layout and format of the report as I go.

However, my favorite part of this project has been the writing aspect. The MPH program typically requires us to write papers and such in scientific or academic voices, which certainly aligns with the audience they’re meant for. The NARAL NC report, on the other hand, is being created for a non-scientific audience, which has been an amazing challenge for me and my writing skills. I have enjoyed this type of writing more than I expected to. The unique combination of abilities it requires has exercised so many different tools from my toolbox, from data translation and choosing relevant statistics to creative writing and narrative formatting.

This report has really driven home the idea that our job as public health professionals is not just to partake in research and the scientific process, but to make sure our findings are accessible to the world. COVID has been a great example of this, especially now with the concerning Delta variant. The research is somewhat unclear, and while that is to be expected this early in the process, I do not feel that it has been communicated to the world in an organized manner. This, plus government mandates and the loss of progress on “opening back up” adds to confusion and alarm. I’m sure we would agree that the United States could have done many things differently throughout this pandemic, but communication would be towards the top of the list in my opinion.

While my practicum is wrapping up and COVID is picking back up, I will always remember the lessons learned at NARAL Pro-Choice NC.

Stay safe,


Long days, short (summer) weeks…. Wrapping up a remote global health practicum

It’s hard to believe that my practicum experience is almost over and that the summer’s almost gone! I keep asking myself where all the time went. For my practicum experience, I have been working with UNC Gillings Zambia on the ARCH study. The goal of the ARCH study is to optimize birth outcomes in low-resources settings, by using household surveillance to gain a better understanding of the social and clinical factors that may affect pregnancy outcomes in women of reproductive age. I think that one of the best parts of the study is that it allows the study team to follow women of reproductive age, from preconception to at least one year after the end of their pregnancy, in the event that they become pregnant during the course of the study. In addition, the study also follows children under the age of 2, to gain a better understanding about factors that impact the health of young children. Thus far, I have learned quite a bit from the study, mostly related to the implementation of such a large-scale study.

One of the most important lessons that I have learned so far has been the importance of flexibility and being willing to adapt to a new situation. At the beginning of my practicum, my preceptor and I thought that it would be most helpful if I worked on developing standard operating procedures (SOPs) for various aspects of the study. As time progressed, it became clear that there were other aspects of study implementation that would be a better fit. As such, we have pivoted from working on SOPs to developing recruitment and training materials. It has been an interesting learning experience, thinking about how best to simplify the language from protocols, written for technical experts, to informationals that can be understood by study participants. I’ve also learned a lot about the seemingly small aspects of study implementation that I had only briefly thought about. As I’ve been charged with drafting some of the training materials and schedules, I find myself thinking about the most pertinent parts of the study protocols and how to engage study staff when they might have days’ worth of training in their future. All in all, it’s been a truly educational experience.

It might not come as a surprise that one of the most challenging aspects of the practicum experience has been my inability to meet most of the people that I’m working with in person. I have tried to keep in touch via email. My preceptor has also been wonderful, as we decided to meet on a weekly basis, just to touch bases. I think that the weekly meetings have been helpful and have provided more opportunity for direct feedback. At this point, we have talked about extending my practicum, but I still don’t think that I will be able to see the actual start of the ARCH study. That said, I plan to follow the study closely and look forward to learning more about the results of the survey.

Lastly, I’m looking forward to enjoying the last weeks of summer, prior to the beginning of the semester. I’m very excited about starting the second year and can’t wait to meet in person!

– ‘Desola

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