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Mak Researcher Designs “COVID Alphabet” for Awareness and Behavioral Change

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By Joseph Odoi

With the increasingly worrying situation of the novel coronavirus and its devastating global effect, Makerere University has once again taken an institutional lead by designing a behavioral change communication model to support government efforts in fighting against the pandemic. The COVID Alphabet (A-Z of COVID in Uganda) was developed by Dr. Gloria Seruwagi, a lecturer at Makerere University’s College of Humanities and Social Sciences (CHUSS) and School of Public Health (MakSPH).

While briefing journalists during the model’s unveiling at Makerere University on February 17th, 2021,  Dr. Seruwagi shared that she got the inspiration to design the simple and relatable evidence-based product after conducting a series of COVID-19 studies in different communities including the REFLECT study in humanitarian contexts and ALERTs study in different informal settlements within Kampala.

“If somebody wants to know what the key issues are about COVID-19 in Uganda, they can look at this Alphabet and have it all at a glance, without having to go through the long process of reading a 4 or 15-page document. This is not just an alphabet for learning phonetics or numbers. It is a Know, Think and Act (KTA) tool packed with nuggets of information” Dr. Seruwagi emphasized.  

The COVID Alphabet is not only easy on the eye and deliberately simple but is also factual and anchored in research. It should resonate with anyone at any level – from the busy policymaker or program manager to someone outside Uganda in need of quick facts.

 The Alphabet also speaks to today’s virtual workplace teams, community leaders, and any person on the street or at home. It contains critical study findings compressed into a quick and concise summary of the COVID trajectory, experiences, and outcomes. It also gives key pointers on key population groups, sectors, mitigation strategies, and action points for different stakeholders.

The Alphabet begins by stating that Awareness of COVID-19 is high but Adherence extremely low. It then flags up the increasingly urgent need for effective Behavioral change messages now more than ever, even more than knowledge-only messages.  Community transmissions are on the rise; as is prevention complacency while Deaths, infection and recovery from COVID-19 remain shrouded in mystery.

Uganda continues to face another battle of the serious infodemic challenge with myths, falsehoods and risky perceptions being plenty. Enforcement fatigue has become more pronounced with relaxation of some restrictions and unfortunately Fatigue from the enforcement side is coinciding with high community transmission. The Alphabet acknowledges the important role and success registered by Government-led approaches; however, it shows that these more community support and leadership.

Hand washing is listed as a more feasible prevention measure compared to sanitizing, social distancing, wearing masks and staying at home. This is in harmony with research carried out by other studies which showed that hand washing was the most adhered to guideline at the peak of COVID-19 as most households had hand washing points. 

Dr. Seruwagi says adds that Infection control has largely been well managed at public places and offices compared to communities. And while the model recognizes that mass distribution of Masks did not reach everybody; mask use among those who have is low, inconsistent and improper.

Dr. Seruwagi unveiling the COVID Alphabet

This also alludes to study findings which found a lot of negative face mask practices including chin-masking, sharing masks, wearing ill-fitting masks, keeping them in pockets and back or not having a mask at all.  Moving forward, Seruwagi advises the government to not only give out masks but revitalize enforcement of SOPs, reminding people of the dangers and health risks posed by the pandemic.

Norms and culture are both drivers and barriers to compliance. This alphabet statement agrees with research findings which show that the practice of hand washing with soap was much higher in Muslim communities because it’s in tandem with their beliefs and socio-cultural practices. The model also highlights the need to Optimally leverage existing community structures, systems and resources for compliance.

Since the outbreak of COVID-19, Psychosocial and mental health challenges that have taken on new and more complex forms. And while the need for social networks and connections is very important, Dr Seruwagi also recommends that Quiet spaces and isolation should be championed as positive and potentially productive.

This is in line with trying to get the community avoid unnecessary movement and avoid or behave responsibly while in public gatherings. It will enable communities to not feel punitively restricted but rather appreciate the protective effect of measures such as curfews.

In terms of Reproductive health, the Alphabet shows that services are severely constrained and products very scarce, inaccessible or expensive. Related to this is that the pandemic has worsened SRH outcomes, especially among adolescents and youth since the advent of the pandemic.

Teenage pregnancies and transactional sex by children and youth have increased; calling for parents, teachers, leaders and other stakeholders to act. ‘’If we are saying that there is a lot of teenage pregnancies and transactional sex by adolescents, what should teachers do, what are parents doing to protect their children?” she remarked in a call for action.

Dr. Seruwagi’s landmark model then turns to the country’s globally lauded success in refugee-hosting. It highlights the Uganda’s porous borders and high refugee population, noting that this comes with daily interaction across borders and some of this interaction risky with potential for disease transmission and other risks beyond health for example security risks.

The model shows that Violence of various forms increased during COVID-19; and everyone was affected including men and children. In some of the studies conducted, Violence against Men (VAM) is emerging as a key theme but the Ugandan culture largely operates in a culture of silence and there are not enough or effective services addressing male survivors of violence – most interventions have focused more on women. Moreover, child protection systems were rendered more fragile by the pandemic.

All these services and intervention points need strengthening. The Willingness and resourcefulness of community leaders needs to be harnessed and effectively utilized. And Dr Seruwagi says that the timing is a good one in terms of policy implementation, with the recent launch of the Community Engagement Strategy where VHTs, community leaders and other local structures are critically positioned to make a significant contribution if well-resourced and supported. It mentions Xanic and resilient approaches for COVID-19 while also highlight children, adolescents and Youth as a severely-affected but largely “invisible” group during Uganda’s the first wave.

Finally, the model recognizes the role of technology like Zoom meetings and while it acknowledges that virtual spaces are the ‘new normal’, Dr Seruwagi calls for a thorough and ongoing review on their safety and impact on productivity or team cohesion. “For example, the people delivering essential services needed during these difficult COVID times might, themselves, be in serious need of mental health and psychosocial support or specific workplace provisions,” she said.

Dr. Seruwagi implored leaders, teachers, parents, civil society organizations, policymakers and all health stakeholders to pick an action point from each Alphabet letter to implement if COVID-19 is to be countered.   “As a country we already crossed a line where infections were managed at facility level. With the current community spread, let’s reflect on this COVID Alphabet and let each person pick at least one action point”. She called upon senior policymakers and BCC specialists to take up the model as guiding tool to support the national response.

The COVID Alphabet is the first of its kind in Africa and has attracted media attention with different people describing it as factual, precise, simple and easy to understand.

Article originally published on MakSPH

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METS Newsletter May 2024

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The newly appointed CDC Uganda Country Director, Dr. Adetinuke Mary Boyd (7th from left) met with country implementing partner Executive Directors to get insights on ongoing projects, discussed leveraging of partnerships as well as strategizing for how best to strengthen health systems. Infectious Diseases Institute (IDI)-McKinnell Knowledge Centre, Makerere University, Kampala Uganda, East Africa.

The Monitoring and Evaluation Technical Support (METS) Program is a 5-year CDC-supported collaboration of Makerere University School of Public Health (MakSPH), the University of California San Francisco (UCSF) and Health Information Systems Program (HISP Uganda).

Highlights of the METS May 2024 Newsletter

  • Enhancing Response to Sexual and Gender-Based Violence
    • Responding to and preventing Sexual and Gender-Based Violence (SGBV) and Violence Against Children (VAC) are critical components of Uganda’s national HIV prevention program. METS developed a new app designed to improve support for SGBV survivors. This followed an assessment in December 2022, that revealed gaps in service access and coordination in Fort Portal and Kampala Regions.
    • The METS team, in collaboration with regional implementing partners, is scaling up the app’s use in pilot districts such as Masaka, Kiryandongo, Fort Portal, and Mubende. The team visited facilities and police stations to install the app and train selected focal persons on its use.
  • Assessing Readiness for Integrated HIV and NCD Care Services
    • METS supported the Ministry of Health to conduct a site readiness assessment for integrated delivery of HIV and Non-Communicable Diseases (NCD) services from 22nd to 26th April 2024, in collaboration with the US Centers for Disease Control and Prevention (CDC), and various implementing partners. The activity was conducted in selected health facilities in Acholi, Mubende, Kayunga, and Rwenzori regions to determine their feasibility for participating in a comprehensive NCD evaluation.
    • The 48 facilities visited have already integrated NCD services (mental Health, diabetes, and hypertension). Of these, 78% have integrated mental health services in their PMTCT clinics. 40% of the facilities have a dedicated NCD services physicians /doctor in the ART Clinic, 29% have doc have dedicated physicians in the PMTCT clinics. 90%. Most of the facilities have clinical and nurses in the ART than PMTCT facilities but more nurses offering NCD services in PMTCT sites.
  • Digitalizing the health sector through strategic partnerships
    • In collaboration with CDC and METS, the MoH organized a national Electronic Medical Records (EMR) stakeholders meeting to orient stakeholders on the national EMR agenda and transition towards a comprehensive digital health facility package. Key actions discussed included expanding the rollout of the EMR and Community Health Information System (eCHIS) and urging development partners to support prioritized health information and digital health investments.
    • The introduction of electronic medical records (EMRs) in health facilities aims to improve the quality of health service delivery by providing real-time accountability transparency, and traceability of medical supplies, monitoring health worker absenteeism, enhancing patient satisfaction through efficient care provision, reducing unnecessary or duplicate diagnostic tests, and offering easy access to management reports for decision-making. Additionally, EMRs will lay the foundation for the implementation of national health insurance.
  • UgandaEMR+ Implementation Showcased at Kisenyi HCIV
    • METS and Reach Out Mbuya (ROM) showcased the implementation of UgandaEMR+ to representatives from the USG and the Ministry of Health (MoH) at Kisenyi HCIV. The visit was aimed at providing a clear understanding of the system’s functionality at the health facility, which serves over 1,200 outpatients daily and supports over 1600 clients on ART.
    • Dr. Peter Akonyera, the ART Clinic In Charge shared positive end-user experiences, noting simplified data use and analysis, efficient data retrieval, and the system’s popularity among users despite existing challenges. He appreciated METS’ support in maintaining system synchronization. The data visualization tools have been particularly useful for clinicians to manage patient schedules and workload distribution effectively, ensuring timely and efficient healthcare delivery.
  • METS Showcases Research at INTEREST 2024 Conference in Benin
    • The International Conference on HIV Treatment, Pathogenesis, and Prevention Research (INTEREST) brought together global scientists to share cutting-edge knowledge in HIV diagnosis, treatment, and prevention. The conference also aimed to build a community of African physicians and scientists to develop local solutions for managing HIV and preventing its transmission.
    • METS submitted an abstract titled “Enhancing HIV Case Identification through a National HIV Testing Services (HTS) Continuous Quality Improvement” based on support to the Ministry of Health (MoH) in designing, implementing, and evaluating initiatives to increase the identification of HIV-positive clients, crucial for achieving the global target of 95% of people living with HIV (PLHIV) knowing their status.
  • Gallery
    • New CDC Director meets Country implementing partner Executive Directors
    • UgandaEMR+ support supervision at Kisenyi HCIV visit
    • EMR Stakeholders meeting
    • CBS guidelines meeting
    • INTEREST 2024 conference – Benin
    • Key Populations assessment – Ishaka district

View on METS

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SIMCS-Trial Vacancy Announcement: Twenty-Five (25) Research Assistants

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

Makerere University College of Health Sciences School of Medicine in collaboration with Baylor College of Medicine received funding from US National Institutes of Health – Fogarty International Center to carry out a study on “Development and evaluation of an information management and communication system for population-wide point of-care infant sickle cell disease screening (SIMCS-Trial)”. The program seeks to recruit 25 research assistants at its study sites. 

Roles and responsibilities  

  • Identify and screen participants for possible enrolment into the study according to the Study Protocol.
  • Obtain informed consent from caregivers of eligible participants as per protocol accordance with GCP and HSP principles.
  • Counsel and explain study procedures to the caregivers of study participants using the mobile app.
  • Enrol eligible participants into the study to meet the study accrual targets.
  • Complete study CRFs, correctly and accurately in compliance with trial procedures/ SOPs and GCP standards.
  • Ensure study participants’ safety and privacy, data integrity and confidentiality.
  • Participate in collection of appropriate study samples/specimens from the participants as per protocol and SOPs as well as performing the test.
  • Carry out any other duties as assigned by superiors in line with your work.

Required Qualification and experience 

  • A degree in any health-related discipline, and registered with the relevant national bodies.
  • Knowledge and familiarity with Microsoft word, Excel, PowerPoint and Access as well as basic internet applications 
  • Skills in using common relevant computer packages and mobile technology for data collection
  • Previous work in a research environment is added advantage.
  • Basic knowledge of clinical research regulatory procedures. 
  • Good Clinical Practice (GCP) training and Research Ethics training skills and knowledge
  • Excellent command of English (written and oral) as well as the local languages (Luganda or Lusoga)
  • Excellent interpersonal skills to develop relationships with participants.
  • Experience of living and or working both in urban and rural environment.
  • Team-working skills to work effectively as part of a multidisciplinary healthcare team 
  • Time management skills and ability to handle multiple tasks simultaneously.
  • Highly organized, detail-oriented and self-motivated/driven. 
  • Ability to handle multiple tasks simultaneously. 
  • Ability to professionally communicate in writing, verbally or other means deemed appropriate. 

Reports to: The SIMCS Co-Investigator/SIMCS Trial Coordinator 

Expected start date: July 2024

How to apply: 1-page type written application letter addressed to the Principal Investigator SIMCS Trial MakCHS SOM together with current CV, copies of academic certificates, and recommendation letters from two past employers should be e-mailed as ONE PDF DOCUMENT to makimpact22@gmail.com

Deadline for receiving applications: Friday 20th June 2024 at 5:00 pm

Only shortlisted candidates will be invited to the interview. 

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CTCA Call for Proposals: Enhance Tobacco Control Institutional Capacity in Africa

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Call for Proposals - Project Title: Enhance Tobacco Control Institutional Capacity in Africa; Grant #339. Deadline 30th June 2024, by 5pm EAT. The Centre for Tobacco Control in Africa (CTCA), School of Public Health, College of Health Sciences (CHS), Makerere University, Kampala Uganda, East Africa.

Project Title: Enhance Tobacco Control Institutional Capacity in Africa; Grant #339

Introduction:

The Centre for Tobacco Control in Africa (CTCA) received funding from the African Capacity Building Foundation (ACBF) for the 2024-2026 to implement a project on institutional capacity. The project investments are geared towards sustaining human resource capacity and knowledge generation to reduce use of all forms of tobacco products in Africa. Specifically, the project aims to:

  1. Enhance training opportunities for African governments and relevant actors in tobacco control in
    the continent
  2. Increase access to knowledge for guiding tobacco use prevention and control in Africa
  3. Reinforce the institutional development of CTCA for an optimal performance of its functions
    and processes.

In 2020, CTCA developed a Tobacco Control Research Agenda (TCRA) with the aim of providing a guide for generating local evidence to drive tobacco control policy formulation and implementation in Africa.

Therefore, CTCA with support from ACBF is seeking researchers across the African continent to be awarded 6 small grants of USD 5000 to implement research that aligns with the TCRA thematic areas below:

  1. Patterns and trends of tobacco use and exposure for all tobacco products including the new
    products at country and regional levels (sex, age, region, types of products, new products).
  2. Effects of tobacco use and exposure on sustainable development (poverty, education, culture, food security, environment, HIV, TB, reproductive health, NCDs).
  3. Tobacco use and populations at risk (youth, young adults, women/gender, elderly, residents
    of urban areas, miltary, prisoners, mental health patients, populations in low socio-economic
    dwellings like slums).
  4. Tobacco control policy research and analysis (smoke free, TAPS, GHWs, ceasation) of cost
    effectiveness, impact, drivers, enablers, innovation, challenges, communication and advocacy
    for tobacco control.
  5. Sociocultural context of tobacco use
  6. Tobacco industry and tobacco control policy
  7. Tobacco production, alternative livelihoods and environment (distribution, value chain,
    environmental impact, historical and determinants of tobacco production)
  8. The economics of tobacco and tobacco control (product, pricing, illicit tobacco trade,
    taxation)

The full research Agenda can be accessed in English and in French.

Submissions

We are pleased to invite submissions from researchers based in Africa. Successful proposals should align with any of the 8 thematic areas of the CTCA Research Agenda. Innovative proposals that address critical issues and contribute to evidence-based policy and practice in the respective areas to inform Tobacco control in Africa are particularly encouraged.

Requirements

These grants will fund work that relates to the CTCA Research Agenda. Activities will include
proposal development, data collection and analysis, report writing and dissemination. All research to be implemented will be approved by the institutional review board and published in peer reviewed journals. These grants are intended for; 1) Researchers based in Tobacco Control Programs/Response; 2) post graduate students who would like to complete their research projects aligned to this call and 3) early and middle career researchers. It is required that this research is executed, and the report completed within 12 months. The applicant should have a mentor in an established institution.

Eligibility

Eligibility is restricted to Africa-based researchers. This refers to individuals who are (a) currently studying at a university or research institute in Africa, and/or b) currently working within a university, research institute, or in tobacco control in Africa. All persons associated with tobacco industry will not be funded and therefore should not apply. Successful applicants will be required to sign a declaration of interest that they do not have any relationship with tobacco industry.

Evaluation criteria

Proposals will be reviewed by a group of experts and researchers. Projects will be assessed against six, equally weighted evaluation criteria:

  • Knowledge contribution in respect to policy, strategy, and evidence to answer local
    challenges:
    Does the study articulate the research gap? Does study make a significant
    contribution toward advancing knowledge in the tobacco control field? Does it answer
    new questions or introduce novel methods, measures, or tobacco control interventions? Is
    it aligned to the WHO FCTC and tobacco control local context requirements? Does the
    study add to the existing body of research?
  • Policy relevance: Will results from the research have generalizable implications? How,
    if at all, will the “lessons learned” have relevance beyond the study? Will the study
    outcomes influence decisions in tobacco control?
  • Technical design: Do the methods appropriately answer the objectives and the questions
    outlined in the proposal? Is the proposed study feasible in one year?
  • Project viability: Are there any other logistical or political obstacles that might threaten
    the completion of the study, for example, government authorization or Human Subjects
    review, civil strife, social cultural sensitivity?
  • Value of research: Is the cost of the study commensurate with the value of expected
    contributions to policy? Are the planned activities justified and coherent?
  • Ethics: Reviewers will consider whether there are any risks of harm to research
    participants, what the proposed risk mitigation strategies are, and how the possible
    benefits of the research compare to the possible harms.

Application Process

Apply HERE not later than 30th June 2024, by 5pm EAT. Applicants are required to provide a
recommendation/support letter from their supervisors or heads of department.

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