I was a member of the Bass Connections Pocket Colposcope team for two years (Fall 2018 – Spring 2020). The overall goal of this team is to investigate and advance the implementation strategy for the Pocket Colposcope, an innovative cervical screening device for increasing access to care in low-resource settings. Overall, this experience deepened my understanding of innovation & entrepreneurship for a global health innovation specifically by teaching me what it takes to actually bring a potentially life-saving device to the hands of a patient. While other innovations such as a mobile app may reach customers immediately, disruptive global health technologies are usually implemented in complex landscapes, and may require time and collaboration with many stakeholders before reaching patients. Thus, I chose this experience to better understand the policy, economics and cultural considerations for implementing global health innovations.

Year 1: Clinical Acceptability in the U.S.

In the first year of my involvement in the team, I was a member of the clinical acceptability team. Our main objectives were to identify local clinics in North Carolina to potentially partner with and to assess patient and provider acceptability of the Pocket Colposcope. Thus, my team researched different clinics offering women’s reproductive health services in order to identify potential partners to pilot the Pocket Colposcope locally. Furthermore, we developed qualitative research tools for investigating patient and provider attitudes toward adopting the device. Over spring break, the other members of my team also went on a trip to Washington D.C., where they interviewed various government and non-profit stakeholders to better understand the acceptability, policy and economics factors for implementing the Pocket Colposcope. A main theme that emerged from the trip was the importance of cost-effectiveness and other cost considerations (e.g. reimbursements, policies surrounding telehealth, etc.) for the successful adoption of a disruptive technology like the Pocket Colposcope.

Year 2: Cost Effectiveness in Peru

In the second year, I was the student leader for the costing team, working with another student and a mentor from the Margolis Center to conduct a cost-effectiveness analysis of the Pocket Colposcope. Although the actual cost-effectiveness analysis is a long-term project, our main role and deliverable was to conduct a systematic literature review of studies on the cost-effectiveness and epidemiology of cervical cancer screening and HPV vaccination. We ended up reviewing 45 articles, and our findings will be used to inform the cost-effectiveness analysis of the Pocket Colposcope. The specific steps of the cost-effectiveness analysis included: 1) defining search criteria, 2) conducting a key terms search across several databases, 3) filtering down our results based on inclusion/exclusion criteria, 4) reviewing the articles and 5) writing a document to document and analyze our results.

Over spring break, I went with the team to Peru to conduct field research. Our team’s original plans to visit health centers in Cajamarca, Peru, were canceled due to COVID-19, but I was able to help the acceptability team conduct interviews of the HOPE Ladies, community health workers who distribute HPV testing kits to the community. I took photos and managed recording to document the interviews, and presented preliminary findings to the former Peruvian Minister of Health. Overall, I was so inspired by the enthusiasm, tenacity and commitment of the HOPE ladies to improving the health and well-being of their communities. Witnessing the obstacles to accessing sexual and reproductive healthcare in the communities – from financial constraints to social stigma – also made me realize that while grassroots efforts to improve testing are impactful, significant long-term improvement still requires large-scale systemic changes to improve treatment.

Originally posted on Lillian Zhu's 2021 I&E Certificate e-Portfolio