Title: Power Dynamics of Malawi Health Care System Subject of Grad Research
Sara Fischer (G’23) is investigating how health care workers are impacted by structural power dynamics across the health system in Malawi, using a Fulbright-Hays Doctoral Dissertation Research Abroad grant.
Degree Pursuing: Ph.D. in government
Undergraduate: Penn State University, 2006
Undergraduate Major: Psychology; French minor
Graduate: Master of Public Health joint degree from the University of Sheffield and the University of Copenhagen, 2011
Hometown: New York
Research Explained: Fischer takes an ethnographic approach to her research, using intensive observational field study and interviews to examine the state of community health workers in Malawi.
“Health workers are a huge part of the health system in many low-income countries, but little is known about how the structures under which they operate mediate the way they do their jobs,” Fischer explains.
The doctoral candidate says it’s unclear how the everyday work of Malawi’s community health staff is impacted by structural power dynamics, but there are signs.
“This obviously has huge implications for the way health care is delivered, particularly in resource-constrained settings, as well as for how we might reconceive of community health worker programs in the future,” Fischer says.
Choosing Political Science: The graduate student says she has always been fascinated by the unequal distribution of power. She engages varied approaches to the study of human behavior and enjoys interdisciplinary scholarship.
“I consider myself to be highly interdisciplinary in my work,” she says. “I think a lot of the best science draws from multiple disciplines and considers the viewpoints of various ontological and epistemological paradigms.”
Why Georgetown?:
Fischer says faculty research attracted her to Georgetown.
“So many of the professors seemed to have a similar research agenda to my own,” the graduate student explains.
It wasn’t until after a campus visit that she accepted the offer to pursue her doctorate at the university.
“I saw the departmental dynamics in action,” she recalls. “Ph.D. students seemed genuinely happy and congenial, and the professors took a real interest in their students. Thinking outside the box was not only accepted but encouraged.”
A Professor’s View: Lahra Smith, an associate professor in the School of Foreign Service who focuses on African politics, migration and equality, has worked with Fischer during her studies at Georgetown.
“Sara has done outstanding ethnographic fieldwork to explore the complex relationships among different levels of healthcare staff in Malawi and uncovered more nuanced decision-making processes than has been previously understood,” Smith explains. “This will help political scientists and others take more seriously the role that these actors play in health policy decision-making and implementation and the landscape of the policymaking process.”
Being a Fulbright-Hays:
“The Fulbright-Hays program is obviously one of the most prestigious in the world, so it is such an honor to have been chosen,” she says. “To be able to spend an entire year abroad, really learning as much as I can, is the stuff scholarly dreams are made of.”
