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Amnesty E. LeFevre, PhD

  • Assistant Scientist

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Education

PhD, Johns Hopkins Bloomberg School of Public Health, 2010
MHA, Johns Hopkins Bloomberg School of Public Health, 2002

Overview

My research interests remain focused on the conduct of evaluations of maternal, newborn and child health (MNCH) interventions in low and middle-income countries. Much of my work to date has focused on the design, implementation, and evaluation of new technologies and community-based packages of integrated MNCH services, including conducting health impact and outcome assessments; economic analyses (cost-effectiveness/ utility, equity); assessments of MNCH service availability and accessibility; quality of care; health information systems; and ensuring the sufficiency and optimal use of human resources. In recent years, I have additionally worked on numerous large-scale evaluations aimed quantifying burden of disease (e.g maternal and child mortality in Afghanistan); exploring optimal service integration (e.g. Family planning into a platform of MNCH services in Bangladesh); and/or improving services delivery (e.g. midwifery services in Afghanistan; effectiveness of community health workers and community to facility linkages in Tanzania and Bangladesh, etc.). 

Beyond my broader interests in MNCH and evaluation research, I am presently the M&E Technical Lead for the Johns Hopkins University Global mHealth Initiative. In this capacity, I focus heavily on evaluating the use of digital health technologies to bridge critical gaps in service delivery and receipt in LMICs. This includes work at three levels: (1) globally to standardize evidence reporting and develop monitoring and evaluation guidelines for digital health; (2) at a country level to support national level deployments of digital health solutions at scale, including the National Department of Health-South Africa in the monitoring and evaluation of MomConnect – the largest mHealth initiative currently underway globally; and (3) sub-nationally, to support small scale deployments of digital health solutions including Innovations Working Group mHealth grantee projects in Asia and sub-Saharan Africa. Current projects include work with the Praekelt Foundation, the National Department of Health and other partners in South Africa to design a series of microexperiments which seek generate data rapidly through phones survey and other tools to improve the uptake and performance of MomConnect and NurseConnect. From a service delivery side, with support from WHO, I am also working with the National Department of Health and partners to use digital solutions to improve vital registration and community identification and management of postpartum infection in mothers and newborns in the Eastern Cape, South Africa. Finally, an emerging area of work includes the use of digital tools to improve data collection for summative evaluations with the broader aim of reducing costs, improving the timeliness of data availability and lessoning the burden of research on respondents. This includes work in Cote d’Ivoire to measure the economic consequences of ill-health among people living with HIV using a phone survey.

  • mHealth
  • digital health
  • International Health
  • maternal, newborn, and child health
  • community health workers
  • evaluation of community based interventions
  • costing and cost-effectiveness
  • equity
  • financial barriers to care
  • micronutrients

5 select publications representing a broad spectrum of work on MNCH program evaluation, mHealth solutions, and economic evaluation are listed below.

  • LeFevre AE, Mohan D, Hutchful D, Jennings L, Mehl G, Labrique A, Romano K, and Moorthy A. Mobile Technology for Community Health in Ghana: what happens when technical functionality threatens the effectiveness of digital health programs? BMC Med Inform Decis Mak. 2017 Mar 14;17(1):27. doi: 10.1186/s12911-017-0421-9.
  • Agarwal S, LeFevre AE, Lee J, L’Engle K, Mehl G, Sinha C, and Labrique A. Guidelines for Reporting mHealth Evidence: the mHealth Evidence Reporting and Assessment (mERA) tool. BMJ 2016;352:i1174 doi: http://dx.doi.org/10.1136/bmj.i1174
  • LeFevre AE, Mpembeni R, Chitama D, George AS, Mohan D, Urassa DP, Gupta S, Feldhaus I, Pereira A, Kilewo C, Chebet JJ, Cooper CM, Besana G, Lutale H, Bishanga D, Mtete E, Semu H, Baqui AH, Killewo J, Winch PJ. Profile, knowledge and work patterns of a cadre of maternal, newborn and child health CHWs focusing on preventive and promotive services in Morogoro Region, Tanzania. Human Resources for Health 2015, 13:98  doi:10.1186/s12960-015-0086-3
  • LeFevre AE, Mohan D, Mazumder S, Lamberti L, Taneja S, Black RE, and Fischer-Walker CL. Diarrhea no more, does zinc help the poor? Evidence on the effectiveness of programmatic efforts to reach poorest in delivering zinc and ORS at scale in UP and Gujarat, India. Journal for Global Health 2016. DOI: 10.7189/jogh.06.021001
  • Bartlett LA, LeFevre AE, Mir F, Soofi S, Arif S, Mitra DK, Quaiyum MA, Shakoor S, Islam MS, Conner NE, Winch PJ, Reller ME, Shah R, El Arifeen S, Baqui A, Bhutta ZA, Zaidi A, Saha S, and Ahmed SA. Development of a community-based clinical diagnosis tool and treatment regimen for maternal puerperal sepsis. Reprod Health. 2016; 13: 16. Published online 2016 Feb 25. doi:  10.1186/s12978-016-0124-1
  • Evaluating integrated chronic care for people living with HIV
  • Evaluation of Low dose high frequency vs. traditional workshop based approaches to training of health care providers in emergency obstetric and newborn care in two states of Nigera
  • mCARE II in Bangladesh
  • Microexperiments of MomConnect: Can we use digital tools to rapidly collect data to improve program performance?
  • Supplement to Aetiology of Neonatal Infection in South Asia: Development and evaluation of a community-based presumptive clinical diagnosis algorithm and treatment regimen for maternal puerperal sepsis
  • Using mobile technology to improve continuity and timely utilization of reproductive maternal newborn and child health services in South Africa: THRIVE Multi-site Phase 1 protocol for formative, adaptation, and field assessment research of Open Smart Register Platform for RMNCH