In 2015, Sarah McGough spent the summer between her first and second years as a graduate student at the Harvard T.H. Chan School of Public Health in Brazil on a fellowship from Harvard’s Defeating Malaria: From the Genes to the Globe initiative. Sarah’s objective, as planned with her research mentor Associate Professor of Demography Marcia Castro, was to create a database of malaria control policies across Brazilian municipalities over a 22-year time period.
Sarah spent the summer in Brazil poring through archives and meeting minutes, looking at maps, interviewing policy analysts, and then creating a system of coding each policy in her database. After pulling the disparate sources of information together, Sarah incorporated policy variables into spatiotemporal and longitudinal models of malaria transmission that also included other drivers, such as climate, topography, deforestation, and demographic variables. The models enabled her to compare neighboring municipalities that had different policies but otherwise similar population and environmental characteristics. She also looked at individual municipalities that had implemented different policies at different times.
Sarah’s analyses of the models allowed her to understand how and when malaria transmission occurred. Ultimately, she could pinpoint which policies had effectively contributed to interrupting malaria transmission. This kind of insight into the real-world impact of policy implementation is critical to future policy interventions.
This work also became the subject of her master’s thesis. Sarah’s travel fellowship enabled her to work directly with Brazilian policy analysts at the central, state, and municipality levels. On her return to Harvard, she reflected, “The most important part was being able to work from the inside.” Beyond simply gaining access to paper files, Sarah gained insight into how Brazil’s Ministry of Health operates and how health policies are implemented. She found the opportunity to build relationships with the experts in Brazil was vitally important: “They really are the cornerstone of malaria control in Brazil – and now I can email them with questions and they know why and who is asking.”
Later in the year, Sarah again returned to Brazil to attend Harvard University’s Science of Eradication: Malaria, a regional course organized in collaboration with the University of São Paulo. She was pleased to find that several course participants were people she knew from her time at Brazil’s National Malaria Control Program. She used the opportunity to update them on her ongoing analysis of the impact of policy implementation on improved malaria control.
Meeting again at the Science of Eradication: Malaria course enabled Sarah to strengthen her links with Brazilian colleagues. To her amusement, in addition to discussions of malaria policy, they also asked, “Did you bring us any chocolate chip cookies?”
Sarah made a name – and lots of friends – for herself in her few months working in the National Malaria Control Program’s office. As a gesture of thanks for the support she had received, Sarah regularly brought baked goods into the office. Indeed, before she left, Sarah had translated her recipes into Portuguese. This, it turned out, was a bonus legacy for her Brazilian collaborators.
Sarah McGough is a doctoral student in the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health