Building on What Works: Implementation Science and Inspiring the Next Generation
PopFam 50th Anniversary Impact Series - Q&A with Patrick S. Kachur
Since 2018, Dr. Patrick Kachur, Vice Chair for Education at Heilbrunn Department of Population and Family Health, has advanced a legacy of progress in evidence-based public health. Along with his teaching courseload, he coordinates implementation science partnerships in Ghana and other countries. He and his collaborators work to identify, document, and scale what works for increasing access to essential health care services.
For PopFam’s 50th Anniversary, we spoke with Dr. Kachur about the extraordinary impact of Ghana’s Community-based Health Planning and Services (CHPS) initiative, the vital role of implementation science, and his hopes for the field’s future.
What drew you to the School of Public Health at Columbia University?
KACHUR: I came here seven years ago after a lengthy career in public health practice with the CDC and state and local government. Most of my career has been in government but I knew I wanted to spend part of my career in a school of public health where I could be involved in training the next generation.
Several of my research colleagues in Ghana alerted me to the opportunity and put me in touch with PopFam department leadership. When I got to know more about the department, it really clicked for me. I found an academic department focused on science, research, and training programs with immediate impact.
Tell us how your work has evolved over the years.
KACHUR: In the 1970s and1980s, low- and middle-income countries had limited resources to provide healthcare services. So they focused on primary healthcare, providing the broadest reach for basic services that save the most lives.
Ghana had an idea to create Community-based Health Planning and Services, or CHPS. For every 5,000 to 10,000 people, they would build a small health outpost staffed by a nurse or community health officer and supported by community volunteers. Dr. Jim Phillips, a PopFam demographer, helped document the initiative’s successes, which included reducing under-five child mortality by 50% and reducing fertility by as much as 15%. In 2021, Ghana achieved their goal of taking CHPS to scale, with a health outpost for every 7,000 people.
Talk about the Advancing Research on Comprehensive Health Systems program.
KACHUR: One aim was to document the impacts of these regional health systems. We also wanted to train research scientists to continue documenting progress and apply the same skills to other health and social issues.
Learning how to make things work, how to ensure that they're delivered consistently over time and across a wide geography requires implementation science, which is more of a qualitative, longitudinal and interview-based approach. It helped Columbia and Ghanian partners track improvements in their national health strategy over time. We wanted to make sure we had enough implementation scientists there, working across a range of health systems.
How has your work at PopFam helped to shape your work in Ghana?
KACHUR: I'm still doing work on malaria, and we've been lucky over the past 20 or 30 years to make substantial progress after decades with very little. It’s a really important time for us in malaria because, for the first time, we have a vaccine that could save hundreds of thousands of children’s lives annually.
Part of our progress is because we had some new tools, but my work in Ghana has helped me build partnerships and understand how not only to show the impact through experimental studies, but really to investigate what makes those new tools work the best they can when taken to scale.
Can you talk a bit about PopFam’s partners in Ghana?
KACHUR: Our main partners there are the university and the Ministry of Health. The University of Ghana has an institute for population studies that serves Ghana and other west African countries. There’s lots of synergy with PopFam with regards to population and demographic science. My counterpart at the university level, Professor Ayaga Bawah, is a former PopFam faculty member.
The other big partner is their government’s Program Planning and Evaluation Unit, headed by Dr. Koku Awoonor-Williams, who was one of the first to try replicating the CHPS model.
Tell us about a student project that particularly impressed you.
KACHUR: One of my students recently worked alongside Ghanaian counterparts on community-based approaches to improving family planning access. They were able to help reduce fertility in some areas slow to make progress using communication channels, such as convening durbars and community meetings, that got everyone excited about the potential impact, not just women of reproductive age.
What are you most proud of contributing to at PopFam, for the students, department, or the communities that benefit from your forced migration research?
KACHUR: I’m most proud of contributing to the next generation of public health students, stoking their passion for making the world a better place. Here at PopFam, idealism is the driving force. The desire for justice and change influences every course. That was a huge inspiration at the start of my own career, and it feels great to pass that torch along.
How do you think the field will change over the next 50 years? And what new developments are you most excited about?
KACHUR: Too often, the story in global health is one of people in Geneva and Washington setting the agenda, then foisting it on partners in countries around the world. With that model disrupted by recent political developments, we now have a real opportunity to build partnerships more like the one between PopFam and their counterparts in Ghana. One with more equal footing, with expertise and responsibility. One that values the knowledge of people on the ground. I look forward to people across continents exchanging impactful knowledge and insights.
Learn more about our work in Ghana
If you’re interested in learning more about health intervention programs in Ghana, read further insights with these published accounts:
The Doris Duke Foundation has generously supported PopFam’s partnership with Ghana for more than 15 years through its African Health Initiative (AHI). Find video spotlights of our former project officer, Ghana team members and communities on their AHI website.