Fulbrighters in focus: Chad Stecher

Arizona State University's College of Health Solutions Associate Professor Chad Stecher has been conducting research in Uganda since graduate school with the goal of improving HIV health outcomes in Sub-Saharan Africa.

Stecher hopes to reach this goal by developing a more accessible and informative database of electronic health records for staff and researchers at Mildmay Uganda, a hospital in Kampala. His time there not only expanded the reach of his research but also gave him a firsthand perspective on how global partnerships can strengthen public health solutions.

Now, as a Fulbright Scholar, Stecher is advancing that work by applying his expertise as a health economist on an international scale.

His idea began to take shape after connecting with ASU faculty who have completed a Fulbright, adding to ASU’s standing as a top producer for Fulbright Student and Scholar Programs.

In the following Q&A, Stecher reflects on his Fulbright experience and what he learned working alongside health providers in Uganda.

Question: What led you to become a Fulbright Scholar?

Answer: I am a health economist, and I do research both in the U.S. and abroad. I have been working in Uganda for over 10 years, and this Fulbright project was born out of my research experiences at Mildmay Uganda.

I've always wanted to work and live abroad, so the Fulbright program has been on my radar since I joined ASU. The specific Fulbright project idea was sparked during a trip to Uganda for an existing research project at Mildmay Uganda. A Fulbright was the ideal grant to support the creation of an analytical dataset of electronic health records because that work requires being in-country for an extended period of time.

Q: What are your research interests?

A: My research interests include health behavior change, physician behavior and health care systems reform. Most of my research has focused on healthy habits and thinking about how to build interventions that can lead to behavior maintenance. This research agenda is what initially brought me to Uganda to study HIV medication habits. I'm also interested in broader economic development questions, and I've worked on a few projects in other East African countries that provide resources to help small businesses or families generate income.

Another area of my research focuses on physician behavior. This is a research topic we plan to explore using the datasets created during my Fulbright project. Specifically we want to understand how Mildmay physicians make treatment choices for their patients. This research agenda is one that I've done mostly here in the U.S., looking at either physician treatment biases or the ways in which physicians learn from their peers.

Q: What research did you conduct in Uganda?

A: Most of my research at Mildmay Uganda has been on the design and testing of behavioral interventions to promote HIV medication adherence habits. HIV is largely a treatable disease, and the risk of transmission goes to zero if you're adherent to your medication. So, getting people living with HIV engaged in HIV care and adherent to their medication is one important strategy for reducing the HIV epidemic in Uganda and elsewhere.

While I was in Uganda completing this research, we started working with Mildmay’s electronic health records. This is data that Mildmay has been collecting for over 10 years, but to date, they have not had the local capacity or bandwidth to analyze these records. Our idea was for me to go back to Mildmay (as a Fulbright Scholar) and start to clean the data by merging files and tables, and ultimately constructing analytical datasets that either internal researchers or external collaborators could use to answer research questions. The ultimate goal was for these analytical datasets to enable local researchers to write their own papers and grants, which would help build a more sustainable research enterprise at Mildmay.

Q: What did you hope to accomplish professionally during your time abroad?

A: My goal with the Fulbright project was to build a resource that could support Mildmay’s research program, and so, personally, I was not imagining a lot of immediate benefit. Professionally, I was hoping to build my research network in Uganda in order to generate new and impactful ideas and future research agendas. I believe that effective problem-solving requires engaging with local researchers whose knowledge and perspectives are essential for identifying the right challenges and anticipating barriers to proposed solutions. These insights are difficult to capture remotely, but spending extended time in-country allows for building the trust and rapport necessary to generate ideas grounded in local realities.

Q: In what ways is the Fulbright scholarship helping you to achieve your research goals?

A: Two things really stand out. First, the relationships. Being in Uganda gave me the chance to meet researchers I never would have crossed paths with otherwise and to learn directly from them about how they tailor their work to fit the local context. Those conversations were invaluable and simply wouldn’t have happened if I’d been working remotely.

Second, the perspective. It’s one thing to read about HIV care and policy from the U.S., but it’s very different to see daily life and understand the economic, social and cultural challenges people face. That kind of firsthand perspective really changes how you think about interventions — not just what might work in theory, but what could actually be sustained in practice. I don’t pretend to fully understand Uganda’s many cultures and communities, but the experience definitely opened my eyes and has pushed my research in directions that I think can have both more immediate and more lasting impact.

Q: What advice would you give to current scholars considering pursuing a Fulbright scholarship?

A: Do it! Make sure you build a strong connection with your host and that your project really fits with their interests — that’s what makes an application stand out.

The advice I received that I would echo is: Be prepared to adapt and change your plans once you get to the country. That certainly was the case for me, and it seemed to frequently be the case for other scholars that I have talked to.

The project might not unfold exactly as you planned, but you may find there’s a real need for things like mentorship, teaching or help with writing papers — and those contributions can sometimes be even more immediately beneficial to your host and colleagues.