Africa continues to record the highest prevalence of hypertension globally. Studies show that Uganda’s hypertension prevalence stands at 26.4% and public health experts are worried that rising prevalence of noncommunicable diseases (NCDs) should be curbed lest it contributes to the disease burden.
In Africa, just like other low- and middle-income countries, the burden of disease is transitioning from infectious diseases to NCDs and the World Health Organisation predicts that they are likely to become a major health system challenge in Africa as they are predicted to become the leading cause of death in the region by 2030.
Studies estimate Uganda’s NCDs prevalence at 33 in every 100 people die of cardiovascular diseases (CVDs). The prevalence of hypertension for instance among adults stands at 26.4% with the highest prevalence in central Uganda (28.5%) which hosts Mukono and Buikwe districts.
In Mukono and Buikwe districts, among persons aged 15 years and above, the age standardized prevalence of hypertension is 27.2%.
Makerere University School of Public Health has for close to three (03) years now been impacting the communities in Mukono and Buikwe districts through its project; Cardiovascular Disease prevention program -Scaling -up Packages for Interventions for Cardiovascular diseases prevention in selected sites in Europe and sub-Saharan Africa (SPICES) Uganda.
The SPICES project focuses on prevention of diseases of the heart and blood vessels. The project has conducted a comprehensive study at both health facility level and community level where a number of community workers and health workers from randomly selected villages and health facilities in Mukono and Buikwe have been trained in cardiovascular disease prevention and control.
So far, a total of 366 health workers and 80 community health workers (CHWs/VHTs) received training. In addition, the project provided the health centers with equipment to support screening and management of cardiovascular diseases. The project team has, with support of health facilities been involved in screening CVD risk, care and management as well as health promotion and profiling at community level.
As a result of this intervention, there are higher volumes of hypertension and diabetes patients being received as a result of sensitization by the community health workers. There are also reports of changes in behavior in lifestyles especially diet and physical activity as well as improved patient health seeking behaviors for chronic services.
For instance, while presenting results at a dissemination workshop held on December 8th 2021 at Colline Hotel in Mukono district, Dr. Geofrey Musinguzi, the Principal Investigator of the SPICES Project expressed that the project has had significant impact in terms of knowledge changes, and in terms of profiles.
“Much as the prevalence of smoking didn’t seem to change, there was a change in frequency of smoking. For example, those who were smoking daily, we saw a reduction from 2018/19 to 2021,” says Dr. Musinguzi.
He adds that there was a significant difference in passive smoking. “Passive smoking is as dangerous as active smoking. At the baseline, people were smoking and exposing their love ones to tobacco but when they were trained from the health facilities and from the community on the dangers of smoking and passive smoking. So, we have seen an attitude of people in families where people are smoking, of if they can’t avoid smoking, doing it away from their families.”
Arising out of the successes of the project so far, Dr. Rhoda Wanyenze, Professor and Dean of Makerere University School of Public Health (MakSPH) has asked government and the Ministry of Health in particular to support noncommunicable diseases care in the districts of Mukono and Buikwe.
Prof. Wanyenze who is also co-principal investigator of the project SPICES project intervention in Mukono and Buikwe could be used as a yardstick to pick lessons for the Ministry of Health to extend the services to other parts of the country.
“We can use this as a learning hub so that we can also get the other regions that do not have the standard for NCD care at the level that we have in these districts. Let us maintain it because it is an opportunity for us to show that it is doable, that we can do something about NCDs and that others can learn something from these districts and facilities and we can do better across the country,” Professor Wanyenze said.
Tereza Ssenjova, a resident of Busabala Mukono said; “I used to be diagnosed with fever, yet I did not have it. Not until recently through SPICES screening that I was told I have high blood pressure and diabetes.”
Prof. Wanyenze urged for the Ministry of Health to rally Ugandans, the leadership at all levels to aggressively advocate for a safer population by preventing and reducing cardiovascular diseases.
“Please do speak about NCDs like the way we speak about COVID-19 lately and the way we have been speaking about other diseases. Encourage people to screen. If there is an opportunity, why not have a machine around you in your place so that you can encourage people to screen periodically. Think of how you can creatively encourage the communities to screen, so that we can discover these diseases early and be able to do something,” says Prof. Wanyenze.
Dr. Gerald Mutungi, assistant Commissioner Health Services- Non-Communicable Diseases (NCDs) department at the Ministry of Health admits that cardiovascular diseases are on a rise but hastens to add that they can be prevented.
“What we have found out is that the communities, once educated, sensitized can come for screening, but also can follow some of the guidelines given to prevent cardiovascular diseases. This has been shown and we have the data now,” Dr. Mutungi says.
Dr. Mutungi welcomes the results and noted that government will scale-up the interventions.
“We are in evidence-based policy and decision making. This is going to influence our policy. We had already started sensitizing VHTs but we were not sure that actually they can play a big role in prevention of cardiovascular diseases. Now this study is showing that yes, they can. We thought they could only support in distributing bed nets, simple things but they have shown us that they can do a lot in prevention and control of diseases,” he said.
Dr. Musinguzi said the project has had a multi-component intervention including health promotion, screening, training among others.
“We think that this intervention can reach many people. I gave an example of the talking T-Shirt. It has the modifiable risk factors. ‘don’t smoke’, ‘do more exercise’, ‘reduce/avoid alcohol,’ ‘maintain a healthy weight’, ‘go for checkup’ ‘control stress’, ‘eat healthy diet’ among others. In fact, we got reports from VHTs that the messages were received by the population. So, we think all ways of delivering messages must be explored to be able to enhance awareness about CVDs and other NCDs,” Dr. Musinguzi contends.
hailed the SPICES project team for the “wonderful research” and requested the project to include Buvuma and Kayunga districts on the study scope.
“I thank you so much for training the VHTs and our health workers around Mukono and Buikwe districts. This is very good,” said Hajat Nabitaka.
She underscores the need for continued sensitization of the population with a view of changing mindsets to be able to fully realise the benefits.
“Some people think these are diseases of the rich people. Not knowing that even a child in primary school can get diabetes. Not knowing that even an ordinary person in community can get pressure due to the various stress factors. Let us utilize the VHTs to solve many problems including social societal problems such as stress,” Hajat Nabitaka.
He adds that the dissemination is; “a great opportunity to share what we have been doing in field with the rest of the world.”
Some health facilities have have adopted strategies to acquire hypertension and diabetes drugs, and all enrolled facilities are now able to identify and manage Type 1 diabetes, unlike in the past.
SPICES project is currently implemented in Uganda, South Africa, France, Belgium and the United Kingdom. It is an implementation science project funded by the European Commission through the Horizon2020 research and innovation.
Article originally published on MakSPH website.
Water, Sanitation and Hygiene (WASH) Short Course 2024
Did you know that with just a Uganda Advanced Certificate of Education (UACE) or its equivalent, along with at least 1 year of working experience in WASH, you qualify to join our Short Course in Water, Sanitation and Hygiene?
The Department of Disease Control and Environmental Health at Makerere University School of Public Health brings you yet another opportunity to enhance your skills and knowledge in Water, Sanitation, and Hygiene from for the 2024 intake, scheduled to run from 20th May to 12th July 2024.
Designed to equip practicing individuals with the necessary attitudes, skills, and scientific knowledge for effective WASH management, this course is open to officers with limited training in WASH and Environmental Health Practitioners seeking continuous professional development. For more details and application instructions, please refer to the attached course poster or visit the course website at https://sph.mak.ac.ug/academics/water-sanitation-and-hygiene-wash.
Apply before Thursday, 28th March 2024 for a rewarding learning experience!
Call for Abstracts: Annual Health Professions Education Scientific Conference
The Health Professions Education and Training for Strengthening the Health System and Services in Uganda Project (HEPI-SHSSU) at Makerere University College of Health Sciences (MakCHS) is organizing the Annual Health Professions Education Scientific Conference.
Venue: Hotel Africana, Kampala, Uganda
Conference Dates: 10th, 11th and 12th April 2024
Theme: Advances in Health Professions Education: Research, Innovations in Teaching and Learning, Quality Assurance
- Quality Assurance and Accreditation
- Health Professions Education Research
- Innovations in teaching and learning
- Graduate Education
- Simulation-based Learning
Abstracts are welcome in any of the above areas for oral presentations, mini-workshops, thematic poster sessions, and didactic sessions.
We welcome abstracts from all people involved in the education and training of doctors, nurses, allied health professionals, students, health providers, and other stakeholders.
Abstracts should be structured into:
Background, Objectives, Methods, Results, Conclusion
For Education innovations: What was the problem, What was done, Results, and Conclusion (300-word limit).
Include the details of the corresponding author, the author(s), their contacts, and Affiliation.
Send your abstract to: firstname.lastname@example.org
Deadline for Submission of abstracts: Saturday 23rd March 2024
CHS Annual Report 2023
With pleasure I present to you the Makerere University College of Health Sciences (MakCHS) annual report for the year 2023. This report provides only a snapshot of activities at MakCHS, as we went about executing our mandates of teaching and learning, research, and service delivery throughout 2023.
Through our mission to provide transformational education and research to improve service delivery and wellbeing of the communities, MakCHS exhibited admirable performance through its five constituent schools; School of Medicine, School of Biomedical Sciences, School of Public Health, School of Health Sciences and School of Dentistry. I wish to congratulate all our staff, students, and stakeholders upon completion of a very productive 2023, as we struggled to return to the pre-COVID University calendar. Special thanks go to each one of you for your individual and cooperate contributions to offering our students, staff and partners memorable learning experiences at MakCHS.
Our major challenge is keeping with the current and emerging needs of the society we serve nationally and globally. This year MakCHS had a systematic review of the 2011 college research agenda to create the 2023-2040 research agenda that is responsive to the third national development plan (NDP III) and global sustainable development goals (SDGs). In addition to key priorities of the 2011 research priorities that are still relevant, the revised research agenda has adopted key pressing societal challenges that include Translational Science, Biomedical Research & Discovery (including pre-clinical studies, genomics, product development & commercialization), Population Health, Climate change, health systems research, urbanization and their impact on health, pollution, food security and immigration. In addition, mental health as wells as Digital Health, Artificial Intelligence and Big Data applications were included as priority areas to improve health outcomes for the 21st century society.
We continue to be spurred on by our mission to provide transformative education to health professionals that will transform health care in Uganda, Africa and globally. We are encouraged by the great words of Jon Gordon, an American author and speaker on leadership who said, “We don’t get burned out because of what we do. We do get burned out because we forget why we do it”. At MakCHS, remembering our vision to be a leading and transformational institution for academic excellence and innovation in Health sciences in Africa keeps us going strong.
I extend my sincere gratitude to all our stakeholders including but not limited to all MakCHS staff, students, alumni, partners, funders, patients and health care providers for your unwavering commitment to serve humanity.
On behalf MakCHS leadership I wish you a happy holiday season and a blessed productive 2024.
Prof. Damalie Nakanjako
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