Past Capstones
2008-2009 Capstone Projects
Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria – Study of Health-Seeking Behavior and Treatment for Malaria and the Use of Bed Nets for Malaria Prevention in Kasese, Uganda.
Kasese, Uganda
Malaria is a significant global health problem, especially in Sub-Saharan Africa where it continues to be a major cause of morbidity and mortality. Ninety percent of the global malaria burden is concentrated in the Sub-Saharan region, presenting a severe obstacle to economic development. Access to preventive and interventive strategies including anti-malarial drugs, insecticide-treated bed nets (ITNs), and long lasting insecticide-treated bed nets (LLINs) have been central to the promotion of malaria health. LLINs are unique in that the netting material is impregnated with insecticide, eliminating the need for re-treatment of ITNs. This Capstone project involved seeking information from experts in the field of malaria control to assess suitable strategies that might be adopted to ensure proper usage of bed nets and replacement of LLINs after their expiry. Specifically the team studied treatment-seeking behaviors as well as the usage and maintenance of ITNs and LLINs by cement factory employees and community members in Kasese, Uganda.
Multi-Service Family Health Center (BMS) – BMS Community Health Center, Health Disparities, and Quality of Care Assessment
New York, NY
Diabetes is an emerging global public health problem and a leading cause of mortality worldwide. In the United States, an estimated 23.6 million adults have diabetes. Evidence suggests that higher rates of diabetes, diabetes-related complications, morbidity, and mortality disproportionately affect African Americans, Latinos, and the socio- economically disadvantaged. In New York City, diabetes was the fourth leading cause of death in 2006. Diabetes disproportionately affects Central Brooklyn and East New York as compared to other neighborhoods in New York City, with approximately 16% of the population diagnosed with diabetes. This Capstone project was an assessment of diabetes quality of care at the Brownsville Multi-Service Family Health Center. Using a mixed methods approach involving electronic medical record extraction, patient diabetic-care surveys and key informant interviews, the project considered structural and systemic gaps in diabetic health care delivery and provided recommendations for improvement.
The Longevity Project – Antenatal Education in Accra, Ghana: A Qualitative Study
Accra, Ghana
Maternal mortality is a problem worldwide, but is particularly devastating in developing countries. A large number of determinants contribute to maternal mortality rates. In addition to the obvious direct obstetric and medical factors, innumerable socioeconomic, cultural, and structural factors play a role. Some research suggests increasing women's knowledge regarding pregnancy, labor, and delivery may positively influence a number of the factors contributing to maternal mortality. On this premise, this study investigated the status of antenatal education and the antenatal learning needs in Accra, Ghana. Through the use of qualitative methods, the Capstone team conducted participant observation, key informant interviews, focus group discussion with local midwives, and semi-structured interviews with pregnant and recently-delivered Ghanaian women. The final report addresses three key themes: perceived and observed antenatal knowledge gaps; use of storytelling as a method of knowledge transfer within this population; and the emerging role of the hospital as a key supporter in pregnancy and childbirth.
Pan American Health Organization/World Health Organization (PAHO/WHO) – Monitoring Socioeconomic Inequalities in Health in Latin America: Case Study on Bolivia.
Equity in health across the Americas is a major concern of the Pan American Health Organization (PAHO). PAHO considers the measurement and monitoring of socio-economic (SE) inequalities in health an important step towards developing effective health policies and reducing equity gaps within and between countries. This study was conducted to develop a tool for the assessment of health disparities in terms of SE inequality. Using the 2003 and 1994 DHS Bolivia datasets, the Capstone team constructed an asset-based index of SE status including education as an indicator. They employed the Slope Index of Inequality and Relative Index of Inequality measures to analyze SE inequalities in health across the population groups. A key discovery of the research was the methodological process whereby socio-economic inequalities in health can be measured; furthermore, this process tool can be implemented by Ministries of Health in Latin America towards evaluation efforts and policy-making.
New York City Poison Control Center, as an affiliate of the Department of Emergency Medicine, New York University School of Medicine – An Assessment of Household Toxins and Community Awareness in Accra, Ghana
Accra, Ghana
Poisoning is a common cause of morbidity and mortality throughout the developing world. An assessment of household poisons including exposure to unintentional poisoning and barriers to safe storage was conducted during a field study in Accra, Ghana in January 2009. In conjunction with the NYC Poison Control Center and the Ghana Poison Information Consultation Centre, this Capstone team examined health-seeking behaviors in the Greater Accra community. Mixed method interviews with community members revealed incidences of kerosene exposure in children due to improper storage practices. Key findings also included the widespread use of palm oil as a first aid technique for kerosene ingestion. Other exposures included ingestion of adult medications, alcohol poisoning, and accidental ingestion of pesticides and rodenticides. A prevention campaign addressing storage of toxic substances and appropriate first aid is essential in improving health outcomes. Successful intervention campaigns must also address deeply held cultural beliefs and health behaviors.
2007-2008 Capstone Projects
Instituto de Saude Coletiva/Universidade Federal da Bahia (Federal University of Bahia)
Salvador/ Bahia/ Brazil
In collaboration with the University of Bahia, students will create a database to analyze violent causes of morbidity and mortality trends among 10-19 year olds, as violence creates more preventable health problems for adolescents than any other age group in Brazil. Using data from Brazilian national health information systems, the Capstone team will identify characteristics of this age group and determine the local health situation in Salvador and Bahia. Students will also conduct a literature review on the epidemiology of violent causes of morbidity and mortality. Expected outcomes include a final report with recommendations, a presentation of results, and a paper for publication in an international journal and/or forum.
Helen Keller International (HKI)
New York, NY
In response to a need identified by HKI, a Capstone team will assist the organization in developing a global, organization-wide monitoring and evaluation (M&E) system to describe the work HKI does and measure progress in achieving its mission. This initiative will require students to review selected project M&E indicators, conduct interviews with key HKI staff and partners, and review best practices in other international development organizations. Students may visit an HKI field office or attend a regional meeting to field test the systems. Students will help to define a minimum set of output indicators and design a methodology of data collection to be used at country, regional and headquarter levels.
Basic Health in El Salvador Project
Basic Health International
Brooklyn, NY and El Salvador
BasicHealth: El Salvador works with the El Salvador Ministry of Health to implement a "see and treat" method of cervical cancer screening to detect abnormalities and provide immediate treatment to women at risk of cervical cancer. This alternative, of Visual Inspection with Acetic Acid (VIA), is being explored as many women who have completed the first step of screening have been subsequently lost in the process of follow-up, resulting in the progression of treatable abnormalities into cervical cancer. The Capstone team will assist BasicHealth: El Salvador conduct an evaluation of the initiative to gauge whether this type of screening and training program will address the needs of El Salvador. The students will also work on a cost analysis to determine whether the project is sustainable and feasible for scale-up.
University of Witswaterand
School of Public Health
Johannesburg, South Africa
The Siyakhana Food Garden Project, an inner-city food garden, aims to offer life skills, healthy lifestyles, permaculture and income generation to children attending Early Childhood Development Centers and people living with HIV/AIDS. The Capstone team will undertake an evaluation of this project, exploring the role of partnerships and issues of sustainability, as they travel to the site. The students are expected to produce a guide, inclusive of recommendations, and a publishable paper.