After attending the University of Cincinnati for undergraduate studies, Sam Blizzard set his sights on Feinberg, hoping to use his skills to improve healthcare at the community and global levels.
Now in his second year at Feinberg, Blizzard is wrapping up a research project which took him to remote communities in two counties in Liberia.
He’s currently drafting a manuscript for his research project, which was a collaborative effort between the Ryan Family Center for Global Primary Care and non-profit Last Mile Health, which works to expand access to care in remote African communities.
Why did you choose Feinberg?
Listen to Blizzard below:
I chose Feinberg because it checked all of the boxes for me. I wanted to be in a large city with a lot of things to do and an opportunity to have an enriching life both at school, but also outside of school, as well as providing a number of possibilities of my research interests. Whether that’s global health, or LGBTQ health, or some sort of community-based research project, as well as being the most supportive and welcoming inclusive environment for me. Knowing that there were so many people at all stages of their career, who are also LGBTQ and interested in medicine, I knew that I would never have to be alone and I knew that I would be able to build a life in a community and a medical school experience that helps me flourish as much as I can.
What are your research interests?
One of the reasons I came to Feinberg was that the school has such a big focus on global health and opportunities to approach healthcare through a global perspective. Community health practices have been a big focus of mine. In the future, I’d love to get involved with the Institute for Sexual and Gender Minority Health and Wellbeing.
Tell me about your research project in Liberia.
I have been working with my mentor, Lisa Hirschhorn, MD, MPH, director of the Ryan Family Center for Global Primary Care and professor of Medical Social Sciences and Psychiatry and Behavioral Sciences. I reached out to her after reading about her projects and was really excited about the possibility of working on similar research. She has done previous research with an organization called Last Mile Health, which was started in Liberia in 2007. Their mission is to ensure health workers are accessible in the world’s most remote communities.
These communities are extremely rural; they have no close by healthcare facilities and have worse health outcomes because of this lack of access. Last Mile Health has been doing a lot of great work with expanding community health worker programs in rural areas of Libera. These health workers already live in these remote communities, are trained on how to evaluate people on a short-term basis and know whether they can provide care or if they need to help that person get a follow-up at another healthcare facility.
This community health worker program has already been implemented, so now we’re collecting survey data to find out the impact of the program. We wanted to look at postnatal care and see if people giving birth were able to get the necessary checkups after birth to see if this program ultimately helps to reduce neonatal mortality. So, my research project is looking specifically at rates of postnatal care after introduction of a community health worker program in two specific counties of Liberia: Rivercess County and Grand Bassa County. Both are similarly rural areas, for the most part, and both have seen the introduction of this community health worker program.
And what did you find?
Rivercess county has seen significant increases in postnatal care – so almost double the rates in some of these rural areas – from before the health worker program started to three years after. So, in a three-year time period, we’ve seen really significant strides and improvements in access and use of this care. So that was between 2015 and 2018 that we captured some of the Rivercess data and then followed up in 2021 and that was all really positive.
Grand Bassa County, we started looking in 2018. The implementation of that community health worker program took place a little bit later. We’re not seeing the same increases in postnatal care rates in Grand Bassa County after this community health worker program started that we did see in Rivercess County, so that’s another area to look into.
That’s why we’re doing this research, because it’s not just about proving that great things are happening, even though sometimes we can do that. It is also about evaluating current processes that are going on to make sure that they can be adjusted or improved to best serve their purpose. It’s the constant evaluation of how we’re doing and how this program is serving people. If there are gaps, how can we adjust it? What’s going wrong? And then we can figure out how to move forward from that.
What are the next steps for your research?
I worked on the initial stages of this project last January and then over the summer, I dedicated eight weeks to this and I actually spent an additional two weeks traveling to Liberia and working with the team there. So, I was able to spend two weeks with Last Mile Health in Monrovia, Liberia, and getting to know all the people working on the program and living in the community. It was amazing getting to know the organization, how they operate and what they do, and then share my own experience with this research and the findings.
It would be great to publish this research, but it’s really more about having these talks on the ground about what we’re seeing and why we think we’re seeing it. That time with Last Mile Health was so crucial, because we all got full context for the issue that numbers alone can’t tell you. It was an amazing experience for me, because I get to not only learn a lot myself, but my work got to be a part of the conversation about how this program moves forward.
Now, I’m in the process of writing up a manuscript for publication and working with collaborators both here with Lisa Hirschhorn, as well as collaborators at Georgetown University and the team at Last Mile Health. We have a lot of quantitative data, but not a lot of qualitative information about why people aren’t seeking or receiving care and what barriers they’re facing. We can look at trends and data, but having those individual stories and identifying themes from these mothers who are sharing about their experiences with childbirth are really important. So there is ongoing collection of qualitative data about why people are or are not able to, or want to, access postnatal care. So, understanding that would be really helpful in Grand Bassa County, where we’re not seeing the increases in postnatal care rates that we’d like to. We want to dig deeper and understand that a bit more.
What advice would you offer to prospective medical students?
Take a minute to think about some of the priorities that you have in terms of research, if that’s what you’re interested in. If you know that you’re really looking for an enriching research experience, think about the strengths of the different schools that you’re looking at.
For me, my biggest interests were global health and LGBTQ health. Honestly, I don’t think there’s a single other school besides Feinberg that excels in those two areas quite like they do here. Feinberg was my top choice because I know that I’m going to find others who are also invested in this work.
There’s been a great infrastructure in place to support me during medical school, which is a time where you’re very busy. So find a school where people support you and understand your direction.
