Margaret Kruk, MD, focuses her research on health system effectiveness and population preferences for healthcare in sub-Saharan Africa. Dr. Kruk is particularly interested in the application of new methods, such as discrete choice experiments and systems dynamic modeling, in studying the interactions between health systems and populations in low-income countries. She works with governments and academic colleagues in several African countries, including Tanzania, Ethiopia, Liberia, and Ghana. She has published on women?s preferences for maternal health care, policy options for human resource shortages, health care financing, and evaluation of large-scale health programs in low-income countries. Prior to coming to Columbia, Dr. Kruk was an assistant professor in Health Management and Policy at the University of Michigan School of Public Health and policy advisor for Health at the Millennium Project, an advisory body to the UN Secretary-General on the Millennium Development Goals. She has also practiced family and emergency medicine in northern Ontario, Canada.
Education & Training:
MPH, Harvard University, 2000
MD, McMaster University, 1994
Selected Global Activities:
Preferences for rural job postings among medical students in Ghana
This project is part of a larger grant funded by the Bill and Melinda Gates Foundation to build an evidence-based roadmap for academic-government collaborative interventions that will strengthen the training of health workers in Ghana. My team fielded a computer-based survey on motivation for rural practice and a discrete choice experiment of preferences for incentive packages among graduating physicians, nurses, and public health workers at Ghana?s two public universities.
Preferences for health services and performance of the health system in post-conflict Liberia
Working with Liberian Ministry of Health and University of Liberia colleagues, we surveyed the population of Nimba country, Liberia regarding perceptions of the role of health care in promoting stability and government legitimacy. The survey employed a discrete choice experiment to measure individuals? preferences for structure and process of primary health care.
Preferences for health services and barriers to utilization of health care in Kigoma Region, Tanzania
We assessed preferences for health services using a discrete choice experiment and reasons for non-utilization of health facilities for childbirth and acute medical/surgical conditions in Kigoma Region, western Tanzania. The second phase, using facility data, is following on the results of the discrete choice experiment to assess the effect of quality improvements on utilization of health centers. This work will inform the policy discussion on the relative importance of demand-side and supply-side factors in improving access to essential health services.
Kruk, ME, Johnson JC, Gyakobo M, Agyei-Baffour P, Asabir K, Kotha SR, Kwansah J, Nakua E, Snow RC, Dzodzomenyo M. "Rural practice preferences among medical students in Ghana: a discrete choice experiment." Bulletin of the World Health Organization in press 2010
Kruk ME, Porignon D, Rockers P, Van Lerberghe W "The contribution of primary care to health and health systems in low- and middle-income countries: a critical review of country experiments." Social Science and Medicine epub 2010
Kruk ME, Wladis A, Mbembati N, Ndao-Brumblay SK, Hsia R, Galukande M, Luboga S, Matovu A, de Miranda H, Ozgediz D, Qui?ones AR, Rockers PC, von Schreeb J, Vaz F, Debas HT, Macfarlane SB. "Human resource and funding constraints for essential surgery in district hospitals in Africa" PLoS Medicine 2010
Kruk ME, Prescott MR, de Pinho H, Galea S "Equity and the child health Millennium Development Goal: the role of pro-poor health policies" Journal of Epidemiology and Community Health 2010
Kruk ME, Freedman LP, Anglin GA, Waldman RJ "Rebuilding health systems to improve health and promote statebuilding in post-conflict countries: a theoretical framework and research agenda" Social Science and Medicine 70 89-97 2010
Kruk ME, Paczkowski MM, Tegegn A, Tessema F, Hadley C, Asefa M, Galea S "Women?s preferences for obstetric care in rural Ethiopia: a population-based discrete choice experiment in a region with low rates of facility delivery" Journal of Epidemiology and Community Health 2009
Kruk ME, Goldmann E, Galea S "Borrowing and selling to pay for health care in low- and middle-income countries" Health Affairs 28 1056-66 2009
Kruk ME, Paczkowski M, Mbaruku G, de Pinho H, Galea S "Women?s preferences for place of delivery in rural Tanzania. a population-based discrete choice experiment" American Journal of Public Health 99 1666-72 2009
Mbaruku G, Msambichaka B, Galea S, Rockers PC, Kruk ME "Dissatisfaction with traditional birth attendants in rural Tanzania" International Journal of Gynaecology and Obstetrics 107 8-11 2009
Kruk ME, Freedman LP "Assessing health system performance in developing countries: a review of the literature" Health Policy 85 263-276 2008