Insights and future plans from recent GPH PhD graduates
At GPH, we currently have 115 doctoral students. Recently, three of our PhD students - Carl Otto Schell, Kritika Dixit, and Bakare Ayobami Adebayo, successfully completed their doctoral studies. In this section, they share their experiences as doctoral students at GPH, discuss their research, the challenges they faced, and their plans for future.
Carl Otto Schell
Title of thesis: Essential Care of Critical illness
Research group: IMPAQT
Describe the key findings of your research and their potential impact on your field?
The aim of the thesis was to assess the burden of critical illness in different global settings and to develop, evaluate and reach consensus around strategies to facilitate implementation of essential care of critical illness
The results from Malawi, Tanzania and Sweden challenge three common misconceptions that have public health impact.
• Critical illness is not uncommon – it is common. As many as 12% of patients in hospital are critically ill.
• Critically ill patients are not always in ICUs – the large majority (>90%) are cared for in low-staffed general wards.
• Critical care is not limited to expensive hi-tech interventions – it can be feasible! Task-shared essential critical care could be implemented in a low-income country. A large global consensus was reached around Essential Emergency and Critical Care (EECC) – 40 effective lifesaving processes that are needed across medical conditions and as low-cost and feasible as they can be implemented in any general ward in the world.
The findings can be used to inform priorities in health systems so critical care can be provided more effectively and reach more patients. A focus on essential care of critical illness has potential to reduce mortality across medical disciplines.
Which were the biggest challenges you faced during your PhD journey, and how did you overcome them?
The large need for this work has been extremely motivating. It has also been a challenge to work-life balance. Besides advice from a great network of family, friends and supervisors, I have managed not to rush towards the exam. Doing PhD-studies half-time over eight years was a great arrangement.
What are your plans for further exploration or application of your work/research?
I’m involved in an implementation project supporting the Government of Tanzania to implement EECC in health facilities across six regions. I am also involved in a Pan- African study of the burden critical illness using methods developed for the thesis and many other projects with the aim of improved essential care of critical illness in different settings.
Bakare Ayobami Adebayo
Title of theses: Understanding motivations and patterns of care-seeking and adherence to medical treatments for paediatric pneumonia in Nigeria
Research group: Global Child Health and the Sustainable Development Goals Group
Describe the key findings of your research and their potential impact on your field?
Motivation for care seeking and treatment adherence is strongly influenced by individual, family, and community factors. Social influences and financial considerations play a substantial role in care seeking decisions. Refusal of medical oxygen is modifiable; however, opportunities to improve acceptance require oxygen being affordable to patients and hospitals.
Which was the biggest challenges you faced during your PhD journey, and how did you overcome them?
The biggest challenge was writing my Kappa. I knew it would require adequate concentration to reflect on my research findings and put everything together into a coherent piece. I acknowledged the threats facing me, particularly my involvement in other research works and commitments in my home country. I remembered the advice from my principal supervisor years back, so I deliberately cut down on other activities and withdrew from every known and potential distraction. I also expressed my fear to my other supervisors, and they supported me. I attended the workshop organized by the KI library. Finally, I discussed with my main supervisor, and we came up with a timeline which was really helpful.
What are your plans for further exploration or application of your work/research?
My plan is to explore post-doctoral fellowship to learn other research and analysis skills necessary to become an independent researcher. I have interest in implementation science. For now, my immediate plan is to explore how pulse oximetry and IMCI can be better integrated into the routine primary care in Nigeria
Kritika Dixit
Title of theses: Understanding psychosocial and economic barriers to develop innovative people-centered models of tuberculosis care in Nepal
Research group: Social Medicine, Infectious Diseases and Migration (SIM)
Describe the key findings of your research and their potential impact on your field?
My thesis informs the design of a locally appropriate psychosocial support program for people affected by tuberculosis (TB) in Nepal. The findings showed TB imposes multifaceted burdens beyond physical health, encompassing deeply interwoven psychological and social challenges such as depression, stigma, and social isolation. Half of the participants in the study perceived TB as a stigmatizing disease, and one-third reported experiencing persistent depression even towards the end of a six-month long treatment period. These were also key psychosocial barriers identified in the study that impede access to TB care. Addressing these challenges is crucial to improving TB care and requires integrating TB education and health literacy into the national TB program, strengthening social protection programs targeted at TB-affected people, fostering peer support, and promoting community-based, people-centered care models within public health.
Which was the biggest challenges you faced during your PhD journey, and how did you overcome them?
Starting my PhD during the peak COVID-19 pandemic in June 2020 presented unique challenges, especially as I embarked on this journey from a distant country with little familiarity with the KI’s education and departmental systems. Like many, I faced uncertainties about how the pandemic would shape my research. Although KI’s online courses allowed me to timely complete the required credits, the absence of peer interactions and discussions hindered opportunities to deepen my understanding of global health.
Courses such as biostatistics and social determinants of health would have been more enriching with in-person engagement. Despite these challenges, I achieved a significant milestone when one of my proposals on the impact of COVID-19 on accessing TB services was awarded the Early Career Research Grant from the Royal Society of Tropical Medicine and Hygiene and the Farrar Foundation, which I am actively working on. To familiarize myself with the team at the Department of Global Public Health, initially I engaged in Fika and journal clubs, and later as the pandemic eased, I made more in-person visits. These efforts helped me build connections, enhance my learning, and make the most of this transformative journey.
What are your plans for further exploration or application of your work/research?
My immediate plans involve building on the findings from my PhD to inform and enhance the national TB program’s strategic plans and interventions. I aim to address the unique barriers to TB care, particularly in remote communities of Nepal, and contribute to the design of people-centered healthcare strategies for Nepal and other low-and middle-income countries. I am also passionate about expanding my work on social protection and securing large-scale research grants to support multi-disciplinary collaborations with experts in global health, health policy, economics, and healthcare delivery.
An essential component of my future work is investigating the critical role of nutrition in TB outcomes and developing intervention projects targeting key determinants of TB in Nepal, such as poverty, undernutrition, and limited awareness of the disease. I wholeheartedly believe that understanding and addressing these socioeconomic determinants of health will enable the development of people-centered care models that empower vulnerable populations and promote equity in healthcare access and outcomes.