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Mak School of Public Health, Ministry of Health to Conduct National Mental Health Integration Study

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As mental health gains recognition as a critical aspect of overall well-being, a pioneering study is set to delve into its integration in schools, communities and healthcare units across Uganda. 

With funding from the World Bank, this landmark study titled; “Assessing the Extent of Integration of Mental Health Services into Primary Healthcare, Community and Schools” will focus on four purposively selected districts in Uganda – Adjumani in the Northern region, Bushenyi in Western Uganda, Kapchorwa in Eastern Uganda, and Butambala in Central Uganda. 

With the potential to revolutionize mental health practices in schools, this study will through rigorous research and analysis shed light on the implementation and impact of mental health integration initiatives in schools, uncovering new insights that could shape policies and practices for generations to come.

A team of stakeholders at the Inception Meeting.
A team of stakeholders at the Inception Meeting.

Latest data from the international Burden of Disease Study indicates that mental illness and substance use disorders account for 3.35% of the total disease burden in Uganda. According to the latest WHO data, at least 7.4% of Ugandans are affected by common mental disorders particularly depression, anxiety and alcohol use disorders.

Comparable to high-income countries, depression and generalized anxiety disorders in Uganda, are prevalent at 5.3% and 4.1% respectively. Uganda ranks among the top five countries globally with the highest depression prevalence. Poverty, HIV infection, disasters, and adverse environmental conditions are factors that increase the risk and consequence of mental health conditions in Uganda.

It is against this background that the World Bank Group solicited for consultancy services for a nation-wide study to assess the extent of integration of mental health services into primary healthcare, schools and communities.

Dr. Juliet Nakku, Senior Consultant Psychiatrist and Executive Director of Butabika National Referral Mental Hospital, during an inception meeting of mental health stakeholders on April 13, stated that the study will reveal the prevalence and types of mental health issues in these settings and their impact on community well-being.

This study that will be conducted by a team of mental health experts from the Ministry of Health and Makerere University School of Public Health. This study will assess the availability, access, and quality of mental health services in PHC, communities, and schools.

The study’s Principal Investigator Dr. Nakku further emphasized that the research will assess existing services, identify gaps/barriers, and explore opportunities/challenges in integrating mental health into primary healthcare and schools. This will involve examining policies, resources, support systems, and obstacles to integration.

Dr. Juliet Nakku, Senior Consultant Psychiatrist and Executive Director of Butabika National Referral Mental Hospital, during an inception meeting of mental health stakeholders on April 13, 2023.
Dr. Juliet Nakku, Senior Consultant Psychiatrist and Executive Director of Butabika National Referral Mental Hospital, during an inception meeting of mental health stakeholders on April 13, 2023.

Over the last 20 years, Uganda has taken measures to enhance its healthcare system and promote better health outcomes for its population. In 1996, the government-initiated efforts to integrate mental health into primary healthcare, providing training for general healthcare workers to identify and address common mental health disorders.

Dr. Hafsa Lukwata, Assistant Commissioner for NCDs and Mental Health at the Ministry of Health, emphasizes that there is increased risk of mental health problems among specific sub-populations, including children, the elderly, refugees, and individuals in uniform.

Dr. Lukwata asserts that the government is addressing mental health through policies that highlight its importance as a fundamental component of health at all care levels. These policies promote decentralization, integration of evidence-based services, and partnerships to increase mental health knowledge and service provision.

Dr. Hafsa Lukwata, Assistant Commissioner for NCDs and Mental Health at the Ministry of Health speaks during the inception at MoH.
Dr. Hafsa Lukwata, Assistant Commissioner for NCDs and Mental Health at the Ministry of Health speaks during the inception at MoH.

She further stresses that mental health conditions impact individuals throughout their lifespan, affecting quality of life. This includes early childhood, adolescence, pregnancy, adulthood, as well as specific groups such as men in uniform, workplace populations, and the elderly who are at an increased risk for mental illnesses.

Uganda, according to Dr. Hafsa invested USD 25m in 2009 to improve mental health facilities and provide training for health workers, with support from the African Development Bank.

“We have set up several health facilities and trained numerous health workers with the support of the African Development Bank,” says Dr. Hafsa. “However, there have been no studies to assess the impact of these investments. Routine data from the Ministry of Health Management Information Systems (HMIS) indicates an increase in new patients treated for mental health conditions.”

She adds that improvements have been made to the structure of mental health care at all levels to increase the number and mix of mental health professionals.

Despite progress, as noted in the 2018 report of the Sectoral Committee on Health, Uganda still grapples with a significant mental health treatment gap of 85%, leaving only 15% of those in need with access to care. Primary healthcare facilities often refer individuals to higher-level tertiary care, and mental health stigma persists, with limited awareness among the general population, as highlighted by the World Bank.

To bridge the gap, WHO suggests integrating mental health services into PHC systems in countries like Uganda. However, challenges such as prioritization, poverty, cultural differences, health system issues, medication supply, workforce shortages, and inflexibility pose barriers to this integration.

A team of researchers, stakeholders including MoH, World Bank, at the Inception Meeting.
A team of researchers, stakeholders including MoH, World Bank, at the Inception Meeting.

Dr. Nakku acknowledges that mental health has received policy priority in Uganda, but gaps remain in delivering services at primary care, community, and school levels, leaving some populations underserved.

“Mental health problems are risk factors for various public health concerns, such as road traffic accidents and injuries. The role of alcohol and substance use in these issues is significant. Integrating mental health into primary health care may be a cost-effective solution with desirable treatment outcomes. There have been efforts to integration. We now want to assess the extent of integration into PHC, communities and schools in Uganda,” explained Dr. Nakku.

The study aims to evaluate the Knowledge, Attitudes, and Practices (KAP) related to mental health care/services among a total of 1380 individuals, including 45 students/pupils from each of the 33 schools. The assessment will focus on both teachers, learners’ senior women teachers, school nurses and matrons.

Dr. Fredrick E. Makumbi, an Associate Professor of Biostatistics at MakSPH outlined how the study will use qualitative and quantitative data to comprehensively understand mental health integration in Uganda. He provided specifics on the quantitative component, including the study population, sample size, sampling procedure, and data analysis plans. He stressed that the collected data will yield indicators for developing a composite measure of integration, stratified by primary healthcare, communities, and schools.

Dr. Fredrick E. Makumbi, an Associate Professor of Biostatistics at MakSPH speaks during the inception meeting.
Dr. Fredrick E. Makumbi, an Associate Professor of Biostatistics at MakSPH speaks during the inception meeting.

“This study is quite interesting because we have primary health care units as a study population. We shall randomly pick study participants from the villages and schools served by the health care units. We also have plans to construct an Integration of Mental Health Services/Care Composite (IMHC) based on scores from the items/indicators of integration at each of the 3 levels. Each indicator present will be scored ‘1’ else ‘0’, and a total score will be obtained as the sum of all individual indicator scores. The proportion of schools/communities/PHC facilities generated will be based on an agreed cut-off,” explained Dr. Fred Makumbi, a Co-Principal Investigator of the MHISU study.

Professor Rhoda Wanyenze, the Dean and study Advisory team member expressed her enthusiasm for hosting a study highlighting that mental health was “an integral part of our lives.” Accordingly, she stressed MakSPH’s commitment to increasing mental health knowledge through research and expressed her delight in partnering with Butabika Hospital, citing their history of effective teamwork. “The School of Public Health will document the learnings from this study and this study is not a one-off.”

Professor Rhoda Wanyenze, the Dean and study Advisory team member expressed her enthusiasm for hosting a study.
Professor Rhoda Wanyenze, the Dean and study Advisory team member expressed her enthusiasm for hosting a study.

Dr. Wilson Winstons Muhwezi, an Associate Professor in the Department of Psychiatry at Makerere University College of Health Sciences, provided insights on the qualitative component of the study during the discussion. He emphasized the purpose of describing and providing context for integration, and how the study team aims to explain trends, relationships, consistencies, and inconsistencies through the numerous question items they have put together.

“We think if we are able to go to very many sub-populations that we have marked out for purposes of collecting this qualitative data, we shall be able to provide context and meaning according to the data sources themselves so that we have better appreciation of what is going on,” says Dr. Muhwezi.

Dr. Wilson Winstons Muhwezi, an Associate Professor in the Department of Psychiatry at Makerere University College of Health Sciences.
Dr. Wilson Winstons Muhwezi, an Associate Professor in the Department of Psychiatry at Makerere University College of Health Sciences.

Dr. Muhwezi expressed excitement to be part of a study that recognizes the value of qualitative data in increasing the wealth of knowledge. “As far as I am concerned, I am very excited about this study because rarely do we get to do studies where the qualitative approach is given prominence like the quantitative approach. I think we will get good information when we come from the field.”

Dr. Oyoo Charles Akiya, the Commissioner NCDs-Ministry of Health, expressed the Ministry’s keen interest in the upcoming study on Ugandan mental health during an inception meeting chaired on their behalf. He emphasized that understanding the mental health needs of Uganda will lead to better interventions and contribute to achieving Sustainable Development Goal 3 – Good Health and Well-being.

Dr. Oyoo Charles Akiya, the Commissioner NCDs-Ministry of Health.
Dr. Oyoo Charles Akiya, the Commissioner NCDs-Ministry of Health.

According to Dr. Oyoo, Ministry of Health will support the study team and that it was eager to learn more about the study and how they can be of service. He expressed gratitude to the World Bank, MakSPH, and Butabika Hospital for their contribution to improving mental health care in Uganda.

Dr. Hafsa Lukwata speaks during the inception at MoH.
Dr. Hafsa Lukwata speaks during the inception at MoH.

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Call For Applications: Masters Support in Self-management Intervention for Reducing Epilepsy Burden

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An aerial photo of the College of Health Sciences (CHS), Makerere University showing Left to Right: The Sir Albert Cook Memorial Library, School of Biomedical Sciences, Davies Lecture Theatre, School of Public Health, Mulago Specialised Women and Neonatal Hospital (MSWNH)-Background Left and Nakasero Hill-Background Right, Kampala Uganda.

The Makerere University College of Health Sciences & Case Western Reserve University, partnering with Mbarara University of science and Technology are implementing a five-year project, “Self-management Intervention for Reducing Epilepsy Burden Among Adult Ugandans with Epilepsy”.

The program is funded by the National Institute of Health (NIH), National Institute of Neurological Disorders and Stroke (NINDS). One aspect of the program is to provide advanced degree training to qualified candidates with an interest in pursuing clinical and research careers in Epilepsy. We are aiming at growing epilepsy research capacity including self-management approaches in SSA.

The Project is soliciting for applications for Masters Research thesis support focusing on epilepsy related research at Makerere University and Mbarara University, cohort 1, 2024/2025.

Selection criteria

  • Should be a Masters’ student of the following courses; MMED in Internal Medicine, Paediatrics, Surgery and Neurosurgery, Psychiatry, Family Medicine, Public Health, Master of Health Services Research, MSc. Clinical Epidemiology and Biostatistics, Nursing or Masters in the Basic Sciences (Physiology, Anatomy, Biochemistry or any other related field).
  • Should have completed at least one year of their Masters training in the courses listed above.
  • Demonstrated interest in Epilepsy and Neurological diseases, care and prevention and commitment to develop and maintain a productive career and devoted to Epilepsy, Clinical Practice and Prevention.

Research Programs

The following are the broad Epilepsy research priority areas (THEMES) and applicants are encouraged to develop research concepts in the areas of; Applicants are not limited to these themes; they can propose other areas.

  • The epidemiology of Epilepsy and associated risk factors.
  • Determining the factors affecting the quality of life, risk factors and outcomes (mortality, morbidity) for Epilepsy, epilepsy genetics, and preventive measures among adults.
  • Epilepsy in childhood and its associated factors, preventative measures etc.
  • Epilepsy epidemiology and other Epilepsy related topics.
  • Epilepsy interventions and rehabilitation

In addition to a formal masters’ program, trainees will receive training in bio-ethics, Good Clinical Practice, behavioral sciences research, data and statistical analysis and research management.

The review criteria for applicants will be as follows:

  • Relevance to program objectives
  • Quality of research and research project approach
  • Feasibility of study
  • Mentors and mentoring plan; in your mentoring plan, please include who are the mentors, what training they will provide and how often they propose to meet with the candidate.
  • Ethics and human subjects’ protection.

Application Process

Applicants should submit an application letter accompanied with detailed curriculum vitae, two recommendation letters from Professional referees or mentors and a 2-page concept or an approved full proposal describing your project and addressing Self-Management Intervention for Reducing Epilepsy Burden Among Adult or epilepsy related problem.

A soft copy should be submitted to the Administrator, Reducing Epilepsy Burden Project.  Email: smireb2@gmail.com; Closing date for the Receipt of applications is 1st July 2024.

For more information, inquiries and additional advice on developing concepts, please contact the following:

Makerere University College of Health Sciences

Prof. Mark Kaddumukasa:  kaddumark@yahoo.co.uk

Mbarara University

Ms. Josephine N Najjuma: najjumajosephine@yahoo.co.uk

Only short-listed candidates will be contacted for Interviews.

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Call For Applications: Masters Support in Brain Health

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Artistic illustration of Medical Science at the College of Health Sciences (CHS), Makerere University, Kampala Uganda.

The Makerere University College of Health Sciences and Uganda Martyrs University (UMU), Research Training and mentorship to strengthen brain health program is a five-year project, funded by the National Institute of Health (NIH), National Institute of Neurological Disorders and Stroke (NINDS) and the Fogarty International Center (FIC). The Major goal is to strengthen brain health research through multidisciplinary training and build a sustainable faculty and institutional capacity for research to improve brain health across the Lifespan in Uganda.

The Project is soliciting for applications for Master’s training support in Brain Health-related research at Makerere University/UMU, 5th Cohort, 2024/2025.

Selection criteria

  • Should be a Masters’ student of the following courses; MMED in Internal Medicine, Obstetrics/Gynaecology, Paediatrics, Surgery and Neurosurgery, Psychiatry, Family Medicine, Public Health, Master of Health Services Research, MSc. Clinical Epidemiology and Biostatistics, Nursing or Masters in the Basic Sciences (Physiology, Anatomy, Biochemistry or any other related field at Makerere University/UMU.
  • Should have completed at least one year of their Masters training in the courses listed above and ready to start their thesis development.
  • Proof of admission onto a master’s program at Makerere or UMU
  • Research work should be related to their selected research area in brain health
  • A letter of support from a mentor and another letter from the department committing to give the candidate protected time to study.
  • Demonstrated interest in Brain Health and Neurological diseases, care and prevention and commitment to develop and maintain a productive career and devoted to Brain Health, Clinical Practice and Prevention.

Research Programs

The following are the broad Brain Health Research priority areas (THEMES) and applicants are encouraged to develop research concepts in the areas of; Meningitis, encephalitis, traumatic brain injury, seizures/ epilepsy, neurodevelopmental disorders, ADHD, Autism, cerebral palsy, mental health disorders, stroke, dementias, Parkinson’s disease and nerve disorders plus “other brain-related topics”

In addition to a formal masters’ program, trainees will receive training in bio-ethics, Implementation science, behavioral sciences research, qualitative and quantitative research methodology, data analysis and research management.

The review criteria for applicants will be as follows:

  • Relevance to program objectives
  • Quality of research and research project approach
  • Feasibility of study
  • Mentors and mentoring plan; in your Mentoring plan, please include who are the proposed mentors, what training they will provide and how often they propose to meet with the candidate.
  • Ethics and human subjects’ protection.

Application Process

Applicants should submit an application letter accompanied with a detailed curriculum vitae, two recommendation letters from Professional referees or mentors and a 2-page concept or approved full proposal addressing a brain health or neurological disease related problem.

A soft copy should be submitted to the Training Coordinator, Brain Health Project.

Email: brainhealthtraining@gmail.com.

Closing date for the Receipt of applications is 10th June 2024.

For more information, inquiries and additional advice on developing concepts, please contact the following:

Prof. Elly Katabira, katabira@infocom.co.ug;

Dr. Mark Kaddumukasa. kaddumark@yahoo.co.uk

Only short-listed candidates will be contacted for Interviews

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Call For Applications: Masters Support in Reducing Stroke Risk Factors

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The Dean’s Gardens with Davies Lecture Theatre (Right), College of Health Sciences, Makerere University, Mulago Hill, Kampala Uganda on a bright sunny day. East Africa

The Makerere University College of Health Sciences and Case Western Reserve University, partnering with Mbarara University of Science and Technology are implementing a five-year project, “A targeted self-management Intervention for Reducing Stroke Risk Factors in High Risk Ugandans”.

The program is funded by the National Institute of Health (NIH), the National Institute of Neurological Disorders and Stroke (NINDS). One aspect of the program is to provide advanced degree training to qualified candidates with an interest in pursuing clinical and research careers in Stroke. Trainees will be expected to develop and maintain a productive career devoted to Stroke Research, Clinical Practice, and Prevention. We are aiming at growing Research Capacity in Stroke Risk Reduction and training the next generation of Stroke health in Sub-Saharan Africa.

The Project is soliciting for applications for Masters Research thesis support in stroke-related research at Makerere University and Mbarara University, cohort 5, 2024/2025.

Selection criteria

  • Should be a Masters’ student of the following courses; MMED in Internal Medicine, Paediatrics, Surgery and Neurosurgery, Psychiatry, Family Medicine, Public Health, Master of Health Services Research, MSc. Clinical Epidemiology and Biostatistics, Nursing or Masters in the Basic Sciences (Physiology, Anatomy, Biochemistry or any other related field).
  • Should have completed at least one year of their Masters training in the courses listed above.
  • Demonstrated interest in Stroke and Neurological diseases, care and prevention and commitment to develop and maintain a productive career and devoted to Stroke, Clinical Practice and Prevention.

Research Programs

The following are the broad brain health research priority areas (THEMES) and applicants are encouraged to develop research concepts in the areas of; Applicants are not limited to these themes, they can propose other areas.

  • The epidemiology of Stroke and associated risk factors.
  • Stroke risk factors and outcomes (mortality, morbidity) for stroke, stroke genetics, and preventive measures in among adults.
  • Stroke in childhood and its associated factors, preventative measures etc.
  • Stroke epidemiology and other stroke related topics.
  • Stroke interventions and rehabilitation

In addition to a formal masters’ program, trainees will receive training in bio-ethics, Good Clinical Practice, behavioral sciences research, data and statistical analysis and research management.

The review criteria for applicants will be as follows:

  • Relevance to program objectives
  • Quality of research and research project approach
  • Feasibility of study
  • Mentors and mentoring plan; in your mentoring plan, please include who are the mentors, what training they will provide and how often they propose to meet with the candidate.
  • Ethics and human subjects’ protection.

Application Process

Applicants should submit an application letter accompanied with a detailed curriculum vitae, two recommendation letters from Professional referees or mentors and a 2-page concept or an approved full proposal describing your project and addressing Stroke Risk Factors or a stroke related problem.

A soft copy should be submitted to the Training Coordinator, Reducing Stroke Project.

Email: reducingstroke@gmail.com. The closing date for the Receipt of applications is 10th June 2024.

For more information, inquiries, and additional advice on developing concepts, please contact the following:

Makerere University College of Health Sciences

Prof. Elly Katabira: katabira@infocom.co.ug

Dr. Mark Kaddumukasa:  kaddumark@yahoo.co.uk

Mbarara University

Ms. Josephine N Najjuma: najjumajosephine@yahoo.co.uk

Only short-listed candidates will be contacted for Interviews.

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