I still remember the fear, almost paralysis, I felt at the start of my career advancing health equity whenever I diagnosed a patient with tuberculosis or HIV.

I knew what medications I should prescribe, but I was stationed in a remote cluster of villages in Colombia, and my clinic didn’t always receive a steady supply of medicines. We sometimes ran out in the middle of a patient’s treatment cycle. Even if we had the medicines, many patients could not make the arduous, hours-long trek upriver to the clinic every time they were due for refills or follow-up. Such interruptions in their treatment regimen put their health at grave risk.

I soon came to realize that these issues required a systemic response. I wanted to be part of that solution, pivoting my career to advancing health equity. I shifted my focus from clinical care to public health, earning an MPH at Harvard Chan School in 2006.

Since then, my career advancing health equity has taken many wonderful turns, as I have worked to expand access to high-quality care. Here are three lessons I’ve learned along the way.

Tip #1 From a Career Advancing Health Equity

Listen carefully to the communities you serve. This was a key takeaway from a maternal health project I collaborated on in rural Guatemala with various partners during my career advancing health equity.

To reduce deaths from postpartum hemorrhage, health officials hoped to bring women living in remote areas to well-equipped hospitals to give birth. After speaking with Indigenous women in the target villages, however, we realized that such a strategy would not succeed. These women had a strong tradition of giving birth at home, supported by friends and family. We recognized the value in honoring their Indigenous tradition and understood we were unlikely to change the course of their birthing journeys.

So we rethought the approach. Rather than bring women into hospitals, we focused on improving training for the midwives who attended home births in rural villages.

Many of these midwives lacked formal education, so there was tension between them and the medical establishment. They didn’t often work together. But we found the midwives keen to learn new skills and eager to help reduce maternal mortality. By listening to the community we sought to serve and respecting their voices, we were successful in saving lives, accomplishing the career goal of advancing health equity.

Read the full article about advancing health equity by Shirley Sylvester at Harvard T.H. Chan School of Public Health.