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Makerere University Hospital Embarks on Expansion, to add 10 ICU beds

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As Makerere University draws closer to marking 100 years, the institution’s Hospital has embarked on an expansion program to support Uganda’s critical care needs.

Construction projects are currently under way at the Bativa Road-based Makerere University Hospital to increase the hospital’s Emergency Department and ICU capacity.

The plan is to remodel the Doctors’ Residence/lower block of the University Hospital into a 10-bed ICU Unit at a cost of approximately Ugx400million.

Works have started with CK Associates, an Engineering firm in Uganda. Dr. Josephine Nabukenya, the then Acting Deputy Vice Chancellor (Finance and Administration) said Makerere University has a bigger dream for the health services and the university hospital in particular citing that there can be no other to do this than now due to the inspiration by the coronavirus pandemic.

“I am glad that we have come this far because we started dreaming three months ago but finally we are here. Indeed, the first costing when we came touring here with the actual users, the anesthetists, the money was supposed to be times two what Makerere was to offer, but because we were winding up the financial year and the University had no money, they said that we can work within the resources available and they tasked Estates and Works Department to go and see how best they could cut down as much as they could do,” said Dr. Nabukenya.

Dr. Nabukenya adds that the institution had engaged the Ministry of Finance, Planning and Economic Development to support the university to realize its dream of turning the hospital into a high-grade in provision of health services to the community.

The DVCFA (2nd R), Dr. Josaphat Byamugisha (3rd R), Mr. Paul Agaba (R), Estates and Works Officials and University Hospital Staff tour part of the Hospital under. refurbishment.
The DVCFA (2nd R), Dr. Josaphat Byamugisha (3rd R), Mr. Paul Agaba (R), Estates and Works Officials and University Hospital Staff tour part of the Hospital under refurbishment.

Critical care medicine is a medical specialty that deals with recoverable acute life-threatening conditions. It spans early detection of potentially life-threatening conditions, to life support and intense monitoring, up to end-of-life care.

Provision of intensive care services therefore requires adequate set-up of hospital systems designed to support the critically ill patient, furnished with adequate supplies and equipment in appropriately sized space and environment by appropriately trained staff.

Dr. Josaphat Byamugisha, the University Hospital Director contends that due to the high cost of care as dictated by the severity of illness, services such as critical care are scarce in low-income countries with countries like Uganda which has approximately one bed per a million people.

“In order to provide affordable high-quality services, majority of Intensive Care Units in high income countries exist within large teaching hospitals or university-affiliated hospitals. It is therefore important that Makerere University Hospital establishes itself as one of the hospitals in the country with cutting edge critical care provision in the region,” Professor Byamugisha discloses.

Dr. Byamugisha says the COVID-19 pandemic has left Makerere University staff, students and general population exposed due to inadequate ICU bed numbers to cater for the surge.

The DVCFA (L), Estates and Works Director Eng. Christina Kakeeto (2nd L), Eng. Ezra Sekadde (3rd L) and University Hospital Staff tour part of the Hospital under refurbishment.
The DVCFA (2nd L), Estates and Works Director Eng. Christina Kakeeto (3rd L), Eng. Ezra Sekadde (4th L) and University Hospital Staff tour part of the Hospital under refurbishment.

Dr. Byamugisha who is also an Associate Professor of Obstetrics & Gynecology further contends that complementary to emergency and operation theatre activities that will allow for more training sites nursing and postgraduate students at school of medicine in Intensive care, the ICU will promote and improve research and collaboration in the field of critical care with key international partners.

Makerere University has committed to the contractor half of the required funds required for the job. Prof. Nabukenya assured the contractor that the university management and government would increase this funding to complete the project.

“With reality, I am sure they (management) will appreciate more and we can see how best to squeeze from what we have. So, like how procurement advised, let us start, let us not be discouraged because we have half the resources. Let us start with what we have, and definitely as management when we come and see that half of the resources have done half the work and the other half is not completed, then definitely we have to step up,” Prof. Nabukenya said.

She urged the contractor to start the work and support the realization of Makerere University dream. “The dream is quite huge. For the sake of not just the Makerere Community, but it will actually support the Ministry of Health or I will say the entire country. So, I think it’s the whole reason why they felt they would help us with the equipment to equip the building when it is done. So, we do a good job in terms of the building, they will not have an excuse to equip. Let us start as we continue with the negotiations.”

Charles Kironde, Director CK Associates hailed Makerere University for awarding them another construction project- University Hospital.

Dr. Josaphat Byamugisha, the University Hospital Director (3rd L), Estates and Works Director Eng. Christina Kakeeto (2nd L) and other officials chat during the event.
Dr. Josaphat Byamugisha, the University Hospital Director (3rd L), Estates and Works Director Eng. Christina Kakeeto (2nd L) and other officials chat during the event.

“I would want to say as the director stated, this a very sensitive project, but much as Estates had stated that we had done dental school before, we have also handled some hospitals in our previous works outside the university for KCCA and MOH, so we have a bit of experience with hospital construction and ICU wards and theatres, in the last 3-5 years we have done so be assured that we will give you quality work to the specifications that you want. At least that is for starters,” said Kironde.

Makerere University Hospital, with its 43-year history deeply embedded in the memory of generations has served not only as a center for providing healthcare services but also as a center for training, research.

Since 1978,the hospital plays a significant role in the lives of students, staff and the surrounding areas. It is a successor of the first health post, Makerere University Students Health Service or sick bay at the current Makerere University police post.

In 1972, when Idi Amin expelled Asians, the university acquired the premises formerly known as Nile Nursing Home. The university Sick Bay relocated to the new premises. On February 16, 1978, President Idi Amin visited the Sick Bay and elevated it to a hospital status.

The university formally launched its centenary celebrations at an event on November 25, where University Vice Chancellor and the chairperson Mak@100 Organizing Committee, Professor Prof. Barnabas Nawangwe and Daniel Kidega respectively called on members of the Makerere University community to get involved with the major milestone.

Health

METS Newsletter March 2024

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A team documenting the background and other governance structure requirements in the EMR Implementation Guidelines during the stakeholder workshop held from 26th February to 1st March 2024. Makerere University School of Public Health (MakSPH), METS Program, 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 March 2024 Newsletter

  • Development of National Electronic Medical Records (EMR) Implementation Guidelines
    • To date, multiple Electronic Medical Records (EMR) systems have been rolled out to health facilities without implementation guidelines to inform the standard EMR process/clinical workflows within a typical health facility, minimum requirements for various EMRs to integrate and exchange patient information, insurance and billing workflows, human resources management, among others.
    • METS Program and USAID/SITES organized a five-day stakeholder workshop on 26th February to 1st March 2024, to develop and validate the EMR Implementation Guidelines for Uganda.
  • Improving the Quality of Voluntary Medical Male Circumcision
    • In February 2024, the METS Program, in collaboration with the Ministry of Health (MoH), Centers for Disease Control and Prevention (CDC), and Implementing Partners (IMs), conducted targeted onsite mentorship across 56 safe male circumcision sites in CDC-supported regions of Uganda.
    • Key findings highlighted the overall facility performance score of 78%, with 5 out of 8 thematic areas scoring above 80%. Notably, 99% of circumcised males had received Tetanus vaccines.
  • Innovation To Strengthen National Health Care Quality Improvement
    • The 10th National Health Care Quality Improvement (QI) conference brought together health service providers from various parts of the country to share experiences and what they are doing to improve service delivery to patients.
    • The Minister of Health, Hon. Dr. Jane Ruth Aceng, called for solutions that will provide answers especially in areas of governance and leadership, health workforce, information systems, service delivery, financing, special groups, and health products.
    • METS made a presentation on improved service delivery models focusing on empowering young women to stay HIV-free with the help of the Determined Resilient Empowered AIDS-free Mentored and Safe (DREAMS) initiative.
  • Gallery
    • Makerere University School of Public Health (MakSPH) launches state-of-the-art auditorium
    • Deploying latest EMR Version at Hoima RRH
    • Training of KCCA staff on use of Point of Care (POC) EMR
    • Stakeholder Workshop on Development of EMR Implementation Guidelines

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New Study Reveals Breastfeeding Mothers Embrace Nutrient-Rich Dish for Health Benefits

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Climbing beans on stakes in one of the gardens visited during the Efd-Mak Kabale District Sensitization in November 2021. Makerere University, Kampala Uganda, East Africa.

A study whose results were recently published in Food Science Nutrition, a peer-reviewed journal for rapid dissemination of research in all areas of food science and nutrition has revealed that there is a growing preference for wholesome meals, highlighting its numerous health benefits.

Titled; Lactating mothers’ perceptions and sensory acceptability of a provitamin A carotenoid–iron-rich composite dish prepared from iron-biofortified common bean and orange-fleshed sweet potato in rural western Uganda,” this study was conducted among pregnant and breastfeeding mothers seeking care at Bwera General Hospital, in Kasese district, western Uganda, between 4th and 15th of August 2023.

Researchers in a 2019 study published in BMC Pregnancy and Childbirth among pregnant and breastfeeding women in Northwest Ethiopia discovered that pregnant and breastfeeding women bear the highest burden of this deficiency due to heightened physiological demands for iron and vitamin A. These demands increase significantly during pregnancy to meet fetal needs and continue during lactation to support breastfeeding.

The 2020 report on Developments in Nutrition among 204 countries and territories for 30 years since 1990 highlights the substantial impact of dietary iron deficiency and vitamin A deficiency on women of reproductive age in low- and middle-income countries across Africa and Asia. These micronutrient deficiencies are of paramount concern in public health nutrition due to their adverse effects.

A 2022 study published in The Lancet Global Health reveals that progress in addressing anemia among women of reproductive age (15–49 years) is inadequate to achieve the World Health Assembly’s global nutrition target of reducing anemia prevalence by 50% by 2030 in low- and middle-income countries, including Uganda.

Breastfeeding mothers require a higher intake of iron, ranging from 10–30 mg/day, compared to 8 mg/day for adult males. To help meet this increased need, the World Health Organization (WHO) recommends iron supplementation programs during the postpartum period, starting immediately after delivery and continuing for the first 6 weeks.

On the other hand, the WHO advises against vitamin A supplementation during the postpartum period, as it offers no noticeable health benefits to either the mother or the infant. Instead, it encourages breastfeeding mothers to maintain a diversified diet that includes vitamin A-rich foods. However, it’s important to highlight that supplementing with vitamin A and iron during this time could enhance the content of these nutrients in breast milk.

In rural Uganda, breastfeeding mothers often face deficiencies in vital nutrients particularly vitamin A and iron. This is as a result of over reliance on plant-based local foods, like sweet potato and non-iron biofortified common bean like Nambale, which lack sufficient amounts of provitamin A and iron, respectively.

To improve vitamin A and iron intake among breastfeeding mothers, Uganda’s government, in collaboration with HarvestPlus, a global program dedicated to ending hunger through providing nutrient-rich foods launched biofortification programs. These initiatives introduced orange-fleshed sweet potato rich in provitamin A and iron-biofortified common bean as staple food in Uganda.

As part of his postdoctoral study, Dr. Edward Buzigi, a Nutritionist and Food security expert, at University of Kwa-Zulu Natal, South Africa, evaluated the perceptions and sensory acceptability of a dish made from a combination of orange-fleshed sweet potato and iron-biofortified common bean, known for their high levels of provitamin A carotenoids and iron.

The aim was to determine whether the test food could replace the traditional white-fleshed sweet potato and non-iron biofortified common beans, which lacks these essential nutrients.

Ninety-four breastfeeding mothers took part in the study comparing two foods. Participants assessed the taste, color, aroma, texture, and overall acceptability of both the test and control foods using a five-point scale. Ratings ranged from “dislike very much” to “like very much,” with attributes deemed acceptable if participants rated them as “like” or “like very much.”

Also, focus group discussions were held to explore participants’ thoughts on future consumption of the test food alongside statistical analysis done using the chi-square test to compare sensory attributes between the two food options, while the qualitative data from focus group discussions were analyzed using thematic analysis.

Findings revealed that taste, color, and aroma were satisfactory to the mothers and showed no significant difference between test food and control food. Mothers had favorable views of the taste, aroma, and color of orange-fleshed sweet potato and iron-biofortified common bean but expressed concerns about the soft texture of orange-fleshed sweet potato. Despite this, breastfeeding mothers expressed positive attitudes towards consuming orange-fleshed sweet potato and iron-biofortified common bean, as long as it was accessible, affordable, and easy to prepare.

Dr. Buzigi lecturers at the Department of Community Health and Behavioural Sciences at Makerere University School of Public Health in Uganda.

Read the scientific article here;  https://onlinelibrary.wiley.com/doi/full/10.1002/fsn3.4053

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Health

Call for Applications: AWE Change Masters fellowship programme support

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L-R: The Departments of Family Medicine (School of Medicine) and Human Anatomy (School of Biomedical Sciences) Buildings, College of Health Sciences (CHS), Mulago Hill, Makerere University, Kampala Uganda, East Africa.

Makerere University College of Health Sciences in collaboration with Duke University, USA are conducting a national collaborative research study on Epilepsy with local leading researchers in the fields of neurology and psychology in Uganda and international experts in the field of neurology and neurosurgery in the USA. The study aims to investigate the panorama of epilepsy in Uganda across the life span by clinically characterizing its features, comorbidities, and risk factors among the general population, with a focus on stigma among adolescents.

Applications are invited for the AWE Change Masters fellowship programme support from postgraduate students of:

  • Makerere University College of Health Sciences
  • Mbarara University of Science and Technology
  • Gulu University

The closing date for the receipt of applications is 22nd May 2024.

Submit all Enquiries and Applications to awechangeproject@gmail.com

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