Featured Projects

Population ageing is occurring globally but much more rapidly in low- and middle-income countries. The WHO developed guidelines for Age-Friendly Health Services (AFHS) at PHC centers to improve care for older patients. This research is aimed at assessing the level of implementation of the WHO framework for age friendly PHCs and to determine the barriers and facilitators to implementation in Lagos, Nigeria. Results will be used to develop and test interventions to improve care readiness and delivery for older people in Nigeria.

Principal Investigators: Lisa Hirschhorn, MD, MPH and Adedoyin O Ogunyemi, MBBS, MPH, FWACP, MA, FMCPH

Publication

As the older population rapidly grows, many developing countries, including Nigeria, may not have the resources to make the world more age-friendly, and more urgently in the health sector to achieve healthy aging. This study builds on existing data done to map gaps in PHC capacity and knowledge of healthcare workers in the care and delivery of effective people-centered PHC for older people in Lagos State. Firstly, we will capture priority interventions from older people (over 60 years) in Lagos State, followed by a selection and co-design process to collaboratively identify potential, feasible interventions for strengthening PHC facilities and care. Finally, we will operationalize the intervention in collaboration with one PHC and the PHC managers; and do early feasibility testing. The results will be used to develop larger funding proposals for broader testing of the intervention to improve age-friendly PHCs in Lagos State.

Principal Investigators: Lisa Hirschhorn, MD, MPH and Adedoyin O Ogunyemi, MBBS, MPH, FWACP, MA, FMCPH

The proposed Harassment and Discrimination Office in Nigeria (HADOIN) project is a new collaboration between University of Jos, Havey IGH and the NU Office of Civil Rights. Our overarching goal of the catalyzer program grant is to establish the Harassment and Discrimination Office in Nigeria (HADOIN) with the capacity to improve intervention and prevention of cases. Established offices that are resources for this project include: The Women’s Center, Office of Civil rights and Title IX Compliance, Center for Awareness Response & Education (CARE), Northwestern Counseling Services and Psychological Services (CAPS), and Northwestern Office of Institutional Diversity and Inclusion. We hypothesize that the establishment of an institutional harassment and discrimination office with accompanying policies and activities at the University of Jos will largely improve awareness and prevention of cases of harassment and discrimination. The specific aims for this project are: 1. Design Standard Operating Procedures (SOPs), other needed infrastructures for reporting, enforcement, prevention, and response. 2. Adapt and develop the training resources, materials and trainers for use in Jos. 3. Conduct and evaluate initial training on harassment. The HADOIN project is very significant to the entrenchment of a new culture of respect of rights of persons in the workplace so as to engender a safe environment for productive science. The Office, courses, trainings, H&D personnel, and mentorship by NU will institutionalize H&D in the University of Jos to bring to book and prevent H&D in the scientific workforce; it will safeguard the investments of the FIC/NIH over the years, in capacity building for HIV/AIDS in Nigeria.

Principal Investigator: Lisa Hirschhorn, MD, MPH

Hypertension is the leading cause of global cardiovascular (CVD) mortality and morbidity. About two-thirds of the 31.1% adults living with hypertension globally are in low-and middle-income countries (LMICs). This protocol aims to evaluate the implementation and effectiveness of community-health extension worker-led health coaching and home blood pressure (BP) monitoring on hypertension control among high-risk adults with uncontrolled BP compared with propensity-matched controls. This study will be embedded within the Hypertension Treatment in Nigeria (HTN) Program and includes a concurrent evaluation of effectiveness and implementation to inform regional, national, and global scaling.

Principal Investigator: Namratha Kandula, MD, MPH

Publication

Ogun State is experiencing a health transition that impacts adolescents. Improving the quality of health services tailored to the needs of urban and peri-urban adolescents has the potential to address some of the challenges resulting from rapid urbanization, health transitions, and the burden of disease associated with adolescent engagement in risk behaviors. This study will investigate provision of adolescent- and youth-friendly health services (AYFHS) in Primary Health Centres (PHC) in Ogun State, which will aid future interventions. These interventions will eventually improve the quality of AYFHS for young people, expand their access to health services and increase appropriate utilization of AYFHS. 

 Principal Investigator: Gregg Montalto, MD, MPH

Elevated blood pressure (BP) is one of the leading modifiable risk factors for cardiovascular disease (CVD) morbidity and mortality around the world. Approximately 1.4 billion adults have elevated BP globally, including as many as 44% of adults in Nigeria, the most populous country in sub-Saharan Africa. Hypertension care needs to transition from secondary and tertiary care centers to primary healthcare centers (PHCs) to improve the reach of hypertensive services. This study, embedded within the HTN Program in Nigeria, will use systems modeling for improving retention in hypertension care in Nigeria as an example for resource-limited settings.

Principal Investigator: Lisa Hirschhorn, MD, MPH

Visual impairment is a growing problem in Kenya, and 80% of this is due to preventable causes.   Identifying at-risk patients in the community and screening underserved populations for treatable eye conditions can help bring those at risk of visual impairment into the healthcare system and receive appropriate therapy.  Since primary care and community outreach are the foundation of sustainable care, this projects aims to utilize the primary care system and local Community Health Workers in Dandora, Kenya to screen and engage those with visual impairment with treatment options.  A smartphone application will be used to gather data on visual impairment in children and adults and help bring those with need into the healthcare system. 

Principal Investigator: Anjum F. Koreishi

Snapper Hill Clinic is a private health center in Liberia that provides primary care services for about 30,000 patients annually. With support from the Havey Institute for Global Health, the clinic aims to raise awareness on the COVID-19 infection and prevention control measures, as well as invest in a telehealth system that will ensure the clinic continues to deliver care with limited expose to the virus. To implement this plan, Snapper Hill has partnered with the Healthcare Federation of Liberia (HFL) to lead the HFL COVID-19 Response Team to expedite detection, reduce transmission of the disease and manage the inevitable case overflows.

Principal Investigators: Becca Kirby, MBA and Kara Palamountain, MBA

Hypertension is a major public health problem due to its high prevalence and major risk factor for cardiovascular diseases. In Mali, cardiologists are only available in tertiary hospitals in larger cities, with most diagnosed cases being monitored by primary care physicians. This pilot study aims to characterize and compare hypertension service availability, readiness, diagnosis, treatment, and control rates in two different healthcare settings in Mali. This project will build upon the successful collaboration with the University of Sciences, Techniques and Technologies (USTTB) and serve as the foundation for a new promising collaboration with cardiologists at USTTB.

Principal Investigators: Mamoudou Maiga, MD, PhD

Publication

Ageing is often accompanied by chronic diseases, multimorbidity, and frailty, increasing need for clinical and social care. This is challenging even in high income countries. In low- or middle-income countries these challenges conspire with background poverty, infectious diseases, changing societies, and under-resourced health and social care systems. There is little knowledge on the perceptions of ageing and needs and priorities of older people in Rwanda to maintain health ageing. The results of this cross-disciplinary study will therefore provide evidence to design novel interventions to maintain health ageing and inform policy and planning. Our longer-term goal is to develop future grants to test prioritized, co-developed interventions to strengthen care and health among this population and create a road map for Rwanda and other countries in the region to meet the goals of the UN Decade of Healthy Ageing’ 2021-2030. 

Principal Investigator: Lisa Hirschhorn, MD, MPH and Alemayehu Amberbir, MPH, PhD

Publication

There has been a growing burden globally from non-communicable disease, such as diabetes, and the situation is worsening in developing countries like Tanzania. This program aims to determine the prevalence of diabetes in Rorya, Tanzania, and to develop and implement a patient and community education program on risk and prevention of diabetes, as well as develop a screening program. The results of this cross-sectional study will be published to raise awareness of the prevalence of diabetes in rural Tanzania with continued community education using the resources developed in this project.  

Principal Investigator: Karin Ulstrup, MD

The goal of this program is to provide Northwestern FSM students with a longitudinal global health experience through an online, interactive collaboration with peers in the developing world. This program will be in collaboration with the RAO Hospital's Physician Assistant School in rural Tanzania, where students will teach each other using presentations of commonly seen primary care sample patients. Meetings will be supervised by attending physicians at Northwestern and RAO Hospital.

Principal Investigator: Karin Ulstrup, MD

Poverty and poor nutrition remain key hindrances to attainment of an integrated primary healthcare delivery in Uganda. Uganda suffers from high rates of child malnutrition, of which 80 percent is due to a lack of protein in the diet. This study, funded by the Havey Institute for Global Health, aims to combat poverty and malnutrition in the Kigezi sub-region in Southwestern Uganda via rabbit breeding to promote protein intake, income generation and food security in selected households.

Principal Investigator: Danielle Steker, MD

Non-communicable diseases (NCDs) are the leading cause of death worldwide, with nearly 80 percent of the deaths in low and middle-income countries (LMICs). Funding from the Havey Institute for Global Health will support a new collaboration between Northwestern, the Global Alliance for Chronic Diseases (GACD) Research Network and the Bill and Melinda Gates Foundation-funded Primary Health Care Research Consortium (PHCRC) to leverage existing funded studies of models to integrate NCDs into primary care in LMICs.

Principal Investigator: Lisa Hirschhorn, MD, MPH

Publication

The survival, health, education, and wellbeing of children have a strong and reciprocal link with long term community poverty, development, and resilience. Poverty and inability to have marketable skills from schooling leads to several long-term issues which repeat across generations in a vicious cycle. Tea plantation companies have employed a huge number of laborers. Literacy level among the community is only 46%, one of the lowest against Assam's 72% overall literacy rate mainly due to a very high dropout rate at the high school level. 

The Project is looking forward to responding the problems of school retention beyond middle school among the children of tea garden workers as a way to improve health in the long term . In every village 50 (ages 10-14) children will be organized – 10 such groups for a total of 500 children will benefit from this project. The project will support tutors hired from the local community to guide, mobilize and coordinate the children into after school tutoring, group learning and sports activities along with improving health literacy. This project is conducted in collaboration with the Johns Hopkins Bloomberg School of Public Health (Anita Shet, Professor of International Health and Pediatrics), and the Center for Development initiatives (CDI), Guwahati, Assam, India (Sr.Lisa Elavunkal, Director).

Principal Investigator: Jyothy Puthumana, MD

The survival, health, education, and wellbeing of children have a strong and reciprocal link with long term community poverty, development, and resilience. Poverty and inability to have marketable skills from schooling leads to several long-term issues which repeat across generations in a vicious cycle. Tea plantation companies have employed a huge number of laborers. Literacy level among the community is only 46%, one of the lowest against Assam's 72% overall literacy rate mainly due to a very high dropout rate at the high school level. 

The Project is looking forward to responding the problems of school retention beyond middle school among the children of tea garden workers as a way to improve health in the long term . In every village 50 (ages 10-14) children will be organized – 10 such groups for a total of 500 children will benefit from this project. The project will support tutors hired from the local community to guide, mobilize and coordinate the children into after school tutoring, group learning and sports activities along with improving health literacy. This project is conducted in collaboration with the Johns Hopkins Bloomberg School of Public Health (Anita Shet, Professor of International Health and Pediatrics), and the Center for Development initiatives (CDI), Guwahati, Assam, India (Sr.Lisa Elavunkal, Director).

Principal Investigator: Jyothy Puthumana, MD

One World Surgery (OWS) is a non-profit organization that provides about 1,400 free surgeries per year in a variety of specialties to patients of low socioeconomic status in rural Honduras. In 2017, the organization initiated preliminary steps toward opening its second center in the Dominican Republic. Funding from the Robert J. Havey, MD Institute for Global Health will maximize the productivity and impact of an already robust investment in infrastructure, including a surgery center, clinic and visitor center, as well as volunteer visits from primary care physicians. By investing in the salaries of local Dominican professionals and shipping donated medications, the institute substantially augments the number of individuals benefiting from this program.

Prinicpal Investigator: Darren Eblovi, MD, MPH

Hillside Healthcare International Clinic is a non-profit organization that provides free medical care, home care, physical therapy and pharmacy services to the Toledo District in Southern Belize. Diabetes is a leading cause of death in Belize, due in part to lack of access to nutritional food sources, education and timely and accurate diagnosis. This project aims to improve the longitudinal care of patients diagnosed with Diabetes Mellitus by increasing the screening and surveillance capabilities at Hillside with a point-of-care (POC) Hemoglobin A1c (HbA1c) device and increasing community knowledge of diabetes and treatment. Student and resident volunteers from Northwestern and other universities rotating at Hillside will contribute to and implement this program via enhanced diagnostic capability, counseling of patients in clinic and community outreach initiatives. 

Principal Investigator: Anita Mulye, MD

Through this funded project, Northwestern University will partner with Clínica de Familia, a Dominican non-governmental organization providing health services in the Eastern Dominican Republic, to provide high-quality primary care to 840 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 in both public and private health centers. Health promoters from these populations will do outreach with the target populations in the community, and through social networks (both actual and virtual) and will incorporate project activities into routine clinical care for key populations at Clínica de Familia. 

Principal Investigator: Shannon Galvin, MD

Hillside Healthcare International Clinic is a non-profit organization that provides free medical care, home care, physical therapy and pharmacy services to the Toledo District in Southern Belize. Respiratory illnesses are one of the most common presenting concerns at Hillside. Diagnostic capabilities are limited in the region, particularly in the setting of infection. The aim of this project is to provide a point-of-care ultrasound device to improve diagnosis of bacterial pneumonias in need of antibiotics. The curriculum involves two physicians trained in ultrasound leading a 5-day workshop including didactics and hands-on training on the use of a Butterfly iQ+ ultrasound device. A successful training curriculum based on pneumonia can lead to subsequent education for other uses, such as echocardiogram, abdominal and extremity ultrasound.

Principal Investigator: Anita Mulye, MD

This study is part of a global research collaboration that provides evidence on how to improve health-system service delivery and aims to design a targeted multilevel and contextually relevant intervention, for future testing, at the primary healthcare level to improve care for patients with type 2 diabetes in the Province of Mendoza, Argentina by conducting a formative research for the intervention package development which includes a synthesis of data already collected through various initiatives to understand the primary care context and needs in the province. The goal is to enhance primary care for patients with T2DM and improve the local healthcare system to meet the unique needs and circumstances of its users. This project is conducted in collaboration with the Instituto de Efectividad Clínica y Sanitaria/ Institute for Clinical Effectiveness and Health Policy (Dr. Ezequiel García-Elorrio, Director of Health Care Quality and Patient Safety).

Prinicipal Investigators: Lisa Hirschhorn, MD, MPH and  Ezequiel García-Elorrio, MD, MSc, MBA, PhD

Pregnancy-related health conditions are a major source of maternal mortality and morbidity globally, with lower- and middle-income countries suffering a higher burden of disease. The Dominican Republic has had a significant increase in maternal mortality over the past two decades due partially to barriers to accessing care for the mother and newborn. The major goal of this study is to develop and pilot M-HARP (Maternal Health Assessment and Referral Integrated into Pediatric Care). M-HARP will adapt a successful US-based health screening and referral protocol to fit the needs of new mothers at Clínica de Familia La Romana (CFLR). CFLR is an integrated health clinic in the DR that provides obstetric, pediatric, primary care and specialized care services to over 50,000 patients annually. We hypothesize that M-HARP will be acceptable, feasible and an effective strategy for connecting mothers to health care services. We will test this hypothesis with two aims (1) Develop strategies and processes for establishing M-HARP into CFLR and (2) pilot M-HARP. This proposal utilizes an existing global health collaboration between an academic institution and health center in the DR to test a novel approach to improving access to postpartum care for mothers. Additionally, this project will allow Regina Fricton, a Northwestern University medical student, to spend a year focused on research that will advance her career trajectory to becomes a global health physician-scientist focused on improving maternal health.

Principal Investigator: John James Parker, MD, MS