David Gathara is an epidemiologist working with the KEMRI Wellcome Trust Research Programme in Nairobi, Kenya. David works on assessment of quality of clinical care in nursing. He was previously involved in clinical trials using statistical models and on human resources for health with a bias in nursing care.
The KEMRI-Wellcome Trust Research Programme is a major Wellcome Trust’s overseas programmes. Its work has had a major influence on national and international health policy. Research spans a wide variety of topics and disciplines including research on malaria and bacterial and viral infectious diseases, work to map disease risk and intervention coverage and work on research ethics and health systems strengthening.
I’m Dr David Gathara, an epidemiologist by training with a undergraduate training in nursing. My interest in research started off in my undergraduate level; the university I went to exposed students to research at a very early stage, right from the first year. At that point my interest in research picked up and I decided to do this more as a career. I was lucky enough after graduation to do a bit of practicing for licensing and ended up with a job in research. After that I’ve moved on to pursue the career mainly academically but also in practise.
My career work has spanned a lot of disciplines. I started off doing routine quality of care system at work, moved on to clinical trials, used some bit of advance statistical methods to analyse routine data for better decision making, and my current work now focuses on human resources for health with a bias to nursing. My main interest in this area is researching what happens when there is nursing work force crisis, when there aren’t enough hands on the ground. A finding that came out of my previous work is that there is poor quality of care, and a lot of it focused on the clinical aspect of care: trying to assess if clinicians actually do the right assessment, if they make the right investigations, if they give the right treatment, and if they adhere to guidelines. But a more important question that kept lingering at the back of my head was: were all these things being done the right way, were the interventions actually getting to their patients. But more importantly, all these interventions, whether be it medical, nutritional, whichever intervention gets to a patient in any patient setting, most of them are identified by nurses and therefore the nursing work force is very important in evaluating what care the patients end up getting.
The current work that I’m trying to develop is what is the role of nurses in the delivery of quality care, and how might we get funding by generating this evidence. This area of work has not been what funders have picked up upon and a lot of the funded search is on clinical work. We hope that by generating this evidence, we can get funders to appreciate the importance of this work force and this area of research.
What I would tell young people who are interested to join the field is that research is really interesting. It is rewarding, especially when you come up with findings that actually end up influencing policy, you’re influencing practice which is very important, and getting people to recognise your work at a global level, when you come up with ideas that funders can believe in and see that you actually have an important question that you can bring a solution to. I think we need more thatching of our setting because we’re new, there are a lot of questions that need answers and there’s only a limited number of us, so they should feel welcome to the field. If you’ve got a bit of patience, you need both the academic and the research experience to go up the ladder.