Researcher of the Month: Christabel Kambala

Our Researcher of the Month for November is Dr Christabel Kambala from the University of Malawi Polytechnic,and lead of our new MHM absorbents project in Malawi. Here, she tells us about her background and what she's currently working on.

What is your background?
I did my BSc in Environmental Health, which I completed here at the Polytechnic (University of Malawi). I then worked for a few years in two NGOs, for CPAR as a Hygiene Education and Promotion Officer, and for Action Against Hunger in a range of roles working on nutrition and emergencies food supplies with vulnerable populations, particularly with pregnant women and children. 

I joined the Polytechnic as a staff member in 2004, and went to Glasgow for a year to complete my Masters in Public Health. I then returned to the Polytechnic to lecture in health education and promotion, and in 2012 I was offered a PhD position at the College of Medicine in collaboration with Heidelberg University in Germany. The project was an impact evaluation assessing the impact of performance-based financing on maternal and newborn care. My PhD looked at perceived quality of care from the women’s perspective. I used a tool that was already developed by colleagues in Burkina Faso looking at quality of care issues in maternal care. Going forward, I’d like to further adapt this tool to make it more context-specific, since we identified a number of challenges with the existing tool.

What are you currently working on?
We want to conduct a situational analysis on MHM absorbent products in Malawi. At the moment we know there are a number of MHM absorbent products don’t know what is happening or who is doing what, so the first step is to actually look at the status of menstruation hygiene and absorbent interventions, to identify and compare approaches. 

The second aspect is to look at the success of specific absorbents. We are thinking of focusing on one or two absorbents for this part, since there are so many types. We will look at their success, explore perceptions of women in terms of what they like and don’t like about pads. Further to this we’ll also look at WASH facilities, and assess facilities and structures within schools to support MHM. This will just be a baseline – to see what is happening. We are hoping that funds might be available to help design an intervention afterwards.

What made you interested in this area of research?
Although my background is in environmental health, I have diversified my skills. I like working with WASH activities in communities, and particularly working with women. My interest in MHM came in here, as I also want to improve the health of adolescents. A big problem is girls dropping out of school when they start menstruating – why? Well, they cannot manage their menstruation and the quality of absorbents is poor. There are no structures in place at school for them to change. Even if they do have structures to change, what materials will they use? Coming back to my interest in working with women, we know that the importance of MHM is to prevent urogenital infections, and these can affect future maternal health issues. WASH is a crucial aspect when it comes to managing menstruation as well as maternal issues.

What do you enjoy most about your work?

I enjoy fieldwork. I really enjoy interacting with people and learning about their problems, challenges and successes. There is a wealth of information if you go right into villages and communities – even solutions to some of the problems can come from there!

What do you find challenging about your research?
There are two main challenges. The first is the relationship with government and policymakers. We’re conducting this research to produce results, so that a change can be seen. But it’s challenging when we have made some recommendations to our policymakers, but the information we provide may not be used in formulating policies. In Malawi we do have a lot of initiatives that are trying to counter this lack of political will. Sustainability is key too. We start projects, implement them for three years, but when it ends it ends. We should try to have an agreement with the government to commit to sustainability of programmes.

The second challenge is the relationship with communities. Sometimes we are not giving much feedback to the people we are getting information from. We don’t always give feedback, and that can raise false hopes. It can be discouraging to participants, so we must do better at doing this.

How do you think your research can have an impact?

We need to explore all necessary avenues for dissemination – not just things like policy briefs. Although we want to translate research in a way that policymakers can understand it quickly, I think we can go even further. We need to involve policymakers from the word go. We want them to know what we are doing, which will enable results to be taken up more effectively. 

We also need to make sure that researchers and policymakers have access to the latest science. Open access journals are very important, as most types of research has been carried out elsewhere. We can learn lessons from these studies, adapt and apply to our own contexts. Finally, I think knowledge brokers – bringing together science and implementation/policy, have a very important role, and this is just starting to strengthen in Malawi. We can use these channels more to connect researchers with policymakers. 

What advice would you give to someone starting out in this area?
I’d advise students to take their research seriously. Don’t just think about your output, think about your passion, your niche, what you want to do. Set goals for where you want to be in your research career – or if you want to go another route like implementation, find out what skills are needed and what kind of difference you’d like to make. It’s also very important to publish your data – there’s no point wasting your energy if others won’t learn from it too! A multisectoral way of doing things is very good, so don’t be afraid to venture into different areas if you can relate them back and build up your skills. Finally, don’t be scared to take challenges. Everyone started somewhere, so don’t be scared to fail – you will always learn and become better.

Is there anything else you’d like to add?
Water is life. Also, hygiene is life! We need WASH for everything. I’d like to commend SHARE for its good work and for being open to new ideas and linking maternal health and WASH, such as in this MHM absorbents project.