Global Health Awarded Projects

This project intends to support activities of the inaugural Global Health Education (GHE) Day, to be held on Wednesday, May 13, 2020 at the Feinberg campus. This will be the first major event for the Center for Global Health Education (CGHE) within the Institute for Global Health, and one that we anticipate holding on an annual basis.

GHE 2020 will be an opportunity to draw together global health researchers, educators, and students from NU and across the region to highlight current and future training opportunities within the Center and foster further collaboration across units at NU. Below we outline the proposed structure of day’s activities, noting the goals/objectives, location, and key participants for each part.

Goals/Objectives:
1. Scientific poster presentation will provide global health students and trainees from programs across the campuses with the opportunity to present and disseminate their scholarly works. This is a requirement for the McGaw Global Health Clinical Scholars.
2. The keynote address by Dr. Gavin Yamey will highlight the skills and training required for addressing the current and emerging issues in global health. He will also discuss how to translate training and knowledge into action for promoting global health equity.
3. The luncheon will help to foster and establish interdisciplinary connections among students, faculty and alumni interested in global health.
4. Workshops and panel will promote skill development in global health and humanities, evaluation and assessment methods in educational programs and career building strategies in research, education and policy global health fields.

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Country: United States

Principal Investigator: William Leonard, PhD and Ashti Doobay-Persaud, MD

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Principal Investigator: Becca Kirby

Northwestern University partners with Clínica de Familia, a Dominican non-governmental organization providing health services in the Eastern Dominican Republic, in order to expand the implementation of a project aimed at providing high-quality primary care to 1,008 individuals from key populations (sex workers, men who have sex with men and trans women). These populations have more limited access to primary care services than the general population because of stigma and discrimination faced by these populations in both public and private health centers. Clínica de Familia has a long track record in the community providing services to these populations.

This project programmatically complements our Catalyzer research proposal which was submitted in November 2023 to conduct a formal evaluation of the program through an implementation science study.

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Principal Investigator: Shannon Galvin

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Principal Investigator: Ashti Doobay-Persaud

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Country: India

Principal Investigator: Jyothy Puthumana

Partner Institutions: Center for Development Initiatives Anita Shet/ John Hopkins Bloomberg School of Public Health

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Country: Kenya

Principal Investigator: Colleen Fant

Partner Institutions: Maseno University

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Country: Tanzania

Principal Investigator: Angira Patel

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Country: Uganda

Principal Investigator: Sandi Lam

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Country: Liberia

Principal Investigator: Becca Kirby

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Country: Nigeria

Principal Investigator: Igor Koralnik

Surgical site infections are common perioperative complications responsible for increased healthcare expenditures. Rates of SSI for abdominal procedures vary from under 10%, in programs with higher resources and strict adhesions to quality improvement measures, to above 20% for programs in lower resources environments. Rates of perioperative infections in Ukraine are a major issue affecting the system at large. Previous attempts to introduce infection control measures were minimally successful in large part because they relied on wholesale implementation of measures developed and reasonable in a high resource western medical environment; in large part, regional issues were not taken into consideration. In addition, older instruments and outdated cleaning techniques were likely significant contributors to this problem. We are proposing a systematic evaluation, education, and implementation project that will address issues pertinent to surgical care in Ukraine, that will result in reasonable and realistic solutions that then can be scaled up to wider regional and national solutions.

Objective: To identify factors contributing to a high rate of peri-operative infectious complications in Ukraine and identify easy to intervene measures in a resource poor environment. To achieve this objective, the
following aims are proposed:

Specific Aim 1: Collect detailed data on factors known to affect peri-operative infections. Survey all
participants involved on their understanding, attitude and barriers for implantation of infectious
prophylaxis measures.
Specific Aim 2: Evaluation of surgical instruments and processes for cleaning, storage and usage with
identification of correctible factors.
Specific Aim 3: Analysis and initial implementation of corrective actions with post implementation result
analysis

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Country: Ukraine

Partner Institutions: Kiev Regional Hospital, Ukraine

Principal Investigator: Vitaliy Poylin, MD

Site-Principal Investigator: Andriy Kebkalo, MD

In Nigeria and Mali, the lack of organized screening programs for human papillomavirus (HPV) associated cancers including cervical and oropharyngeal cancers and other related health services factors aggravate the incidence and mortality due to these diseases. In LMICs, nearly 20-30% of all cancer cases are HPV-associated cancers. As a result, our team was recently successful in securing new major grants' funding from the NIH, on oropharyngeal cancer (R01CA274952 Hou/Morhason-Bello/Murphy), and cervical cancer (U01CA275129 Hou/Holl/Maiga). The current local laboratory capacities in Ibadan and Bamako sites are not sufficient to implement our proposed strategies in these two grants. We request funding for this project award to purchase two GeneXpert 4-module instruments for HPV testing and one slide scanner for telepathology for each Ibadan and Bamako. These new instruments will reinforce our capacity in participants recruitments for these two and other future projects. These will also improve significantly our training capacities in these two important sites for Northwestern University's collaborations in West Africa.

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Country: Nigeria and Mali

Partner Institutions: University of Lagos and University of Jos, Nigeria

Principal Investigator: Jian-Jun Wei, MD

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Country: Uganda

Principal Investigator: Danielle Steker

Frontline healthcare workers (FHWs) represent an especially important population—surveillance of respiratory symptoms in these individuals and their families would help protect these individuals, prioritize testing, and reduce potential exposure to other FHWs and vulnerable patients in the global health setting. This need is heightened in the context of FHWs without direct, clear COVID-19 exposure or when symptoms are mild (e.g. children of FHWs). The continued lag in availability of COVID-19 laboratory testing, particularly in the global health setting, necessitates the need for advanced, non-invasive remote monitoring systems that can act as surveillance systems for disease progression by measuring key physiological parameters relevant to COVID-19. Objective measurements of mild infection for FHWs and their close contacts would help triage and prioritize confirmatory testing in FHWs over a typical 14-day self-quarantine period. We have developed an advanced, wearable, soft and flexible sensor capable of continuously capturing COVID-19 related symptoms like respiratory rate, cough count, temperature, heart rate, ECG, body position, and physical activity integrated with a mobile phone. In the proposed implementation project for COVID-19 monitoring, we aim to capture core vital sign data and novel respiratory biomarkers from 10 frontline healthcare workers over the course of 2 weeks of continuous wear using the chest sensor at University Teaching Hospitals Women and Newborn Hospital (UTH) in Lusaka, Zambia—we have an ongoing IRB and relationship with UTH (Professor Bellington Vwalika, Chair of Department of Obstetrics and Gynecology) in collaboration with the University of North Carolina (Jeffrey Stringer MD, Division Director of Global Women's Health).

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Country: Zambia

Partner Institutions: University Teaching Hospitals Women and Newborn Hospital (UTH) in Lusaka, Zambia

Principal Investigator: Steve Xu, MD, MSc

Site-Principal Investigator: Bellington Vwalika and Jeffrey Stringer, MD

Snapper Hill Clinic (the “Clinic”), with support from Northwestern University, propose to raise awareness on COVID-19 infection and prevention control measures and to continue to deliver care to patient through a telehealth system. The Clinic is dealing with the COVID-19 pandemic impacting Liberia by:

Aim 1: Delivering Awareness on COVID-19 Infection Prevention and Control Measures and;
Aim 2: Implementing Telehealth System.

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Country: Liberia

Partner Institutions: Snapper Hill Clinic, Liberia

Principal Investigator: Kara Palamountain, MBA

The proposed project builds upon an existing relationship that Riders for Health (RFH) has with Northwestern University as a sub-contractor to the C-THAN grant (U54EB027049) funded by the National Institute of Health Biomedical Imaging and Bioengineering (NIBIB)'s Point-of-Care (POC) Technologies Research Network (POCTRN). More specifically, RFH is working with C-THAN on a project titled "University Optimized Sample Transportation to support POC deployment Information Sharing and Motorcycle Routing in Diagnostic Networks" with the aim to generate insights for how to deploy POC devices in a centralized diagnostic network.

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Country: Malawi

Partner Institutions: Riders for Health Malawi (Riders) Malawi

Principal Investigator: Kara Palamountain, MBA

In 2018, Northwestern University Feinberg School of Medicine (NU) was awarded a D43 grant from the Fogarty with Muhimbilli University of Health and Affiliated Sciences (MUHAS) in Dar es Salaam to strengthen the existing partnerships through building research capacity in Patient Centered Outcomes Research (PCOR) in HIV in Tanzania. The grant was launched with enrollment of PHD, post-doctoral and master's levels students and in-person workshops which have built collaborations between MUHAS and NU faculty, However the COVID-19 pandemic has disrupted travel to NU to continue the training and to Tanzania to continue to build faculty capacity and peer-to-peer networks. We are proposing developing a new blended learning opportunity to continue the work to support PCOR capacity and skills development for the trainees and selected interested faculty in Tanzania building on widely used massive open on-line course (MOOCs) developed by MD Anderson and other relevant courses combined with a virtual journal club modeled on the successful implementation research reading course ongoing through NUCATS and a course in progress through the R01 in Abuja (Huffman and Ojji PIs).

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Country: Tanzania

Partner Institutions: Muhimbili University of Health and Allied Sciences, Tanzania

Principal Investigator: Lisa Hirschhorn, MD, MPH

This is a project proposal that seeks to provide user-feedback for an interdisciplinary response focused global effort during the COVID-19 global pandemic. The project described below involves researchers who are applying their skills and training to this global program, but the proposal is focused on non-research project efforts to assist the Network in efficiently improving its impact to support policy-makers and public health decision-makers around the world in a timely manner.

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Partner Institutions: The COVID-19 Mobility Data Network

Principal Investigator: Jennifer Chan, MD, MPH

The Northwestern Medicine (NM) Institute for Global Health (IGH) and the University of Sciences Techniques, and Technologies of Bamako (USTTB), have an established successful training relationship, and now seek to build a sustainable doctoral research training program -- the Northwestern Medicine IGH Scholars Program. The initial six (6) Northwestern Medicine IGH Scholars will focus on TB, HIV, and colorectal cancer to address pressing local and global research priorities and significant health problems in Mali, and in sub-Saharan Africa. While the six candidates will leverage the resources of existing IGH-funded research projects to conduct their PhD thesis research project at USTTB, IGH-funded research projects are not permitted to support any tuition for students, and, given Mali’s low income status, neither USTTB nor the students themselves have the resources.

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Country: Mali and sub-Saharan Africa

Partner Institutions: Universite des Sciences, des Techniques et des Technologies de Bamako, Mali

Principal Investigator: Mamoudou Maiga, MD, PhD

The last century has produced a wealth of evidence based interventions (EBIs) to reduce morbidity and mortality, yet there is a gap between the knowledge that has been generated on interventions and the effective delivery of those interventions in many low and middle income countries. The resulting inadequacies in access and quality is associated with over 8 million deaths. Implementation research (IR) is essential to understand how to address these delivery and policy gaps, learning from countries that are effectively implementing EBIs and generating the transferable knowledge needed to continue progress towards the global Sustainable Development Health Goals and effective Universal Health Coverage.

The proposed partner institutions, Northwestern University and the University of Global Health Equity (UGHE) in Rwanda, have a successful track record of carrying out studies to understand the contextual factors that influence the choice of implementation strategies and adaptations needed to transfer lessons learned from one setting to another. The two universities have been collaborating on a Bill & Melinda Gates Foundation-funded project (Dr Binagwaho, Vice Chancellor UGHE, Dr Hirschhorn, Northwestern) to apply IR to understand reductions in under- 5 mortality in countries that exceeded expectations based on their resources and region. The Northwestern has also been a leader in developing capacity in IR in the US and in other settings including through the Center for Prevention Intervention Methodology (Ce-PIM: Introductory
online sessions, Prevention Science and Methodology Group online series, implementation science reading courses)3, Ce-PIM and the Third Coast CFAR (online introduction to IR and Implementation Science Working group)4, development and testing of an Implementation Research Logic Model5 by J.D. Smith for training and designing IR studies, and ongoing work to adapt and implement the reading course and introductory implementation research embedded in an RO1 to improve hypertension care in Nigeria.

Aims:
1. Develop, pilot, and evaluate a 1-year combined in-person and distance course with didactic and distance mentoring to increase IR knowledge among existing MGHD students and build advanced IR capacity for selected students at UGHE.
2. Provide distance mentoring to the selected 3-4 masters students to integrate IR into their master’s theses.
3. Integrate results of evaluation to adapt pilot curricula for ongoing integration into courses at UGHE, providing resources for expansion into other projects at Northwestern and UGHE.

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Country: Rwanda and United States

Partner Institutions: University of Global Health Equity, Rwanda/US

Principal Investigator: Lisa Hirschhorn, MD, MPH

The Northwestern Access to Health Project (ATH) is an interdisciplinary global community health project that brings law, public health, medical, and business faculty and graduate students together with communities, health advocates, government and university institutions, and human rights organizations in other countries. ATH operates as part of the Center for International Human Rights at the Northwestern Pritzker School of Law and the Institute for Global Health at the Feinberg School of Medicine. Founded in 2011 by Professor Juliet Sorensen and Dr. Shannon Galvin, ATH encourages Northwestern graduate students to engage in global health issues by working directly with communities and local NGOs. By working across disciplines, ATH aims to create targeted and sustainable projects that respond to health-related issues of poor communities, and to teach students how to engage in interdisciplinary, transnational partnerships that encourage global citizenship and understanding.

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Country: Nigeria

Principal Investigator: Shannon Galvin, MD

This proposal leverages over 12 years of teaching and expertise in conducting needs assessments for development of new global health technologies from the Northwestern University Kellogg School of Management (Kellogg). Since 2006, Kellogg has trained over 300 MBA students conducted global health technology market research in the following 18 countries: Botswana, Brazil, Cambodia, China, India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, Swaziland, Tanzania, Uganda, Vietnam, Zambia, and Zimbabwe. Through a 10-week course taught at Kellogg by Research Associate Professor Kara Palamountain, MBA students learn to conduct needs assessments during a 2-week field research trip supervised by Kellogg faculty. The field research trips are student-funded, although the Global Health Initiative provided $40,000 in 2018 and 2019 to cover a portion of the field research trip cost. This $40,000 of funding allowed for the 30 students per year to receive at least $1,000 travel scholarships and two needs based scholarships to cover the full cost of the field research trip. We propose $25,000 from the Global Health Project Award to continue this travel subsidy for students.

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Partner Institutions: Northwestern University Kellogg School of Management

Principal Investigator: Kara Palamountain, MBA

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Country: Sub-Saharan Africa

Principal Investigator: Jaline Gerardin