THE ASSESSMENT, DEVELOPMENT, AND DEPLOYMENT OF GLOBAL HEALTH INTERVENTIONS: A PROPOSED FRAMEWORK FOR SUCCESS

Open Access
Author:
Haddad, Taylor
Area of Honors:
Biobehavioral Health
Degree:
Bachelor of Science
Document Type:
Thesis
Thesis Supervisors:
  • Joshua Morrison Smyth, Thesis Supervisor
  • Helen Marie Kamens, Honors Advisor
Keywords:
  • Global Health
  • Community-based interventions
  • Community-based participatory research
  • Cultural competency
  • Intervention success
  • Bottom-up approach
  • Top-down approach
  • Formative research
  • Community collaboration
  • International health
  • Development
  • Biopsychosocial model
  • Working framework
Abstract:
Purpose: The purpose of this thesis is to propose an evidence-informed, working theoretical model to help guide the assessment, development, and deployment of community-based global health interventions, with a goal of decreasing, harmful, unsuccessful projects in the future. Design: This thesis is comprised of three components: 1) a critical evaluation of three, large-scale unsuccessful and/or harmful global health interventions, 2) an analysis of a Short-term global health fieldwork experience (STGHFE) in South Africa, and 3) an analysis of elements from a successful two-year cluster randomized trial diabetes global health intervention in South Africa. Major findings: From an in-depth analysis of previous global health interventions, common themes found across the literature were that a “heavy” top-down approach, facile preparatory research, poor communication with local beneficiaries and stakeholders, lack of external collaboration and harmonization between overlapping interventions, and omission of a biopsychosocial model of health attributed to the poor success, harmful, and culturally insufficiency of the interventions. The ethnographic accounts from rural, northeast South Africa, highlight the importance of a bottom-up approach, the utilization of the biopsychosocial model, open communication with local beneficiaries and stakeholders, and collaboration with external groups. Furthermore, the evaluation of the successful diabetes intervention in the western cape of South Africa shows that through avoiding these harmful shortcomings, large global health interventions can be helpful, culturally competent, and successful in the field. Conclusions: To mitigate the production and deployment of harmful and/or unsuccessful community-based global health interventions, a theoretical model is proposed. Existing in chronological order of completion, the four components are 1) a bottom-up approach, 2) in-depth formative research on the target population, 3) open communication with beneficiaries and local stakeholders, and 4) usage of a biopsychosocial lens of health. Sub-findings include a proposal for a second layer within a framework including patience with intervention deployment, integrity checks, and the use of in-depth final intervention evaluations that analyze cost-effectiveness, cultural competency, and results.