Martijn Vink is working as an epidemiologist for HealthNet TPO. What does that mean? And how do our projects benefit from his work? Martijn is working at the HealthNet TPO head office since April 2010, in those 2.5 years he has contributed to several projects in Afghanistan and Central Africa.
When working as an epidemiologist, people frequently ask you what that means in practice. This also goes for Martijn: “Originally, epidemiology was the discipline that studied infectious diseases on a population level, focusing on the variation over time and in geography and on variations in relation with other – possible - influencing factors. That is where the name ‘epidemiology’ comes from. Nowadays, epidemiology has evolved into a research area focusing on various health problems, not only infectious diseases, and on the functioning of health systems.” Here the link with HealthNet TPO becomes obvious: research and health. Martijn explains “I am trained as a Medical Doctor and a public health specialist. During my medical practice, I became more and more interested in research and that’s why I decided to specialize in epidemiology.”
HealthNet TPO has an elaborate research department, focusing on various public health themes, including mental health. “I think the organization is unique in the sense that research has always been a core component of the intervention programmes. This is true for the (child) mental health programmes, but also for the malaria and cutaneous leishmaniasis programmes in Afghanistan and Pakistan. In collaboration with the London School of Hygiene and Tropical Medicine, we have performed more than 60 malaria and cutaneous leishmaniasis studies, which have had a huge impact on current intervention strategies. This type of research is still continuing, but also in other programmes we are performing operational research activities (see below).” In practice this means that Martijn – as an epidemiologist - is training local staff members and helping with the design, data collection and analysis of new research studies.
Currently Martijn is involved in projects in Afghanistan and in Central Africa. “In Afghanistan I am running a distance-learning course on Applied Epidemiology for 10 staff members. In collaboration with Afghan staff I am also working on the design of a new malaria study and a cutaneous leishmaniasis study.” Another study Martijn and his colleagues are working on is an effectiveness study of the Public-Private Partnership (PPP) programme in Uruzgan province, which is part of the programme of the Dutch Consortium Uruzgan (DCU). In remote and insecure areas of this province HealthNet TPO facilitates private practitioners to perform specific public health tasks, such as childhood vaccinations and reproductive health care for pregnant women. Martijn outlines the aim of the study: “Sixty local private practitioners are now part of this programme, but we lack information about their precise impact on local vaccination coverage and the proportion assisted deliveries. Apart from these questions, in this study we also want to find out how local people perceive the quality, costs and accessibility of these private practitioners.” This type of information can help HealthNet TPO to further improve the programme, so that more local people can profit from these health services. “The Afghan Ministry of Public Health is also very interested in the study outcomes, because they want to implement the PPP approach in the whole country”, adds Martijn.
Martijn recently went to Afghanistan; he explains the purpose of this trip: “I prefer to have direct contact with the staff members with whom I am working. This makes communication much easier. And it is also very instructive to observe how programmes are running ‘in real life’ and to see the opportunities and challenges for our local staff. During my visit I had many discussions about the three studies mentioned above. I also visited a couple of our projects in Nangarhar province, which was very interesting. I am very impressed by the work being done in the hospitals and health centres and by the experience and courage of my Afghan colleagues.” Based on HealthNet TPO’s experience in malaria and cutaneous leishmaniasis control in Afghanistan, other disease control programmes are planned in Africa. Martijn explains: “There is still so much work to be done in countries like South Sudan and the DR Congo, to combat diseases such as malaria, but also to control neglected tropical diseases. Another ambition is to further improve our Monitoring and Evaluation (M&E) system and to make better use of M&E data for operational research.”
In short: epidemiology helps HealthNet TPO to make the right choices, based on accurate information. This helps to improve programme implementation, which in turn helps to improve the health situation of the most vulnerable people.