Scholarship / AAS -District Program Coordinator role- solving a challenge and to implementing change or reform [4]

Questions/Instructions:

How have you contributed to solving a challenge and to implementing change or reform?
Be specific and include:
- What aspect/s of your leadership knowledge, skills and practice you consider to be well established and effective?
- Which people or organizations you worked with to solve the problem?
- What creative methods were used?

2000 characters
One of the essays for Australia Awards Scholarship

IMPROVING TUBERCULOSIS CASE DETECTION AND TREATMENT

My response:

Being a public health professional, I wholeheartedly believe that positive change in the community is possible. To achieve this change is not about what you do or who you are but about your true commitment and solidarity with local communities.

In my role as district program coordinator (DPC) for Birat Nepal Medical Trust (BNMT, bnmt.org.np), I have built an extensive collaboration with Nepalese government officials, local authorities, and key stakeholders. Also, the strong community engagement particularly in vulnerable settings has fulfill my dream of working with hard to reach communities to improve their health, including through TB case detection.

Despite having larger numbers of migrant workers, homeless people, and the vulnerable indigenous Chepang people, the TB program in Chitwan district of Nepal which I support (population 700,000) has a high proportion of missed TB cases. Tuberculosis in the district span across these populations. This means vulnerable people with TB never come to seek healthcare because of lack of awareness, education, or money. To address these challenges, I coordinated with local management committees of the metropolitan office to connect with laborers and homeless people. I proactively designed contact tracing plan and deployed additional field staff to provide enhanced support to these groups outside of normal work hours. We also worked with local communities and healthcare facilities to try and coordinate visits to reach the Chepang communities who live in remote areas. With the help of proactive field staff, we increased TB case notification by 22% and managed to meet the district and WHO's target.

This was not an easy task to achieve due to length of TB treatment duration, not adequately trained health workers, poor counseling and support, and poverty and under-nutrition. I cannot see the certain situation and leave it thinking it is normal. To further improve not just TB case detection but also adherence to TB treatment, I worked with local and regional groups to provide people with TB with a pillbox, which carried two weeks' worth of medicines to their home, enhanced frequency of supervisory visits, and conscientiously formalised recording and reporting of patients' progress.

Finally, my technical ability and determination to take part in TB review meetings led me to a position in which I performed accurate and reliable TB data analysis, which was fed back to the national program. In essence, we are continuously supporting the government's initiatives and strategies to improve the health status of the country.

Scholarship / Health economics - Australian Award Supporting Statement Question [2]

the example requirement essay

Please: -give up to three practical examples of how you intend to use the knowledge, skills and connections you will gain from your scholarship. Possible tasks can be personal and/or professional; and List any possible constraints you think may prevent you from achieving these tasks. *:

Example 1: Health economics is a field with a severe dearth of trained researchers, particularly in LMICs, where the need is greatest. By developing a career in HE research in Nepal, I aim to address this gap by becoming an internationally trained health economist with a unique and deep practical knowledge of the field realities of rural health systems in Nepal. I actively will contribute to local, regional, national, and international seminars, workshops, conferences and policy dialogues to build awareness of the strengths and weaknesses of HE analysis. I also always engage young Nepali students with enthusiasm for the topic to build capacity and ensure a new generation will be given good training in the field. Possible constraints include the need of funding to foster research and academic environment. I will address this with the help of my mentorship network, both existing and from the university. Coming to DU will be the ideal platform to make the jump towards higher studies and develop as an independent researcher.

Example 2: the scholarship will establish my skills in robust cost-effectiveness evaluation of community level public health interventions with a specific focus on TB. Through my employment at BNMT, I have access to data on a range of interventions and the necessary network to communicate the findings with policy makers to ensure lasting policy and practice change. I will apply my knowledge to conduct a cost-effectiveness analysis of current TB approach with innovative intervention including ACF and socio-economic interventions. conventional DOTS program from provider, health system and patient's perspectives. Possible constraints include effectively and sustainably engaging the relevant stakeholders which I will address through the BNMT established collaborative network.

Example 3: This scholarship provides me opportunity to create important networks not just with public health professional and health economists, but also with community based organisations, equity organizations, and women's organizations. In doing so, it will be possible to harness our collective voices to advocate for health related economic issues, policy reform activities, within the government. The intersectoral and multidisciplinary working increase awareness about their rights to healthcare, reduce disparities in healthcare, protect vulnerable populations through effective community based interventions. This includes the Nepal Public Health Association, Nepal Health Economics Association and equity groups to increase awareness among people about their rights to health care, effective purchasing mechanism and cost-effective interventions at community level. Possible constraints include conflicting political priorities and agendas.

Hopeful of your critical feedback.

Scholarship / Why do you choose this learning course of Deakin University? Applying to the university in Australia [5]

Why do you choose this course and the institution?

Australian Award Scholarship

During the summer of 2011, I saw a real eye of view of people standing at the out-patient department of the most reputed hospital in Kathmandu. I thought how much is the pain to have the illness and standing in line for hours just to get a few minutes of check-up even without diagnosing a real problem and spending the huge chunk of money is highly unbearable. I think that How costly is the unhealthy beginning of the day. I know this entirely unsatisfied spending puts people into impoverished life.

Within the first year of my professional career, I decided to study Master in public health which specialize on health economics in the future. The lives of homeless people, people spending huge amount before they diagnose with TB, I think we need alternative actions and they need more rigid socio-economic interventions.

Firstly, I am really intrigued with the pioneer team of health economist and well-designed curricular independent learning course of Deakin University with research domain especially in economics of health problems and health care oriented. Anna's strong analytical techniques in economic evaluation of chronic disease will surely meet the interest of mine to methodologically evaluate infectious disease modelling of Nepal. Rob Carter's pioneering activity in assessing cost-effectiveness study and Prof Cathy's involvement in priority populations play key role in developing ideas of vulnerable populations in Nepal.

Meanwhile, MPH in concentration in health economics and evaluation course at the University of Melbourne offer a research capstone project of my choice in my country of origin and this is suited to my area of interest. The cross-faculty network at Melbourne which includes global health, economics and medicines provides multi-directional understanding of health care issues and methodological evaluation of them. For example: Arthur Hseuch's study of delay in diagnosis of mental problems is a huge benefit to understand policy issues in disease control programs.

Scholarship / Current Duties and Responsibilities as District Program Coordinator [6]

I have written in this way.

Current Duties and Responsibilities

1. Design and implement active tuberculosis case finding interventions in close coordination, cooperation, and motivation with stakeholders at all levels
2. Perform regular supervisory visits to TB treatment centres, laboratories and field meetings with volunteers and mobilizers
3. Deliver monthly reports describing the progress of the project
4. Coordinate health economic research activities
5. Adopt patient-centric care through home visits followed by socioeconomic and psychosocial support