webinar flyerOn May 18, 2021, the African Center for Global Health and Social Transformation (ACHEST), participated at the Human Resources for Health 2030 end-of-program event.
HRH 2030 has been USAID’s flagship health workforce program for the last six years
The virtual event under the theme: "Six Years in 60 Minutes: Learning from the HRH2030 Program” was therefore one of the legacy series to share achievements as well as explore the broader picture on global health, including the COVID-19 era and the launch of the new USAID Vision for Health Systems Strengthening.

The panel of experts included ACHEST Executive Director Prof. Francis Omaswa and Dr. Elsie Kiguli-Malwadde, the Director of Medical Education and Development

ACHEST Medical Induction Course
Dr. Kiguli-Malwadde spoke about ACHEST’s induction course which supports newly qualified health professionals to adjust to the working world.
“Medical internship is a transition phase between being medical students and becoming fully qualified medical professionals. It has been reported that this period can be stressful and sometimes it makes the young professionals feel inadequate and uncomfortable. So, we felt that it was important to prepare them for this period,” said Dr. Elsie Kiguli-Malwadde
It should be noted that in 2020, the course received recognition in the HRH 2030 in the health workforce resilience global competition.

The ACHEST Director of Health Workforce and Development , Dr. Elsie Kiguli-Malwadde was one of the speakers at the two-day health Profession's Education Conference in Kampala on 27th – 28 May 2021.
The conference was under the theme; "Transforming Health Professions Education in the 21st Century: From Theory to Practice".

The Conference was organized by the Eastern Africa Health Professions Educators' Association (EAHPEA), and the Health Professions Education Partnership Initiative (HEPI) which is co-hosted by the College of Health Sciences, Makerere University.
The goal of the HEPI, which started in August 2018, is to improve service delivery of the Ugandan health system through strengthened interdisciplinary health professional education and research training to produce graduates with competencies to address the priority health needs
of the population.

HEPI has seen the birth of “Health Professions Education and training for Strengthening
the Health System and Services in Uganda(HEPI-SHSSU).” The innovation
is implemented by a partnership between ACHEST, Makerere College of Health Sciences, Busitema University School of Health Sciences, Kabale University School of Medicine, Clarke International University, Mulago School of Nursing and Midwifery, Yale University and John Hopkins University.

The ACHEST Director of Health Workforce and Development, Dr. Elsie Kiguli-Malwadde participated at the symposium on the updated WHO guideline on health workforce development, attraction, recruitment and retention in rural and remote areas.
The virtual symposium was hosted on 13th May 2021by The Network: Towards Unity for Health (TUFH) and the World Health Organization. It started off in a plenary and then broke up into smaller groups for discussion.

Dr.Kiguli-Malwadde who is the TUFH Secretary General and AFREHealth Vice President reporting on what was discussed in her group, called for a multisectoral approach to health advocacy.
“Advocacy may vary from locality to locality depending on what the challenges are. But it should be multi-sectoral. This approach has its challenges but that is the way to go. Include all stakeholders. Issues of transport and financing should not be left to the ministries of health,” she said.
Commenting on research, Dr. Kiguli-Malwadde said “evidence is important and we should continue doing research in the rural communities to come up with evidence for advocacy.”

The Network: Towards Unity for Health (TUFH) is the recipient of the 2020 Association of Faculties of Medicine of Canada (AFMC) - Charles Boelen International Social Accountability Award.
The award was received by the TUFH Secretary-General, Dr. Elsie Kiguli-Malwadde who is also the Director of Medical Education and Development at the African Center for Global Health and Social Transformation(ACHEST).
In the virtual award ceremony held on Sunday, April 18th, 2021, Dr. Kiguli-Malwadde said: “It is an honor for me to receive the Charles Boelen social accountability award.”
This award celebrates accomplishments reflecting the principles of social accountability as defined in the Global Consensus for Social Accountability of Medical Schools (www.healthsocialaccountability.org).
Winners are selected based on their focuses on response to the priority health needs of citizens and society in education research and/or service delivery missions, consistent with values of quality, equity, relevance, and effectiveness. They should also have work in respect to the social determinants of health; a strong partnership with the main health stakeholders for efficient synergy in health development; and use of proper evaluation indices and mechanisms to assess the impact of the academic institution on health system performance and population health status. The criteria also looks at the contributions made to national and relevant sub-national policies in support of academic institutions engaged in actions for greater societal impact.
In this regard, AFMC on its website (https://ct.enews.afmc.ca/ext/page/hmdbknln noted that TUFH had done outstanding work.
“The TUFH Social Accountability and Accreditation Taskforce established the foundation (i.e technology amplification, knowledge sharing, case-based e-learning) for a global community of practice resulting in a global policy paper with concrete local action recommendations to inform policymakers and country change agents. The task force is committed to addressing the needs of the most vulnerable populations by creating communication and knowledge sharing e-learning platforms for global and national interprofessional and intersectoral communities of practice that build each participant’s respective capacity,” AFMC stated.
Watch the virtual award ceremony here:

WEBINAR FLYERThere is a need for individuals to take responsibility for managing their own health.
This was the call to action from the April 21, 2021 webinar on Ischaemic Heart disease for all in Uganda.
The webinar, which featured high-level experts in cardiology, was organized by Uganda Heart Foundation, Uganda Heart Institute, and the African Center for Global Health and Social Transformation(ACHEST). It was chaired by the ACHEST Executive Director, Prof. Francis Omaswa together with Prof. Paul D'Arbela from Mother Kevina Postgraduate School, Nsambya Hospital.

Dr. Barbara Kakande, a Consultant Cardiologist and Uganda Heart Association started off the discussion by defining Ischaemic Heart Disease as a group of syndromes or diseases that occur because of a change or alteration in the structure of the blood vessel that supplies the heart. Because of this, there is an imbalance between the oxygen that the heart muscle is receiving versus the oxygen which the heart is demanding. “So Ischaemic occurs when the demand for blood is higher than the supply. It is also called coronary heart/artery disease. Usually, the left side of the heart is the one which is affected due to many factors including the fact that the left side has a thicker wall compared to the right side,” explained Dr. Kakande.
Approximately one-third to a half of cardiovascular diseases in the world are Ischaemic. Some of the risk factors include aging, smoking, tissue factors, adhesion molecules, and family history.

Francis Omaswa answers questions on what is needed for World Malaria Day.

Kampala, 22 April 2021 – Over the past two decades, the world has made great progress in Prof Francis Omaswa Executive Director-ACHEST reducing malaria cases and deaths, but the pace has stalled in many high malaria burden African countries. Global malaria cases dropped by 29% between 2000 and 2019, but only by 2% between 2015 and 2019 when deaths fell by 15% compared with 60% between 2000 and 2019. Professor Francis Omaswa, Executive Director of the African Centre for Global Health and Social Transformation, explains what needs to be done to get malaria control and prevention back on track.

Why do we need to rethink malaria prevention?                                               There are two major reasons why we need to rethink malaria in Africa. First, is the fact that performance indicators have stagnated and are getting worse in some areas. Second, is that health systems are transitioning from top-down leadership to community ownership with generation and application of local solutions by the affected communities. We are off the track towards malaria elimination due to governance issues. Less money is going into malaria prevention programmes. The burden of malaria is not seen as a priority by political leaders and even the population themselves. There is a slackening of effort despite data indicating that we are stagnating.

The new direction for malaria control is to stop the top-down response and embark on an integrated, people-centred primary health care systems. This is the foundation of health systems of the future not only for malaria control but to achieve Universal Health Coverage and achieve the Sustainable Development Goals.

CONFERENCE FLYEROn March 19, 2021, THET UK partnered with the African Center for Global Health and Social Transformation (ACHEST) and Esther Alliance to host the second conference on COVID-19 Partnerships.
The conference was held under the theme: “COVID-19 Partnerships in the International Year of Health and Care Workers: Protect. Invest. Together.” This is in line with the World Health Organization year-long campaign to recognize health workers for their dedication and resilience in fighting the COVID-19 Pandemic.
Participants had the opportunity to reflect on what has been achieved by the Health Partnership community since the first conference in April 2021; and looked into the future, recognising the immense pressure that is now falling on health workers in every country. With the worrying increases in infections and the slow pace of vaccination campaigns in sub-Saharan Africa observed since the start of 2021 the conference discussed afresh at how the Health Partnership community is pulling together, especially now, when solidarity is more important than ever.
In his opening remarks, THET Director Ben Simms said: “We are here to celebrate but we also here to express our urgency and our anger. 2021 is not the same as 2020. We will never look at the world in the same way. We have been reminded about inequality, racism, about the underfunding of health services; and the effects of the pandemic continue to be felt. We need to argue that every health worker has the right to be properly equipped and supported. That every health worker, as every citizen, has the right to be vaccinated. We meet with humility.”
The virtual conference had 412 people from 44 countries across the globe participating. It also had 16 sessions and 48 speakers on wellness and compassion, advocacy, health systems strengthening, and COVID-19 response among others.
Advocacy in an era of COVID-19
This session explored the role individual health workers can play in advocating for change, including the challenge of overcoming 'anti-science' positions in communities and nations. ACHEST Executive Director Prof. Francis Omaswa was a panelist on this session. He expressed concern about the increased disinformation spread both through social media such as Whatsapp; as well as some politicians who give dissenting views.
He said: “We are challenged right now with handling information; misinformation, correct information. And when some of our leaders are not supporting health workers in getting the correct information out there, so that the public is together with health workers, based on the actual information, then the life of health workers becomes very complicated. We are challenged with issues of alternative factors versus real/actual facts. In this type of scenario, the health workers are in a dilemma. They themselves have to find out what the facts are. And then on top of that, they have to manage a community/public that is battling issues of what is true and not true.”
Prof. Omaswa referred to an example of the head of state in Africa who took a line that COVID-19 doesn’t exist in his country. “How do we deal with situations like that at global level, national level and down to community level? What about other heads of state? What has been their role? I am looking at health workers and other professionals such as lawyers. How do we speak truth to power so that it is possible for health workers to be able to do their job based on real facts not alternative facts and innuendo.,” asked Prof. Omaswa.

The recognition plaqueACHEST Consultant, Dr. Peter Eriki, received national recognition for his outstanding contribution to the fight against Tuberculosis.
Dr. Eriki, a TB and chest specialist, was the first Ugandan manager of the National TB Program (NTBP). He also served as a Regional Adviser for TB and Leprosy based in Congo Brazzaville; then as a World Health Organization (WHO) Country Representative in Angola, Kenya, and Nigeria.
Before his current consulting role at ACHEST, Dr. Eriki worked as Director Health Systems and Deputy Executive Director. He also served as a President of the Uganda National Association of Community and Occupational Health (UNACOH)
Dr. Eriki received the award from the Health Minister Dr. Jane Ruth Aceng during the national celebrations to mark World TB Day on March 24, 2021 in Moroto. Commenting on this achievement, Dr. Eriki says it is very humbling to be recognized when one is still alive”
According to the WHO-Afro, (https://www.afro.who.int/regional-director/speeches-messages/world-tb-day-2021 ), there were an estimated 2.5 million TB cases in the African Region in 2019, accounting for 25% of the global burden. More than 500,000 African lives are lost to this disease every year. This is inexcusable when TB screening and treatment is available for free in all countries.
The theme of World TB Day 2021 - ‘The Clock is Ticking’ –conveys the sense that the world is running out of time to act on the commitments to end TB made by global leaders. This is especially critical in the context of the COVID-19 pandemic that has put End TB progress at risk.
Dr. Eriki had this to say on prevention: “TB is an airborne infection, spread through coughing, laughing, singing, talking, etc. It's curable. The best prevention method is finding all the sick infectious people and putting them on treatment and encouraging them to complete treatment until cured."

The independent Africa Health Agenda International Conference (AHAIC) Commission has unveiled the State of Universal Health Coverage (UHC) in Africa Report.

 KENYA PRESIDENT UHURU KENYATTAThe report’s executive summary was released on the first day of AHAIC 2021 conference – a biennial convening of health ministers, private sector leaders, civil society and representatives from multilateral organizations taking place virtually from 8-10 March 2021.

The report highlights the progress made by African countries towards realizing Health for All and details the challenges and opportunities faced by countries in achieving UHC.
Compiled between November 2020 and March 2021, the State of UHC in Africa report takes stock of Africa’s progress in fulfilling commitments made by African leaders over the years, such as the Abuja Declaration (2001), the Africa Health Strategy (2007-2015, 2016-2030) and the Addis Ababa Call to Action on UHC (2019). It acknowledges the impact of colonial legacies, poor governance, and economic challenges on the continent’s health policies and outcomes. It details the performance of African countries on key UHC indicators, including effective coverage with needed health services, financial risk protection and health outcomes.

DR. TEDROS SPEAKING DURING THE VIRTUAL CONFERENCEAccording to the report, Africa’s health systems are poorly attuned to meet the health care needs of the poor, the disabled and other vulnerable groups, with coverage of essential health care services in Africa being decidedly low: only 48 per cent of the population receives the health care services they need. This means that approximately 615 million people in Africa may not receive the healthcare services that they need.

Quality of health care services provided in African countries is also low and is considered the poorest performing indicator of UHC – when quality of health care services is considered, service coverage scores across African countries are even lower. The report also reveals that coverage of essential services needed by women and girls in Africa is low, with data indicating that between 2015 to 2019, only 49 per cent of African women had their demand for contraceptives satisfied.

ACHEST STAFF TAKE A PICTURE WITH RESEARCH ASSISTANTSThe African Center for Global Health and Social Transformation (ACHEST|) is one of the partners that is implementing a new project on clinical skills update and mentorship in reproductive, maternal, new-born, child, and adolescent health in Uganda.
The project is under the Ministry of Health and is supported by the World Bank. The project which kicked off in February 2021 is expected to run until December 2021.
ACHEST will be carrying out its assigned tasks in selected districts in Eastern Uganda, while other partnering agencies will cover the rest of the regions.
The objectives of the project are to improve utilization of essential health services with a focus on reproductive, maternal, newborn, child and adolescent health services in target Districts; (b) scale-up birth and death registration services, and (c) to provide an immediate and effective response to an eligible crisis or emergency.

The Uganda Demographic Health Survey 2016 shows that far too many women continue to die pointlessly due to pregnancy and childbirth-related causes. The maternal mortality ratio stands at 336/100,000 live births while the neonatal mortality rate was 27 deaths per 1,000 live births.
“Our wives, sisters, and mothers are still dying. They are dying because of excessive bleeding, infection, obstetric labour, abortion, hypertension, and other direct and indirect causes,” said Dr Romano Byaruhanga while giving an overview of the maternal health and perinatal situation in Uganda. He expressed hope that the project would help identify the missing gaps in maternal health care services.
He made the remarks during the March 1-4th 2021 training of research assistants that was organized by ACHEST ahead of the fieldwork. The research assistants were trained in different data collection tools including the use of information and communication technology.
Other facilitators were Dr. Dan Kajungu, the Executive Director of the Makerere University Centre for Health and Population Research, and ACHEST’s Dr. Elsie Kiguli-Malwadde the Director of Health workforce Education and Development, Robert Odedo, the Head of Consulting and Dr. Peter Eriki, the Director of Health Systems.

DR. ELSIE KIGULI-MALWADDE 1ACHEST in partnership with the Ministry of Health and Health Professions Education Initiative held the 3rd interns’ induction course on February 26, 2021.
The course was hosted online due to the COVID-19 pandemic. About 70 newly qualified doctors, nurses, midwives and pharmacists participated. These graduates are currently doing internship from different hospitals across Uganda.
The objective of the course is to enable the young health professionals to be conversant with the Ugandan health system and the Ministry of Health Vision and Mission; to understand the basics of government procedures and rules and quality assurance in the health care system. It also ensures that medical interns are prepared to work in the Ugandan health system and understand the referral system, job market, career progression and postgraduate training; and how to take good care of themselves.
The course was moderated by the ACHEST Director of Health Workforce Education and Development, Dr. Elsie Kiguli-Malwadde, who described internship as the transition period between being a student and a fully-fledged professional.
“Internship is a fulfilling experience because you take on responsibilities that you couldn’t take on as students. But it is also busy and sometimes challenging and if we are not careful it can be stressful. Sometimes, it leads to burnout and can lead to mental health problems leading to poor patient care,” observed Dr. Kiguli-Malwadde.
Notably, this induction course has helped the young professionals who have gone through it to adjust and find internship exciting. Previous sessions were hosted in March and July 2020 with over 100 participants respectively.
The Deputy Director of Mulago hospital Dr. Rosemary Byanyima guided interns on how toDr. Rosemary Banyima manage the expectations of the hospital, Ministry of Health, the public, and their parents. She emphasized the need for professionalism, by giving a detailed description of the dos-and-donts while at work.
“When you come as an intern you have expectations but the hospital also has expectations as we are preparing you for the job market. There are many stakeholders in this. Apart from the clinical skills you have, you have to be very professional. We don’t expect you to hold any other job because an internship is a full-time job and an extra job would affect your performance. We expect you to manage time for your ward rounds. Don’t be on the phone for too long. Be courteous and empathetic to patients. These are people who are unwell and we have to put ourselves in their shoes and treat them the way we would want to be treated,” said Dr. Byanyima
The second speaker, Prof. Sarah Kiguli a senior pediatrician at Mulago National Referral Hospital had an interactive segment with the interns as she spoke about career opportunities and facilitating factors. Interns freely shared their experiences. Some of the common challenges that came out strongly were being nervous, worried, and excited on the very first day of internship due to the fear of the unknown; and being overwhelmed and exhausted due to the high patient numbers.

Flyer showing the panel of the Health is Made At Home Webinar“You are a Professor of Latrines… Shut up!”
Prof. Miriam Were had studied the pattern of hospital admissions and noticed that 80 % of cases were not just preventable, but were infectious diseases acquired mostly through the oral-faceal route. To prevent these needless admissions, she was advocating for building latrines as a key element to promote hygiene in the communities in Kenya. Yet, for this well-intended advice, Prof. Were was derogatively labeled the “professor of latrines.”
It wasn’t the first time she was ridiculed. Earlier, during her academic journey, she had chosen to undertake research on people’s participation in community health. However, her supervisors were not impressed.
They told her that is not an academic topic and she must look for an academic topic. She refused and thought they were going to throw her out. Her effort was to make sure that the problems were manageable.
She adds: “The thing is, there has been a lot of resistance, but COVID-19 has dawned on us all and community health is now respected.”
Prof. Were, Co-Founder of UZIMA Foundation-Africa, narrated this sad experience during a webinar on Health is Made at Home, Hospitals are for repairs – Mutual learning between Africa and Europe. The webinar held on December 15, 2020, was hosted by the African Center for Global Health and Social Transformation(ACHEST) in partnership with the African Forum for Research and Education in Health (AFREhealth) and Lord Crisp Nigel the author of the book “Health is made at home, hospitals are for repairs.”

ACHEST’s Director of Health Workforce Education and Development Dr. Elsie Kiguli-MalwaddeDR. ELSIE KIGULI-MALWADDE has been appointed to the WHO working group that is developing global competency standards on refugee and migrant health.

The strategic working group will provide technical support and inputs for WHO Health and Migration Programme PHM and the Health Workforce HWF departments in the development of global competency standards for refugees and migrant health.
It will also support high level advocacy and provide advice to enhance the buy-in by other academic institutions/ universities to use the global competency standards.

Dr. Kiguli-Malwadde, who is also the AFREhealth Vice President, was appointed alongside 9 other experts from top academic institutions/WHO Collaborating Centres that are leading in global or regional health and migration/displacement.

Commenting on her appointment, Dr. Kiguli-Malwadde said, “It is a privilege for me to serve on this committee, these global standards are key to transformation of health professions education. It is important to guide the training and influence the practice for the underserved groups such as refugees and migrants.”

Other experts on the working group include Associate Prof. J O Vearey, the Director African Centre for Migration & Society, University of the Witwatersrand in Johannesburg; Professor Cynthia Whitehead, the Director of Department of Family and Community Medicine (WHO Collaborating Centre) University of Toronto; Prof. Paul Spiegel, the Director Johns Hopkins Center for Humanitarian Health; Dr. Aula Abarra Honorary Clinical Lecturer Department of Infectious Disease, Faculty of Medicine, Imperial College, and London School of Hygiene and Tropical Medicine; and Fouad M. Fouad an Assistant Professor of Epidemiology and Population Health at the American University of Beirut, Lebanon.

The Executive Director of the African Center for Global Health and Social Transformation (ACHEST), Prof. Francis Omaswa has been appointed to the Independent Commission to review the status of Universal Health Coverage (UHC) in Africa. Prof Francis Omaswa 
The commission, established by AMREF Health Africa, will review the continent’s progress towards achievement of Universal Health Coverage (UHC) targets by 2030.

In addition to reviewing the continent’s progress, the commission dubbed “Africa Health Agenda International Conference (AHAIC) Commission on the State of UHC in Africa,” will provide recommendations on leadership, accountability, technology/innovation and health security, to help guide the continent towards achieving UHC targets.

Prof. Omaswa has been appointed alongside 10 other commissioners from a range of disciplines and sectors across Africa.

They include Co-chair Solange Hakiba (Rwanda) who is experienced in working with various donor agencies, including USAID, DFID, the Global Fund to fight AIDS, Tuberculosis and Malaria and Bill & Melinda Gates Foundation; and Co-Chair Prof Edwine Barasa (Kenya), who serves as the Director of the KEMRI-Wellcome Trust Research Programme in Nairobi, Kenya; the Head of the Programme’s Health Economics Unit and Professor of health economics at the University of Oxford.

Webinar flyerUganda’s Community Engagement Strategy (CES) for COVID-19 response will empower individuals and their households to fight the pandemic as well as address other social challenges.
“The strategy is not limited to COVID-19 alone. It addresses everything from food production, nutrition, to hygiene and so on,” said Dr. David Okello the Director of Health Systems at the African Center for Global Health and Social Transformation (ACHEST) and member of the Community Engagement sub-committee that developed CES.
Dr. Okello made the remarks while delivering a keynote address on CES, at a webinar hosted by the Palliative Care Association of Uganda on November 27, 2020.
CES was launched by the Uganda government on October 20, 2020, with the objective of ensuring that all people in Uganda are aware, empowered, and are participating in the prevention and control of the COVID-19 outbreak as both a duty and a right, using existing structures, systems and resources as much as possible. It is based on the premise that good health starts with and is created by individuals, their families, and the communities; and is supported, where necessary, by the skills, knowledge of professionals. Individuals have the primary responsibility for maintaining their own health and that of their communities.

If well implemented, Dr. Okello, explained that CES would strengthen the existing Community Health System for Integrated People-Centered Primary Health Care (IPCHC) and ensure that infections are minimized in the community. It will enable prompt identification, testing, treatment and rehabilitation as needed in communities.