As part of the SPRINGS project, PhD researcher Frederike Kooiman is exploring how climate change affects the risk of diarrhoeal diseases in young children and what we can do to mitigate it. We sat down with her to discuss about her PhD and to hear about her recent fieldwork in Ghana, where she spent time developing study tools, connecting with health care workers, and understanding the everyday realities that shape health in the region.
What is your PhD research about in a nutshell?
I’m studying how climate change influences diarrhoeal disease caused by four specific pathogens, and what interventions could reduce this impact. To do that, I’m reviewing existing studies and later analysing data collected directly from the field, specifically in the SPRINGS case study site in Ghana.
You recently spent time in Ghana for fieldwork. What was the focus of your visit?
The main goal was to develop the Case Report Forms (CRFs), the questionnaires we’ll use in SPRINGS to gather data for the diarrhoeal surveillance study.
This study will follow children under five who arrive at one of four selected health facilities with diarrhoea over a two-year period. We’ll collect stool samples, survey their caregivers about risk factors like drinking water, sanitation, and animal contact, and also gather water samples from various local sources. These will help us explore how water quality and even weather patterns maybe linked to diarrhoea cases.
But before any of that can happen, the tools need to be right. I wanted to make sure the questions were locally relevant, that the design was logistically feasible, and that we weren’t missing any important risk factors specific to the area.
What was the process like, gathering input for the forms?
I started by building on insights from our SPRINGS Consortium Meeting, where researchers and stakeholders shared context-specific knowledge. That helped shape the first version of the forms.
Then, I travelled to Akuse and surrounding communities to visit all four health facilities involved in the study. I met with nurses and public health officers who will play a key role in data collection, and asked for their input. I brought printed versions of the CRFs and asked about feasibility, missing questions, and whether the options made sense locally.
We also talked logistics: how many children they typically see with diarrhoea, and whether they had access to tools we’ll need for the study, like MUAC tape (for measuring malnutrition) or reliable refrigeration for sample storage.
Beyond developing the forms, were there any experiences during your visit that really stayed with you?
One afternoon, I travelled to Kasunya, about 30 minutes from Akuse, to stay the night with a nurse who had invited me to her home. Spending time with her and her colleagues, chatting as they prepared fufu and light soup outside the clinic, helped me seethe rhythm of their daily work and the challenges they face.
For instance, in some rural health posts, there’s no fridge, which makes storing vaccines and stool samples very complicated.Sometimes they borrow a neighbour’s fridge. Nurses also face difficult choices, like paying out-of-pocket for a child’s treatment when a family can’t afford it. These stories grounded the research in reality for me. They showed how committed these healthcare workers are, and how deeply connected they are to their communities.
What insight shave stuck with you so far?
Beyond the logistical hurdles, I was struck by how well-trusted the nurses are in their communities. That kind of trust could really help our research, as it makes people more willing to participate. It reminded me that good data doesn’t just depend on forms and protocols, it depends on relationships.
How does your work feed into the bigger SPRINGS picture?
The data we collect in Ghana will serve several parts of SPRINGS and other working groups within the consortium. For example:
- It helps identify the key risk factors for diarrhoea, which can inform better health interventions.
- It supports environmental modelling, like understanding how pathogens move through water systems.
- It contributes to economic analysis, like calculating the cost of treating diarrhoea.
- And it strengthens global datasets on diarrhoeal disease by feeding into the PlanEO platform.
That’s why it is important to design the data collection forms in a way that ensures all necessary information is gathered effectively for others to be able to use it.
What’s next for you?
I’ve now digitised the CRFs so they can be used on smartphones or tablets. The next step is to pilot the forms, make sure they’re not too time-consuming, and make any final tweaks. Once we get ethical approval and complete the nurse training, data collection in Ghana can begin.