KI-Makere Collaboration: Towards better health services for vulnerable groups in Uganda
2010 - 2014
The development in Africa with the epidemiological transition leads to maternal and infectious disease causes of death increasingly co-existing of chronic diseases, the double burden challenging the often fragile health system. Equity in access to good quality care is a concern at measurement and intervention levels. The research also needs to develop and evaluate strategies to scale up evidence based interventions in maternal, neonatal health as well as increasingly for non communicable disorders such as diabetes mellitus. There is a need to develop national resources to conduct health policy and systems research through PhD, Post doc and Institutional capacity building.
- Evaluate costs and effects of integrated community case management (iCCM) for malaria and pneumonia through community health workers.
- Evaluate costs and effects of facility and community interventions for maternal/neonatal care practices in facilities and communities on newborn care practices and newborn survival
- Determine enablers and barriers to adherence to chronic care models using HIV as tracer
- Evaluate social and material capital for assessment of equity of access to care
- To determine the distribution of type 2 diabetes related risk factors and disease prevalence as well as exploring options for screening and intervention at PHC levels in a rural low-income setting
Former PhD students from Makerere have become post docs and principle investigators of some of the above studies. Attempts are made to facilitate institutional capacity building through the establishment of a local research group with joint supervisory teams. Most of the studies are being carried out in the Iganga/Mayuge Health and Demographic Surveillance Site (DSS) established in collaboration between our research group and the School of Public Health Makerere university. Studies related to aims 1. And 2. are conducted as cluster Randomized Controlled Trials with communities as study units. A mixed methods design is used for aim 3 including cross sectional and RCT studies with qualitative and quantitative methods. For aim 4 a cross sectional design is used with self reported access to care as dependant variable. Regarding aim 5 four sub-studies will be conducted in the DSS, one suing a population based cluster survey, another comparing two point-of-care tests for screening at PHCs and one cross sectional investigating health workers knowledge, finally one that studies individuals perceptions and attitudes to type 2 diabetes.
Several of the former PhD students have become principle investigators and been enrolled as post docs strengthening Makerere School of Public Health. The evaluation of the Home Based Management of Fever as well as the shown symptom overlap (malaria and pneumonia) in children led to a policy change introducing the iCCCM which is now being evaluated. Studies within the neglected field of neonatal health have facilitated a number of processes nationally including quality and access challenges.