Harvard T.H. Chan School of Public Health Student Aims to Improve Nigeria’s Health System

As a medical student in Nigeria, Adanna Chukwuma had a clear mission: to complete her studies and become a surgeon. This plan remained solidly in place until one day, on her way to clinical rotations, she was in a car accident that changed her life. In addition to the pain and anxiety caused by a critical spinal injury, Adanna and her family faced another challenge – like millions of Nigerians, Adanna did not have health insurance. After extensive negotiation with the hospital, she was finally admitted for a six-week rehabilitation period. After recovering from the accident, Adann’s mother had to sell the family’s car to pay for her hospital bills.

The accident served as a turning point in Adanna’s life, changing her priorities and her career path. Her experience showed her a side of health care beyond doctor’s medical knowledge. She became preoccupied by questions such as who has access to health care? how are decisions regarding health care made in households? how do people in remote areas get to health clinics? She became fascinated with the intricacies of health systems, and her focus turned from medical practice to public health.

After completing her medical training, she served as a Medical Officer with the Nigerian National Youth Service Corps in Yobe State where she treated patients—primarily women and children—at a free clinic. She also organized health care outreach programs to deliver ACTs and insecticide-treated bednets to treat and prevent malaria in remote villages. The National Malaria Control Program in Nigeria estimates that malaria is responsible for 60% of outpatient visits to health care facilities, 30% of childhood deaths (25% of which are deaths among children under one year), and 11% of maternal death.

The experience with the Nigerian National Youth Service Corps provided her with an opportunity to work at the interface between the national health system and the community-based health care delivery to solve public health challenges. It also fuelled her desire to pursue higher education as a means to better understand health and health care delivery, including ways to help her government improve health interventions through better health policies and decision-making.

Support from the ExxonMobil Foundation allowed her to complete graduate training in Global Health Science at University of Oxford and pursue an advanced degree at Harvard T.H. Chan School of Public Health. As a doctoral candidate in the Harvard T.H. Chan School of Public Health’s Department of Global Health and Population, Adanna’s training is focused on improving health systems. At Harvard, her research focuses on designing interventions that improve the uptake of tools known to be effective in treating and preventing malaria, such as ACTs and insecticide-treated bednets. She hopes to gain a better understanding of how West African health systems impact health outcomes for patients with malaria. “One of the great things about this program is that I’m gaining skills that will enable me to go back and test complex interventions,” Adanna says. By gaining skills to analyze problems from different perspectives and across disciplines, she hopes to facilitate changes to improve health systems and policies to ultimately safe lives.

When discussing role models, Adanna cites Dr. Mohammad Ali Pate, Former Minister of State for Health in Nigeria, and Defeating Malaria Board Member, as a key influencer and mentor. “I think while change through government is hard, governments are in the end responsible for the health care of their citizens. And they are able to do things on a scale that non-profits can’t,” says Adanna. “Exciting changes are happening back home in Nigeria and I want to be involved.” After graduation, she intends to return to Nigeria where she hopes to work for the government to evaluate and improve health interventions.

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Adanna Chukwuma

Adanna is an ExxonMobil Malaria Fellowship Awardee.