Hernandez, Mariana

School of Public Health



Uttar Pradesh Health Systems Strengthening Project

The overall objective of the project is to provide support to the Uttar Pradesh (UP) health system through project partners and the Government of UP (GOUP) to accelerate progress towards reducing maternal, neonatal and child morbidity and mortality. The project focuses specifically on strengthening systems components that form the foundations for achieving quality, efficiency, equity and coverage of critical interventions. The project provides strategic technical assistance to its partners in the areas of health systems strengthening analytics, technical and advisory support, and capacity building. Our current research and analytic activities are divided under 6 broader workstream areas – performance management and training, human resources for health, data use for decision-making, payments and financing, social accountability, and organization development. Besides, the team also is responsive to short-term analytic demands of the GOUP leadership.

PI Mentor: Brian Wahl

With the help of the Global Health Established Field Placement, I was able to work as a research assistant in a Johns Hopkins Bloomberg School of Public Health office in Lucknow, India for 6 months. During this placement, I worked on all aspects of a qualitative research project aimed at answering the question: How do we make government-run health programs and initiatives more responsive to community needs?

         To answer these questions, I conducted a literature review, organized and conducted qualitative interviews with implementors of social accountability programs, and designed an analysis plan. The analysis is still ongoing but will result in written recommendations provided to the state Ministry of Health for improving social accountability within the public health system moving forward. Additionally, it will serve as the basis of my capstone, an abstract submission to the Sixth Global Symposium on Health Systems Research, and- hopefully- a published article.

         Getting to put the research methods I learned about in my first year into practice under the guidance of experienced professional researches who trusted my input was an invaluable experience. My interviews were conducted with employees of international NGOs, local community service organizations, and the state government. Engaging with respondents across multiple sectors gave me much deeper insight into the complex landscape of global health work, including priorities, relationships, and roles of various stakeholders- a deeper understanding than it is possible to gain in a purely didactic setting.

         My placement introduced me to a wide array of opportunities and connections beyond my research project as well. I was able to participate in the COPASAH (Community of Practitioners on Accountability and Social Action in Health) Global Symposium, a Gates Foundation planning meeting, and a JHSPH core competencies workshop. At these events I witnessed the ceremony and politicking involved in global health work. I gained firsthand insight into the process of balancing priorities amongst various stakeholders and managing their varied expectations. Academics, government officials, donors, and social workers each imagine their role and the role of their partners differently. Creating a successful, long-term partnership requires navigating these and gaining some level of consensus.

         During my time abroad, I learned a great deal about global health research. I also learned about myself- as a professional, as a student, as an individual. I have been lucky enough to travel before, but never to a place like India. The language barrier was more prevalent than I anticipated. I was lucky enough to have colleagues around to provide translations when required and most shopkeepers were able to state prices in English, even if they could say nothing else. Especially when traveling to tourist locations with visitors from all over, I was very aware of how privileged I was to be a native English speaker. This was perhaps most evident during the sessions of the Global Symposium, where the majority of the programming was conducted in English- although translations were available in Spanish, French, and Arabic. There I attended one Latin American region session that was conducted in Spanish and I could sense the relief/ease in the room. It highlighted to me the distance that can arise between those who work on the ground in local languages and “outside” global health professionals when English is treated as the lengua franca. Sharing a language, residence, community, or background goes so far in the trust-building that is required to create community-led public health successes. As I grow my own global health career, I will strive to center the lessons I learned during my GHEFP about trust and consensus-building across sectors and experiences.

COPASAH Global Symposium

Delhi Water

Tea Break

Radio Station

Workshop Rapporteur


October 2022



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