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Health Professions Education Conference – 2023 Held

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The Health Professions Education Conference – 2023 themed, ‘Health Professions Education for Improved Health Outcomes’ was held on the 11th to 12th May 2023 with calls from stakeholders for competency-based education, quality assurance in training institutions, partnerships and enhanced supervision. The conference was organised by Health Professional Education Partnership Initiative (HEPI-SHSSU) and the East African Health Professionals Educators Association (EAHPEA).

HEPI-SHSSU is an NIH funded project hosted by Makerere University College of Health Sciences (MakCHS) working in partnership with Busitema University, Kabale University, Clarke International University, Mulago School of Nursing and Midwifery, Yale University, John Hopkins University and African Centre for Health and Social Transformation (ACHEST). The vision of the HEPI-SHSSU partnership is to transform Health Professions Education (HPE).

In her remarks, Professor Sarah Kiguli – Principal Investigator, HEPI-SHSSU welcomed participants to the conference. She expressed the privilege of the initiative in hosting the conference together with EAHPEA. ‘In this initiative, we believe, it is relevant to have all the HPE stakeholders working together to transform the sector which is key in creating strong health systems leading to improved health outcomes. This can only be achieved by engaging and working with all stakeholders present here’ she said.

The keynote address was read by Dr. Sanny Okuruafo, Technical Advisor – WHO Uganda Office who represented Dr. Yonas Tegegn Woldermariam – WHO Representative in Uganda. The address gave insights of why the health workforce is a key enabler for achieving the health-related sustainable development goals considering their role in ensuring health and well being of the population;  how Competency-based education is the foundation for training health workers to address the contemporary health needs of populations; and the discourse on competency – based education in recent years and how the Global Competency and Outcomes Framework for Universal Health Coverage was birthed in 2022. The keynote address underlined that:

  • Enhancement of health professions education lies in allowing a comprehensive and more cohesive approach to identifying the needed competencies that enable effective performance. This enables the health workforce to gain competencies that are on demand by the employers.
  • In enhancing health professions education in Uganda, the Framework offers an opportunity to ensure that competency-based curricula from competency-based outcomes are developed based on:
    • the essential service package,
    • legislation, policies, regulations, and guidelines guiding service delivery and health worker practice.
    • Occupational role and scope of practice for health worker category
    • Local epidemiology, mortality, and morbidity, and
    • Emergency risk assessments from All-hazards emergency risk assessments

The address concluded that the aforementioned proposals would ensure that ‘the health workers produced in Uganda will be trained using curricula that is rooted in the health and health system needs towards improved individual and population health, and efficient management and organization of the health sector of the country’.

Dr. Woldermariam implored health professional educators and health training institutions to embrace the WHO Global Competency and Outcomes Framework that will ensure that health workers produced in Uganda have the competencies and behaviors to meet Uganda’s health and population needs in the development and emergency contexts. ‘This will ultimately improve the health and well being of Ugandans, and ensure that Uganda achieves its National development and health sector goals’ he concluded.

Professor Barnabas Nawangwe, Vice Chancellor – Makerere University commended HEPI-SHSSU and MakCHS for convening HPE stakeholders to deliberate on this important issue.

Professor Nawangwe stressed that it is crucial that health training institutions come-up with appropriate innovative methods of training and education of current and future health professionals. He also reiterated the importance of retention of faculty through improvement of terms and conditions of service as well as support of career progress. The Vice Chancellor also called for an evaluation of the contribution of health workers to the economy of a nation and the effect if training institutions do not produce health professionals.

‘I wish to emphasise that HPE is important for national development and call on all training institutions to ensure that our curriculum as well as training matches international standards’, Professor Nawangwe advised.

Some of the issues arising from the plenary discussion included:

  • Large number of students in health training institutions is affecting clinical practice and the teacher to student ratio.
  • Institutions are moving towards student-centred learning where they are encouraged to research and make presentations
  • Soft skills and practicum are embedded in the curriculum
  • Mentors in health centres require payment from training institutions which is a challenge.
  • Competency-based training has been adopted by the training institutions
  • The attitude of students admitted has continued to improve.
  • While curricula have been reviewed, there remains gaps in the instruction/teaching
  • There are staffing gaps at health centres where students are sent for practicum thereby causing supervision gaps.
  • Inter-professional learning (for example training doctors and nurses together because they work together)

Increase number of faculty and refresher training whenever curricula are reviewed to keep abreast with new trends.

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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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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