After completing a Fulbright Scholarship in Brazil in 2014, Adriana Lein knew she wanted a master’s program that incorporated fieldwork. The Duke Global Health Institute (DGHI) Master of Science in Global Health (MSc-GH) program was a perfect fit for her to continue fieldwork and conduct research with faculty.
Lein, who hails from Athens, Ohio, completed an undergraduate degree in international relations at Macalester College. In a first-year seminar on global health, she fell in love with the theory, interdisciplinary study and progress toward social justice that defines the field.
Coming from Appalachian Ohio, she saw health disparities in her home community and recognized that studying global health could help her improve health in her community. This background, coupled with internships with several community health organizations, solidified Lein’s passion for global health.
Lein focuses her global health studies on health systems strengthening through innovative models of service delivery. “My goal is to find creative solutions that improve the design of a health system to lessen disparities,” she summarized. Community-based care models, using technology to confront barriers in access and quality, and women’s empowerment are specific interests of hers.
Right now, Lein is working with FHI 360 in their research utilization department as part of her MSc-GH program. The project she focuses on, called Linkages, is a USAID/PEPFAR program that looks at engaging public and private sector partners to optimize HIV service delivery to key populations. Lein is also part of the Assist Zika team, where she is updating USAID guidelines for prenatal counseling.
Discovery through fieldwork
During her time as an undergraduate, Lein interned with the Centro Cultural Chicano in Minneapolis, Minnesota. At this nonprofit that serves the Latino community, she worked on programming for women’s health classes. She helped the center translate and culturally adapt material and researched additional content to incorporate into the classes that focused on building skills to navigate the U.S. health system. “One of the most rewarding experiences in this internship was getting to co-teach one of the classes at the end of my time developing it,” she said.
Before coming to Duke, Lein completed a Fulbright Scholarship in the state of Paraná in Brazil. At The Federal University of Technology, her partner school, she created language and cultural programming, served as a teaching assistant and took a seminar course on social development. Additionally, she completed an independent project focused on promotion of family health and models of healthcare delivery and prevention in Brazil. “My Fulbright really helped underscore the universality of challenges in global health,” she reflected.
Fieldwork and research at Duke and beyond
Lein returned to Brazil to conduct her MSc-GH thesis research. Her goal was to evaluate adequacy of health infrastructure under the Family Health Strategy, Brazil’s universal primary care program, in the state of Minas Gerais. Using Ministry of Health data, she created an index that quantified quality of care, tested the index, then used it to analyze rates of avoidable hospitalizations in high-risk disease categories.
Currently, Lein is working with assistant professor of emergency medicine and global healt Catherine Staton, DGHI post-doctoral fellow João Vissoci and the Federal University of Minas Gerais on a health systems strengthening initiative to measure infrastructure, work processes and incentive improvement. Their research group is focused on quality improvement to strengthen health systems utilizing epidemiological and health informatics to identify current gaps in areas such as access to services, quality of care and patient outcomes.
Reflecting on her time at DGHI, Lein is thankful for the flexibility of the MSc-GH program and the abundance of research opportunities with faculty. “I really appreciate the ability students have to pursue their own interests at DGHI,” Lein shared. “I was able to pursue my interests in policy and Portuguese through a fellowship with the U.S. Department of Education while completing my master’s degree, which has really helped me in my fieldwork.”
After Lein graduates in May, she wants to pursue a career focused on evaluation, design and management of global health policy.
I really appreciate the ability students have to pursue their own interests at DGHI.Adriana Lein, 2nd-year MSc-GH student