Up Close: Nishi Suryavanshi

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Combining Behavioral and Clinical Research to Improve Health Outcomes for Women in India 

“If there is one thing I have learned during my extensive field experience in rural areas, it’s that no disease is a purely clinical in nature,” notes behavioral scientist Nishi Suryavanshi, PhD.

Based in CCGHE’s Pune, India, office, Dr. Suryavanshi joined clinical research efforts back in 2000, during the Six Weeks Extended Nevirapine (SWEN) trials. “I was working on community-based research on women’s reproductive health and tuberculosis when the team from Hopkins led by Dr. Bollinger was looking for people with a behavioral science background to do formative research before initiating the landmark SWEN study.”

At the time, Dr. Suryavanshi was wary about getting involved. “I had typical misconceptions about clinical 

research and was reluctant to join the effort.” Despite her reservations, she participated in extensive training on research regulations and ethics, and had a change of heart. “I recognized the value of research and realized that integrating social, structural, and behavioral aspects of disease was critical. When a multidisciplinary team involving physicians, behavioral scientists, nurses, etc., works to increase public awareness about clinical research, it ultimately helps advance the science. People can have better options for treatment for diseases like HIV, TB, and cancer.”

Suryavanshi focuses on HIV and TB research in clinical settings as well as in urban and rural community settings. She has worked on efforts involving the stigma of TB, disclosure of HIV among children, infant feeding patterns among HIV positive mothers, and empowerment of women in low resource settings to ensure that patients receive the health screenings and services they need. “In a country like India with a huge population, it is very important to make sure that national programs on TB and HIV services reach door-to-door in an optimized way. There is need for broader, multi-disciplinary, culturally appropriate strategies to enhance TB control efforts and prevent HIV transmission from mother to child.”

India relies on community-based health outreach workers (ORWs) to link patients to care, particularly in rural areas. Dr. Suryavanshi is leading an effort to provide ORWs with training on motivational counseling techniques, professional empowerment, and mobile health technology. “Through this study we would like to enhance capacity of grass root level heath workers to help HIV positive women stay in care and prevent mother-to-child transmission of disease. As technology is advancing all over the world, people in India, too, are becoming very techno savvy. Using technology we can help develop tools to make patients aware about clinical research participation, improve their health and adherence to medications.”

She hopes her work will increase the number of HIV positive women who seek care from antiretroviral therapy (ART) centers, who opt for exclusive breastfeeding, who test their babies for HIV, and who assume an active role in their health care. “If we can show that our work is making an impact in the lives of HIV positive pregnant and post-partum women by keeping children free of HIV, it would be a big achievement. And for TB patients, for them to complete their treatment without any hassles or fear of being ostracized, that would be a great achievement.”

CCGHE Director Bob Bollinger has high praise for Dr. Suryavanshi’s work. “Nishi’s expertise is of tremendous value to the JHU-Indo research portfolio. Her work ensures that clinical research efforts meet patients where they are.”

Dr. Suryavanshi knows that the behavioral component of clinical research is critical. “For the success of clinical studies, clinical and behavioral interventions should go hand in hand. Understanding the behavior of patients, their families, and healthcare providers helps inform the design of future research studies as well as appropriate care strategies.”