Lu, Lihan

School of Public Health



Mozambique-Comprehensive Mortality Surveillance in Action (COMSA) - Mozambique

The project will assess adolescent girls' understanding of anaemia (what it is?), its salience and consequences (why it is important?) and generate concrete and actionable ideas that would guide development of intervention program / strategy and implementation plan.

PI Mentor: Agbessi Amouzou

When I arrived in Maputo, Mozambique, I was fortunate to overlap with IIP colleagues who were there at the end of a workshop to train the trainers/in-country colleagues. During the first month of my placement, I learned about COMSA-Mozambique alongside others who were trained during an off-site training. There I met many of the candidates training to become verbal-social autopsy interviewers for the provinces they come from. The training went from morning until evening there was a lot of material to go over. However, I was invited to support the data collection tool development by testing and identifying differences between the android application and the questionnaires. I worked with the data management team, including the IT technicians for COMSA. It was this experience that gave me insight into the data backbone of COMSA and helped guide my next steps.

The second and third month of my experience was the most challenging and stressful. The off-site training was over, and everyone returned to the office – there I had to learn about the lay of the land and the most common language spoken was no longer English, but Portuguese. Now that my IIP colleagues have left, there was a bit of growing pain to figure things out on my own. Fortunately, my in-country colleagues were all very helpful and glad to offer advice when asked. During this time, I also began planning the major task that was given to me: coordinate baseline mapping of COMSA clusters with the Chief of Cartography.

I remember meetings that always ended up digging up more issues to be addressed. With the expected start date being pushed back and pressure to complete the task because other activities depend on it, there was no other option than to continue the work into the night. Even though it was difficult during the planning phase (I even caught the flu that sent me to the hospital), I felt the reward once we were ready and traveled around Mozambique to provide training and monitored the cartography activities.

Looking back, there were a few lessons learned that I plan on applying to future projects. First, when working with a group of individuals coming from different backgrounds, it is always wise to listen and learn from others first. During the planning phase, we ran into so many logistical issues that frustrated everyone. But somewhere between the exchange of ideas, we were able to come to a solution. 

Second, if you are stuck, seek help. Sometimes we are limited by the resources we each own and offer, so it is helpful to ask around to see if anyone else knows something that is the missing piece. When the planning group was stuck on a logistical issue and couldn’t find a way out, we called up the financial manager, who offered some options we didn’t even know was there.

Third, when you feel rushed, slow down. There were many times during my placement that I felt pressured to finish a task because others have expressed their need for it. But the pressure to rush also makes me more prone to make errors that I ended up having to fix later. I don’t think the result was helpful for anyone involved. If you feel ever feel rushed, take a few deep breaths, let your colleagues know that you understand, and do your best but don’t take any shortcuts to sacrifice quality.

My GHEFP experience with COMSA confirmed my desire to work with all stages of health data and prompted me to think about health data systems more critically. I was surprised to find my interest grow in the field of demography and vital statistics; I have subsequently supplemented a few courses on these topics to my GDEC curriculum.

I am grateful to have spent 6 months in Mozambique, learning from my dedicated colleagues about the challenges of working in Mozambique, such as the difficulty of traveling and the lack of network access in rural areas, and the power of informal networks, such as reaching the community through village chiefs. The next time I return to Mozambique, I would like to improve my Portuguese and learn more about the field from the local perspectives.

Discussing data collection during a supervision trip for pilot phase


Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

August 2019



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