Corrina Moucheraud
Corrina Moucheraud
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Associate Professor of Public Health Policy and Management
Co-Director of the Global Center for Implementation Science
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Professional overview
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Corrina Moucheraud, ScD, MPH is an Associate Professor in the Department of Public Health Policy & Management, and Co-Director of the Global Center for Implementation Science. As a global health researcher and implementation scientist, she seeks to improve outcomes by strengthening health systems and enabling the delivery of effective, equitable health services. Much of Dr. Moucheraud’s focus is on meeting the needs of women and young people, particularly in low- and middle-income countries. Dr. Moucheraud is currently leading efforts for cervical cancer prevention, including HPV vaccination, in Kenya and Malawi. She also researches HIV & non-communicable disease prevention and treatment internationally and in the U.S.
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Education
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MPH, Health Behavior, University of North Carolina Gillings School of Public Health, Chapel Hill, NCScD, Global Health & Population, Harvard T.H. Chan School of Public Health, Cambridge, MA
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Honors and awards
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Visiting Scholar, Clinical and Translational Science Awards Program (NCATS, NIH) (2021)Delta Omega Honorary Society (2020)Faculty Career Development Award (UCLA) (2017)Hellman Fellowship (UCLA) (2017)Maternal Health Task Force award (Harvard University) (2013)
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Publications
Publications
Effects of spousal migration on access to healthcare for women left behind : A cross-sectional follow-up study
AbstractWest, H. S., Robbins, M. E., Moucheraud, C., Razzaque, A., & Kuhn, R. (n.d.).Publication year
2021Journal title
PloS oneVolume
16Issue
12 DecemberAbstractBackground Women left behind by migration represent a unique and growing population yet remain understudied as key players in the context of migration and development. Using a unique longitudinal survey of life in Bangladesh, the Matlab Health and Socioeconomic Surveys, we examined the role of spousal migration in healthcare utilization for women. The objective of this study was to assess realized access to care (do women actually get healthcare when it is needed) and consider specific macrostructural, predisposing, and resource barriers to care that are related to migration. Methods and findings In a sample of 3,187 currently married women, we estimated multivariate logistic and multinomial regression models controlling for a wide range of baseline sociodemographic factors measured as far back as 1982. Our analyses also controlled for selection effects and explored two mechanisms through which spousal migration can affect healthcare utilization for women, remittances and frequent contact with spouses. We found that women with migrant spouses were approximately half as likely to lack needed healthcare compared to women whose spouses remained in Bangladesh (predicted probability of not getting needed healthcare 11.7% vs. 21.8%, pHigh Rates of Uncontrolled Blood Pressure in Malawian Adults Living with HIV and Hypertension
AbstractHoffman, R. M., Chibwana, F., Kahn, D., Banda, B. A., Phiri, L., Chimombo, M., Kussen, C., Sigauke, H., Moses, A., Van Oosterhout, J. J., Phiri, S., Currier, J. W., Currier, J. S., & Moucheraud, C. (n.d.).Publication year
2021Journal title
Global HeartVolume
16Issue
1AbstractBackground: Hypertension is among the most commonly diagnosed non-communicable diseases in Africa, and studies have demonstrated a high prevalence of hypertension among individuals with HIV. Despite high prevalence, there has been limited attention on the clinical outcomes of hypertension treatment in this population. Objective: We sought to characterize rates of and factors associated with blood pressure control over one year among individuals on antiretroviral therapy (ART) and antihypertensive medications. Methods: We performed a prospective observational cohort study at an HIV clinic in Malawi. We defined uncontrolled hypertension as a systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg at two or more follow-up visits during the year, while controlled hypertension was defined asNomadic Tibetan women’s reproductive health : findings from cross-sectional surveys with a hard-to-reach population
Provider experiences with three- and six-month antiretroviral therapy dispensing for stable clients in Zambia
AbstractPhiri, K., McBride, K., Siwale, Z., Hubbard, J., Bardon, A., Moucheraud, C., Haambokoma, M., Pisa, P. T., Moyo, C., & Hoffman, R. M. (n.d.).Publication year
2021Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIVVolume
33Issue
4Page(s)
541-547AbstractMulti-month dispensing of antiretroviral therapy (ART) has been taken to scale in many settings in sub-Saharan Africa with the benefits of improved client satisfaction and decreased client costs. Six-month ART dispensing may further increase these benefits; however, data are lacking. Within a cluster-randomized trial of three- versus six-month dispensing in Malawi and Zambia, we performed a sub-study to explore Zambian provider experiences with multi-month dispensing. We conducted 18 in-depth interviews with clinical officers and nurses dispensing ART as part of INTERVAL in Zambia. Interview questions focused on provider perceptions of client acceptability, views on client sharing and selling of ART, and perceptions on provider workload and clinic efficiency, with a focus on differences between three- and six-month dispensing. Interviews were analyzed using inductive thematic analysis to identify key themes and patterns within the data. Providers perceived significant benefits of multi-month dispensing, with advantages of six-month over three-month dispensing related to a reduced burden on clients, and for reductions in their own workload and clinic congestion. Among nearly all providers, the six-month dispensing strategy was perceived as ideal. Further research is needed to quantify clinical outcomes of six-month dispensing and feasibility of scaling-up this intervention in resource-limited settings. Clinical Trial Number: NCT03101592.Trust In Governments And Health Workers Low Globally, Influencing Attitudes Toward Health Information, Vaccines
AbstractMoucheraud, C., Guo, H., & Macinko, J. A. (n.d.).Publication year
2021Journal title
Health AffairsVolume
40Issue
8Page(s)
1215-1224AbstractTrust, particularly during emergencies, is essential for effective health care delivery and health policy implementation. We used data from the 2018 Wellcome Global Monitor survey (comprising nationally representative samples from 144 countries) to examine levels and correlates of trust in governments and health workers and attitudes toward vaccines. Only one-quarter of respondents globally expressed a lot of trust in their government (trust was more common among people with less schooling, those living in rural areas, those who were financially comfortable, and those who were older), and fewer than half of respondents globally said that they trust doctors and nurses a lot. People’s trust in these institutions was correlated with trust in health or medical advice from them, and with more positive attitudes toward vaccines. Vaccine enthusiasm varied substantially across regions, with safety being the most common concern. Policy makers should understand that the public may have varying levels of trust in different institutions and actors. Although much attention is paid to crafting public health messages, it may be equally important, especially during a pandemic, to identify appropriate, trusted messengers to deliver those messages more effectively to different target populations.What is the impact of removing performance-based financial incentives on community health worker motivation? A qualitative study from an infant and young child feeding program in Bangladesh
"a loving man has a very huge responsibility" : A mixed methods study of Malawian men's knowledge and beliefs about cervical cancer
A Qualitative Assessment of Provider and Client Experiences with 3- And 6-Month Dispensing Intervals of Antiretroviral Therapy in Malawi
Can complex programs be sustained? A mixed methods sustainability evaluation of a national infant and young child feeding program in Bangladesh and Vietnam
Can Self-Management Improve HIV Treatment Engagement, Adherence, and Retention? A Mixed Methods Evaluation in Tanzania and Uganda
Health care workers’ experiences with implementation of “screen and treat” for cervical cancer prevention in Malawi : A qualitative study
Integrated care experiences and out-of-pocket expenditures : A cross-sectional survey of adults receiving treatment for HIV and hypertension in Malawi
Variability in health care quality measurement among studies using service provision assessment data from low- And middle-income countries : A systematic review
AbstractMoucheraud, C., & McBride, K. (n.d.).Publication year
2020Journal title
American Journal of Tropical Medicine and HygieneVolume
103Issue
3Page(s)
986-992AbstractQuality of care is essential for improving health outcomes, but heterogeneity in theoretical frameworks and metrics can limit studies’ generalizability and comparability. This research aimed to compare definitions of care quality across research articles that incorporate data from Service Provision Assessment (SPA) surveys. Following Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we used a keyword search in PubMed. Each author reviewed abstracts, then full texts, for inclusion criteria, and peer-reviewed publications of empirical analysis using SPA data. The search yielded 3,250 unique abstracts, and 34 publications were included in the final analysis. We extracted details on the SPA dataset(s) used, theoretical framework applied, and how care quality was operationalized. The 34 included articles used SPA data from 14 surveys in nine countries (all in sub-Saharan Africa plus Haiti). One-third of these articles (n = 13) included no theoretical or conceptual framework for care quality. Among those articles referencing a framework, the most common was the Donabedian model (n = 7). Studies operationalized quality constructs in extremely different ways. Few articles included outcomes as a quality construct, and the operationalization of structure varied widely. A key asset of SPA surveys, owing to the standardized structure and use of harmonized data collection instruments, is the potential for cross-survey comparisons. However, this is limited by the lack of a common framework for measuring and reporting quality in the existing literature using SPA data. Service Provision Assessment surveys offer unique and valuable insights, and a common framework and approach would substantially strengthen the body of knowledge on quality of care in low-resource settings.“It is big because it's ruining the lives of many people in Malawi” : Women's attitudes and beliefs about cervical cancer
AbstractMoucheraud, C., Kawale, P., Kafwafwa, S., Bastani, R., & Hoffman, R. M. (n.d.).Publication year
2020Journal title
Preventive Medicine ReportsVolume
18AbstractAdoption of routine cervical cancer screening in Malawi is very low, even though it has the highest cervical cancer burden in the world. We performed a multi-level assessment of Malawian women's knowledge and perceptions of cervical cancer risk and screening. Using the Multi-Level Health Outcomes Framework, we conducted interviews with 60 adult Malawian women aged 18–62 at facilities with cervical cancer screening. Eligible participants were recruited regardless of HIV status or history of screening, and asked about their experiences with cervical cancer disease and screening. Interviews were audio recorded and a theory-informed codebook was developed. Analysis focused on thematic differences across groups by age, HIV status, and screening history. Half of the sample (n = 30) had either never been screened for cervical cancer or were at the facility for their first-ever screen. Most women said that cervical cancer is dangerous, and many knew someone affected. Many women spoke about the importance of screening for prevention of cancer. Risk factors were generally well-understood, including increased risk with HIV, although this was misunderstood by some HIV-negative women to mean they were not at risk. Social networks were identified as a key determinant of screening, and gender issues were likewise highly salient. Despite high knowledge levels about cervical cancer, there remain significant challenges to improving screening, including interpersonal and system-level barriers. Future work should strengthen service delivery, target social networks and intimate partners, and develop targeted communication strategies for HIV-positive and -negative groups, especially in high-burden settings.'Blood pressure can kill you tomorrow, but HIV gives you time' : Illness perceptions and treatment experiences among Malawian individuals living with HIV and hypertension
ART Adherence Among Malawian Youth Enrolled in Teen Clubs : A Retrospective Chart Review
Barriers to HIV treatment adherence : A qualitative study of discrepancies between perceptions of patients and health providers in Tanzania and Uganda
Does health worker performance affect clients' health behaviors? A multilevel analysis from Bangladesh
Engagement in Agriculture Protects Against Food Insecurity and Malnutrition in Peri-Urban Nepal
Scaling up diagnostic-driven management of sexually transmitted infections in pregnancy
AbstractWynn, A., Moucheraud, C., Morroni, C., Ramogola-Masire, D., Klausner, J. D., & Leibowitz, A. (n.d.).Publication year
2019Journal title
The Lancet Infectious DiseasesVolume
19Issue
8Page(s)
809-810Abstract~The costs of diabetes treatment in low- A nd middle-income countries : A systematic review
AbstractMoucheraud, C., Lenz, C., Latkovic, M., & Wirtz, V. J. (n.d.).Publication year
2019Journal title
BMJ Global HealthVolume
4Issue
1AbstractIntroduction The rising burden of diabetes in low- A nd middle-income countries may cause financial strain on individuals and health systems. This paper presents a systematic review of direct medical costs for diabetes (types 1 and 2) in low- A nd middle-income countries. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (PubMed, International Bibliography of Social Science, EconLit) were searched for publications reporting direct medical costs of type 1 and 2 diabetes. Data were extracted from all peer-reviewed papers meeting inclusion criteria, and were standardised into per-patient-visit, per-patient-year and/or per-complication-case costs (2016 US$). Results The search yielded 584 abstracts, and 52 publications were included in the analysis. Most articles were from Asia and Latin America, and most focused on type 2 diabetes. Per-visit outpatient costs ranged from under $5 to over $40 (median: $7); annual inpatient costs ranged from approximately $10 to over $1000 (median: $290); annual laboratory costs ranged from under $5 to over $100 (median: $25); and annual medication costs ranged from $15 to over $500 (median: $177), with particularly wide variation found for insulin. Care for complications was generally high-cost, but varied widely across countries and complication types. Conclusion This review identified substantial variation in diabetes treatment costs; some heterogeneity could be mitigated through improved methods for collecting, analysing and reporting data. Diabetes is a costly disease to manage in low- A nd middle-income countriesand should be a priority for the global health community seeking to achieve Universal Health Coverage.Using partner notification to address curable sexually transmitted infections in a high HIV prevalence context : A qualitative study about partner notification in Botswana
Основные (жизненно важные) лекарства для всеобщего охвата медицинской помощью
AbstractWirtz, V. J., Hogerzeil, H. V., Gray, A. L., Bigdeli, M., de Joncheere, C. P., Ewen, M. A., Gyansa-Lutterodt, M., Jing, S., Luiza, V. L., Mbindyo, R. M., Möller, H., Moucheraud, C., Pécoul, B., Rägo, L., Rashidian, A., Ross-Degnan, D., Stephens, P. N., Teerawattananon, Y., T'Hoen, E. F., … Reich, M. R. (n.d.).Publication year
2019Journal title
Kazan Medical JournalVolume
100Issue
1Page(s)
4-111Abstract~Association of antiretroviral therapy with high-risk human papillomavirus, cervical intraepithelial neoplasia, and invasive cervical cancer in women living with HIV : a systematic review and meta-analysis
Maternal Health Behaviors and Outcomes in a Nomadic Tibetan Population
AbstractMoucheraud, C., Gyal, L., Gyaltsen, K., Tsering, L., Narasimhan, S., & Gipson, J. (n.d.).Publication year
2018Journal title
Maternal and Child Health JournalVolume
22Issue
2Page(s)
264-273AbstractIntroduction Despite significant global improvements in maternal health, large disparities persist. In China, rural women and women who live in western regions experience lower rates of maternal healthcare utilization and higher rates of maternal mortality than women elsewhere in the country. This paper examines maternal health care-seeking among nomadic Tibetan women in rural western China, a particularly understudied group. Methods Secondary data analysis was conducted with survey data collected in 2014 in Qinghai Province, China. Participants (rural, nomadic, adult women) provided birth histories and information on care received during antenatal, intrapartum and/or postpartum period(s). Using bivariate and multivariable logistic regression models, these outcomes were explored in relation to maternal characteristics (e.g., educational attainment and parity), use of health insurance, and time. Results Approximately half of all women had ever used antenatal care, institutional delivery, and/or skilled birth attendance. The utilization of these services has increased over time, from 10% of births prior to the year 2000, to approximately 50% since 2000. Utilization increased by year (odds ratios ranging from 1.1 to 1.3) even after controlling for covariates. Women with health insurance coverage were significantly more likely to use these services than women without insurance, although less than 20% of women reported that insurance paid for any antenatal and/or childbirth care. Discussion Utilization of maternal care is improving among this population but rates remain low in comparison to other women in rural, western China. Further targeted interventions may be needed to reach and adequately address the maternal health needs of this unique population.