Dr. Karamchedu:

No matter where you are in the world, the one thing that ties healthcare across countries and cultures is that people come to you at the most vulnerable moments of their lives, and healthcare systems aim to provide the best care within the constraints of their resources.

The systems themselves are widely different in the parts of the world I had the privilege to live in. Sweden has predominantly publicly funded healthcare, Singapore has a highly subsidized public healthcare model and on the other end of the spectrum is the US with a mostly privatized healthcare system. India sits somewhere in the middle with both public and private healthcare offerings.

Each of the systems has its advantages and pitfalls and seeing them up close makes you realize that there is rarely a single correct way to solve a healthcare problem. At their core, the problems they are trying to solve are very similar, with access to care, prevention strategies, improving health literacy and adapting to rapidly changing lifestyles and technologies at their core.

What it made me realize is that healthcare challenges are not isolated national issues but more shared global problems that require collaboration. This was made very clear during the COVID-19 pandemic. If we took time to learn from different systems around the world we would probably find better solutions for our problems back home.

Dr. Karamchedu:

Global health organizations occupy a unique place in healthcare because they have to step into the realities of the communities they serve. That means they not only have to look at a problem from a clinical perspective but also with the mindset of an anthropologist, a public health specialist and sometimes even a diplomat.

Solutions cannot be purely top down as they often are in traditional healthcare structures. They need to be bottom up, rooted in and aligned with a community’s cultural beliefs, social structures and constraints. In the case of sleep health interventions, this includes their daily routines. If these are not factored in, even the most well-intentioned interventions may fail. Something that works well in one setting may not translate easily into another.

This is something we try to put into practice in our work at Sleep Doodles. The biological need for sleep is universal, but a society’s relationship to sleep is shaped by culture, work demands, social expectations, climate and importantly structural barriers to accessing a good night’s rest, such as poverty, lack of safe, stable housing, noise, air or light pollution, and even discrimination.

When we design our workshops and other educational resources, we are very mindful of the audience we are trying to reach. Even within low-resource settings, not all challenges and forms of suffering are homogenous. Different groups within the same community often face very different barriers. In addition to tailoring solutions to each group’s circumstances and needs, we also make an effort to understand where their questions and concerns lie before designing our sessions.

For in person sessions, we try to understand the demographic of the attending audience, review sleep patterns collected over a period of time before the session and identify the main concerns participants have about their sleep. When creating educational material such as picture books, posters, or infographics, we focus on making the information accessible and the solutions implementable regardless of resources.

Ultimately, the most effective global health interventions are found at the intersection of scientific evidence and local insight. Listening carefully to the communities you are designing for takes priority if we want to create lasting impact.