Global Health Day Highlights International Collaboration and Health Systems Improvement

Northwestern investigators, faculty, students and community partners shared and celebrated global health research, education and outreach during the 13th annual Global Health Day organized by the Robert J. Havey, MD Institute for Global Health.

This year’s event, held on December 6 in the Robert H. Lurie Medical Research Center, featured a global health case competition, poster presentations and keynote address, with opening remarks given by Robert Murphy, MD, the John Philip Phair Professor of Infectious Diseases and executive director of the Havey Institute for Global Health.

“Each year on Global Health Day, we are able to highlight the incredible work and research of our faculty, students and partners and learn more about global health research, education and outreach efforts,” Murphy said.

The event kicked off with a global health case competition, followed by a poster session in which attendees learned about new global health research from Feinberg students, faculty and community partners.

Rya Muller, a second-year MD/MPH student, shared her research in which she spent two months this summer visiting hospitals in Zambia to identify barriers to care for children who are born with myelomeningocele (MMC), a congenital condition in which the spine and spinal canal don’t completely close before birth due to lack of folic acid in the mother’s diet.

“Zambia is a lower middle-income country with no folic acid fortification program, so they have a high incidence of MMC. But there are only two hospitals in Zambia that offer fetal MMC surgery and there’s a lot of data that shows that patients lack access to surgical care, which increases mortality in Zambia,” Muller said.

Using a mixed-methods survey administered to 68 healthcare providers at 12 Zambian health facilities, Muller found while 99 percent of respondents knew how to diagnose MMC in infants, only 24 percent indicated that the diagnoses was made in-utero. Additionally, only half of respondents said that they refer MMC patients for further care interventions within six hours after birth.

“Here in the U.S., mothers get their ultrasounds early and can determine if there’s a congenital defect. Mothers in Zambia are getting their ultrasounds, but these defects are not getting picked up, and so most mothers don’t know their baby has a defect until after the baby is born,” Muller said. “From our findings, we suggest that folic acid fortification, access to prenatal diagnosis and antibiotics are focus areas of improvement for care for Zambian MMC infants.”

Emily Lynott and Ella Kuffour, both Buffett Undergraduate Research Fellows under the guidance of Faith Summersett Williams, ‘16 MS, ‘18 PhD, research assistant professor of Pediatrics in the Division of Adolescent and Young Adult Medicine, presented their work which aimed to better understand health inequities in Switzerland by incorporating heath equity principles into research training for doctoral students.

“The learning health system is a concept that imagines a relationship between healthcare and the research components of the healthcare system. Healthcare interactions are used to collect data and then that data is then analyzed and used to, in turn, improve the care that’s being delivered,” Kuffour said. “Because Switzerland’s healthcare system is largely decentralized and governed on a local level rather than nationwide, there are some areas where people can slip through the cracks.”

Through their work, Lynott and Kuffour helped create a course aims to extend the learning competencies within the Swiss Learning Health System (LHS) to improve skills in health equity, disparity identification and LHS methods to measure and promote equity for all patient populations.

“Our goal is that through learning these concepts and hearing community narratives, they will be able to incorporate these into their doctoral work,” Lynott said.

For their research project, Ramzy Issa, a second-year MD/MPH student, and Osama Hassan, a second-year MD student, aimed to highlight knowledge gaps in U.S. medical students’ understanding of healthcare systems abroad and evaluate the effectiveness of a workshop they created focused on Gaza’s current healthcare infrastructure.

By conducting a retrospective survey following an optional workshop that detailed the healthcare system in Gaza which addressed both recent structural changes and the broader effects of war on population health, Issa and Hassan found that students reported improvements in their knowledge of Gaza’s public health challenges, medical supply shortages and the impact on vulnerable populations during war.

“By fostering awareness of international healthcare issues and encouraging advocacy, these workshops provide students with a crucial foundation in global health, preparing them for future work in diverse healthcare settings and ultimately contributing to a more globally minded medical workforce,” Issa said.

Margaret Kruk, MD, MPH, professor of Health Systems and director of the Quality Evidence for Health System Transformation (QuEST) Center at the Harvard T.H. Chan School of Public Health, delivered this year’s keynote address which explored the importance of cross-country collaboration in improving health system performance.

Kruk discussed how public health investigators and providers must re-evaluate the concept of public health and the role of health systems across the world in order to improve both trust across patient populations and ultimately patient outcomes.

“We need to be thinking of health systems as a partner, not as the main driver of health,” Kruk said.

Furthermore, Kruk emphasized that collaborating with existing health systems and allowing them to lead in this change is key for success.

“That’s the challenge for all of us is to find those opportunities where we can add the fuel, we can provide the support, we can ask the tough questions, we can show comparisons and say why is this happening here, but then let the locals lead as they should and as they need to when wanting to improve their health systems,” Kruk said.

Poster Presentation Award Recipients

• Best Poster: Berivan Ece — “Training and Capacity Building in Patient-Centered Outcomes Research for HIV Care in Tanzania”
• Best Student Poster: Claudia Oropeza — “A Capacity Building Workshop for Microbial Genomic Surveillance in Peru”

Honorable Mentions

• Honorable Mention: Dulce Garcia — “Molecular Epidemiology of SARS-COV-2 in Bolivia and Peru”
• Honorable Mention Student: Kate Klein, MA, MPH — “Understanding Barriers and Facilitators to a Mobile Clinic HPV Screening Intervention”

Global Health Case Competition Winning Teams 

• 1st place: Team 5 (Erika Ruiz-Yamamoto, Nkatha Mwenda, Rebecca Marcus) — “Combating Childhood Obesity in Mexico”
• 2nd place: Team 2 (Shail Belani, Joseph Biju, Aryan Kalluvila, Antony Vincent) — “A Fit Future: Tackling Childhood Obesity in Mexico Through Policy, Access, and Awareness”