Outside the biomedical box of integrated care research. Meet some of our new RESPOND-AFRICA staff
The RESPOND-AFRICA consortium is made up of a range of diverse professionals from Europe and Africa. They are working on several different projects all aimed at improving health outcomes for people living with chronic diseases such as diabetes, hypertension, and HIV in Africa. They are experts in unique activities that range from infectious disease care, non-communicable diseases care, project management, implementation, social science, or health economics. Have you ever wondered what it takes to be involved in a large global health program including multi-country randomised control trials? We have interviewed some of our new RESPOND-AFRICA members who are both on the ground and behind the scenes to give you an idea. Follow along in our series documenting some of our RESPOND-AFRICA consortium members!
Interviewee name: Dr. Edna S Majaliwa
Role in RESPOND-AFRICA: Medical Reviewer / Study Physician
Projects involved within RESPOND-AFRICA: META
Where they are based: Hindu Mandal Hospital-Tanzania
Past role/job: Endocrinologist at Muhimbili National Hospital Dar es salaam-Tanzania
Who are you?
I am an endocrinologist working in Meta Project —currently, phase 3 of Metformin Treatment in Africa (META-3). I have done some simple research on children and youth with type 1 diabetes in Tanzania, trained students in endocrinology, and worked as a research assistant in a trial of Multivitamin and HIV in the early 2000s.
How has your journey helped you lead to this point in your career?
I have always been interested in research. To me research is intriguing. I started formal research when I was a research assistant in Multivitamin and HIV in 2002-2003 and later in the trial of Tuberculosis as a research physician in 2003 done by MUCHS-HARVARD collaboration in Tanzania. Later I left research and started with clinical work and master’s studies in paediatrics, where I did research on children with diabetes. Afterwards, I continued with research in paediatrics and youth as well as working as an endocrinologist. At the end of 2019, I joined the META phase -2 trial as a clinical reviewer and study physician.
I would love to really see the adolescents and youth side of HIV-NCD being researched more
How did you initially get involved in research?
Immediately after finishing my internship, I knew I wanted to do research, but there were not so many opportunities or I didn’t know where to find them. Then there was an advert in The Muhimbili University of Health Sciences, that they needed a research assistant and I applied and was employed as a research assistant. However the study was nearing the end, so it ended a year later. I joined the University for a master’s (Paediatric and Child Health) and from then I started doing simple research. I joined endocrinology school in 2007, while continuing with my simple audit kind of research —published and unpublished— until I met the meta trial and grabbed the opportunity.
How has the field of integrated care, especially in sub-Saharan Africa, been changing?
Back then, when I started practising, there were lots and lots of vertical programmes. We had programmes for Malaria, Tuberculosis, Leprosy, HIV and Prevention of mother-to-child transmission (PMTCT) to mention but a few, and people in programmes, wouldn’t move to any other area, mostly because the funding was separate. Our trainings were more on acute conditions so the system was more focussed on acute management. In the era of HIV, chronicity started to show up and NCD increased hence gaining more visibility. Unfortunately, people with chronic conditions had multiple conditions, such as HIV and diabetes, and it was like chopping a patient. I finished managing diabetes and then had to refer them to the HIV clinic. Recently there is a realization that the client must be managed in one clinic so all the services are under one roof which is very helpful, taking into account the few numbers of health care providers available in Sub Saharan Africa.
What areas of HIV and NCD research and/or project management do you think are being neglected?
I would love to really see the adolescents and youth side of HIV-NCD being researched more. This group is kind of left in between, they do not fit with the paediatrics, but physically, physiologically and psychologically they are not adults either. I would really like to see more of this age group included (16-25 years).
What do you hope to do in your role and as a member of the RESPOND-AFRICA consortium?
I hope to contribute to the growth of the group’s vision, to manage to pull the adolescent group into our consortium in the coming research agendas and, of course, to learn as we move forward.
Besides research and randomised control trials, what do you enjoy doing?
God! I love travelling, I love to see new places and read books.