Scientific solutions to today’s health problems require innovation and collaboration. We partner with institutions around the world on interdisciplinary research to address the most pressing health issues facing the world today. We also want our science to translate into action so that it can make a difference. We conduct policy research and convene stakeholders to ensure the highest quality science and research translates into the best possible action on the ground.
Please visit our EXPLORE database for a comprehensive view of the global research being conducted by faculty at the David Geffen School of Medicine and UCLA Health in collaboration with international partners.
The Conrad N. Hilton Foundation has announced a $2.6 million grant to UCLA Center for World Health Director and Distinguished Professor of Medicine, Dr. Thomas J. Coates to expand implementation of the integrated early childhood development (ECD)/Option B+ model in Malawi. The model, which provides ECD training in concurrence with an Option B+ program to prevent mother-to-child transmission of HIV, seeks to improve caregiving skills of mothers living with HIV and to promote early stimulation and communication with infants exposed to HIV.
In 2015, UCLA, Partners in Hope (PIH) Medical Center in Malawi, and the University of Witwatersrand in South Africa joined with the Hilton Foundation on a two-year pilot program to assess the feasibility and acceptability, as well as initial outcomes, of supporting Option B+ mothers in Malawi. The program focused on Option B+ mothers in recognition of the fact that these mothers have numerous vulnerabilities in addition to their HIV infection. The pilot work further defined and documented these vulnerabilities, including lack of partner support, struggles with paying for transport and providing proper nutrition to their children, and community level stigma and discrimination. The focus on HIV-exposed infants was in line with studies suggesting an increased risk of developmental delays among HIV-exposed uninfected children. Additionally, like their mothers, HIV-exposed infants face increased vulnerability in nearly every aspect of life, particularly in the environment of extreme poverty that exists in rural Malawi.
From 2015-2017, the pilot worked with mother-infant pairs at two district hospital sites in Malawi- Kasungu and Nkhotakota. Mothers were enrolled in once per month ECD sessions for 10 months, timed to coincide with the women’s ART refill dates. From April to December 2016, 161 mother-infant pairs were enrolled in the program. 95 (59%) of pairs remained active in both ECD sessions and in their HIV care. Of the 47 (24%) infants classified with moderate developmental delays at baseline, 44 (94%) moved to normal development at follow-up. Home visits showed that over 90% of infants had appropriate stimulation and communication from caregivers outside of clinic settings. Exit interviews with the mothers indicated strong satisfaction with the program and a keen interest in continuing with ECD activities in their communities.
Under the new grant, PIH will expand access to ECD training in clinics at nine health centers and seven hospitals in Lilongwe District, and expand to additional facilities in the original two districts (Kasungu and Nkhotakota). Building upon PIH’s existing infrastructure, the project will make use of Expert Clients to support mothers and their infants. Expert Clients are HIV+ individuals who provide support to community members to support disclosure, retention, and prevention. Under the grant, an additional 80 Expert Clients and 20 Lead Expert Clients will be trained on ECD/Option B+ integration.
The project will also incorporate a cost-benefit analysis of the integrated ECD/Option B+ model and identify the most cost effective method to deliver ECD and Option B+ in a low resource, high HIV prevalence setting, such as Malawi. The cost data will be used in advocacy efforts with the government around the cost-benefit of adding ECD into standard health programs as part of the national strategy.
Other faculty involved in the project are Alan Schooley, MD, (Clinical Co-Director and Supervisor for Central Region, EQUIP Malawi Project), Kathryn Dovel, PhD (Associate Research Director, Partners in Hope), Linda Richter, PhD (Distinguished Professor and Director, DST-NRF Centre of Excellence in Human Development at University of the Witwatersrand), and Laurie Bruns (Senior Regional Africa Director, UCLA Center for World Health).
Photo: Faculty at the Soka Ikeda College of Arts and Sciences in Chennai, India graciously receive students from the International Alliance for the Prevention of AIDS.
Amrita Ayer is a second year student at the David Geffen School of Medicine at UCLA. This past summer, she completed a short-term training program (STTP) in global health research in Chennai, India.
What motivated you to pursue the global short-term training program (STTP)?
I came to DGSOM wanting to do global health work in the future, but not knowing what that entailed. The global STTP seemed like an incredible, natural way for me to learn from another health system, further develop research skills, and form a relationship with mentors both here and abroad.
Did you have global health experience prior to completing your research project?
I actually didn’t have any global health experience going in, which made me a bit nervous at first, as I wanted to be sure I could contribute effectively. On the other hand, this lack of experience also meant that I had no expectations of my STTP, meaning that I could participate in and enjoy it with an open mind. The strong mentorship I received, through the Center for World Health, my faculty mentor (Dr. Kiran Mitha), as well as the physicians and staff members at the partner site made me feel prepared and as though I was part of a community working toward a common goal.
What did your research project consist of?
While in Chennai, I worked with a local non-governmental organization (NGO) called the Internation Alliance for the Prevention of AIDS (IAPA). I did a qualitative research project to evaluate the success of a telephone triage pilot the NGO had developed in concert with UCLA last year. The research consisted of semi-structured interviews with the NGO’s staff, volunteers, and patients and allowed me to further develop my research skills. I am now preparing an abstract to submit to conferences and will continue to work with the NGO in whatever capacity they need.
What drew you to this particular site and topic?
I picked Chennai as my STTP site for both professional and personal reasons. Professionally, this STTP served as an incredible model of community health work and advocacy, which are important to me. Personally, I felt a strong connection to the location, as it is my father’s birthplace and so I care deeply about the community.
How did participating in a global STTP influence your career plans?
This global STTP reaffirmed my desire to work internationally in the future, as it showed me a sustainable, ethical partnership between a U.S.-based institution and an international organization. I think that global health and local health are really two sides of the same coin of advocacy and health justice and I would like to engage both fronts in my career.
What advice would you give to medical students interested in participating in a global STTP?
Practically, I would tell them to be organized—create a timeline where you can plan your project, meet with mentors, and submit your proposal to the IRB early, so that you are ready to go once you arrive in country. Perhaps a little paradoxically, though, I would also tell them to be very flexible, because the (global) STTP can have many moving parts and the best way to enjoy them is to be open to changes.
Amrita can be reached at AAyer@mednet.ucla.edu
It is our great pleasure to present to you the UCLA Center for World Health (CWH) 2016-2017 annual report
The UCLA Center for World Health
(CWH) was established in 2012 as a joint initiative of the David Geffen School of Medicine at UCLA and UCLA Health to produce leaders who will meet the changing health needs of our planet and optimize health care through community partnerships.
UCLA attracts extraordinary minds – both faculty and students – that strive towards a culture of innovation and are dedicated to strengthening human capital. We have exceptional intellectual capacity and a robust history of generating research that benefits millions worldwide.
We are committed to transform the practice of world health to close the gaps and make a sustainable difference by providing clinical experiences, innovative research opportunities as well as humanitarian training.
This report summarizes the highlights of our programs, and describes the expansion of our educational, research, capacity building and health systems strengthening projects that support our vision of a world in which all people achieve their right to high-quality, compassionate, and affordable health care. We develop major collaborations in global pediatric care that will have a lasting impact on the well-being of all children. We work with people around the world to develop the skills they need to solve problems where they live. We work with them to develop educational and health systems that make a difference. We train them to leverage the science and technology necessary to understand how best to improve health locally. We partner with them to educate their next generation of leaders, and we strive toward clinical excellence for everyone, everywhere.
We are also very proud to feature our Global Health Education Program and the accomplishments of some of the students and faculty of the David Geffen School of Medicine at UCLA.
provides additional information on the projects of our many global faculty and partners that we weren’t able to feature in this report.
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