When I started this practicum in the middle of May, I had originally planned for this coming week to be my last week. I recently decided, along with my team, to extend the end date since the really interesting part is just beginning. Although the past couple of weeks have been filled with data cleaning, I am finally ready to begin the analyses we proposed as the basis of my practicum. We are using data from a household survey and combining it with data from health facilities across Zambia in order to gain a more holistic understanding of the services, equipment, and patient satisfaction with the country’s health care system. To our knowledge, this comprehensive picture of health facilities and services has not been examined before; prior research has focused on either just the health facility capacity/readiness or just the consumer experience.

Although I will likely have more final thoughts in the coming weeks, I am grateful to have been a part of this project and team. At the start of the practicum, I learned about antenatal care/nutrition recommendations and health facility quality measures, as well as gained a better understanding of the amount of work and careful organization required to select the variables of interest. These variables are the basis for our exploratory analyses and due to the nature of real-life data, have provided me with an opportunity to learn about and practice more advanced statistical methods. Our ultimate goal is to run a series of statistical models to better understand client satisfaction with antenatal care as well as growth, monitoring and promotion services. We will then publish a paper to share our findings.

Perhaps the greatest lesson I’ve learned from this practicum is the value of “thinking outside the box.” Doing so has helped my preceptor, Dr. Stephanie Martin, and I, organize our thoughts about which variables to use and how to carry out the analyses, it helped us overcome some issues with a messy dataset and methodological concerns (e.g. missing values, yes/no questions, issues merging datasets, lots of interesting variables to explore, etc.), and it prompted our research questions. Although I am nearing the end of my practicum, I also feel as though it is just the beginning. I look forward to digging further into the data to see what sorts of discoveries can be made, and using those to circle back to the big picture of reducing childhood stunting and understanding health care satisfaction and quality in Zambia. I hope our findings will not only be informative and worthwhile to the Zambian government and USAID, but will help others conducting similar research.

– Liana