We recently sat down with our very own Dr. Sumeet Sodhi, a senior research scientist who has worked with Dignitas International since 2006, to share her perspective on our research and the exciting studies currently underway.
Q: How would you describe Dignitas’s research mandate?
A: Dignitas’s goal is to do the kind of research that improves health care for the people of Malawi and other countries facing a similar disease burden.
We do a combination of patient-centered research and systems research. Patient-centered research focuses on patient perceptions, health outcomes and timeliness of care. It also looks at the impediments to accessing health care that people living in developing contexts face. This is a really critical component because you can have the best treatments in the world but if patients don’t accept the treatment, or if they don’t like the taste of it, or if they feel it’s going to to cause stigma, then it’s not going to be as effective as you think.
Systems research looks at different models for delivering care and assesses optimal strategies for treating diseases in varying settings. In this vein, we’re looking at the best ways to train health workers and the best tools in order to equip them to help their patients.
Overall, we conduct research that feeds back into our medical programs and improves health care delivery in Malawi. But we have to ensure that we’re improving the quality of health care in a way that is cost effective. In places like Malawi, if you’re going to put resources into something, it means you’re not putting resources into something else. We want to make sure we’re using resources wisely and in ways that achieve the best impact.
Q: What makes Dignitas’s research different from the kind of research done by other international organizations in Africa?
A: Dignitas is unique because we both deliver health care and conduct research. That gives us credibility – we’re working both sides of our brain. Groups that just focus on research sometimes come up with recommendations that just aren’t feasible on the ground. But we’re neck deep alongside local health workers working to address the challenges. We live it day in and day out.
Q: What research studies currently underway are you most excited about?
A: We recently launched a large comprehensive evaluation to study the impact of Malawi’s new Option B+ PMTCT (Prevention of Mother-to-Child Transmission) program, which is being nationally rolled out to improve our efforts to decrease the transmission of HIV from mothers to their babies during pregnancy. We are doing another complimentary study that compares models of care in providing health services associated with Option B+ and assesses how family-centered and community outreach approaches might result in better health outcomes for mothers and their children. We are currently gathering clinical data in sites across six Malawian districts while also conducting surveys with health workers.
Our Lablite study is also a really interesting, multi-country study. We recently completed the first phase of this study, which investigates the effectiveness of HIV care provided without the use of expensive laboratory testing and supporting health care workers instead. The Lablite study is based on the groundbreaking DART trial, which showed that the clinical monitoring of patients enrolled on antiretroviral treatment is just as safe and effective as lab tests in low resource settings in sub-Saharan Africa. On this project, we’re collaborating with researchers in Zimbabwe, Uganda and the UK. With limited health care dollars, many African countries simply cannot afford the cost of purchasing and maintaining expensive lab equipment. The results of the Lablite study could provide a practical alternative that ensures the delivery of high quality care.
Q: Can you give us an example of how Dignitas’s research is directly improving patient lives in Malawi?
A: Since first opening our Tisungane HIV/AIDS Clinic in October 2004, we’ve enrolled more than 20,000 people on life-saving antiretroviral treatment.
One of our first patients was an HIV-positive grandmother. A few years after she had started treatment, we met the woman’s daughter at the clinic, as she had also acquired the virus. When the daughter recently became pregnant, we worked with her during her pregnancy to ensure she received proper treatment and care. As a result, her baby was born HIV-negative.
By working hand-in-hand with the Ministry of Health, we’ve been able to break the cycle of AIDS in this family and in other families across Malawi. We’re doing this by influencing health policy with research evidence as we have done in preventing mother-to-child transmission and by being committed to our patients for the long term.
Dr. Sumeet Sodhi serves as a Senior Research Scientist for Dignitas International. She is also a family physician at Toronto Western Hospital and an Assistant Professor with the Department of Family and Community Medicine at the University of Toronto. Sumeet has extensive experience working in Africa, Asia and Canada’s northern communities. Her current research interests include evaluating HIV/AIDS and primary care service delivery models in resource-poor settings, developing and evaluating knowledge translation tools to support health workers in the clinical management of HIV/AIDS and primary care conditions, and the observational cohort analysis of patients enrolled in antiretroviral treatment programs in sub-Saharan Africa.