Fieldwork Provides Students With New Perspectives on Global Maternal and Women’s Health

By Jennifer MacCallum, Faculty Coordinator, Women and Health Initiative; Kayla McGowan, Project Coordinator, Women and Health Initiative

GHP 547 Students 2018This January, eleven students from the Harvard T.H. Chan School of Public Health took part in the Field Experience in Maternal Health winter session, supported by the Women and Health Initiative and the Maternal Health Task Force. The course enables students to apply their skills, knowledge and coursework to maternal health issues in diverse settings around the world. This year, students partnered with host organizations in Ethiopia, Sierra Leone, Somaliland, Uganda, the United States and Zambia.

Hannah Kim, SM ’18, and Moulshri Mohan, MPH ’19, traveled to Zambia to work with the Population Council on their Scaling Up Family Planning and Comprehensive Sexuality Education programs. Kim and Mohan analyzed a facility audit tool, which assessed the availability of family planning methods, human resources, training and stock in districts with high fertility and unmet need for family planning. Additionally, they synthesized data from focus group discussions with adolescents in schools with high rates of teenage pregnancy. Their analysis revealed that women face persistent stigma—related to religion, social norms and/or misconceptions—that often prevents contraceptive use. Their field experience also illustrated the complexity of gaining insight from research. As Mohan reflected, “Data in the real world is very messy…not as neat or perfect as [the data] presented to us in class.” Kim echoed this sentiment, stating, “I got a glimpse of how I could apply the theories and skills I’ve learned in classroom to a real-life setting—and the unpredictable challenges that I will have to face in my future career.”

Other students’ projects delved into health care access and human rights issues. Rachel Shin, MPH ’18, and Nambi Ndugga, MPH ’19, traveled to Somaliland to work with Edna Adan University Hospital where they collected demographic data and conducted 200 semi-structured interviews with patients, health care providers and midwifery students about antenatal care-seeking behaviors and cultural perceptions of female genital mutilation (FGM). The majority of health care providers interviewed identified education as the primary way they could end FGM in Somaliland, where the practice is widespread.

While conducting this research, Shin and Ndugga learned the importance of cultural competency and respect. “Taking the time to learn a little bit about the culture, the language and the social network of the people in the country goes a long way,” Shin illuminated. Ndugga added, “You are not the expert—the local physicians, health care workers, public health practitioners are… they are your best resource, appeal to them for help and thank them for their time.”

Two students’ projects explored the critical issue of improving maternal health through midwifery. Jiaxi Yang, PhD ‘23, traveled to New York to work with the United Nations Populations Fund, while Rebecca Oran, MPH ’19, collaborated with Every Mother Counts. Each project focused on midwifery as an effective, sustainable model for delivering high quality maternal health care. While many areas of the world with the highest maternal mortality burden face a shortage of midwives, studies show that the midwifery model reduces overall spending and increases patient satisfaction. The lack of compensation, recognition, retention and education opportunities for midwives has led to a global deficit of this crucial cadre of the health workforce. “Midwives are vital resources in providing care to women,” Oran stated. From her fieldwork experience, she learned that it is “evident just how much women value midwives in their care and how midwives are often a forgotten part of the care team.”

This course continues to be an enriching opportunity that allows students to gain new perspective in public health research and interventions—regardless of their prior experience or background. As Oluwatomi Adeoti, MPH ’18, explained, “As a medical doctor who has been involved in only the service delivery aspect of health care, I did not think I was going to gain much [new knowledge] from an internship. To my great surprise…I am now enlightened about the power of advocacy to improve health outcomes for mothers and children around the globe and will try to incorporate advocacy into my career as a public health professional.”

Learn more about student fieldwork in maternal health.

Read blog posts from students documenting their fieldwork experiences.

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If your organization is interested in hosting a Harvard T.H. Chan School of Public Health student next winter, please email whi@hsph.harvard.edu.