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International Health

Health Systems Program

Date: Mar 2017

Today is Global Health Day at Johns Hopkins University (JHU), an annual event held to exchange global health knowledge and share experiences and expertise within the Johns Hopkins local and international community. In order to honor the day, JHU is hosting two featured speakers: Ambassador Deborah Birx, U.S. Global AIDS Coordinator & U.S. Special Representative for Global Health Diplomacy and Olusoji Adeyi, Director of Global Practice for Health, Nutrition, and Population at the World Bank.

In a current political climate where attitudes towards public health are growing increasingly negative, it is important to celebrate past successes and reflect on what can be done to shape future health responses. In the face of looming health threats such as an increase in refugees, the opioid epidemic, climate change, and a growing burden of non-communicable diseases (NCDs), it is especially important to stress the positive impact public health has had worldwide.

Ambassador Deborah Birx is an acclaimed leader in the field of HIV/AIDS, with three decades of experience focusing on HIV/AIDS immunology, vaccine research and global health. She will provide her insight from years of experience ending preventable child and maternal deaths, working towards an aids-free generation, and responding to the burden of infectious disease threats.

Dr. Olusoji (Soji) Adeyi, an Alumnus of the Health Systems Program in the Department of International Health, will be giving a talk entitled, The Future of Global Health Systems: Shaping the 21st Century. He has extensive experience leading global public health policy and strategy initiatives and integrating health systems and health interventions. He has also served as the World Bank’s Sector Manager for Health, Nutrition and Population in Eastern and Southern Africa, and was founding Director of the Affordable Medicines Facility-malaria (AMFm) at the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Both sessions are open to the public and will address critical health issues and the best way to respond. “We hope to foster a positive public attitude towards the effectiveness of global public health interventions,” states Health Systems Program Professor, Dr. Adnan Hyder, “we need to promote the values of service, discovery and knowledge that public health has provided.” Global Health Day is a celebration of vital scientific research that has directly contributed to our capability to live healthy, productive lives. Join the festivities and see the full schedule of events here

The Health Systems Program sponsored Johns Hopkins Bloomberg School of Public Health (JHSPH) doctoral student, Abigail Greenleaf, to attend the Comparative Survey Design and Implementation (CSDI) Workshop in Mannheim, Germany on March 16 – 18 to present preliminary findings from a mobile phone survey (MPS) study conducted in Bangladesh, Tanzania and Uganda. The study was part of the Data for Health Initiative (D4H), funded by Bloomberg Philanthropies.

CSDI brings together survey practitioners who work on projects across cultures and regions. Presenters shared best practices around questionnaire development, translation and comparability of data; all concepts pertinent to D4H’s MPS work. Abigail’s presentation was part of the “Innovative Uses of Technologies & Tools” session, and reviewed the interactive voice response (IVR) survey, a MPS method. The IVR survey uses pre-recorded questions in order to provide for remote data collection.

D4H seeks to help government officials and public health leaders make informed decisions on health care priorities by collecting public health data. The Initiative seeks to improve civil registration and vital statistics (CRVS) systems, explore ways to expand current non-communicable disease (NCD) surveillance efforts, and provide training on data analysis and use to governments in low- and middle-income countries (LMICs).

JHSPH is a partner organization that is leading the research and development (R&D) component of the NCD arm of the Initiative. NCDs can be prevented by the reduction of exposure to major risk factors such as tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. Researchers at JHSPH are evaluating the viability of mobile phone surveys to gather NCD risk factor information. With increasing mobile phone access in rural and hard-to-reach areas, mobile phone surveys (MPS) can be used to improve the efficiency, timeliness and cost-effectiveness of data collection in LMICs by interviewing respondents over their own personal mobile phone.

There is currently a dearth of research about IVR practices in LMICs. In 2016, the JHSPH team piloted an NCD risk factor MPS in three countries in order to promote IVR survey best practices. In addition to Abigail, the team consisted of researchers from the Department of International Health: Drs. Dustin Gibson, Alain Labrique and George Pariyo, as well as Program Director, Dr. Adnan Hyder; and Mr. Joe Ali of JHU Berman Institute of Bioethics.

The D4H team is hopeful that as IVR surveys become more common, these preliminary findings will help inform future IVR studies in low- and middle-income countries.  

While the world has made significant progress towards empowering women and reducing gender inequalities, there is still an urgent need to improve equal access to education and health care. Currently, one of the most pressing issues related to female health is the high rate of maternal and perinatal deaths, many of which are preventable. The International Center for Maternal and Newborn Health (ICMNH) at Johns Hopkins Bloomberg School of Public Health (JHSPH) aims to address the burden of these preventable deaths by enhancing the knowledge base to understand the major causes of maternal and neonatal morbidity and mortality, and developing evidenced-based public health interventions against them in different communities around the world.

ICMNH is hosted by the Health Systems Program in the Department of International Health. In partnership with many local and international stakeholders and collaborators, ICMNH develops and evaluates inexpensive community-based approaches that save millions of mothers and babies. The Center conducts research in sub-Saharan Africa and South Asia and relies on a strong local workforce in these regions in order to provide cost-effective methods of reducing maternal and newborn deaths.

ICMNH has a large field site in Bangladesh that was established in 2001 as a partnership between Johns Hopkins Bloomberg School of Public Health, the Bangladesh Ministry of Health and Family Welfare, and several Bangladeshi NGOs. The Projahnmo Field Site has a complete census and on-going surveillance of a population size of 750,000, which allows them to have the capacity and infrastructure to do large, community-based studies. The field site capacities include a state-of-the-art laboratory managed by Dr. Samir Saha and his team at the Child Health Research Foundation (CHFR), a high-quality data center managed by Johns Hopkins – Bangladesh, and a multidisciplinary team of investigators with expertise in epidemiology, pediatrics, neonatology, obstetrics, pneumology, and vaccine development. The field site is focused in the Sylhet region in particular, which has the highest rates of newborn and infant mortality in all of Bangladesh.

The work of the Center has been instrumental in helping to develop national and global guidelines for improving maternal and newborn health. The World Health Organization (WHO), along with the United Nations International Children's Emergency Fund (UNICEF), recently released a joint statement on guidelines for managing possible severe infections in infants, based largely off of the Center’s work.

The Center is part of a WHO-led, multi-country project called the Alliance for Maternal and Newborn Health Improvement (AMANHI) study, which has led to an impressive bio-specimen repository of 2,600 women that includes placental samples,  saliva swabs, and other samples. The Center is developing partnerships with other universities and centers in order to detect biological and genetic markers of adverse pregnancy outcomes. This will enable better prediction of healthy or unhealthy outcomes for both mothers and babies in the future.  

As communities move closer to gender equality in all aspects of society, the burden that existing health disparities place on women must be addressed. Cost-effective methods of significantly reducing preventable maternal, newborn and child health are known, and it is critical to prioritize the implementation of these efforts. It is especially important to make sure that the methods are sustainable, based off of sound evidence, and community-based. Read more about the Center’s work in maternal and newborn health.  

Assistant Professor Olakunle (Kunle) Alonge has been with the Health Systems Program for four years, from when he joined in January 2013 as Assistant Scientist. In that time, he has taught implementation research and practice, and has focused his work on approaches to strengthening health systems, injury epidemiology, and evaluating the impact of child injury interventions.

Prior to coming to Johns Hopkins Bloomberg School of Public Health (JHSPH), Kunle attended medical school at the University of Ibadan in Nigeria. He served as the district health manager and medical director under the Ministry of Health in Bayelsa State in south Nigeria for four years, where he coordinated and oversaw the delivery of primary health care services.

When Kunle originally came to JHSPH to get his master’s, he focused on epidemiology and biostatistics. His priority was to get a thorough understanding on how to best do public health research. Upon getting his master’s, he served as county health manager and medical coordinator in Liberia, and later returned to working with JHSPH, joining the Hopkins team in Afghanistan. In Afghanistan, he assessed the performance of the health system and provided monitoring and evaluation services for technical assistance in strengthening health activities and research.

Kunle came back to the United States to get his PhD degree in the Department of International Health at JHSPH. In addition to serving as assistant scientist for the Health Systems Program, he also joined the Johns Hopkins International Injury Research Unit (JH-IIRU), housed within the Program. He managed JH-IIRU’s program in Bangladesh on child drowning and worked on measuring and quantifying the burden of childhood injuries and likely interventions.

Currently, Kunle works mainly in three areas within the Health Systems Program: conducting research on implementation science, health systems strengthening strategies, and child injuries; teaching courses on implementation research and practices, health systems in low- and middle-income countries, and child injuries (confronting the burden of injuries, summary measures of population health); and providing mentorship and service for students in the Program by advising master’s students and serving as co-coordinator for the Master of Science in Public Health (MSPH) program. Kunle is also co-director of the school-wide DrPH concentration in health equity and social justice, and serves as the section editor for the health systems section of the Journal of Health, Population and Nutrition.

Kunle hopes to continue to develop his skills in implementation science and evaluating complex interventions. His primary focus is on studying how to implement and evaluate health systems strengthening and child injuries interventions. He also aims to continue studying issues around access to health care, health equity and improving child health. Going forward he wants to continue making a difference in people’s lives by developing a body of work in implementation science, a body of work in systems science, and a body of work in child injuries. Read more about his work in his faculty profile