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Osuret J, Van Niekerk A, Kobusingye O, Atuyambe L, Nankabirwa V. Driver yield and safe child pedestrian crossing behavior promotion by a school traffic warden program at primary school crossings: A cluster-randomized trial. Traffic Inj Prev 2024; 25:510-517. [PMID: 38324586 DOI: 10.1080/15389588.2024.2305426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To determine the effect of a school traffic warden program on increasing driver yield and safe child pedestrian crossing behavior in Kampala, Uganda. METHODS We designed and implemented a school traffic warden program in specific school zones in Kampala, Uganda. We randomly assigned 34 primary schools in Kampala, in a 1:1 ratio, using a computer-generated randomization sequence, to control or intervention arms in a cluster randomized trial. Each school in the intervention group received one trained adult traffic warden stationed at roads adjacent to schools to help young children safely cross. The control schools continued with the standard of care. We extracted and coded outcome data from video recordings on driver yield and child crossing behavior (defined as waiting at the curb, looking both ways for oncoming vehicles, not running while crossing, and avoiding illegal crossing between vehicles) at baseline and after 6 months. Using a mixed effect modified Poisson regression model, we estimated the prevalence ratio to assess whether being in a school traffic warden program was associated with increased driver yield and safe crossing behavior. RESULTS A higher proportion of drivers yielded to child pedestrians at crossings with a school traffic warden (aPR 7.2; 95% CI 4.42-11.82). Children were 70% more likely to demonstrate safe crossing behavior in the intervention clusters than in control clusters (aPR 1.7; 95% CI 1.04-2.85). A higher prevalence was recorded for walking while crossing (aPR 1.2; 95% CI 1.08-1.25) in the intervention clusters. CONCLUSION The school traffic warden program is associated with increased driver yield and safe child pedestrian crossing behavior, i.e., stopping at the curb, walking while crossing, and not crossing between vehicles. Therefore, the school traffic warden program could be promoted to supplement other road safety measures, such as pedestrian safety road infrastructure, legislation, and enforcement that specifically protects children in school zones.
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Affiliation(s)
- Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ashley Van Niekerk
- Institute for Social and Health Sciences, University of South Africa, Cape Town, South Africa
- Masculinity and Health Research Unit, South African Medical Research Council, and University of South Africa, Cape Town, South Africa
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Lynn Atuyambe
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Victoria Nankabirwa
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
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Osuret J, Van Niekerk A, Kobusingye O, Atuyambe L, Nankabirwa V. Child pedestrian crossing behaviour and associated risk factors in school zones: a video-based observational study in Kampala, Uganda. Inj Prev 2023:ip-2023-044932. [PMID: 37963725 DOI: 10.1136/ip-2023-044932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Pedestrian crashes, often occurring while road crossing and associated with crossing behaviour, make up 34.8% of road casualties in Uganda. This study determined crossing behaviour and associated factors among child pedestrians around primary schools in Kampala, Uganda. METHODS We conducted a cross-sectional study in 2022 among 2100 primary school children. Data on their crossing behaviour were collected using video recordings from cameras staged at the crossing points of 21 schools. We estimated prevalence ratios (PR) with their corresponding 95% CIs using a modified Poisson regression model for the association between unsafe behaviour and the predictors. RESULTS The prevalence for each of 5 unsafe child pedestrian behaviour was 206 (25.8%) for crossing outside the crosswalk, 415 (19.8%) for failing to wait at the kerb, 238 (11.3%) for failing to look for vehicles, 361 (17.2%) for running and 235 (13%) for crossing between vehicles. There was a higher likelihood of crossing outside the crosswalk when an obstacle was present (adjusted PR (aPR) 1.8; 95% CI 1.40 to 2.27) and when children crossed alone (aPR 1.5; 95% CI 1.13 to 2.06). Children who crossed without a traffic warden (aPR 2; 95% CI 1.40 to 2.37) had a significantly higher prevalence of failing to wait at a kerb. CONCLUSION These findings reveal the interaction between child pedestrians, vehicles and the environment at crossings. Some factors associated with unsafe child pedestrian behaviour were the presence of an obstacle, crossing alone and the absence of a traffic warden. These findings can help researchers and practitioners understand child pedestrian crossing behaviour, highlighting the need to prioritise targeted safety measures.
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Affiliation(s)
- Jimmy Osuret
- School of Public Health, Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ashley Van Niekerk
- Institute for Social and Health Sciences, University of South Africa, College of Human Sciences, Pretoria, South Africa
- South African Medical Research Council and University of South Africa, Masculinity and Health Research Unit, Cape Town, South Africa
| | - Olive Kobusingye
- School of Public Health, Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Lynn Atuyambe
- School of Public Health, Department of Community Health and Behavioural Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Victoria Nankabirwa
- School of Public Health, Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda
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3
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Sell K, Jessani NS, Mesfin F, Rehfuess EA, Rohwer A, Delobelle P, Balugaba BE, Schmidt BM, Kedir K, Mpando T, Niyibizi JB, Osuret J, Bayiga-Zziwa E, Kredo T, Mbeye NM, Pfadenhauer LM. Developing, implementing, and monitoring tailored strategies for integrated knowledge translation in five sub-Saharan African countries. Health Res Policy Syst 2023; 21:91. [PMID: 37667309 PMCID: PMC10478471 DOI: 10.1186/s12961-023-01038-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/11/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Integrated knowledge translation (IKT) through strategic, continuous engagement with decision-makers represents an approach to bridge research, policy and practice. The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA +), comprising research institutions in Ethiopia, Malawi, Rwanda, South Africa, Uganda and Germany, developed and implemented tailored IKT strategies as part of its multifaceted research on prevention and care of non-communicable diseases and road traffic injuries. The objective of this article is to describe the CEBHA + IKT approach and report on the development, implementation and monitoring of site-specific IKT strategies. METHODS We draw on findings derived from the mixed method IKT evaluation (conducted in 2020-2021), and undertook document analyses and a reflective survey among IKT implementers. Quantitative data were analysed descriptively and qualitative data were analysed using content analysis. The authors used the TIDieR checklist to report results in a structured manner. RESULTS Preliminary IKT evaluation data (33 interviews with researchers and stakeholders from policy and practice, and 31 survey responses), 49 documents, and eight responses to the reflective survey informed this article. In each of the five African CEBHA + countries, a site-specific IKT strategy guided IKT implementation, tailored to the respective national context, engagement aims, research tasks, and individuals involved. IKT implementers undertook a variety of IKT activities at varying levels of engagement that targeted a broad range of decision-makers and other stakeholders, particularly during project planning, data interpretation, and output dissemination. Throughout the project, the IKT teams continued to tailor IKT strategies informally and modified the IKT approach by responding to ad hoc engagements and involving non-governmental organisations, universities, and communities. Challenges to using systematic, formalised IKT strategies arose in particular with respect to the demand on time and resources, leading to the modification of monitoring processes. CONCLUSION Tailoring of the CEBHA + IKT approach led to the inclusion of some atypical IKT partners and to greater responsiveness to unexpected opportunities for decision-maker engagement. Benefits of using systematic IKT strategies included clarity on engagement aims, balancing of existing and new strategic partnerships, and an enhanced understanding of research context, including site-specific structures for evidence-informed decision-making.
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Affiliation(s)
- Kerstin Sell
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany.
- Pettenkofer School of Public Health, Munich, Germany.
| | - Nasreen S Jessani
- Centre for Evidence-Based Healthcare, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Firaol Mesfin
- Non-Communicable Diseases Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Eva A Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Anke Rohwer
- Centre for Evidence-Based Healthcare, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Peter Delobelle
- Chronic Diseases Initiative for Africa, University of Cape Town, Cape Town, South Africa
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bonny E Balugaba
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Bey-Marrié Schmidt
- School of Public Health, University of the Western Cape, Cape Town, South Africa
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Kiya Kedir
- Non-Communicable Diseases Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Talitha Mpando
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Jean Berchmans Niyibizi
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Esther Bayiga-Zziwa
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Tamara Kredo
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics and Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nyanyiwe Masingi Mbeye
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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4
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Nagavci B, Nyirenda JLZ, Balugaba BE, Osuret J, Meerpohl JJ, Grummich K, Kobusingye O, Toews I. Evidence-based guidelines for hypertension and diabetes in sub-Saharan Africa: a scoping review. BMJ Open 2022; 12:e067156. [PMID: 36549745 PMCID: PMC9791379 DOI: 10.1136/bmjopen-2022-067156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The Collaboration for Evidence-Based Healthcare and Public Health in sub-Saharan Africa (CEBHA+), a research network, aims to build capacities for evidence-based healthcare. Hypertension (HTN) and diabetes mellitus (DM) are two priority areas of the network, both are major causes of burden of disease in this region. This review aimed to: (1) identify existing evidence-based guidelines for HTN and DM, (2) map their recommendations and (3) assess their quality. SETTING Sub-Saharan Africa. DESIGN Scoping review. METHODS Systematic searches for evidence-based guidelines, developed with systematic review of evidence and certainty of evidence assessment, were undertaken in electronic databases and grey literature, and ministries of health of all countries in this region were contacted. Included guidelines were assessed with the Appraisal of Guidelines for research and evaluation II (AGREE-II) tool. Searches were conducted between 7 December 2021 and 14 January 2022. Results are presented descriptively. RESULTS 66 potentially relevant guidelines were identified, developed in 23, out of 49 sub-Saharan African countries. Of these, only two guidelines (on DM) reported the use of systematic review of evidence and certainty of evidence assessment. Their quality appraisal showed that both have relatively similar scores on domains of AGREE-II, with higher scores on Scope and Purpose and Clarity and Presentation domains, and lower on Stakeholder Involvement, Applicability, Rigour of Development and Editorial independence domains. The overall scores of both guidelines were 50% and 58%, respectively. CONCLUSIONS Less than half of the countries in sub-Saharan Africa developed and published their own guidelines for HTN or DM. The quality appraisal showed that the two included guidelines scored relatively low in several crucial domains of AGREE-II. Countries in this region could consider adopting or adapting already published high-quality recommendations, in order to facilitate a more efficient and faster development of much needed trustworthy evidence-based guidance.
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Affiliation(s)
- Blin Nagavci
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - John L Z Nyirenda
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Bonny E Balugaba
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Cochrane Germany Foundation, Freiburg, Germany
| | - Kathrin Grummich
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Ingrid Toews
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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Ssekamatte T, Mugambe RK, Nalugya A, Isunju JB, Kalibala P, Musewa A, Bikaako W, Nattimba M, Tigaiza A, Nakalembe D, Osuret J, Wafula ST, Okech S, Buregyeya E, Tsiouris F, Michaels-Strasser S, Kabasa JD, Bazeyo W. Employment status of AFROHUN-Uganda one health alumni, and facilitators and barriers to application of the one health approach: a tracer study. BMC Health Serv Res 2022; 22:1205. [PMID: 36167534 PMCID: PMC9513298 DOI: 10.1186/s12913-022-08537-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 09/07/2022] [Indexed: 12/05/2022] Open
Abstract
Background The One Health (OH) approach integrates multiple competencies in the prevention and control of disease outbreaks. Through a range of OH competence-based activities, the Africa One Health University Network (AFROHUN) built the capacity of selected students at Makerere University and Mbarara University of Science and Technology. This study applied the Systems Theoretical Framework (STF) of career development to establish the employment status of AFROHUN-Uganda alumni, and the facilitators and barriers to application of the OH approach in their organisations. Methods We conducted an embedded mixed-methods study among a random sample of 182 AFROHUN-Uganda alumni of the 2013–2018 cohorts. For quantitative data, descriptive statistics were computed using Stata 14.0 statistical software. A total of 12 in-depth interviews were conducted, and NVivo 12 Pro was used to organise data during thematic analysis. Results While the majority, 87.4% were or got employed after participating in the AFROHUN Uganda capacity building programme, 68.1% were employed at the time of the survey, 57.7% had worked with their current employer for at least a year, and 39% held managerial positions. The facilitators of applying the OH approach into employing organisations included being knowledgeable about OH, the presence of a multidisciplinary workforce, the nature of activities implemented, and existing partnerships and collaborations between organisations. The barriers to the application of the OH approach included limited funding, a negative attitude towards working with people from other disciplines, and limited knowledge of the One Health approach. Conclusion Notably, more than two-thirds of the OH alumni were employed, and more than a third held managerial position. While these findings portray a fairly good absorption rate of the OH alumni into the workforce, they also highlight the facilitators of application of the OH approach that need to be promoted as well as the barriers that need to be addressed if the application of the OH approach is to be improved within the workforce. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08537-7.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda. .,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Patrick Kalibala
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Angella Musewa
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Winnie Bikaako
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Milly Nattimba
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Arnold Tigaiza
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Doreen Nakalembe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Solomon T Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Samuel Okech
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Fatima Tsiouris
- Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - John David Kabasa
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - William Bazeyo
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
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6
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Ssekamatte T, Isunju JB, Nalugya A, Mugambe RK, Kalibala P, Musewa A, Bikaako W, Nattimba M, Tigaiza A, Nakalembe D, Osuret J, Wafula ST, Buregyeya E, Tsiouris F, Michaels-Strasser S, Kabasa JD, Bazeyo W. Using the Kolb's experiential learning cycle to explore the extent of application of one health competencies to solving global health challenges; a tracer study among AFROHUN-Uganda alumni. Global Health 2022; 18:49. [PMID: 35550588 PMCID: PMC9096757 DOI: 10.1186/s12992-022-00841-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/02/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The Africa One Health University Network (AFROHUN) with support from the United States Agency for International Development (USAID), has since 2012 conducted pre and in-service One health (OH) trainings with the objective of improving global health security. These trainings aim to build competencies that, enhance a multidisciplinary approach to solving global health challenges. Despite the investment in OH trainings, there is limited documentation of the extent of acquisition and application of the OH competencies at workplaces. This tracer study explored the extent of acquisition and application of the OH competencies by the AFROHUN-Uganda alumni. METHODS A cross-sectional study was conducted among a random sample of 182 AFROHUN-Uganda alumni of 2013-2018 cohorts. A blended approach of interviewer-administered and self-administered questionnaires was used. Virtual platforms such as Zoom, Microsoft teams, and Skype, and phone interviews were used to collect data when face-to-face interactions with alumni were not possible. Data were collected electronically, either through a link or with the aid of the KoboCollect mobile application, pre-installed on android enabled devices, and analysed using STATA14.0. RESULTS The majority of respondents, 78.6% (143/182) had jobs that required application of OH knowledge and skills, 95.6% (174/182) had learned employable skills from OH activities and 89.6% (163/182) had applied such skills when searching for employment. About 21.7% (34/180) to a very high extent required OH field-specific theoretical knowledge at their workplaces, 27.4% (43/80) to a very high extent required OH field-specific practical knowledge/skills, 42.7% (67/180) to a high extent required a change in attitude and perceptions towards working with people from different disciplines, 49.0% (77/180) required collaboration and networking skills, and more than half, 51.0% (80/180) required team building skills. CONCLUSIONS The majority of OH alumni to a very high extent acquired and applied OH competences such as teamwork, effective communication, community entry and engagement, report writing and problem-solving skills. This study revealed the significant contribution of the AFROHUN Uganda OH activities towards supportive work environments, and highlights areas of improvement such as supporting the trainees to acquire people-management skills, innovation, and an entrepreneurial mind set.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda. .,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Patrick Kalibala
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Angella Musewa
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Winnie Bikaako
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Milly Nattimba
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Arnold Tigaiza
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Doreen Nakalembe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Fatima Tsiouris
- Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - John David Kabasa
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - William Bazeyo
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
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7
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Ndejjo R, Ssemugabo C, Osuret J, Zziwa EB, Fonn S, Alfvén T, Mukanga D, Khayesi M, Wanyenze RK. Positioning Africa's public health doctoral students to lead societal transformation and development. BMJ Glob Health 2022; 7:bmjgh-2021-007996. [PMID: 35168932 PMCID: PMC8852658 DOI: 10.1136/bmjgh-2021-007996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/23/2022] [Indexed: 12/24/2022] Open
Abstract
The public health context is becoming increasingly more complex requiring highly trained professionals equipped with knowledge, competencies and tools to address or transform current and future challenges. Doctoral degree training offers an opportunity to build the capacity to detect and respond to such dynamic health challenges. In this paper, we discuss how Africa's public health doctoral students can be better positioned for the different career pathways to provide leadership on complex health and development challenges. Public health PhD graduates can take up careers in academia, civil service, private sector and civil society, among others. To thrive in these pathways, PhD training should equip them with knowledge, skills and competencies in leadership, creativity and social competence among others. To produce career-ready PhD graduates, there is need to rethink training curricula to build critical skills for diverse career pathways, introduce students to entrepreneurship, and enhance linkages between universities and industry. Experiential learning, exposure to networks and partnerships, postdoctoral programmes and mentorship and exchange programmes can further equip PhD students with key knowledge, skills and competencies. For students to position themselves for the different careers, they ought to plan their careers early, albeit with flexibility. Students should build their soft skills and embrace technology among other transferable competencies. By identifying potential career pathways and being positioned for these early, Africa can produce transformative PhD students on a path for success not just for themselves but for society at large, including in new environments such as that created by COVID-19.
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Affiliation(s)
- Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda .,Centre of Excellence for Sustainable Health, a Collaboration Between Makerere University and Karolinska Institutet, Kampala, Uganda
| | - Charles Ssemugabo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Esther Bayiga Zziwa
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Sharon Fonn
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Centre of Excellence for Sustainable Health, a Collaboration Between Makerere University and Karolinksa Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - David Mukanga
- Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Meleckidzedeck Khayesi
- Injuries and Violence Prevention Department, World Health Organization, Geneva, Switzerland
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.,Centre of Excellence for Sustainable Health, a Collaboration Between Makerere University and Karolinska Institutet, Kampala, Uganda
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8
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Namatovu S, Balugaba BE, Muni K, Ningwa A, Nsabagwa L, Oporia F, Kiconco A, Kyamanywa P, Mutto M, Osuret J, Rehfuess EA, Burns J, Kobusingye O. Interventions to reduce pedestrian road traffic injuries: A systematic review of randomized controlled trials, cluster randomized controlled trials, interrupted time-series, and controlled before-after studies. PLoS One 2022; 17:e0262681. [PMID: 35073351 PMCID: PMC8786203 DOI: 10.1371/journal.pone.0262681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 12/30/2021] [Indexed: 11/19/2022] Open
Abstract
Background
Road traffic injuries are among the top ten causes of death globally, with the highest burden in low and middle-income countries, where over a third of deaths occur among pedestrians and cyclists. Several interventions to mitigate the burden among pedestrians have been widely implemented, however, the effectiveness has not been systematically examined.
Objectives
To assess the effectiveness of interventions to reduce road traffic crashes, injuries, hospitalizations and deaths among pedestrians.
Methods
We considered studies that evaluated interventions to reduce road traffic crashes, injuries, hospitalizations and/or deaths among pedestrians. We considered randomized controlled trials, interrupted time-series studies, and controlled before-after studies. We searched MEDLINE, EMBASE, Web of Science, WHO Global Health Index, Health Evidence, Transport Research International Documentation and ClinicalTrials.gov through 31 August 2020, and the reference lists of all included studies. Two reviewers independently screened titles and abstracts and full texts, extracted data and assessed the risk of bias. We summarized findings narratively with text and tables.
Results
A total of 69123 unique records were identified through the searches, with 26 of these meeting our eligibility criteria. All except two of these were conducted in high-income countries and most were from urban settings. The majority of studies observed either a clear effect favoring the intervention or an unclear effect potentially favoring the intervention and these included: changes to the road environment (19/27); changes to legislation and enforcement (12/12); and road user behavior/education combined with either changes to the road environment (3/3) or with legislation and enforcement (1/1). A small number of studies observed either a null effect or an effect favoring the control.
Conclusions
Although the highest burden of road traffic injuries exists in LMICs, very few studies have examined the effectiveness of available interventions in these settings. Studies indicate that road environment, legislation and enforcement interventions alone produce positive effects on pedestrian safety. In combination with or with road user behavior/education interventions they are particularly effective in improving pedestrian safety.
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Affiliation(s)
- Stellah Namatovu
- School of Public Health, Makerere University Kampala Uganda, Kampala, Uganda
- * E-mail:
| | | | - Kennedy Muni
- Department of Epidemiology, University of Washington, Seattle, WA, United States of America
| | - Albert Ningwa
- School of Public Health, Makerere University Kampala Uganda, Kampala, Uganda
| | - Linda Nsabagwa
- School of Public Health, Makerere University Kampala Uganda, Kampala, Uganda
| | - Fredrick Oporia
- School of Public Health, Makerere University Kampala Uganda, Kampala, Uganda
| | - Arthur Kiconco
- School of Public Health, Makerere University Kampala Uganda, Kampala, Uganda
| | - Patrick Kyamanywa
- School of Health Sciences, Kampala International University, Bushenyi, Uganda
| | - Milton Mutto
- School of Public Health, Makerere University Kampala Uganda, Kampala, Uganda
| | - Jimmy Osuret
- School of Public Health, Makerere University Kampala Uganda, Kampala, Uganda
| | - Eva A. Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximillians Universitaet (LMU Munich), Munich, Germany
| | - Jacob Burns
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximillians Universitaet (LMU Munich), Munich, Germany
| | - Olive Kobusingye
- School of Public Health, Makerere University Kampala Uganda, Kampala, Uganda
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Mpando TL, Sell K, Delobelle P, Osuret J, Niyibizi JB, Ntawuyirushintege S, Geremew B, Jessani NS. Integrated Knowledge Translation in Non-Communicable Disease Research in Sub-Saharan Africa: A Comparison of Systematic and Ad Hoc Stakeholder Engagement. Front Trop Dis 2021. [DOI: 10.3389/fitd.2021.753192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundLow- and middle-income countries (LMICs) are currently experiencing an increasing prevalence of non-communicable diseases (NCDs). To address this as well as other health challenges, Integrated Knowledge Translation (IKT) approaches to build mutually beneficial relationships between researchers and decision-makers can concurrently inform research as well as enhance evidence use in policy and practice. The Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) is a research consortium which conducts research on NCDs and uses an IKT approach to facilitate the uptake of this research in five African countries: Ethiopia, Uganda, Rwanda, Malawi, and South Africa. Tailored IKT strategies were designed and implemented to plan and guide stakeholder engagement. This systematic approach contrasts with more commonly used ad hoc approaches to stakeholder engagement.MethodsIn this article, we explore the experiences of researchers engaged in the CEBHA+ IKT approach across the five African countries. Data sources included: 1) an informal document review of CEBHA+ country-specific IKT strategies, IKT team meeting minutes and activity reports, and 2) a semi-structured survey of IKT implementers to elicit country-specific experiences on actual implementation and adaptation of the IKT strategies. Results were collated and contrasted across all CEBHA+ countries with a focus on systematic versus ad hoc approaches to engagement.ResultsSouth Africa, Malawi and Ethiopia country teams indicated that their engagements benefited from a systematic IKT strategy. This was especially the case in the early stages of the project as it allowed focused and intentional engagement. However, ad hoc engagement was still required as new professional relationships developed, and contextual circumstances - including the SARS-CoV-2 pandemic - required responsive engagement with decision-makers and other stakeholders. In Rwanda and Uganda, continuous systematic engagement was found to bolster ownership of the research at both community and national levels.ConclusionPolitical and health climates are constantly shifting with a need to maintain flexibility in how IKT strategies are implemented. While strategic IKT can benefit from deliberate planning and stakeholder engagement, there is value in remaining flexible to respond to the needs of stakeholders and contextual circumstances. This paper highlights how IKT implementers in the five African CEBHA+ countries responded to this challenge.
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Osuret J, Namatovu S, Biribawa C, Enock Balugaba B, Bayiga Zziwa E, Muni K, Ningwa A, Oporia F, Mutto M, Kyamanywa P, Guwatudde D, Kobusingye O. State of pedestrian road safety in Uganda: a qualitative study of existing interventions. Afr Health Sci 2021; 21:1498-1506. [PMID: 35222616 PMCID: PMC8843294 DOI: 10.4314/ahs.v21i3.62] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Pedestrians in Uganda account for 40% of road traffic fatalities and 25% of serious injuries annually. We explored the current pedestrian road traffic injury interventions in Uganda to understand why pedestrian injuries and deaths continue despite the presence of interventions. Methods We conducted a qualitative study that involved a desk review of road safety policy, regulatory documents, and reports. We supplemented the document review with 14 key informant interviews and 4 focus group discussions with participants involved in road safety. Qualitative thematic content analysis was done using ATLAS. ti 7 software. Results Five thematic topics emerged. Specifically, Uganda had a Non-Motorized Transport Policy whose implementation revealed several gaps. The needs of pedestrians and contextual evidence were ignored in road systems. The key programmatic challenges in pedestrian road safety management included inadequate funding, lack of political support, and lack of stakeholder collaboration. There was no evidence of plans for monitoring and evaluation of the various pedestrian road safety interventions. Conclusion The research revealed low prioritization of pedestrian needs in the design, implementation, and evaluation of pedestrian road safety interventions. Addressing Uganda's pedestrian needs requires concerted efforts to coordinate all road safety activities, political commitment, and budgetary support at all levels.
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11
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Itiakorit B, Zziwa EB, Osuret J. Prevalence and determinants of occupational Injuries among welders in small scale metal workshops in Wakiso District, Uganda. East Afr Health Res J 2021; 5:106-112. [PMID: 34308252 PMCID: PMC8291212 DOI: 10.24248/eahrj.v5i1.658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/10/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Injuries are a public health concern accounting for 2.78 million fatalities globally. Welders are exposec to a broad range of injuries (e.g. cuts, burns, eye injuries, skin irritations, and musculoskeletal disorders) and yet, there is paucity of information on context specific determinants to inform injury prevention and control. This study determined the factors associated with occupational injuries among welders in Uganda. Methods: A cross-sectional study was conducted among welders in Wakiso District, Uganda. Pretested and translated questionnaires were used to collect data from 327 randomly selected respondents using face to face interviews. 2 parishes were purposively selected, and 20 metal workshops were systematically selected in each parish. Descriptive statistics and adjusted odds ratios were computed Results: A high prevalence 287 (87.8%) of self-reported occupational injuries was found among welding workers with cuts/burns 242 (84.3%) and eye injuries 180 (62.7%) reported as the most sustained injuries. Occupational injuries were associated with being a causal labourer with informal training (AOR 4.70 (2.03–10.84)) and working for longer hours (AOR 2.63 (1.26–5.51)). Those with more work experience were less likely to be involved in occupational injuries (AOR 0.30 (0.11–0.84)). Conclusions: The prevalence of occupational injuries among small-scale welding workers was high and this was associated with learning their trade at work and working for longer hours. Mitigation measures that focus on safety at workplace, advocating for capacity training, and enforcement of workplace regulations should be instituted.
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Affiliation(s)
- Brian Itiakorit
- College of Health Sciences, School of Public Health, Makerere University, Kampala_Uganda
| | - Esther Bayiga Zziwa
- College of Health Sciences, School of Public Health, Makerere University, Kampala_Uganda
| | - Jimmy Osuret
- College of Health Sciences, School of Public Health, Makerere University, Kampala_Uganda
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12
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Ssemugabo C, Wafula ST, Ndejjo R, Osuret J, Musoke D, Halage AA. Characteristics of sanitation and hygiene facilities in a slum community in Kampala, Uganda. Int Health 2021; 13:13-21. [PMID: 32236413 PMCID: PMC7807239 DOI: 10.1093/inthealth/ihaa011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 02/06/2020] [Accepted: 02/14/2020] [Indexed: 11/28/2022] Open
Abstract
Background This study assessed characteristics of sanitation and hygiene facilities in a slum community in Kampala, Uganda. Methods We conducted a household-based cross-sectional study among 395 households in Kasubi slum using a semi-structured questionnaire and observational checklist to collect data. Results Almost 98.0% (387/395) of households owned a sanitation facility and 77.0% (298/387) shared it with other households. The most common type of sanitation facility was a pit latrine with slab (66.9% [259/387]). Most (90.5% [305/337]) latrines had a door or shutter, a roof (92.9% [313/337]) and a depth >1.5 m (68.2% [229/337]). Overall, 21.3% (84/395) and 65.6% (259/395) of households had improved and functional sanitation facilities, respectively. Only 16.5% (65/395) of the households had a hand-washing facility. Student-led (adjusted prevalence rate [PR] 2.67 [95% confidence interval [CI] 1.83–3.94]) and households that owned their house (adjusted PR 2.17 [95% CI 1.33–3.53]) were 2.67 and 2.17 times more likely to have improved sanitation facilities, respectively. Households that owned their house (adjusted PR 1.90 [95% CI 1.18–3.05]) were 1.9 times more likely to possess a hand-washing facility. Conclusions The coverage of improved sanitation and hygiene facilities was low. The majority of households were using a shared pit latrine with a slab that had no hand-washing facility. Sanitation and hygiene interventions should prioritize improving sanitation and hygiene facilities.
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Affiliation(s)
- Charles Ssemugabo
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Abdullah Ali Halage
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
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13
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Mugambe RK, Yakubu H, Wafula ST, Ssekamatte T, Kasasa S, Isunju JB, Halage AA, Osuret J, Bwire C, Ssempebwa JC, Wang Y, McGriff JA, Moe CL. Factors associated with health facility deliveries among mothers living in hospital catchment areas in Rukungiri and Kanungu districts, Uganda. BMC Pregnancy Childbirth 2021; 21:329. [PMID: 33902472 PMCID: PMC8077901 DOI: 10.1186/s12884-021-03789-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/08/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Health facility deliveries are generally associated with improved maternal and child health outcomes. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we assessed the factors associated with health facility deliveries among mothers living within the catchment areas of major health facilities in Rukungiri and Kanungu districts, Uganda. METHODS Cross-sectional data were collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data were collected on the place of delivery for the most recent child, mothers' sociodemographic and economic characteristics, and health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of health facility deliveries as well as factors associated with private versus public utilization of health facilities for childbirth. RESULTS The majority of mothers (90.2%, 806/894) delivered in health facilities. Non-facility deliveries were attributed to faster progression of labour (77.3%, 68/88), lack of transport (31.8%, 28/88), and high cost of hospital delivery (12.5%, 11/88). Being a business-woman [APR = 1.06, 95% CI (1.01-1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02-1.17)] favoured facility delivery while a higher parity of 3-4 [APR = 0.93, 95% CI (0.88-0.99)] was inversely associated with health facility delivery as compared to parity of 1-2. Factors associated with delivery in a private facility compared to a public facility included availability of highly skilled health workers [APR = 1.15, 95% CI (1.05-1.26)], perceived higher quality of WASH services [APR = 1.11, 95% CI (1.04-1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78-0.92)], and availability of caesarean services [APR = 1.13, 95% CI (1.08-1.19)]. CONCLUSION Health facility delivery service utilization was high, and associated with engaging in business, belonging to wealthiest quintile and having higher parity. Factors associated with delivery in private facilities included health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.
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Affiliation(s)
- Richard K Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
| | - Habib Yakubu
- The Center for Global Safe Water, Sanitation and Hygiene, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Solomon T Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Simon Kasasa
- Department of Epidemiology and Biostatistics, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Abdullah Ali Halage
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Constance Bwire
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - John C Ssempebwa
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Yuke Wang
- The Center for Global Safe Water, Sanitation and Hygiene, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Joanne A McGriff
- The Center for Global Safe Water, Sanitation and Hygiene, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Christine L Moe
- The Center for Global Safe Water, Sanitation and Hygiene, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
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Buregyeya E, Atusingwize E, Nsamba P, Nalwadda C, Osuret J, Kalibala P, Nuwamanya R, Okech S, Ssekamatte T, Nitumusiima S, Wakabi T, Bikaako W, Yawe A, Naigaga I, Kagarama J, Kabasa JD, Bazeyo W. Lessons from a community based interdisciplinary learning exposure: benefits for both students and communities in Uganda. BMC Med Educ 2021; 21:5. [PMID: 33397353 PMCID: PMC7784318 DOI: 10.1186/s12909-020-02429-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/07/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Makerere University implemented a One Health Institute (OHI) in 2016 involving undergraduate students selected from different disciplines. The students were first taken through theoretical principles of One Health followed by a field attachment in communities. The field attachment aimed to expose students to experiential educational opportunities in the communities in a One Health approach. In this paper, we present students' experiences and their contributions to the communities of attachment. METHODS This was a cross-sectional study, utilizing qualitative data collection methods. The study involved students who participated in the OHI field attachment and community members in a One Health demonstration site-Western Uganda. Four focus group discussions (FGDs) and four in-depths interviews (IDIs) were conducted among the students, while four FGDs and twelve IDIs were conducted among community members. All interviews were audio-recorded, transcribed and analysed manually. RESULTS The four themes that emerged are: students' understanding and appreciation of One Health concept, their experiences and gains from the multi-disciplinary field attachment, students' contributions to the community, and challenges faced by the students. Students had good knowledge of One Health. They appreciated that health cannot be achieved by one discipline or sector and thus the need to collaborate across sectors. Regarding experiences and gains during the multi-disciplinary field attachment, the students appreciated that each discipline had a role to play in achieving health in the community. They appreciated the training citing skills gained in communication, team work and collaboration. They also reported a feeling of gratitude and accomplishment because they felt they made a positive change to the community by putting in place interventions to address some of the community challenges. Similarly, the communities appreciated the students' contribution in solving their health challenges, ranging from conducting health education to improving sanitation and hygiene. CONCLUSIONS Through the OHI, students gained One Health competencies including communication, teamwork, and collaboration. Adopting an interdisciplinary model in university teaching system especially during field placement would strengthen skills of collaboration, team work and communication which are critical for a multi-disciplinary approach which is needed among the future workforce in order to solve the current health challenges.
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Affiliation(s)
| | | | - Peninah Nsamba
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | | | - Jimmy Osuret
- Makerere University School of Public Health, Kampala, Uganda
| | - Patrick Kalibala
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Ronald Nuwamanya
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Samuel Okech
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | | | | | - Timothy Wakabi
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | - Winnie Bikaako
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | - Agnes Yawe
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | - Irene Naigaga
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | | | - John David Kabasa
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | - William Bazeyo
- Makerere University School of Public Health, Kampala, Uganda
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
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Stratil JM, Paudel D, Setty KE, Menezes de Rezende CE, Monroe AA, Osuret J, Scheel IB, Wildner M, Rehfuess EA. Advancing the WHO-INTEGRATE Framework as a Tool for Evidence-Informed, Deliberative Decision-Making Processes: Exploring the Views of Developers and Users of WHO Guidelines. Int J Health Policy Manag 2020; 11:629-641. [PMID: 33131223 PMCID: PMC9309924 DOI: 10.34172/ijhpm.2020.193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 09/29/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Decision-making on matters of public health and health policy is a deeply value-laden process. The World Health Organization (WHO)-INTEGRATE framework was proposed as a new evidence-to-decision (EtD) framework to support guideline development from a complexity perspective, notably in relation to public health and health system interventions, and with a foundation in WHO norms and values. This study was conducted as part of the development of the framework to assess its comprehensiveness and usefulness for public health and health policy decision-making.
Methods: We conducted a qualitative study comprising nine key informant interviews (KIIs) with experts involved in WHO guideline development and four focus group discussions (FGDs) with a total of forty health decision-makers from Brazil, Germany, Nepal and Uganda. Transcripts were analyzed using MAXQDA12 and qualitative content analysis. Results: Most key informants and participants in the FGDs appreciated the framework for its relevance to real-world decision-making on four widely differing health topics. They praised its broad perspective and comprehensiveness with respect to new or expanded criteria, notably regarding societal implications, equity considerations, and acceptability. Some guideline developers questioned the value of the framework beyond current practice and were concerned with the complexity of applying such a broad range of criteria in guideline development processes. Participants made concrete suggestions for improving the wording and definitions of criteria as well as their grouping, for covering missing aspects, and for addressing overlap between criteria. Conclusion: The framework was well-received by health decision-makers as well as the developers of WHO guidelines and appears to capture all relevant considerations discussed in four distinct real-world decision processes that took place on four different continents. Guidance is needed on how to apply the framework in guideline processes that are both transparent and participatory. A set of suggestions for improvement provides a valuable starting point for advancing the framework towards version 2.0.
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Affiliation(s)
- Jan M Stratil
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | | | - Karen E Setty
- The Water Institute, Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carlos E Menezes de Rezende
- National Supplementary Health Agency, Ministry of Health, Brasília, Brazil.,Department of MaternalInfant Nursing and Public Health, College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Aline A Monroe
- Department of MaternalInfant Nursing and Public Health, College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Inger B Scheel
- Department of Global Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Manfred Wildner
- Bavarian Health and Food Safety Authority, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | - Eva A Rehfuess
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
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16
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Muni KM, Ningwa A, Osuret J, Zziwa EB, Namatovu S, Biribawa C, Nakafeero M, Mutto M, Guwatudde D, Kyamanywa P, Kobusingye O. Estimating the burden of road traffic crashes in Uganda using police and health sector data sources. Inj Prev 2020; 27:injuryprev-2020-043654. [PMID: 32229535 DOI: 10.1136/injuryprev-2020-043654] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/09/2020] [Accepted: 03/14/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND In many low-income countries, estimates of road injury burden are derived from police reports, and may not represent the complete picture of the burden in these countries. As a result, WHO and the Global Burden of Diseases, Injuries and Risk Factors Project often use complex models to generate country-specific estimates. Although such estimates inform prevention targets, they may be limited by the incompleteness of the data and the assumptions used in the models. In this cross-sectional study, we provide an alternative approach to estimating road traffic injury burden for Uganda for the year 2016 using data from multiple data sources (the police, health facilities and mortuaries). METHODS A digitised data collection tool was used to extract crash and injury information from files in 32 police stations, 31 health facilities and 4 mortuaries in Uganda. We estimated crash and injury burden using weights generated as inverse of the product of the probabilities of selection of police regions and stations. RESULTS We estimated that 25 729 crashes occurred on Ugandan roads in 2016, involving 59 077 individuals with 7558 fatalities. This is more than twice the number of fatalities reported by the police for 2016 (3502) but lower than the estimate from the 2018 Global Status Report (12 036). Pedestrians accounted for the greatest proportion of the fatalities 2455 (32.5%), followed by motorcyclists 1357 (18%). CONCLUSIONS Using both police and health sector data gives more robust estimates for the road traffic burden in Uganda than using either source alone.
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Affiliation(s)
- Kennedy Maring Muni
- Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Albert Ningwa
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Esther Bayiga Zziwa
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Stellah Namatovu
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Claire Biribawa
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Mary Nakafeero
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Milton Mutto
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - David Guwatudde
- Department of Epidemiology & Biostatistics, Makerere School of Public Health, Kampala, Uganda
| | - Patrick Kyamanywa
- School of Health Sciences, Kampala International University, Bushenyi, Uganda
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
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17
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Ssekamatte T, Isunju JB, Balugaba BE, Nakirya D, Osuret J, Mguni P, Mugambe R, van Vliet B. Opportunities and barriers to effective operation and maintenance of public toilets in informal settlements: perspectives from toilet operators in Kampala. Int J Environ Health Res 2019; 29:359-370. [PMID: 30426766 DOI: 10.1080/09603123.2018.1544610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 11/01/2018] [Indexed: 05/20/2023]
Abstract
Although classified by the Joint Monitoring Programme (JMP) as unimproved sanitation facilities, public toilets still play a critical role in eliminating open defecation in informal settlements. We explored perspectives of toilet operators on opportunities and barriers to operation and maintenance (O&M) of public toilets in informal settlements. A cross-sectional study design was used. Up to 20 in-depth interviews were used to obtain data on the experiences of public toilet operators. Thematic content analysis was used. Ressults show that opportunities for improving O&M include; operation of public toilets is a source of livelihood; operators are knowledgeable on occupational risks, and the community is involvedin sanitation activities. Barriers to effective O&M include; high operation costs, failure to break even and a lack of investments in occupational health Therefore, there is need to recognise the significance of public toilets as a viable alternative to open defecation in areas where ownership of private sanitation facilities is difficult. Failure to observe the health and safety of toilet operators may further compromise O&M.
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Affiliation(s)
- Tonny Ssekamatte
- a Department of Disease Control and Environmental Health , Makerere University School of Public Health , Kampala , Uganda
| | - John Bosco Isunju
- a Department of Disease Control and Environmental Health , Makerere University School of Public Health , Kampala , Uganda
| | - Bonny Enock Balugaba
- a Department of Disease Control and Environmental Health , Makerere University School of Public Health , Kampala , Uganda
| | - Doreen Nakirya
- b Department of Environmental Management, School of Forestry , Environmental and Geographical Sciences
| | - Jimmy Osuret
- a Department of Disease Control and Environmental Health , Makerere University School of Public Health , Kampala , Uganda
| | - Patience Mguni
- c Environmental Policy group , Wageningen University & Research , Wageningen , Netherlands
| | - Richard Mugambe
- a Department of Disease Control and Environmental Health , Makerere University School of Public Health , Kampala , Uganda
| | - Bas van Vliet
- a Department of Disease Control and Environmental Health , Makerere University School of Public Health , Kampala , Uganda
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18
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Ssemugabo C, Wafula ST, Ndejjo R, Oporia F, Osuret J, Musoke D, Halage AA. Knowledge and practices of households on safe water chain maintenance in a slum community in Kampala City, Uganda. Environ Health Prev Med 2019; 24:45. [PMID: 31200642 PMCID: PMC6570909 DOI: 10.1186/s12199-019-0799-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/30/2019] [Indexed: 11/15/2022] Open
Abstract
Background More than half of the disease burden in Uganda can be prevented through improving water, sanitation, and hygiene (WASH). In slum communities, water supply is insufficient but also highly contaminated; therefore, ensuring that the safe water chain is maintained by households is paramount to preventing water-related diseases. This study aimed at assessing knowledge and practices of households on safe water chain maintenance in slum communities in Kampala City, Uganda. Methods This was a community-based cross-sectional study carried out among 395 households in slum communities in Kampala, Uganda. Data were collected using a semi-structured questionnaire. Prevalence ratios (PRs) and their 95% confidence intervals were used as a measure of association between safe water chain management and associated knowledge and practice factors. The PRs were obtained using a multivariable modified Poisson regression with logarithm as the link function, with robust standard errors. Results Majority (76.7%, 303/395) of the households collected their water from a piped water system and paid for the water (72.9%, 288/395). Almost all (97.2%, 384/395) of the participants said that they knew the dangers associated with drinking unsafe water, boiled their drinking water (95.4%, 377/395), and used storage containers that minimize contamination (97.0%, 383/395). However, only (32.4%, 128/395) of the households satisfactorily maintained the safe water chain. Female- (adjusted PR = 1.82, 95% CI (1.19–2.78)) and student-led households (adjusted PR = 1.58, 95% CI (1.03–2.41)) and those whose heads had attained post-primary education (adjusted PR = 1.48, 95% CI (1.02–2.17)) were more likely to satisfactorily maintain the safe water chain. This was similar among members who thought most contamination occurs during storage (adjusted PR = 1.47, 95% CI (1.10–1.97)). Conclusion Only a third of the households maintained the safe water chain satisfactory. Female-led, student-led, and post-primary educated-led household and household that thought most contamination occurs during storage were more likely to maintain the safe water chain. There is a need to improve the level of awareness about the importance of the safe water chain among slum dwellers.
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Affiliation(s)
- Charles Ssemugabo
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Solomon Tsebeni Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Frederick Oporia
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Abdullah Ali Halage
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
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