Moving beyond the encyclopedia: Cultural insights for effective global health intervention design

Written by Kat Morgan, incoming MPH candidate, Columbia University Mailman School of Public Health and the Gold Family Summer Research Scholar in the 2021 Institute for Public Health Summer Research Program

Through the Institute for Public Health Summer Research Program – Public and Global Health Track, I’ve had the opportunity to engage with prominent scholars and examine an array of public and global health topics. Recently, I had the invaluable opportunity to listen to a seminar on public health economic empowerment interventions in Africa from the William E. Gordon Distinguished Professor, Fred Ssewamala, PhD. As he shared personal anecdotes about working in context with fellow Ugandans, I began to ask myself, what is my future role in global health? And more importantly, how can I be an effective public health professional as a cultural outsider in different global health contexts?

Photo: GowlingWLG

Dr. Ssewamala’s research interests are broad, with an overarching theme of identifying structural, behavioral, and biomedical barriers to meaningfully intervene in public health issues, primarily through multisector work involving private, government, and community partnerships. As he reviewed the logistical challenges of designing and implementing applied public health research in Africa, I felt more conscious of my position as a cultural outsider native to the global north. With career aspirations in research and intervention design, I want to understand how westerners can better engage with communities in different cultural contexts to recognize what people need and how to serve those needs best.

Capacity building, or “actions that build, strengthen, and maintain the necessary competencies and resources needed to sustain or improve health service delivery to vulnerable and underserved populations,” is a component of designing and delivering effective public health interventions. How can outside researchers strengthen and empower communities to maintain lasting change after an intervention is over? According to Dr. Ssewamala, humility is the answer. Reading encyclopedias isn’t enough to gauge community needs. A researcher should identify their role in context with community members. Locals understand their cultural and political context better than an outside researcher ever could; they are the conceptual thinkers that understand local conditions and practices. One must engage with stakeholders, working with the community, local actors, and individuals affected by public health work.

Dr. Ssewamala emphasized the importance of incorporating local people into the research team. The researcher must be willing to go back to the chalkboard and redesign interventions based on community input by acknowledging that outsiders lack local insight and practicing active listening. He also noted that public health research can be informed at the local level, where domestic work can inform global health research when implementing projects abroad. One can consult colleagues from different parts of the world to gauge regional customs and additionally undergo local cultural training to prepare for international fieldwork.

Public health courses teach helpful theoretical frameworks but often fail to deliver personal insights, particularly from cultural insiders such as Dr. Ssewamala who have on-the-ground experience designing and implementing research in different global contexts. I’m grateful to have had the opportunity to hear Dr. Ssewamala speak and share recommendations for culturally relevant global health practice.