As a young child in Kenya, Rachel Ogumbo, Pharm D, MBS, BCPS, experienced family members dying in hospital waiting rooms because they could not pay for care. That early experience fueled her passion to address health inequities and led her to her current role as pharmacy team lead for the Academic Model Providing Access to Health (AMPATH) Consortium and her selection as a 2024-25 Fogarty LAUNCH Fellow.
“I intend to use the training I receive in health equity research to emphasize building sensible community-based strategies that improve quality access to healthcare for underserved populations,” said Dr. Ogumbo, who lives full time with her family in Eldoret, Kenya, and works with Kenya colleagues to guide pharmacy clinical care and education.
Her Fogarty Fellow project is “Translating research into practice by utilizing the STRiDE risk prediction tool to screen for Gestational Diabetes in a community-based pregnancy peer group in Western Kenya.” Gestational diabetes is a type of diabetes that develops during pregnancy when the body doesn’t produce enough insulin, the hormone that helps to control blood sugar.
“Globally, gestational diabetes is a growing concern responsible for 17% of maternal and newborn complications including pre-eclampsia, hemorrhage, infection and still birth,” said Dr. Ogumbo. “Ninety percent of these outcomes are experienced in low- and middle-income countries because most women don’t have access to early screening and treatment.”
Women who experience gestational diabetes and their offspring are also both at higher risk for developing diabetes in the future which contributes to the growing burden of noncommunicable diseases.
An oral glucose tolerance test is the standard of care for pregnant women in high-income settings, though estimates suggest that 25-70% of women at high risk for gestational diabetes are not screened including many in underserved communities such as non-Hispanic Blacks and Native Americans.
The limited availability and cost of this test make it inaccessible to most women in low- and middle-income countries such as Kenya. “To improve availability of gestational diabetes screening, innovative approaches are needed,” said Dr. Ogumbo. “The Stratification of Risk of Diabetes in Early Pregnancy (STRiDE) risk prediction tool offers a unique method to ascertain risk and the need for additional testing.”
Based on a study of more than 7,000 women from Kenya and India, the STRiDE tool uses a common blood test for Type 2 diabetes called HbA1c and other factors such as age, body mass index, family history, gestational age, past pregnancy and blood pressure to estimate a woman’s likelihood of screening positive for gestational diabetes. Women who are at highest risk can then be referred to a healthcare facility for the longer and more definitive oral glucose tolerance test as well as any needed care.
Dr. Ogumbo’s Fogarty project will utilize the network of AMPATH’s community-based peer groups for pregnant women called “Chamas for Change” to assess the feasibility and acceptability of the STRiDE tool from providers, community health workers and participants’ perspectives. “We will recruit 100 Chama group participants, three community health volunteers and two clinicians to provide more convenient screening during their group meetings. Providing screening during these meetings will make it more accessible and convenient for women who rarely engage with formal healthcare systems. We will also conduct interviews to determine the barriers and facilitators for its use,” said Dr. Ogumbo
The Northern Pacific Global Health Leadership, Education and Development for Early-Career Researchers (NPGH LEADERs) Program is a 12-month mentored clinical research training sponsored by the National Institutes of Health’s Fogarty International Center in partnership with several NIH Institutes and Offices. Fellows represent academic institutions from the U.S. including Indiana University, as well as 31 partner institutions, including AMPATH partner Moi University, in nine low and middle-income countries.
Dr. Ogumbo’s Fogarty LAUNCH fellowship included a week of onsite research training at the National Institutes of Health in Washington, DC, and ongoing virtual research training throughout the fellowship year. Speakers at the training included Dr. Anthony Fauci and past Fogarty Center Director Dr. Francis Collins.
At the training, Dr. Collins said, “You are part of an amazing program that is going to populate the world with people like you who have this insight in terms of how global health research can make life better for people in all countries. Going forward, we need you more than ever. When I served as NIH director and went to visit in various countries, especially in Africa, I would always run into former Fogarty Fellows. They were always telling me how that experience had changed their lives and targeted them in a particular direction. So, this is a powerful program.”
Another key component of the Fogarty Fellowship is guidance provided by the fellow’s mentorship team including experts from both the host institution and U.S. institutions. Dr. Ogumbo’s mentor team includes:
- James Akiruga, MBCh.B,MMed--department chair of family medicine, community health and medical education at Moi University College of Health Sciences and lead physician in community group-based care
- Laura Ruhl, MD, MPH--assistant professor of clinical medicine at Indiana University, past AMPATH field director and the principal investigator for the Chama for Change program
- Sonak Pastakia, PharmD, MPH, PhD, BCPS, FCCP—professor at Purdue University College of Pharmacy, co-chair of AMPATH’s chronic disease management team, and co-investigator for the STRiDE GDM study
- Violet Naanyu, PhD, MSc, MA--associate professor in the School of Arts and Social Sciences at Moi University and lead of the AMPATH qualitative research core
- Tina Tran, PharmD-- assistant professor of health outcomes at Temple University School of Pharmacy and a former Fogarty Fellow
“Dr. Ogumbo’s proposed study will impact the communities in a positive way by increasing gestational diabetes screening uptake,” said Dr. Akiruga. “Hopefully this will influence equitable resource allocation for screening services within this community that has several competing healthcare needs.”
Dr. Ruhl, who was part of the team that developed Chamas for Change community groups in 2011, added, “We have integrated vaccine and family planning delivery and screening for hypertension and diabetes into the Chamas groups over time. Dr. Ogumbo’s proposal for screening and diagnosing gestational diabetes within our group model will naturally layer into our services, improve access to care and improve overall outcomes for women experiencing gestational diabetes in pregnancy.”
“Dr. Ogumbo’s passion to help create opportunities for her fellow Kenyans, especially women, is infused in everything she does,” said Dr. Pastakia. “She has a firsthand understanding of the challenges they face and the immense talent and potential they possess that frequently goes untapped. It is these intangible qualities that make her the exact type of leader that the field of global health desperately needs to carry us forward.”
Applications for the 2025-26 cohort of Fogarty LAUNCH Fellows are currently open and the deadline to apply is September 13.
Interested IU students or post-doctoral trainees in the health professions can contact IU contact principal investigator Dr. Dibyadyuti Datta and NPGH Program Coordinator Bridget DeMouy for more information.
