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On February 26th 2015, the ReBUILD team in Uganda conducted a second validation meeting at Churchill Courts Hotel in Gulu.
The meeting was aimed at generating debate on and attaching meaning to issues coming out of the ReBUILD sub studies, as well as get an understanding of how to move forward with the findings and the rest of the work in terms of recommendation and policy implications.
The validation meeting shared findings from Sub-studies 1 (Findings and implications from Household experiences of health system during and after conflict), 2(Findings and implications from Health Worker Key Informant Interviews and document review) (and 5 (Findings and implications from Aid Effectiveness study).
The one day meeting was attended by about 30 participants from Gulu, Amuru and Kitgum districts. They included District Health Officers, Biostatisticians and health facility managers of PNFP and Public facilities, Health workers and representatives of selected CSOs from the three districts.
The meeting was opened by Dr. Robert Ongom Assistant DHO Gulu district on behalf of the DHO who was unable to attend the meeting. Dr. Ongom who was also acting as DHO, noted that the Northern Uganda region is now peaceful, but in post-conflict recovery period with a lot of rehabilitation work going on. He said efforts like these (ReBUILD research) to understand health service delivery are important to make meaningful rehabilitation. He further noted that ReBUILD is quite holistic and not the usual scope (of many other research projects) focused on health care itself. "It will help district stakeholders and the country to be able to understand the terrain (of post-conflict health systems) and make meaningful decisions", he said.
Intense debate was around issues related to drug stock-outs and how they affect patterns of health seeking behavior, temptation to push the agenda of using service delivery lessons from the conflict period to organize regular service delivery, availability of social amenities like good schools, uncoordinated recruitment exercises, low funding levels, weak coordination of the activities of development partners which leads to unfair distribution of their resources, among other issues.
On drug stock-outs, it was said that these are caused by people flocking health facilities once they hear that drugs have been delivered. This reaches the extent of people claiming illnesses they are not actually suffering from. One repercussion of drug-stock outs mentioned is the 'toxic branding' of health workers as 'thieves of drugs'. This does not only demotivate health workers but also puts them at risk of being insulted and disrespected by the people they serve.
Validation meeting participants urged political leaders not to mislead the people about drug stock-outs but rather to balance the picture about the shortages by considering health facility level challenges as well as systemic problem which emanates from poor financing of the health system as a whole.
In response to the finding that the health status of the people seemed to be much better during the war when people were still living in camps, the research team was cautioned not to appear to be "Pushing the agenda of using lessons from camps to drive better service delivery". It was noted that this would be equated to "normalizing a bad situation".
One critical element in motivation to work in rural areas is the availability of education services and facilities especially at nursery level. "Provision of social amenities such as quality nursery schools for kindergarten going children would be a good incentive to attract health workers to rural/remote areas", noted one participant. It was noted that while big children can be taken to boarding schools or can go to school on their own, smaller children need to access nursery schools that are convenient for working parents to drop and pick their children. Unfortunately, many rural areas lack such good quality nursery schools.
Uncoordinated recruitment exercises among the districts in the face of a competitive labour market in the region was also confirmed as a vital finding and a challenge for Northern Uganda, especially for Human Resources for Health. While illustrating the effect of this on Amuru district, a participant from Amuru noted that "even with a (now) functional District Service Commission, Amuru still has challenges attracting health workers. This is attributed to the rural nature of the districts with scanty social amenities which discourages potential employees from taking up jobs on offer. "For instance, by the time candidates arrive in Amuru for the job interview, they have passed through all the villages (rural) and have made up their mind to or not to take up the job. In the previous recruitment drive, Amuru advertised for 30 midwives but only seven applied and only three of these took up the jobs." said the district official.
Regarding aid effectiveness, participants at the meeting engaged in a rich discussion regarding the lack of coordination by the centre and district authorities, of activities by development partners. As the findings from sub study 5 indicated, participants agreed that development partners prefer investing where infrastructure is already well-developed, where results will be realized quickly and where their own interests, priorities and visibility will be served better. "The tool used in analyzing this work can be used by districts to bring out priority areas; it can be used if one is to prioritise aid relations in the districts. This is a critical area; it touches issues of donor priorities, donor visibility, donor interests which affect outcomes of development funding", one of the participants summed up the situation.
The Department of epidemiology and Biostatistics is one of the 4 departments that make Makerere University School of Public Health. It houses the Master of Public Health Distance program, Masters in Health Services Research and short courses in Epidemiology and Biostatistics. Soon it will run Masters of Health Informatics.
Started in 2001 together with HPPM, CHBS, DCEH when the then Institute of Public Health was granted semi-autonomy
Started with few staff- Prof Wabwire-Mangen, Prof Konde-Lule, Dr David Ndungutse, Prof Nazarius Mbona Tumwesigye, and Dr Simon Kasasa. Prof David Guwatudde joined in 2005 and Dr Bagenda joined in 2006 from Departments of Surgery and Obstetrics and Gynecology respectively.
By close of 2014 we had 13 regular academic staff, 6 honorary lecturers, 1 Administrator, 1 Asst Admin and 2 drivers
As mentioned above we run Masters of Public Health through distance education (MPH-DE), Masters in Health Services research (MHSR) and short courses in epidemiology and biostatistics
The program is designed for individuals who desire graduate public health training while they continue to work. The program is modeled on the same objectives of the MPH Fulltime Programme and covers exactly the same academic content. For more information follow the link [insert link for MPH-DE]
The MHSR training programme is implemented in collaboration with Ministry of Health (MoH), faculty and staff of the School of Medicine (SOM), other colleges and schools of the University, governmental and non-governmental health care organizations both locally and internationally. MHSR specialists, graduates and students are engaged in numerous community-wide collaborations to improve the lives of Ugandans. For more information follow the link; http://musph.mak.ac.ug/index.php/study/navigations/short-courses/304-programmes-mhsr
The Department of Epidemiology and Biostatistics at Makerere University School of Public Health has developed and packaged short courses to respond to the expressed training needs by graduate students from various disciplines, researchers and people employed in other sectors. The acquired skills will enhance the participants' productivity at their work places or improve the quality of dissertation or publications in case of student or academic participants. The courses run in July and August of every year. For more information please follow the link; http://musph.mak.ac.ug/index.php?option=com_content&view=article&layout=edit&id=82
Masters in Health informatics
This program is in final stages of approval by Makerere University. It is slated to start in 2015/16 academic year.
Research Programmes and recent research output
By Dec 2014 the department was running or spearheading 22 research and consultancy projects. Key among these were TB COSONET study, BCG trials, and the PMA2020 nationwide study The department boasts of a research centre named Family Health Research and Development Centre (FHRDC). Other project cover child health, newborn infections, alcohol and Policy and comparative Viral load costing study.
Sound policy is critical to the successful delivery of health services for improved health outcomes. Research evidence is one of the key ingredients in the formulation of sound health policy. Influencing policy making processes is therefore becoming a major assignment of health researchers and other policy practitioners, globally.
The ReBUILD buy priligy research consortium, working in Uganda, Zimbabwe, Sierra Leone, Cambodia and the UK, is a post-conflict health systems research initiative to support health system development in post conflict settings.
The consortium is organizing a 4-day policy influencing residential training to be held 2nd – 5th March 2015 in Entebbe.
Participants on the training will get a grounded understanding of how to influence the policy making process in varying settings to achieve desired policy outcomes.
They will learn skills to help plan and deliver effective advocacy strategies; enhance their ability to lobby decision makers; and gain confidence in the ways in which they relate to different stakeholders. They will also have a more thorough understanding of power dynamics in a policy influencing context.
At the end of the training, participants will be able;
1. To identify different approaches to advocacy and the values and strategies that underline them
2. To analyze the external environment and policy processes to identify buy clomid online appropriate 'levers of influence'
3. To use social media and mass media platforms/outlets for policy engagement
4. To understand evidence needs of policy makers
Content of the Training:
• Policy advocacy/lobbying -- know key steps to developing an advocacy strategy, plus new advocacy tools and methods
• Policy influencing – approaches and strategies – learn the difference between propecia online Insider and Outsider approaches and when to use them
• Using Social media buy generic propecia online for policy influencing – gain knowledge on the most appropriate social media platforms to use for policy influencing. Participants will gain skills in using some of the selected social media platforms
• Using Mass media for policy influencing – participants will gain insights in how to effectively work with mass levitra online media, as well as identify opportunities for engaging media practitioners
• Interaction with a panel of policy makers (from Ministries of; Finance, Health, Labour and Social Development, Parliament, Office of the Prime Minister) – participants will get to understand what effective policy influencing entails from a policy-maker's perspective
• Writing and delivering effective Policy briefs –participants will have hands-on experience writing policy briefs. At the end of the training, each participant will have a ready or near-ready policy brief for presentation. . A session will also be organized for participants to practice delivery of policy briefs to policy makers.
• The training is targeting about 35 participants on a first come, first milf porn served basis
• buy clomid online Research teams and individual researchers
• Policy practitioners in government and non-government agencies
• Researchers with ready findings to work with are particularly encouraged to apply
Policy Influencing Training Application form,Click here to download document
Some of the speeches that were said at the MakSPH-CDC Fellowship Program Dissemination Workshop at Silver Springs Hotel on 17th December, 2014