Dr. Elsie Kiguli-MalwaddeThe ACHEST Director of Health Workforce Education and Development, Dr. Elsie Kiguli-Malwadde, has been appointed Vice President of The African Forum for Research and Education In Health ( AFREHealth).

AFREhealth is an independent body that emerged from the Medical Education Partnership Initiative (MEPI) and Nursing Education Partnership Initiative (NEPI) with an aim of nurturing an interdisciplinary health professions organisation that is impactful in addressing Africa’s health challenges.

A new AFREhealth Executive Committee was announced at the Governing Council meeting held via an online zoom meeting on August 4, 2020.

ACHEST’s Dr. Kiguli-Malwadde will deputise the Associate Professor Abigil Kazembe from Malawi, who has been appointed President.

Other members of the Executive Committee are the Secretary, Ms Judy Khanyola (Rwanda); Treasurer, Prof. Milliard Derbew (Ethiopia); Immediate Past President, Prof. Marietjie de Villers (South Africa); and additional members Prof Fatima Suleman (South Africa) and Prof. Nelson Sewankambo (Uganda).

In a statement, Prof. Marietjie de Villiers said the newly constituted Executive Committee takes office with immediate effect.
“Our profound gratitude goes to the out-going office bearers for their dedicated and selfless service to AFREhealth during the past two (2) years. We thank and congratulate the new office bearers for stepping forward to serve AFREhealth in this new role. The AFREhealth community will accord the new Executive Committee our maximum support for taking AFREhealth into an exciting future. Long live AFREhealth!” the statement reads.

Commenting on her appointment, Dr. Kiguli-Malwadde said, “ I am greatly honoured and humbled that the Governing Council has considered me fit for this appointment. I enjoy working with the AFREhealth community, it is based on the African spirit of working together to make life better in Africa.”

For more information about AFREhealth, visit:https://www.afrehealth.org/

IMAGE OF THE FLYER FOR THE INDUCTION COURSE VIRTUALLY HELD ON JULY 10 2020As a young medical student, Prof. Sarah Kiguli says she knew what she wanted to specialise in. She had helped a woman give birth and felt a sense of fulfillment.

The first day as a newly qualified doctor, she was assigned to the Mulago Hospital’s Paediatric Acute Care Unit, where she saw children convulsing or children who could barely support themselves. She was deeply moved, and instantly knew this is where she wanted to be for the rest of her career. After internship, she served as a medical officer for two years and then pursued graduate training in Paediatrics and Child Health.

She has never looked back. “It has been years but I have never left Makerere College of Health Sciences and Mulago Hospital,” she says, “Later, I also did a Masters in Health Professions Education, my second passion”

Today, Prof. Kiguli urges young health professionals to know what their passion is - something that sparks one’s inner desire for the career before choosing their areas of specialisation.

“I sing in my heart and smile when I treat a child and see them begin to sit and eat. Do graduate training in an area which you love, and where there is need,” says Prof. Kiguli

Her story was one of the powerful experiences that medical interns who participated at the recent induction course got to benefit from, as they transition from being students to navigating work life challenges.

The award winning training programme, which has received global recognition at the USAID HRH2030 Health Workforce Resilience Awards, is organised by ACHEST in partnership with Health Professionals Education Initiative (HEPI), Makerere University College of Health Sciences and Ministry of Health.

IMAGE OF THE BOOK“Health is made at home and only repaired in hospitals when it breaks down. Be clean, eat well and do not share accommodation with animals,”
Any Ugandan who was old enough in the 2000s is likely to remember this slogan.
It was contained in the Ministry of Health radio advert to advocate for people-led primary health care as a foundation of health systems.
The catchy phrase “Health is made at home” was invented by the then Director General of Health Services, Prof. Francis Omaswa, who is currently the Executive Director at the Africa Center for Global Health and Social Transformation(ACHEST).
It has been widely quoted by health experts and enthusiasts to emphasise the role of an integrated and people-centered approach to health care that starts with individuals, families and communities.
Fast forward to 2020, “health is made at home” will no longer just be a quotation, but also a title of a recently published book on global health!
The Health is made at home; Hospitals are for repairs book has been published and launched on June 29th 2020 by global health writer, Lord Nigel Crisp and is now available at www.healthismadeathome.uk.

In his remarks during the virtual book launch on , Lord Crisp acknowledged that the title of the book was inspired by Prof. Omaswa.
“The title of the book was invented by my friend Prof. Francis Omaswa over 20 years ago,” he said.

IMAGE2The African Center for Global Health and Social Transformation (ACHEST) has participated in a critical discussion on United Nations Development Programme’s (UNDP) recent report on Migration from Africa.

The report titled, ‘Scaling Fences: Voices of Irregular African Migrants to Europe,’ brings out experiences of irregular migrants from Africa, and offers practical suggestions on expanding legal pathways for migrants in line with the 2018 Global Compact for Safe, Orderly and Regular Migration.
Up to 3,069 adult African migrants who had travelled from 43 African countries of origin were interviewed across 13 European countries. They had all arrived in Europe through irregular means at least six months before they were interviewed for this study.

Presenting the findings at a webinar on July 3, 2020 , Dr Jide Okeke, the UNDP Regional Programme Coordinator for Africa, said the research confirms that migrants are taking calculated risks, comparing the potential gains and losses of migration with those of staying in given conditions at home.

“Irregular migration is not without risk. In spite of the risks, only 2 percent of the respondents said they would stay at home if they had previous knowledge of the risks involved,” Dr. Okeke told the webinar organised by UNDP and Africa Foundation for Development (AFFORD).
Irregular migration, for those interviewed in the report, is an investment for a better future. Economic motivations, closely tied to self-actualization, and a sense that aspiration can only be fulfilled through departure from Africa, were fundamental views shared by respondents.

The African Center for Global Health and Social Transformation (ACHEST) has received an Honourable Mention in the first-ever Health Workforce Resilience Awards. The awards were launched in February 2020 by the Human Resources for Health in 2030 (HRH2030) Program, with an aim of identifying successful solutions that strengthen the resilience of the human resources for the health workforce in low- and middle-income countries. Nearly 500 individuals and organizations applied for the prize, but only 99 eligible applications from 31 countries were reviewed by a panel of judges. During the virtual award ceremony on June 24, 2020, two winners from Nepal and Brazil were awarded $25,000 each for designing and developing tools and approaches to improve or enhance health worker resilience.  ACHEST was recognised with an honorable mention, and took home $5,000.
 ACHEST was especially credited for initiating a medical interns induction program, which offers life skills and career expectations to newly qualified doctors, pharmacists, nurses and midwives.             

Wanda Jaskiewicz, the HRH2030 Project Director, while presenting the Honorable Mention recognition said: “ACHEST developed training strategy to help newly qualified health professionals in Uganda, to undertake the challenging transition from being students to entering the profession as agile responsible and resilient health workers.” 

     ACHEST Recognized in the Health Workforce Resilience Awards

She added: The industrial training they (ACHEST) provide helps health workers to navigate the challenging work environment, build strong relations, foster self-confidence; identify and manage stress and burnout, thereby introducing them to the job market and career progression.”  

The ACHEST Director of Non-Communicable Diseases and Healthy Ageing, Dr. David Okello, has urged the Rotary Club of Kampala to support senior citizens in Uganda.
Dr. David Okello - Director Non-Communicable Diseases at ACHESTWhile being inducted as a member of the Rotary Club of Kampala on June 12, Dr. Okello, in his speech, gave some remarks on the plight of the elderly persons.
“One of the issues that is of interest to me is the plight of the elderly persons in Uganda. Life expectancy in Uganda is increasing, and we now have a critical mass of older persons as part of our national demographics. Older persons have played their role in our communities, and have reached a stage where they need to retire enjoying a dignified healthy life,” said Dr. Okello

“Unfortunately, a majority of them living in the rural areas are generally neglected and not provided with adequate social services, including health care. Traditional African social systems in many places are in transition and disintegrating,” he added.
Dr. Okello, acknowledged efforts by the Uganda government to provide some stipend for senior citizens. However, this support currently does not cover everyone in need. It is also limited in scope.

Webinar Title: The Global Health Workforce (HWF) Crisis; moving from conflict to collaboration

Health workforce must be prioritised as a global public health good in order to achieve Universal Health Coverage(UHC), global health experts have said.

While speaking at the webinar on global health workforce crisis recently, the experts urged countries to implement and comply with the WHO Global Code of Practice and in general abstain from recruiting health professionals from countries that are currently facing critical shortages. This would ensure sharing a global pool of skilled and portable health workers through a global accreditation system, and thus social justice equity and health systems strengthening.
Adopted in 2010, the Code aims to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel and to facilitate the strengthening of health systems.

The webinar 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), under the theme: “Global Health Workforce Crisis: Moving from Conflict to Collaboration.”
It comes on the heels of a compelling blog by Prof Francis Omaswa, in which he raised alarm on the clandestine movements of health workers inspired by the rich and powerful countries. The blog COVID - 19 EXPOSES A GLOBAL SCRAMBLE FOR HEALTH WORKERS shows that countries are recruiting health workers without regard to maldistribution, shortages, ethics and the WHO Code.

To many young medical graduates, joining the job market can be daunting. They are not familiar with how the health sector operates and what is expected of them; what the government policies and health worker entitlements and benefits are among others.
Without proper guidance, one is at risk of being stressed and burnt out, which could lead to mental health problems and poor patient care.
Against this background, the African Center for Global Health and Social Transformation (ACHEST) in conjunction with the Ministry of Health and Makerere University College of Health Sciences,Health-Professional Education Partnership Initiative (HEPI) recently held an induction course for over 100 newly qualified newly qualified doctors, nurses and pharmacists in Uganda.
The March 2020 induction course was the first part of the two sessions planned this year. Another session will be announced in due course.
The objective of the course is to enable the young doctors 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. Other objectives are to ensure 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.
Internship is the transition period between being a student and a fully-fledged professional.

The Executive Director of the African Center for Global Health and Social Transformation (ACHEST), Prof. Francis Omaswa has been named on the 15-member committee appointed by President Yoweri Museveni to oversee Uganda’s National Response Fund for COVID-19.
The committee, is tasked with mobilizing, managing and ensuring transparency of the money and other donations towards the fight against the pandemic in Uganda.
Eng. Emmanuel Katongole, the Chairman Board of Directors, Uganda National Oil Company, was appointed to head the committee while General Duties Minister in the Office of the Prime Minsiter Mary Karooro Okurut was tasked with the political oversight role.
Other members are Robert Kabushenga, Managing Director of Vision Group, Apollo Makubuya a city lawyer, Kishor Jonanputra the chairman Picfare Group, Patrick Mweheire, the Regional Chief Executive Officer of Standard Group and Gustavas Bwoch, the Centenary Bank Board Chair.
Also on the committee are: Bishop Joshua Lwere from the National Alliance of Pentecostal and Evangelical Churches; Aga Sekalala, the Managing Director Ugachick; Dr. Ian Clarke, Chairman Uganda Healthcare Federation; Keith Muhakanizi, Permanent Secretary to the Treasury; Dr. Diana Atwine, Permanent Secretary to the Ministry of Health and Dorothy Kisaka, the Deputy Head of Delivery Unit
While unveiling the team, Uganda’s Prime Minister, Rt. Hon. Dr. Ruhakana Rugunda, said: “This is a team of eminent people who will be looking after these resources.”
“The target is building the health sector and empowering the frontline workers in the health sector,” Dr Rugunda stressed.
Speaking about the appointment, Prof. Omaswa said: “I applaud the government of Uganda for engaging prominent members of the Private Sector in Uganda in the control of COVID-19. It is a good example to other countries. I will provide technical support to the Task force and reach out to partners.
As of April 8, 2020 the number of confirmed COVID-19 cases in Uganda were at 53. In a bid to stop the spread of the infection, the country is currently under lockdown with several businesses closed and movement of Ugandans restricted. President Museveni also announced a 14-day curfew that began on April 1, where Ugandans were ordered to stay in their homes from 7:00pm to 6:30am.
As all this is being observed, the Ministry of Health is carrying out surveillance for 18,860 people who travelled to Uganda through Entebbe Airport between March 7 -22 , 2020
Compiled by Carol Natukunda, Communications Specialist, ACHEST

The African Center for Global Health and Social Transformation (ACHEST) is one of the 200 organizations around the world that are featured in this year’s Global Health 50/50 report.
The report titled “Power, Privilege and Priorities’ reviews gender-related policies and practices of organisations that aim to promote health and/or influence global health policy.
Now in its third year, the report publishes a Gender and Health Index across four dimensions:
1) Commitments to equity
(2) Presence of workplace gender equality and diversity policies
(3) Gender and geography of global health leadership, and
(4) Whether gender is addressed in health policies and programmes.

The Index shows that ACHEST commits to gender equality, with gender referring to men and women or gender mainstreaming in policy and planning; has gender equality affirmative policy with specific measure(s) to improve gender equality and/or support women's careers.
 The index also shows that ACHEST commits to non-discrimination in line with national laws; and highlights gender parity in the organization’s senior management.

The Health Systems Advocacy Partnership (HSAP) has been running for five years with an aim of contributing health systems so that people in sub-Saharan Africa gain better access to sexual and reproductive health services. The Partnership focuses on strengthening human resources for health and access to essential sexual and reproductive health commodities, while advocating for good governance and equitable health financing.
The project is being implemented by the African Center for Global Health and Social Transformation (ACHEST), AMREF and HEPS- Uganda as key partners in the Ugandan context.
Below, are some of experiences from the HSAP project.

SHRH COMMODITIES –
Call her a woman on a mission. Jennifer Atim, a midwife frantically paces up and down the maternity ward at Amach HC IV in Lira District with a purpose: To make sure that every mother who reports for antenatal care or even childbirth is checked for preeclampsia and other pregnancy related complications.
Better known as a silent contributor to maternal deaths, Preeclampsia is a life-threatening condition among pregnant women.
Thanks to HSAP, Atim is one of the health workers Lira who is well equipped with information on detecting preeclampsia before it is too late to claim a life or lives.

The African Center for Global Health and Social Transformation(ACHEST) successfully hosted the Annual Reflection meeting of the Health Systems and Advocacy partnership(HSAP) in Kampala from March 11-13th 2020.
Now its fifth and final year, HSAP has been focusing on four building blocks for strong health systems namely; strengthening human resources for health and access to essential sexual and reproductive health commodities, while also advocating for good governance and equitable financing.Annual Reflection Meeting In Kampala
In the Ugandan context, the project has been implemented by ACHEST in partnership with AMREF and HEPS-Uganda.
During the Annual Reflection Meeting in Kampala, partners deliberated on the project outcomes, the progress made so far and impact made in as far as strengthening Uganda health system is concerned..
Some of the achievements highlighted were: strengthening capacities of stakeholders, bringing CSOs on board to push for Sexual Reproductive Health Rights, documentation and evidence-based advocacy; and strong collaboration at the national, regional and global level among others.

Remarks for Professor Francis Omaswa
Convocation of the Aga Khan University
Kampala, February 8, 2020

President Firoz Rasul,
Ambassador Amin Mawji
Members of the Board of Trustees of the Aga Khan University,
Members of Government and the Diplomatic Corps,
Faculty and staff of the University,
Distinguished guests,
And, most importantly, our graduating students:

Good morning to you all. It is a pleasure to be here with you today to celebrate the graduation of the Class of 2019.

Prof. Omaswa Francis at the graduation ceremonyI am aware of the outstanding reputation of the Aga Khan University here in Uganda, and of its hospital in Nairobi where my wife and I worked during our days in Nairobi. The establishment of a new Aga Khan University Hospital in Kampala is a most welcome development. It should help to raise the standard of care, to educate health care leaders, and to generate knowledge that is needed to address some of Uganda’s critical health challenges. I want to thank His Highness the Aga Khan for his commitment to improving quality of life in East Africa, and the very significant long-term investments that he has made in Uganda over many years.

I should tell you that my first encounter with HH the Aga Khan was also the first time that I saw an aero plane that brought him to the town of Soroti in Eastern Uganda where I was a school boy around 1956/7

My remarks today are addressed to the happy graduands as they commence their respective journeys as health professionals here in Uganda, Africa and globally. Imagine your selves 20 to 30 years from today; where will you be? What will you have achieved professionally and in your personal life? I have no doubt that you have all been thinking about this and what I will do now is to share with you thoughts based on my own 50years experience on my own professional journey. I graduated as a medical doctor in 1969 at Makerere Medical School as you have been told. Health my dear friends, is not only my area of expertise but is more than anything else my passion. Here are some suggestions for your consideration:

First, you have to take good care of your selves through personal discipline. Ordinary matters such as being clean and smart, eating well, having adequate sleep and having peace of mind cannot be taken for granted. I have also found having a spiritual life to be empowering and an anchor that keeps me on course. You have to cultivate these habits purposefully and deliberately. Keep friends and seek to work with people who will advance your career and life not those who will award you PHD; in full “pull her down”. Please join and be active memebrs of your professional associations where will meet professional colleagues who will lift you up and not pull you down.

Second, I call upon you to pursue excellence in whatever you do. Everything that you do must be done to the highest achievable standard taking into account your personal capability. This includes the big and the small things in your work and life. If you bathe a patient it must be done the best way possible. If you clean the floor, apply a dressing to a wound, teach others or lead the way, it must be to the highest possible standards. Keep in mind that what you are doing well today can be done event better tomorrow and the next day. This is known as “Continuous Quality Improvement” in Total Quality Management principles. In this way you are getting better and better all the time in your daily life both professional and social.

Third, you need to cultivate your people skills on how to get on in a complex world. When I was a school boy, I was introduced to a book titled “How to win friends and influence people”. I found this book to be useful and I still recommend young people to read and use it. In your life, you are going to meet all types of people; nice and friendly, nasty and aggressive, generous and greedy. You will have to manoeuvre your pursuit for excellence among all these characters and succeed.

What I have found helpful is to be positive and helpful to all people. If you can help someone, why not do it? I have also found it helpful to work for the common good and not my own personal good. Once it is known that you work for all people including of course yourself, you will be given more things to do on behalf of the community from which you can also benefit. That is the best route to becoming a leader.

The African Center for Global Health and Social Transformation (ACHEST) coordinated the AfricanNursing Now Board meets Health Minister Dr. Jane Ruth Aceng Nursing Now Regional Board meeting in Kampala on February 3-4, 2020
Nursing Now is global campaign that seeks to improve health globally by raising the status and profile of the nurses and midwives.
Launched in 2018, the campaign has over 528 Nursing Now groups in over 112 countries, actively working to influence policy and to empower nurses and midwives to take their place in tackling the 21ST century health challenges.
The African Regional Meeting in Kampala was attended by the Co-chairs of the Nursing Now Campaign Global Board Lord Nigel Crisp and Professor Sheila Tlou. Other Board members were Professor Annette Kennedy, President of the International Council of Nurses, Munashe Nyika from Zimbabwe who represents young Nurses and midwives on the Board and Professor Francis Omaswa who was host to the Board meeting. The meeting also attracted Nursing and Midwives’ leaders from Kenya, Malawi, Rwanda, Uganda and Zambia who gave first-hand insights into the challenges they face that often leave them feeling undervalued.
During group discussions, it was noted that the problems go beyond limited political support and health budgets to lack of personal attributes such as lack of self-confidence, communication and public speaking skills. Nursing Now Board meets the Prime Minister Rt Hon Dr. Ruhakana Rugunda
The meeting strongly urged nurses and midwives to confront the challenges and organize themselves into professional associations which would help advance their careers.
Prof. Francis Omaswa, particularly encouraged the various Ugandan nurses groups to form a federation that incorporates all the current sub-specialized associations.
He stressed that such an alliance would promote professionalism, service standards, quality of the training, mentorship and succession issues among others.
Currently, there is only a Nurses and Midwives Union in Uganda, which is basically advocates for labour rights.

In 1999, the Uganda government established staffing norms – a human resource planning tool that gives indication of the number and caliber of staff required in a given health facility.
Two decades later, the outdated norms are still being used to recruit health workers. They have not been revised to match the rapid population growth, the changing disease burden and rapidly changing global health situation. Uganda’s population has more than doubled from 21 million people in 1999 to over 40 million in 2019.

This is one of the disturbing revelations in a new report of the study titled ‘Health Workforce Financing in Uganda: Challenges and Opportunities’ that was launched on January 29,2020 by the African Center for Global Health and Social Transformation(ACHEST), conducted in partnership with Wemos, a global health advocacy CSO.
The report is part of ACHEST and Wemos’ contribution to the Health Systems Advocacy Partnership programme.
The findings show that despite efforts made by the Uganda government and its partners, the shortage of health workers still persists. Insufficientfunding and poor management of funds are the underlying factors that require to be addressed before the improvement and retention of health workers isrealized. The report also shows that the total health expenditure has been decreasing in the last decade. A large share of the health budget in Uganda is funded by development partners, yet in most cases, these funds cannot be used to pay health workers salaries.The delayed National Health Insurance Scheme process, means the household out of pocket spending on health remains high and catastrophic.
The report gives the following recommendation:
• Update the staffing norms of the health sectortaking into account the population growth, increasing disease burden of the country and internationally agreed standards. The on-going review of the Human Resources for Health Strategic Plan should prioritise the issue of updating the staffing norms.
• The training of health professionals should be adjusted to address the cadres that have highest shortages. Government should implement the WHO recommended Country Coordination and Facilitation (CCF) mechanism, that brings together the ministries of Education, Health, Local Government, Public Service, Finance and other relevant stakeholders to forecast and plan the training of health professionals according to needs. In addition, Government should ensure the timely disbursement of resources to the MoH, to facilitate fresh recruitment of trained and currently unemployed health workers to address prevailing staffing shortages.

• Government should reverse the declining per capita expenditure on health by incrementally moving towards the internationally recommended allocation of 5% of GDP to health.

• Government should expedite the passage of the National Health Insurance Scheme Bill to minimise the exposure of the population to the exorbitant cost of health care.

• The Government should undertake tax reforms to reduce leakages, tax evasion, unfair tax exemptions and capital flight. In addition, Government should expand the tax base by tapping into hard-to-reach economic activities, as well as improve efficiency of revenue administration mechanisms.

• Development partners should increase and expand support for health workforce development, including recruitment and salaries, through more flexible and dependable funding.The previously strong Sector-Wide-Approach(SWAps) in the health sector should also be revived.
Development partners should also increase the share of funds channelled through the Government and support the plan for a Joint Action Fund.

During the launch of the report, participants acknowledged that investing in health was crucial to a country’s gains.
The Ministry of Health represented by a member of the Human Resources for Health technical working group said the ongoing human resources strategic planning would address challenges in leadership management ,performance, induction, registration of health workers and professional development among others.
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Find the link to the report here********