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Manjari Quintanar Solares: from the clinic to a life in public health

December 17, 2015 by Tracy Romoser and Manjari Quintanar Solares

For Manjari, striving to ensure babies have a healthy start is all in a day's work.

Mother holds an infant with health workers in the background.

“I’ve always been very interested in improving children’s health and quality of life. . . .that’s what drove me to pediatrics in the first place.”—Manjari Quintanar Solares. Photo: Courtesy of the David and Lucille Packard Foundation.

Editor’s note: Manjari Quintanar Solares is a program officer in the Devices and Tools Program and leads on projects related to the planning, introduction, and evaluation of health technologies and associated systems that go into developing country health delivery programs. PATH communications officer Tracy Romoser brings us this interview.

Q: As the technical advisor in PATH’s newborn health technology portfolio, you develop and advance innovations for newborns. Why is this work so important?

A: As a global community we’ve made big progress decreasing mortality in children under five, but there’s still much to be done in neonatal health. Babies are the beginning of people, and we need to do our best so that they have a healthy start.

Q: How has your work at PATH been influenced by your background as a practicing pediatrician in Mexico and as assistant director for the National Immunization Program at the National Center for Child and Adolescent Health, Ministry of Health in Mexico?

A: It has enriched my contributions at PATH. I come from a similar resource-constrained setting as the health care workers we design and develop technologies for, so I understand the challenges they face and I bring that perspective to my work. Like them, I sometimes had to improvise solutions from what I had at hand in the facility where I worked.

Baby lying in a nest of blankets in a large terracotta container.

“What originally brought me into clinical life later opened the door to my work in public health.”—Manjari Quintanar Solares. Photo: PATH/Mike Wang.

Managing child health programs at the ministry of health gave me a different perspective into health systems. It helped me understand the bottlenecks that affect program implementation and how decisions to incorporate new health interventions are made when funds are constrained.

For example, as a clinician there were times when a facility wouldn’t have all the doses of vaccines we needed at a given point. That meant telling a mother—who might have traveled far to get a vaccine for her baby—that she had to come back on a different day. While working in the national immunization program, I understood that sometimes the reasons for those delays often involved processes to guarantee vaccine effectiveness. This experience provided me with a bigger perspective.

“It excites me that I can use everything I’ve learned so far here at PATH. I keep learning and I keep putting it all to use.”

Q: How do you describe your work to people who aren’t familiar with your field?

A: I help develop and scale up devices, tools, and medications that save or improve babies’ lives. These technologies empower health workers in resource-constrained settings who have many responsibilities and see many, many patients every day. The devices and tools we develop make their work easier and more effective, and in this way we contribute in improving quality of patient care.

Q: What projects here at PATH are you especially excited about and why?

A: All of them! It’s all exciting work. For instance, sickle cell disease is a hereditary disease that affects many children in the developing world and leads to many serious complications. Because it is typically not diagnosed at birth in these settings, the children don’t receive the treatment and counseling they need on time and many die before their fifth birthday. We are currently landscaping point-of-care diagnostic tests that could be suitable for resource-constrained settings. We need to address this neglected disease to help health systems take care of these children. It’s expected the number of children who are affected will continue to increase as populations grow.

A group of neonatal resuscitation devices.

Compared to other lifesaving medical equipment, neonatal resuscitation devices are relatively simple: a mask that covers a baby’s nose and mouth is attached to a bag that pumps air when squeezed. Photo: PATH/Jillian Zemanek.

Q: Please tell us about your neonatal resuscitator work at PATH.

A: Birth asphyxia is one of the main causes of neonatal mortality, and neonatal resuscitation is an intervention that can help those babies breathe. My team and I work on several aspects of this intervention. We have conducted bench- and user-evaluations of new neonatal resuscitation designs such as the Upright resuscitator. We develop user-friendly tools to help ministries of health and other organizations quantify how much equipment they need for their facilities, and we provide them with the necessary information to make procurement of this equipment a more straightforward process. We have also facilitated the development of guidelines on how to reprocess (clean and disinfect) the neonatal resuscitation equipment in resource-constrained settings.

Q: What do you think will be important to focus on in the future?

A: As a global community, we need to continue striving to reduce inequity in people’s living conditions and in their access to high-quality health care. Many of the interventions that we know effectively reduce neonatal mortality take place in health facilities. We need to strengthen health systems and prioritize the needs of the health workers who are directly delivering these lifesaving interventions. We need to make sure that they have at hand effective devices, tools, diagnostics, and medications, that they know how to use them, and that they have enough supply of them. In this way, we will empower them to provide children with the best care possible. We will be doing our part to help those babies survive and thrive.