ADVANCED WORKSHOP ON PUBLIC HEALTH PRACTICE TO CONTROL INJURIES AND DISABILITY

Johns Hopkins University, Bloomberg School of Public Health, in partnership with Makerere University School of Public Health, was awarded an NIH training grant for the chronic consequences of Trauma, Injuries and Disability (TRIAD). A workshop was organized, and it took place at the MakSPH Annex office premises, Kololo, Kampala on the 2nd and 4th of September 2014. 

The goal of this grant was to strengthen research capacity on the long term health and economic consequences of trauma, injuries and disability across the lifespan in Uganda. The main objectives were to create a comprehensive public health mission assessment, and to use performance measures to measure performance. The workshop was attended by 79 people. 

On the first day, various subtitles were discussed including: the reason for Essential Public Health Functions, what Essential Public Health Functions were, connecting EPHF to Health Systems, Performance Improvement Concepts, Understanding EPHF Measurement and Assessment Tool, Implementing the Measurement and Assessment Tool, all of which was followed by a group exercise. 

On the second day, all participants were transported to Luweero district where a practical session of using the district level assessment tool was to be conducted. They then went on to talk about Turning Data into Performance Improvement, Follow Up and Support Supervision and Building Relationships for Ongoing Performance Improvement. 

 

Disability & Rehabilitation Exhibition & Seminar

Chronic TRIAD was pleased to provide a full day of events focused on a topic which JHU faculty member Stephen Wegener likes to call the “tail end” of TRIAD: disability and rehabilitation (D&R) in Uganda.

The morning of 23 May began with an exhibition in the Dean’s Garden of different organizations that provide D&R services including the D&R division of the Ministry of Health (MOH), Occupational Therapy at Mulago Hospital, Comprehensive Rehabilitation Services in Uganda, National Union of Women with Disabilities of Uganda, the Community-Based Rehabilitation Alliance, and the Spinal Injuries Association of Uganda. Following the exhibition and lunch, Chronic TRIAD led a widely attended D&R seminar in the Davis Lecture Theatre. The goals of this seminar were to reflect on what Uganda has been doing to address D&R, what is the impact of these policies, interventions, and services, and what more could be done in the future.

Dr. Stanley Bubikire of the MOH first presented the state of D&R in Uganda including the services provided. Dr. Wegener then introduced the seminar participants to the Chronic TRIAD program including its objectives and its current work to build capacity to conduct trauma, injury, and disability research. Another JHU Chronic TRIAD faculty member, Dr. Jacob Bentley, delivered the third presentation. After highlighting the different leading models and frameworks for disability, Dr. Bentley presented some findings from a recent study conducted by JHU Chronic TRIAD faculty member Dr. Abdulgafoor Bachani. Dr. Bachani has been working with the Iganga-Mayuge Demographic Surveillance Site to measure the existing burden of disabilities in those two districts, including how the burden varies by individual characteristics such as socioeconomic status. Finally, Dr. Bentley presented disability statistics across different countries including Uganda.

The seminar culminated in a question and answer session with a panel of the three presenters. This lively discussion covered topics such as enforcing building requirements to improve accessibility for persons with disabilities, addressing the challenge of limited human resources, and improving the availability of degree programs related to D&R such as physiotherapy and occupational therapy.

Chronic TRIAD Basic Workshop

Following on our successful Chronic TRIAD consultative workshop, we announced our plans to conduct our first Chronic TRIAD Basic Workshop our on the burden of injury and disability in Uganda and then received over 200 applications from Makerere University School of Public Health (MakSPH) students and representatives from the health and police sectors and non-governmental organizations.

On 29-30 April 2013, we conducted this workshop at the Silver Springs Hotel in Kampala.

The two-day workshop fulfilled the following objectives: 1) to describe the incidence, causation, and lifelong impacts of trauma, injuries and disability (TRIAD) on individuals and society; 2) to introduce and discuss the importance of a multidisciplinary approach to the prevention & care of TRIAD across the lifespan; 3) to identify basic methods for key research around TRIAD; and 4) to introduce and discuss the need for investment in specific interventions for prevention and management of TRIAD in Uganda.

Dr. William Bazeyo, dean of the MakSPH, welcomed the participants and facilitators and participants. Participants engaged in lively discussions with the facilitators about specific injury problems that burden different populations within Uganda. The workshop sessions covered topics such as the public health approach to injury, injury research and surveillance, and essential clinical traumatology and emergency trauma care systems. We were lucky to count on expert facilitators from MakSPH and the Johns Hopkins Bloomberg School of Public Health including Drs. David Guwatudde, Lynn Atuyambe, Nazarius Mbona Tumwesigye, David Bishai and Mr. Jeffrey C. Lunnen, as well as Dr. Milton Mutton from the Pincer Group International.

Drs. David Bishai and Milton Mutto spearheaded a group activity in which participants walked on the streets of Kampala, identified individual and environmental risk factors of injury, and considered the level of injury severity by those risk factors. Participants gained a better sense of the true scope of the problem of trauma, injuries, and disability in Uganda and learned more about the research methods that can be taken to address the burden.

Development and Pilot Testing of Rapid Assessment Tool for Pre-Hospital System in Kampala, Uganda

 

A collaborative Project of Johns Hopkins International Injury Unit and Makerere School of Public Health

INTRODUCTION
High mortality and morbidity from injuries is a global public health problem. In Uganda, injury related mortality for unintentional injuries including Road Traffic Injuries makes up for 25% of all recorded deaths. Providing early and prompt care to the injured has proven to reduce negative health outcomes, and research has demonstrated that efficient pre-hospital care systems can significantly reduce morbidity and mortality from RTIs. However, in many developing countries including Uganda, these systems are often over-looked and under-developed, with focus being heavily placed on primary and secondary prevention. A number of players, including the Police, private-for-profit, and private-not-for-profit, as well as local humanitarian agencies, provide care in mostly fragmented fashion. The Ministry of Health has finalized plans to form a standalone public institution by an Act of Parliament, called Uganda National Ambulance Service (UNAS) with a mandate to coordinate all emergency-related health services in the country. We envision Kampala city becoming a forerunner of premier pre-hospital emergency system in Uganda. A major challenge is the assessment of available resources and prioritization of the areas of improvement in pre-hospital care. Development of an assessment tool using a holistic framework, with focus on finding gaps will ensure formulation of specific strategies of capacity development in human, systems and material resources.

OBJECTIVES
a) To develop a rapid assessment tool for EMS systems in Kampala City
b) To pilot test the tool in order to describe the current capacity of pre-hospital care in Kampala City
c) To describe the gaps and propose specific strategies for improving EMS in Kampala.

METHODOLOGY
We conducted a cross sectional study in the city of Kampala in order to understand how acutely ill and injured patients reach the hospitals and what services are provided to them in the pre-hospital phase.
In order to gain maximum knowledge and to understand all aspects of pre-hospital care system, we carried out document reviews, in-depth interviews with key players, focus group discussions with lay people and care providers, and onsite inspection of ambulances and ambulance stations about the services they provide and the processes that are followed. All the major organizations and stakeholders were identified under the guidance of Ministry of Health, Makerere University School of Public Health, as well as Kampala Capital City Authority (KCCA).

RESULTS
The final phase of data analysis is under way, and we plan to engage all the stakeholders again to inform them about the preliminary findings and observations on the pre-hospital system in the city of Kampala on 29th January 2016

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