Q&A with Rohina Joshi

Rohina Joshi is a senior research fellow in the Office of the Chief Scientist. Her work involves conducting research in alternative models of care for chronic disease management using a team approach involving physicians and non-physician healthcare workers. This includes the entire life span of a research project – from thinking up new research ideas, writing applications to fund research, and seeing an awarded project through from inception to publication and policy translation. Rohina also teaches at the Sydney School of Public Health at The University of Sydney.

How long have you been working at The George Institute?

11.5 years.

What attracted you to working at The George Institute?

I began working at The George Institute as a doctoral student and stayed on because it’s truly a global research organisation with high-quality research programs being conducted in high-, low- and middle-income countries. Knowing that The George Institute improves the health of millions of lives across the globe keeps me going.

What are your research and/or professional interests?

My two key areas of interest are around task-sharing between physicians and non-physicians for better management of individuals with chronic disease, and improving health information systems through sustainable disease monitoring systems.

What is your current research focus?

Developing sustainable and effective models of healthcare using a team of physicians and non-physician healthcare workers (for example, pharmacists, community health workers, nurses etc). One of the studies that I’m currently working on aims to identify the barriers and enablers for hypertension management in three rural communities in India. This will include a feasibility study involving a task-sharing model of healthcare for the management of hypertension.

What are some of your recent highlights/successes?

I was very fortunate to be involved in the Andhra Pradesh Rural Health Initiative, a flagship project of The George Institute for Global Health in India. Through that study, we established a surveillance system to identify causes of death in a region which did not have reliable information using lay health personnel, completed a disease and risk-factor profile of the population (approximately 200,000), and conducted the first randomised control trial in India using non-physician healthcare workers to identify and manage individuals with cardiovascular disease (heart attacks and strokes).

The results of study were widely published, discussed in the Indian Parliament to highlight the problem of chronic disease in rural India and have contributed to evidence that trained non-physician healthcare workers can screen individuals with heart disease, provide lifestyle management and recommend guideline based drug therapies.

What impact will your work have on health and why?

In the context of low- and middle-income countries, there’s a shortage of physicians and communities don’t have access to good quality healthcare. My research aims to provide evidence for an alternative model of healthcare which utilises the potential of non-physician healthcare workers in collaboration with physicians. This model has been used to improve maternal and child health in developing countries and is currently being used to manage the HIV/AIDS epidemic in Africa.

There isn’t yet enough evidence to show the effectiveness of this model for chronic conditions. This model of care is also very useful in the context of high-income countries where physician availability is not a major impediment to healthcare, but associated costs are unsustainable in the long term. Using a task-sharing model of care (perhaps with the use of technology) will ensure that individuals get high-quality, evidence-based care wherever they are located on the globe.

What is your professional background?

I trained as a physician from Christian Medical College, Ludhiana in India and did a Masters in Public Health from Sree Chitra Tirunal Institute for Medical Sciences and Technology in Kerala, India. I then went on to do doctoral studies based at The George Institute at the University of Sydney.

What values of The George Institute do you appreciate the most and why?

I appreciate the mission of The George Institute to improve the health of people worldwide through high-quality, ethical research. Being such a young organisation, having The George Institute as one of the top 10 for scientific impact is a true testament to the dedication and talent of the staff working here.

Why do you enjoy working at The George Institute?

There are so many reasons why I enjoy working at The George Institute. I like knowing that my work has an impact of the health of communities. The ability and commitment to conduct large-scale research across the globe which has an impact on the health of millions of individuals is important to me. I appreciate the daily interaction with colleagues which is truly inspiring.

A person I admire is…my mum.

To unwind at the end of the day, I…read books with my children.

A saying I live by is…I don’t live by sayings!

One day I hope to…see my research being translated into policy and people getting affordable, effective and good quality healthcare.

My first job was…as a research assistant at The Centre for Chronic Disease Control in New Delhi, India.