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Julia Coit

Harvard Medical School, Department of Global Health and Social Medicine
Research Associate
Julia is a field epidemiologist and design thinker with over ten years of experience conducting research in Latin America and the US to address complex questions in global health. Her work has included: childhood obesity initiatives, social marketing strategies for micronutrient-fortified snack foods and numerous studies addressing pediatric tuberculosis in Peru. She believes that context-conscious design that leverages human empathy has the potential to revolutionize the way we experience healthcare. She earned a B.A. in Psychobiology and Hispanic Studies at Wheaton College and an MPH in Global Health and Epidemiology at Boston University.

The role of context-conscious design innovation in diagnosing and treating childhood tuberculosis in the urban shantytowns of Lima, Peru

Over 400 children die each day of tuberculosis (TB), a treatable infectious disease. To address the problem, the global research community has prioritized development of new tools to diagnose TB, and millions of dollars have been invested to date. However, though a lack of reliable tests is a major driver of under diagnosis and TB mortality in kids, there is more to the story.

A patient journey map shows the experience of being diagnosed with TB and starting treatment in this setting. There are various pain points in the process: patient/provider interactions rife with patient discrimination given the highly stigmatized nature of TB; a shortage of expert physicians, prompting referrals that require caregivers to make multiple, long-distance trips to understaffed clinics; and a complicated, under-resourced public health system that involves an onerous paperwork burden are just a few. These challenges occur in a setting of poverty and high disease burden where many caregivers have TB themselves, further adding to the difficulty of each step.

The complexity of diagnosing and treating childhood TB provides an opportunity for context-conscious, patient-centered design innovation. Successful solutions must include reliable diagnostics, but should also consider the built environment, the role of stigma, family dynamics, existing public health systems and the hopes and dreams of the caregivers who suffer unnecessarily because of these challenges.

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