Kuskaya: a training program for collaboration and innovation in global health

Figures & data

Figure 1 Framework for understanding shared key components related to the development of innovations and global health training programs.

Notes: Global health and innovation literature emphasizes interdisciplinarity, teamwork, and mentoring as key components for a successful approach. Grand Challenges Canada developed the term Integrated Innovations™ to refer to the coordinated application of scientific/technological, social, and business innovation to develop solutions to complex challenges. This approach highlights the powerful synergies realized by aligning all three to address a single challenge – specifically, speaking to developing whole solutions for complex global health challenges.

Table 1 Kuskaya fellowship call for applications for Peruvian and US candidates: the number of applications, candidates interviewed, and candidates accepted into the program

For cohort	Number of Kuskaya applications	Number of candidates interviewed	Number of new candidates accepted
2014–2015	46	23	7 (15.2%)
2015–2016	72	28	11 (15.3%)
2016–2017	121	35	7 (5.8%)
2017–2018	88	31	8 (9.1%)

Figure 2 Overview of the Kuskaya Training Program timeline.

Notes: The Kuskaya Training Program is composed of requisite and elective training opportunities, depending on the background and academic profile of the fellow. The mandatory components include courses, a year-long research project, seminars, and mentoring and check-in meetings. However, the Program has built in flexibility due to the diverse backgrounds of our fellows. For instance, additional virtual coursework (including Introduction to Epidemiology, Introduction to Biostatistics, How to Develop your Research Proposal) is available for those who do not have a background in public health. In addition, the research project timeline varies depending on the project; some fellows only submit an addendum whereas others submit an entire proposal and the length of time in the field varies as well. The monthly checkins with the entire Kuskaya team (directors, mentors, and fellows) and regular meetings with mentors serve as a control to ensure that projects are on track.
Abbreviations: IRB, independent review board; UPCH, Universidad Peruana Cayetano Heredia.

Table 2 List of past and current research projects in the Kuskaya training program and corresponding articles, calls for proposals, and advanced degrees

Research project	Year	Products
Knowledge, attitudes and practices related to tuberculosis in pharmacy workers in a cross-sectional survey in El Agustino, Peru	2014–2015	Papers • García PJ, Hernández-Córdova G, Pourjavaheri P, Gómez-Paredes HJ, Sudar S, Bayer AM. Knowledge, attitudes and practices related to tuberculosis in pharmacy workers in a cross-sectional survey in El Agustino, Peru. PLoS ONE. 2018;13(7):e0196648. Published. Degrees and further studies – Fellowship with Inter-American Training for Innovations in Emerging Infectious Diseases Program – Master in medical science, Morsani College of Medicine, University of South Florida – PhD in computer science, School of Computer Science and Engineering, University of Washington
Knowledge, attitudes, and practices regarding cystic echinococcosis and sheep herding in Peru	2014–2015	Papers • Merino V, Westgard CM, Bayer AM, García PJ. Knowledge, attitudes, and practices regarding cystic echinococcosis and sheep herding in Peru: a mixed-methods approach. BMC Vet Res. 2017;13:213. Published. • Control strategies for echinococcosis: lessons learned in Peru. In preparation. Additional funding – “MASI RUWAMUJ: Community Agents for the Eradication of Cystic Equinococcosis.” BioIncuba. Rejected. Degrees and further studies – Master in public health in disasters, Universidad de Oviedo, Spain and Karolinska Institutet, Sweden
Understanding perceptions of climate change, priorities, and decision making among municipalities in Lima, Peru	2014–2016	Papers • Siña M, Wood RC, Saldarriaga E, et al. Understanding perceptions of climate change, priorities, and decision-making among municipalities in Lima, Peru to better inform adaptation and mitigation planning. PLoS ONE. 2016;11(1):e0147201. Published. • Potential health impacts of climate change in Latin America: a systematic review. In preparation. • Revealing and quantifying the social benefits of investing on green areas in Lima: a tool for monetary benefits assessment of a climate change mitigation strategy. In preparation. Additional funding – “Consultancy service for the reduction of the environmental footprint in homes and microenterprises.” Cienciactiva, 2016–2017. Awarded. Degrees and further studies • PhD student in Public Health, School of Public Health and Administration, Universidad Peruana Cayetano Heredia • Master in epidemiological research, School of Public Health and Administration, Universidad Peruana Cayetano Heredia • PhD student in health economics, School of Public Health, University of Washington
A One Health-based approach to assess echinococcosis	2015–2016	Papers • A One Health-based approach to assess echinococcosis. In preparation. • The One Health triad in public health interventions in Latin America: a systematic review. In preparation. Degrees and further studies – Master in One Health, The Royal Veterinary College and The London School of Hygiene and Tropical Medicine, University of London
Kuska-Rumi Wasi: an architectural intervention to prevent vector-borne diseases	2015–2016	Papers • Calderón-Anyosa R, Gálvez-Petzoldt C, García PJ, Carcamo CP. Housing Characteristics and Leishmaniasis: A Systematic Review. AJTMH. 2018;99(6):1547–1554. • From natural disasters to social conflict: lesson learned from a housing conditions intervention to prevent vector-borne diseases. In preparation. Additional funding – “Kuska-RumiWasi: New construction technologies for the prevention of vector-borne diseases.” Award for Interuniversity and Multidisciplinary Research. Peruvian Consortium of Universities. 2015–2016. Awarded. – “Kuska-RumiWasi: Housing for better health.” Breca Group Lima – Peru. Rejected. – “Kuska-RumiWasi: New construction technologies for the prevention of vector-borne diseases.” CONCYTEC. Rejected. Degrees and further studies • Master in biomedical informatics, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima
Pre–post educational intervention based on empowerment models in a group of students from a National Scholarship Program	2015–2016	Papers • Pre–post educational intervention based on empowerment models in a group of students from a National Scholarship Program. In preparation. Additional funding – Key characteristics of national scholars from the Peruvian Consortium of Universities. Award for Interuniversity and Multidisciplinary Research. Peruvian Consortium of Universities. Rejected. Degrees and further studies • Resident, Internal Medicine Residency Program, Department of Medicine, University of Washington • Master in gender studies, Pontificia Universidad Católica del Perú, Lima
Determinants of reproductive health and pregnancy in adolescents in the Peruvian Amazon	2015–2016	Papers • Determinants of reproductive health and pregnancy in adolescents in the Peruvian Amazon: mixed-methods study in Loreto, Perú. In preparation.
Nuestras Historias: Design and evaluation of a multimedia, motivational, educational intervention for pregnant women and partners in Loreto, Peru	2015–2016	Papers • Limaye NP, Blas MM, Alva IE, Carcamo CP, García PJ. The Amazon Hope: A qualitative and quantitative assessment of a mobile clinic ship in the Peruvian Amazon. PLoS ONE. 2018:13(6):e0196988. Published. • Limaye NP, Rivas-Nieto AC, Carcamo CP, Blas MM. Nuestras Historias - Designing a novel digital story intervention through participatory methods to improve maternal and child health in the Peruvian Amazon. PLoS ONE. 2018:13(11):e0205673. Published. • Decision-making during pregnancy- perspectives from community health workers and mothers in the Peruvian Amazon. In preparation. Additional funding – “Nuestras Historias: Evaluating the Impact of Community-Created Digital Stories to Motivate Healthy Pregnancy and Newborn Decisions in the Peruvian Amazon, A Cluster Randomized Trial.” Saving Lives at Birth: A Grand Challenge for Development. Finalist. Degrees and further studies • Resident, Medicine-Pediatrics Track, Boston Combined Residency Program
Developmental defects of enamel in children prenatally exposed to antiretroviral therapy	2015–2016	Papers • Developmental defects of enamel in children prenatally exposed to antiretroviral therapy: a retrospective cohort study. In preparation. • Prevalence and distribution of developmental defects of enamel in primary teeth: a systematic review and recommendations for future research. In preparation. Additional funding – National and International Mobilization Contest in Science, Technology and Innovation (CTeI), National Council of Science, Technology and Technological Innovation (CONCYTEC in Spanish). Rejected. Degrees and further studies • PhD student in public health, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima
Design of a public health training program for Peruvian journalists of print media	2015–2017	Papers • Designing an evidence-based public health training program for Peruvian journalists. In preparation. • A systematic review of a decade of research (2005–2015) on public health related training programs for journalists. In preparation. Degrees and further studies • Master in anthropology, School of Social Sciences, Universidad Nacional Mayor de San Marcos, Lima • Assistant Professor, School of Social Work, University of Connecticut
Leisure activities for older adults in public spaces	2015–2016	Papers • How leisure activities in public spaces improve well-being in older adults. In preparation. • Leisure activities for older adults in public spaces: a systematic review. In preparation. Degrees and further studies – Master in comparative studies of literature, art and thought, School of Humanities, Universidad Pompeu Fabra, Barcelona
Critical linkages between land-use change and human health in the Amazon region	2016–2017	Papers • Mastel M, Bussalleu A, Paz-Soldán VA, Salmón-Mulanovich G, Valdés-Velásquez A, Hartinger SM. Critical linkages between land use change and human health in the Amazon region: A scoping review. PLoS ONE. 2018:13(6):e0196414. Published. • Structural barriers to incorporating new and relevant time sensitive environmental and health education messages in public. In preparation.
Understanding partner violence and alcohol use in Peru: a mixed methods assessment	2016–2017	Papers • Domestic violence and alcohol use over time in the Peruvian demographic and health survey. In preparation. • Qualitative assessment on the intersection of alcohol use and physical domestic violence in Peru. In preparation. Degrees and further studies – Clinical fellow in psychology, Harvard Medical School – Massachusetts General Hospital
Building an SMS messaging system on sexual and reproductive health together with adolescents and youth in Peru	2016–2018	Papers • Building an SMS messaging system on sexual and reproductive health together with adolescents and youth in Peru. In preparation. Degrees and further studies – Fellow, ADA International Fellowship Program, US Department of State’s Bureau of Educational and Cultural Affairs
LIBRE: promoting Child Development through Reading Aloud Together	2016–2018	Papers • Association between the number of books at home and early reading skills in children of Peru. Submitted/under review • Exploring the literary habits of caregivers and young children ages 11–25 months old in an urban settlement in Lima, Peru: A qualitative analysis. In preparation. • Relationship between interactive patterns and depressive symptomatology in mothers and children from 9 to 11 months in Lima. In preparation. • Effectiveness of a program that seeks to promote shared reading and improve language development. In preparation.
Overcoming gaps for the implementation of maternal health interventions in the Peruvian Amazon	2017–2018	Papers • Overcoming gaps for the implementation of maternal health interventions in the Peruvian Amazon. In preparation. • Cultural and structural barriers and facilitators for maternal and newborn health care. In preparation. • Toward an intercultural health care model in the Peruvian rainforest: perspectives from the community and health providers. In preparation. Additional funding – Identifying and overcoming gaps in maternal and neonatal health services in the Peruvian Amazon. Peruvian College of Medicine. Rejected.
Community health workers in the Peruvian Amazon: characteristics and attitudes toward technologies	2017–2018	Papers • Community health workers in the Peruvian Amazon: Characteristics and attitudes toward technologies. In preparation.
Prevalence of metabolic syndrome in adults in rural Peru: a qualitative approximation	2017–2018	Papers • Prevalence of metabolic syndrome and its related factors among adult groups in San Marcos, Peru using traditional cooking systems and improved cooking systems: a cross-sectional study. In preparation. • A qualitative study to explore the perception towards metabolic syndrome and cardiovascular diseases in a rural community in San Marcos Cajamarca. In preparation. Degrees and further studies – PhD student in epidemiology, Swiss Tropical and Public Health Institute, University of Basel
Household-level risk factors for water contamination and antimicrobial resistance in drinking water in rural Peru	2017–2018	Papers • Household-level risk factors for water contamination and antimicrobial resistance in drinking water in rural San Marcos, Cajamarca, Peru. In preparation. • Antibiotic-resistant E. coli in drinking water samples from rural Andean households in Cajamarca, Peru. Submitted/under review. • Prevalence of antibiotic resistance and extended-spectrum beta-lactamase production in migratory shorebirds in Paracas National Reserve in Peru. In preparation. Additional funding – “Environmental Health Scholars Individual Development Plan,” GEOHealth Hub, Rollins School of Public Health, Emory University. Rejected. Degrees and further studies – MD student, School of Medicine, University of Washington

Table 3 Conferences, symposiums, and summits organized by the Kuskaya program between 2014 and 2017

Year	Event titles	Description	Organizers	Targeted audience (number of participants)
2014	Innovations in Global Health Conference	The Innovations in Global Health Conference was keynoted by Dr King Holmes, the William H Foege Chair of the Department of Global Health, followed by Dr Steve Gloyd, Associate Chair. Dr Holmes provided a broad overview of the advancement of global health research in various parts of the world and Dr Gloyd addressed the innovations within global health education.	Kuskaya Program, School of Public Health, UPCH	Researchers, professors, students, and health professionals from public health and higher education institutions (N=100)
2014	I One Health Symposium	The First Annual Symposium “One Health: The Intersection of Animal, Human and Environment Health” was organized by the School of Public Health and Administration and the School of Veterinary Medicine and Husbandry, with academic support from the Pan American Health Organization. The Symposium was part of the celebrations for the 16th anniversary of the School of Public Health and Administration and the 53rd anniversary of the Universidad Peruana Cayetano Heredia. Topics included the economic impact of animal health, surveillance of zoonotic diseases, and One Health in action.	Kuskaya Program, School of Public Health, UPCH School of Veterinary Medicine, UPCH Pan American Health Organization	Researchers, professors, students, and professionals from various veterinary sciences, public health, NGOs, international organizations, and higher education institutions (N=70)
2014	Climate and Health Summit	The Summit was organized by The Global Climate and Health Alliance and the School of Public Health and Administration, part of the parallel events surrounding the UN Climate Change Conference in Lima (COP20). The Summit was an occasion to showcase success stories, and to deliberate on the role of health and how best to mobilize the international health sphere in the run-up to COP21 of the United Nations Framework Convention on Climate Change (UNFCCC) and the UN General Assembly in 2015.	Kuskaya Program, School of Public Health, UPCH Global Climate and Health Alliance	Researchers, professors, students, professionals, COP20 delegates from international agencies, NGOs, governmental institutions, and higher education institutions related to health and climate change (N=280)
2015	Global Health in the 21st Century: A Perspective from the Fogarty International Center	This symposium was keynoted by Dr Roger Glass, the Director of the Fogarty International Center and Associate Director for International Research at the US National Institutes of Health. Dr Glass presented new frontiers in global health focusing on global health education.	Kuskaya Program, School of Public Health, UPCH	Researchers, professors, students, and health professionals from public health and higher education institutions (N=80)
2015	The Lancet Countdown: tracking progress on health and climate change – Launch of Annual Publication	The Lancet Countdown: tracking progress on health and climate change is an international, multidisciplinary research collaboration working to monitor and assess the relationships between health and climate change globally. The event was keynoted by Anthony Costello, Co-Chair of the Commission and Director of the University College London Institute for Global Health and Victor Galaz, Lead of the Adaptation chapter of the report, from the Stockholm Resilience Center. The purpose of the event was to launch a report that reviewed climate science and its impacts on human health, and to present policy-response options around key themes.	Kuskaya Program, School of Public Health, UPCH The Lancet Countdown Commision	Researchers, professors, students, and professionals from international agencies, NGOs, governmental institutions, and higher education institutions related to health and climate change (N=50)
2015	Innovations in Global Health Symposium	The symposium was keynoted by Dr Myat Htoo, Program Director for the NIH Fogarty International Center. He spoke on mentoring in global health. His presentation was followed by three presentations from 2014 to 2015 Kuskaya fellows related to national control programs for echinococcosis, mitigation and adaptation strategies for climate change, and pharmacy workers’ attitudes and practices related to tuberculosis.	Kuskaya Program, School of Public Health, UPCH	Researchers, professors, students, and health professionals from public health and higher education institutions (N=70)
2016	II One Health Symposium	The Second Annual Symposium “Putting Concepts in Action” was organized by the School of Public Health and Administration and the School of Veterinary Medicine and Husbandry. The Symposium was part of the parallel events hosted on the global “One Health Day.” Topics included one health risk analysis structures, inclusion of one health in veterinary education, and next steps for one health.	Kuskaya Program, School of Public Health, UPCH School of Veterinary Medicine, UPCH	Researchers, professors, students, and professionals from veterinary sciences, public health, NGOs, international organizations, and higher education institutions (N=60)
2016	The Lancet Countdown: tracking progress on health and climate change Workshop	The Lancet Countdown: tracking progress on health and climate change is an international, multidisciplinary research collaboration working to monitor and assess the relationships between health and climate change globally. This event serves to capture the region’s and, specifically, Peru’s response to climate change, focusing on health resilience and adaptation as well as health co-benefits of mitigation.	Kuskaya Program, School of Public Health, UPCH The Lancet Countdown Commision	Researchers, professors, students, and professionals from international agencies, NGOs, governmental institutions, and higher education institutions related to health and climate change (N=60)
2017	Innovations in Global Health Symposium	The symposium was keynoted by Dr Kevin Bialy, NIH Fogarty International Center’s International Health Program Officer for the Western Hemisphere. He spoke on addressing global health problems from the perspective of applied anthropology. His presentation was followed by three presentations from 2016 to 2017 Kuskaya fellows related to child development, domestic violence and alcohol use, and climate change and health.	Kuskaya Program, School of Public Health, UPCH	Researchers, professors, students, and health professionals from public health and higher education institutions (N=80)

Abbreviations: NGOs, nongovernmental organizations; UPCH, Universidad Peruana Cayetano Heredia.

Table 4 Background of Kuskaya fellows: health related and non-health-related disciplines

Health-related disciplines	Number of fellows	Non-health-related disciplines	Number of fellows
Medicine	5	Communications	2
Public health	4	Architecture	1
Psychology	3	Anthropology	1
Veterinary medicine	2	Computer science	1
Health administration	2	Economics	1
Environmental health	2	Electronic engineering	1
Nursing	2	Environmental chemistry	1
Dentistry	1	Environmental science	1
		Law	1
		Public policy	1
		Sociology	1
Total	21		12