NanaEfua Afoh-Manin, MD, MPH, MPA

2023-2024

Chief Medical & innovation Officer, Shared Harvest Foundation, Los Angeles, CA; Senior Researcher, Health Inequality Lab Malcolm Wiener Center for Social Policy, Harvard Kennedy School, Cambridge, MA

NanaEfua (Nana) Afoh-Manin, MD, MPH, is an impassioned and mission-driven leader, emergency physician and innovator dedicated to advancing health equity and social justice through public policy, technology, and philanthropy. She earned her degrees from esteemed institutions, including a medical degree from the University of Rochester School of Medicine and a Master of Public Health from Columbia Mailman School, reflecting her steadfast commitment to multidisciplinary approaches in addressing complex societal challenges.

As a recent graduate at the Harvard Kennedy School of Public Policy, Dr. Afoh-Manin not only achieved academic excellence in management, leadership, and decision science, but also demonstrated exceptional leadership as the President of the Student Government. In this capacity, she spearheaded initiatives fostering courageous discourse and pioneered the convergence of business acumen with philanthropic endeavors to drive meaningful societal impact.

Her clinical research portfolio encompasses critical areas such as workforce financial well-being, burnout mitigation, and navigating the intricate grand technological challenges posed by emerging AI in emergency care. Dr. Afoh-Manin's overarching ambition is to influence federal policy, particularly in reforming loan forgiveness programs for healthcare professionals and bridging the intergenerational wealth gap, thereby empowering minority and first-generation clinicians and scholars.

Prior to her sabbatical to delve into health policy studies, Dr. Afoh-Manin served as the founding member and Chief Medical & Innovation Officer at Shared Harvest. This pioneering social enterprise and nonprofit organization tackled pressing social determinants of health crises such as burnout and educational debt while playing a pivotal role in emergency response efforts during the Covid-19 pandemic, rendering aid to over 10,000 Angelenos. Her innovative civic-tech contributions earned her investments from the Google for Startup (GFS) Black Founders Fund, underlining her impactful endeavors in community development by working closely with dozens of community clinics and nonprofit organizations to build human resource capacity. Additionally, she acquired residency with esteemed tech accelerators such as the Los Angeles CleanTech Founders Business Accelerator, UCLA Techquity, and PlugIn South LA, further showcasing her dedication to innovation and social impact. She believes strengthening the workforce and alleviating debt is a fundamental component of achieving equity and economic mobility.

Dr. Afoh-Manin's commitment to community welfare extends beyond her professional roles; she has actively contributed to various task forces and was a recipient of community service awards. Notable recognitions include the Service Award from the National Medical Association, the President’s Service Award from the Association of Black Psychologists, and a nomination for LA Sparks Women of the Year. Furthermore, her initiatives have received grants from esteemed foundations such as the California Wellness Foundation, the Weingart Foundation, the Direct Relief Fund for Health Equity, the Annenberg Foundation, HRSA, and the California Department of Public Health.

Merging her academic and creative prowess, in 2021, Dr. Nana co-produced "I Am Not Your Hero," a documentary short film and educational core curriculum with Oscar Gold recognized director, Kellie Kali, that addresses structural racism, mental health, and suicide in medicine. She teaches this curriculum to medical students as a Clinical Instructor at Charles Drew Medical School and the University of California, Riverside.  Dr. Afoh-Manin's current initiative, Project #RESUS - short for resuscitating the hope in medical education pathways - chronicles the people's lived experiences through a collection of articles, poems, and case studies on BIPOC physician well-being that she hopes will become part of national medical training and help to inform health policy.

Dr. Afoh-Manin hopes to grow her business acumen at the junction of government, tech and philanthropy.  She is open to opportunities in national government or international humanitarian foundations. Beyond her professional pursuits, Dr. Afoh-Manin finds fulfillment as a devoted soccer mom and traveling background dancer, embodying a holistic approach to life that encompasses family, creativity, and community service. Her journey exemplifies the transformative potential of empathy-driven servant leadership and the profound impact of interdisciplinary collaboration in creating lasting improvements in society.

Evaluate the Impact of Loan Repayment Programs (LRP) on Burnout, Financial Wellbeing and the Retention of Physicians and Dentists serving in medically underserved regions of the US

Objectives:

  1. Study how medical student debt affects burnout, financial wellbeing, and physician retention.
  2. Evaluate the 5-year impact of the CalHealthCares LRP on Med-Cal patient care access and physician retention in medically underserved regions of California.
  3. Examine the link between medical student debt, financial insecurity, and wellbeing among healthcare professionals to better understand “burnout”.

Background:

The impending exodus of healthcare professionals, as predicted by the Surgeon General report (2022), threatens equitable access to quality medical care, particularly in medically underserved areas where doctor shortages are noted. Federal and State Loan Repayment Programs (LRPs) aim to mitigate financial strain and bolster workforce durability in these areas. One such program, the CalHealthCares LRP initiated by Physicians for Healthy California (PHC) in 2018, targets the recruitment and retention of physicians and dentists working in medically underserved regions of California and aims to improve access to care for Medi-Cal patients. However, research on the efficacy of LRPs in achieving recruitment and retention goals is scarce. Additionally, the evolving understanding of burnout, exacerbated by the COVID-19 pandemic, necessitates accurate assessment tools to examine its association with medical student debt and financial insecurity. Federal budget allocations to improve the US health system, most recently as Department of Health and Human Services' $2.7 billion Healthcare Workforce Initiative (2023), underscores the need to align policy initiatives with effective programs and workforce needs.

Methods: 

This practicum body of work proposes three-part staged research:

  1. 1. In Stage 1, we analyzed four major Loan Repayment Programs in California, and we conducted a financial wellbeing survey among a convenient sampling of 25 physicians and dentists, exploring the correlation between burnout, financial wellbeing and medical student debt.
  2. In Stage 2, we plan to conduct focus group interviews with 20 CalHealthCares LRP participants to assess the program's strengths and weaknesses and the perceived financial wellbeing of the cohort using Stanford Wellbeing Survey.
  3. In Stage 3 we plan to conduct a five-year impact evaluation of CalHealthCares LRP.

Results:

The development of the financial wellbeing instrument will help to align state and federal program aims of retention with the needs of physicians and dentists enrolled in federally funded LRPs. The CalHealthCares LRP cost and impact analysis will provide critical information to policymakers on how

effective the program is in achieving its aims and its return on investment to comparable programs.

Recommendations:

  1. Funding from the Department of Health and Human Services (HHS) to support this study and the development and distribution of an updated financial wellbeing instrument.
  2. A broader cost analysis of the Public Service Loan Forgiveness (PSLF) and National Health Service Corps (NHSC) federal programs base on study findings.
  3. Five-year appropriations to state and local programs that show outperformance of federal programs in the recruitment and retention of physician and dental workforce.

Preceptors:

Kimberlyn Leary, PhD,MPA, Deborah Hughes-Hallatt MA, Marcella Alsan, MD PhD