The University of Iowa

Guiding students to child and maternal health in India

March 24th, 2010

by Hannah Fletcher, UI College of Public Health Office of Communications and External Relations.

Throughout her life, Anne Wallis has dreamt of India. The assistant professor of epidemiology has spent her free time drowning in Indian novels and marveling at its rich religious, cultural, and linguistic history.

“Sometimes you can’t explain why you’re interested in one place, except to say that you’re drawn to it,” she says.

Wallis’ wanderlust has been satiated – for now – thanks to the UI’s Winterim program, a three-week, winter-break study abroad program that takes students to India to directly learn about the country. Wallis led a class of 15 on a journey into Indian maternal and infant health.

The course examined maternal and child health in Madurai, the capitol of the southern state of Tamil Nadu, and the surrounding region. Maternal and child health in India has been improving over the past decade. The infant mortality rate, for instance, has been steadily dropping – the rate is about 30 deaths in the first year of life per 1,000 live births; in 2000, the rate was 64 per 1,000 births.

“Maternal and child health definitely draws you in,” Wallis said. “And what is more addicting is something my mentor called the ‘epidemiologic way of thinking’ – using a logical, problem-solving approach to understanding a public health issue. Viewing health from a population perspective, as opposed to treating individuals, supports the ability to create powerful change over time that affects entire populations.”

Wallis’ investigation found that the Tamil Nadu infant and maternal mortality rates were lower than national averages due to the state’s many innovative policies and programs, such as informative maternity picnics, birth companions, and paying women for hospital deliveries. Such programs seemed to be increasing the number of hospital births and improving health outcomes. However, the policies have not been formally evaluated, Wallis said.

“On one hand, I see a very progressive government where the key indicators for maternal and infant health seem to be getting better. On the other, those same indicators really hide the pockets of people – rural villagers, the urban poor — who may get lost in the statistics,” she said. “I am very interested in the culture of pregnancy in south India. Significant improvements may not be possible without alleviation of poverty and improvement of the status of women.”

Wallis hopes her research will lay a foundation for future, extensive studies in which researchers can use their knowledge to improve health outcomes in India and other developing nations.

With Wallis’ guidance, the students designed and conducted research projects. They explored topics such as the perceived origin of waterborne illness and birth control awareness and practices. Some students designed educational posters that will be used in the Madurai hospital to educate visitors about the importance of hand washing and clean water, while others created a brief curriculum to educate women about cervical and breast cancer.

Erin Reynolds, a Ph.D. candidate in epidemiology, expanded her project studying malaria to include examination of chikungunya, a re-emerging mosquito-borne illness. The experience has amplified her research opportunities.

“I have the opportunity to return to Madurai this fall and work with Meenakshi Mission Hospital to conduct a needs assessment that will identify gaps in knowledge and prevention practices related to chikungunya, which should be very interesting,” she said.

Upon their return, several students presented a seminar on their research and happily shared stories of dicey rickshaw rides, an angry monkey, and bouts of gastrointestinal illness. Even the challenges of living in a different culture did not hinder their appreciation for the chance to live and learn in India. Wallis was impressed by their adaptability and their projects.

“Each and every person did an incredible job,” Wallis said. “The trip was awesome — in the true sense — and probably changed all of our lives.”

View the full story with photos on the UI College of Public Health Web site.