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Home » Degrees » Doctorate » DRPH

Explore Doctor of Public Health Programs (PhD & DPH)

Pursuing higher positions in public health can prove to be beneficial for individuals with leadership characteristics. Those in public health that seek the most out of their degree should consider enrolling into Doctor of Philosophy (PhD) in Public Health or Doctorate of Public Health (DrPH) in Public Health programs across the country.

The Doctorate of Public Health (DrPH) and the PhD in Public Health are advanced terminal degrees for public health, meant for experienced public health professionals that already have their Masters in Public Health (MPH) or similar degree. Specific degree nomenclature varies based on university and specific public health school. Some offer DPH degrees, while other universities name the terminal degree PhD in Public Health, Doctorate in Public Health, or Doctoral Public Health.

These terminal degree programs in public health can prepare learners for careers in research, education, or even management within the public health sector. Graduate level public health specialists are in great need across the country to assist with nationwide epidemic research as well as the implementation of vital government programs.

George Washington University

School of public health.

Earn your DrPH online from the George Washington University. Our CEPH-accredited program combines interactive, online classes and an on-campus immersion to prepare you to become a thought leader. You will graduate poised to shape public health policy, programs, and initiatives in the U.S. and worldwide. No GRE required.

• Complete the online DrPH program in as few as 36 months. 
• The online DrPH program is CEPH accredited. 
• No GRE required.

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PhD in Public Health vs. Doctor of Public Health

A PhD in Public Health will be focused on developing the skills needed to become an advanced researcher. The understanding of research theories and methodologies is an important part of this degree. Even though a PhD in Public Health is more narrowly focused, it lends itself to careers in various health sectors, such as academia, governmental agencies, and pharmaceutical companies.

A DrPH is an advanced graduate-level degree that focuses on the professional and practical elements of the field, rather than the academic. It is designed for public health practitioners and is geared towards practice and fieldwork. It is multidisciplinary and will cover everything from communications and marketing to advocacy and economics. It was developed to train students and practitioners for careers in public health leadership. 

Both the DrPH and PhD have career options in academia available to them. These two degrees are suited for individuals who have received an MPH or another graduate-level degree and have worked in their field for a number of years. The DrPH is ideal for the public health practitioner looking to advance their career to positions needing additional education. The PhD may suit an individual earlier on in their career who is looking to embed themselves in a career of research.

What are the Typical Pre-Requisites of a DrPH/PhD Degree?

As mentioned above, the prerequisites for advanced degrees require a master’s degree and post-graduate work experience. For some programs, if an individual applying does not have their master’s in public health they will require master’s level classes in public health up to a certain amount of credit hours. A recent Graduate Record Exam (GRE) score is often required along with academic transcripts. An additional requirement for admittance into a Doctorate program is a personal statement or statement or purpose.

Concentration Options for a DrPH/PhD

The degree options for a DrPH or a PhD become more specialized within those concentrations. Those receiving their PhD in public health will have to pick a program by the department they wish to specialize and conduct research in. This could be Health Policy and Administration, Health Economics, Health Systems, etc. A DrPH will also specialize by department, but will often pick from the core public health concentrations (Epidemiology, Environmental Health, etc.) along with a few additional departments (i.e. International Health and Social and Behavioral Sciences).

Online Doctor of Public Health Options

Entering the right educational program is important to the success of a career. Students that are interested in obtaining their degree online should research their chosen school’s accreditation status prior to applying. Since this program is highly research-oriented, learners are expected to take part in a lot of independent learning in an online environment.

Online Doctorate programs will have the same requirements and courses as a traditional degree. Online programs allow for greater flexibility with work and family life but also require self-discipline and accountability. Some online programs will require site visits to the campus or alternate sites for orientations, leadership development, adviser meetings, etc. Classes will be taught online either through live streams or recorded video. Online discussion forums and group work are also the main parts of the online curriculum. A dissertation is still a requirement for online doctorate programs and it may be required that it is presented in person.

Typical Curriculum & Classes

In general, the DrPH degree curriculum will consist of core courses, research courses, and a culminating project such as a capstone course, dissertation, or thesis. The core courses, much like the MPH, will cover the main concentrations in Public Health (Epidemiology, Biostatistics, Environmental Health, Health Policy, etc.) and will also include statistics and data management. Each of these classes are taught with a focus on Leadership and Organization. Additional classes may include:

• Marketing and Public Relations
• Community and Cultural Understanding

These will guide the focus of the degree. A Dissertation or thesis is often required at the end of each semester, year or at the end of the program.

PhD in Public Health

The PhD in Public Health is much less straightforward and will vary significantly from program to program and within degrees. A PhD in Public Health is much more research-based and will cover topics ranging from disease and injury prevention to health informatics and communication. Many schools do not offer a PhD in Public Health per se, but in Health Policy, Bioethics, Environmental Health Sciences, Chronic Disease Epidemiology, etc. Each of these is rooted in public health but are much more focused in their scope. Because of this, classes and curriculum will be much more focused and centered around research.

Different Career Opportunities

After completing a DrPH or Ph.D. in Public Health, graduates may seek out positions in government agencies, healthcare facilities, or even community organizations. Professionals at this level have the capacity to become instructors of public health at universities, researchers for public health associations, and directors of nonprofit agencies.

Having a doctorate degree in this discipline gives learners the most education available for this field. With a Ph.D. in Public Health, professionals in the field may have access to careers working with government organizations in the planning, implementation, and training of important public health procedures. Organizations, such as  American Public Health Association ,  accept members that are in public health careers that desire to communicate their studies and policies on different platforms. Getting involved with a society such as this one can allow professionals to spread their work to educational and professional settings across the country.

Information updated as of April 2020

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Doctor of Philosophy

The primary mission of the PhD program is to provide scholars with the disciplinary background and skills required to contribute to the development of our understanding of better ways of measuring, maintaining, and improving the public’s health. Examples of research conducted by PhD students includes but is not limited to: cancer epidemiology, clinical trials, cardiovascular disease, molecular epidemiology, vector-borne diseases, parasitology, mental health epidemiology and HIV/AIDS. Students are encouraged to work with faculty throughout the university since much of the work done in EPH is interdisciplinary.

How to Apply

Applications are submitted through the Graduate School of Arts and Sciences .

Select program: "Public Health" and your Concentration: Biostatistics (PhD or MS), Chronic Disease Epidemiology (PhD or MS), Environmental Health Sciences (PhD), Epidemiology of Microbial Diseases (PhD) or Epidemiology Infectious Disease (MS), Health Informatics (MS) Health Policy and Management (PhD) or Social and Behavioral Sciences (PhD).

The GRE and TOEFL code for Yale GSAS is: 3987. A writing sample is not required.

The deadline is December 15th.

PhD Program

All PhD students are guaranteed five years of 12-month stipend and tuition support in the form of YSPH fellowships, teaching fellowships, traineeships and research assistantships. In addition to support for tuition and living costs, students receive a health award to covers the full cost of single-student Yale Health Plan Hospitalization/Specialty Coverage.

Faculty Advisors

PhD applicants are not required to secure a faculty mentor prior to applying to the program.

We expect applicants to provide information in their personal statement about the research they hope to conduct if admitted and to state the faculty in our department whose research aligns with their interests.

Diversity Research Awards

The PhD program in Public Health enhances commitment its PhD students who identify as underrepresented minority students, first-generation college graduates and students from economically disadvantaged backgrounds by offering research awards to the top candidates admitted to the program. Each year a minimum of two PhD admitted students will be offered $2,000 each for research funds in addition to their financial aid package. Recipients have up to 2 years to spend these funds, which can be used for books, computers, software, conference travel, research travel or research supplies.

This funding is offered upon acceptance into the program. The criteria for the award is:

• Previous involvement in diversity-related initiatives in their community and/or volunteer activities helping underserved populations.
• Research interest in serving an underserved population

External Fellowships

Doctor of philosophy (phd) overview.

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Doctoral Degrees

The Bloomberg School’s doctoral degree programs target students with specific career goals in public health research, teaching or leadership, and typically require a longer time commitment. We offer two different doctoral degree programs.

Doctor of Philosophy (PhD)

In the Doctor of Philosophy (PhD) degree program at the Bloomberg School, students focus on the creation of new and innovative knowledge – it’s primarily a degree for individuals with goals in public health research or teaching. Generally, the program consists of one to two years of full-time coursework, followed by two to five years of full-time, independent research. PhD programs are based within individual departments, so students should explore and contact their department of interest for more information.

Doctor of Public Health (DrPH)

The Doctor of Public Health (DrPH) degree program at the Bloomberg School is designed for the student who already has an MPH or equivalent degree and who intends to pursue a leadership position as a public health professional.

Through the integration and application of a broad range of knowledge and analytical skills in leadership, policy, program management and professional communication, coupled with preparation in a specific public health field, graduates of the DrPH program are prepared for either domestic or international careers in public agencies or private sector settings that emphasize improving population health.  

Doctor of Public Health (DrPH)

The DrPH program trains innovative leaders who will develop, implement, and disseminate evidence-based programs and policies to advance public health and health equity. GPH is committed to an interdisciplinary approach in its DrPH curriculum, with an emphasis on leadership development, health policy and management and implementation science and training in the areas of mixed-methods data collection and analysis; ethics organizational management and governance; education and workforce development and policy advocacy. 

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The DrPH is the highest professional degree in public health. The goal of our DrPH program is to develop transformative leaders in public health practice who can collaborate with diverse partners across settings and sectors, synthesize knowledge, and generate practice-based evidence to address global public health issues, with a commitment to health equity. Students work with an interdisciplinary faculty whose expertise in research and practice address critical global health challenges. Students benefit from NYU’s location in New York City with its world-class Department of Health and Mental Hygiene, highly diverse communities and expansive network of UN agencies, donor organizations, non-profit and business organizations.

A total of 42 credit hours is required for the DrPH, including 12 credits of electives. Students are expected to complete the degree within four to seven years, depending on previous academic coursework in public health, and whether the student is registered on a full-time or part-time basis. GPH strongly believes in the importance of faculty mentoring. Early in the first semester, each DrPH student will be assigned a faculty mentor, based on areas of common interest. The faculty mentor will support the DrPH student throughout their academic and professional development journey. This includes helping the student with course selection, developing a plan for their advanced applied practice experience, qualifying portfolio preparation, and their dissertation. Faculty mentors will also help students network with other NYU faculty and with health professionals working in the field locally, nationally and globally.

In addition to faculty mentors, the program will provide students with educational opportunities to work with experts in communication skills, negotiation and conflict management and networking with leaders in public health to explore their professional journeys and leadership styles. 

Meet Our Students

Applicants are expected to have earned an MPH or another relevant graduate degree and must have at least 3 years of full-time public health or other relevant work experience. Learn more about application requirements and deadlines.

For a complete list of application requirements and to apply for the DrPH, please complete the SOPHAS application!

• Current Students

DrPH - Doctor of Public Health

The Doctor of Public Health (DrPH) degree at Berkeley School of Public Health is conferred in recognition of a candidate’s command of a comprehensive body of knowledge in the field of public health and related disciplines, and of the candidate’s proven ability to initiate, organize and pursue the investigation of significant problems or interventions in public health. The focus of this degree is the development of transdisciplinary knowledge about the determinants of health and the scientific and professional leadership skills to translate this knowledge into effective health interventions.

Those who earn this degree are expected to occupy leadership positions that have major influence on public health research, policies, programs, systems and institutions. Such leadership may be in diverse traditional and nontraditional settings at the international, national, state, or local levels and in the public, private and academic sectors.

Applicants must hold a master’s or doctoral degree in the health sciences or in another related field or non-US equivalent degree. Applicants must also have a minimum of two years or more of professional public health experience post-master’s degree showing progressive responsibility and evidence of leadership potential.

The DrPH program is a full-time campus-based program of study designed to be completed in three or four years for those applicants with an MPH from a CEPH-accredited institution and at least two years of postgraduate professional public health leadership experience. Any students with deficiencies in coursework equivalent in content to the MPH at UC Berkeley must take prerequisite courses either before starting the program or during the first year of the program.

Students will participate in an integrative doctoral training program that incorporates knowledge and skills from all divisions of the School of Public Health as well as the Schools of Education, Public Policy, Social Welfare and the Haas School of Business. The required course work consists of 4 full-time semesters (48 units) and a minimum of 12 units of dissertation research credits. This course work encompasses a thorough grounding in leadership, research methods and the application of these methods to the analysis of public health and policy issues. Students must fulfill all the course requirements from the Council on Education for Public Health CEPH specific competencies listed in the student handbook. Due to the diverse experience each student brings to the program, it is expected that students will also select courses and independent studies that advance their knowledge and ultimately their proficiency in all of the core and breadth knowledge areas listed below.

• Health Politics and Policy Analysis
• Public Health Interventions
• Global Health Sciences
• Research Design and Methods
• Public Health Ethics

Each student is also required to complete a research and/or professional residency in a public health setting that will provide the opportunity to advance knowledge and skills, identify data for dissertation research, conduct analyses and participate in decision making. Examples include: positions with local, state, or national legislatures, international agencies, city, county and state departments of public health or health services, policy think-tanks, multi-hospital systems and large health maintenance organizations.

As part of the UC Berkeley School of Public Health, DrPH students are eligible to take elective classes at other schools within the University including the Haas School of Business, Goldman School of Public Policy, City Planning, Journalism and others.

The DrPH program is a full-time professional degree program with a residency requirement. For this reason, the program is not recommended for persons who want to continue to work full-time. Overall, the program averages 3-4 years in length. There are no online or night courses available. The first two years of the program are primarily devoted to required coursework.

UC Berkeley DrPH graduates are employed in leading universities, policy research centers and “think tanks” across the country and internationally.

The DrPH is a professional degree program designed primarily for students interested in occupying leadership positions in the field. However, the program includes coursework in research methods, academic mentorship and completion of a dissertation involving the conducting of original research on a problem of public health importance. A number of graduates of the DrPH have gone on to accept university teaching positions or positions as full time researchers in academic or other scholarly settings. Although there is no specific “academic track” within the DrPH, students interested in teaching and research should choose as electives additional coursework in theory and research methods and undertake a dissertation consistent with such a career choice.

DrPH Admissions

Applicants must hold a master’s or doctoral degree in the health sciences or in another related field or non-US equivalent degree and have a minimum of two years or more of professional public health experience post-master’s degree, showing progressive responsibility and evidence of leadership potential. Questions about the applicability of a prior master’s or doctoral degree towards this requirement should be directed to the program office.

A Statement of Purpose is required, that explains how the DrPH program would help build on prior experiences and contribute to his or her career goals. Identify possible topics and research areas you may want to focus on for the dissertation project.

DrPH applicants are also required to provide a writing sample. Writing samples should be no more than 7,000 words in length and examples can include: publications in peer-reviewed journals on which you were the sole or first author, papers written for a graduate course, media pieces, or reports written for public agencies.

We recommend submitting a GRE if you have no other evidence of quantitative, verbal, or analytical abilities in your application.

Note: The average entering student has a verbal score above the 86th percentile and a quantitative score above the 66th percentile.

Official transcripts from all institutions (including community college and graduate coursework) are also required, with a minimum B average (3.0) or equivalent (work completed in the last two years of a bachelor’s degree program and in all post-baccalaureate coursework.

We look at an application in its entirety to determine a person’s strengths and relative fit to our program; available advisors, areas of research interest and academic history are important considerations as is research work experience. Letters of recommendation are also carefully reviewed.

Go to the Berkeley Public Health Graduate Admissions Dates and Deadlines page for general application information and instructions. Some dates and deadlines are specific to the application process for the DrPH program:

December 1: Application deadline

January: Admission committee begins review of applications. Members of the committee may contact applicants during this review period to arrange for phone interviews. Interviews for admission are conducted on an ad hoc basis – not receiving a request for an interview is not indicative of an admissions decision and vice versa.

March (Early): First round of communication of offers are sent. Candidates are offered admission during this time are able to attend a Spring Visit Day in mid-March.

March (Late)—April (Late): Subsequent rounds of communication of offers and final decisions made during this period, after Spring Visit Day. The academic year begins in the fall; spring admission is not permitted.

The DrPH Program typically hosts a Spring Visit Day in mid-March for those candidates who have been offered admission during the first round of offers.

The UC Berkeley Graduate Division and the DrPH Program do not allow for deferred admission. We recommend that you update your CV, obtain at least one new letter of recommendation and reapply.

Some applicants who are not admitted are encouraged to reapply the ensuing year to allow for additional coursework and/or relevant research experiences.

Waitlisted candidates will receive information about their final status on or before June 1. Some of our best students were originally on the waitlist for admission before receiving their offer of admission. We regret the inconvenience and ask for your patience during this process.

The faculty listed here teach the DrPH seminars and provide mentoring and advising to all DrPH students. In addition, faculty throughout the School work with DrPH students as advisers, mentors and Qualifying Exam and dissertation committee members.

Sometimes faculty are unable to respond to prospective students’ queries about mentorship prior to admissions decisions because the admissions committee is responsible for making recommendations for admitted students’ assigned advisors. Applicants with an interest in working with a particular faculty member should indicate this in their applications.

Core Faculty

Drph student directory.

• 2024–2025 Cohort div; cls: uk-animation-fade; delay: 18" uk-grid > Olumayowa Adebayo Christine Board Paulina Castro Nava Joyce Cheng Priya Gangolly Amy Garfinkel Pritika Khatri Frederick Mubiru Chinwe Obudulu Lucia J. Rodriguez Alvizo Pamela Williams

Olumayowa Adebayo is a first year DrPH student. Her formative years were marked by an acute awareness of the public health challenges in her community, particularly among women and children, which steered her away from an initial pursuit of a medical career towards a preventive and health-promoting approach. She holds a bachelor’s degree in physiology and completed her Master’s degree in Public Health with a concentration in reproductive and family health. Her career began as a program officer managing a project aimed at empowering women through financial literacy, gender socialization, and family planning. Most recently, she has worked as a research consultant, supporting the implementation and coordination of reproductive health research programs. Olumayowa is dedicated to tackling health disparities and improving service delivery, with a strong focus on maternal and child health. Her research interests also align with these areas, aiming to develop evidence-based strategies to enhance health outcomes for women and children.

A southern California native, Christine Board was drawn to public health from a young age through childhood experiences in her community and family. She received her BA in public health from UC Berkeley in 2015, and an MPH in Epidemiology from Berkeley in 2021. Her career in healthcare began working in healthcare administration, with a focus on health equity and reducing gaps in disparities through clinical quality improvement, education, and data equity. Currently, she works as a data analyst for a clinical research team looking at the health care delivery for type 2 diabetes patients and the impacts of social and clinical determinants on short and long-term health outcomes. She has a passion for applied social epidemiology that has been driven by her love for narrative, and she believes the ability to share our stories and have our voices valued, is an integral part of health equity and our health and healing. Her primary area of interest lies in illuminating the systemic inequities that have harmed communities, not only to reduce health disparities but to improve overall wellness and the quality of life these communities deserve. Understanding that historically data has not been collected to serve the communities it has been taken from, she hopes to join those pioneering a movement on the decolonization of data. In her free time, she enjoys dancing, being outdoors and gathering in community.

Paulina Castro Nava (she/her) is a first-year Doctor of Public Health student. She earned her Bachelor of Arts in Human Biology from Stanford University and her Master of Public Health and Certificate in Public Health Economics from the Johns Hopkins School of Public Health. Through years of conducting community-based participatory research in food justice and supporting a federally-qualified health center through a pandemic, she developed her commitment to co-create healthier communities to cultivate health equity. Most recently, she served her hometown of Ventura County, California as the first Climate Change and Health Equity Coordinator, developing multilingual health education, collaborating with community organizers, and implementing clinician trainings to bridge the public health, community-based, and medical to establish a foundation for addressing the climate crises as a health equity imperative. Diagnosed with multiple sclerosis in 2023, she understands the importance of and advocates for an accessible health system with investment in the socio-ecological determinants of health. She enjoys hosting reflective journaling sessions with friends and reading (especially Octavia Butler).

Joyce Cheng is a mother of three. Joyce started her career in the non-profit community health sector in 2006 and held a leadership role since 2020. She brings lived and in-field experience in serving communities of color. Joyce serves as the Executive Director and Community Researcher at the Chinese Community Health Resource Center to lead a mission to build a healthy community through culturally and linguistically appropriate preventive health, disease education and management, research, and advocacy. She serves as Co-Principal Investigator, Co-Investigator, Community Advisor for national- and state-funded research studies.

As the Director of Community Outreach at the Chinese Hospital, Joyce leads collaborative efforts within the integrated health system and among local partners. Amid the COVID pandemic, in collaboration with San Francisco City and community-based partners, Joyce oversaw the operations of the primary COVID-19 testing site in San Francisco Chinatown, where over 25,300 screenings were administered between January 2021–February 2023.

As Senior Community Advisor at the University of California, San Francisco, she advocates for community engagement and participation while ensuring scientific rigor. Moreover, as Board Member of local- and state-level committees, Joyce seeks opportunities to improve the ways communities are engaged through research.

Furthermore, as a Doctor of Public Health student, Joyce aims to strengthen her training in community engagement partnership and research, equitable health information delivery as well as to explore cross-sectoral partnership and innovative systems thinking. Joyce is passionate about mentoring youth and early professionals, leading collaborative efforts, and incorporating artistic expressions into her work.

Priya Gangolly is a first-year doctoral student. She has predominantly focused her career on the health technology industry, specializing in building trust and credibility for social networks and building online products to improve population health. As an early member of Facebook’s Health team, she collaborated with government agencies across Asia, South America, and the US on products addressing global health challenges, and developed campaigns with the CDC to counter online misinformation during the pandemic. At other tech companies, she established online communities for patients and physicians to interact and share evidence-based information and research, alongside initiatives addressing emerging public health issues like loneliness and burnout. Her previous professional experience includes Stanford Children’s Hospital, the United Nations Foundation, and the Department of Health & Human Services where she assessed ethical considerations of vaccine mandates. Priya’s research interests are network effects, online health information seeking behavior, algorithmic bias, digital wellbeing, human-centered design, and ethics of emerging health technologies. She holds a BA in Psychology and Healthcare-Social Issues from the University of California, San Diego, and an MPH in public health communication and marketing from George Washington University. She enjoys travel, tennis, and volunteering with rescue dogs.

Amy Garfinkel is a first-year DrPH student. She is passionate about developing, implementing, and evaluating programs that increase access to nutritious food, support community food systems, and engage communities in experiential learning opportunities about food and nutrition such as cooking and gardening. Her experience ranges from implementing farm to school programming at the school district level to supporting farm to school programs statewide at the California Department of Food and Agriculture. She received her BA in Social Welfare and MPH in Public Health Nutrition from UC Berkeley.

Pritika Khatri, a DrPH student at UC Berkeley, hails from the serene rural Himalayas of Nepal, bringing over 10 years of experience in health research, policy, and global health. With a background in MPH and Nursing, she currently manages multiple clinical trials on cardiovascular diseases in Virginia, collaborating closely with cardiologists and nephrologists. Her role includes site selection, protocol development, regulatory compliance, CRO management, and team coordination. Previously, as a Research Fellow for Southeast Asia at the World Health Organization, she worked at the intersections of gender and intersectionality in health policy, conducting comprehensive scoping reviews and developing study modules to address health disparities, working in Bengaluru, India. Additionally, as a Quality Assurance Officer for Save the Children International, she supervised Nepal’s first paperless tuberculosis survey, covering 57,000 people in 99 clusters.

Pritika’s roles reflect her broad impact on global health. As a Program Manager for the Harvard Lown Scholar Program, she played a pivotal role in establishing and managing a health center in Nigeria, providing health services to more than 60,000 people across nine communities.

Her research interests include utilizing data science and artificial intelligence to explore health disparities, particularly in sexual and reproductive health and rights in low- and middle-income settings. Beyond academia, she loves hiking, reading non-fiction, writing poetry, and is an avid dancer.

Frederick Mubiru will be joining the DrPH program at UC Berkeley in the Fall,2024. He is a Global Health professional with over 20 years of experience, holding a BSc and MSc in Population and Reproductive Health from Makerere University, Kampala. He is also a certified Project Management Professional (PMD Pro by Humentum) and has earned a Global Health Leadership certification from the University of Washington-Seattle.

Prior to UC Berkeley, Frederick served as a Technical Advisor at FHI 360’s Scientific and Technical Evidence Advancement Department, leading research utilization and knowledge management for projects such as USAID Research for Scalable Solutions (R4S), BMGF SMART HIPs, USAID MOSAIC, and Knowledge SUCCESS. His work also included advocacy for new family planning and HIV prevention technologies like Hormonal IUD, DMPA SC for Self-Injection and D-Ring and Ca-Prep, and exploring private sector distribution channels for reproductive health commodities. Earlier, as Director of the USAID-funded Uganda Family Planning project (APC), Frederick oversaw the scaling up of high-impact community-based family planning initiatives and implemented critical adolescent health programs across 25 districts of Uganda.

His leadership and membership extend to several global and local communities of practice, including the Implementing Best Practices Consortium, FP Insights, Scale-Up Community of Practice, and the East African FP/RH Community of Practice. Proficient in English and Luganda, and conversant in basic German and Swahili, Frederick’s career spans diverse international settings, including Uganda, Mozambique, Nigeria, Ethiopia, Nepal, Ghana, Kenya, and the USA. His pragmatic approach, dependability, passion for inclusive development programming, and logical decision-making make him a respected leader in public health.

Frederick enjoys networking and collaborating on charity and developmental activities through Rotary International, his neighborhood, and church communities. He also enjoys jogging in natural environments, following global news and events, and sports such as soccer and athletics.

Chinwe Obudulu is a registered dietitian with diverse experience working alongside medical and public health practitioners, researchers, entrepreneurs, and policy makers to implement nutrition and health initiatives. Struggles with childhood obesity drove her initial interest in dietetics, and she has since aligned her career with understanding the determinants that influence food choice and reducing health disparities. As the daughter of Nigerian immigrants, Chinwe is passionate about providing health education grounded in cultural understanding and in using food and nutrition to support physical, mental, and social wellbeing. She began her dietetics career working with communities under the Expanded Food and Nutrition Education, Head Start, and the Ryan White HIV/AIDS programs.

Chinwe was part of the inaugural class of Biden-Harris Administration White House interns within the Office of Science and Technology Policy where she gained an interdisciplinary perspective on public policy and health. Most recently, Chinwe has worked as a Nutritionist at the USDA facilitating the development and implementation of the Dietary Guidelines for Americans. She holds a Bachelor of Science in Nutritional Sciences from the University of Texas at Austin and a Master of Science from the University of Texas Medical Branch. She enjoys traveling, cooking, being active (running, weight lifting and Pilates), drawing portraits, writing, comedy shows, and trying to learn how to dance (so far, to no avail).

Lucia J. Rodriguez Alvizo is a public health professional driven by her lived experiences. Her work is deeply influenced by her roots in Arandas, Jalisco, where she aims to leave a lasting impact akin to the indelible mark of red dirt on white clothes. As an immigrant, Lucia draws inspiration from her mother’s resilience in navigating complex systems to achieve health and well-being. She honors the knowledge gained from her own experiences and those around her. Lucia works passionately to bring her full self into everything she does, including her experience navigating her mental health and grief. Her mission is to ensure that health systems are as diverse and dynamic as the populations they serve. Through her work, Lucia hopes to ensure everyone is able to achieve their highest level of health possible and thrive in a life they find fulfilling. Community, growth, and finding moments of joy are important to Lucia in navigating the cycles of life.

Pamela Williams was born and raised in the Bay Area and currently hails from South San Francisco. Following the completion of her undergraduate degree, she lived in Namibia as a Peace Corps HIV/AIDS Prevention and Community Health Volunteer. Since then she worked as research staff for UCSF, San Francisco General Hospital, and Stanford University. She also completed a MSc in Global Health from UCSF. Most recently she’s worked as a data analyst for a global health supply chain program that provides procurement support to strengthen local capacity in HIV supply chains in over 25 countries. In the DrPH program, Pamela plans to pursue the study of reproductive health, specifically, non-hormonal, reversible, male contraception.

• 2022–2023 Cohort div; cls: uk-animation-fade; delay: 18" uk-grid > Larissa Benjamin Ravneet Gill Caleb Harrison Marisol De Ornelas Rouselinne Gómez Mounika Parimi Marlena Robbins Cara Schulte Morgan Vien Brian Villa Brian Wylie

Larissa Benjamin is a third year DrPH student. Larissa was born in Detroit, MI to parents from divergent socioeconomic and racial backgrounds who were brought together by their shared commitment to fighting social inequality. Larissa holds a BS in Evolutionary Anthropology and English from University of Michigan, and an MPH from UC Berkeley in Health and Social Behavior with a specialty in multicultural health. She is a proud former Kaiser Permanente Public Health Scholar, and a current APHA KP Community Health Scholar and Perez Research Fellow. She has 5 years of work experience in health and science communications, and 3 years of experience as a Project Policy Analyst at UC Berkeley School of Public Health on health equity-centered projects (PIs Herd and Mujahid). She is a Graduate Student Researcher with Dr. Mujahid’s social epidemiology group PLACE and works on the Social Determinants Core (PI Mujahid) of the newly NHLBI-funded RURAL cohort study in the Southeastern US. Larissa’s dissertation research uses mixed methods to explore how historical and structural factors drive neighborhood-level exposures to cardiovascular risk in rural communities in this region.

Ravneet Gill is a third year DrPH student at UC Berkeley. Her research focus is on breast cancer prevention among low income and geriatric women within the diverse Asian American subgroups in the United States. She is a proponent of preventive oncology and her professional pursuits are guided by the glaring need for reformation in health equity and the role of data disaggregation in addressing persistent cancer health disparities.

Ravneet holds a Bachelor’s degree in Biology and a Master’s in Public Health. Her professional experience includes over seven years of post-graduate work experience in the managed care industry, leading cancer prevention programs for Medicaid, Medicare, and ​​Dual-Eligible beneficiaries.

Ravneet loves traveling, visiting museums, and trying different cuisines from around the world. She loves to cook, write, hike, and spend time with family and friends.

Caleb Harrison is a third-year DrPH student. Prior to coming to Berkeley, he worked as the lead epidemiologist at a local health department, overseeing disease surveillance and program evaluation efforts. His research interests include evaluating policies that seek to reduce health inequities in rural settings. Caleb’s time outside of work and studies is usually spent cooking or engaging in outdoor recreation with his wife and two kids.

Marisol De Ornelas (she/her) joined the UC Berkeley’s DrPH program Fall 2022 and is an American Public Health Association and Kaiser Permanente Community Health Scholar. Marisol attended Boston University where she received a Bachelor of Science in Health Sciences and a Master of Science in Public Health. She brings over eight years of experience in public health research and project management. Marisol’s research focuses on assessing interventions on perinatal and mental health outcomes among underserved populations. She is a Graduate Student Researcher at the UC Berkeley’s Wallace Center for Maternal, Child, and Adolescent Health. Outside of her scholarly work, you’ll likely find her cooking Venezuelan arepas, reading the “Ideas” section of the Atlantic , or outdoors on an adventure!

Rouselinne Gómez is a third-year student at UC Berkeley in the Doctor of Public Health program. He is a Medical Doctor who graduated from the Autonomous University of Nuevo León and earned his master’s degree in Public Health from the National Institute of Public Health (INSP) in Mexico. Prior to entering the DrPH program, he worked as a researcher in the Health Economics Unit at the INSP in Mexico. His research focused on influencers for health system navigation for the Mexican Public Healthcare system. During his time as a doctor he worked providing care for rural communities in Chiapas, Mexico. Rouselinne is currently interested in working on sexual and reproductive health issues.

Mounika Parimi is a Doctor of Public Health student at UC Berkeley. She was born and raised in Bengaluru, India, and immigrated to the US as a teenager. Mounika received her Bachelor of Arts in Music and Biology from the University of Redlands and a Master of Science in Public Health from the London School of Hygiene and Tropical Medicine. Mounika has previously worked as a researcher studying the immunology of type 1 diabetes at the City of Hope in Duarte, California, and as a Fulbright scholar at the Center for Regenerative Therapies in Dresden. During her Master’s, Mounika’s work focused on the association between diabetes during pregnancy and congenital abnormalities. Most recently, Mounika has worked as a consultant and project manager with the Real-World Insights department of IQVIA in the United Kingdom. In this role, she has co-designed and managed several retrospective cohort studies in the UK/EU setting for various non-communicable diseases (including cardiovascular disease, asthma, and cancer). Her current research interests include post-partum health and women’s health over the life course, especially among racial and ethnic minority communities. Mounika is a graduate student researcher at UC Berkeley’s Wallace Center for Maternal, Child, and Adolescent Health. In her personal life, Mounika is an avid cook, singer, and enjoys weekend hikes with her spouse and toddler.

Marlena Robbins is a third year doctoral student researching the cultural, social, and policy aspects of psilocybin use within Native communities, highlighting differences between urban and rural perspectives to inform educational frameworks, culturally informed psychedelic assisted therapy models and public health policy. Robbins is a graduate student researcher at the Berkeley Center for the Science of Psychedelics (BCSP), focusing on evaluations and data analyses to refine the program’s structure. Her collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA) led to the development of a tribal engagement toolkit, showcasing the significance of psychedelics in spiritual and recreational contexts among Native American communities. Recently, Robbins was invited to join the Federally Recognized American Tribes and Indigenous Community Working Group for the Natural Medicine Health Act with the Colorado Department of Regulatory Agencies. This role enables her to advocate for the protection of sacred plants against commercialization and cultural misappropriation.

Cara Schulte is a third-year doctoral candidate at UC Berkeley, where her research focuses on the intersection of climate change, global health, and human rights. She is a fellow with the Berkeley School of Law Human Rights Center and the Chowdhury Center for Bangladesh Studies. In addition to her full-time doctoral research, Cara currently works as a researcher for Climate Rights International and as a research assistant to the United Nations Special Rapporteur on Climate Change and Human Rights. She is also a graduate student instructor in Global Health Ethics and a guest lecturer in Human Rights Research and Practice. Cara earned her MHS in Environmental Health Science and BA in Public Health from Johns Hopkins University. She is a member of the Delta Omega Honorary Society in Public Health.

Morgan Vien joined the DrPH program at UC Berkeley School of Public Health in fall 2022. Her research is focused on the intersection of precision public health, public-private partnerships, and regulations and legal considerations to improve population health. Additionally, Morgan is a research associate and works on public health and healthcare projects with the team at Health Research for Action (HRA), a research center at Berkeley Public Health. Morgan received her MPH in Health and Social Behavior from UC Berkeley and her BS in Public Health Science with minors in Biology and Sociology from Santa Clara University. She enjoys spending time with family and friends, playing piano, traveling, and creating arts and crafts.

Brian Villa is a third-year DrPH student. He received his B.A. in South and Southeast Asian Studies, MPH in Health and Social Behavior, and MSW in Strengthening Organizations and Communities from UC Berkeley. He is currently the Research Projects Director for Professor Emily Ozer’s research lab and serves as a core member of the San Francisco Unified School District (SFUSD) and UC Berkeley Research-Practice Partnership. One of the projects he supports explores the impact of youth-led participatory action research (YPAR) on school decision-making processes. Prior to graduate school, he taught Ethnic Studies at a High School in San Francisco through the Pin@y Educational Partnerships. He also worked as the Community Health Program Manager at the RYSE Youth Center in Richmond, CA. Brian enters the DrPH program as a APHA/KP Community Health Scholarship recipient and is excited to continue his work on YPAR, adolescent mental health, racial justice, health equity, and healing-centered liberatory approaches. He enjoys cooking, playing sports, and writing music.

Brian Wylie completed his undergraduate degree at UC Berkeley, professional training in occupational therapy at USC, and his MPH in epidemiology at Harvard. During and since then, he completed a Fulbright in South Korea, developed health and wellness programs for the Los Angeles YMCA, and worked for the California Department of Public Health in infectious disease prevention and the San Francisco Department of Public Health in opioids and chronic pain management. When not working or studying, he’s usually out with his poodle Lucy, being active (running, lifting, cross country skiing), or listening to live music. Also, Go Bears!

• 2021–2022 Cohort div; cls: uk-animation-fade; delay: 18" uk-grid > Juan Carlos Bordes Brittany Campbell Purba Chatterjee Renee Clarke Yao Doe Blake Erhardt-Ohren Olufunke Fasawe Bhavya Joshi Silvana Larrea Solange Madriz Wan Nurul Naszeerah Nadia Anahi Rojas Ida Wilson Emily Winer

Juan Carlos Bordes (he/him/any) is a fourth-year DrPH candidate. Their background as a clinician in occupational therapy has led them to work in various adult healthcare settings, including hospitals, skilled nursing facilities, and acute rehabilitation hospitals. Being an occupational therapist has allowed Juan Carlos to engage with individuals navigating the healthcare system, their support systems, and the multiple team members involved in patient care and collaborate with hospitals and healthcare professional organizations on various inclusion efforts. These experiences provided a foundation that led Juan Carlos to seek to make an impact through public health. Some of Juan Carlos’ goals during the DrPH program are to promote health equity and anti-racism within healthcare, with a particular interest in optimally addressing healthcare workers’ emotional health and well-being. In their spare time, Juan Carlos enjoys spending time with his niece and nephews, going on long walks around the Bay, engaging in mindfulness activities, and spending quality time with friends.

Brittany Campbell is a fourth-year DrPH student bringing 7 years of experience working on projects that center cancer health equity and community engagement at the UCSF Center for Vulnerable Populations and the Helen Diller Family Comprehensive Cancer Center. Prior to attending UC Berkeley, she was awarded a NCI Diversity Supplement to understand patients’ experience navigating care following a positive genetic test result in the safety-net setting. This project led to her current research interests at the intersection of cancer survivorship, mind-body wellbeing, and healing from racial trauma. She received her Master of Public Health from Saint Louis University and Bachelor of Arts in International Studies from the University of Missouri. She is a proud St. Louis, Missouri native who enjoys music, dancing, and bringing people together in the spirit of healing and connection.

Purba Chatterjee is a fourth year Dr PH student. Purba grew up in India; her formative years were spent in Chennai and Kolkata. Purba came to the US to pursue her undergraduate studies. She has a Bachelor’s in Economics from University of California Los Angeles and a Master’s in Public Health from the London School of Hygiene and Tropical Medicine. Purba has over 15 years of public health program management experience. She has worked on HIV/AIDS and other non-communicable diseases projects in Uganda, India, and now Kenya. After completion of the DrPH program, Purba plans to pivot to global mental health research with a focus on the impact of stigma on access to mental health care in low and middle-income countries. She is passionate about partnering with the community to build capacity, address stigma, and increase access to treatment for common mental health disorders. In her current role as the Associate Director of Global Equity, UCSF Dept. of Ob/Gyn, Bixby Center, she oversees operations and administration for HIV/AIDS affiliated research studies in Western Kenya and co-leads global health equity initiatives. Aside from work, Purba enjoys going on long hikes with her husband, daughter, and son. She is also an avid traveler, loves to cook, and enjoys practicing yoga!

Renee Clarke is a fourth year DrPH candidate with over 10 years of experience in the healthcare industry. Renee completed her Master of Public Health in Maternal and Child Health at the University of South Florida and holds two bachelor’s degrees in nursing and health sciences. Prior to University of California, Berkeley, she served in a variety of clinical settings including Emergency Management, Neonatal Intensive Care, Women’s Health as a Registered Nurse. Her passion has always been service leadership and eliminating health disparity gaps among women, infants, and children. Renee’s interest in improving health outcomes extends nationally and internationally. She has served in places such as Niger (Africa), Milot, Haiti and St. Thomas, Virgin Islands. Quality improvement, evaluation, implementation and decreasing health disparities has always been a cornerstone of her experiences. Renee was born in the twin island of Trinidad and Tobago and enjoys traveling, learning new cultures, outdoor activities and spending time with friends and family.

Yao Doe joins the DrPH program from fall 2021 at UC Berkeley. He was born and raised in Ghana. He Attended Kwame Nkrumah University of Science and Technology in Ghana where he completed his BSc. Chemistry. Upon completion, he worked as a laboratory chemist for a year and then moved to medical school in Ukraine. After graduating from medical school, he did his residency in the Department of Obstetrics and Gynecology in Kyiv, Ukraine. Following the completion of his residency, he returned home where he worked as head of the OB/GYN department of a hospital in Ghana and a medical director of a hospital in Togo.

Besides working as a medical doctor, he took active roles in community outreach programs such as screening for breast and cervical cancer, HIV prevention, vaccination programs, chronic-care home visits in underserved communities, and vesicovaginal and rectovaginal fistula repair in sub-regions of Ghana.He also introduced an innovative program that employed the use of prophylactic misoprostol (an inexpensive and easy to use medication that needs no refrigeration) for postpartum hemorrhage and he provided training for midwives and nursing assistants in various regions in rural Togo and this led to drastic reductions in postpartum hemorrhage and subsequent reductions in the evidence of maternal mortality and hospital referral rate in rural areas of Togo. Being thirsty for more knowledge, he moved to the United States to further his studies in Public Health at the University of New Haven, where he obtained his degree in Master of Public Health.

Yao’s primary interest is in maternal and child health, especially the prevention of maternal morbidity and mortality in developing countries. He likes playing soccer, going on road trips, and listening to classic country music.

Blake Erhardt-Ohren is a fourth year DrPH student. She is passionate about improved access to sexual and reproductive health (SRH) services, particularly abortion services, for forcibly displaced populations. Prior to joining the program, she spent three years at Pathfinder International, where she provided monitoring and evaluation support to SRH projects around the world. During her master’s program, she worked at CARE USA, assisting with the Supporting Access to Family Planning and Post-Abortion Care (SAFPAC) project in emergency settings. She holds a BA in History from UC San Diego and an MPH in Global Health from Emory University. In her free time, Blake enjoys hiking, cooking, and traveling.

Olufunke Fasawe is a fourth year DrPH candidate from Nigeria. She joined the program from the Clinton Health Access Initiative (CHAI) where she worked as a Senior Director, Primary Health Care (Global), Director of Programs (Nigeria) and Technical Lead for the Sexual, Reproductive, Maternal, Newborn and Child Health Program (Nigeria). She has over ten years’ experience in global health working on program design, implementation, monitoring, and evaluation cutting across HIV/AIDS, Routine Immunization, Sexual and Reproductive Health, Maternal and newborn health, Cervical Cancer, and health systems strengthening. Prior to starting her career with CHAI, she worked with the Joint United Nations Programme on HIV/AIDS in Geneva as a health economics consultant conducting economic modeling for HIV programs and. She also interned at the World Health Organization Headquarters in Geneva during her Masters program. Olufunke holds a Master’s degree in International Health Management, Economics and Policy from SDA Bocconi, Milan, Italy; she earned her Bachelor of Dental Surgery degree from the University of Lagos, Nigeria. She loves to play tennis and enjoys running outdoors. She is passionate about gender equity and promotion of universal health care in developing countries.

Bhavya Joshi, joined the DrPH in the fall of 2021. As a Global Public Health Fellow, Bixby Summer 2022 Fellow, and the Human Rights Center Fellow 2022, Bhavya’s research focuses on understanding reproductive needs of marginalized populations in countries affected by crises. As a women human rights advocate and educator, Bhavya supports women rights defenders from across the globe to build their capacity to use international human rights mechanisms for advocacy and activism at national, regional, and international levels. Before joining the program, she managed, implemented, and evaluated public health projects in South Asia for more than 5 years. Within India, she has worked in 18 out of 28 states. Bhavya received her MA in International Law and Human Rights from the United Nations mandated University for Peace, Costa Rica and is finishing her second MA in Peace, Security, Development and International Conflict Transformation from University of Innsbruck, Austria. Her bachelor is in Political Science from Delhi University, India. She is a travel enthusiast and is fond of outdoor sports, drinking coffee and experimenting with cuisines.

Silvana Larrea is a fourth-year DrPH candidate at UC Berkeley. She is a Medical Doctor from the National Autonomous University of Mexico and received her MPH in Epidemiology from the National Institute of Public Health (INSP) in Mexico. Prior to starting her graduate program in UC Berkeley, she was a Program Officer for the Poverty, Gender, and Youth department in the Population Council Mexico office. In the Population Council, she provided technical support for the Council’s research portfolio: design, implementation, and evaluation of interventions and developing new proposals, IRB protocols, briefs, donor reports, and manuscripts. She is also a co-investigator in diverse research projects related to migration and health, with a focus on sexual and reproductive health. Her research interests include sexual and reproductive health, migration and health, and inequalities in health. Her dissertation research focuses on the challenges and opportunities of accessing and using sexual and reproductive health services for in-transit migrant women in Mexico.

Solange Madriz, MA, MS is a fourth-year doctoral student as well as an Academic Coordinator at the Institute of Global Health Sciences at University of California, San Francisco. She has designed, implemented and monitored global health programs in diverse settings including Mexico, Guatemala, Ecuador, Paraguay, India and the United States. Her research focuses on global health and professional development of health professionals in low-resource settings. In addition to her research activities, Ms. Madriz teaches graduate level courses on global health for public health practitioners and medical providers. From 2015 to 2018, Ms. Madriz led the implementation of a maternal and newborn health quality improvement project in all the secondary health facilities of the states of Huehuetenango and Alta Verapaz, Guatemala. During the COVID-19 pandemic Ms. Madriz led the educational program to train over 100 community-based organization members as case investigators and contact tracers working for the San Francisco and California Departments of Public Health. She lives with her husband and 2-year old daughter in the Mission District of San Francisco. Ms. Madriz obtained her undergraduate degree from the Central University of Venezuela and a MA in International Studies from the University of San Francisco followed by a MS in Global Health from the University of California, San Francisco.

Lt. Wan Nurul Naszeerah (she/her) is a fourth-year Doctor of Public Health (DrPH) student with Designated Emphases in New Media (Berkeley Center for New Media) and Development Engineering (Blum Center for Developing Economies) at the University of California-Berkeley. As a Digital Transformation of Development (DToD) Fellow, Wan is passionate in enhancing public health preparedness through infoveillance and infodemic management in Southeast Asia. Born and raised in Brunei, Wan is currently developing a human-centered digital intervention against vaccine misinformation for the Malay-speaking communities in Southeast Asia.

This professional endeavor stems from her personal experience as a native speaker of the Malay language, for which social media technologies have not been equitably developed to moderate the spread of vaccine misinformation and to sufficiently address the emerging issues of vaccine hesitancy in this region. Hence, she has been collaborating with data scientists as well as developing her computational skills, specifically in Artificial Intelligence and Natural Language Processing, both of which are increasingly integrated into today’s public health preparedness and research. She believes that global health equity can only be achieved when there is equity in public health technologies.

Prior to becoming a Cal student, Wan had served as an infantry-trained military officer in Brunei, where she was involved in training, operations, research, and communications in the context of military medicine and health. In 2015, Wan had also graduated from the Yale School of Public Health, where she was trained in infectious diseases epidemiology and global health as Yale’s Global Health Research Fellow. She identifies as a first-generation graduate in her Malay family. She currently lives in the Bay Area with her supportive husband and sweet toddler.

Nadia Rojas (she/her) is a fourth-year DrPH candidate and a proud Bay Area native. She received her MPH from UC Davis and BA from UC Berkeley with a double major in Ethnic Studies and Integrative Biology. Before attending the DrPH program, Nadia worked at ChangeLab Solutions, a national nonprofit in Oakland, CA, where she developed tools and resources for community-based organizations, policymakers, and public officials across subject matters on upstream policy interventions. Nadia also worked at the School of Public Health at Berkeley, where she led the data collection and management of various projects evaluating Berkeley’s soda tax. Nadia is a DACA recipient and a strong advocate for the undocumented community. She co-founded Graduates Reaching a Dream Deferred Northern California (GRADD NorCal), where she was instrumental in organizing conferences throughout California for undocumented youth interested in attending graduate school. Nadia’s dissertation focuses on the association between sleep, physical activity, and cognitive function among Latinas in California’s Central Valley. Her additional interests include research that will reduce health disparities and promote equity among communities that have been marginalized, including the undocumented population. Nadia enjoys eating lots of vegetables and loves salsa and bachata dancing.

Ida Wilson is an Oakland native and DrPH candidate. She received a Master of Arts in Applied Anthropology from San José State University and a Bachelor of Science in Anthropology from UC Riverside. Ida has served as a Project Manager for the Center for Critical Public Health at the Institute for Scientific Analysis for several NIH- and Tobacco Related Disease Research Program-funded projects that investigated substance use among young adults in the Bay Area and in rural counties in Northern California. In addition to her duties as Project Manager, she also served as the Coordinator for the Center’s Internship program. Ida’s current research focuses on framing police violence as a public health issue by examining the experiences of Black and Latina women. Her additional research interests include health inequities, as well as the use of critical perspectives in examining public health issues by exploring the ways in which socio-structural systems contribute to health inequities for marginalized populations.

Emily Winer (she/her) is a fourth year DrPH candidate. Emily’s doctoral work is focused on the impact of using participatory, arts-based methods when engaging youth in research. Her other research interests include youth mental, social, and emotional health, the built environment and health, and the role of the arts in public health research and practice. Before coming to UC Berkeley, Emily worked at the International WELL Building Institute as one of the developers for WELL, a global certification for advancing health and wellbeing in buildings and communities. Emily’s work focused on the promotion of mental health through design and policy strategies at the building, organizational, and urban scale. Emily holds a BA in Psychology from Carleton College and an MPH from Columbia University’s Mailman School of Public Health. Outside of the DrPH program, Emily enjoys baking, ceramics, yoga, and spending time outdoors.

• 2020–2021 Cohort div; cls: uk-animation-fade; delay: 18" uk-grid > Mikail Aliyu Samanta Anríquez Ifunanya Dibiaezue Amanda Mazur Julia Ryan

Mikail Aliyu is a fifth-year DrPH student at UC Berkeley. He graduated from the University of Lagos, Nigeria with a degree in pharmacology. He started his career in the pharma industry working with Sanofi, where he focused on increasing access to essential medicines at primary health care level in anglophone West and East African countries. Mikail later received his MPH from the University of Leeds, in the UK, and moved into management consulting as a Program Officer at The Palladium Group. Before UC, Mikail managed a Bill and Melinda Gates Foundation-funded investment called the Technical Support Unit (TSU) project. Through this grant, he provided technical support to the Federal Ministry of Health in Nigeria to create an enabling environment for women and girls to access better reproductive health and family planning (RH/FP) services. He worked closely with government officials and decision-makers to facilitate the creation of enabling structures and processes for accountability, priority setting, and coordination of RH/FP services—this involved strategy design, policy development, and implementation. Notably, he supported the development and execution of the Nigerian Family Planning Blueprint. Mikail is passionate about reducing barriers and addressing sociocultural norms that hinder access to reproductive, maternal, child and adolescent health, and nutrition using system thinking and context-based approaches. In his spare time, he enjoys traveling, sports and trying new food.

Samanta Anríquez (she/her/hers) is a fifth-year DrPH student, who came sponsored by the Fulbright commission in Chile (2020–2021). She served in Chilean public health services for 6 years, focusing in Primary Care and Family Practice in extreme zones, where she has been the director of a family health center in the Chilean Patagonia. She has a medical specialization in Public Health and a MSc of Epidemiology, both from the Universidad Católica of Chile, where she focused her research on Chronic Multimorbidity and Primary Care Models. She has advocated for Health and Human Rights as a volunteer in Amnesty International while being a medical student at the Universidad of Chile and later worked with Medical Residents Union in Chile. She is currently a fellow at the UC Berkeley Human Rights Center, where her work with Amnesty International Chile focuses on the reparation of Human Rights violations in the Chilean social outbreak in October 2019. She is the mother of two beautiful girls who joined her, and her husband in this adventure.

Ifunanya Dibiaezue is a fifth year DrPH student. She is a Public Health Professional with over 7 years of experience in maternal and child health, communicable and non-communicable disease prevention, nutritional awareness and training programs, and public health policy development. She holds a Bsc degree in Biomedicine from the University of East Anglia, Norwich, UK, and a Master of Public Health (MPH) from the University of York, York, UK. While working as an Assistant Program Officer in Africare under the Global Alliance for Clean Cookstoves Project, Ifunanya helped increase the earning capacity of over 1000 women cooks, reduce indoor air pollution and reduce the incidence of respiratory diseases by 65% in Lagos State, Nigeria. In addition, she has helped improve the health of people living with HIV/AIDS (PLWHA) in Southern Nigeria. She has coordinated over 25 HIV testing and counseling programs, and training campaigns with over 70 clinical staff to improve the overall quality of care for PLWHA. She is also very passionate about promoting healthy lifestyles among women. She is the founder of ActivEaters, an organization that focuses on improving the quality of health of women through diet, exercise, and behavior change.

Amanda Mazur is a fifth-year DrPH student at UC Berkeley. She received her MS in Global Health Sciences from UCSF and a BS in Biological Science and BA in International Relations from the University of Calgary. Before attending UC Berkeley, Amanda worked at UCSF on projects in adolescent sexual and reproductive health and coordinated international behavioral health research projects focusing on HIV adherence and stigma reduction, detection and treatment of common mental disorders in community rural health clinics, and understanding intersectional stigma related to HIV and cancer. Prior to starting graduate studies, she worked with the United Nations Development Programme in Zimbabwe to accelerate achievement on the UN Millennium Development Goals. Her research interests include global mental health, sexual and reproductive health, and understanding how systems level approaches can address health outcomes in low-resource settings.

Julia Ryan is a fifth year DrPH student with a passion for improving sexual and reproductive health in vulnerable communities globally. Over the past seven years, she has worked on a broad range of quantitative and qualitative research projects at academic institutions, non-profit organizations, and governmental agencies. Most recently, she spent three years as a qualitative research coordinator focused on HIV prevention in sub-Saharan Africa with the Women’s Global Health Imperative at RTI International. Prior to that, she worked on reproductive health research with UNC Project in Malawi, vertical HIV transmission with USAID, Ebola response with the WHO, and Zika response with the CDC. Julia received her BA in Health and Societies with a concentration in Public Health at the University of Pennsylvania, and her MSc in Reproductive and Sexual Health Research from the London School of Hygiene and Tropical Medicine (LSHTM). She grew up in Boston and Philadelphia and loves hiking with her dog, reading, and snowboarding.

PhD Programs

Doctoral programs in the public health sciences   are offered through  Emory's Laney Graduate School .

PhD Program in Behavioral, Social, and Health Education Sciences

The field of behavioral, social, and health education sciences  (BSHES) is committed to applying a broad spectrum of behavioral and social science knowledge, theory, and methods to promote health, prevent disease, and improve quality of life. The PhD BSHE program applies a collaborative, interdisciplinary approach to research and advocates an ecological perspective to understanding and influencing the factors that shape health and illness.

Program Information | Brochure | Admissions | How to Apply

PhD Program in Biostatistics

The PhD program in biostatistics prepares students for research careers by offering a blend of theoretical and methodological courses. Our teaching curriculum is based on the principle that almost every biostatistician will have to spend at least some of his/her time on statistical analysis of real-life data.

PhD Program in Epidemiology

The PhD program in epidemiology trains future leaders in public health. Our curriculum is grounded in the methodologies of epidemiology and biostatistics enabling graduates to contribute new thinking to the field. These methodologies are applied to a broad range of clinical and public health concerns domestically and globally, including cancer, cardiovascular disease, environmental exposures, infectious diseases, and reproduction.

PhD Program in Environmental Health Sciences

The PhD program in environmental health sciences seeks to improve human health by better understanding the impact of environmental factors in the development of disease. PhD students will receive comprehensive training to become fluent in population and laboratory-based research in environmental health science by bridging the interdisciplinary areas of Exposure Science, Biological Mechanisms of Susceptibility and Disease, and Environmental Determinants of Population Health.

Program Information | Admissions | How to Apply

PhD Program in Global Health and Development

The Global Health and Development (GHD) program will train leaders and scholars who use science to improve public health policy and practice for underserved populations globally. Graduates will acquire a solid understanding of the theoretical frameworks of implementation science and relevant methodological skills required to guide programs and policies that are designed to improve health outcomes in a variety of settings across the globe. 

Program Information | Admissions | Apply 

PhD Program in Health Services Research and Health Policy

Emory's health services research and health policy program trains students to undertake original research (relying on social science theory and using sophisticated empirical analyses) to evaluate current issues in health policy. Our program combines a strongly interdisciplinary and policy-oriented public health approach with rigorous social science training in either economics or political science.

Program Information |  Admissions | How to Apply

PhD Program in Nutrition and Health Sciences

The nutrition and health sciences (NHS) program provides the expertise and skills necessary to investigate relationships between human nutrition and health, and contributes to improving nutrition worldwide. The NHS faculty were recently ranked 4th in the United States in terms of research productivity. Core strengths in metabolomics and predictive medicine, clinical nutrition, population-based intervention trials and epidemiology, and public nutrition programs ensure a quality training in whichever aspect of human nutrition that most inspires you.

• Patient Care

College of Public Health

Quick links, doctoral training, doctor of philosophy (phd).

The Doctor of Philosophy (PhD) is designed to prepare public health professionals to make substantive contributions to public health inquiry and practice. Public health professionals are focused on health promotion, disease prevention, and programs aimed at specific problems that disproportionately affect minority and economically disadvantaged groups. The PhD is a research degree and is granted after the student has shown proficiency and distinctive achievement in a specific field, has demonstrated the ability to do original, independent investigation, and has presented these findings with a high degree of literary skill in a dissertation.

• Granted in recognition of high attainment in a specified field of knowledge.
• Is a research degree and is not conferred solely upon the earning of credit or the completion of courses.
• This degree requires a minimum of 55 credits post-masters.

Doctoral Milestones are a set of target activities that PhD students work towards during their 4-5 years of training. Starting with the most basic levels of achievement in each category, students gain experience and skills in Research, Teaching and Professional Development to prepare them for their next steps after completing their PhD. This may be a post-doctoral fellowship, an academic position as an Assistant Professor, or an entry position in a research or corporate setting. Students who graduate from the USF College of Public Health doctoral program are better prepared for these next steps because they have built a consistent and impressive portfolio of Doctoral Milestones – and our program helps them achieve these skills right from their first day of the program!

Examples of Doctoral Milestones:

Research skills – Grant writing, manuscript preparation, authorship of published manuscripts, presentations at professional conferences, experience on research studies

Teaching skills – Teaching assistantships, Instructor of Record experience, extensive teaching preparation and skill-building programs

Professional development – Preparation of materials for post-graduate positions, such as professional CVs, teaching and research statements, research presentation materials, cover letters, interviewing skills

The College of Public Health PhD students are supported by fellowships, which include tuition waivers and health insurance, research assistantships and graduate teaching assistantships, for which they apply and are appointed.

Additional opportunities are available for graduate students to obtain funding for graduate education. These options can typically be classified into three areas:

• National Scholarships, Fellowships, and Grants:  These are funds that are awarded by national, regional, or private agencies to individual graduate students.
• College, Department or Program Scholarships and Fellowships:  Students are also encouraged to review their specific college website, and also the USF Foundation Scholarships page.
• USF Office of Graduate Studies Scholarships and Fellowships:  The USF Office of Graduate Studies offers fellowship opportunities for new and continuing students. Some of these fellowships are only available to students through nominations by their Major/Department, while others are available by direct submission from students who meet the eligibility requirements outlined below.

For more information on these and other funding opportunities please visit the Office of Graduate Studies website .

On average, the doctoral program requires four to five years for completion following the Master’s or other advanced degree. The College of Public Health PhD program is delivered primarily on-campus. Students are required to be in or regularly commute to the Tampa for the duration of their program.

Concentrations

Below are concentrations in the College of Public Health in which a PhD can be earned.

• Biostatistics
• Community and Family Health
• Environmental and Occupational Health
• Epidemiology
• Global Communicable Disease
• Health Services Research

• Graduate Programs

PhD in Public Health

Our PhD in Public Health program provides students with the rigorous academic skills, practical experience, and multi-disciplinary studies that will enable them to meet the public health challenges of the 21st century. The University of Washington offers a PhD degree in the following areas:

• PhD in Biostatistics
• PhD in Biostatistics - Statistical Genetics Pathway
• PhD in Environmental Health Sciences
• PhD in Environmental and Occupational Hygiene
• PhD in Environmental Toxicology
• PhD in Epidemiology
• PhD in Global Health Metrics & Implementation Science
• PhD in Health Services
• PhD in Nutritional Sciences
• PhD in Pathobiology
• PhD in Public Health Genetics

Doctor of Philosophy in Biostatistics

Recent graduates hold the following positions:

• Data scientist, Google 
• Senior research statistician, AbbVie Inc.
• Biostatistics manager, Amgen
• Senior biostatistician, Boehringer Ingelheim
• Senior research investigator, Bristol-Myers Squibb
• Biostatistician, Duke Clinical Research Institute
• Aassistant professor, Medical College of Wisconsin
• Assistant professor, Northwestern University Feinberg School of Medicine
• Assistant professor, University of Florida
• Postdoctoral associate, University of Pittsburgh
• Mathematical statistician, U.S. Food and Drug Administration

Program Information

PhD Degree Requirements Worksheet (PDF, 2023-24) Student Handbook (PDF, 2023-24)

Statistical Genetics

Doctoral students interested in statistical genetics can pursue that training through either the biostatistics PhD program or the human genetics PhD program. Within the biostatistics PhD program, statistical genetics students take the usual requirements for a biostatistical major but their electives are appropriately selected genetics courses. Students interested in statistical genetics should state that in their application.

A partial list of faculty with interest in statistical genetics

Department of Biostatistics Yong Seok Park Chien-Cheng (George) Tseng

Department of Human Genetics with secondary appointment in the Department of Biostatistics Daniel E. Weeks Eleanor Feingold

Application Deadline

The priority deadline for applications is December 15. The hard deadline for applications is January 5.  

Using   SOPHAS , the centralized application service for graduate schools of public health.

Questions? Contact  [email protected]

Biostatistics News

Recent dissertation titles.

Browse titles in D-Scholarship , the institutional repository for research output at the University of Pittsburgh

Graduates will be able to:

• Develop and implement advanced parametric and nonparametric methods, and the corresponding inference procedures  
• Formulate various linear and mixed models and master the statistical inference on these models
• Apply linear, generalized linear and non-linear regression models to analyze cross-sectional or clustered, or longitudinal data with applications to health sciences  
• Derive quantities and inference statistics for time-to-event data and apply nonparametric, parametric and semiparametric survival models to such data
• Contribute to the body of knowledge in the field of biostatistics by submitting article(s) for publication in peer-reviewed journal(s), or preparing book chapter(s) for publication

Requirements

72 credits, including:

• Coursework in fundamentals of statistical theory and applications
• A statistical consulting practicum
• Coursework in epidemiology and public health
• Advanced dissertation research in an area of specialization

Why Pittsburgh?

We’re in one of the best cities in the country, no lie... a “most livable” burgh, loved by tech nerds, foodies, outdoor adventurers, artists, and home-bodies.

• Open access
• Published: 23 March 2006

The Directly Observed Therapy Short-Course (DOTS) strategy in Samara Oblast, Russian Federation

• Y Balabanova 1 , 3 ,
• F Drobniewski 1 ,
• I Fedorin 2 ,
• S Zakharova 3 ,
• V Nikolayevskyy 1 ,
• R Atun 4 &
• R Coker 5  

Respiratory Research volume  7 , Article number:  44 ( 2006 ) Cite this article

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The World Health Organisation (WHO) defines Russia as one of the 22 highest-burden countries for tuberculosis (TB). The WHO Directly Observed Treatment Short Course (DOTS) strategy employing a standardised treatment for 6 months produces the highest cure rates for drug sensitive TB. The Russian TB service traditionally employed individualised treatment.

The purpose of this study was to implement a DOTS programme in the civilian and prison sectors of Samara Region of Russia, describe the clinical features and outcomes of recruited patients, determine the proportion of individuals in the cohorts who were infected with drug resistant TB, the degree to which resistance was attributed to the Beijing TB strain family and establish risk factors for drug resistance.

prospective study

2,099 patients were recruited overall. Treatment outcomes were analysed for patients recruited up to the third quarter of 2003 (n = 920). 75.3% of patients were successfully treated. Unsuccessful outcomes occurred in 7.3% of cases; 3.6% of patients died during treatment, with a significantly higher proportion of smear-positive cases dying compared to smear-negative cases. 14.0% were lost and transferred out. A high proportion of new cases (948 sequential culture-proven TB cases) had tuberculosis that was resistant to first-line drugs; (24.9% isoniazid resistant; 20.3% rifampicin resistant; 17.3% multidrug resistant tuberculosis). Molecular epidemiological analysis demonstrated that half of all isolated strains (50.7%; 375/740) belonged to the Beijing family. Drug resistance including MDR TB was strongly associated with infection with the Beijing strain (for MDR TB, 35.2% in Beijing strains versus 9.5% in non-Beijing strains, OR-5.2. Risk factors for multidrug resistant tuberculosis were: being a prisoner (OR 4.4), having a relapse of tuberculosis (OR 3.5), being infected with a Beijing family TB strain (OR 6.5) and having an unsuccessful outcome from treatment (OR 5.0).

The implementation of DOTS in Samara, Russia, was feasible and successful. Drug resistant tuberculosis rates in new cases were high and challenge successful outcomes from a conventional DOTS programme alone.

Since the 1990s the World Health Organization Directly Observed Therapy Short Course (DOTS) management strategy has become the internationally recommended approach for tuberculosis (TB) control programmes [ 1 – 3 ]. By the beginning of the new Millennium, 149 countries in the world had adopted the DOTS strategy to varying degrees and important measures of DOTS success (case detection and treatment success) were included in the Millennium Development Goals framework [ 4 ]. In the former Soviet Union (FSU) only a limited number of WHO DOTS implementation programmes exist and currently countries of the FSU report the lowest case detection rates (22%) with 9% of cases failing treatment and a death rate of 7% during treatment [ 4 ]. WHO has acknowledged that until TB is controlled in Africa and Eastern Europe, this disease will remain of major world-wide concern; current analysis indicates that it is unlikely that the Millennium Development Targets for TB will be met in these regions [ 4 ].

Russia is one of 22 TB high-burden countries as defined by the WHO [ 5 , 6 ]. Russia has a highly-specialised tuberculosis health care system with a large organisationally-vertical network of specialized institutes, dispensaries, hospitals, outpatient clinics, sanatoria and rural feldsher points. Case detection is based largely on the presence of radiological abnormalities on chest X-rays with or without bacteriological confirmation detected through a national policy of compulsory annual fluorographic population screening [ 7 – 9 ]. In contrast to the WHO recommended tuberculosis control DOTS strategy, which favour minimising hospital stays, clinical guidelines and health system financing incentives, TB patients in Russia experience frequent and lengthy hospitalisations, and historically have received individualised treatment regimens with doses of the main first line drugs and duration of chemotherapy varying from internationally accepted standard treatment regimens. The system also included prolonged periods of follow-up and repetitive courses of anti-relapse therapy [ 10 , 11 ].

The rationale for implementing the DOTS strategy in Russia is to establish cost-effective tuberculosis control by reducing unnecessary care costs due to lengthy hospitalisations, while improving cure rates and reducing the development of drug resistant TB [ 3 , 7 , 12 – 14 ].

In 2002, with assistance from the UK Department for International Development, a TB control programme that adhered to internationally accepted norms and standards was launched by the regional Ministry of Health. We have reported elsewhere on the considerable body of research undertaken in Samara that explores the epidemiological profile, the health care system structures and processes, and public health challenges being faced by the oblast [ 7 , 9 – 12 ], [ 15 – 23 ]

This paper describes the clinical features and outcomes of patients recruited to a DOTS programme which was implemented in civilian and prison sectors in Samara Oblast.

At the initial stage of implementation of DOTS a standard protocol was agreed with the Regional Ministry of Health. This was followed by extensive training of medical doctors and TB nurses with the involvement of WHO and experts from Russian Federal TB Institutes. Two project medical co-ordinators based in Samara were appointed to oversee implementation which was rolled out in three phases.

Under phase one, initiated in April 2002, patient recruitment commenced at two pilot TB dispensaries in Samara City and at two TB prison colonies (one, an inpatient prison facility used for initial therapy, the second an outpatient facility where continuation of therapy occurred) that looked after all prisoners with TB in the oblast. Recruitment was expanded in January 2003, under phase two, to all TB facilities in Samara city (five dispensaries and three TB hospitals) and to the neighbouring city Togliatti. Under phase three, a further rollout occurred in January 2004 to the rural district of Krasny Yar. We report results through all three phases and include patients recruited up to the third quarter of 2004.

Patients were recruited into standard WHO categories (Table 1 ). In 2002, initially only new cases were recruited (category I and III). From April 2003, recruitment was extended to include relapse cases (category II). Because of the prevalence of drug resistance and concerns that resistance profiles would be further amplified [ 23 – 25 ] chronic cases were ineligible for recruitment.

Given implementation of the internationally supported programme ceased in third quarter 2004, clinical outcomes presented are until the third quarter of 2003. Outcomes for patients recruited subsequently were registered within the newly adopted Russian national system which continued following this programme [ 26 , 27 ].

Standard TB control treatment outcomes were recorded (Table 1 ). Treatment success under the DOTS strategy was determined by cures and treatment completions and unsuccessful treatment included patients who failed and defaulted [ 28 ].

A modified feature of the programme was introduced where patients registered initially under the DOTS cohort could be transferred to an "individual treatment regimen", an approach that reflected the Russian legacy of individualised approaches to treatment. According to the prevailing views of Samara phthisiatrists not only patients who were diagnosed with MDRTB but also some severely ill patients or those with severe co-morbidities or perceived adverse reactions would be removed from the DOTS programme and managed within the regional TB programme using an individualised approach in line withy earlier Russian traditions. Cases, following recruitment, which were subsequently determined to have MDR TB, were transferred out to an individually-tailored MDRTB drug regimen. A further feature of the modification of the DOTS programme was the continuation of the intensive phase of treatment beyond two months (for one more month) despite patients becoming smear-negative in the end of the second month of therapy intensive phase. This was done, in accordance with Russian traditions, where extensive radiological changes were present.

Standard technical approaches to documentation and diagnostic/treatment protocols were employed[ 28 ]. Sputum collection was performed at recommended intervals. During the intensive phase of therapy ethambutol was administered instead of streptomycin because a previous drug resistance survey had documented very high rates of primary resistance to streptomycin [ 9 , 23 ].

For all patients smear microscopy and culture was performed at recommended intervals. Smear microscopy and culture were performed using standard Ziehl-Neilsen microscopy and culture on Lowenstein-Jensen media. All positive isolates were tested for drug susceptibility to isoniazid, rifampicin, ethambutol and streptomycin. Quality-assured drug susceptibility testing (DST) was performed at three civil and one prison site using an absolute concentration method on Lowenstein-Jensen media. DST was assured by a period of training by staff from the WHO Supranational Reference Laboratory (SRL) in London (Health Protection Agency MRU) and in Samara. A blinded analysis of a test panel of TB cultures was performed. A proportion (10%) were retested by the SRL in London.

DNA was extracted and Beijing family strains were analysed in London and Samara by detection of the IS6110 insertions in the dnaA-dnaN intergenic region on a proportion of sequential isolates (n = 740).

Direct supervision of treatment adherence was completed by TB nurses at TB hospitals and dispensaries with out-patients receiving treatment daily or three times weekly. Upon release, ex-prisoners completed their treatment upon transfer of their care to the civilian service.

Medical co-ordinators performed regular visits to all participating DOTS sites to support implementation, ensure recruitment was maintained, and review documentation and adherence to the protocol. Over-arching project management group meetings which included all clinical stakeholders and the project directors from each DOTS site occurred on a monthly basis.

Socially disadvantaged patients were identified by a responsible physician at each dispensary and offered additional support to encourage treatment adherence with weekly food packages at a cost of 100 Russian Roubles (3 Euros) per person per week.

Data were entered and stored into a password protected database. The statistical analysis was performed using Excel and SPSS 12. Proportions with 95% confidence intervals (CI), relative risks (RR), odds ratios (OR), and χ 2 test are used for comparison of categorical variables.

The study was approved by the Samara Regional Ethics Committee.

2,099 patients were recruited from 1 st April 2002 to 30 th September 2004, including 1,971 individuals with pulmonary tuberculosis (93.9%) and 128 patients with extrapulmonary disease (6.1%); 1,684 of recruits were men (80.2%) and 415 (19.8%) women. 640 patients were recruited in the prison sector and 1459 were civilian TB patients.

One third (33.1%; 694/2,099) of recruited patients were WHO category I and 24.3% (162/694) of these were smear-negative cases with extensive parenchymal involvement; 58.8% (1,234/2,099) of cases were WHO category III patients. Recruitment into WHO category II was limited to relapse cases only and 171 patients (8.1%) were recruited.

The mean age of patients was 38.5 years (95%CI 37.9–39.1 years; range: 16–90 years) with prisoners being significantly younger than civilians (mean age 30.9 years; 95%CI 30.2–31.6 years versus mean age 41.9 years; 95%CI 41.1–42.7 years). Female patients were older than male patients (mean age of men was 38.0 (95%CI 37.4–38.6) years and mean age of women with TB was 40.4 (95%CI 38.8–42.0) years).

Details of bacteriologically (smear and/or culture) confirmed cases are shown in Table 2 . Table 3 shows differences between the infectious status of civilian and prison populations with TB where civilians were more likely to have infectious disease whether determined by smear status or culture status. Overall the rate of laboratory diagnosed TB cases was slightly higher in civilian patients than prisoners.

Cultures from 948 sequentially new and 94 relapse cases were isolated and tested for susceptibility to first-line drugs. Of the new cases, 24.9% (236/948) new cases had isolates resistant to isoniazid, 20.3% (192/948) new cases had isolates resistance to rifampicin, and 17.3% (164/948) had MDRTB (vs 34.0% (32/94) of relapse cases being MDR (OR-2.5; 95%CI 1.6–3.9). Table 3 and Figure 1 show the differences between civilian and prison patients.

Rates of first-line drug resistance among civil and prison patients.

Molecular epidemiological analysis demonstrated that a half of all isolated strains (50.7%; 375/740) belonged to the Beijing family. Of note, seven isolates (0.9%) were mixed strains. The prevalence of the Beijing strain (60.9%; 117/192) among prisoners was significantly higher (OR-1.7; 95% CI 1.2–2.4) than in civilians (47.1%; 258/548) confirming earlier research findings in a drug resistance survey in the same region in the preceding year [ 19 ].

For 709 isolates data on both drug resistance and strain type were available (31 isolates were non-viable or were contaminated and DST could not be performed). Drug resistance including MDR TB was strongly associated with being infected with the Beijing strain (for MDR TB 35.2% in Beijing strains versus 9.5% in non-Beijing strains, OR-5.2 (3.4–7.9) (Table 5 ) confirming earlier research in a different population of patients treated under the Russian system in the same region[ 19 ].

Multivariate analysis suggests that being a prisoner (OR – 4.4; 95%CI 2.7–7.1), having a relapse of TB (OR-3.5; 95%CI 1.7–7.1), being infected with the Beijing family strains (OR-6.5; 95%CI 4.0–10.5) and having unsuccessful outcome of treatment (OR-5.0; 95%CI 1.1–22.7) were risk factors for MDR TB.

During the course of treatment the majority (97.7%; 284/290) of smear-positive new cases converted by the end of the intensive phase of treatment.

Treatment outcomes among new cases confirmed by culture are shown in Table 6 . Because recruitment of relapses was initiated at a later stage, the number of these is small. Overall 85.4% (786/920) of newly diagnosed and recruited patients were treated according to the WHO protocol. Nearly fifteen percent (134/920) of patients were transferred out of the DOTS clinical protocol and this included patients transferred to individual regimens because MDRTB (17.3% of all new cases were MDR and 34.0% of all relapse cases) or extensive radiological abnormalities, adverse drug reactions, or co-morbidities). MDR TB patients were removed from the programme according to DOTS project criteria and further treated with tailored schemes using second-line drugs. More smear positive patients were transferred out than smear-negative cases (22.4% versus 11.6%; OR-2.2; 95%CI 1.5–3.2). In total 75.3% (592/786) of patients were successfully treated and in 7.3% (57/786) treatment failed or patients defaulted. The odds of failing treatment or defaulting were higher in smear positive patients (OR – 10.6; 95% CI 3.4–32.8).

There was no statistically significant difference in treatment outcomes between male and female patients.

The rates of unsuccessful treatment was higher among civilians compared to prisoners (OR-4.5; 95%CI 2.1–10.0)

Twenty-eight patients (3.6 %; 28/786) died during the course of treatment with a significantly higher proportion (11.3%) of smear-positive cases dying versus smear-negative (OR -12.5; 95%CI 5.0–31.3).

Discussion and conclusion

The WHO have argued that the introduction of DOTS cohort treatment strategies improves case detection and treatment and leads to a reduction in TB prevalence and death rates by cutting the duration of illness and case fatality.

Two examples from middle and high incidence countries (Peru and China) support this view. In Peru, the incidence rate of pulmonary TB has decreased annually by 6% after the nationwide implementation of DOTS[ 29 ]. In 13 provinces of China that implemented DOTS, the prevalence rate of culture-positive TB was cut by 30% between 1990 and 2000 [ 30 ]

The introduction of DOTS resulted in profound changes to the delivery of clinical care within the Samara TB Service. Although a direct observation component had, broadly. been present within the old system through lengthy hospitalisation periods, the strict adherence of physicians to standard regimens, the emphasis on laboratory diagnosis, and a robust system of recording and reporting of cohorts were new [ 7 ].

Similarly fewer than 70% of patients with TB were cured or completed treatment in Samara compared to 75.3% in the cohort groups. This is in keeping with the cure rates reported for DOTS programmes internationally (Table 7 ) and the global treatment success rate under DOTS has been high since the first observed cohort in 1994 (77%)[ 4 ].

The relatively high failure rates noted elsewhere in Eastern Europe, (9% of cases failed treatment and 7% died during treatment) are believed to be associated with high rates of multidrug resistance (which in itself is an indicator of a programme with low cure rates previously). In Samara, prior to the introduction of the DOTS cohort strategy we established that drug resistance was high in both new (approx 20%) and chronic cases in Samara [ 9 , 17 , 23 ].

Dye et al [ 4 ] further established that the prevalence will decrease sooner if case detection by DOTS programs (and hence the quality of treatment) can be improved more quickly, thus reducing the burden of illness during this period in future years. The DOTS programmes emphasise the importance of bacteriological confirmation. [ 7 ]Prior to the establishment of the cohort, there were more than 1.5 million flurographic examinations of the general population for early diagnosis of TB reflecting the national policy of fluorography screening of the population for TB for early diagnosis. We have reported on the subjective nature of radiological examination elsewhere [ 31 ] and emphasised the need for bacteriological confirmation of the diagnosis in line with international standards.

Previously, less than one-third (30.1%) of cases were bacteriologically confirmed (Coker et al, 2003 IUATLD) compared to the DOTS cohort where 49.6% of all cases (and 57.6% in civilian cases) were bacteriologically confirmed. [ 10 , 11 ]Overall the proportion of cases which had a bacteriological confirmation of the diagnosis was similar to rates reported from other regions of Russia [ 4 ];.

[ 31 ]Although the laboratory component of the TB service in Samara Oblast has been extensively upgraded and improved with prison and civil laboratory services working to these improved standards, maintenance and further quality improvement remains a priority. Without appropriate laboratory support, over-diagnosis of tuberculosis remains a possibility, resulting in unnecessary treatment and side-effects without benefit, and compounding service inefficiencies [ 13 ].

Relatively low default rates occurred with implementation of DOTS in Samara. This may be, in part, attributable to a programme of externally financed social support. This component was discontinued after external funding ceased, and it remains to be seen whether adherence rates will suffer. Of note, substance abuse, alcoholism, poverty and unemployment are common amongst patients with TB in Samara Oblast, co-factors likely to influence treatment adherence [ 22 ]. The sustainable success of DOTS in Russia is likely to be dependent on how care and support for these social and behavioural factors are integrated into TB care systems.

Effective responses in support of TB control demand political commitment and investment from local and federal budgets into non-medical support to patients and their families. However, few integrated social support systems for tuberculosis patients currently exist, and current laws and regulations have the potential to ensure that health and social care budgets remain disconnected from each other and from need [ 32 , 33 ]. Consequently, to compensate for inadequate social support systems for tuberculosis patients, providers use sophisticated practices to ensure lengthy admissions in the winter months – a response to social rather than medical need [ 32 , 33 ]. Whilst the two recent decrees on TB control issued in 2003 (#109 and #50) [ 26 , 27 ] support convergence of Russian TB control practices with WHO's DOTS strategy (with some specific differences reflecting Russia's clinical legacy), the sustainability of reforms needed to ensure cost-effective implementation such that DOTS implementation is allied to structural reform remains uncertain.

The rate of successful treatment (75.3% overall and 79.0% in civil sector) though below the 85% WHO target, was higher than reported from other several DOTS pilot regions in the former Soviet Union (68.1% according to the meta-analysis performed by Faustini et al, 2005 [ 25 ]). The zero mortality among prisoners may be misleading: several patients died after data censoring. Furthermore, policy that very severely ill patients are released from prison for treatment in the civilian sector means that deaths of these ex-prisoners are recorded as civilian deaths.

The high prevalence of drug resistance and the frequency of the Beijing strain family (previously shown to be associated with drug resistance) [ 19 ] remains a major clinical and public health challenge. Extremely high rates of drug resistance among prisoners despite significantly lower default rates in prison likely reflects on-going transmission of resistant strains. Rapid isolation of MDR TB cases, good co-ordination between the prison and civilian TB services and enhancement of infection control and treatment are needed to prevent further nosocomial and institutional spread of MDR TB and would increase the success of the current TB programme. This issue is likely to become considerably more of a problem as the emergent epidemic of HIV in Samara matures

Although the DOTS strategy does not include specific therapy for multi-drug resistant cases its effective implementation reduces the occurrence and further transmission of resistant strains [34]. However, in regions such as Samara with very high rates of MDR TB it is essential to ensure the availability of appropriate and timely diagnosis and treatment of existing cases as well as preventing the development of new ones. Rapid drug susceptibility techniques, with appropriate treatment to be tailored to circumstance may be necessary. Cost-effectiveness analysis of rapid methods in the post-Soviet context is required to inform investment and policy changes.

Abbreviations

Confidence Interval

Directly Observed Therapy Short-Course

multi-drug resistant tuberculosis

Supranational Reference Laboratory

tuberculosis

World Health Organization

WHO: Treatment of tuberculosis: guidelines for national programmes. Geneva , World Health Organization; 1997.

Google Scholar  

WHO: The global plan to stop tuberculosis. Geneva , World Health Organization; 2002.

WHO: An expanded DOTS framework for effective tuberculosis control. Geneva , World Health Organization; 2002.

Dye C, Watt CJ, Bleed DM, Hosseini SM, Raviglione MC: Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence, and deaths globally. Jama 2005, 293 (22) : 2767–2775.

Article   CAS   PubMed   Google Scholar  

WHO: TB - a global emergency. Geneva , World Health Organization; 1994.

WHO: Anti-tuberculosis drug resistance in the world. Report no.2: prevalence and trends. Geneva: World Health Organisation 2000.

Coker RJ, Dimitrova B, Drobniewski F, Samyshkin Y, Balabanova Y, Kuznetsov S, Fedorin I, Melentsiev A, Marchenko G, Zakharova S, Atun R: Tuberculosis control in Samara Oblast, Russia: institutional and regulatory environment. Int J Tuberc Lung Dis 2003, 7 (10) : 920–932.

CAS   PubMed   Google Scholar  

Drobniewski F, Balabanova Y, Coker R: Clinical features, diagnosis, and management of multiple drug-resistant tuberculosis since 2002. Curr Opin Pulm Med 2004, 10 (3) : 211–217.

Article   PubMed   Google Scholar  

Drobniewski F, Balabanova Y, Ruddy M, Weldon L, Jeltkova K, Brown T, Malomanova N, Elizarova E, Melentyey A, Mutovkin E, Zhakharova S, Fedorin I: Rifampin- and multidrug-resistant tuberculosis in Russian civilians and prison inmates: dominance of the beijing strain family. Emerg Infect Dis 2002, 8 (11) : 1320–1326.

Article   PubMed   PubMed Central   Google Scholar  

Atun RA, Samyshkin YA, Drobniewski F, Kuznetsov SI, Fedorin IM, Coker RJ: Social factors influencing hospital utilisation by tuberculosis patients in the Russian Federation: analysis of routinely collected data. Int J Tuberc Lung Dis 2005, 9 (10) : 1140–1146.

Atun RA, Samyshkin YA, Drobniewski F, Kuznetsov SI, Fedorin IM, Coker RJ: Seasonal variation and hospital utilization for tuberculosis in Russia: hospitals as social care institutions. Eur J Public Health 2005, 15 (4) : 350–354.

Coker RJ, Dimitrova B, Drobniewski F, Samyshkin Y, Pomerleau J, Hohlova GY, Skuratova N, Kuznetsov S, Fedorin I, Atun R: Health system frailties in tuberculosis service provision in Russia: an analysis through the lens of formal nutritional support. Public Health 2005, 119 (9) : 837–843.

Floyd K, Hutubessy R, Samyshkin E, Korobitsyn A, Fedorin I, Volchenkov G, Kazeonny B, Coker R, Drobniewski F, Jakobowiak W, Shilova M, A A: Health-systems efficiency in the Russian Federation: tuberculosis control. Bulletin the World Health Organization 2006, 84 (1) (January 2006) : 43–51.

WHO: Global tuberculosis control: surveillance, planning, financing. Geneva , World Health Organization; 2003.

Atun RA, McKee M, Drobniewski F, Coker R: Analysis of how the health systems context shapes responses to the control of human immunodeficiency virus: case-studies from the Russian Federation. Bull World Health Organ 2005, 83 (10) : 730–738.

PubMed   PubMed Central   Google Scholar  

Balabanova Y, Fedorin I, Kuznetsov S, Graham C, Ruddy M, Atun R, Coker R, Drobniewski F: Antimicrobial prescribing patterns for respiratory diseases including tuberculosis in Russia: a possible role in drug resistance? J Antimicrob Chemother 2004, 54 (3) : 673–679.

Balabanova Y, Ruddy M, Hubb J, Yates M, Malomanova N, Fedorin I, Drobniewski F: Multidrug-resistant tuberculosis in Russia: clinical characteristics, analysis of second-line drug resistance and development of standardized therapy. Eur J Clin Microbiol Infect Dis 2005, 24 (2) : 136–139.

Dimitrova B, Hutchings A, Atun R, Drobniewski F, Marchenko G, Zakharova S, Fedorin I, Coker RJ: Increased risk of tuberculosis among health care workers in Samara Oblast, Russia: analysis of notification data. Int J Tuberc Lung Dis 2005, 9 (1) : 43–48.

Drobniewski F, Balabanova Y, Nikolayevsky V, Ruddy M, Kuznetzov S, Zakharova S, Melentyev A, Fedorin I: Drug-resistant tuberculosis, clinical virulence, and the dominance of the Beijing strain family in Russia. Jama 2005, 293 (22) : 2726–2731.

Drobniewski F, Balabanova Y, Ruddy M, Fedorin I, Melentyev A, Mutovkin E, Kuznetzov S: Medical and social analysis of prisoners with tuberculosis in a Russian prison colony: an observational study. Clin Infect Dis 2003, 36 (2) : 234–235.

Drobniewski FA, Atun R, Fedorin I, Bikov A, Coker R: The 'bear trap': the colliding epidemics of tuberculosis and HIV in Russia. Int J STD AIDS 2004, 15 (10) : 641–646.

Drobniewski FA, Balabanova YM, Ruddy MC, Graham C, Kuznetzov SI, Gusarova GI, Zakharova SM, Melentyev AS, Fedorin IM: Tuberculosis, HIV seroprevalence and intravenous drug abuse in prisoners. Eur Respir J 2005, 26 (2) : 298–304.

Ruddy M, Balabanova Y, Graham C, Fedorin I, Malomanova N, Elisarova E, Kuznetznov S, Gusarova G, Zakharova S, Melentyev A, Krukova E, Golishevskaya V, Erokhin V, Dorozhkova I, Drobniewski F: Rates of drug resistance and risk factor analysis in civilian and prison patients with tuberculosis in Samara Region, Russia. Thorax 2005, 60 (2) : 130–135.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Farmer PE, Timperi R, Mitnick C, Kim JY: Responding to outbreaks of MDRTB: Introducing 'DOTS-Plus'. In Tuberculosis: a comprehensive international approach . Edited by: Reichman LB, Hershfield ES. New York , Marcel Dekker Inc.; 1999.

Faustini A, Hall AJ, Perucci CA: Risk factors for multi-drug resistant tuberculosis in Europe: a systematic review. Thorax 2005.

Ministry of Health of the Russian Federation P: Prikaz of the Ministry of Health of the Russian Federation # 109 from 21 March 2003 "On improvement of TB control activities in the Russian Federation".

Ministry of Health of the Russian Federation P: Prikaz of the Ministry of Health of the Russian Federation # 50 from 13 February 2004 "On implementing of TB recording/reporting system".

Suarez PG, Watt CJ, Alarcon E, Portocarrero J, Zavala D, Canales R, Luelmo F, Espinal MA, Dye C: The dynamics of tuberculosis in response to 10 years of intensive control effort in Peru. J Infect Dis 2001, 184 (4) : 473–478.

China Tuberculosis Control Collaboration. The effect of tuberculosis control in China Lancet 2004, 417–422.

Balabanova Y, Coker R, Fedorin I, Zakharova S, Plavinskij S, Krukov N, Atun R, Drobniewski F: Variability in interpretation of chest radiographs among Russian clinicians and implications for screening programmes: observational study. Bmj 2005, 331 (7513) : 379–382.

Atun RA, Baeza J, Drobniewski F, Levicheva V, Coker RJ: Implementing WHO DOTS strategy in the Russian Federation: stakeholder attitudes. Health Policy 2005, 74 (2) : 122–132.

Atun RA, Samyshkin YA, Drobniewski F, Skuratova NM, Gusarova G, Kuznetsov SI, Fedorin IM, Coker RJ: Barriers to sustainable tuberculosis control in the Russian Federation health system. Bull World Health Organ 2005, 83 (3) : 217–223.

CAS   PubMed   PubMed Central   Google Scholar  

DeRiemer K, Daley CL: Tuberculosis transmission based on molecular epidemiologic research. Seminars in Respiratory and Critical Care Medicine 2004, 25 (3) : 297–305.

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Acknowledgements

The UK Department for International Development (DFID) funded this study, but the views and opinions expressed are those of the authors alone.

We would like to thank all doctors and nurses who took part in this study.

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Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK

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YB participated in the design of the study, its coordination, acquisition of data, statistical analysis and drafted the manuscript; RC participated in acquisition of funding, design of the study, its supervision and drafted the manuscript; IF participated in administration of the study, its design and revision of the manuscript; SZ participated in design and coordination of the study, data acquisition and manuscript revision; VN carried out laboratory work and revised the manuscript, RA participated in acquisition of funding, design of the study, its supervision and revision of the manuscript, FD participated in acquisition of funding, design of the study, its supervision and gave final approval of the version to be published. All authors read and approved the final manuscript.

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Balabanova, Y., Drobniewski, F., Fedorin, I. et al. The Directly Observed Therapy Short-Course (DOTS) strategy in Samara Oblast, Russian Federation. Respir Res 7 , 44 (2006). https://doi.org/10.1186/1465-9921-7-44

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DOI : https://doi.org/10.1186/1465-9921-7-44

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Dr. Anindita Dasgupta is a social and behavioral scientist whose research focuses on understanding how gendered inequities of health intersect with sexual and reproductive health among populations of girls and women who are marginalized in the United States, India, and the Middle East. Dr. Dasgupta’s research uses a reproductive justice lens – with the goal of using research to tackle systems of oppression to improve reproductive health outcomes of birthing people through intervention and epidemiologic research. Dr. Dasgupta is currently funded by the National Institute of Alcohol Abuse and Alcoholism to implement and evaluate the PrEP for WINGS intervention, which aims to reduce hazardous alcohol use, intimate partner violence and increase PrEP initiation for women engaged in the criminal legal system in New York City ( R01AA030462 ).

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Goddard-Eckrich D, Stringer KL, Richer A, Dasgupta A , Brooks D, Cervantes M, Downey DL, Kelleher P, Bell SL, Hunt T, Wu E, Johnson KA, Hall J, Guy-Cupid GN, Thomas BV, Edwards K, Ramesh V, Gilbert L. 'Yeah, they suck. It's like they don't care about our health.' Medical mistrust among Black women under community supervision in New York city. Cult Health Sex. 2024 Jun 24:1-16. doi: 10.1080/13691058.2024.2358084. Epub ahead of print. PMID: 38915232.

Khadra MM, Suradi HH, Amarin JZ, El-Bassel N, Kaushal N, Jaber RM, Al-Qutob R, Dasgupta A . Risk factors for miscarriage in Syrian refugee women living in non-camp settings in Jordan: results from the Women ASPIRE cross-sectional study . Confl Health. 2022 Jun 7;16(1):32. doi: 10.1186/s13031-022-00464-y. PMID: 35672855; PMCID: PMC9171994.

Brooks MA, Dasgupta A , Ta???n N?, Meinhart M, Tekin U, Yükseker D, Kaushal N, El-Bassel N. Secondary Traumatic Stress, Depression, and Anxiety Symptoms Among Service Providers Working with Syrian Refugees in Istanbul, Turkey . J Immigr Minor Health. 2022 Feb 25. doi: 10.1007/s10903-022-01344-6. Epub ahead of print. PMID: 35212824.

Brooks MA, Meinhart M, Samawi L, Mukherjee T, Jaber R, Alhomsh H, Kaushal N, Al Quotob R, Khadra M, El-Bassel N, Dasgupta A. Mental health of clinic-attending Syrian refugee women in Jordan: associations between social ecological risks factors and mental health symptoms . BMC Womens Health . 2022 Jan 8;22(1):4.

Mukherjee TI, Khan AG, Dasgupta A, Samari G. Reproductive justice in the time of COVID-19: a systematic review of the indirect impacts of COVID-19 on sexual and reproductive health . Reprod Health. 2021 Dec 20; 18(1):242. PMID: 34930318

Dasgupta A , Saggurti N, Ghule M, Reed E, Donta B, Battala M, Nair S, Ritter J, Gajanan V, Silverman J, Raj A. Associations between intimate partner violence and married women’s condom and other contraceptive use in rural India . Sexual Health . 2018 Nov;15(5):381-388. PMID: 30045806

Dasgupta A , Silverman J, Saggurti N, Ghule M, Donta B, Battala M, Nair S, Gajanan V, Raj A. Understanding men’s elevated alcohol use, gender equity ideologies, and intimate partner violence among married couples in rural India . American Journal of Men’s Health . 2018; 12(4):1084-1093. PMID: 29779428

Dasgupta A , Raj A, Nair S, Naik DD, Saggurti N, Donta B, Silverman J. Assessing the relationship between intimate partner violence, externally-decided pregnancy and unintended pregnancies among women in slum communities in Mumbai, India . BMJ Sexual & Reproductive Health . 2018 PMID: 29972358

Dasgupta A , Davis A, Goddard-Eckrich D, El-Bassel N. Reproductive health concerns among substance-using women in community corrections in New York City: Understanding the role of environmental influences . J Urban Health . 2017 July 24. PMID: 28741282

Dasgupta A , Battala M, Nair S, Naik DD, Saggurti N, Silverman JG, Balaiah D, Raj A. Associations between high local social support and depression/anxiety among women contending with partner violence and husband's heavy alcohol use in slum communities in Mumbai, India . Journal of Affective Disorders. 2013 February 15;145(1):126-9. PMID: 22877967

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Increased risk of tuberculosis among health care workers in Samara Oblast, Russia: analysis of notification data

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• 1 Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom.
• PMID: 15675549

Setting: Samara Oblast, Russia.

Objective: To compare the rates of tuberculosis (TB) in health care workers (HCWs) working in TB services, general health services (GHS) and the general population in a region of the Russian Federation.

Design: Analysis of notification rates of TB among HCWs, GHS workers and the general population during the 9-year period from 1994 to 2002.

Results: During 1994-2002, TB incidence among staff employed at the TB services in Samara Oblast was ten times higher than among the general population, reaching 741.6/100 000 person years at risk. Staff working at in-patient TB facilities were found to be at highest risk, with an incidence rate ratio of 17.7 (95% CI 11.6-27.0) compared to HCWs at the GHS.

Conclusions: HCWs at TB services in the Russian Federation are at substantially increased risk for TB, suggesting significant risks from nosocomial transmission. Control of institutional spread of TB in the Russian Federation is an area that requires urgent attention, especially given the epidemic of human immunodeficiency virus that Russia is currently witnessing.

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But the success of an almost decade-long relationship is not without its challenges. Sustainable donor support and aligned interests on research priorities remain key, she said. 

Real-time research 

Dr Emmanuel Asampong, coordinator of the regional training centre at the University of Ghana, notes that “the impact of implementation research on disease themes in Africa and beyond is impressive because the initiative promotes the use of real-time research results in various contexts – such as neglected tropical diseases programmes, national malaria programmes, and tuberculosis control programmes – to provide solutions to challenges.” 

The global training programme, which has played a significant role in positioning University of Ghana as a research-intensive university, supports seven regional training centres across six WHO regions. With additional partners in Colombia, Indonesia, Kazakhstan, Malaysia, Senegal and Tunisia, the programme develops and updates implementation research courses, provides faculty training and supports career development. 

The University of Ghana also partners with TDR on a  postgraduate training scheme , which provides a full academic scholarship for master’s students. The training is specifically focused on implementation research to tackle infectious diseases of poverty. 

The list of TDR alumni across the world runs long, and the University of Ghana can claim many public health leaders among them. 

“My postgraduate training at the University of Ghana, supported by TDR, was an invaluable catalyst in shaping my academic and professional journey,” said Dr Mbele Whiteson, Senior Resident Medical Officer at the Ministry of Health in Zambia. “I have learned to recognize the intricate interplay between health outcomes and social determinants.”‎ For more information, please contact Dr Mahnaz Vahedi .

View Professor Awandare’s full presentation to TDR’s Joint Coordinating Board