Stray Cats Come Back

Unlike many in the global public health space who get the lifetime ‘calling’, I’ve been somewhat of a ‘stray cat’.

Sometimes I have worked in the global health space…and at other times, I frankly have not.

Although formally trained in population health demography and epidemiology, I’ve rather found myself in strange tangos with private sector companies seeking greater social impact. At times, I have been forced to make the business case for health against the competing priorities of food security, agriculture, basic education, and livelihood empowerment. Whatever the developing country challenge, I’ve enjoyed making the business case using a holistic approach with and without health as a main driver. I’m at my best when I’m examining ongoing costs beyond the project lifecycle, while determining the business-value and the most competitive triple bottom-line.

Little did I know that one experience, in particular, would ‘call’ me back into the global public health space.

In 2009, I took on a seemingly innocent assignment in West Africa to conduct a performance evaluation of a PEPFAR – funded program implemented by Abt & Associates, EngenderHealth and Jhpiego. The Quality Health Partners project aimed to provide a continuum of care consisting of Anti-Retroviral Therapy (ART) for Persons Living with HIV (PLHIVs) at selected health facilities.

What struck me most on this assignment was the limited use of data for decision-making by regional and district hospital senior leadership and management. With a little nudging and prodding from USAID and other colleague organizations, I witnessed a transformation in selected West African hospital management teams who began to better interpret available data, that had always been there. Hospital management teams began to examine inconvenient dosing frequency, dietary restrictions, pill burden, treatment regimen and lifestyle factors. Piecing these points of data together, hospital management teams were able to make decisions based off of:

• Serum neopterin levels in HIV infected patients with and without Tuberculosis
• Behavioural links between Men who have Sex with Men (MSM) and heterosexual networks
• Determinants of ART adherence for HIV-infected persons considering economic barriers and social influences

This experience brought health back into the forefront for me. It took an HIV and AIDS decision-making experience for me to appreciate the links between health, leadership, management, economics, livelihood and society.

I aim to bring fresh perspectives around leading and managing practices to the GTL role and encourage healthcare practitioners to make meaningful decisions from available data. It is thrilling to be back in the global public health space, and at a minimum, I can attest that stray cats do come back.

Note: Jennifer Pierre, is MSH’s Global Technical Lead (GTL) for Leadership and Management