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Next step for the fruitful collaboration between Makerere University and KI

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One of KI’s largest international collaborations is with Makerere University in Uganda. In time for Makerere’s 100th anniversary, the partnership is to manifest itself in a Centre of Excellence for Sustainable Health. A delegation from KI travelled in May to Uganda to cement the relationship.

“The foundation of a virtual centre for sustainable health gives us a totally new way to build international collaborations,” says KI president, Ole Petter Ottersen. “Mutuality and far-sightedness will pervade all our projects with the aim of improving health for all. The centre will enable more international collaborations, not just in Uganda but also with more countries in Africa, such as Somalia, and other parts of the world. In today’s turbulent world, it is especially important to work on a global stage and stand up for responsible internationalisation.”

From research to extensive collaboration

The partnership between Makerere University and Karolinska Institutet was established back in 2000. At first it was mainly focused on research, but it was soon extended to everything from student and teacher exchanges to joint doctoral studies. There is now a related alumni network containing hundreds of researchers and healthcare workers in Sweden and Uganda. 

One of the students who was quick to snap up the chance to change their study environment from Makerere University to Karolinska Institutet was Noeline Nakasujja. Today, she is a practising psychiatrist and departmental head at the Department of Psychiatry at the College of Health Sciences, Makerere University

“I spent a month in Stockholm in 2005, which was a real eye-opening experience,” she says. “It opened a window onto our cultural differences and onto the differences in resources between universities. It made me realise how much we can achieve even with limited resources.”

Noeline Nakasujja, practising psychiatrist and departmental head at the College of Health Sciences, Makerere University. Photo: Timothy Nkwasibwe
Noeline Nakasujja, practising psychiatrist and departmental head at the College of Health Sciences, Makerere University. Photo: Timothy Nkwasibwe

Since the exchange programme began, some 300 students and teachers have participated. 

“During my time in Sweden, I almost immediately saw a clear difference in student-teacher relations,” she continues. “We have a much more marked hierarchy. At Karolinska Institutet, I saw how it was even possible to have a more relaxed relationship without compromising the seriousness of the teaching.”

After her exchange, Noeline Nakasujja also took the opportunity to take a joint PhD at KI and Makerere.

“My time as a doctoral student led to me receiving a doctoral student from KI,” she says. “That personal contact was the key to creating a platform that has enabled others to successfully navigate a foreign university.” 

Since then, Noeline Nakasujja and her department have accepted numerous students from KI, and she finds her first-hand experience of the Swedish study environment comes in very useful here. She now believes that the new Centre of Excellence for Sustainable Health can deepen the relationship between the two universities even more.

“We need to strengthen the preventative work we’re doing in Ugandan healthcare,” she says. “Patients with Alzheimer’s can particularly benefit from early intervention, such as physical exercise and social activities that help to slow the onset of disease.”

She goes on: “The only way to create truly sustainable health and social care services is by breaking the circle and offering prophylactic intervention.”

There are several partners attached to the Centre of Excellence for Sustainable Health, including universities in Congo, Somalia, Kenya, Malawi and Ethiopia.

“The collaboration enables us to create an environment for the exchange of knowledge and experience that will have a knock-on effect on other international partnerships,” she explains.

Innovation developed in Uganda now implemented in Sweden

Susanne Guidetti, professor of occupational therapy at the Department of Neurobiology, Care Sciences and Society has been involved in developing student and teacher exchanges between Makerere and KI since 2004. Back then, she had just come home from having lived with her family in Nairobi for a few years and was put straight in touch with Julius Kamwesiga, an affiliate of Makerere University.

professor of occupational therapy at the Department of Neurobiology, Care Sciences and Society. Photo: Timothy Nkwasibwe
Professor of occupational therapy at the Department of Neurobiology, Care Sciences and Society. Photo: Timothy Nkwasibwe

The studies were conducted with Mulago National Specialised Hospital and gave the participants access to daily exercise with the help of their mobile phones. Stroke awareness is low in Uganda, where most people live in remote areas far from the nearest clinic. 

“When we can work together to offer more people stroke rehabilitation, we give them a real possibility to live a better life,” Guidetti says. “After the project, one of the participants came up to me and said: ‘The surgeon helped me survive, but my contacts with the occupational therapist made life worth living again’.”

The study will now undergo a larger-scale follow-up in Uganda, and its findings have prompted further studies in Sweden.

“What made our study unique was that we brought knowledge and experience from Uganda to Sweden. Here, our innovation will make it possible to help stroke patients in remote parts of Sweden, too,” she says. “There are now several mobile phone-based rehab options, but in Uganda we helped to pioneer the technique.”

Today, Guidetti has an important part to play in the Centre of Excellence for Sustainable Health. 

“Our project is a good example of how we can create an equivalent platform for sharing knowledge. Hopefully, we’ll be able to develop it further at the Centre and take new steps together towards sustainable health.”

The Centre of Excellence for Sustainable Health enables not only the sharing of knowledge and experiences, but also the development and spread of innovations that can bring the goal of sustainable global health closer to being achieved. The knowledge and the network  that the centre possesses make it easier for us to take on today’s pressing societal challenges together, not only in Sweden and Uganda but globally, too. 

“We have an incredible amount to learn from each other,” says Professor Ottersen. “Let us be inspired by each other’s solutions, big and small, and together find more ways to tackle global health challenges. With the founding of the Centre of Excellence for Sustainable Health, our partnership takes the step from aid funding to being a true partner-driven collaboration.”

More about Susanne Guidettis’ research project

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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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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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