Margaret Elizabeth Kruk | |
---|---|
Born | Poland |
Nationality | American and Canadian |
Occupation(s) | Public health expert, physician and health systems researcher |
Spouse | Sandro Galea |
Academic background | |
Education | BA., Arts and Science, McMaster University MD., McMaster University MPH., Harvard University |
Academic work | |
Institutions | Harvard University Columbia University University of Michigan |
Margaret Elizabeth Kruk is a public health expert,physician,and health systems researcher. She is Professor of Health Systems at the Harvard T.H. Chan School of Public Health [1] and Director of the Quality of Evidence for Health Transformation (QuEST) Centers and Network. [2] She is slated to become Distinguished Professor of Health Systems and Medicine at Washington University in St. Louis in January 2025. [3]
Kruk is most known for her work on measuring health system quality and its impact on healthcare demand,health outcomes,and trust,using observational studies,implementation science and econometric methods. [4] She has published more than 200 research articles and book chapters. In 2018,she chaired the Lancet Global Health Commission on High Quality Health Systems. [5] She co-edited the third edition of the Disease Control Priorities book series and served on the Lancet Commissions on Investing in Health I and III,and the Institute of Medicine Committee on Health System Strengthening,among others. [6] She also served as co-lead for the Bulletin of the World Health Organization Special Issue on Health Care Quality in the SDG Era. [7]
Kruk has received awards such as the 2010 University of Michigan William J. McNerney Research Award,along with the 2018 Alice Hamilton Award [8] and the 2021 Marianne Wessling Resnick Memorial Mentoring Award,both from the Harvard T.H. Chan School of Public Health. [9] She was also named in the Canadian Women in Global Health List by the Canadian Society for International Health in 2018. [10]
Kruk graduated from McMaster University with a bachelor's degree in Arts and Science in 1991,followed by a Doctor of Medicine degree in 1994. After completing her residency,she earned her medical license from the College of Physicians and Surgeons of Ontario in 1995 and board certification from the Canadian College of Family Physicians in 1996. Between 1996 and 1998,she was a Family and Emergency Physician and Chief of Staff at Geraldton District Hospital,and later worked as Interim Country Manager and Project Physician for Doctors without Borders (MSF) in Lebanon. In 1999,she enrolled at the Harvard School of Public Health,where she received a Master of Public Health degree in Health Policy and Management in 2000. [11]
Kruk began her academic career at the University of Michigan School of Public Health,where she assumed the roles of Assistant Research Scientist and Lecturer before becoming an Assistant Professor in 2007. In 2010,she joined Columbia University as an Assistant Professor and became an Associate Professor in 2014. Subsequently,she was appointed Associate Professor of Global Health at the Harvard T.H. Chan School of Public Health in 2015. In 2019,she became a Professor of Health Systems. [1]
In 2020,Kruk became Director of the Harvard QuEST Centers and Network,a multi-country research consortium focused on developing tools to assess health system quality,testing solutions to health system deficits,and supporting high-impact health systems research globally. [2]
Prior to her roles in academia,Kruk served as the Policy Advisor for Health for the UN Millennium Project and was an Associate and later Engagement Manager for McKinsey and Company. [12]
Kruk's policy engagement has extended to the Joint Health Systems Research Committee for the UK Department for International Development (DFID), [13] the UK Economic and Social Research Council,the UK Medical Research Council,and the Wellcome Trust,which she chaired from 2020 to 2021. She has served in advisory roles to organizations,including the World Bank Technical Advisory Group on Investing for Resilient Health Systems (2021),and the Gates Foundation Technical Advisory Group on Exemplars in COVID-19 response (2020/23), [14]
Kruk has contributed to the field of public health by developing novel measures of health system quality and assessing how these systems' performance influences population demand for healthcare,health outcomes,and trust,using measures,implementation science and econometric methods to design and evaluate large-scale health system reforms. [4]
In a highly cited study reporting the findings of the Lancet Global Health Commission on High Quality Health Systems,Kruk underscored the critical need for high-quality health systems in low- and middle-income countries (LMICs) to meet evolving health needs,proposing assessment criteria and systemic reforms. [15] Her research also found that universal health coverage in low- and middle-income countries could prevent 8.6 million deaths annually if it includes high-quality care to address both non-utilization and poor-quality health services. [16] Building on this research,she,along with Todd Lewis and colleagues,developed a survey to assess health system performance from the viewpoint of the population applicable to countries at all income levels. Results from this People's Voice Survey showed that fewer than 50% of people across 16 countries feel secure in their health systems. [17]
In 2015,Kruk and collaborators proposed the first formal framework for resilient health systems. This drew from lessons from the Ebola epidemic,emphasizing the importance of effective response,maintenance of core functions,and post-crisis reorganization. [18] Additionally,alongside Lynn P. Freedman,she proposed a framework for evaluating health system performance in developing countries,reviewing indicators across effectiveness,equity,and efficiency to assist policymakers in assessing the impact of various policies and expenditures. [19]
Through the Lancet Commission on Investing in Health,Kruk and colleagues introduced a framework to achieve health gains by 2035,highlighting high returns on health investments,the potential for a "grand convergence" in health outcomes,fiscal policies to reduce non-communicable diseases,and progressive universalism for universal health coverage. [20]
Another facet of Kruk's work focused on health system performance in maternal,neonatal,and child health. Analyzing basic maternal care quality in health facilities across five sub-Saharan African countries,she revealed lower scores in primary care facilities,which handle a significant portion of deliveries,and a consistent association between low delivery volume and poorer quality. [21] Along with Sanam Roder-DeWan,she proposed service delivery redesign that would shift all deliveries to higher level health facilities for all women over time in low-income countries as a way to reduce persisting high rates of newborn mortality. [22] In a survey conducted with colleagues in Tanzania,she demonstrated that 19-28% of women in Tanzanian health facilities experienced disrespectful or abusive treatment during childbirth,underscoring the urgency of solutions to ensure dignity and reduce maternal mortality. [23] She further showed that disrespectful treatment during childbirth led to lower satisfaction,perceived poorer care quality,and reduced intention for future deliveries at the same facility,emphasizing the need for better interpersonal care in maternal health. [24] She led papers for global research collaborations in maternal and child health,including the Lancet Maternal Health Series (2016) and the Lancet Child Health Series (2022). [25] [26]
She married Sandro Galea in New York in 2001. They have two children. [27]
Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pregnancy,underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while she is pregnant or within six weeks of resolution of the pregnancy. The CDC definition of pregnancy-related deaths extends the period of consideration to include one year from the resolution of the pregnancy. Pregnancy associated death,as defined by the American College of Obstetricians and Gynecologists (ACOG),are all deaths occurring within one year of a pregnancy resolution. Identification of pregnancy associated deaths is important for deciding whether or not the pregnancy was a direct or indirect contributing cause of the death.
An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills,or in an environment lacking minimal medical standards,or both. An unsafe abortion is a life-threatening procedure. It includes self-induced abortions,abortions in unhygienic conditions,and abortions performed by a medical practitioner who does not provide appropriate post-abortion attention. About 25 million unsafe abortions occur a year,of which most occur in the developing world.
Global health is the health of populations in a worldwide context;it has been defined as "the area of study,research,and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus,global health is about worldwide health improvement,reduction of disparities,and protection against global threats that disregard national borders,including the most common causes of human death and years of life lost from a global perspective.
The Global Burden of Disease Study (GBD) is a comprehensive regional and global research program of disease burden that assesses mortality and disability from major diseases,injuries,and risk factors. GBD is a collaboration of over 12,000 researchers from more than 160 countries. Under principal investigator Christopher J.L. Murray,GBD is based in the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and funded by the Bill and Melinda Gates Foundation.
International Community for the Relief of Suffering and Starvation (ICROSS) is an international non-governmental organisation that provides health and development services for pastoral communities in East Africa.
Although emphasized by the country's ruling Baath Party and improving significantly in recent years,health in Syria has been declining due to the ongoing civil war. The war which has left 60% of the population food insecure and saw the collapse of the Syrian economy,the surging prices of basic needs,the plummeting of the Syrian pound,the destruction of many hospitals nationwide,the deterioration in the functionality of some medical equipment due to the lack of spare parts and maintenance,and shortages of drugs and medical supplies due to sanctions and corruption.
The Expanded Programme on Immunization is a global health initiative launched by the World Health Organization in May 1974,with the aim to make vaccines available to all globally
Sir Andrew Paul Haines,FMedSci is a British epidemiologist and academic. He was the Director of the London School of Hygiene &Tropical Medicine from 2001 to 2010.
Christopher J.L. Murray is an American physician,health economist,and global health researcher. He is a professor at the University of Washington in Seattle,where he is Chair of Health Metrics Science and the director of the Institute for Health Metrics and Evaluation (IHME).
The Institute for Health Metrics and Evaluation (IHME) is a public health research institute of the University of Washington in Seattle. Its research fields are global health statistics and impact evaluation.
Muhammad Ali Pate is a Nigerian physician, politician,and the current Minister of Health and Social Welfare of Nigeria,appointed in 2023. He also serves as a Professor of the Practice of Public Health Leadership in the Department of Global Health and Population at Harvard University. He is also the Director of the Global Financing Facility for Women,Children and Adolescents (GFF) at the World Bank Group.
Anthony Costello is a British paediatrician. Until 2015 Costello was Professor of International Child Health and Director of the Institute for Global Health at the University College London. Costello is most notable for his work on improving survival among mothers and their newborn infants in poor populations of developing countries. From 2015 to 2018 he was director of maternal,child and adolescent health at the World Health Organization in Geneva.
Abuse during childbirth is generally defined as interactions or conditions deemed humiliating or undignified by local consensus and interactions or conditions experienced as or intended to be humiliating or undignifying. Bowser and Hill's 2010 landscape analysis defined seven categories of abusive or disrespectful care,including physical abuse,non-consented clinical care,non-confidential care,non-dignified care,discrimination,abandonment,and detention in health facilities.
The Alliance for Surgery and Anesthesia Presence is a multidisciplinary society of surgeons,anesthesiologists,obstetricians and public health specialists organized to improve the delivery of surgical care,particularly in low and middle income countries. The body,named the Burden of Surgical Disease Working Group at its founding in 2007,was renamed in 2010. It became an international society in 2013 under the umbrella of the International Surgery Society.
Joy Elizabeth Lawn is a British paediatrician and professor of maternal,reproductive and child health. She is Director of the London School of Hygiene &Tropical Medicine Maternal,Adolescent,Reproductive &Child Health (MARCH) Centre. She developed the epidemiological evidence for the worldwide policy and programming that looks to reduce neonatal deaths and stillbirths and works on large-scale implementation research.
Peter Salama was an Australian epidemiologist who worked for UNICEF (2002–16) and the World Health Organization (2016–19). He was particularly known for his work at both organisations managing their responses to Ebola epidemics in Africa. Richard Horton,editor of The Lancet,described him as "a loyal and committed health advocate and multilateralist" who "brought depth and strength to WHO".
Joanne Katz is an epidemiologist,biostatistician,and Professor of International Health at the Johns Hopkins Bloomberg School of Public Health. She holds joint appointments in the Departments of Biostatistics,Epidemiology and Ophthalmology within the School of Medicine. Her expertise is in maternal,neonatal,and child health. She has contributed to the design,conduct and analysis of data from large community-based intervention trials on nutritional and other interventions in Indonesia,Philippines,Bangladesh,Nepal,and other countries.
Nina Schwalbe is an American public health researcher who is the founder of Spark Street Advisors,a public health think tank based in New York City. Schwalbe specializes in vaccines. She has previously worked at Gavi,UNICEF and USAID.
Felicia Marie Knaul is a British-Canadian health economist who is director of the University of Miami Institute for Advanced Study of the Americas and a professor at the Miller School of Medicine. She is an economist with the Mexican Health Foundation and president of the non-governmental organization Tómatelo a Pecho,an advocacy organisation that promote women's health in Latin America. Her research and leadership has focused around raising awareness of breast cancer in low and middle income countries.
Rifat Atun is a British physician and academic who,as of January 2024,serves as the Professor of Global Health Systems and Director of the Health System Innovation Lab at Harvard University. He is one of the most important figures in the contemporary study of comparative health systems and healthcare innovation and has made substantial contributions to health systems theory,health systems reform,and innovation in health systems.
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