Pivot Works
Pivot Works
Program Type
SURGH
Organization Name
Internship Location
Boston/Cambridge, MA
Organization
Pivot was created in 2014 to establish a model system of healthcare based on the integration of science and service delivery at a district level. Pivot works in a rural region of southeastern Madagascar in partnership with the Ministry of Public Health. The organization’s strategic objectives include:
• Strengthen pillars of the health system at all levels of care
• Improve quality of services across medical programs and clinical specialties
• Integrate social protection to ensure equitable access to care
• Advance partnerships to scale impact
• Strengthen organizational capacity to aid in replication and sustain growth
• Revolutionize global health science to rapidly generate a new kind of evidence base
Harvard Medical School has been a partner of Pivot since the NGO’s founding and faculty at the Medical School lead Pivot’s research activities. The multidisciplinary research agenda includes impact evaluation, health systems research, epidemiology and disease surveillance, and community health analytics.
Position Overview
In 2014, prior to the start of clinical activities, Pivot—in partnership with Harvard Medical School and the Madagascar National Institute of Statistics—collected baseline data from 1600 households across the Ifanadiana District as part of the IHOPE cohort. Follow-up surveys occurred in 2016, 2018, 2021, and 2023.
In 2023, Pivot conducted a new baseline survey, the Vatovavy Regional Household Survey (VRHS), collecting data from 4800 households across three districts. Together, the IHOPE and VRHS datasets contain detailed information on the health and well-being of a population-representative sample.
Pivot has also developed a patient registration database through CommCare, with more than 500,000 patient encounters documenting healthcare access, illness, and health system reach.
The intern will conduct secondary analysis of available data to answer a research question aligned with program priorities.
Project Details
The final project will be defined with the student based on their interest and organizational needs. Example questions include:
What demographic characteristics are associated with zero-dose immunization?
What is the health status of older adults in the population, and how does care-seeking differ by age group?
Among children under five, does previous household report of acute malnutrition predict current malnutrition?
Child and adolescent health: What is the health status of children aged 5–14? What factors are associated with early first pregnancy among women under 18?
How does health system reach vary across districts? What are the characteristics of repeat health system users compared with the general population?
To answer one of these questions, the intern will analyze an existing dataset. Preliminary findings will be shared with Pivot teams for feedback and refinement.
Intern Responsibilities
• Complete all necessary training for compliance with Harvard IRB requirements (CITI online training)
• Conduct secondary analyses: clean and prepare data using R or Stata; analyze using appropriate methods; develop data visualizations (graphs, maps); prepare presentation or report
• Present findings to Pivot clinical and monitoring and evaluation teams and incorporate feedback
• Attend weekly Pivot research team meetings
• Read scientific articles to contextualize findings
Qualifications
Essential skills: Familiarity with data analysis and statistics; experience analyzing data in R, SAS, or Stata; experience reading scientific literature
Preferred skills: Interest in maternal and child health; basic French; experience developing presentations
Learning Outcomes
• Analysis of real-world health systems utilization and impact data
• Data visualization to convey key points
• Presentation of results to multidisciplinary audiences
• Familiarity with health systems strengthening in partnership with government in a low-income country
Nature of Internship
Data Analysis
Keywords
Health equity, health systems strengthening
Additional Onboarding for Selected Intern(s)
Research—CITI training will be required and the student will be added to an IRB.
Work Environment
Hybrid. Most Pivot staff are based in Madagascar. Other staff work remote/in-person at Harvard Medical School (641 Huntington Ave.). Intern will work in Boston, at least two days per week in person.