Mobilizing Action from Across the Ocean

Changemaker Catalyst Award recipient Alexandra Gabor spent her summer as an Evaluation Intern for Child Health and Mortality Prevention Surveillance (CHAMPS) Program, a Centers for Disease Control and Prevention (CDC) funded program which focuses on accurately identifying and analyzing causes of death among children under the age of five in order to inform healthcare practices policies, thus improving child health. Alexandra is in her second (and final) year of her Master’s in Public Health Program in Epidemiology, Class of 2022. 

In 2015, the Bill and Melinda Gates Foundation funded the Child Health and Mortality Prevention Surveillance (CHAMPS) Program to track causes of death in children under 5 in Sub-Saharan Africa and South Asia through Minimally Invasive Tissue Sampling (MITS). The goal of the CHAMPS project is to generate high quality data that can be used by ministries of health and other implementing partners engaged in child health services to formulate child survival interventions. As CHAMPS Kenya enters a new fiscal year, my main responsibilities as an evaluation intern are to map out CHAMPS data to action (D2A) activities and assess their effectiveness. This evaluation will reveal any potential health systems gaps that can be addressed in future CHAMPS activities and will inform the development of the next fiscal year’s work plan. Although we have not reached the evaluation step yet, we have been planning monthly activities.

As a changemaker in the making, I worked alongside my Kenyan counterparts to pinpoint the public health issue of utilizing the data collected to inform healthcare delivery services in children under five. Although the data is available, there is a time and information gap when using this data at local and national healthcare facilities. My main contribution is to coordinate and mobilize staff members to effectively and efficiently disseminate this information to service providers.

One of the biggest challenges that our team faced was actually implementing the CHAMPS D2A activities. When the scope of work was formulated in 2020, there were relatively low cases of COVID-19 in Kenya. The CHAMPS team was maybe too optimistic in the interventions that they thought they could implement within the 2020-2021 fiscal year. As the pandemic spread throughout the African continent and into Kenya in both urban and rural areas, the CHAMPS D2A team was unable to proceed according to the original timeline. 

CHAMPS D2A 2020-2021 Gantt Chart


As COVID-19 restrictions in Kenya loosened, the CHAMPS team was informed on how to implement D2A activities safely. One of the activities that we were able to implement was the Integrated Management of Acute Malnutrition (IMAM) Quality Improvement training. The aim of this training was to equip healthcare workers (i.e. nutritionists, clinical officers, and nurses) with concise and practical guidance on how to ensure appropriate management of severe acute malnutrition both in and outpatient. This training was a success in that all 22 participants gained knowledge, which was measured through a pre-test and post-test with the largest improvement between these two tests being 65%. The IMAM training set the stage for the rest of the interventions we intend to implement in the next few months.

Participants taking notes at the IMAM Quality Improvement Training in Kisumu


Participants during a practical session at the IMAM Quality Improvement Training in Kisumu

Because we were unable to implement all of the D2A activities in the previous fiscal year, we were given an extension. One of my main responsibilities is to coordinate meetings between the CHAMPS D2A’s co-principal investigator, officer, and coordinator. These meetings occur every three weeks in which we discuss updates regarding the implementation of D2A activities as well as reports that must be submitted to the CHAMPS program officer. Shortly after the end of the meeting, I send everyone the minutes which encapsulates the main takeaways and actionable items with agreed upon due dates. 

CHAMPS D2A standing Zoom meeting. Elizabeth Oele, CHAMPS D2A Officer (top left), Alexandra Gabor, Evaluation Intern (top right), Janet Agaya, CHAMPS D2A Coordinator (bottom left), Dickens Onyango, CHAMPS D2A Co-Principal Investigator (bottom right).


Collaborating on the CHAMPS D2A Proposal for FY 2022

As the D2A coordinator, Janet provides me with a more frequent update on any field work for the week. We collaborate to complete various reports that are sent to us which include the scope of work, progress report, and project management plan. One challenge in completing these reports at the end of the fiscal year is the lack of organization of all the interventions implemented by the different staff members. To combat this, one of the documents that we are creating is a template to log each D2A activity. This activity log will help us keep track of the implemented activities, which indicators they fall under, and outcomes according to the evaluation metrics. Not only will this aid us in completing these reports efficiently but this will also keep us accountable for achieving each objective. Creating documents such as this activity log and the gantt chart have certainly mobilized the staff members to conduct field work in a timely manner, which is one of my greatest accomplishments this summer.

The biggest lessons I learned during my remote practicum surround flexibility. Given that there is an eight hour time difference between New Orleans and Kisumu, we had to accommodate each other when scheduling meetings. Our meetings were typically in the mornings in central standard time which would be in the late afternoon in east africa time. However, there were some meetings that took place in the morning in east africa time and would span over a few hours or even half of the day; I was unable to attend these meetings and would have to catch up through other means. Apart from meeting schedules, I also had to be flexible when it came to requesting certain documents. Because this project has spanned over three years, there have been different lead personnel so tracking down older documents could be a challenge. Due to COVID-19, some staff are not in the office full-time, which also made it difficult to get in contact with them to obtain said documents. Looking ahead at my future career, I would prefer an in-person public health position. I believe that my work could be completed more efficiently and effectively with in-person meetings where tasks can be completed soon after they are delegated.