Task-sharing is THE superpower!

Interview with Supriya Bhavnani, Research Scientist as the Public Health Foundation of India and coordinator of the Braintools Project at Sangath.

In the framework of the Braintools project, we worked closely with Supriya. Being introduced to Delhi by her has been a treat beyond anything we could have imagined. She is knowledgeable, sensitive, well connected and so funny. Her career spans from the Veneto countryside to the Delhian slums, from the circadian rhythm of fruit flies to the wellbeing of children with autism. She is not only an accomplished researcher, but also the proud mum of a beautiful two-year old boy. How does she manage it all? “Oh, it does not take much,” she says with her usual sense of humour. You just need the support of five people to make it possible for a woman to have a career! I think we know exactly what she means...

We could not resist interviewing her for you. Read on and be inspired!

Can you tell us a bit more about Sangath?

Sangath was founded in Goa in 1996 and started out as a small child development clinic. While it was definitely servicing a need that the population had, over time, a number of children started dropping out from these services. Sangath founders came to realise that this model of care was not appropriate to meet the huge treatment gap for mental health disorders in settings such as ours and so started working on using task-sharing to bridge this gap. Task-sharing is an approach in which, given the scarcity of highly skilled professionals, the lay health workers are trained to deliver clinical tasks. Sangath has partnered with various national and international organisations over the course of the last 2 decades, and also actively works in synchrony with central and state government agencies. Sangath has received the prestigious MacArthur Foundation Prize in 2008 and the WHO Public Health Champions Award for India in 2016.

Can you tell us a bit about your role within the BRAINTOOLS project?

I am coordinating all activities at the India site of the Braintools project. This includes obtaining all ethical and governmental clearances for implementation of the project, conducting formative work to develop and adapt existing protocols and instruments for data collection, community sensitisation around the novel technology being used in the project, identification and recruitment of children for the test-retest reliability study component and also coordination of your visit to make sure you have an opportunity to interact with the people most relevant to the potential adaptation of BabyBrains.

How did you get there? What’s your research story?

I did a PhD in Genetics at the University of Leicester, UK and then went on to do a postdoctoral stint at National Brain Research Centre in India before I got my first independent grant (INSPIRE Faculty award) from the Government of India. All this while (10 years) I worked on neurodevelopment using Drosophila as a model system, which I enjoyed and found very exciting. In fact, I set up the first Drosophila lab in NBRC as well. However, as time passed, I started developing an interest in translational work and realising that my line of research was rather far away from it, in fact, it was completely on the opposite end of the translational spectrum! I decided to try and take the leap in January 2015 and Prof Vikram Patel was kind enough to allow me to join his team, luckily he was on the lookout for a team interested in working in the space of translational neuroscience, and this provided a good fit with my qualifications.

Which type of settings do you work in?

Sangath is now working in 4 states in India with sites in both rural and urban settings. Our research varies from home-based visits to school-based interventions, hospital-based training of health workers and also public engagement through the use of social media.

Do you find that your research is well received in the communities you work with?</h2>

Community engagement is something we at Sangath take very seriously. All our studies contain a systematic in-depth qualitative evaluation of the acceptability of our intervention to the participants. Overall process indicators like numbers and reasons for consent refusal in our studies also provide qualitative indicators. We take pride in the warmth with which we are received in the communities where we work.

Who are your partners?

Sangath has long-standing partnerships with top national and international organisations, which is a testament to the success of our collaborative work. Within the area of early child development itself, we work within consortia which include investigators at the University of Manchester, Birkbeck College, Harvard Medical School, University of Reading, All India Institute of Medical Sciences, Public Health Foundation of India and Indian Institute of Technology Bombay.

Can you give an example of change that Sangath brought about?

An exciting example of change that Sangath has demonstrated through work done over the last decade has been the adaptation and delivery of a parent-mediated intervention for Autism. This intervention called PACT has been developed by Jonathan Green’s group in the University of Manchester, UK and has been shown to be effective in improving outcomes of children with Autism when delivered by highly skilled professionals such as clinical psychologists in those high-income settings. Sangath, in a long-standing collaboration with Jonathan, has successfully adapted the intervention such that is can be delivered by minimally trained non-specialist workers and a recent randomised control trial has also demonstrated the effectiveness of the intervention. We are now in the process of evaluating the efficacy of this intervention as delivered by health workers that are already embedded within the public health systems of India and foresee this as being a significant step toward improving the access that children with autism have to care in our country.

What is the superpower that would close the ‘treatment gap’ in India?

We strongly believe that task-sharing is the ‘super-power’ that will help bridge the enormous treatment gap for mental health conditions, not just in India but in all low resource settings and are committed to building the evidence base on which such work can be administered at scale.

Written by Silvia.

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