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Former Grade III Teacher graduates with a PhD: NCDC approves her Study Intervention for Adolescent Care

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Sixty four-year-old Sarah Bunoti Nantono is a retired teacher and Lecturer of Psychology. She enrolled for a Ph.D. program at Makerere University School of Public Health (MakSPH) in 2013 with the goal of studying early adolescent reproductive health. 

Having taught for more than thirty years, Dr. Sarah Bunoti Nantono had moved up the academic ladder from being a primary school teacher to a lecturer at Kyambogo University. She believed that earning a PhD would be her ultimate goal in life. While at Kyambogo University, the second largest of the now 13 public universities in Uganda, Dr. Sarah Bunoti devoted her professional life to training social scientists, teachers and teacher educators.

Eleven years later, Dr. Bunoti Sarah Nantono is one of the 46 females of the 132 PhD graduands in the #Mak74thGrad, which begins on Monday, January 29, 2024. 

She successfully earns a Doctor of Philosophy ( PhD) in Public Health from Makerere University following her in-depth research titled; “Pubertal and Child Rights Awareness, Communication, and Child Protection against Sexual Abuse and Exploitation among 10–14-year-olds in Jinja Primary Schools: Opportunities, Challenges, and the Effectiveness of a School-Based Intervention.”

Dr. Sarah Bunoti is a seasoned lecturer with a proven track record in teacher training, social sciences, and psychology. Holding an MSc in Environment from Makerere University Institute of Environment, she also earned a Bachelor of Science in Zoology and Psychology from Makerere University in 1999, a Diploma in Teacher Education from ITEK in 1995, and a Grade III Primary School Teachers’ Certificate from the National Institute of Education. Beginning her career in 1981 as a primary school teacher,  and later  as a Teacher Trainer in the Ministry of Education in 1995, Sarah transitioned to Kyambogo University in 2000, where she currently serves as a part-time Lecturer, following her retirement. Sarah Bunoti Nantono is not only an educator but also an accomplished author, contributing to the development of the Child Rights Curriculum (CRED-PRO).

Dr. Sarah Bunoti’s PhD research examined how Jinja primary school children, aged 10 to 14, understood puberty and their rights related to sexual and reproductive health (SRH). The study looked at their knowledge sources, difficulties, and prospects for managing pubertal health effectively. 

The 10-14 age group comprises 10% of the global population, with Uganda having a higher percentage at 16%. This period marks the onset of significant changes, known as the storm in Psychology, involving body transformations and social shifts.

According to Dr. Sarah Bunoti, timely support during these changes fosters a sense of achievement, but delays can lead to anxiety and unpreparedness. Uganda, aligning with international agreements, including the UN Convention on the Rights of the Child, works to uphold children’s sexual well-being through policies and partnerships. 

Dr. Sarah Bunoti further notes in her research that the 10-14 age group in Uganda encounters puberty during primary school without appropriate information, support, protection, or preparation for the changes, leading to psychological challenges, sexual abuse, early marriages, unplanned pregnancies, and a rise in school dropouts.

Dr. Sarah Bunoti's PhD Defense Panel [Professor Stella Neema, Associate Professor Joseph Ssenyonga, Dr. Siu E. Godfrey, Dr. Beyeza-Kashesya Jolly and supervisors Associate Professor Lynn Atuyambe, Prof. Nazarius Mbona Tumwesigye alongside the session chairperson Prof. Garimoi Orach] determining the verdict before she was declared to have passed her defense. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Sarah Bunoti’s PhD Defense Panel [Professor Stella Neema, Associate Professor Joseph Ssenyonga, Dr. Siu E. Godfrey, Dr. Beyeza-Kashesya Jolly and supervisors Associate Professor Lynn Atuyambe, Prof. Nazarius Mbona Tumwesigye alongside the session chairperson Prof. Garimoi Orach] determining the verdict before she was declared to have passed her defense.

Busoga region, where the study was conducted faces particularly high rates of teenage pregnancies (7%) and school dropouts (91%). Children hold misconceptions driven by myths about puberty, emphasizing the lack of systematic guidance. Current Adolescent Sexual Reproductive Health programs focus on older children in secondary schools, neglecting the needs of those under 15.

Traditional sources, like family discussions, have diminished, placing the responsibility on schools, which often lack the necessary resources and teacher training. As a result, many 10-14-year olds are ill-prepared for changes and lack protection against sexual abuse, highlighting the necessity for evidence-based school interventions to address this information gap.

“Previously in our African traditional setting, the Aunties, Uncles and grandparents talked about puberty and prepared children for adulthood however with the breakdown of African traditional settings, schools are expected to do the role of talking to children about puberty.

Unfortunately, schools often look at puberty as an issue that is concerned with the family and expect the family to do that but also one possible problem is that the teachers themselves don’t know what to do when they are preparing these children for that,” observes Dr. Sarah Bunoti. 

Unfortunately, some stakeholders use threatening language, warnings, and punishments, contributing to risk behaviors, including sexual abuse, mood swings, and trauma among children.

“We wanted to find out what these children know about puberty, challenges they face and the support they get. We also wanted to find out from key duty bearers, these are parents and teachers, what kind of support do they give to the children and to what extent do they fulfill their obligations to protect the children against sexual abuse,” said Dr. Sarah Bunoti.

The study covered 16 primary schools purposefully selected for their diverse characteristics, including boarding status, religious affiliations, gender specifications, and geographical locations. The investigators also engaged with government officials to understand their stance on current sexual and reproductive health issues among young adolescents. 
The study exposed deficiencies in children’s understanding of puberty and child rights, along with teachers’ inadequate knowledge and skills in teaching puberty. 

Findings for instance revealed that kids—particularly boys—don’t often get the chance to talk candidly about puberty with adults. In all focus group conversations, the study gave boys and girls a forum to openly address their experiences, difficulties, and rights related to sexual and reproductive health. This emphasizes how important it is for all people to become widely sensitive to the issues that face kids.  Stepmothers were found not to communicate about puberty because of generalization and others.

Sarah Bunoti Nantono on the day of her PhD Defence. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Sarah Bunoti Nantono on the day of her PhD Defence.

“Surprisingly, discussions on pubertal challenges elicited more extensive responses from both boys and girls compared to other topics. Boys, although engaging in perceived anti-social behavior, demonstrated a level of conscience. It became evident that children, despite being sexually and biologically mature, require guidance on navigating the impact of hormones on their sexual feelings. The blame for communication gaps often falls on parents, who may be absent due to work, divorce, or being orphaned,” says Dr. Bunoti. 

Subsequently, she developed, applied, and assessed two intervention books; A children’s Resource book and a Teachers’ guide. The Randomized Control Trial demonstrated improved pubertal knowledge among children and enhanced teaching capabilities in teachers, affirming the intervention’s effectiveness. These intervention books were approved by the National Curriculum Development Centre (NCDC) and approved for teaching pubertal health and safety in primary schools nationwide. 

Dr. Bunoti has recommended empowering and involving young communicators to convey Sexual and Reproductive Health and Rights (SRHR) information to 10-14-year-olds, working collaboratively with parents and teachers, a strategy she believes will narrow the generation gap and enhance effective communication. Additionally, she calls for increased awareness and participation of male parents and teachers in SRH communication and child protection.

“Parents and adults should supplement school-based SRHR education by instilling age-appropriate individual, family, and community values and skills rooted in social, cultural, and religious contexts. Provide specialized training for Senior Women Teachers and Male Teachers, and reduce their teaching load to ensure dedicated attention to this critical aspect of education,” Dr. Bunoti expertly says. 

Her study, funded by Sida and supervised by Dr. Lynn Atuyambe and Prof. Nazarius Mbona Tumwesigye, successfully attained this recognition.

During her PhD defense, Associate Professor Lynn Atuyambe remarked, “It was a very enjoyable defense. You truly and successfully defended your PhD—now, you own your PhD.”

“I want to thank most especially your family, they’ve been part of this journey I am not guessing, I know they’ve been and am excited to see them and I like the support they have offered to mum. The highest level of education in the world is a PhD, you can do no more than that. You have reached at the saddle of your life in academia, congratulations and I wish you good luck,” said Dr. Lynn Atuyambe

Associate Professor Lynn Atuyambe, Dr. Sarah Bunoti's supervisor speaking during her defense. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Associate Professor Lynn Atuyambe, Dr. Sarah Bunoti’s supervisor speaking during her defense.

How her PhD Journey started

About a decade ago, SIDA had been consistently supporting Makerere University. However, they decided to extend their support to other public universities. When the opportunity arose, she seized it. 

“I have a habit of greeting, and my children often question why I greet so much. Sometimes, it turns out to be quite beneficial. One day, I walked into my Dean Dr. J Katigo – Kaheeru’s office and greeted, asking how he was. He said, ‘Sarah, I am glad you’ve come, read this but I said Doctor I am not ready for this,  but he said, ‘Sarah, you can’t give any more excuses, this is a God given opportunity, they want a concept for the SIDA Scholarships, go ahead and write a concept.’ I later met Professor Mary N Okwakol, my undergraduate Lecturer of Zoology, and Professor Albert Lutalo Bbosa, the former Vice Chancellor of Kyambogo University, who too reassured me of my potential to attain a PhD.    Out of 26 submissions from Kyambogo University, only three concepts were selected, and fortunately, mine was one of them,” Dr. Sarah Bunoti recalls. 

Once her concept was ready, Dr. Bunoti came to Makerere University, but her research topic was broad. Unfortunately, her background did not align with the faculties that typically received sponsorship from SIDA. Zoology, Psychology, Education, and Environmental Studies were her strengths, but none fell within the supported areas. 
Feeling disconsolate, she sought guidance from the then Director of Research and Graduate Studies at Makerere University, Professor Elly Katunguka. “He said, ‘why should you really struggle looking for a home, go and try School of Public Health. With your background, you’ll find a home,” she recalls.

Acting on his advice, Dr. Sarah Bunoti visited the School of Public Health one morning. However, the Dean, Prof. William Bazeyo, then, was away on leave; “I spoke with Assoc. Prof. Fred Wabwire-Mangen, the Acting Dean at the time. I explained my situation, highlighting my expertise in teaching, psychology, and environmental studies. He encouraged me to submit my concept, assuring me that these areas were valued in public health. This led to provisional admission, and I began refining my proposal with their guidance.”

As she exited Dr. Mangeni’s office, he promptly contacted Professor Anne Katahoire, who was by then the Director of Makerere University Child Health and Development Centre  and  Prof. Atuyambe, who was in Nairobi for a conference and told them; “We have a prospective student here, are you willing to take her up and without hesitation, Prof. Anne said yes and Prof. Lynn said, ‘I am in Nairobi but when I come back, I want to see that student,” Sarah recollects.

Subsequently, Prof. Mangeni reached out to Prof. Nazarius Mbona Tumwesigye upon recognizing the importance of the statistics component, he promptly invited her to discuss further details at the school. “In a short span, I found myself with a dedicated team of supervisors, a supportive Doctoral Committee chaired by Prof. Christopher Garimoi Orach with Prof Joseph Oonyu (RIP) and Dr. Christine K. Nalwadda, and a scholarly home in the Department of Community and Behavioral Sciences at the Makerere University School of Public Health,” Sarah Bunoti says.

Dr. Sarah Bunoti expresses gratitude to the MakSPH PhD Forum, the MakSPH family, the funder and her mother institution -Kyambogo University for the immeasurable support.

Dr. Sarah Bunoti (holding flowers) in a group photo with her PhD supervisors, examiners and family after her PhD defense. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Sarah Bunoti (holding flowers) in a group photo with her PhD supervisors, examiners and family after her PhD defense.

Dr. Sarah Bunoti expresses gratitude to the MakSPH PhD Forum, the MakSPH family, the funder and her mother institution -Kyambogo University for the inestimable support. She is also grateful to head teachers, teachers, children, and parents from her 16 project schools; Jinja City and District Education, Health and  Community Development officers as well as the Family and Child Protection Unit of the Uganda Police Force and others for the information and support rendered to her.

“I can’t quantify the support I received from MakSPH, from PhD forum, from my supervisors you all did a good job to support me in this. In addition, SIDA did a good job because with our teaching salary, paying for my PhD would have been a problem but they paid all my tuition even when the scholarship was ending they said Sarah, we are paying for two years at ago and paid for the field’s activities,” she recalls. 

She is equally grateful to everyone who provided her and her research team with useful information; Kyambogo University for assigning a teaching assistant to help her focus and her husband, Dr. Bunoti, who has promised to support her dream.  
“I want to thank my family, my sister Mrs. Rebecca Lucy and her husband Eng. Dr  James Muwuluke, my children. They have been there for me, my husband, Dr. Bunoti met me when I was a primary school teacher and he was a Doctor teach and told me, Sarah, I will support you until you are tired of reading and has kept his word, there are few empowered men who will want a woman to come up and get the title they hold,” she said. 

Dr. Sarah Bunoti with her family. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Sarah Bunoti with her family.

“Given what I have gone through, am so excited about this achievement. My family is so excited about this. My husband is extremely excited. They have written short paragraphs about me about my resilience. I had decided not to hold any celebration but my sister and her husband says this could not pass since it is no mean achievement,” she says.

Dr. Godfrey Siu Etyang, her Ph.D. overseer, has invited her to collaborate on a parenting project at the Child Health and Development CenterCollege of Health Sciences, Makerere University. Over the past month, she has been actively contributing to the development of a comprehensive parenting curriculum for the unit.

Dr. Bunoti anticipates scaling up the approved intervention, particularly to additional primary schools in the Busoga region and beyond and has already began talks with Ministry of Education and Sports to support children’s understanding of puberty, a sine qua non for education and parenting.

Unexpected difficulties affected Dr. Sarah Bunoti Nantono’s journey to earning her Ph.D., resulting in longer than the expected four to six years. Midway through her studies, she developed insomnia, which was an unexpected health problem. In 2020 when it appeared that she would soon graduate, the Doctoral Committee insisted that she must publish her work, and was reluctant to accept a monograph, one of the options for one to graduate with a PhD at Makerere University. Further delays were due to lengthy processes to have her manuscripts published and clearances through the Institutional Review Board (IRB). Other than these challenges, Dr. Nantono also had to repeat the entire data collection process and deal with the untimely death of Assoc. Prof. Joseph Oonyu, a key member of her doctorate committee, in October 2020. Despite these challenges, Dr. Nantono feels proud to have completed her doctorate, demonstrating her incredible endurance in the face of adversity.


Congratulations Sarah!

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Digital Mobile Technologies to Study Tuberculosis: A Multi-Discplinary Program

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An aerial view of the Makerere University School of Public Health construction site on the Main Campus. To the Right is the Infectious Diseases Institute (IDI) and in the background are Dag Hammaskjold Hall (Green roof) and University Hall (Brown tiles).

A TRAINING PROGRAM SPONSORED BY FOGARTY INTERNATIONAL CENTER NATIONAL INSTITUTES OF HEALTH, USA

INFORMATIONAL SESSION

Makerere University School of Public Health under D43 multi-disciplinary training program in digital mobile technologies to study tuberculosis that was recently funded by the NIH, through the University of Georgia (UGA) has an opportunity for funding of a masters’ research thesis. This is available to two (02) first year students of the Graduate programmes offered at Makerere University who have progressed to concept proposal development stage of their graduate program. These should be in good academic standing and have or are about to complete year 1 in Academic Year 2023/24. The support will start at the beginning of Academic Year 2024/25, i.e., end of August 2024 when the students are starting their year 2.  Students of geography and or digital health related courses are encouraged to apply, females too.  Students will be provided with secondary data to address the following, or similar, issues relating to tuberculosis (TB):

  1. Characterizing mobility patterns between urban and rural areas of Uganda using archived cell-phone (CDR) metadata
  2. Correlation between self-reported geolocated mobility patterns of TB patients and CDR data
  3. Differences in mobility patterns of TB patient’s pre-diagnosis and post-diagnosis
  4. Gender differences and relationship between IGRA and TST in a prospective cohort
  5. Patterns of change in serial IGRA test results by sex, age, HIV status
  6. Temporal changes in contact, mobility and geographic networks in TB converters and non-converters
  7. Ecological Momentary Assessment (EMA) of social contacts and location patterns of movement by residents at risk for TB infection

Interested students are encouraged to attend an information session on Wednesday 17th July 2024 at MakSPH Annex Kololo where details about the research questions and funding opportunity will be provided to prospective applicants. Prospective applicants will be required to work with their mentors and training grant personnel to develop a 2-5-page concept that will be vetted for possible funding by training faculty of the training program.

Interested students should register their attendance with the training Coordinator, Mr Ivan Mutyaba by sending an email expressing interest in attending the session to imutyaba@musph.ac.ug by close of business on Thursday, 11th July 2024.

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METS Newsletter June 2024

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Makerere University School of Public Health (MakSPH) Dean, Prof Rhoda Wanyenze (Left), MoH Director General, Dr. Henry Mwebesa (Right) and other stakeholders join Dr. Amy Boore (2nd Right) to cut cake at her farewell event. Golden Tulip Hotel, 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 June 2024 Newsletter

  • Tracking Trends in HIV Outcomes: The Implementation of HIV Case-Based Surveillance
    • METS in partnership with the Ministry of Health (MoH) and various implementing partners, is spearheading the HIV Case-Based Surveillance (CBS) initiative across Uganda. By February 2024, CBS had been activated in 504 health facilities, with 349 sites (69%) actively transmitting data.
    • Trends of New HIV Diagnosis: An analysis trends over a 20-year period (2000-2022) revealed an increase in new HIV diagnosis over time, peaking in 2014 and 2018, before starting to decline. Diagnoses among females consistently exceeded those among males each year.
    • Case-Based Surveillance (CBS) complimenting other HIV surveillance programs: CBS provides valuable insights into infection patterns and highlights the need for targeted interventions, particularly among females. Next steps include continued scale up of CBS implementation to reach 80% of ART sites; improving data transmission from facility to the national repository to achieve at least 90% of the CBS activated sites; and strengthening data analytics and use of the data for program improvement.
  • Enhancing HIV Prevention Data Collection Through Bootcamps
    • METS in collaboration with HISP Uganda held a workshop in Mbarara to update the Health Management Information System (HMIS) tools for PrEP (Pre-Exposure Prophylaxis) in the HIV Prevention Tracker. The workshop focused on digitizing paper forms to efficiently collect data on key and priority populations.
  • Electronic Medical Records (EMR) upgrades in Eastern Uganda
    • The two-week activity kicked off with a week-long training session at Northeast Villa in Kumi focused on the enhancements of UgandaEMR+, including improved point-of-care (POC) functionalities and data visualization techniques.
    • The initiative successfully trained over 15 AIDS Information Centre (AIC) staff members, including M&E leads, IT personnel, data officers, and M&E managers, in the practical use of UgandaEMR+. Additionally, the two facilities, Ochero HCIII and Kapelebyong HCIV, were upgraded and their staff trained on the new system.
  • Tribute to Dr. Joshua Musinguzi (9/09/1963 – 7/06/2024)
    • Dr. Joshua Musinguzi’s efforts to minimize HIV incidence and death strategically focused on translating knowledge into policies and actions, which has helped Uganda manage the HIV epidemic.
  • Gallery
    • Bidding farewell to Dr. Amy Boore, Program Director, Division of Global Health Protection – CDC
    • Analysing the UgandaEMR Clinical Laboratory Module
    • UgandaEMR+ training for USAID SITES
    • Training for clinicians at Ruharo Mission Hospital on SARI and ILI
    • HIV Treatment Services (HTS) Implementers Meeting

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Job Opportunity at MakSBSREC: Assistant Administrative Officer

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The Davies Lecture Theatre (Right), School of Biomedical Sciences (Blue) and other buildings at the College of Health Sciences (CHS), Mulago Campus, Makerere University, Kampala Uganda, East Africa.

Makerere University is pleased to announce a vacancy for the position of Assistant Administrative Officer (REC Administrator) within the School of Biomedical Sciences Research Ethics Committee (MakSBSREC). This is an excellent opportunity for qualified individuals to contribute to the ethical oversight of research involving human participants.

Position Details:

  • Job Title: Assistant Administrative Officer (REC Administrator) – MakSBSREC
  • Reports to: Chairperson MakSBSREC
  • Engagement: Full-time
  • Duration: 1 Year, renewable upon satisfactory performance
  • Duty Station: Kampala

Qualifications, Desired Skills, and Experience:

  • Bachelor’s degree in Social Sciences and Humanities, Medicine and Surgery, Ethics and Human Rights, or any related field.
  • Master’s degree in Bioethics (an added advantage).
  • Up-to-date training in Human Subject Protection or Good Clinical Practice.
  • Proficiency in English (both spoken and written).
  • Prior experience in regulatory work in research studies or projects.
  • Excellent communication, organizational, and interpersonal skills.
  • Ability to work independently with minimal supervision and meet deadlines.

How to Apply:

Qualified and interested candidates are invited to submit a soft copy of their application documents and a motivation letter to deansbs.chs@mak.ac.ug with the subject line “Application for the position of Assistant Administrative Officer (REC Administrator)”. Address your application to the Dean, School of Biomedical Sciences.

Deadline for submission: July 2, 2024, by 5:00 pm Ugandan time.

Please provide a reliable 24-hour phone contact. Only short-listed candidates will be contacted for interviews.

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