Alison B. Comfort, PhD
Health Economist, Department of Obstetrics, Gynecology & Reproductive Sciences
Dr. Alison B. Comfort is a health economist whose research focuses on better understanding the role of health technologies, specifically pregnancy tests, in improving reproductive and maternal health outcomes and assessing the role of price and other factors to influence uptake of health products, such as contraceptives and anti-malarial bed nets. More broadly, Dr. Comfort is interested in conducting rigorous impact evaluations of interventions to improve reproductive health and maternal and child health, both in the United States and in developing countries. At the Bixby Center, she is working with the Beyond the Pill program to conduct implementation science research on provider training and patient education in clinic settings in the United States to increase contraceptive provision, including through school-based health centers.
Dr. Comfort has led several randomized controlled trials, including an impact evaluation to assess the effect of providing community health workers with free pregnancy tests for distribution to improve provision of hormonal contraceptives and receipt of antenatal care counseling in Madagascar. She has evaluated the long-term effects of in-utero conditions on maternal survival later in a woman’s life using secondary data from several African countries. She has also conducted several studies related to malaria, including an impact evaluation investigating the effect of price on demand and use of bed nets. In India, she is looking at the consequences of being uninsured on access to health services and health spending and the implications for longer term poverty. She speaks French, Spanish and Malagasy, and previously served as a Peace Corps Volunteer in Madagascar.
Areas of interest:
- Contraception
- Education and training
- Health insurance
- Impact evaluations
- Malaria
- Maternal health
- Pregnancy
- Reproductive health
Honors and awards:
- Audience Choice Award for pregnancy tests research, UCSF’s Maternal Neonatal Child Health Shark Tank Presentation, 2016
- Daniel Bell Award for Outstanding Social Science Research, Abt Associates, 2014
Education:
- Amherst College, Bachelor’s in Economics and Spanish
- Harvard University, Doctorate in Health Policy (Economics concentration)
In the news:
- Healthcare workers may be heroes, but they are also human (op-ed) | Morning Consult
- Madagascar trial: how a simple pregnancy test can change lives (op-ed) | The Conversation
- Reproductive healthcare workers affected by mental health stressors of pandemic | Contraceptive Technology Update
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"She should support me, she's my doctor:" Patient perceptions of agency in contraceptive decision-making in the clinical encounter in Northern California. Perspect Sex Reprod Health. 2023 Jun; 55(2):94-103. Rao L, Rocca CH, Muñoz I, Chambers BD, Devaskar S, Asiodu IV, Stern L, Blum M, Comfort AB, Harper CC. PMID: 37216964.
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Perceived norms about male circumcision and personal circumcision status: a cross-sectional, population-based study in rural Uganda. medRxiv. 2023 Apr 26. Perkins JM, Kakuhikire B, Baguma C, Jeon S, Walker SF, Dongre R, Kyokunda V, Juliet M, Satinsky EN, Comfort AB, Siedner M, Ashaba S, Tsai AC. PMID: 37163008; PMCID: PMC10168507.View in: PubMed Mentions:
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The role of informational support from women's social networks on antenatal care initiation: qualitative evidence from pregnant women in Uganda. BMC Pregnancy Childbirth. 2022 Sep 16; 22(1):708. Comfort AB, El Ayadi AM, Camlin CS, Tsai AC, Nalubwama H, Byamugisha J, Walker DM, Moody J, Roberts T, Senoga U, Krezanoski PJ, Harper CC. PMID: 36114484; PMCID: PMC9479405.
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Telehealth for Contraceptive Services During the COVID-19 Pandemic: Provider Perspectives. Womens Health Issues. 2022 Sep-Oct; 32(5):477-483. Rao L, Comfort AB, Dojiri SS, Goodman S, Yarger J, Shah N, Folse C, Blum M, Hankin J, Harper CC. PMID: 35691762; PMCID: PMC9110325.
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Assessing differences in contraceptive provision through telemedicine among reproductive health providers during the COVID-19 pandemic in the United States. Reprod Health. 2022 Apr 22; 19(1):99. Comfort AB, Rao L, Goodman S, Raine-Bennett T, Barney A, Mengesha B, Harper CC. PMID: 35459218; PMCID: PMC9026031.
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Social and provider networks and women's contraceptive use: Evidence from Madagascar. Contraception. 2021 08; 104(2):147-154. Comfort AB, Harper CC, Tsai AC, Moody J, Perkins JM, Rasolofomana JR, Alperin C, Ranjalahy AN, Heriniaina R, Krezanoski PJ. PMID: 33901430; PMCID: PMC8541759.
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Mental health among outpatient reproductive health care providers during the US COVID-19 epidemic. Reprod Health. 2021 Feb 24; 18(1):49. Comfort AB, Krezanoski PJ, Rao L, El Ayadi A, Tsai AC, Goodman S, Harper CC. PMID: 33627155; PMCID: PMC7903398.
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The association between men's family planning networks and contraceptive use among their female partners: an egocentric network study in Madagascar. BMC Public Health. 2021 01 25; 21(1):209. Comfort AB, Harper CC, Tsai AC, Perkins JM, Moody J, Rasolofomana JR, Alperin C, Schultz M, Ranjalahy AN, Heriniaina R, Krezanoski PJ. PMID: 33494746; PMCID: PMC7831255.
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Implementation science: Scaling a training intervention to include IUDs and implants in contraceptive services in primary care. Prev Med. 2020 12; 141:106290. Harper CC, Comfort AB, Blum M, Rocca CH, McCulloch CE, Rao L, Shah N, Oquendo Del Toro H, Goodman S. PMID: 33096126; PMCID: PMC8032203.
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Improving Capacity at School-based Health Centers to Offer Adolescents Counseling and Access to Comprehensive Contraceptive Services. J Pediatr Adolesc Gynecol. 2021 Feb; 34(1):26-32. Comfort AB, Rao L, Goodman S, Barney A, Glymph A, Schroeder R, McCulloch C, Harper CC. PMID: 32730800; PMCID: PMC7385555.
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The impact of pill counting on resource-limited health facilities: a thematic qualitative analysis in eSwatini. Health Policy Plan. 2020 May 01; 35(4):452-460. Krezanoski JD, Matshotyana K, Nxumalo N, Comfort AB, Khumalo P, Krezanoski PJ. PMID: 32073622.
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Comparison of traditional methods versus SAFEcount for filling prescriptions: A pilot study of an innovative pill counting solution in eSwatini. PLoS One. 2019; 14(12):e0224323. Krezanoski PJ, Krezanoski JD, Nxumalo N, Gabert R, Comfort AB, Khumalo P, Matshotyana K. PMID: 31800584; PMCID: PMC6892485.
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Do home pregnancy tests bring women to community health workers for antenatal care counselling? A randomized controlled trial in Madagascar. Health Policy Plan. 2019 Oct 01; 34(8):566-573. Comfort AB, Juras RC, Bradley SEK, Ranjalahy Rasolofomanana J, Noeliarivelo Ranjalahy A, Harper CC. PMID: 31408150.
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Extending health insurance coverage to the informal sector: Lessons from a private micro health insurance scheme in Lagos, Nigeria. Int J Health Plann Manage. 2018 Apr 15. Peterson L, Comfort A, Hatt L, van Bastelaer T. PMID: 29658152.
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Cost-effectiveness analysis and mortality impact estimation of scaling-up pregnancy test kits in Madagascar, Ethiopia and Malawi. Health Policy Plan. 2017 Jul 01; 32(6):869-881. Kolesar RJ, Audibert M, Comfort AB. PMID: 28387867.
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The effect of price on demand for and use of bednets: evidence from a randomized experiment in Madagascar. Health Policy Plan. 2017 03 01; 32(2):178-193. Comfort AB, Krezanoski PJ. PMID: 28207055.
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Exploring the use of routinely-available, retrospective data to study the association between malaria control scale-up and micro-economic outcomes in Zambia. Malar J. 2017 01 04; 16(1):15. Comfort A, Leegwater A, Nakhimovsky S, Kansembe H, Hamainza B, Bwalya B, Alilio M, Johns B, Olsho L. PMID: 28052759; PMCID: PMC5209918.
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Providing free pregnancy test kits to community health workers increases distribution of contraceptives: results from an impact evaluation in Madagascar. Contraception. 2016 Jan; 93(1):44-51. Comfort AB, Chankova S, Juras R, Hsi CN, Peterson LA, Hathi P. PMID: 26409247.
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A false dichotomy: RCTs and their contributions to evidence-based public health. Glob Health Sci Pract. 2015 Mar; 3(1):138-40. Hatt LE, Chatterji M, Miles L, Comfort AB, Bellows BW, Okello FO. PMID: 25745128; PMCID: PMC4356283.
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Association between malaria control and paediatric blood transfusions in rural Zambia: an interrupted time-series analysis. Malar J. 2014 Sep 26; 13:383. Comfort AB, van Dijk JH, Mharakurwa S, Stillman K, Johns B, Hathi P, Korde S, Craig AS, Nachbar N, Derriennic Y, Gabert R, Thuma PE. PMID: 25261276; PMCID: PMC4190292.
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Household malaria knowledge and its association with bednet ownership in settings without large-scale distribution programs: Evidence from rural Madagascar. J Glob Health. 2014 Jun; 4(1):010401. Krezanoski PJ, Tsai AC, Hamer DH, Comfort AB, Bangsberg DR. PMID: 24976960; PMCID: PMC4073249.
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Households with young children and use of freely distributed bednets in rural Madagascar. Int Health. 2014 Mar; 6(1):29-34. Krezanoski PJ, Comfort AB, Tsai AC, Bangsberg DR. PMID: 24366350.
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Effect of health insurance on the use and provision of maternal health services and maternal and neonatal health outcomes: a systematic review. J Health Popul Nutr. 2013 Dec; 31(4 Suppl 2):81-105. Comfort AB, Peterson LA, Hatt LE. PMID: 24992805.
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Financial incentives and maternal health: where do we go from here? J Health Popul Nutr. 2013 Dec; 31(4 Suppl 2):8-22. Morgan L, Stanton ME, Higgs ES, Balster RL, Bellows BW, Brandes N, Comfort AB, Eichler R, Glassman A, Hatt LE, Conlon CM, Koblinsky M. PMID: 24992800.
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Hospitalizations and costs incurred at the facility level after scale-up of malaria control: pre-post comparisons from two hospitals in Zambia. Am J Trop Med Hyg. 2014 Jan; 90(1):20-32. Comfort AB, van Dijk JH, Mharakurwa S, Stillman K, Gabert R, Korde S, Nachbar N, Derriennic Y, Musau S, Hamazakaza P, Zyambo KD, Zyongwe NM, Hamainza B, Thuma PE. PMID: 24218409; PMCID: PMC3886421.
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Effect of incentives on insecticide-treated bed net use in sub-Saharan Africa: a cluster randomized trial in Madagascar. Malar J. 2010 Jun 27; 9:186. Krezanoski PJ, Comfort AB, Hamer DH. PMID: 20579392; PMCID: PMC2909249.