March 5, 2025

Addressing Health Barriers by Adopting ‘One Health’.

Dr. Sandra Maripe (IPPHL Cohort 6) is our spotlight for October 2024. She is a Medical Doctor and the Health Management Team Coordinator for Ngami District for the Botswana Ministry of Health. During her residency following medical school, Dr. Sandra Maripe saw how villagers in Botswana struggled to access health care. That’s when she realized she wanted to dedicate herself to primary health care since the patients were “often coming in when it was too late for us to help them.”

Dr. Maripe, who is the health management team coordinator for Ngami District for the Botswana Ministry of Health and supervises a hospital and 29 clinics, now aims to implement the Ministry’s strategy to revitalize the district’s entire primary health care system. As part of her journey, she participated in the 2023 cohort of the International Program in Public Health Leadership (IPPHL). The program, created by the Evans School of Public Policy and Governance at the University of Washington and funded by the Gates Foundation, has trained 192 public health professionals across 29 African countries over the past seven years. The program’s curriculum now also incorporates lessons from Exemplars in Global Health. Exemplars in Global Health in an interview with the IPPHL alumnus, talked about addressing health barriers by adopting ‘one health’ and her time as an IPPHL Fellow.

Could you tell us about your personal journey? How did you become interested in primary health care?

Dr. Maripe: After I completed my medical studies, I took part in a one-year internship program, rotating through all the disciplines, including surgery, pediatrics, child health, and maternal health. During that experience, I developed an interest in primary health care because of the variety of patients we saw. I also saw how they struggled to access health care, often coming in when it was too late for us to help them.

Could you tell us about your work with the Ngami District Health Management team? What are you currently trying to accomplish, and why?

Dr. Maripe: I supervise all our public health facilities in the Ngami District, including one district hospital and 29 clinics. We try to address our health challenges mainly through stakeholder collaboration and community engagement. Our district is severely impacted in terms of socio-economic status. There is a lot of poverty and unemployment at the community level. We also experience pockets of malnutrition in some small villages and settlements. All this affects their health care-seeking behavior and their ability to access care.

For example, we go into villages and conduct community health screenings. We also engage communities and their leadership. Every village is led by a chief, so we engage the chiefs and the business communities and stakeholders in those areas. By doing this, we address health barriers together, adopting a ‘one health for all’ approach. For example, in one village we identified that malnutrition is an issue so we’re working to establish a community garden.

Additionally, since we’re a tourism hub, we face challenges of human-wildlife conflict. People’s farms are affected by elephants, and they can’t afford electric fencing. We have now engaged the business communities in the same area we intend to create community gardens to support food security.

Could you tell us about your experience with the International Program in Public Health Leadership?

Dr. Maripe: It has been a wonderful experience. It has significantly improved my leadership skills – we covered many topics during the program, such as how to lead people, manage change and transition, and handle conflict in the workplace.

I appreciated the 360-degree tool we used to assess ourselves through the eyes of our leaders and peers. It was an eye- opener for me, showing that people always remember how you treated them, even if they forget the words you said.

I also learned the importance of giving feedback, whether positive or negative, and concepts like the theory of change, which we can use in our daily programs and projects. I’m now also connected socially with people from several countries – I have friends in over 20 African countries that I’m still in touch with.

Have you used Exemplars in Global Health since IPPHL? If so, how?

Dr. Maripe: From the first day we were introduced to Exemplars in Global Health, we started receiving insights from the program to understand and appreciate what other countries are doing.

For example, I recently read about how Nepal reduced maternal mortality and neonatal deaths by engaging female community health care workers and collaborating with donors. We’re also working on a program for community health care workers, and I’ve appreciated how other countries like Liberia and Ethiopia have utilized community health workers to improve primary health care. It helps us to learn from those countries.

Read more here!