PRODUCED QUARTERLY BY THE MESAU CONSORTIUM; A MEPI INITIATIVE Vol. 3 No.1 December 2013 MESAU Newsletter MESAUNewsletter Mesau Director’s Message

Dear Reader, wish you, your Faculty of Health families and friends the very best in 2014. As sciences rolls out competence-based Iwe make resolutions for the New Year we need to reflect on medical training where we are and where we are going but most importantly how to sustain Professor Paul Waako and Dr. MESAU efforts and achievements and also strengthen our resolve to build Peter Olupot-Olupot a firm foundation for transformative education in . In this issue of Founder Dean and Associate Dean MSAU News there are examples of what difference MEPI investments are making Busitema University, Faculty of The curriculum is being implemented in our institutions. It is, however, not Health Sciences through a highly coordinated and easy to sustain interest and momentum organized sandwich of lectures, but so far so good. We should always he Faculty of Health Sciences at reflect on what difference our efforts patient-centred problem based are making at three levels: the Busitema University has rolled learning (pc-PBL), practicals, clinical individual, the institution and the wider out competence-based medical exposure, meet the client sessions, environment (the local community, the training. The Faculty that was country, the region and beyond). grand rounds, research and accreditedT by the National Council Various contributors to MESAU News community based training. have provided testimonies of the of Higher Education to offer health positive impact that MEPI funding professional training in September and support has on the institutional infrastructure, faculty development, 2013 admitted the first batch of to pg 2 strengthening research administration Medical students last September. The and management, and transforming and strengthening educational programs training curriculum that had been with the overall aim of improving submitted for accreditation in 2007 health service delivery for AIDS and was revised in 2012 with the input Contents related infectious diseases, and non- communicable diseases (NCDs). The from the MESAU-MEPI consortium „ MEPI-CVD linked award: educational achievements range from and upgraded to competence-based strengthening e-learning, students’ curriculum. The journey continues community based education and research and ensuring that libraries and information sciences play their rightful Following the accreditation of the „ A Year of Faculty role in health professional education. school the University admitted 53 Development at Mbarara There are excellent examples of research capacity building efforts to students of which one third are females University: Progress and address the rapidly growing burden as required by the University policy; Challenges of NCDs. Researchers do not function alone but need the support and one third of all students’ admissions guidance of research administrators should be females. The Late call for „ My Community- Based and managers (RAM). MESAU has admissions to the medical school placed great emphasis on uplifting the Educations Experience: capacity of RAM as described in this attracted 1,300 qualified applicants issue. of which 53 were selected on merit. We need to define appropriate metrics The University recruited 10 full-time „ MESAU Strengthens of success. What does success eLearning Capacity look like? Adequate systematic staff to join the Hospital-based documentation of MESAU processes, Faculty to implement the curriculum. activities and outcomes supports An extra 12 academic staff will be „ Cardiovascular Disease and promotes learning that is rooted in home grown educational, social recruited in February 2014 as the Awareness Campaign in and other innovations arising from Uganda government has approved Mbarara our institutions. The MESAU portal and MESAU News are contributing a supplementary funding for the enormously to sharing of ideas and medical school to ensure smooth „ The World Bank awards knowledge. implementation of the curriculum. 952 scholarships

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MAKERERE UNIVERSITY 1 MESAU Newsletter Busitema University Faculty of MEPI-CVD linked Health sciences Cont’d award: The journey continues

By Dr. Isaac Ssinabulya and Dr. Yvonne Nabunnya

The year 2013 has been of great achievements as we build capacity in cardiovascular disease (CVD) training and research. After a successful integration of the CVD module into the COBERS curricula at Makerere and Mbarara Universities, there is growing interest among medical students in carrying out CVD awareness activities at the respective health facilities as well as communities around them. Increasingly we have had several student groups organize outreach and CVD campaigns. This is a great The Busitema University top management poses for a photo with the founder staff of Busitema Uni- opportunity for students to preach versity Faculty of Health Sciences at the official admission ceremony of the 53 medical students. CVD prevention and early linkage to Front row from left to right: Professor Paul Waako (Dean), Professor (Vice-chan- care as well as identifying areas for cellor) Dr. Samuel Baker (First Deputy VC), Mr. Elisha Obella (AR) and Dr. Peter Olupot-Olupot quality improvement and research. (Associate Dean). Standing are Founder staff of the medical school The students are subsequently taking the lead in these activities and we are certain many of them will consider a lifelong career in University of Science and Technology. result of this collaboration. This is cardiovascular management and This serves a big number of patients aimed at building local capacity to prevention. from western Uganda cutting down optimally utilize the established In our fourth year of implementation, long distances previously travelled catheterization laboratory at UHI. we have had a total of 25 trainees to access such services. Yale is also providing training to one supported for their residency Case Western Reserve University faculty in pulmonary hypertension, program and 3 for PhD. We have (CWRU) staff have providedan area of increasing concern in noted an upward trend in the mentorship to trainees, expertise on Uganda as a result of pollution, number of researches done at various projects as well as transfer infectious processes and lifestyle. postgraduate level with a CVD of advanced cardiac intervention focus, from about one study per In conclusion the MEPI-CVD program skills to Ugandan cardiologists has generated interest and baseline year to more than six studies. Eleven and trainees. Patients have been trainees have completed and 4 of CVD data, a basis upon which to build able to save lots of money while lifelong careers. A lot still remains to them have had manuscripts from receiving quality care using the their research work submitted to be done and the stage has been set recently acquired facility at the UHI. to expand these achievements to peer review journals for publication Currently a faculty from Makerere is while the rest complete their final tackle the increasing CVD burden in undergoing training in interventional Uganda today. drafts. We have had 4 publications cardiology at CWRU - Ohio as a from our three PhD students and several manuscripts submitted. Two presentations have been made so far at international conferences by trainees as they share their research findings with the rest of the world [Accra – Ghana and Senegal]. Special thanks to our collaborating partners; the Uganda Heart Institute (UHI) has provided a platform for cardiology training to staff/trainees from Makerere and Mbarara Universities and as a result a functional cardiology service Some of the trainees who have benefited from the program has been established at Mbarara

2 MESAU Newsletter A Year of Faculty Development at Mbarara MEPI-NEUROLOGY University: Progress and Challenges LINKED PROGRAM Samuel Maling, Wilfred Arubaku and Mark Kaddu Mukasa, Samantha Mary At the beginning of 2013, a training College of Health plan was developed covering the Sciences The Strategic Plan of Faculty of following areas: Pedagogy: Clinical Medicine has faculty development teaching, Small group facilitation, MEPI Neurology Linked Program is as a priority. Most faculty recruited Large group teaching, Feedback integrated within the existing frame work have no formal training in health & evaluation, Use of technology in of training at two major Medical schools professions education. To qualify as teaching & learning, Leadership & in Uganda, namely Makerere University a faculty member all you need is an management skills, Academic skills & College of Health Sciences and Uganda academic qualification. The practice career management, Organizational Martyrs University Nsambya and also on the ground then is people teach & curricular development, we partner with Case Western Reserve according to the way they were Educational scholarship and University, USA. taught in medical school. Moreover, Assessment. The other areas were: The main objective of this program Aim two of the MESAU consortium 2) Grant writing, submission and is to enhance the quality and ensure proposes to facilitate faculty management 3) Responsible sustainability of the program and development programmes for all conduct of research 4) Manuscript development of strong Medical training teaching staff across all disciplines. writing 5) Strategic plan and policy for residents in neurology. The program At Mbarara University of Science development 6) Mentorship skills will determine the magnitude of Training 7) Financial management neurological diseases in Uganda and and Technology, an Education distribution of traditional and emerging Resources unit was established with and accountability 8) Community risk factors in order to formulate faculty development as one of its six placement supervision. appropriate strategies for prevention, functions. early detection and control. To achieve all this, a survey is to be conducted in a Training No. trained rural community-based cohort in central Grant writing, submission and management 22 Uganda and faculty, medical students, Responsible conduct of research 16 residents and health workers from Manuscript writing 23 different districts are being trained in Development of strategic plan 34 neurology related disciplines to be able to Pedagogy;OSCE 30 assess the Neurological challenges faced Mentorship skills training 10 in Uganda. The results from this survey will Moodle training 8 provide baseline epidemiological data Community placement supervision 30 Qualitative data Analysis; Atlas Ti 10 to complement existing data from rural TOTAL ATTENDANCES 160 areas on prevalence and risk factors for neurological disorders and will facilitate PhD training. The success of the program will be pegged on strengthening existing strategic partnerships and engaging the community where the survey is to be done. The Medical Education Partnership Initiative-Neurology program in collaboration with Case Western Reserve University are committed to building capacity for Neurological disease control in addition to providing baseline data which will help to address some of the core priorities of the government. This strategy aims to support efforts to Training group in manuscript writing formulate and implement guidelines for prevention, early identification, and Key out puts include development of draft departmental strategic plans, treatment of Neurological disorders such Office of Research Administration strategic plan, Centralized Institutional as Epilepsy, stroke and so on. Research Innovations Management Office strategic plan, mentorship We hope that by the end of this guidelines due to be implemented in semester two and five grants were Program, the research environment for submitted for funding. Following the OSCE training, eight departments neurological disorders will be improved of: Ophthalmology, Dermatology, Peadiatrics, Obstetrics and Gynecology, to allow operational and implementation Anaesthesia, Psychiatry, Surgery and Internal Medicine used the practical research on priority neurological skills acquired during the training to better organize the just concluded disorders in Uganda. A critical mass of semester one clinical examinations. personnel will be trained and will assist the Ministry of Health in establishing Challenge and 2014 plan: The most significant challenge experienced effective policies for the treatment and during faculty development is conflicting time demands on staff arising control of neurological diseases and from teaching, providing clinical care and availability for training. The plan improve outcomes. for 2014 is to continue training to achieve at least 3/4 of faculty trained in at least three areas with major emphasis on junior faculty.

3 MESAU Newsletter

Why we need content for the MESAU Portal: Content is king The reason Google, Facebook and to their circle of friends. It provides of content, at least once every few YouTube continue to command so the platform for users to post short weeks, and more often, once a week or much attention (they were the top commentaries on different subjects, daily and distributing our content to three most visited sites in 2012 and post videos and pictures, participate other websites on a free-reprint basis. 2013 - alexa.com) is because they have in polls, invites and grow their network This will help our portal get links in compelling content. The traditional by connecting with new friends. exchange for the right to publish the understanding of content is long Facebookers post 2.7 billion likes daily content. It will also help spread our winding technical paragraphs that no while 300 million photos are uploaded message and enhance our visibility. one has time to read. In contemporary daily. YouTube users upload 72 hours’ In short, MESAU has a mature website terms, content has evolved to include worth of video every minute, and that’s already indexed and getting anything and everything from short Google searches per day in 2011 were traffic, we should make sure most of descriptions, event pictures, minute approximately 4.7 million. our investment is devoted to content. long videos, infographics, tables, polls, Great content improves Google search quizzes and discussion platforms. Therefore, without fresh regularly rankings and ‘findability’ and MESAU Facebook’s success hinges on the updated content, MESAU risk of portal should likewise have great key deal breaker of getting users to becoming invisible and consequently content. generate content that is relevant irrelevant. We need frequent updating

MESAU Portal: Now One Year Old! On Thursday, 2nd January 2014, MESAU Portal will make ONE YEAR! The portal was put online on Wednesday, January 2nd 2013. • Visit our Page http://mesau.mak.ac.ug/ • Like our Facebook page, so far our page has 516 likes and still counting https://www.facebook.com/MESAUMEPI • Join our conversation on Twitter by Following Us, so far we have 44 Followers https://twitter.com/MESAUMEPI Below are the Statistics for MESAU portal! Audience Overview January 2nd 2013 to December 31st 2013

2,758 People have visited the Portal

Visits (This show the number of visits to site.) 5,717

Unique Visitors (Unique Visitors is the number of unduplicated (counted only once) visitors to site over 2,758 the course of a specified time period.)

Page views (Page views is the total number of pages viewed. Repeated views of a single page are 20,351 Country / % Visits counted.) Territory Visits

Pages / Visit (Pages/Visit (Average Page Depth) is the 1. Uganda 4,121 72.08% average number of pages viewed during a visit to the 3.56 2. (not set) 407 7.12% site. Repeated views of a single page are counted.) 3. United States 365 6.38% Avg. Visit Duration (The average time duration of a 00:05:44 United session.) 4. 124 2.19% Kingdom

Bounce Rate (Bounce Rate is the percentage of 5. Kenya 52 0.91% single-page visits (i.e. visits in which the person left 54.70% 6. Pakistan 44 0.77% the site from the entrance page).) 7. India 40 0.70% 8. Nigeria 34 0.59% % New Visits (An estimate of the percentage of first 48.24% time visits.) 9. South Africa 33 0.58% 10. Canada 31 0.56% 4 MESAU Newsletter My Community- Based Educations Experience: A Research Opportunity

Martha Kirabo, MBChB III the highest unmet need at 80%. This between the ages 15 to 49 were information, combined with what interviewed. Data analysis revealed Makerere University College of I saw at Nebbi hospital led me to a huge unmet need in Panyango. Health Sciences write a research proposal entitled, Most of the respondents knew about “FACTORS ASSOCIATED WITH THE family planning but were not using In the labour suite, a young girl USE OF LONG TERM METHOD OF any method. After a brief health is tightly clenching her belly and FAMILY PLANNING BY WOMEN IN education with each respondent, screaming. The midwife who is also NEBBI”. most were willing to use implants and attending to three other mothers is Long term family planning methods older women opted for sterilization. impatient. She yells at the girl in Alur, are applied once over a long period the native language used in the area. of time and they include; Intra- On noticing the medical students, Based on these findings, I applied Uterine Devices (IUDs), Implants for the Stella mini grant from an she smiles and narrates to us that and sterilization. These methods are the young girl before us is a 14 year organization called THE NETWORK: of interest due to their affordability. Towards Unity For Health, to carry old who has had a miscarriage and is Since the birth control method is now expelling the uterine contents. out an intervention. The grant will durable, women don’t need to travel be used to carry out a community This would have been her second often to health centres to renew child. oriented health education for 12 or replace them thus reducing on months in Panyango sub-county to A multigravida 14 year old is not an transport costs. Adherence to these promote usage of long term family uncommon site in Nebbi hospital. methods is also easier unlike pills planning. The activities include: This is confirmed by the ante-natal which have to be swallowed daily. Training community leaders and sessions where most of the attendees The main objectives of this study Village Health Teams to educate their are teenagers. During my interaction were1) to determine the proportion members about family planning; with a few of them, I discovered of women using a long term method a radio programme involving that most were not on any birth and 2) to assess factors associated community members and health control while others had started with the use or disuse of modern workers discussing birth control using a modern family planning(FP) contraceptives. methods, individual experiences method but had terminated the use The MEPI-MESAU-funded study and question-answer sessions and for no apparent reason. The Uganda was carried out from August to a community out- reach campaign Demographic Health Survey (UDHS) September 2013 where quantitative where health personnel from the 2011 revealed that West Nile region and qualitative data was collected district will administer implants to has the lowest family planning usage from two sub counties in Nebbi consenting women. at 20% compared to the national district; rural Panyango and urban average of 30%. The region also has Nebbi Town Council. Women

A Focus Group Discussion in one of the villages. The Writer is sitted to the right on chair directly in-front of the women)

5 MESAU Newsletter NOLA Presents Yet another Exciting Experience for Research Administrators

Harriet Nambooze for me included the customer care Of utmost importance was the session where the glaring lesson need for research administrators I was privileged to attend the 2013 was the need for the research not to neglect their own personal Society of Research Administrators administrators to always endeavour development, the need for them meeting (SRA) that was held in to go beyond what is expected of to seek external help, look out New Orleans Louisiana (NOLA) them in the quest to help research for mentors/coaches as well as dubbed the most “unique” city of happen. This could be as simple as networking to learn. USA. The meeting was held from providing your telephone number 26-30 October 2013. The SRA once to the researchers or as complex as The NIH presentation on pre and again provided an avenue for staying a bit late in office in order post award issues for NIH grants with research administrators to get first to assist a researcher to submit an foreign components emphasised hand information on best practices application before the deadline. the need for institutions to ensure and new approaches to research that they are registered with Grants. administration as well as network The conference also highlighted gov and eRA Commons and Sams. with over 1400 seasoned research issues that organizations need to gov in order to be able to submit administrators from all over the pay attention to when building grant applications electronically. world. effective research offices. Issues There were also updates from NIH on highlighted that stood out included various issues, like the resumption The conference provided me the need for staff development by of operations after the US shut with an opportunity to meet with building capacity of staff, succession down, the research performance research administrators from other planning by backing up every role; in progress reporting (RPPR) system MEPI consortia from South Africa, other words building in redundancy, and the transition into the Payment Tanzania, Ghana, Zimbabwe and dealing with the generation Y Management System (PMS). Mozambique together with the syndrome but also not forgetting Given that research administration Grants Management Specialist for the older generations. Another issue is just gaining ground in sub MEPI. We particularly paid attention highlighted was the need to build Saharan Africa with very limited to changes that have occurred in a culture that will ensure success in training courses and opportunities the funding environment and new the operation of the office through for exposure it is imperative that regulations including My NCBI, annual surveys and staff turn-over resources are earmarked to support migration from CCR to SAMS and of rates, celebrating successes and research administrators to attend course the uncertainty of the US shut empowering staff to do their work. regional and international fora as down and how it had impacted the Others included communication a way of providing them with the different institutions. using social network, newsletters knowledge, skills and the networks and websites as well as consistency, to help them perform their work It was gratifying to witness our cooperation and accountability. better. very own Henry Tumwijukye, the Deputy Director of Administration and Grants at Makerere University Johns Hopkins University (MUJHU) receiving a partnership award for international or inter-collegiate collaboration. This was in recognition of the multi-country partnerships that he has forged across the African continent that have enhanced and made a positive impact on the research administration profession in Africa. This was achieved through organizing short term workshops that focussed on pre and post award grant processes, resulting in support to over 38 research institutions in Uganda, Kenya, Rwanda, Malawi, Zimbabwe, Tanzania and Nigeria. This award coupled with a good representation from the African continent proved that research MakCHS research administrators in a MODERAS (e-Research software) demonstration administration as a profession is gaining ground in Africa. Other high notes of the conference

6 MESAU Newsletter Research Administrators as Servant Leaders

Doreen Ritah Birungi, Administrator- MEPI-NEUROLOGY Programme Mine has been a learning curve traversed through determination and positive thinking with windows of opportunity turned around into success. My recent travel to New Orleans, Louisiana, to attend the Society of Research Administrators’ conference exposed me to quite a number of Innovative and enterprising ideas. Continual improvement and coming up with better controls in management of projects, and Institutional related matters, were some of them. As research administrators we are expected to protect researchers and institutions from potential risks encountered while conducting The author (right) with Rhoda Namubiru (another MEPI linked award administrator) research. Continuous training will pose for a photo at the conference bring about imparting of skills and ideas which will also add value to our quality of work. In addition, we are and focus on team interest and rules and guidelines are followed expected to serve our researchers well need. hence forth in line with the donor’s and ensure that rules are followed thus requirements and also monitor gaining researcher’s trust and instill • We should be seen as role models, the progress of the project. confidence in them in our ability to team building and share decision lead. making to be able to serve and II. We should also be intelligent; lead the external funding activities gathering information through During the recently concluded 1 from the support offices within professional development will week’s annual conference which th nd the institution. help administrators to become took place from 26 Oct – 02 more knowledgeable with policies Nov. 2013, we acquired a number Therefore, I learnt that, as research and procedures of our institution. of essential tools which included administrators, we should listen practicing servant leadership in to others in an institution, be III. We should be responsible, being Research administration and how it skillful communicators, who clearly able to share and loving, and avoid can lead to influence and successful communicate with a vision and being rude to others. The “more leadership in an institution. We were excellent listeners to ourselves as well one shares, the more one can advised and learnt to always be as to others. We should know that provide and serve the institution”. sincere i.e heartfelt considerations better communication leads to more A kind person is more trusted than to people, “we serve and we lead” informed decisions and therefore someone who is not kind. before procedures. Through striving solution-oriented between the to serve and then lead, it is our duty College and our partners/funders. I It is a great opportunity being in an as research administrators to ensure gained knowledge on how a leader environment that recognizes research that rules are followed and serve with can identify means of building a administration as a key component integrity thus earning the trust of community of followers and gain in helping the institution achieve our researchers. Hence the question; trust among those in the institution its overall goals and objectives in How could you be a servant leader in through the following; research. We are therefore obliged to research administration and protect provide services our researchers need researchers from the potential risks I. Being attentive, as administrators so that they can positively focus on encountered in conduct of research? we need to be observant, good their work they have been funded to listeners, seek advice and pay perform and thus attain maximum • Servant leaders are defined by attention to the needs of those we benefits for all partners. their ability to bring integrity, serve. We should not presume to humility, empowering and know what others need, without With gratitude, I would like to extend developing others in carrying out first asking them. Even explaining special thanks to the College Principal the tasks within an institution. We why something cannot be done, and the Principal Investigator of should encourage, inspire and instead of simply saying “NO”, MEPI-NEUROLOGY Project who have support others. This is reflected can go a long way in addressing extended great support to me to when we set clear goals to help the needs of others. In addition, I enable me carry out my role as a others to see beyond self-interest learnt that we should ensure that research administrator, effectively. 7 MESAU Newsletter Cardiovascular Disease Awareness Campaign in Mbarara

Dr. Joselyn Rwebembera and Dr. Francis Bajunirwe Creating awareness in the general Majority of respondents were young public about these cardiovascular adults in the age category 18-30 The burden of non communicable diseases and their risk factors is one of years, followed by those in 31-50 age diseases (NCDs) in developing the ways to curb the emerging public group. Overall, systolic blood pressure countries is on the rise, where 60% of health problem. showed a fairly uniform distribution, NCD related deaths are in people less however there was a slight skew to than 70 years compared to 30% for the The Department of Internal Medicine, the right indicating there are some USA. Adjusted for age, NCD mortality with support from the MEPI- few persons with hypertension with for Uganda is twice that for the USA. CVD project invited the general significantly higher Blood Pressures We are grappling with these emerging public of Mbarara through radio compared to the rest of the group. NCDs, yet we still have the ‘unfinished announcements, posters, and banners There was uniform distribution of the business’ of communicable diseases. for a cardiovascular disease awareness Body Mass Index. campaign. Physicians and residents Cardiovascular diseases are quite from the department of Internal Clients received brochures with basic expensive to treat. If not adequately Medicine, Mbarara University of information about cardiovascular treated, the resultant mortality and Science and Technology and medical diseases. All clients were given record morbidity are quite high. And in our students of clinical years participated cards, where their measurements setting, these are especially affecting in the campaign. were recorded for them to keep. the young, productive age groups. The final station was for dialogue. Unfortunately, most development The campaign was held in November Here, clients met medical students, partners and local government 2013 at the Independence Park residents and physicians, who policy makers are focusing mainly on grounds, which are located in the interpreted their measurements for infectious diseases like malaria, HIV, centre of Mbarara Municipality. A total them. Other medical advice regarding and TB, among others. of 928 participants were screened cardiovascular disease prevention at the exercise. Measurements done and risk reduction was given to the A number of risk factors for included Blood Pressure, height and clients. Those who needed immediate cardiovascular disease are modifiable. weight (from which the body mass medical intervention or any form of Diabetes, hypertension, smoking, index was calculated), random blood follow up were referred to the Mbarara alcohol consumption and obesity can sugar, waist and hip circumferences Regional Referral Hospital medical be dealt with and controlled, with (from which the waist-hip ratio was emergency and medical outpatients’ a translation into marked reduction calculated). clinic respectively. in an individual’s cardiovascular risk.

Table 1: Summary of Characteristics. Characteristic n (%)

Age (years) 5-17 43 (4.6) 18-30 508 (54.9) 31-50 296 (32.0) 51-70 66 (7.1) 71-85 13 (1.4)

Systolic Blood Pressure (SBP, mmHg) A residence and medical student measure a client’s height SBP 140 104 (11.4) Diastolic Blood Pressure (DBP, mmHg) DBP 90 75 (8.2) ‘Hypertension’ (mmHg) Combined systolic and diastolic (SBP>140 and DBP>90) 63 (6.8) Isolated systolic HTN (SBP>140, normal DBP) 41 (4.4)

Dialogue station 8 MESAU Newsletter Cardiovascular Disease Awareness Campaign in Mbarara

Random Blood Sugar (mmol/L) Hypoglycemia (<4.4mmol/L) 93 (11.7) Normal (4.4-7.8mmol/L) 638 (80.6) Pre-diabetes (7.-11.0mmol/L) 38 (4.8) Diabetes (>11.0mmol/L) 23 (2.9) Body Mass Index Underweight (<18.5) 46 (5.0) Normal (18.5-24.9) 559 (60.8) Overweight (25-29.9) 222 (24.1) Obese (30-34.9 71 (7.7) Blood sugar measuring station Severe obesity (35-40) 21 (2.3) Morbidly obese (>40) 1 (0.1)

Waist hip ratio (women) Low cardiovascular risk (<0.81) 106 (27.8) Intermediate cardiovascular risk (0.81-0.85) 98 (25.7) High cardiovascular risk (>0.85) 178 (46.6) Waist hip ratio (men) Low cardiovascular risk (<0.96) 506 (94.1) Intermediate cardiovascular risk (0.96-1.0) 23 (4.3) High cardiovascular risk (>1.0) 9 (1.7)

A medical student measures a client’s blood pressure

9 MESAU Newsletter

MESAU Strengthens eLearning Capacity

Jane McKenzie-White, Bob Bollinger and Nelson Sewankambo

MESAU is now implementing innovative measures to meet the goal of expanding medical education in order to improve the health of the Ugandan population. These innovations have included the expansion of MESAU medical schools’ online educational capacity, through installation of the necessary technical infrastructure and engagement of the faculty and staff in eLearning training. Over the last 1.5 years, MESAU has conducted eLearning online and faceto- During the two-day training workshop at Busitema, faculty work together to add content face training for its consortium on their shared Moodle course site members. In addition to training, each medical school has focused on the installation of an online Global Health Education (CCGHE). eLearning, strategies to minimize learning management system (LMS) This online course is designed to potential barriers and specific steps to accommodate both blended (a provide participants with the basic to move coursework into a blended combination of online and face-toface understanding of the structure and online course format. The main focus, instruction) and fully online functionality of the Moodle platform. however, was a demonstration of medical coursework for its students. The course allowed participants to the Moodle platform and hands-on Moodle, an open-source LMS, has experience the framework, basic instruction and skills practice using been installed by most of the MESAU configuration and functionality of an the basic features of Moodle. Faculty institutions. Regardless of the LMS, online course in Moodle while building were given ‘Instructor’ access to this online infrastructure will enable a shared site and were required their skills as an online instructor to work together to add content MESAU to not only extend the reach through hands-on experience with oftheir faculty to students in more rural during the workshop. adding content, interactive activities Access to this site for the faculty was communities, but allow the sharing and online assessments. The course of medical expertise at all levels of maintained following the workshop culminated in a final project requiring so participants could continue medical education and training across participants an individual course site consortium members. practicing skills, working together within the platform to build their own and getting assistance as needed. eLearning training for MESAU faculty online course. and staff has been done both online Several faculty have now begun In September, MESAU conducted converting their coursework into a and face-to-face. Efforts are focused onsite, face-to-face eLearning on assisting faculty in moving blended format within the workshops for each consortium respective institutions’ LMS systems. coursework into a blended and institution. All faculty and interested online format. Since June of 2012, The CCGHE will continue to support staff were invited to take part in these MESAU as their faculty and staff 17 MESAU faculty and technical staff twoday workshops conducted for their have taken a Moodle Basics online build their eLearning capacity and institution. The workshop began expand their online course offerings course offered by their U.S. partners, with a discussion of the benefits of the Johns Hopkins Center for Clinical for their students in the coming year.

10 MESAU Newsletter Living and working in rural areas can be rewarding professionally and fulfilling socially Dr Peter James Kitonsa MBChB It’s not ‘trendy’, in Uganda today, for fresh university graduates to seek employment in rural areas. Most prefer the flashy lights, traffic and ‘good life’ of the city. They are partly not to blame given the ‘hard living conditions’ in rural areas coupled with a lot of negative propaganda and a feeling of demotion if, after school, a city-borne turned rural. Having completed my medical training last year I am now doing my internship. I lived and worked in rural places during my medical training and now during my internship. Each placement has painted a different picture; for example rural Karamoja Students improvise to weigh children during COBERS placement in (in North-Eastern Uganda) and rural Nyakibale, Rukungiri district Kisiizi (in South-Western Uganda). Both places have several things in common; the locals are poor, there are very few if any health professionals, we were given a chance by the College out the procedure the next time. This much of the population is elderly with to spend time learning and working in rule of three is so helpful in that one grandchildren since most of the youths rural Karamoja for over three months gets many chances to do procedures, gravitate to the city, and most of the prior to starting our internships. This of course under supervision, as diagnoses made are based on clinical experience changed most of our compared to colleagues at a teaching judgment. I have come to realize negative perceptions concerning hospital where you compete for that rural areas give health sciences working in rural areas and Karamoja in the same patients with your equals, students and fresh graduates the much particular. postgraduate students (residents) and needed hands-on experience and an other superiors. And mind you with early chance to practice what has been In a rural health center, your seniors professional work the more you do taught in school. A good example will want to teach you as much as (practice) the more you learn and the is the Community Based Education, possible so that when you are ‘ready’, better you get. Research and Services (COBERS) that is you relieve them of some work. This implemented by Makerere University is to the advantage of the student. Oftentimes you need to have love College of Health Sciences. We were so The supervising health worker will for your profession and must have delighted when soon after completing let you watch what he/she does the patience with the living conditions in our final year exams last year (2013) first time, assist him/her the second order to work in rural areas. For example time and he/she will watch you carry a place like Kaabong, Northern Karamoja, where you admit an infant on the ward with severe malnutrition, start them on High Energy Milk (HEM) feed according to standard protocol, only to find out later that the patient received very little if any HEM as it had to be shared by all the patient’s siblings. In these circumstances doing Directly Observed Therapy (DOT) is the best option here and that is where health sciences students come very handy and implement the strategy. Another rural place is Kisiizi in Rukungiri district, South-Western Uganda. This place, unlike Karamoja, has utilized its natural resources like people and water to improve the living conditions of the local population. Let me share with you two of the peculiar things in this area; the locally generated electricity and the community health MakCHS students pose for a photo infront of Kisiizi Hospital Chapel. Among other benefits, insurance scheme. With the insurance rural placements are socially rewarding for students to pg14 11 MESAU Research Administration Capacity BuildingMESAU Newsletter Jane McKenzie-White, Bob Bollinger, core group of MESAU institutional The third and final training workshop TBN faculty experts/leaders. Following took place in July 2013 in Uganda the workshop, trainees generated at the Makerere University campus. The MEPI MESAU leadership reports identifying activities Training,provided by the JHU RA was successful in obtaining an and infrastructure necessary for with approximately twenty-five (25) Administrative Supplement award successful RA capacity at their own MESAU staff, focused enhancing to support the research grants institutions. All training materials skills and knowledge to build on administrative capacity across the were shared with the MESAU trainees previous training sessions with five MESAU institutions. As a result for future training of in-country staff. flexibility each day to address specific of this one year program, three needs expressed by the trainees. workshops have taken place, training The second training workshop took approximately 60 MESAU faculty and place in April 2013 in Uganda.In MESAU now has a cadre of staff staff. the true sense of a train-the-trainer trained in best practices of model, working with the JHU RA research grants administration and The first training workshop took team, MESAU staff prepared and compliance. Additionally and most place in November 2012 on the Johns conducted their own Research importantly, the MESAU institutions Hopkins campus. A team from Johns Administration (RA) Training now have the capacity to support Hopkins Research Administration workshop for thirty (30) additional not only their programs, but can (JHU RA) was assembled to arrange MESAU trainees. The JHU RA team train and supervise other staff a one-week intense workshop in was on site for support and to and institutions in developing a core skills from pre- to post-grant provide further recommendations. competent research administrative award. The JHU RA team trained a infrastructure.

Initial training workshop for MESAU Trainees in November 2012: Betty Mabisi, Edith Wakida, Harriet Nambooze, Joan Larok, Paul Teefe, Goddy Muhumuza, Achilles Katamba, Peter Akera JHU Trainers/Staff: Matt Miller, Ga- briela Smit, Rose Warlick, Kelly Klein, Alex Galea, Gail Jessop

The World Bank awards 952 scholarships to 50 Training Institutions towards Health workforce development of Health (MoH). Part of the proceeds of highest in remote and hard to reach Dr. Isabella Epiu, this credit has been applied to finance areas, among lower level health pursuing Master a scholarship scheme targeting 952 facilities and the PNFPs. In addition, of Medicine in health workers over a period of 5 years. several students from remote areas Anaesthesia, who qualified were unlikely to stay Makerere Dr. Isabella Epiu, the student leader in their districts. Previous attempts University for the health workers that received by the MoH to bond staff had proved College of Health scholarships at Makerere University futile in attracting and retaining the Sciences College of Health Sciences talked to Mr. health workers who had benefited Moses Arinaitwe, the Human Resource from various training programs. In an for Health Policy Adviser for the UHSSP attempt to address this challenge, the Government of Uganda received at the MoH about the background to Ministry of Public Service, working a credit from the International the Scholarship scheme, target and with the MoH developed the hard Development Association (IDA) of achievements to date. to reach incentive framework. The the World Bank towards the cost of framework gazetted had to reach implementing the Uganda Health Background underserved Districts and approved Systems Strengthening Project, targeted incentives to the health (UHSSP) implemented by the Ministry Staff turnover and vacancies are to pg13 12 MESAU Newsletter The World Bank awards 952 scholarships to 50 Training Institutions towards Health workforce development From 12 workers in the affected areas. In expected to return to those areas targeted to undertake courses in building on the implementation of after training. This was possible with Human Resources for Health Policy, the framework, the UHSSP undertook the anticipation to earn improved Planning and Development and a scholarship scheme to support incentives approved under the hard 6 MoH Central staff were to do training of health workers to serve in to reach incentives framework unlike postgraduate studies in leadership the hard to reach and underserved in the past. and management. 450 health workers areas using guidelines developed by In addressing professional aspects, in Government and Private not for the MoH to promote transparency two interventions are being Profit health facilities were targeted and accountability in selection and implemented through training to receive scholarships under award of the scholarships. professional health facility managers the hard- to- reach/underserved and implementing a mentorship districts scheme. This would include The UHSSP Scholarship scheme aims programme to assist graduate essential health cadres: Technicians, to improve pre-service and in-service medical workers to perform Caesarian Dispensers and Clinical Officers; 264 education for selected health cadres in deliveries, and manage emergence health workers had been targeted short supply and hard to reach areas. obstetric care. Up to 400 health for scholarships in short supply/ It was designed to benefit employees workers in Health Center IVs will priority disciplines largely comprised working with both Government and receive hands-on training through of – Anesthesia, Ear Nose & Throat, Private Not for Profit (PNFP) training a mentorship program, to ensure Ophthalmology, Radiology, Family institutions. Pre-service beneficiaries that they can perform Caesarian Medicine; Technicians (Laboratory, who had applied for courses in deliveries, and manage emergence Pathology, Pharmacy and short supply also benefited from the obstetric care. In regards to providing Radiotherapy), Tutorship, and Store scheme. The overall objective of the support towards improving the keeping; 120 health facility managers scheme was to improve the quality Professional Management of Health from 60 hospitals were targeted and the numbers health workforce Facilities and Logistics and Supply for a Masters Program in Hospital graduates, especially laboratory Chain Management the project has Management at Nkozi University; technicians, radiology technicians, also supported strengthening of 60 Health facility managers at lower tutors, pharmacy technicians, and the capacity of the pharmacists and level health facilities comprised of store keepers/logistics assistants for Health Facility Managers. Medical superintendents/Hospital medicines and postgraduate clinical Administrators were targeted for specialists to fill vacant positions Targeted scholars scholarships in Advanced Diploma that exist in the health facilities. in Health Services Management; and Students from hard to reach areas 8 senior staff at the central were 50 health workers in Logistics and who benefited from the scheme were

Hard-to-travel roads in Kapelebyong County, Amuria District. Many health workers are reluctant to work in such places. Those that do are usually cut off from study and other opportunities.

13 MESAU Newsletter From 14 The World Bank awards 952 Living and scholarships to 50 Training Institutions working in towards Health workforce development rural areas can Management at Regional Referral be rewarding Marty’s University Nkozi, a one year Hospitals (RRH), National Referral Masters in Hospital Management and a Hospitals, MoH, General Hospitals, professionally one year Advanced Diploma in Health and Dispensers in Districts. Services Management were developed, and fulfilling approved and are being implemented. Achievements to date The graduates of these courses have socially In the financial year 2012/13 returned to the Health Facilities where alone, 413 health workers received they will be appointed to the recently scholarships in various disciplines. created positions of Directors, Medical scheme or society, as referred to by In the current financial year 2013/14, Superintendents of General Hospitals most of the locals, one is required 488 scholarships have been given and Health Centre IV’s and Assistant to pay an equivalent of two US to various health workers in several Medical Superintendents of Health dollars annually and is thus entitled training institutions in the country. Centres III and II. to health services in the hospital. The wide range of institutions Given that most of the people In strengthening the capacity of includes public and private here earn less than a dollar a day the pharmacy division to coordinate universities and tertiary institutions and yet may fall sick any time, this procurement planning, monitor logistics including those owned and managed scheme has greatly improved the and supply chain management and by individual entrepreneurs health of the area and saved them develop and monitor the performance and Church Foundation bodies. the nightmares of having to sell off agreement with the National Medical In providing the scholarships, their land at giveaway prices each Stores 56 scholarships have been the Project has strengthened time they required expensive care awarded to Pharmacy Professional in collaboration with public and private like a surgical operation. For the various levels to improve the quality of institutions. New health systems people not under the scheme, they graduates. support strengthening courses are required to pay some deposit depending on what they can that directly address the health These are commendable efforts by sector needs in today’s changing afford. Good enough, the hospital Uganda government to strengthen its doesn’t send away any patient for environment have been developed health system and especially with a and approved by the relevant failure to pay. This scheme is good component to improve distribution of for fresh graduates to learn how authorities and are now running. In health workers in hard to reach areas. this respect, under a memorandum to use local communities to solve of understanding between Uganda local problems. Kisiizi hospital built a mini dam -on the local river- that generates electricity for the hospital and supply some to all the neighbors within about 5km radius from the hospital. The fact that the electricity rarely goes off unless water levels are very low especially in the dry season leads to some competition on the local market, and businesses has soared in this area To my fellow fresh graduates, litigation against health practitioners is becoming more common place in Uganda. There are a lot of lawyers roaming around like hungry lions looking for ‘sleepy’ health workers. Like in other professions, these people are very much concentrated in urban areas. In contrast rural Uganda still offers a rather fertile ground to practice one’s profession and get the much needed practical experience without necessarily engaging in defensive medicine but putting the patients’ interests first.

14 MESAU Newsletter MEPI-MESAU Registers a Bumper Harvest

The year 2013 ended with a bumper harvest for MEPI established four medical schools or colleges has resulting from the good performance by the Medical added a new pool of health workers who successfully Education for Equitable Services for All Ugandans completed their studies in 2013 as shown in the (MESAU) consortium in Uganda. MESAU institutions accompanying table. used the MESAU platform to advocate for and support Busitema University’s efforts to dialogue with the To successfully implement transformative education central government to open a new medical school in as a means to achieve health equity requires use of the rural area of Eastern Uganda. In October 2013, fifty evidence regarding the many existing challenges three first year students were enrolled in this medical including the inadequate numbers and mal-distribution school. of health workers, the quality of education, the priority health issues of the time and in foreseeable future, Whereas MEPI funding was intended to support and evaluation of which educational interventions medical education, other health professional students work. Building research capacity is therefore critically at MESAU medical schools or colleges have benefitted important if we are to make significant advances in from the strengthened infrastructure, resources and transformative learning. The evidence generated the innovative education approaches. For example would facilitate policy makers and decision makers all students benefit from the skills laboratories, the to inform their decisions. In this issue of MESAU News community based education, research and services pages 15 and 16 are publications emerging from MEPI (COBERS), inter-professional education, and research investments. There is need to do much more in the area capacity building efforts. MEPI funding to the already of education research.

Table 1: Number of health workers who completed their training in 2013 from MEPI- MESAU funded universities

Institution Numbers of different types of health workers who completed degree training MBChB Medicine Nursing BScN BPharm Pharmacy DBS Dentistry BLD Medicine L BSc Radiography Therapy BSc Language & S peech (Diploma) OfficersClinical Counselling Management/ care & HIV/AIDS Community in Diploma Diploma Nursing aboratory

Gulu University 72

Kampala International 142 10 15 17 82 133 University

Makerere University 129 12 31 11 10 1 College of Health Sciences

Mbarara University of Science 76 31 26 77 20 and Technology

Some of the students from MakCHS at a recent Makerere University graduation ceremony

15 MESAU Newsletter How to support the career path of young Research Investigators – Lessons from Makerere University College of Health Sciences

By Isaac Roy Kyeyune (Grants Fellow 1. Capacity building and trainings; and knowledge dissemination, IT – MakCHS Grants and Contracts These involve short term general services among others. Office) trainings, new information 5. Mentorship; this strategy is to In institutions of higher learning dissemination workshops, in identify seasoned mentors in the especially in Africa, there is growing different areas like electronic different areas of research and concern about the general decline registrations and submissions, grants so that they are matched of research culture among faculty developing grant concepts, with new investigators. This is and students. This trend has critically budget development and intended to pass on skills and and negatively affected the capacity monitoring among others. knowledge as well as support and of many of these institutions to 2. Dissemination of funding guide them into senior staff that conduct research and also mobilize opportunities to staff and can effectively conduct research and manage resources associated partners; Access to funding 6. Presentations and with research activities. In reaction opportunities and notices is key dissemination; Career to this, many institutions especially to creating interest and start-up development and growth involve universities and research institutions excitement among researchers sharing, exposure both nationally are enhancing their research and into developing research and internationally. It helps grants capacity through developing concepts and grant applications. researchers and investigators to different structures and systems that The strategy has specifically been disseminate their research work support the staff and stakeholders to to match new investigators with and achievements as well as conduct research, identify, apply for smaller grants that are simpler to pick timely guidance from other and manage grants. apply for and easier to win. international researchers from 3. Regular target outreach several regional and international Makerere University College of programs; this involves research associations and Health Sciences has come out to put specialized small group target networks. Key among these are in place efforts that encourage and meetings often out of the need SRA, ARAA, INORMS which the promote the career paths of new expressed by a certain unit of College has membership. and young investigators as the next people or person with a plan or 7. Resource mobilization efforts; generation to replace the outgoing interest to write and submit. through increased efforts to layer of established researchers and 4. Grants and Research support mobilize funds through grants academicians. The aim of this is to Office; establishment of a grants applications, membership to develop them into seasoned and and research support office networks, improved regional independent researchers able to combining a variety of one-stop and international networks and take lead of their different research center services related to research collaborations among others. interests, apply for and win grant and grants. Some of the key services All these strategies are being put awards from both local and external include grants and contracts into a holistic College strategic funders. Some of the key strategies set support, budget development, plan to be implemented as a up are; training and capacity building, guideline to ensure coherence and IRB support services, Information consistence as well as monitoring and evaluation. Published Manuscripts 1. Henry Francisco Kaadaaga, Judith Ajeani, Sam Ononge, Paul among patients in the medical emergency admission E Alele, Noeline Nakasujja, Yukari C Manabe and Othman service of a large urban hospital in Subsaharan Africa; a Kakaire. Prevalence and factors associated with use of cross sectional study”.The Pan African Medical Journal. herbal medicine among women attending an infertility 2013;15:23 clinic in Uganda. BMC Complementary and Alternative 6. Roselyne Akugizibwe, Josephine Kasolo, Duncan B. Medicine 2014, 14:27 doi:10.1186/1472-6882-14-27 Makubuya and Ali M. Damani. Magnitude of missed 2. Joseph KB Matovu, Julie Denison, Rhoda K Wanyenze, Joseph opportunities in the management of protein energy Ssekasanvu, Fredrick Makumbi, Emilio Ovuga, Nuala McGrath malnutrition among children under 5 years in Wakiso and David Serwadda. Trends in HIV counseling and testing district, Uganda. Journal of Epidemiology and Public uptake among married individuals in Rakai, Uganda. BMC Health. Vol. 5(11), pp. 463-470, November 2013 Public Health 2013, 13:618 7. Lalitha Rejani, Christopher Kenneth Opio. “A missed 3. Asiimwe J, Sembajwe LF, Senoga A, Bakiika E, Muwonge H, diagnosis or a masquerading disease: back to the Kalyesubula R. Overnight soaking or boiling of “Matooke” to basics”. The Pan African Medical Journal. 2013;15:29 reduce potassium content for patients with chronic kidney 8. Kateete DP, Kabugo U, Baluku H, Nyakarahuka L, Kyobe disease: does it really work? African Health Sciences 2013; 13(3): S, Okee M, Najjuka CF, Joloba ML. Prevalence and 546 - 550 Antimicrobial Susceptibility Patterns of Bacteria from 4. Nakibuuka J, Nyakoojo WB, Namale A, Ddumba E, Leontsini Milk Men and Cows with Clinical Mastitis in and around E, et al. Utility of Transthoracic Echocardiography and Carotid , Uganda” PLoS One. 2013 May 7;8(5):e63413. Doppler Ultrasound in Differential Diagnosis and Management doi: 10.1371/journal.pone.0063413. of Ischemic Stroke in a Developing Country. J Cardiol Clin Res 9. Andrea Beaton Okello E, Lwabi P, Mondo C, McCarter 2013 1(2): 1012. R, Sable C. Echocardiography screening for 5. Christopher Kenneth Opio, Emmanuel Seremba, Ponsiano rheumatic heart disease in Ugandan schoolchildren Ocama, Lalitha Rejani, Magid Kagimu, William Martens Lee. 2012 Jun 26;125(25):3127-32. doi: 10.1161/ “Diagnosis of alcohol misuse and alcoholic liver disease 16 to pg16 MESAU Newsletter Published Manuscripts

CIRCULATIONAHA.112.092312. Epub 2012 May 24. PE,Ajayi AM. Imanirampa L. Journal of Experimental 10. Misaki Wayengera. Zinc finger nucleases for the targeted Pharmacology 2013:5 33–44. mutagenesis of the sickle cell disease mutation: An in- 23. Okello E, Kakande B, Sebatta E, Kayima J, Kuteesa M, et al. silico study. BMC Blood Disorders” Theoretical Biology “Socioeconomic and Environmental Risk Factors among and Medical Modelling 2012, 9:30 doi:10.1186/1742- Rheumatic Heart Disease Patients in Uganda”. 2012. PLoS 4682-9-30 ONE 7(8): e43917. 11. Jane Nakibuuka Blondin, N. Namale, A. Ddumba, 24. David P. Kateete, Samuel Kyobe. 2012. Rhomboids of E. A descriptive epidemiological study on stroke in Mycobacteria: Characterization using an aarA mutant of Kampala, Uganda: A hospital based study. AJNS, 2012. Providencia stuartii and Gene Deletion in Mycobacterium 31(1), (AJNS- African Journal of Neuro Sciences) smegmatis” PLoS One. 2012;7(9):e45741 12. Kwizera Arthur, Dunser M, Nakibuuka J. National 25. David Lagoro Kitara, Bwangamoi PO, Wabinga H. 2011. intensive care unit bed capacity and ICU patient “Pyomyositis, its risk factors in patients of Gulu Regional characteristics in a low income country. BMC Res notes, Referral Hospital, Uganda. A cross-sectional study. East and 2012.5(1) 475 Central African” Journal of Surgery 16(3):58-63 13. BJ Kirenga, L Nakiyingi, W Worodria, and M Okot- 26. Miriam Nansunga, Paul Alele, Yuka Manabe and Josephine Nwang. Chronic respiratory diseases in a tertiary KasoloAssociation of testosterone levels with socio- healthcare facility in Uganda. African Journal of demographic characteristics in a sample of Ugandan men” Respiratory Medicine 2013)Vol 8, No2 March was accepted for publication by African Health Sciences. 14. Lydia Nakiyingi, Kateete DP, Ocama P. Evaluation of in- house PCR for diagnosis of smear-negative pulmonary tuberculosis in Kampala, Uganda. MC Res Notes. 2012 Articles submitted to MEPI Sep 5;5(1):487, PMID: 22947399 supplement in Academic Medicine 15. Lydia Nakiyingi, Bwanika JM, Lukande R, Kirenga B, Mwambu TP, Worodria W, Okot-Nwang M. Destructive 1. Kintu Mugagga, Samuel Dare, Masilili G. Mwalisi and rib lesions in an HIV sero-negative male: an unusual Peter H.Sebuwufu. The wooden skul : an innovation presentation of tuberculosis in a high tuberculosis through use of local materials and technology to promote prevalence setting.Trop Doct. 2012 Nov 6. PMID: the teaching and learning of human anatomy. Submitted to 23131749 Academic Medicine 16. Jacob ST, Meya D, Nakiyingi L, Burke R, Horton CL, Iga B, 2. Zohray M. Talib, Elsie Kiguli-Malwadde, Hannah Wohltjen, Wald A, Reynolds SJ, Mayanja-Kizza H, Scheld WM; The Miliard Derbew, Yakub Mulla, David Olaleye, and Nelson impact of early monitored management on survival Sewankambo. A Paradigm Shift: Medical Schools in Africa in hospitalized adult Ugandan patients with severe Form In-Country Consortia to Improve Medical Education sepsis: a prospective intervention study. Crit Care Med. and Health Workforce Planning 2012 Jul;40(7):2050-8.PMID: 22564958 3. Francis J. Njiri, MSc, Mara J. Child, MPH, MPA, Gabrielle 17. Henry Kajumbula, Byarugaba W, Wayengera M. O’Malley, PhD, Sarah Baird, PhD, MS, Vincent Ojoome, MMed, Targeting wild-type Erythrocyte receptors for Natalie Brogan, MPH, CPH, Luke D. Davies, Kalay Moodley, Plasmodium falciparum and vivax Merozoites. MMED, Nadia Tagoe, MSc, Rhona Baingana, MSc, Netsanet Genetics and Vaccine Therapy. Genetic Vaccines and Animut, Esther Lisasi, MPH, Kagiso Sebina, MSc, Vanessa Therapy 2012, 10:8 doi:10.1186/1479-0556-10-8 Vaila, MSc, Shemiah Nyaude, MSC, Moise Muzigaba, MPH, 18. Haruna Muwonge, Sharif Kikomeko, Larry Fred Prosper Okonkwo, MD, James Kiarie, MMed, MPH. Evolution Sembajjwe, Abdul Seguya, and Christine Namugwanya. of a Multi-University Monitoring and Evaluation Technical How Reliable Are Hematological Parameters in Working Group Predicting Uncomplicated Plasmodium falciparum 4. Damen Haile Mariam, MD, MPH, PhD, Atiene Solomon Malaria in an Endemic Region? ISRN Tropical Medicine. Sagay, MBChB, Wilfred Arubaku, Rebecca J. Bailey, MSPH, Volume 2013 http://dx.doi.org/10.1155/2013/673798 CEd, Rhona K. Baingana, MSc, Aluonzi Burani, Ian D. Couper, 19. Kisuule I, Kaye DK, Najjuka F, Ssematimba SK, Arinda A, MBBCh, MFamMed, Christopher B. Deery, MPH, Marietjie Nakitende G, Otim L Timing and reasons for coming De Villiers, MBChB, PhD, MFamMed, Antony Matsika, Mpho late for the first antenatal care visit by pregnant women Mogodi, Kien Alfred Mteta, MD, MMed, and Zohray M. Talib, at Mulago hospital, Kampala Uganda. BMC Pregnancy MD. Experiences of Community-Based Education Programs and Childbirth 2013, 13:121 (25 May 2013) in Africa: The Case of Schools within the Medical Education Partnership (MEPI) Network 20. James Kayima, Wanyenze R, Nuwaha F. “Hypertension awareness, treatment and control in Africa: A systematic 5. Kintu Mugagga, Grace Akello, Peter Akera, Wilfred Arubaku, review” – BMC Cardiovascular diseases Lynn Atuyambe, Florence Ayebare, Rhona K. Baingana, MSc, Anne Katahoire, Simon P.S Kibira, MSc, David K. Mafigiri, 21. Lule Herman, E. Ovuga, M. Mshilla, S. Ojara, G. Kimbugwe, PhD, Samantha Mary, Scovia N. Mbalinda, Ruth Nabaggala, A. P. Adrawa, and N. Mahuro Knowledge, Perceptions Henry Oboke, Elialilia Okello, Gad N. Ruzaaza, James K. and Acceptability to Strengthening Adolescents’ Tumwine, and Nelson K. Sewankambo. Experiences of Sexual and Reproductive Health Education amongst Health Professions Students in Uganda during Community- Secondary Schools in Gulu District. World Academy of Based Education: Shaping of Attitudes Towards Working in Science, Engineering and Technology 79 2013 1518- Rural Areas 1533 6. David K. Mafigiri, Florence Ayebare, Rhona K. Baingana, 22. Paul E Alele, Abayomi M Ajayi, Lawrence Elialilia Okello, Nelson Sewankambo. Mapping the Imanirampa. Chronic khat (Catha edulis) and alcohol evolution of medical education in Uganda: A qualitative marginally alter complete blood counts, clinical analysis of the ‘Medical Education for EquitableServices for chemistry, and testosterone in male rats. Alele All Ugandans’ consortium (MESAU).

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