Unknown - Support to the monitoring and evaluation of mhealth solutions
The United Nations Innovation Working Group (IWG) catalytic grant competition, managed by the mHealth Alliance (http://mhealthalliance.org/our-work/iwg-grants/about-iwg-grants), is a 3 year initiative which funds mobile health (mHealth) programs to improve maternal, newborn, and child health in support of the UN Secretary General's Every Woman, Every Child global strategy. With support from WHO, Johns Hopkins Global mHealth Initiative (JHU-GmI) is providing technical support to monitoring and evaluation of IWG grantees in multiple sites throughout Africa and Asia.
Life in Ghana
When I landed in Ghana, I deplaned into the humid and hot night and shuffled through immigration and customs past standing antibacterial dispensers and posters of Ebola awareness. I felt completely confused about the time and so excited to get settled and start the practicum. Life was filled with extremes: power was on or off with no schedule, data collection was intensive interviews and spreadsheet puzzles or there were non-responders and missing reports. I practiced patience, flexibility, and gratitude daily, both in my personal and professional life. Further, living in the capital city of Ghana was an entirely different experience than is lived by those in the rural areas. I had a grocery store that sold brie cheese and almond milk (at absurd import prices) and across the road the street vendors sell vegetables, sunglasses, coconuts and anything that can help them make a profit. The most surprising thing to me was how close the dichotomy of developed and developing or rich and poor could be mashed together within the borders of Accra. I was lucky in language as Ghana’s official language is English, but I took the opportunity to learn some key phrases in Twi – much to the entertainment of my friends and taxi drivers. Language is an opportunity to connect with people across cultures, and it definitely enhanced my practicum experience.
I was very excited to have the opportunity to participate in research and contribute with economic evaluation. I had learned the tools of economic evaluation across many first year quarters and late night study sessions, so this was my chance to apply this knowledge and gain experience to the point of confidence in future projects of the post graduate school world. It was invaluable to have the ability to be part of research while in country and understand the difference between project plans and on the ground reality. I would advise students who pursue their practicums internationally to have an open mind, to be friendly and ask questions. I had the experience that some expats adopt an separation attitude, thinking ‘this is not my world,’ but I would share with complete conviction that the most valuable insight and lessons came from my coworkers who were local and had a deep understanding of why projects met challenges and how the health system functions. Global health is more about stakeholders, resource allocation, and health systems than about appropriate or innovative interventions. The skills we gain from a master’s degree at Johns Hopkins help us to succeed in building and improving global health, but it important to remember sustainability and local ownership will be the only way to lasting impact.
I have reflected at length about the future of my career. I had imagined and reimagined my dream job, but I have now left the idea of the perfect job behind. I want to work with people who are passionate about health systems and willing to put in time, accept input from others, and actually build capacity by sharing skills with others. I do not envision myself in a program implementation role as most of the projects I have seen implemented have not been sustained. I believe our next generation of professionals will be more connected than ever before and more willing to share work, results, and data than ever before. The field is changing rapidly with the influx of technology and the rapidly expanding public health missions resulting from epidemiological shift from communicable to non-communicable diseases and emergence of new pathogens. With my career, I will work in positions that build capacity of health systems to strengthen them and enable populations to achieve better health, improved economic outlook, and explore private public partnerships in health.