A public health game plan grounded in the Golden Rule
Valencia Lambert, SM ’24, brings a passion for community partnerships to her work addressing women’s reproductive health and infectious-disease outcomes in sub-Saharan Africa.
Growing up in Tanzania, Valencia Lambert says that she was aware from a young age that inequities can impact health decision making and access to quality care. It’s what sparked her initial interest in the field of public health. “I’ve always had a game plan to use my ambitions for advocacy, to embrace different perspectives, and to fully dive into public health in my work,” she says. “And to always dig deeper, to learn more.”
Yearning to build new skills that she could use to help her community, Lambert chose to move to the United States to attend Cornell University for her undergraduate studies, majoring in global and public health sciences and minoring in human development and inequality studies. A few months after graduating in 2020, she returned to Tanzania, where she worked as a research assistant for a project focused on contraceptive use in the country’s rural northwest. Run by the Center for Global Health at Weill Cornell Medicine, the project allowed her to combine her academic interests with her passion for empowering and supporting women.
Evaluating women’s contraceptive autonomy
In some sub-Saharan African communities and elsewhere around the world, women may be dissuaded from using contraception after hearing about possible side effects, fear-inducing myths, and misconceptions, as well as others’ opinions and beliefs about the subject. The project Lambert joined was a randomized trial of a family planning seminar for religious leaders, looking at whether contraceptive use changed in communities where the intervention occurred. Key to the team’s success with this and other projects was the fact that the Tanzanian principal investigator was a practicing pastor.
“It’s common for religious leaders to present this idea that family planning is not acceptable,” she says. “He was able to leverage his experience as both a pas-tor and a Tanzanian to ensure that the intervention was appropriate, accept-able, and feasible.”
Lambert’s analysis focused on another aspect of the project—evaluating the influences that impact women’s contraceptive autonomy. The team interviewed nearly 75 women to under-stand what influenced their use of family planning through three classifications: intrapersonal, which includes their own knowledge of family planning and interpretations of religious beliefs; interpersonal, which includes thoughts from intimate partners, friends, parents, and relatives; and community, which includes health professionals, religious leaders, and other women in their com-munities. They found that the women were highly influenced by their families and social networks.
“It was rare that a woman decided completely on her own about whether or not she would use family planning,” says Lambert, noting that understand-ing the influences on women’s health decisions is a critical first step in implementing family planning interventions.
“In certain patriarchal communities, a woman’s decision is highly influenced by her husband’s perceptions of family planning,” she says. “Hence, if you don’t engage men, then the intervention might not be received well by the community.”
She hopes that the project’s focus on educating religious leaders about family planning and guiding them to pass that knowledge along to their communities can ultimately allow both men and women to make more informed deci-sions regarding whether family planning is the right choice for them.
With this sort of educational effort, Lambert believes in following the Golden Rule. “In everything that you do, do unto others as you would have them do unto you,” she says. “It’s such a valuable message, and although religious, it is fundamental in public health, too. In the field, I was constantly think-ing ‘Is this something I would be okay with someone doing to me or asking of me?’ That included the women, the religious leaders, and all the individuals we worked with.”
She adds that this belief is tied into one of her core public values: the importance of community partnerships.
“They’re the ones who have the best understanding of the community. It makes the work feel less imposing, which global health is perceived to be,” she says.
Building implementation skills
At Harvard Chan School, one of the courses that gave Lambert invaluable tools for her work in community health was Large Scale Effectiveness Evaluations, led by Margaret Kruk, professor of health systems. The course focuses on solving why some projects and pro-grams, although implemented with the best intentions, do not yield hoped-for results. Lambert was enthusiastic about the class. “It showed me how critical and cautious we must be in figuring out if our interventions are effective and acceptable,” she says. “I’ll always carry this lesson with me.”
Lambert says that she’s using every opportunity at Harvard Chan School to the fullest, from the coursework to the relationships she’s built to the support she’s received. While a first-year master of science student, Lambert was a Rose Service Learning Fellow, which brought her to Uganda, where she took on a project aimed at understanding the barriers to HIV testing and care among women.
Most recently, she has received support from the William L. Paly, MD, SM ’81, Scholarship.
Paly and his spouse, Amy Judd, SM ’81, met at Harvard Chan School, where they were both drawn to pursue their interests in health care and social jus-tice. Paly once conducted fieldwork in sub-Saharan Africa as a Peace Corps vol-unteer and later became an orthopedic hand surgeon. He was actively engaged in many community, creative, and recre-ational interests and is remembered for his exuberance and curiosity.
“In creating a scholarship in Bill’s memory, I am gratified and honored to support inspiring Harvard Chan students, like Valencia, who have the same commitment to health equity and global health missions that have long been tremendously important to our family,” says Judd. “The work she is carrying out will empower women and support their personal health care decision-making, which is crucial.”
Lambert is grateful that the scholar-ship helped remove the financial burden for her education and looks forward to pursuing her goals in honor of Paly and Judd by making an enduring impact on women’s health.
