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Stiles CE, O'Neil E, Kabali K, O'Donovan J. The use of low-cost ruggedized Android tablets to augment in-service training of community health workers in Mukono, Uganda: perspectives and lessons learned from the field. Afr Health Sci 2021; 21:1482-1490. [PMID: 35222614 PMCID: PMC8843268 DOI: 10.4314/ahs.v21i3.60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Despite potential for community health workers (CHWs) to effectively reduce morbidity and mortality in sub-Saharan Africa, they still face multiple barriers including access to on-going and refresher training. Digital technology offers a potential solution to improve the provision of ongoing training for CHWs. Objectives This report shares participant insights and experiences following the implementation of a mobile health (mHealth) assisted Integrated Community Case Management (iCCM) refresher training programme for CHWs in Mukono, Uganda. We seek to document benefits and challenges of such an approach. Methods CHWs were trained to recognize, treat and prevent childhood pneumonia via locally made videos preloaded onto low cost, ruggedized Android tablets. Subsequent interviews were compiled with key stakeholders including CHWs, CHW leaders and programme supervisors to better understand the strengths, barriers and lessons learned following the intervention. Results Success factors included the establishment of CHW leadership structures, the ability to use the tablets to learn on an “any pace, any place” basis and using the tablets to conduct community teaching and outreach. Barriers included appropriate consideration of the implementation timeline and avoiding a “one size fits all” approach to digital literacy training. Conclusions The strength of the program stemmed from a grassroots approach that prioritized stakeholder input at all stages. Leadership at a local level, a history of local engagement and trust built up over a period time were also integral. As organizations aim to scale up digitally enhanced training initiatives, it is paramount that attention is paid to these human factors which are key for program success.
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Affiliation(s)
- Christina E Stiles
- Omni Med, Waban MA, USA and Kisoga Town, Mukono District, Uganda
- The University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Edward O'Neil
- Omni Med, Waban MA, USA and Kisoga Town, Mukono District, Uganda
- Steward St Elizabeth's Medical Center, Department of Emergency Medicine, Boston, MA, USA
| | - Kenneth Kabali
- Omni Med, Waban MA, USA and Kisoga Town, Mukono District, Uganda
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Erume J, Roesel K, Dione MM, Ejobi F, Mboowa G, Kungu JM, Akol J, Pezo D, El-Adawy H, Melzer F, Elschner M, Neubauer H, Grace D. Serological and molecular investigation for brucellosis in swine in selected districts of Uganda. Trop Anim Health Prod 2016; 48:1147-55. [PMID: 27142028 PMCID: PMC4943980 DOI: 10.1007/s11250-016-1067-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 04/19/2016] [Indexed: 01/07/2023]
Abstract
Brucellosis is a notifiable zoonotic disease affecting livestock, humans, and wildlife in Uganda. Pigs can be infected with human pathogenic Brucella suis biovars 1 and 3 and can be a significant source of brucellosis for humans. Uganda has a rapidly growing pig population, and the pork consumption per capita is the highest in East Africa. The objective of this work was to determine the seroprevalence of brucellosis in Ugandan pigs. A cross-sectional serosurvey of pigs was conducted in three of the major pig-keeping districts in Uganda (Masaka (n = 381 samples), Mukono (n = 398), and Kamuli (n = 414)). In addition, pigs originating from these districts were sampled in the major pig abattoir in Kampala (n = 472). In total, 1665 serum samples were investigated by serological and molecular tests. Only three putative brucellosis-positive samples were detected serologically using indirect ELISA. These sera were found negative for Brucella antibodies by CFT; however, two had antibodies against Yersinia enterocolitica as determined by SAT. Presence of antibodies against Yersiniae was confirmed by Y. enterocolitica antibody-specific ELISA. The two Yersiniae ELISA-positive samples were brucellosis negative using real-time PCR. We tested additional 142 sera from the 1665 samples with real-time PCR. All tested negative. Under this type of production system, we expect a maximum B. suis prevalence of less than 1 % at 95 % confidence level, and therefore, the risk of acquiring brucellosis from the pigs or their products is negligible. However, pigs may harbor the zoonotic Y. enterocolitica. This is the first study to investigate the occurrence of brucellosis in pigs in Uganda and the first study to report Y. enterocolitica antibodies in swine in Uganda.
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Affiliation(s)
- Joseph Erume
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Kristina Roesel
- International Livestock Research Institute (ILRI), C/O Bioversity International, P. O. Box 24384, Kampala, Uganda
| | - Michel M Dione
- International Livestock Research Institute (ILRI), C/O Bioversity International, P. O. Box 24384, Kampala, Uganda
| | - Francis Ejobi
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Gerald Mboowa
- Mycobacteriology (BSL-3) Laboratory, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Joseph M Kungu
- International Livestock Research Institute (ILRI), C/O Bioversity International, P. O. Box 24384, Kampala, Uganda
| | - Joyce Akol
- International Livestock Research Institute (ILRI), C/O Bioversity International, P. O. Box 24384, Kampala, Uganda
| | - Danilo Pezo
- International Livestock Research Institute (ILRI), C/O Bioversity International, P. O. Box 24384, Kampala, Uganda
| | - Hosny El-Adawy
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute for Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743, Jena, Germany
| | - Falk Melzer
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute for Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743, Jena, Germany
| | - Mandy Elschner
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute for Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743, Jena, Germany
| | - Heinrich Neubauer
- Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Institute for Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743, Jena, Germany
| | - Delia Grace
- International Livestock Research Institute, P. O. Box 30709, Nairobi, Kenya
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