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Enhancing Capacity of Community Health Workers to Prevent and Control NCDs in Wakiso District

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By Filimin Niyongabo, Grace Biyinzika Lubega and Joviah Gonza, MakSPH

Non-Communicable Diseases (NCDs) have increasingly become common in not only developed but also developing countries. Over time, there has been an increasing burden of NCDs in Uganda and these have been related to a number of risk factors, some of which include physical inactivity, unhealthy diet, tobacco and alcohol use among others. Common NCDs in Ugandan communities today include cardiovascular diseases, diabetes, cancer and others.

In order to enhance the capacity of communities to prevent and control NCDs, Makerere University School of Public Health (MakSPH) in partnership with Nottingham Trent University, Wakiso District Local Government and the Ministry of Health, with support from the Global Challenges Research Fund (GCRF) as part of the NTU QR GCRF allocations 2019/20, trained 620 community health workers (CHWs), who are commonly known as Village Health Teams (VHTs), on NCDs. The training emphasized distinguishing between communicable and non-communicable diseases, as well as causes, risk factors, prevention and control of NCDs. The training also included sharing of past experiences regarding common NCDs, pre and post assessment exercises, and a certificate awarding ceremony. VHTs trained included those from Busiro South health sub-district (Bussi and Zzinga Islands, Kasanje Town council, Kajjansi Town Council, and Katabi Town Council), and Entebbe Municipality.

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ENABLING Project Social Scientist Positions: (1) Team Lead (3) Research Associates

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An elevated shot of the School of Biomedical Sciences Building, College of Health Sciences (CHS), Makerere University. Kampala Uganda, East Africa

Makerere University College of Health Sciences-MAKCHS- Centre of Excellence in Women’s Health in collaboration with Makerere University-Johns Hopkins University (MU-JHU) Care Limited received funding from Bill and Melinda Gates Foundation; Enabling Platforms for Maternal Immunization: Uganda (ENABLING Project). The Project aims to identify, characterize, and support the delivery platform, policy, and preparedness requirements for introducing new maternal vaccines. The Project seeks to recruit suitable candidates for the following positions;

Social Scientist, Team Lead (01)

Social Scientist Research Associate (03)

Duty Station: Kampala

Engagement: Full Time 

All applications must be submitted to the email: enablingproject71@gmail.com before Monday, 29th July 2024 at 23:59hrs EAT

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Call for Abstracts: Makerere Bioethics Conference 2024

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Call For Abstracts: Makerere Bioethics Conference (MakBC 2024), 11th - 12th November 2024. Deadline: 15th August 2024. Hotel Africana, Kampala Uganda, East Africa.

The Centre for Bioethics under Makerere University Biomedical Research Centre (MakBRC) is delighted to announce the MAKERERE BIOETHICS CONFERENCE (MakBC 2024), scheduled to take place on 11th and 12th November 2024 at Hotel Africana, Kampala, Uganda. This year’s theme is ‘Contemporary Issues in Bioethics Practice,‘ and we invite researchers, practitioners, and students to submit their abstracts for presentation.

Thematic Areas:

  • Emerging Technologies in Health
    • Genetics and Genomics
    • Assisted Reproductive Health
    • Drug and Vaccination Development
    • Nanotechnology
    • Robotic Surgery
  • Data Science
    • Artificial Intelligence and Machine Learning
    • Biotechnology
    • Big Data
    • Digital Health
  • Research Ethics
    • Research Ethics
    • Research Integrity
  • Clinical Ethics
  • Public Health Ethics

Important Dates:

Abstract Submission Deadline: 15th August 2024

Registration Deadline: 16th September 2024

Submission and Registration:

Abstract Submission: Click here to Submit your Abstract

Online Registration: Click here to Register for the Conference

For more information contact Conference Secretariat:

Department of Anatomy, 
Last Floor, School of Biomedical Sciences
Makerere University College of Health Sciences, 
P.O Box 7072 Kampala, Uganda. 
Email: makbioethicsconference@gmail.com     
Website: https://chs.mak.ac.ug/makbc2024 
Tel: +256 782 363 996 or +256 772 246 681

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Mak Researchers Partner with Safe Bangle Technologies to Roll out a Real-Time Domestic Violence Reporting Bracelet

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A Woman putting on the Real-Time Domestic Violence Reporting Bracelet. Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda, Safe Bangle Technologies roll out of a real-time domestic violence reporting bracelet. Kampala Uganda, East Africa.

By Joseph Odoi

A Consortium of Researchers from Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda together with Safe Bangle Technologies have rolled out a real time domestic violence reporting bracelet.

    This roll out was made possible with support from the United States Agency for International Development (USAID) under the PARTNERSHIPS FOR ENHANCED ENGAGEMENT IN RESEARCH (PEER) program and the National Academies of Sciences.

    Dr. Juliet Kiguli, the Principal Investigator from Makerere University, along with Dr. Roy Mayega, Deputy Chief of Party at RAN, and Dr. Agnes Nyabigambo, the study coordinator, initiated the PEER program to identify entry points for testing SafeBangle Technologies (a social enterprise based at Resilient Africa Network (RAN) with a mission to create a safer and more secure environment for women and children through innovative, affordable, and creative technology solutions to curb GBV in Africa.) wearable safety bracelet in the informal settlements. This decision stemmed from findings of increased intimate partner violence (IPV) and gender-based violence (GBV) in three informal settlements in Kampala, Uganda, following a longitudinal study, geospatial mapping, and interviews. The project, titled ‘The Impact of the COVID-19 Pandemic on Gender-Based Violence among Women and Girls in Informal Settlements in Kampala,’ highlighted the urgent need for affordable and immediate reporting mechanisms for violence.”

    ‘’While carrying out a study after the Covid-19 Pandemic, we identified gaps when it comes to reporting and response to Gender Based Violence (GBV) among women in informal settlements. Therefore, we used incorporated the SafeBangle intervention to solve the problem of lack of affordable and immediate reporting mechanisms for violence using a bracelet that reports violence in real time’’ explained Dr. Kiguli.

    Innovation details

    According to Saul Kabali and Messach Luminsa, the innovators behind SafeBangle from SafeBangle Technologies, hosted at the Resilient African Network Lab. ‘’The inspiration behind SafeBangle came from a deeply personal place. ‘’We heard countless stories of women who couldn’t call for help during moments of danger. We were deeply affected by the story of Aisha, a young woman in a rural village who was attacked while walking home alone at night. With no way to call for help, she felt helpless and vulnerable. This incident made us realize the critical need for immediate reporting alert tools, accessible to women like Aisha. We knew technology could play a crucial role and this incident awakened a strong desire in us to create a solution’’

    Saul Kabali, Executive Director and Chief Operations Lead at SafeBangle Technologies explaining how the bracelet works at 2023 Imara Girls Festival exhibition. Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda, Safe Bangle Technologies roll out of a real-time domestic violence reporting bracelet. Kampala Uganda, East Africa.
    Saul Kabali, Executive Director and Chief Operations Lead at SafeBangle Technologies explaining how the bracelet works at 2023 Imara Girls Festival exhibition.

    “While developing SafeBangle, we tested with the users in both rural and urban contexts. We piloted the innovation around Kampala with support from Digital Human Righs Lab and Naguru Youth Health Network as well as it in five districts of Karamoja region with support from Save the Children and Response Innovation Lab. Right now it has become handy in Kamapala‘s informal settlements. We envision a future where SafeBangle becomes a standard tool in the fight against GBV, ensuring every woman feels safe and secure as it has the potential to transform how we respond to GBV in Africa” added Kabali.

    HOW THE SAFEBANGLE TECHNOLOGY WORKS

    The SafeBangle is wearable technology similar to a smartwatch that sends an alarm by SMS to people chosen by a woman herself if she feels threatened.

    How the SafeBangle Real-time Domestic Violence Reporting Bracelet works.  Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda, Safe Bangle Technologies roll out of a real-time domestic violence reporting bracelet. Kampala Uganda, East Africa.
    How the SafeBangle Real-time Domestic Violence Reporting Bracelet works.

    In terms of the acceptability of the SafeBangle innovation as a solution to GBV among at-risk women in informal settlements Of the 72 adolescent girls and women who received the SafeBangle, 22 activated the reporting button, resulting in 19 receiving immediate and appropriate support, including counseling, police intervention, and health services.

    All adolescent girls and women who experienced GBV received a phone call from Somero Uganda to discuss the most appropriate intervention, including counseling, police cases being handled by the probation office, referral for health services, and post-exposure prophylaxis. All the GBV survivors received support and are still receiving continuous follow-up.

    Researchers conducted a survey among 644 girls and women in Kinawataka (Nakawa Division) and Bwaise (Kawempe Division) to gain insights into awareness and understanding of sexual and gender-based violence among adolescent girls and women in informal settlements. The survey measured socioeconomic factors, mental health symptoms, and exposure to GBV. Focus group interviews were conducted with a separate sample of women over 18 in the settlements to explore responses to GBV.

    Preliminary impact of SafeBangle on tracked survivors.  Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda, Safe Bangle Technologies roll out of a real-time domestic violence reporting bracelet. Kampala Uganda, East Africa.
    Preliminary impact of SafeBangle on tracked survivors.

    A tabular representation of the key findings and lessons learned from your study on gender-based violence (GBV)

    Key FindingsLessons learned
    Prevalence of GBV.
    – Overall prevalence: 34.1% of women and girls reported experiencing GBV.
    – Among adolescents (15-19 years): Over 50% reported experiencing GBV.
    – The pandemic highlighted the need for accessible and comprehensive support services for GBV survivors.
    – Schools emerged as crucial safe spaces for girls, emphasizing their well-being during crises.
    – Economic independence proved crucial, enabling women to leave abusive environments.
    – Involving men and boys as allies in GBV prevention efforts is essential.
    Age-related trends– GBV prevalence tends to decrease with increasing age.
    Physical and health consequences.– Women and girls suffered physical violence, injuries, and deaths, primarily from domestic violence and unsafe abortions due to limited healthcare access.
    – GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS.
    Social and economic impact. .– GBV contributed to family breakups, strained marriages due to financial stress.
    – Economic hardships forced some women and girls into transactional sex, exposing them to further health risks and exploitation.
    – Pandemic-related job losses and economic constraints increased financial dependence on abusers, trapping women in violent situations.
    – School closures and increased household responsibilities limited women’s job opportunities and subjected them to sexual harassment.
    Psychological effects– Survivors experienced guilt, shame, anxiety, fear, and suicidal thoughts due to ongoing abuse.
    Long-term effects– Post-COVID-19, survivors faced disrupted education, early marriages, pregnancies, social stigma, and persistent mental health issues.
    A tabular representation of the key findings and lessons learned from your study on gender-based violence (GBV)

    Reproductive Health Consequences: GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS.

    Family Breakdown: The rise in GBV led to family breakups as women fled abusive relationships. Marriages were strained due to increased financial stress.

    Transactional Sex for Survival: Desperate for basic needs due to job losses and economic hardship, some women and girls resorted to transactional sex, exposing them to further health risks and exploitation.

    One study participant stated, “The time of COVID-19 was so terrible for some of us. We in fact got a lot of diseases from it because you would want to get food and didn’t have money. That way you would be forced to get a man who would use you and pay.” – (FGD_Girls_19–24years_Kinawataka).

    Economic Effects: COVID-19 restrictions caused job losses and limited economic opportunities, particularly for women in the informal sector. This increased financial dependence on abusers and trapped women in violent situations.

    Limited Access to Employment: School closures and increased household chores limited women’s ability to seek employment, perpetuating gender inequality in the workforce. Some faced sexual harassment from potential employers.

    Psychological Effects: Survivors of GBV experienced guilt, shame, anxiety, fear, and even suicidal thoughts due to the constant threat and unpredictability of abuse.

    Post-COVID Effects: GBV survivors faced long-term consequences, including disrupted education, early marriage, early pregnancy, social stigma, and persistent mental health issues.

    Lessons learned

    The pandemic highlighted the need for accessible and comprehensive support services for survivors of GBV, the significance of schools as safe spaces for girls, and the need to prioritize their well-being during crises. Economic empowerment emerged as a significant protective factor for women and girls. Those with greater economic independence were better equipped to leave abusive environments and secure their safety and well-being, while dependent ones suffered abuses. Engaging men and boys as allies in the fight against GBV and involving them in prevention efforts can help promote positive behavior change and foster more equitable relationships.

    Recommendations

    To address GBV against women and girls, the researchers recommend the following moving forward;

    1. There is need to integrate technology-driven solutions like SafeBangle into national GBV prevention and response strategies. SafeBangle can be a valuable tool for policymakers as cases of violence that would have gone unreported will be brought to light and the would-be victims will be able to get immediate help from trusted relatives and friends.
    2. Provide economic opportunities and vocational training for women and girls to enhance their financial independence and reduce vulnerability to violence. There is therefore a need to introduce education and training programs that empower women and girls, by providing them with skills, resources, and opportunities to start their own ventures and to participate fully in community affairs.
    3. Strengthen and enforce existing laws and policies related to GBV, including laws against domestic violence, child marriage, and sexual assault without discrimination be it for law enforcers, leaders, and employers where such cases were suffocated. Ensure that perpetrators are held accountable through swift and fair legal processes that have no room for corruption.
    4. Establish and promote effective, accessible, and confidential reporting mechanisms for GBV incidents that provide confidence and can be trusted by survivors to enhance reporting of such incidences of GBV. Community Engagement and Involvement: Involve community leaders, religious leaders, and elders in discussions about GBV to promote gender equality, change social norms, and reinforce the message that violence against women and girls is unacceptable.
    5. Launch extensive public awareness campaigns to challenge harmful gender norms, report cases of GBV, raise awareness about the consequences of GBV, and promote positive behaviors and attitudes towards women and girls.
    6. Implement comprehensive sexuality education in schools and communities, educating young people about healthy relationships, consent, and reproductive rights to be able to make informed decisions about their own lives and well-being.
    7. Engage men and boys as allies in the fight against GBV, encouraging them to challenge harmful masculinity norms and behaviors. This will help minimize GBV because mostly they are the perpetrators. Strengthening Support for Survivors: Provide ongoing support and follow-up services for survivors of GBV mostly counselling services to aid their recovery and facilitate their reintegration into society.
    8. Provide ongoing support and follow-up services for survivors of GBV, mostly counseling services to aid their recovery and facilitate their reintegration into society.
    9. Provide avenues to seek free or subsidized services by survivors of GBV medical services and legal processes by survivors of GBV to enhance reporting of GBV cases, access to medical care, counseling, legal support, and other essential services.
    10. Encourage and support more research and innovations like SafeBangle to curb incidents of GBV.
    11. A comprehensive and inclusive approach is required. The efforts should involve government institutions, civil society organizations, community leaders, and individuals working together to address the root causes and provide support to survivors.
    12. Involve media in GBV prevention activities and for enhancing campaigns against GBV mostly on radio and TV.

    MORE ABOUT THE STUDY

    The core project team, included researchers at Makerere University School of Public Health (MakSPH), Medical College of Wisconsin (MCW) led by Prof.  Julia Dickson-Gomez, SafeBangle Technologies, and Somero Uganda, a community-focused NGO, began the project by designing their research protocol and taking a CITI Program course on human subjects social/behavioral research. Team members also met with the Ministry of Gender, Labour, and Social Development (MGLSG) in support of the gender-based violence policy process, Ministry of Health and local government. They also established relationships with the Kampala Capital City Authority (KCCA) and Nakawa and Kawempe probation offices to support legal processes for the GBV survivors. SafeBangle Team also received an award from Defenders Protection Initiative.

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