Global Alliance on Disability and Health Innovation (GANDHI) (2016-2017)

Life can change in an instant. Without notice, an acute illness or injury can result in life-altering disability with a rippling effect that extends far beyond the individual and years into the future. Of the one billion people living with disability around the globe, more are women, and as many as 190 million people have severe functional impairment. The most vulnerable are those who suffer acutely from loss of functionality and drastic change in social roles as they transition home from the hospital. Yet this experience is not well understood; most measures quantify death, readmissions and burden without considering quality of life.

This Bass Connections project examined disability from multiple perspectives and cultures. The newly-formed Global Alliance on Disability and Health Innovation support the development of innovative interdisciplinary approaches to promote functional independence, community reintegration and an improved quality of life after an acute injury or illness. The team’s goal is to determine the system of services and support needed for adults newly living with disability to achieve their greatest quality of life.

During the fall, 20 students met weekly for an interdisciplinary seminar, joined by a different country partner representative each week via WebEx (Singapore, Netherlands, Norway, Brazil) or in person (China, Tanzania, Nepal, Uganda, Argentina, United States). Each student prepared and presented a country profile on disease burden, healthcare organization and health financing. These profiles were integrated into a comparative country analysis for the team’s multicountry stakeholder study, which includes family caregivers, healthcare providers, community leaders, government officials and nongovernmental organization leaders.

In 2016-17 the team launched an interdisciplinary advisory group that met together and engaged in individual consultations for project-specific needs. Team members piloted study frameworks with the intent of scaling them up to additional countries. The team conducted a qualitative multilevel stakeholder analysis in Argentina and a process evaluation of hospital-to-home care transitions at the Duke Heart Center. A GIS mapping study of services for children post-surgery in Uganda resulted in a paper, “Spatial Distribution of Rehabilitation Services for Children Following Surgery in Uganda: Using the Data to Plan Interventions.”

Team member Kira Battle received a Bass Connections Follow-on Student Research Award to investigate physical rehabilitation and transitional care in Uganda, collaboration with Duke Global Neurosurgery and Neuroscience. Team member Chelsea Liu received independent project funding from DukeEngage to complete a summer research project related to GANDHI’s work. She will travel to Beijing to work with the Beijing Tiantan Hospital and the Chinese Stroke Association to improve stroke patients’ education and recovery post-discharge.

Timing

Fall 2016 – Spring 2017

Team Outputs

Sarah Jean Barton, Sahil Sandhu, Isabelle Doan, Lillian Blanchard, Alex Dai, Alexandra Paulenich, Emily R. Smith, Brittney J. van de Water, Anna H. Martin, Jasmine Seider, Florence Namaganda, Shem Opolot, Nelia Ekeji, Mathama Malakha Bility, Janet Prvu Bettger. 2019. “Perceived barriers and supports to accessing community-based services for Uganda’s pediatric post-surgical population,” Disability and Rehabilitation.

Catherine Staton and Janet Prvu Bettger, Developing Capacity to Improve Care Transitions for Injury Patients in Tanzania ($476,809 grant awarded from the Fogarty International Center, U.S. National Institutes of Health, 2018)

Physical Rehabilitation in Acute Care Settings of Low- and Middle- Income Countries: A Mixed Methods Systematic Review (poster presentation by Kira Battle at World Confederation for Physical Therapy Congress 2017, Cape Town, South Africa, July 2-4, 2017)

Pediatric Post-Surgical Community Resource Geospatial Mapping in Uganda (oral presentation at Annual Research Meeting of AcademyHealth, New Orleans, LA, June 25-27, 2017)

Strategies to Strengthen Health Systems Globally: A Duke Showcase (event at Duke on April 4, 2017, featuring presentations by Janet Bettger, Yuhkai Lin, Michelle Roberts, Rachel Shapiro, Nelia Ekeji, Anna Martin)

Assessing Capacity to Improve Pediatric Care Transitions in Low-income Countries (poster by Jasmine Seider, Brittney Sullivan, Anna Martin, Sarah Jean Barton, Emily Smith, Nelia Ekeji, Mathama Malakha Bility, Christopher Fitzgibbon, Janet Prvu Bettger; presented at American Physical Therapy Association Combined Section Meeting, San Antonio, TX, February 15-18, 2017)

Bass Connections Follow-on Student Research Grant (Kira Battle)

Duke Support for Interdisciplinary Graduate Networks (D-SIGN) grant for Global Alliance on Disability and Health Innovation – Children and Adolescents Health Group

Presentation in the Innovation Section of the Annual Research Meeting of AcademyHealth (Boston, MA, June 26, 2016)

Project website

Reflections

Strong Relationships Are Vital for Global Collaboration (Sophie Haet and Brittney Sullivan)

Cultivating Clinicians: Interprofessional Development in Global Health (Sarah Jean Barton, Kira Battle, Anne Gross, Elish Mahajan, Jasmine Seider, Brittney Sullivan, Alissa Stavig)