A Research Question Moves from a Meeting in Mission Hall to a Nairobi Health Center

By Emily Hall, RN, MSN, MPH

At UCSF Global Health Sciences, a research rotation offers doctoral students the opportunity to work on an ongoing research project to gain skills that can be helpful later during our dissertation research. For my first research rotation after two quarters of coursework, I joined a project focusing on reproductive healthcare called SPARQ: Strengthening People-centered Accessibility, Respect, and Quality.

Through activities carried out in Kenya and India, this study looks at the important issue of mistreatment of women who are seeking reproductive healthcare services using the concept of person-centered care. Person-centered care is healthcare that is respectful of and responsive to patient needs, preferences, and values and ensures that patient values guide clinical decisions.

During May and June 2016, I worked to develop tools for two activities being conducted in Kenya: 1) data collection tools for observing reproductive healthcare services and 2) guides for conducting interviews with providers and staff at healthcare facilities about person-centered care.

I worked with the UCSF and Kenya-based teams to understand the objectives of these activities and to create tools that were applicable to resource-limited healthcare settings. My experience as a nurse practitioner in global health was important to this process and allowed me to contribute a unique element to the project.

We included these tools in our application to the Kenyan Medical Research Institute for permission to complete this research in Kenyan healthcare facilities. Once we had received approval, I spent two weeks in Nairobi helping to train the field officers who would collect data on how to use these tools. This included helping them become familiar with the terms and forms, as well as piloting the tools in health centers to see how they work in the field. Through this process the tools and guides were finalized, ensuring that specific factors of the Kenyan healthcare system, culture, and language were well integrated. For example, we are interested in whether patients offer bribes or providers request them. By using a common Kiswahili phrase, kitu kidogo ("a little something"), we could be clearer during data collection.

As an early doctoral student planning a study for my dissertation, completing this research rotation has given me insight into what is required to conduct good research. I had an opportunity to be mentored on reproductive health research that has a quality focus, a topic of particular interest to me. The process of tool development and rollout showed me how a research question moves from a meeting in Mission Hall to a health center in Nairobi. I learned how research is operationalized on an international team, including elements like hiring and training of project staff and managing data collection and quality.

Completing a doctoral program is enabling me to move into the role of researcher. Experiences like working with the SPARQ team at UCSF and in Nairobi are helping me make the transition.

Emily Hall is a student in the Global Health Sciences PhD program and Assistant Clinical Professor in the UCSF School of Nursing.