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Infrastructure Expansion for MakSPH, Vital for Uganda’s Public Health System – Prof. David Peters

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Kampala— Professor David Peters, Dean of the Faculty of Health at York University, Canada, has hailed Makerere University School of Public Health (MakSPH) as a global leader and a cornerstone of Uganda’s public health system. He emphasized the school’s vital role during the launch of its new state-of-the-art auditorium on March 15, 2024, part of its ambitious expansion plans to bolster Public Health capacity, training, research, and service across Africa.

Drawing from extensive experience in global health systems, Professor Peters emphasized the critical role of Makerere University in driving forward public health initiatives in the region.

The ambitious MakSPH new home building construction broke ground on 28th February, 2020. The project that seeks to address the increasing demand for public health education and research, with an estimated cost of $10 million USD.

While making a case for the building, the Netherlands Ambassador to Uganda then, Henk Jan Bakker, announced the Dutch contribution to a tune of $420,000 through the Hague based Dutch organisation for internationalisation in education Nuffic and through the SET-SRHR project at Makerere University. This contribution was channeled to towards the construction of a state-of-the-art Auditorium, which is part of building design.  Infrastructure forms the foundation of a healthy community and indeed as noted by Ambassador Henk, “Public Health is not only Uganda’s concern but also a global epidemic thus worth investing in.”

“I want to say how grateful I am to have been able to work with colleagues at Makerere University for now over two decades,” said Professor Peters.

Professor David Peters, YorkU Health photo
Professor David Peters, YorkU Health photo

Adding that; “The School of Public Health is responsible for educating and training critically needed public health workers for conducting critical science-based research that really addresses the origins of public health problems as well as for the prevention and intervention for diseases and disabilities and because it strengthens the practice of public health through knowledge translation.”

Professor Peters highlights the School of Public Health’s critical role in addressing historical and current public health challenges, including population growth, urbanization, inequity, justice, commercial influence, climate effects, and technological changes.

“And this is huge cost to the population, whether it be a maternal child, chronic diseases or aging, but also on epidemics and the costs, literally the catastrophic costs of health spending,” he said.

For Prof. Peter, while ideas on medicine and disease have really spread across countries and regions for millennia, efforts at public health and global level are really relatively recent from the last few centuries.

In the 19th century, historical concerns revolved around epidemics, famine, and conflict, closely linked to trade and environmental disruptions impacting industry and agriculture. This prompted nations to collaborate in safeguarding trade and preventing disease spread, laying the groundwork for international health regulations and the establishment of the World Health Organization (WHO).

Global public health education emerged from these efforts, rooted in scientific advancements like the germ theory and influenced by colonialism. Global health initiatives aimed to address health issues in other populations, with the Rockefeller Foundation playing a significant role in supporting and establishing schools of public health. The first, Johns Hopkins, founded in 1916, paved the way for numerous others worldwide, totaling around 35 new schools of public health, alongside several medical schools.

In modern global health, scientific advancements applied in resource-limited settings have saved countless lives. However, Professor Peters contends that this focus on biomedicine and technology, while successful in tackling specific health issues, often neglects broader local health system challenges.

Works on the main entrance for the main block for the new building taking shape with slab works on top. This section will act as a reception area and host a lobby. Main Camupus, Makerere University, Kampala Uganda, East Africa.
Works on the main entrance for the main block for the new building taking shape with slab works on top. This section will act as a reception area and host a lobby.

He further notes that vertical and horizontal approaches, though effective at times, fail to address the comprehensive needs of communities and systems. Additionally, the dominance of Western institutions in global health perpetuates a crisis-driven mentality, prioritizing quick wins over sustainable, community-centered strategies.

This approach, exemplified during crises like the Ebola outbreak in West Africa, sidelines long-term planning and neglects social determinants of health.

Dr. Peters, also the former senior public health specialist with the World Bank argues that while science drives progress, it comes at the expense of sustainability, coherence, and holistic health approaches, favoring curative care over prevention, a perception he believes needs to change.

Looking ahead in global public health education, Professor Peters acknowledges Makerere University‘s leadership in this field and its ongoing commitment. He highlights the university’s efforts to tailor institutional design and curriculum to local needs, particularly evident in the Master of Public Health program at Makerere School of Public Health, including distance learning options.

Emphasizing the need for innovative teaching methods, such as active learning and interdisciplinary approaches, Professor Peters stresses the importance of practical experience and IT integration.

Renowned for his collaborative efforts in advancing health policy and systems research, implementation science, and enhancing institutional capacity in health systems, Professor Peters advocates for professionalism grounded in competencies. He champions collaboration among health and education stakeholders, policymakers, communities, professional organizations, and academia to drive the evolution of global public health education.

“You need to be socially relevant, coherent and accountable. This does mean that physical infrastructure is needed. Our twinning operation between Makerere and Uganda. We need the buildings for teaching, community convening and group work, but also for research wet labs, specimen storage, computing, for use of big data and for the IT infrastructure,” said Prof. Peters.  

Learning between collaboration across institutions and linking global to local is really critical. He contends that Makerere School of Public Health is an essential to the public health system and a leader in this as well.

An overhead shot of works on the main entrance for the main block for the new building taking shape with slab works on top. This section will act as a reception area and host a lobby. Main Campus, Makerere University, Kampala Uganda, East Africa.
An overhead shot of works on the main entrance for the main block for the new building taking shape with slab works on top. This section will act as a reception area and host a lobby.

Taking inspiration from a program at the College of Health Sciences, funded by the Bill and Melinda Gates Foundation, which aimed to enhance all health schools at Johns Hopkins and Makerere University, Professor Peters emphasizes the broader scope of the initiative beyond mere technological advancements.

Dubbed the “grander challenge,” the project focused on institution-building, innovation, and human resource development for sustainable healthcare delivery. Makerere University seeks to be a transformative institution, fostering academic excellence and innovation while driving positive health outcomes in Uganda and the broader East Africa region.

“See the Makerere School of Public Health as transformational and being able to develop and generate knowledge, develop capabilities at individual levels as well as the leadership and organizational levels to model best practices and to support organizations and to develop partnerships to stimulate change,” he says.

He notes that there is a strong investment case for infrastructure at Makerere University. “It provides education training, it conducts research, it strengthens practice. If you see it as an essential part of infrastructure, here’s something that colleagues in North America put together around, this is around the National Academy of Sciences saying that ‘investment in schools of public health should be seen as analogous to government support for public goods like national defense and transportation infrastructure. It is that important.’”

According to Professor Peters, a global review found similar things how what they do in terms of education and research but also towards sustainable development goals and what it does globally. And that you need funding, human resources, agency, collaborations, and infrastructure in being able to do that.

“We need your time, your talent and your treasure to be able to contribute to Makerere School of Public Health. I want to thank you and to finally say that Makerere School of Public Health needs you, but we all need Makerere School of Public Health,” Professor David Peters.

An aerial view of the new MakSPH building taking shape with slab works on top. Main Campus, Makerere University, Kampala Uganda, East Africa.
An aerial view of the new MakSPH building taking shape with slab works on top.

In 2021, the USAID ASHA Program awarded $1.1 million to create an augmented reality solution for Makerere University‘s new School of Public Health. Partnering with Johns Hopkins University under the leadership of Prof. David Peters, this funding aims to launch the Makerere University Centre of Excellence for Global Health.

Since 2000, Johns Hopkins has engaged in 48 collaborative research and training projects valued at over $6 million, spanning various fields such as doctoral training, medical education, laboratory training, and health systems development, including projects like the Asha Grant.

Caitlin Kennedy, a Professor of International Health, Social, and Behavioral Interventions at Johns Hopkins, expressed excitement about the university’s involvement in the building collaboration and eagerly anticipates exploring the new space and further nurturing partnerships cultivated over the years.

“I would like to send a sincere thanks to the Asha Grant and USAID for the amazing financial support. I hope others will see projects like this, and be inspired to provide more funding for public health infrastructure,” said Prof. Caitlin.

Caitlin Kennedy extends gratitude to everyone involved in bringing the building to shape, from the visionaries to the diligent planners and builders. She also thanks the faculty, staff, and students who will transform it into a vibrant learning environment.

“We at Johns Hopkins are really looking forward to continuing to do great public health collaborations with you in that space for many years to come. Thank you so much. Everyone and congratulations enjoy the space.”

Caitlin Kennedy, Professor of International Health, Social, and Behavioral Interventions at Johns Hopkins.
Caitlin Kennedy, Professor of International Health, Social, and Behavioral Interventions at Johns Hopkins.

Funds raised so far

Currently, we’ve raised a total of $4,804,314, but we still face a deficit of $5,195,686 for the construction. We’re grateful for contributions from various sources: MakSPH Staff Community ($46,043), MakSPH Departments ($144,972), Private Institutions/Companies ($52,528), Other Individuals ($131,949), and a generous donation of $675,000 from Makerere University. Additionally, MakSPH has committed $2,133,822 from internally generated funds, while the Rockefeller Foundation contributed $100,000 towards furnishing the auditorium. Your support is crucial in making a meaningful impact and driving transformation. Join us on this journey by contributing through https://sph.mak.ac.ug/givedonate.

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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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