February 6, 2026
Global WACh Certificate Student Maggie Nickel supports efforts to improve birth outcomes in Kenya
Sexually transmitted infections (STIs) in pregnancy are associated with adverse birth outcomes, including preterm birth, low birth rate, infant mortality, and increased mother-to-child HIV transmission. The prevalence of STIs among pregnant women in East Africa remains high and is higher among women living with HIV. In Kenya, the standard-of-care (SOC) model only treats visible symptoms, leaving many pregnant women with asymptomatic infections left untreated or treated inappropriately. It is critical to focus on moving beyond SOC toward more precise diagnostic strategies to treat pregnant women accordingly and improve birth outcomes.
A collaborative study led by researchers from the School of Nursing, Department of Global Health, and Kenyatta National Hospital is evaluating perinatal outcomes using different models for STI testing, as well as the implementation and cost outcomes within routine antenatal care in Kenya. Known as the PrIMI study, it is comparing the SOC model with a universal testing strategy and an asymptomatic testing strategy.
During Fall Quarter 2025, Margaret (Maggie) Nickel, a second-year MPH student in the Department of Global Health and the Global WACh Certificate Program, joined the qualitative researchers of the PrIMI team to fulfill the Certificate’s 90-hour capstone requirement. The team included Tessa Concepcion (Global WACh) and Kenyan colleagues Eunita Akim, Benito Odhiambo, and Salphine Watoyi. Maggie’s role assisted with a study objective to interview research participants (pregnant women living with and without HIV receiving antenatal care) on their perceptions on acceptability, feasibility, appropriateness, and satisfaction of the STI testing methods.
The capstone’s hands-on learning component allowed Maggie to take leadership in study activities, fostering deeper understanding of global health research and the complexities of cross-cultural research as it applies to women, adolescent, and child health. Maggie developed qualitative training materials for Kenyan field staff, populated code in R (a software program widely used in data science) to randomize interview participants, aided in performing preliminary analysis of completed interview data, and participated in weekly study team calls.
Through the capstone experience, Maggie achieved several key learning outcomes related to research design, implementation, and program management. It deepened her understanding of the research lifecycle, data collection methodologies, as well as qualitative study design and research protocols as components of larger mixed-methods research frameworks. In addition, the capstone strengthened her capacity for adaptability in applied research settings, as changes in timelines and funding require flexibility and responsiveness during the research process.
Maggie looks forward to applying these learning outcomes towards her academic and professional development as she hopes to work in Maternal and Child Health (MCH) program or project management roles after graduating in June. She is seeking professional and mentorship connections in the MCH field as she begins the job search.
This capstone will be featured at the Global WACh Student Poster Symposium in Spring 2026. Please join us to learn more about her project along with projects by other graduating certificate students.