By Professor Stephen Lawoko
Having spent 28 years of my life in Sweden, returning to Uganda July 2017, to serve my country was an honor,though with mixed feelings of excitement and uncertainty. Exciting because I felt my experience in research and education in the health sciences domain would be of great value to university students, faculty and community at large.
Uncertain because I had never worked professionally on long-term basis in Uganda, having left the country after completing senior six. I was now to join as Dean of Health Sciences at a young but dynamic University, Victoria University.
For the past 16 years, I had served in different capacities at the Karolinska Institute in Sweden, a top notch world class Medical and Health Science University founded in 1810 and therefore more than 200 years old! Now an Associate Professor, my agenda was clear, but what were my expectations of this 7 year old Victoria University?
I had read and heard of over-filled Universities in Uganda with tutor-student ratios way below optimal. On one occasion while in Sweden, I had actually been invited as a guest lecturer at one such University and experienced it. Some proponents had suggested that this was a reflection of popularity while others argued it was mirroring shortage of higher education facilities in the country, amidst high demand.
Whatever the case, Victoria University stood out! What I found on ground upon taking on my new role was a modern culturally diverse cosmopolitan University in central Kampala, with all the environmental recipes for an ideal learning environment! Student-tutor ratios were optimal with lots of spacious classrooms, a fully-fledged library and skills laboratory!
Energetic scholars had just returned from field placements, where they had interfaced with and provided health services to disadvantaged communities during their recess term! Among them where Maria Ssematiko, Winnie Apolot and Irene Samari.
At the university, they mingled freely with faculty and where not shy to share of their experiences with their new Dean. It appeared that student-faculty communication was good. Just like the students, faculty members where from all corners of globe. In general, these conditions mirrored what I had left behind at the Karolinska Institute in Sweden, 200 years older than Victoria University!
Five months have passed since I took on the new position as Dean of Faculty of Health Sciences at the Victoria University. My observations, reviews of past andcurrent strategic plans, interactions with faculty and students, among others, indicate that Victoria University is growing at an exponential pace to become a world class University!
Last week I presided over the defense of three bachelors theses in Public Health Sciences, which is one of four programs offered at the Faculty of Health Sciences. As Dean of the faculty, I had carefully matched each thesis with a set of three appropriate independent expert examiners in line with the University policies and recommendations. The following is a summary of the three important theses Authored by Ms. Maria Ssematiko, Ms. Winnie Apolot and Ms. Irene Samari respectively.
Anaemia, a condition characterized by low blood haemoglobin concentration, is currently a global public health problem that has adverse health consequences. It is a result of iron deficiency in the body, mainly due to poor nutritional practices and is therefore a preventable.
Yet, a striking 40% of the world’s children under 5 years old are affected by the disease, according to the World Health Organization (WHO) statistics. Using data from over 1000 women extracted from the Uganda Demographic and Health Surveys, Ms. Maria Ssematiko’s thesis assessed the influence of women’s demographic and empowerment features on anaemia status among their children (0-5) years old.
Ms. Ssematiko’s study found the prevalence of anaemia among Ugandan children under 5 years to be as high as 65%, which is 25% more than the global average! Further investigation revealed that maternal illiteracy, teen-age motherhood and residing in rural settings increased the likelihood of having a child with anaemia among Ugandan Women.
In addition, the study identified significant religious and ethnic variations in the prevalence of Anaemia. According, Ms. Ssematiko recommended that interventions to address infant Anaemia should target and be tailored to suit mothers with specific socio-demographic characteristics (identified in her study), if Anemia is to be effectively controlled at National level in Uganda.
Immunization is proven to be the most effective way of preventing mortality of children below five years. Yet, infant mortality remains relatively high in Uganda at 43 deaths per 1000 live births. An understanding of both the demand (i.e. caretaker) and supply (i.e. caregiver) factors can inform effective interventions to reduce immunization related mortality.
The thesis of Ms. Winnie Apolot assessed and identified parental and health facility factors that negatively influence completion of immunization services. Using data generated from 185 mothers in Budumbili west as a case study, Ms. Apolot found poor knowledge of immunization schedules among parents to reduce the likelihood of immunization completion.
Surprisingly, unlike previous studies, Ms, Winnie Apolot’s study did not find any association between general education levels and completion of Immunization. Ms. Apolot concluded that these finding have the implication that generic interventions alone (e.g. universal primary/secondary education) my not adequately address the gap in immunization practices among mothers. The study emphasized the need to complement general education with comprehensive orientation of mothers about the immunization process at the community level,by healthcare providers.
The World Health Organization estimates that 10% of the African population lives with some form of disability. There is broad consensus among researchers that disability influences the mental wellbeing of People living With Disabilities (PWDs).
However, not all PWDs encounter mental health problem, and the research on factors that may distinguish between PWDs who develop mental distress and those who do not is lacking. Ms. Irene Samari’s thesis set out to fill this research gap.
Using data generated from 130 PWDs from CoRSU (Comprehensive Rehabilitation Services Uganda), a facility offering services to people with disability in central Uganda, the study found the prevalence of psychological distress (which is a generic indicator of mental illness) among PWDs to be ashigh as 70%.
The characteristics among PWDs that increased the likelihood of distress included young age, being single, socio-economic disadvantage (reflected in low education and low income), and having another health condition besides the disability (i.e. Comorbidity). Ms. Samari concluded that interventions to reduce distress among PWDs should be comprehensive, targeting the identified risk groups as well as detecting and dealing with comorbid conditions among PWDs.
The global, regional and community relevanceof these bachelors’ theses cannot be overemphasized. The millennium development goals (MDGs) 3,4 and 5highlighted several aspects related to these works including reduction of high child mortality rates, and closing the gap in health and healthcare utilizationamong disadvantaged populations.
Though tremendous progress was made in the achievement of the MDGs by 2015, significant gaps remained and the research of Maria, Winnie and Irene remain relevant in addressing these gaps. They incorporate an understanding that research on risk factors for ill health, uptake and supply of health services can provide important insight for preventive and curative interventions targeted at specific groups at risk in the communities.
They provide evidence ofbarriers to the effective uptake and supply of health services, emanating from the healthcare supply side as well as the demand side. They underline the importance of a comprehensive approach in addressing these health risk and gaps in delivery, and finally, they exhibit the high level of training and research of relevance for the global community offered at the Victoria University.
Congratulation Maria, Winnie and Irene for your important contribution to global health research! The challenge remains in the translation of your findings from paper to interventions that will transform the lives of the populations you have studied. It is my hope that your research journey has not ended here. You started it; you either finish it or encourage those following you to pick up from where you stopped! Aluta Continua, Victoria University on your journey towards excellence in education, research and community service!
Professor Stephen Lawoko, Dean Faculty of Health Sciences, Victoria University