The numbers in a research study offer a glimpse into people’s lives, but there are always deeper stories behind the figures. Health economist Alison Comfort, PhD, has been drawn to math and economics her whole life. The unique power of her work comes in recognizing the real-life experiences behind the data.
Listening to people’s stories is a throughline in her work. She recalls of her time in the Peace Corps in Madagascar, “I used a lot of that time sitting with women in my community, and just listening to their stories and hearing about their pregnancies and why they were or weren’t using birth control.” She sees commonalities with the conversations she often has with other women, talking about what they want for their lives and how many kids they want to have. The resonance of these experiences—and the importance of immersing herself in them—helped inspire her to move her family to Uganda while she embarks on new research on reproductive health and HIV.
Her project in Uganda is grounded in conversations and community, working to understand how people’s social networks influence their decisions around health. “Some people may tend to be more isolated, while others have a really tightly knit social network, and some people may act as bridges to other social groups and have access to maybe new and novel information,” she says. “These differences in their social networks have implications for their health decisions.” Her team has already published research showing that people’s family members, friends and others play an important role in providing information about when pregnant people should start prenatal care. In her current research, she is finding that, among women living with HIV in Uganda, those who are pregnant tend to be much more isolated . This seems to affect their behaviors like taking their HIV medication regularly.
Living in the country where she’s doing work is allowing her to build authentic partnerships with her research team. She works closely with researchers who understand the biggest challenges women are facing and have ideas of how to solve these problems, informed by a deep knowledge of the local community. She’s able to integrate with the research team and get to know the culture deeply and do more meaningful research that’s shaped in collaboration with the field team. “I realized that it’s one thing to work on it from the United States, which I have done for many years. But it’s another thing to have the chance to live in the country where you are doing the research and really experience what it is like, what individuals are facing with decisions that they’re making about their health. I had that in Madagascar and want to create something similar with my research in Uganda.”
By combining data with the real-world experiences behind it, Alison wants the research to result in concrete changes in people’s lives. Her previous research in Madagascar found that providing free pregnancy tests through community health workers led to more women seeking reproductive and maternal health services by being able to confirm if they were pregnant or not. On the strength of the findings of that trial, the Ministry of Health expanded access to free pregnancy tests through community-based programs across the country.
Alison hopes that her team could have similar success in the future by uncovering ways to engage people’s social networks to improve health outcomes. Her ultimate goal is to figure out how to support people in leading meaningful, healthy lives. “All my research questions come back to women accessing care when they want and how they want to.”
