Focus: Health systems research and implementation

Affiliation: University of Gondar, School of Public Health; Yale University, School of Public Health


Site and Background: This training site will be based at the Institute of Public Health at the University of Gondar, under the direction of Dr. Abebaw Gebeyehu, and working in strong collaboration with the Federal Ministry of Health and Regional Health Bureaus. The University of Gondar is renowned in research undertaking for more than half a century specifically, but not limited to, in the fields of health sciences. Research activities at the University of Gondar have wide scale involvement of students, focus has been given on applied researches, promoting multidisciplinary collaboration and vigorous team based researches, and generous intra-institutional funding for young researchers.

The Institute of Public Health continues to be a leader in the field of public health within the country. It provides quality education, research, consultancy services and leadership to improve public health and eliminate health disparities. Teaching and research activities of the Institute focus on practical applications of both basic and advanced public health sciences in order to solve community health problems in the nation. The Institute provides opportunities for continued learning and growth through the creation of partnerships between local and international universities and organisations. Currently, it has academic links with a range of local and international universities including Addis Continental Institute of Public Health, Ethiopia, University of Bergen, Norway, Touro University, USA, Institute of Public Health, and University of Heidelberg, Germany. The Institute of Public Health is also currently collaborating with key partners on a range of projects including Ethiopian Public Health Association (EPHA)/CDC for Dabat Research Center, NOMA: University of Oslo supporting the integrated Masters in Health Informatics and ENGINE: Funding Master’s thesis researches on Nutrition.

Program Director Elizabeth Bradley has had more than 6 years of collaboration with these institutions as part of the Ethiopian Health Management Initiative (EHMI), currently sponsored by the US Centers for Disease Control and Prevention (CDC) and the Ethiopian Millennium Rural Initiative (EMRI), an effort to improve primary healthcare across rural Ethiopia.  Bradley has worked with both faculty and policy makers to evaluate and reform healthcare delivery at in both government hospital and rural primary health care settings.  In both cases, the partnerships have leveraged academic guidance to ensure scientifically rigorous and locally relevant research, while at the same time developing capacity for management and evaluation within Ethiopian practitioners, clinicians, and scholars.  As part of EHMI, over 160 Ethiopian healthcare executives have been trained in quality improvement, with emphasis on using the principles of implementation science to create evidence-based change in their health facilities.  Additional ongoing research efforts include an evaluation of the role of governing boards in hospital quality in Ethiopia, the use of positive deviance methodology to identify organizational factors associated with improvements in rural primary care, and the use of cost-effectiveness analysis to inform plans for national scale up of rural health systems strengthening efforts. 

In addition to building capacity among a cadre of Ethiopian hospital executives, Bradley has actively mentored 26 US trainees in the management sciences who were serving as Yale/Clinton Health Access Initiative (CHAI) fellows at hospitals through Ethiopia. She trained 5 postdoctoral students, all of whom spent time onsite in Ethiopia, and provided mentorship to more than 10 Yale undergraduate and Masters of Public Health students who worked on projects related to the site in Ethiopia. In addition to mentoring  fellows and students involved on site or working on relate projects, Bradley has actively mentored 17 pre-doctoral and 22 post-doctoral US trainees over the past 10 years, including both PhDs and MDs. She has served as Co-Director of the Robert Wood Johnson Scholars Program for 3 years, and is currently the Director of the Yale Global Health Initiative, in which she provides leadership in developing independent researchers in diverse studies of implementation research including quality improvement, health care disparities, and management effectiveness in public health care delivery systems. 

Examples of success in creating new US researchers/professionals doing global health work from this training site include the following:  (1) Shoba Ramanadhan, was a Postdoctoral Fellow at the Yale where she studied health management capacity-building programs in low- and middle-income countries, where she used network analysis to understand the flow of information and resources across networks of Ethiopian hospital executives in Ethiopia.  She is now a research scientist in the Viswanath Lab at the Dana Farber Cancer Institute and Harvard School of Public Health; (2) Steven Neri was an MPH student at Yale and then a post-graduate fellow with the EHMI program, where he received training, mentorship, and field experience in hospital management in developing settings.  He is now the Country Director for Project HOPE in Namibia.