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Mukono RDC Commends Mak on Empowering VHTs; Calls on Parliament to Appropriate Resources to Motivate them

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Hajat Fatuma Ndisaba Nabitaka, the Resident District Commissioner for Mukono district has appealed to Ugandan legislators to support efforts of community health workers (CHWs)/VHTs through appropriating some remuneration for them.

Hajat Nabitaka said she has moved the entire Mukono District during the COVID-19 pandemic period and throughout the taskforces and has since appreciated the great role played by CHWs.

“We thank you so much, you are the frontline soldiers. Because you do sensitize our people in the communities and you are always there throughout. If those in parliament could know what you do, they would speak passionately for you to receive some kind of salary,” said Hajat Nabitaka.

She was speaking at a dissemination workshop for Makerere University School of Public Health’s Cardiovascular Disease prevention program under the SPICES project held on December 8th 2021 at Colline Hotel in Mukono district.

“Sincerely speaking, we have many people who receive a lot of money, yet their out-put is minimal as compared to the work done by VHTs. I am appealing to the Commissioner [NCDs], researchers to advocate for renumeration for VHTs. I think this catchment area of the VHTs is the best. They are the ones who can solve some of the social problems affecting majority of families. Kindly think about the VHTs, keep up training the VHTs and speak for them,” she added.

Hajat Fatuma Ndisaba Nabitaka, the Resident District Commissioner for Mukono district
Hajat Fatuma Ndisaba Nabitaka, the Resident District Commissioner for Mukono district.

 Dr. Gerald Mutungi, assistant Commissioner Health Services- Non-Communicable Diseases (NCDs) department at the Ministry of Health says currently, the VHTs are working under non-monetary motivation scheme.

“They have been working and we are discussing their small allowance in the Ministry. The problem is that the numbers are so big. Even when you give them small allowances the budget becomes so big,” Dr. Mutungi observes.

Dr. Gerald Mutungi, assistant Commissioner Health Services- Non-Communicable Diseases (NCDs) department at the Ministry of Health
Dr. Gerald Mutungi, assistant Commissioner Health Services- Non-Communicable Diseases (NCDs) department at the Ministry of Health

He further advances that; “But to tell you the truth, the discussion is in the Ministry. I don’t know how it will end but this adds on the evidence that they are so useful and that they need to be motivated.”

The SPICES project Principal Investigator Dr. Geofrey Musinguzi says the study has proven  that if well trained, community health workers (CHWs/VHTs) have potential to deliver messages on prevention and control of cardiovascular diseases as well as enhance awareness amongst the various risk factors that raise cardiovascular diseases.

Through VHTs, the SPICES project reached a total of 10,936 people in households in 80 randomly selected villages in Mukono and Buikwe. Dr. Musinguzi contends that, trained VHTs that are trusted in communities are a gateway to increased community knowledge about CVDs and participation.

SPICES project Principal Investigator Dr. Geofrey Musinguzi
SPICES project Principal Investigator Dr. Geofrey Musinguzi

“As you observed, out of the many people the y [VHTs] visited, only 1% rejected them in their households. So, 99% were receiving them. So, to us we really think that is one resource that is available. If supported, they can actually deliver more in prevention of cardiovascular diseases,” said Dr. Musinguzi.

Under community intervention model of the SPICES project, Dr. Musinguzi notes that the key enablers of implementing the program is the availability of committed and motivated VHTs, receptive communities, supporting local and religious leaders as well as social gatherings and infrastructure like SACCOs, worship places, local infrastructure such as radios, public address system for health education.

Despite the unprecedented times brought by COVID-19 community health workers with support from SPICES project reached out a number of households in the project area in respect to CVDs. The project sensitized and empowered community health workers and health workers on COVID-19 prevention and subsequently equipped with tools such as facemasks, sanitizers, temperature monitors and standard operating procedures.

“Community Health Workers are largely motivated and over two years working with them, we have actually seen them do a lot of work, deliver these interventions. They have also reached quite a number of people in the households. COVID was a problem in reaching out those places but amidst that challenge, we moved to the community members,” contends Dr. Musinguzi.

Sarah Nalweyiso, a Village Health Team Member in Buikwe District says they (community health workers) received training in September 2020 under the SPICES project on how to continue with the work amidst the pandemic challenges.

“We received gumboots, notebooks, pens, sanitizers and masks,” says Nalweyiso.

 The SPICES project Principal Investigator Dr. Geofrey Musinguzi alongside  Dr. Gerald Mutungi, assistant Commissioner Health Services- Non-Communicable Diseases (NCDs) department at the Ministry of Health hands certificates to Community Health Workers at a dissemination workshop held on December 8th 2021 at Colline Hotel in Mukono district.
 The SPICES project Principal Investigator Dr. Geofrey Musinguzi alongside  Dr. Gerald Mutungi, assistant Commissioner Health Services- Non-Communicable Diseases (NCDs) department at the Ministry of Health hands certificates to Community Health Workers at a dissemination workshop held on December 8th 2021 at Colline Hotel in Mukono district.

She adds that they trained community members about behavior change and highlighting dangers of excessive consumption of alcohol, benefits of exercising, reducing consumption of cooking oils as well as eating fruits and vegetables.

“When we finished the training, we came back to our villages and started examining people using the risk factor assessment tools to evaluate the risk of cardiovascular disease.”

Esther Namaganda, another VHT member from Buikwe district says; “We moved around our communities mainly to screen the members for risk factors of cardiovascular diseases.”

The poor health seeking behavior was one of the highlighted contributors to delayed presentation to health facilities with cardiovascular diseases.

Dr. Isaac Ssinabulya, Cardiologist at the Uganda Heart Institute -UHI thanked SPICES Project on the great work it has done.

“We conducted research, myself and Dr. Mutungi on non-communicable diseases and established that the highest percentage of the most affected people are in communities, nearly 60%. We only see fewer people in hospitals,” Dr. Ssinabulya.

He adds that there are many people who flock UHI from farther places in this country coming for treatment and end up spending a lot of money, yet the diseases can be prevented.

Dr. Ssinabulya hailed the Community Health Workers for their support in ensuring people are empowered and are able to be screened early enough in order to mitigate the risks associated to advanced treatment of CVDs which include high cost of treatment as well as loss of life.

Pressure is one of the highly prevalent diseases in Mukono and Buikwe at 24%. “This high number requires to ensure that whoever visits our health facilities is screened and are counseled towards keeping healthy lifestyles. Let us work together to reduce the queues of people coming for treatment,” says Dr. Ssinabulya.

Dr Josephine Birungi, a Senior Research Scientist based at Medical Research Council/Uganda Virus Research Institute (MRC/UVRI) in Entebbe underscored the role of VHTs and noted that their work and contribution can be sustained through continuous engagement and training.

 Dr Josephine Birungi Research Scientist based at Medical Research Council/Uganda Virus Research Institute (MRC/UVRI) and Dr. Isaac Ssinabulya, Cardiologist at the Uganda Heart Institute -UHI
 Dr Josephine Birungi Research Scientist based at Medical Research Council/Uganda Virus Research Institute (MRC/UVRI) and Dr. Isaac Ssinabulya, Cardiologist at the Uganda Heart Institute -UHI

She commended the VHTs on the good work. “We need to deploy family-centered-approach to educate the masses about these challenges such as NCDs. It will help efforts by SPICES project to continue. For instance if I knew my husband has diabetes, I will not put a lot of salt in food. But if I don’t know, we shall not make a change.”

She tipped both health workers and the Ministry of Health on continuous capacity building as well as sensitization of the masses.

“We need to sensitize the masses. We should reciprocate the attention we give to HIV/AIDs to NCDs. I appeal to all of you to support sensitization of our communities not only about heart diseases but also on other diseases such as HIV/AIDs among others,” Dr. Birungi.

Article originally published on MakSPH website.

Health

Boy Children Report More Physical & Emotional Abuse

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Men in the intervention group during the Parenting for Responsibility (PfR) project training session.

By George Kisetedde

On 3rd August, 2022, the CHDC (Child Health and Development Centre) disseminated study findings from one of the research studies carried out at the centre. These findings were presented under the title,“The Prevention of Violence against Children and Women: Baseline and Implementation Science Results from Parenting Cluster Randomised Trial.” Moderated by Dr. Anthony Batte, a lecturer at CHDC. Study findings were presented by Joseph Kahwa, the trial manager of the Parenting for Responsibility (PfR) project, under which this study falls.

Kahwa described PfR as a community based parenting programme delivered to both male and female parents. This programme aims to improve parenting skills, prevent violence against children, and to improve spousal relationships.

Findings from the study

Findings from this study showed that parents maltreat boy children more than girl children. The boys reported more emotional and physical violence than girls. Furthermore, the boy children reported that male caregivers specifically, maltreat them more. On the other hand, the girl children reported more sexual violence from caregivers than boys. On the whole, the children reported that female caregivers emotionally and physically abused them more compared to male caregivers.

More findings, according to Kahwa, showed that 46.5% of parents in Amuru can provide their children with soap to wash, 44.5% can provide school fees, 44.4% can provide school materials, 44.2% can provide new clothes, 43.3% can buy school uniform, and 35.9% can provide a pair of shoes.

How the research is conducted

The study is divided into 16 group sessions. The first 9 sessions are single sex, that is, male caregivers and female caregivers train separately. The next 7 sessions are mixed with male and female participants combined during training.

A mixed group parenting session for both men and women.
A mixed group parenting session for both men and women.

Kahwa explained that this programme was initiated to deal with VAC (violence against children) and IPV (intimate partner violence). These two vices are closely linked and have a significant impact on how children turn out.

Kahwa added that the PfR research programme aims at addressing the four major factors that may lead to VAC/IPV. These include; poor parental bonding, harsh parenting, unequal gender socialisation and spousal relationships.Poor parental bonding refers to the absence of a healthy close connection between a parent and their child. When a parent and child are not close, the parent may lack empathy for the child and the ability to perceive and respond to their child’s needs. When this bond is weak, a parent is unable to appreciate a child’s needs and can end up being unrealistically tough, which results in harsh parenting. Unequal gender socialisation generally refers to the different expectations that parents have of their children depending on their gender-male or female. The quality of the spousal relationship between parents also affects a child’s life. These four areas are what the parenting sessions concentrate on during the training.

The PfR study employed a cluster randomised controlled trial (RCT) design. Male and female caregivers were recruited from cluster villages in the Wakiso and Amuru districts in Uganda. One child aged 10 to 14 per household was randomly selected and assessed.

The caregivers were divided into two groups; the intervention group and the control group. The intervention group underwent all the 16 sessions of the training while the control group underwent a 2 session lecture on parenting. The impact of the PfR intervention was then ascertained by comparing baseline and endline results (or the before-and-after experiences of parents). The study participants were from 54 Villages selected in both Amuru and Wakiso districts. 108 caregiver groups (54 groups per intervention)were selected. This resulted in 2328 parents recruited and 886 children.

In conclusion, Mr. Kahwa said that maltreatment is still prevalent in the population. Generally, the PfR programme was well-received by parents and it had ad good attendance from parents. The programme also registered good male engagement. The peer facilitators who were recruited also had great potential in expanding the PfR programme at community level.

This study was conducted by Dr Siu Godfrey as the Principal Investigator. Other members of the team included Carolyn Namutebi, Richard Sekiwunga, Joseph Kahwa, Dr Betty Okot, and Martha Atuhaire. They were supported by the Director from CHDC, Dr. Herbert Muyinda and the CHDC Finance & Administration team. The team from Glasgow & Oxford Universities in the UK included, Prof Daniel Wight, Dr Jamie Lachman , Francisco Calderon and Dr Qing Han. On the other side, the team from the SOS Children’s Village from Gulu and Wakiso included, Rachel Kayaga, Sindy Auma Florence and Godfrey Otto.

Contact: George Kisetedde – kisetedde@gmail.com | Edited by Agnes Namaganda – agnesvioletnamaganda@gmail.com

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Makerere Medical Journal: Golden Jubilee Edition 2022

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Cover Page of the Makerere Medical Journal Golden Jubilee Edition 2022.

It’s with great pleasure that I welcome you to the Golden Jubilee edition of this phenomenal journal. Yes, The Makerere Medical Journal marks 50 years of publication with this year’s edition and all this has been made possible by the endless efforts and contributions of the Makerere University College of Health Sciences Staff and students because without your research submissions and financial support, the journal wouldn’t have made it this far. To you reading this, thank you for contributing to the sustainability of this great project, year in year out.

Here’s a quote to ponder on as you delve into this year’s well-crafted articles and it’s by Zora Hurston (1891-1960), “Research is formalized curiosity. It is poking and prying with a purpose.” And doesn’t that just define our purpose as researchers?!

This edition’s articles cover pertinent topics ranging from Antimicrobial Stewardship, COVID-19 interventions, Oral Health amongst others. It also features student projects, write-ups on student-led organizations and societies that are making a difference in the life of a health sciences’ student and many more interesting writings. Featured in this issue are international manuscripts from countries like Nigeria and we were also honored to work with other universities within the country and feature some of their students’ articles.

I would like to extend my most sincere gratitude to my team of editors that engaged in a rigorous peer review process to ensure that the articles published are up to standard. As the editorial team, we are quite pleased to see the number of undergraduates involved in research steadily increasing and all the efforts that have been put in by the different stakeholders to see this happen are commendable.

With that said, I hope you enjoy every second of your read!!!

LINDA ATULINDA,
MBChB IV

EDITOR-IN-CHIEF,
Research and Writers’ Club 2021-2022

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Health

Call for Applications: HEPI Masters Support Fellowship

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Panelists L-R: Professor Elsie Kiguli-Malwadde, Professor Francis Omaswa, Professor Jehu Iputo and Professor Joel Okullo at the HEPI-ACHEST Health Professions Education Symposium, 17th June 2022, Makerere University.

Applications are invited for the Health Professional Education Partnership Initiative (HEPI-SHSSU) Masters fellowship programme support from postgraduate students of:

  • Makerere University College of Health Sciences (MakCHS)
  • Kabale University School of Medicine
  • Clarke International University
  • Faculty of Health Sciences, Busitema University

The programme will support graduates in their final year of training leading to the award of a Masters degree on any of the Master’s graduate training programs at the stated University for a maximum of 19 successful candidates.

The closing date for the receipt of applications is 30th September 2022.

Inquiries and Applications must be submitted to hepishssu@gmail.com

See attachment for more details 

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