Corrina Moucheraud, ScD, MPH, a global health policy, systems, and services researcher, has been named an associate center director at the UCLA Center for Health Policy Research (CHPR).
She brings over 15 years of experience in global public health research — focusing on areas including HIV/AIDS, women’s health, malaria, and non-communicable diseases such as hypertension — with projects in many lower-resource countries in sub-Saharan Africa and south Asia. She has been a UCLA CHPR faculty associate for the past five years. In this Ask the Expert Q&A, Moucheraud shares her knowledge on how global health policies can be used to inform U.S. health policies, and the deeper implications underscoring the intersection of these two realms.
Q: Your research projects span the global scale in countries across Africa and Asia. What is the connection between global health policy and U.S. health policy, and how may they inform each other?
It is increasingly evident that public health is global health — the challenges we face here in the U.S. are inextricably linked to what’s happening in other countries. Of course this was highlighted by the COVID-19 pandemic. Likewise, the questions that I explore in my research, and the methods that I use — such as how to maximize quality and ensure impact while operating with scarce resources and budget constraints — are just as relevant in Lilongwe, Malawi as they are in Los Angeles, California.
I currently have international projects on topics like trust in the health system, cost-effectiveness of cancer screening, vaccine uptake and hesitancy, how bias manifests in health care – and all are timely topics here in the U.S. too. We can also gain insights and be exposed to new ideas from lower-resource settings that may inform policies and programs trans-nationally. For example, I’ve participated in research about HIV treatment models in some high-burden African countries that are really at the forefront of innovation, and have the potential to change the way we think about and deliver care here, too. In addition, given the many global forces that affect public health and U.S. health policy — like migration and climate change, just to name two — we must acknowledge the interconnectedness of health across nations. Policymaking, public health research, and health care delivery here in the U.S. is made stronger, more relevant, and more innovative if we can see ourselves as part of “global health.”
Q: Are there any lessons you’ve learned from global projects in improving health care and the health care system in the groups you’ve worked with? If so, what lessons could be incorporated or what programs could be adapted and applied here?
I’ve been lucky to be involved in global research projects that have clear policy and program implications, including for public health here in the U.S. For example, I recently published a paper in Health Affairs that used data from 144 countries to examine how trust in institutions (governments, doctors, and nurses) is associated with trust in health information from these sources. This provides important insights about who’s the best public health messenger, and how trust might intersect with attitudes toward health care. This is a theme I’m further investigating through work in Kenya (led by UCLA Fielding School of Public Health Associate Professor, May Sudhinaraset) about the association between trust in the health system and health care-seeking, and I see this as having important implications for the U.S., too.
I’m also co-chairing a Working Group within the “Rethinking Malaria in the Context of COVID-19” initiative (a global engagement organized by Harvard University in partnership with the World Health Organization’s Global Malaria Programme) about integrated service delivery for malaria control. Malaria affects the health and well-being of many around the world — and, due to climate change, we will see increasing burden of mosquito-borne diseases in the U.S. Mosquitos do not respect borders, so effectively developing, implementing and leveraging policies for malaria control should be a priority for everyone. The global interconnectedness of people, policies and programs — and our joint responsibility for and engagement in public health — provides ample lessons and opportunities for cross-learnings.
Q: It’s no secret that in the U.S., there are highly diverse states which have many different racial and ethnic groups. What are some of the cultural competency approaches you’ve applied on a global scale and how can they be used to help reach groups here?
One of my favorite things about being a researcher who collects primary data is always expanding my knowledge about data and measurement. In international projects that I work on, we’re often looking for new ways to measure complex social phenomena — for example, how do you assess someone’s socioeconomic status if they don’t have a paycheck to report on? Researchers who work in diverse settings have to devise innovative and culturally-relevant ways to measure things like this, while maintaining rigor and validity. I think there is a lot to be learned from global scholars about culturally competent measurement for diverse populations. This also has implications for program and policy design, since — as we all know from the California Health Interview Survey (CHIS), the Census, and other population-based surveys — how we ask questions and how we measure things impact resource allocation, policy formulation, and ultimately the lives of individuals and communities.
