Employment status of AFROHUN-Uganda one health alumni, and facilitators and barriers to application of the one health approach: a tracer study

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.

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

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.

Revealing the hydrological transport and attenuation of 14 antibiotics in a low-flow stream

The fate of antibiotics has mostly been studied in lab-scale systems. Few studies have precisely evaluated the attenuation of antibiotics in natural streams. We used Lagrangian sampling combined with a tracer test and one-dimensional transport with inflow and storage model (OTIS) to reveal the effects of dilution and self-attenuation processes, and diurnal variation of light on the degradation of 14 antibiotics in a 3.6 km low-flow stream. The results showed that the order of in-stream attenuation rates were macrolides (0.18-0.25 h^-1) > tetracyclines (0.16-0.18 h^-1) > fluoroquinolones (0.094-0.13 h^-1) > sulfonamides (0.056-0.082 h^-1); half of the mass of antibiotics were lost within 0.44-1.96 km. The dilution effect, including longitudinal dispersion and transient storage, accounted for 20.70%-91.60% of the total attenuation while self-attenuation processes accounted for 8.40%-79.30%. Over 60% of sulfonamides were dissipated by dilution, while over 68% of the removal of macrolides and tetracyclines was attributed to self-attenuation. A comparison of the attenuation rates between day and night demonstrated that photo-dependent attenuation played a dominant role, especially for sulfonamides, accounting for more than 50% of their self-attenuation. Photo-independent attenuation reduced most macrolides and tetracyclines. This in situ experiment increased our understanding of antibiotic attenuation in natural streams.

Biokinetic measurements and modelling of urinary excretion of cerium citrate in humans

Tracer kinetics in healthy human volunteers was studied applying stable isotopes of cerium citrate to obtain biokinetic human data for the urinary excretion of cerium. These data were then used to compare and validate the biokinetic model for lanthanides (cerium) proposed by Taylor and Leggett (Radiat Prot Dosim 105:193-198, 2003), which is substantially improved and more realistic than the biokinetic model currently recommended by the International Commission on Radiological Protection (ICRP Publication 67, 1993); both models are primarily based on animal data. In the present study, 16 adults were investigated and two cerium tracers were simultaneously administered, both intravenously and/or orally. The cerium concentrations in urine were determined by inductively coupled plasma mass spectrometry. Ingested cerium citrate was poorly absorbed, and its low excretion was similar to the prediction of the biokinetic model of Taylor and Leggett. In contrast, after injection of cerium citrate its urinary excretion was rapidly increased, and the model underestimated the experimental results. These results suggest that urinary excretion of cerium may be dependent on the administered chemical form of cerium (speciation).

The Doctor of Medicine curriculum review at the School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania: a tracer study report from 2009

BACKGROUND

The School of Medicine (SoM) is one among five at Muhimbili University of Health and Allied Sciences (MUHAS). It currently houses eight undergraduate and many post-graduate programmes. The Doctor of Medicine (MD) programme reported herein is the oldest having ten semesters (5 years) followed by a 1 year compulsory rotatory internship at a hospital approved by the Medical Council of Tanganyika (MCT). However, this training was largely knowledge-based and thus the need to shift towards competency-based education (CBE) and full modularization necessitated this study.

METHODS

A cross-sectional tracer study of MUHAS MD graduates from SoM who completed training between 2006 and 2008 was conducted using quantitative (structured interviewer-administered questionnaires) as well as qualitative methods [In-depth questionnaire (IDI) and Focus group discussions (FGDs)].

RESULTS

A total of 147 MD graduates were traced and interviewed, representing 29 % of the 510 students who graduated from the SoM between 2006 and 2008. Majority (70.1 %, n = 103/147) were males. About 70 % graduated in 2008 and majority (68 %, n = 100/147) were doing internship. Majority (60.5 % n = 89/147) were based in/near Dar es Salaam at district, regional or referral hospitals. With reasonable concordance, most competencies ranked low except on four aspects. Teaching, System-based Practice and Good Practice had the lowest. Seminars/Tutorials, Laboratory Skills/Practicals, Theatre Skills, Outpatients clinics, Family Case Studies, Visits/Excursions and Self Reflection were rated less useful teaching methods compared to Lectures, Teaching Ward Rounds, Elective Studies, Field Work, Presentations, Continuous Assessments Tests, Final Examinations, Short Answers, Clinical/Practical Examinations. ICT and Library facilities were not considered to meet the students learning needs and Clinical Logbooks also ranked low. Teachers were generally ranked less favorably including in professional role-modelling and accessibility outside scheduled teaching sessions.

CONCLUSIONS

This tracer study results allowed subsequent curriculum review and the introduction of full modularization and competency-based learning at MUHAS. It is envisioned that these tracer study findings will improve teaching, learning and inform next curriculum review at MUHAS leading to increased output of appropriately trained health professionals to fill the big gap in human resources for health (HRH) in Tanzania. The revised curricula are also being processed through TCU for accreditation as required.

Hydraulic characterization and optimization of total nitrogen removal in an aerated vertical subsurface flow treatment wetland

In this study, a side-by-side comparison of two pilot-scale vertical subsurface flow constructed wetlands (6.2 m(2)×0.85 m, q(i)=95 L/m(2) d, τ(n)=3.5 d) handling primary treated domestic sewage was conducted. One system (VA-i) was set to intermittent aeration while the other was aerated continuously (VAp-c). Intermittent aeration was provided to VA-i in an 8 h on/4 h off pattern. The intermittently aerated wetland, VA-i, was observed to have 70% less nitrate nitrogen mass outflow than the continuously aerated wetland, VAp-c. Intermittent aeration was shown to increase treatment performance for TN while saving 33% of running energy cost for aeration. Parallel tracer experiments in the two wetlands showed hydraulic characteristics similar to one Continuously Stirred Tank Reactor (CSTR). Intermittent aeration did not significantly affect the hydraulic functioning of the system. Hydraulic efficiencies were 78% for VAp-c and 76% for VA-i.

Stable isotope 15N and 13C labelling of different functional groups of earthworms and their casts: A tool for studying trophic links

Earthworms (Oligochaeta: Lumbricidae) have substantial effects on the structure and fertility of soils with consequences for the diversity of plant communities and associated ecosystem functions. However, we still lack a clear understanding of the functional role earthworms play in terrestrial ecosystems, partly because easy-to-use methods to quantify their activities are missing. In this study, we tested whether earthworms and their casts can be dual-labelled with 15N and 13C stable isotopes by cultivating them in soil substrate amended with 15N ammonium nitrate and 13C-glucose. Additionally, we also wanted to know whether (i) earthworms from different functional groups (soil-feeders vs. litter-feeders) and their casts would differ in their incorporation of stable isotopes, (ii) if enrichment levels are higher if the same amount of isotopes is applied in one dose or in staggered doses, and (iii) if isotopic enrichment in casts changes when they are stored in a conditioning cabinet or in a pot filled with soil placed in a greenhouse. Our findings show the feasibility of dual-labelling tissues and casts of both litter-feeding (Lumbricus terrestris) and soil-feeding (Aporrectodea caliginosa) earthworms using the same method. The advantage of this method is that earthworms and their casts can be labelled under realistic conditions by cultivating them for only four days in soil that received a one-time addition of commercially available stable isotopes instead of offering labelled plant material. In earthworms, the isotopic enrichment remained at a stable level for at least 21 days; labelled casts could be stored for at least 105 days without significantly decreasing their isotopic signals. This simple and efficient method opens new avenues for studying the role of these important ecosystem engineers in nutrient cycling and their functional relationships with other organisms.