Editor’s note: This is the first in an ongoing series of interviews we’ve planned for the students graduating from the CHOICE Institute where we’ll get their thoughts on their grad school and dissertation experiences.
This first interview is with Elisabeth Vodicka, who defended her dissertation, “Cervical Cancer in Low-Income Settings: Costs and Cost-Effectiveness of Screening and Treatment,” on January 24th, 2018.
- What’s your dissertation about?
My dissertation focused on the economics of integrating cervical cancer screening and treatment into existing health systems in East Africa (Kenya and Uganda). Although cervical cancer is preventable and treatable if detected early, screening rates are low in the region (3-20% depending on regional characteristics). One strategy for improving access to potentially life-saving screening is to leverage the fact that women engage with various health systems platforms for other types of care, like for family planning, taking their children in for vaccinations, tuberculosis and HIV-treatment, etc. Since these programs are already funded and staffed, screening could be offered to women in these settings via service integration for potentially low marginal costs.
To understand the economic impact of offering cervical cancer screening and treatment to women when and where they are already engaging with the health system, I conducted costing, cost-effectiveness and budget impact analyses of integrating screening into two health care settings. First, I collected primary data and conducted a micro-costing analysis to determine direct medical, non-medical and indirect costs associated with integrating screening services into an HIV-treatment center in Kenya. For my subsequent aims, I conducted economic evaluations evaluating the potential value created in terms of cost per life year saved and budget impact to the Ministry of Health of integrating screening and treatment into HIV-treatment centers in Kenya and routine childhood immunization clinics in Uganda.
- How did you arrive at that topic? When did you know that this is what you wanted to study?
I have long been passionate about women’s health issues and improving access to care in low-resource settings. During my second year in the program, I was offered an opportunity through the University of Washington’s Treatment, Research, and Expert Education program to conduct a micro-costing study to identify the costs associated with providing cervical cancer screening to women attending receiving HIV treatment at Coptic Hope Center for Infectious Diseases in Nairobi, Kenya. This opportunity presented a perfect overlap of my interests in women’s health, access, and health economics methods. After conducting the primary data collection, I began exploring the possibility to continue this line of research through my dissertation.
- What was your daily schedule like when you were working on your dissertation?
To be honest, I can’t say that I had a daily schedule that was consistent over the years of working on my dissertation. While I developed my short and long proposals, I was still in classes, working as an RA, and doing consulting work on the side. These commitments often dictated the time I had to focus on preparing my dissertation proposals, which I often worked on late at night. Once I passed my general exam, my time was much more flexible. I tend to be most productive at night, so took advantage of time flexibility to make the most of my productive hours. Often this meant exercising and taking care of other tasks during the day and then leveraging my peak brain time to work on my dissertation in the evenings.
Additionally, creating regular social opportunities and accountability for my dissertation progress were key success strategies for me. My cohort and I created a dissertation writing group that met weekly to create accountability. Toward the final months of the dissertation (crunch time!), I joined a co-working space, used an online co-working app, and recruited friends and family to work together virtually and in-person to maximize accountability and meet my goals for each dissertation aim.
- If you are willing to share, in what quarter did you submit your final short proposal and in what quarter did you graduate/defend? What were some factors that determined your dissertation timeline?
I submitted my short proposal in Fall Quarter 2015, and I defended in Winter Quarter 2018. Together, my chair and I developed a timeline that mapped out each stage of the dissertation process from the short proposal to final defense.
- How did you fund your dissertation?
Ongoing funding was received through work as an RA and TA. The TREE program generously supported my in-country work in Kenya. I also received additional financial and travel support through internal funding within CHOICE (e.g., Reducing Barriers for the Ambitious Fund, Rubenstein Endowment, etc.).
- What comes next for you? What have you learned about finding work after school?
Currently, I am continuing to work as a freelance consultant on projects related to expanding access to care in low- and middle-income settings. This allows me the time and flexibility to target my employment search within groups that are an excellent fit – both organizationally and culturally – for my research interests and professional goals.
In terms of finding employment after school, the most important lesson that I have learned is to start early and network broadly. During my first year in the program, I set a goal to reach out to one new person in the field every month working on topics or in organizations that interested me. Over time and many networking coffees later, I learned about the types of organizations that might be a good fit for my interests, work style and personality, and developed positive relationships with other like-minded individuals.
Incremental Thoughts 