Caitlin Baumhart joined the MPH Program in January 2018, while working on her Master of Professional Studies in International Development after finishing 4 years in Tanzania with the Peace Corps. As a student studying in the Infectious Disease Epidemiology concentration, she quickly became immersed in work with the Northeast Regional Center for Excellence in Vector-Borne Diseases (NEVBD) at Cornell. Caitlin first worked with NEVBD’s on its newly created Clinician Education Program (CEP), which was being piloted in Tompkins County, NY. To establish an evidence-based CEP, Caitlin helped conduct a needs assessment to better understand the gaps in tick-borne disease knowledge and available resources in the county. Upon her arrival, focus groups had already been conducted, but the sub-population of Emergency Room and Urgent Care clinicians had not been reached. To fill this gap, Caitlin designed and disseminated an online survey, analyzed and reported on the results, and created a set of recommendations for next steps. Caitlin is currently working with other MPH alumnae, Stephanie Morse and Dr. Ana Barsallo, to publish the manuscript and survey results this fall.

Prior to graduation, MPH faculty pointed Caitlin toward USAID’s Sustaining Technical and Analytic Resources (STAR) Internship Program, which was initiated to develop capacity and resources for the global health workforce. Caitlin applied to the WHO Contraceptive Guidelines 1-year Intern position, and since June 2019, she has worked with the World Health Organization’s (WHO) Sexual and Reproductive Health and Research Team. Caitlin’s role is a bit different from many of the other STAR internships, since she worked more directly with WHO than with USAID.

Caitlin’s role included the maintenance and updating of WHO’s contraceptive guidelines. In this role, Caitlin helped author and distribute a Guidance Statement for the updated recommendations in the Medical Eligibility Criteria (MEC) for Contraceptive Use, and maintained the evidence database for the Selected Practice Recommendations (SPR) for Contraceptive Use. She is currently helping to update the Family Planning (FP) Global Handbook for Providers, as a WHO consultant.

The MEC guideline update was spurred by what can be “a delicate topic in HIV/family planning communities,” says Caitlin. Previously, some observational studies had shown that women using DMPA, “a progestogen-only injectable commonly known as Depo-Provera,” might be at a higher risk of acquiring HIV. Because the MEC looks at the medical safety of contraceptives, this topic became urgent and a large $50 million randomized clinical trial with four different sub-Saharan African countries called The ECHO Trial was funded by the global community.  The study, published in the Lancet, found that DMPA “did not increase a woman’s risk of acquiring HIV as compared to 2 other contraceptive methods (Copper-IUD and progestogen arm implant),” says Caitlin. “With this new, high quality data, WHO needed to update their MEC recommendations for women who are at high risk of acquiring HIV. Typically, the MEC guidelines for contraceptive use are updated every 5 – 7 years, because the process is extremely rigorous and takes years.”

As part of the WHO secretariat, Caitlin helped to organize a WHO Guideline Development Group Meeting in Geneva, with a panel of 28 external experts (non-WHO employees) from around the world, to discuss the results from the trial. “I planned and facilitated the meeting, took notes, and helped with other technical components and presentations,” says Caitlin. Following the Geneva meeting, as a member of the writing team, she worked for two days straight to help draft the guidance statement for women at high risk of acquiring HIV—”one of over 2500 conditions” in the MEC. “It was a very busy summer!”—they published the Guidance Statement within a month, on August 29^th, 2019.

Of course, this is just one of many projects. Caitlin is in the process of drafting a scoping survey for clinicians and other stakeholders, to follow up on these MEC guidelines and plan for additional improvements. These results will be used for the 2022 Edition of the MEC and SPR, which will be a more complete update of the entire guidelines – rather than a special one-subject guidance statement.  “My work with NEVBD [the Northeast Vector-Borne Disease Center at Cornell] during my MPH really helped prepare me for this” says Caitlin, citing her applied practice with IRB applications, ethics and guideline review committee processes, and survey development.

The MPH program’s Planning Course, where students work with a real public health organization to design a public health intervention and write a grant proposal, helped to prepare Caitlin for her role with the WHO and USAID. “The planning grant application, along with the two grants I wrote during Peace Corps gave me a great foundation for future grant submissions. Additionally, I was part of a USAID committee to review concept notes – and later full grant proposals. I organized and facilitated this process with USAID and helped distribute the award. I have now seen both sides of the grant proposal process.”

Caitlin also points to her “International Public and NGO Management” course, which she took as an elective with Dr. John Mathiason, Adjunct Professor with the Cornell Institute for Public Affairs. “We frequently discussed the UN and global policy standards. He provided me with a lot of valuable insights,” says Caitlin. “With the Guideline Development Group, the 28 experts made the decisions on what the new recommendations should say – and 4 of these experts were advocates and community members. The WHO did not make the decision about what the recommendation said – WHO just facilitated the process and did the leg work for publication.

Of course, Caitlin worked on many other projects with WHO and USAID. She developed and hosted webinar series attended by many ministries of health and implementation organizations from around the globe, “I have enjoyed applying my cultural competency skills on a daily basis”. In addition, her WHO team works closely with the CDC’s Division of Reproductive Health. Caitlin has facilitated their weekly joint calls, maintained the evidence database for the contraceptive guidelines, and she is currently conducting systematic reviews with the CDC team.

After completing her internship in June, Caitlin was hired as a WHO consultant to finish updating the Family Planning Global Handbook for Providers. “We are doing a small revision to add a chapter for post-ECHO Trial recommendations, and adding a new chapter on family planning and contraceptive guidance for the acute phase of a public health emergency, such as COVID-19”. She is also managing the French translation for the Handbook.

As Caitlin finishes the Handbook updates through September, she is also searching and applying for positions in the fields of public health, epidemiology, infectious diseases, and global health. In the meantime, she is trying to refine some of her data and statistical analysis skills while exploring some of the many new positions that have been posted as a result of the COVID-19 public health workforce needs.