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Makerere University

Country: Uganda
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64 Projects, page 1 of 13
  • Funder: UKRI Project Code: ES/T01492X/1
    Funder Contribution: 596,479 GBP
    Partners: Makerere University

    In this proposal, Makerere University (hub) intends to work with the University of Witwatersrand, University of Ibadan, Moi University, University of Rwanda and University of Western Cape (spokes) and their partners to enhance the capacity of Gender and Social Work Departments to research changing notions of motherhood and fatherhood, and to use the results to advocate for improved family and child welfare policies and interventions. The preference for Sciences in Africa led to a reduction in research funding for the Humanities and Social Sciences, negatively affecting the interest and capacity to research contemporary social challenges affecting the continent, including identities, motherhood and fatherhood. The notions of Motherhood and Fatherhood are at the core of the debate on gender identities, socialisation, perceptions, status, realities and imaginations. These identities are created, (re)negotiated, contested, affirmed and (re)born at different levels; at family/ household level, community, cultural traditional, national and global levels. Yet motherhood and fatherhood as identities also change and transform. Symbolic representations of motherhood and fatherhood become political especially when informed by ideologies surrounding nationalisms-whether national or tribal, subsequently informing ideals about manhood, womanhood; or masculinity and femininity. Research on motherhood and fatherhood globally points to various forms of fathers and mothers. What do these forms mean or how important are these forms to fathers, mothers and subsequent proof of masculinity and femininity? Different developments, such as colonialism, urbanisation, HIV/AIDS, war and conflict, structural adjustments and technology have reshaped and transformed the material and cultural foundations of parenting, and with it the gendered identities of motherhood and fatherhood. Nonetheless, there is a tendency to treat them as temporary and or deviant from the norm. As a result, there is a dearth of research in family studies. With a few exceptions, research in motherhood and fatherhood in Africa is undertaken as a socio-demographic variable explaining certain economic trends and as a predictor of reproductive health and child wellbeing and outcomes. Limited research has been undertaken to focus on parenting and what the identities of motherhood and fatherhood imply for those who perform them, and how they perform them. Consequently, there is limited evidence for legislators and policy makers in family relations and children's welfare to work with. With the exception of South Africa, we continue to see Family and Children's policies and laws which assume that all mothers are married and will have the support of a spouse or at least extended family. Key questions to be examined will include the following: (1) What are the changes in motherhood and fatherhood in Africa and how does it relate to changes in femininity and masculinity? (2) What are the major drivers of these changes? (3) How best can these changes be conceptualised, studied and researched about? (4) How can researchers engage policy makers for child friendly parenting policies in view of these changes? In this multi-disciplinary proposal, Makerere University and her six collaborators seek to explore ways to enhance the capacity of researchers to research motherhood and fatherhood, and to engage policy makers for better family and child friendly policy making and interventions. This theme is trans-disciplinary, bringing together expertise from Gender Studies, Social Work, African Studies and Ethics to generate new knowledge and build researcher's capacity through research and ethics training, doctoral and post-doctoral research support, conference presentations, workshops and publications to mention a few.

  • Funder: UKRI Project Code: MR/V015214/1
    Funder Contribution: 176,865 GBP
    Partners: Makerere University

    This proposal is focused on extending the international commitment to universal health coverage (UHC) to people suffering limb loss in Low- and Middle-Income Countries. It builds on multi-disciplinary EPSRC- and MRC-funded research establishing the prevalence of limb loss; service-users' experiences of attempting to access and receive services and innovation in the design of 'Fit-For-Purpose' body-powered prostheses. This research has evidenced the need for more comprehensive and structural health systems change focused on the development of an integrated supply-chain system servicing regionally distributed service outlets. At present there is no system to manage and regulate the quality and costs of imports of devices and components from overseas. International donors have played a major role in defining the geography and characteristics of services with an emphasis on internal conflict in Northern Uganda. Since the end of this conflict funding has ceased and underfunded services do not meet needs resulting from significant foreign refugee flows into the West and growing domestic needs arising from Road Traffic Accidents, domestic violence, cancer and diabetes. The Ugandan Ministry of Health (MoH) has proposed the use of Public-Private-Partnerships in health system strengthening. Our proposal will design and test a PPP model as the basis for a more integrated and distributed partnership model to deliver universal health coverage for amputees. National Medical Stores is the sole provider of supplies into public hospitals. With the exception of the National Referral Hospital it is not supplying orthopaedic workshops with essential supplies and patients who do access these facilities are subject to user fees. Joint Medical Stores (JMS) is an established (not-for-profit) provider of medical supplies to the not-for profit sector. Our proposal focuses on building a PPP platform to support a social enterprise model for supplies management at national level. This will include a more transparent approach to international sourcing combined with efforts to reduce dependency on foreign supplies through local manufacture. We will exploit the potential of an upper limb socket designed by the EPSRC team for local manufacture and task-shifting. We propose a second-level PPP based on a model designed in Fort Portal Regional Referral Hospital to support supply chain management during COVID-19. A recently signed PPP involving an established health partnership with Knowledge for Change, a registered NGO and JMS will design and test a model to promote service-focused supply chain agility at a public hospital located in close proximity to fast-growing refugee camps. Our long-term aims are to use our innovations in prosthesis design, coupled with fine-resolution modelling of demand, to pilot new, distributed prosthesis service models, characterised through our collaboration with JMS. We propose to pilot a Public private partnership model to help support the more effective integration of foreign aid with one or more of the new service models. Towards the end of the project, we will bring together the key stakeholders to develop a larger scale project which will explore how we can build on the lessons learnt in this study. Our specific objectives are: 1. Supply Chain Innovation: Co-design and test the contribution that a Public-Private-Partnership approach can make to sustainable supply chain integration for prosthetics componentry and repair services. 2. Demonstrate the role that technological innovation can have on prosthetic services: Test the potential for local manufacture and supply-chain entry of a user-adjustable, locally repairable socket design. 3. ODA Innovation: Generate the evidence-base for a new model for Overseas Development Assistance (ODA) based on principles of partnership, social enterprise and sustainability

  • Funder: UKRI Project Code: MR/V03510X/1
    Funder Contribution: 200,267 GBP
    Partners: Makerere University

    Thanks to the development of drugs known as antiretrovirals, people living with HIV (PLHIV) can live long, healthy lives. Unfortunately, PLHIV need to take antiretrovirals for the rest of their lives. Antiretrovirals are generally safe but can cause serious side effects in some people, particularly with long-term use. Common side effects are discovered in clinical trials. If a drug causes side effects that are too severe or too common it will fail the trial. It isn't possible to test enough people in a clinical trial to discover less common side effects. These are found by monitoring people taking the drug in the real world. It is also essential that the safety of a drug is monitored in people of all ethnicities because some side effects are more common in people belonging to a particular ethnic group. Our work focuses on the 3.5% of the Ugandan population - 1.5 million people - who live with HIV. At the moment we have very little information about how many PLHIV suffer side effects due to antiretrovirals. The importance of encouraging and enabling healthcare professionals to report drug-related side effects is recognised by the Ugandan government. However, systems for monitoring drug-related side effects have only recently been developed in Uganda and the number of reports is very low. Only 400 reports on side effects due to antiretrovirals were made during the 12-months from October 2018 to September 2019. We urgently need to improve reporting of drug-related side effects due to recent changes in the treatment offered to PLHIV in Uganda. In 2018, Uganda began a programme to rapidly roll-out antiretroviral combinations including dolutegravir (DTG), the new drug recommended by the World Health Organisation (WHO), to PLHIV. Uganda is also rolling-out Isoniazid Preventive Therapy (IPT) to prevent active tuberculosis - the main cause of death in PLHIV. Although DTG has some important advantages over other antiretrovirals, we know that in some people it can cause liver damage, high blood sugar, anxiety, insomnia or depression. In addition, the risk of side effects is likely to be higher when DTG and IPT are taken together. We aim to test whether reporting via a mobile application is effective at increasing reporting of antiretroviral-related side effects by healthcare professionals. If successful, our project will also improve our understanding of which side effects are most common in Ugandan PLHIV and how many people they affect. These are essential first steps in our work to make sure that every PLHIV is treated with the right antiretrovirals at the right dose in the future. The mobile application that we will test is called Med Safety(R). Med Safety(R) was developed by a European drug safety project and adapted for Uganda's National Drug Authority (NDA) by the UK's Medicines and Healthcare products Regulatory Agency (MHRA) but isn't yet widely used. We will recruit 3820 healthcare professionals from 382 HIV treatment centres to: 1) investigate factors that affect the success of rolling out Med Safety(R) among healthcare professionals and how healthcare providers feel about using the application; 2) discover whether using Med Safety(R) leads to more reports of drug-related side effects than the traditional web- and paper-based forms; and 3) whether using Med Safety(R) saves money for healthcare providers. We will also train researchers in drug safety. This project will show whether Med Safety is effective at improving the reporting of drug-related side effects by healthcare professionals. Our learning from deploying the Med Safety(R) application across a population that encompasses large, developed cities and isolated rural areas will be invaluable for wider global efforts in drug safety monitoring. Our strong links with National and International agencies including the NDA, MHRA and WHO will help to ensure that our work improves the safety of PLHIV.

  • Funder: UKRI Project Code: NE/M007995/1
    Funder Contribution: 97,245 GBP
    Partners: Makerere University

    Extending and sustaining access to safe and reliable water services remains central to improving the health and livelihoods of poor people, particularly women, in Africa. Here an estimated 350 million rural inhabitants still have no form of safe drinking water, and depend on poor quality unreliable sources for all their domestic needs. Improving access to water, and helping to achieve new international goals of universal access to safe water hinges on accelerated development of groundwater resources, usually through drilling boreholes and equipping them with handpumps. However, emphasis on new infrastructure has obscured a hidden crisis of failure, with >30% of new sources non-functional within 5-years and many more unreliable. This problem has remained stubbornly persistent over the last four decades, with little sign of sustained progress despite various interventions. Part of the reason for this continued failure is the lack of systematic investigations into the complex multifaceted reasons for failure and therefore the same mistakes are often repeated. The accumulated costs to governments, donors and above all rural people are enormous. Addressing the functionality crisis requires a step-change in understanding of what continues to go wrong. The complex issue must be approached from a truly interdisciplinary viewpoint: combining innovative natural sciences to assess the availability of local water resources and how this changes with seasons and climate; with detailed social science research of how local communities function and make decisions about managing their infrastructure; and understanding of how the engineered structures can degenerate. Underlying these reasons for source failure may be other contributory factors, such as government incentives, the role of the donor community, or long term changes in the demand for water. The overall aim of the project is to build a robust, multi-country evidence base on the causes of the unacceptably high rates of groundwater system and service failure and use this knowledge to deliver a step-change in future functionality. To achieve this aim, our research draws on a novel interdisciplinary approach using the latest thinking and techniques in both natural and social science and applies them to three African countries that have struggled for decades with service sustainability - Uganda, Ethiopia and Malawi. There are five main provide a rigorous definition of functionality of water points which accounts for seasonality, quality and expectations of service; 2. to apply this new definition to Ethiopia, Uganda and Malawi to get a more realistic picture of water point functionality and therefore water coverage figures; 3. to investigate in detail 50 water points in each country by taking apart the water points and pumps, testing the local groundwater conditions, examining the renewability of groundwater and exploring in detail the local water committee; 4. we will also build on this information to forecast future rural water supply coverage by modelling the impact on water points of various potential future pathways; and 5. finally we will use all this information to develop an approach for building resilience into future rural water supply programmes and helping people decide when it is worth rehabilitating failed sources. To carry out this ground breaking research we have brought together a consortium, led by the British Geological Survey, of leading interdisciplinary UK researchers at BGS, KCL, ODI and Cambridge with groundwater academics from three highly regarded African universities (Universities of Addis Ababa, Mekerere and Malawi), and WaterAid, a leading NGO on developing rural water supply services across Africa with a history of innovation. The research has the potential to have a major impact on the delivery of reliable clean water throughout Africa, and if the results can be taken up widely break the pattern of repeated failure.

  • Funder: UKRI Project Code: MR/S013164/1
    Funder Contribution: 199,059 GBP
    Partners: Makerere University

    Health institutions worldwide, including the World Health Organization (WHO), have recognised that adoption and innovative use of information from electronic medical records will be necessary to provide equitable care to the growing population of the world. Uganda is committed to meeting this goal, however, there are challenges to developing and implementing electronic health record data capture and analysis systems, especially as implementation of these systems have mostly occurred in high-income countries where challenges are different. In this project, we will assess whether or not Uganda is ready to implement an electronic health record data capture system at the point of care that can centrally process information through statistical analysis and provide important information to care providers and public health practitioners to support healthcare delivery. This assessment involves collecting information from key stakeholders about barriers, facilitators, costs and other 'readiness' factors, such as acceptability and training of the healthcare professionals who will enter data into the system. We will map these measures to known models of electronic health record adoption readiness and technology adoption success. We will also assess the opinions of the community on how their health information should be handled and used. Additionally, we will look at the technology components of this system that may already exists and determine the costs to provide all necessary components. Finally, we conduct analyses to determine how long it will take to see benefits in terms of cost savings in healthcare provision. The Ministry of Health in Uganda has recommended a 'stepped' approach to adopting electronic health records, we will therefore focus on areas of greatest concern to the Ministry of Health. While Uganda has a number of important health concerns, such as child and maternal health and cancer, we will focus predominantly on malaria and HIV, and also look at scope for other infections. The reason for this choice is that these infections are still some of the leading health problems in Uganda, and they are treatable. This means that if successful implementation of electronic health record data capture occurred, combined with faster, more efficient and effective treatment due to processing those data and providing key information, such as who to target for testing and treatment, we could reduce costs to the health system and increase human health. The findings of the study will be shared with the scientific community and provided to the Uganda Ministry of Health as a report. The Ministry of Health plans to use this report as a guide to developing their electronic medical record and information analysis platform.