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UPDATES FROM THE FIELD
As COVID-19 cases remain relatively low and stable in Uganda, Kenya and Ghana, ICHAD field team members continue to safely implement study activities, including data collection via telephone and delivery of multiple family group sessions, in socially distanced environments. Our field teams continue to look into the spread and impact of this deadly virus. The Suubi4Cancer team received an amendment to collect additional data on the impact of COVID-19 on the well-being of study participants and on health service provision.
For our U.S. team, the fall semester is in full swing which has brought multiple panel discussions and speaker series topics to a broader audience. In October, ICHAD Directors Fred Ssewamala and Ozge Sensoy Bahar and SMART Africa Global Fellow Timothy Opobo participated in the McDonnell International Scholars Academy Symposium that featured a panel on “Challenges and Opportunities in Developing Child Savings Programs in Israel and Uganda,” highlighting ICHAD’s work in engaging with policymakers to promote Child Development Accounts in Uganda. ICHAD and the SMART Africa Center’s October speaker series featured Columbia University Professor and ICHAD Affiliate, John Santelli who discussed HIV prevention projects in Rakai, Uganda.
Congratulations to ICHAD team members who recently had a paper, “Gender, HIV Knowledge and Prevention Attitudes Among Adolescents Living with HIV Participating in an Economic Empowerment Intervention in Uganda,” accepted for publication in AIDS Care. Check out the “Social Corner” section below for other exciting updates.
As always, please feel free to contact us with any news or updates that you would like us to include in our upcoming newsletter. Also, follow us on Facebook and Twitter to learn about all of our latest updates!
We wish you all continued health and happiness!
The ICHAD and SMART Africa Teams
Left: Staff conduct telephone interviews at the ICHAD Calling Center in Masaka, Uganda. Right: A Kyaterekera study participant has privacy during a phone interview.
Kyaterekera Project
Through a combination of economic empowerment, vocational skills training, and HIV risk reduction (HIVRR) sessions, the Kyaterekera Project is focused on reducing new incidences of sexually transmitted infections and HIV among women engaged in sex work in Uganda. In October, the team completed Wave 3 (6 months) follow-up interviews at 3 sites with 90 out of 107 participant assessments completed by telephone. To date, the team has completed 454 out 517 assessments from 18 sites, with a retention rate of 88%, and will continue to track down those not interviewed previously. In addition to Wave 3 telephone interviews, the team commenced qualitative interviews at 6 sites, with 16 out of 17 participants completing interviews. Adhering to the Ministry of Health COVID-19 guidelines, the team also delivered 4 HIVER sessions at one remaining site. HIVER sessions have now been delivered at all 19 sites.
ICHAD Research Assistants continue to conduct Wave 3 telephone interviews by phone while practicing proper social distancing at the ICHAD Calling Center in Masaka, Uganda.
Suubi4Her
The Suubi4Her study seeks to examine the impact and costs associated with an innovative combination intervention that aims to prevent HIV risk behaviors in communities heavily impacted by HIV/AIDS. In October, the Suubi4Her team continued to conduct Wave 3 telephone interviews and as of October 27, 677 participants (out of the expected 1,259) had been interviewed. Telephone interviews are conducted at the respective schools, which enables participants to respond to personal questions without any shyness, and the team conducts home visits for those that have relocated due to COVID-19. The team and study participants continue to adhere to all safety measures against COVID-19, including practicing social distancing and wearing face masks. Following the completion of the qualitative interview training, facilitated by ICHAD Co-Directors, Drs. Proscovia Nabunya and Ozge Sensoy Bahar, the team started administering qualitative interviews to randomly selected dyads (guardians and their children). As of October 23, a total of 24 dyads have been interviewed and their data is being transcribed and translated from Luganda to English. The team will continue with these interviews over the coming months.
Pre-test for Qualitative Interviews at Kinoni Health Center III, Nakaseke, Uganda.
Suubi4Cancer
The Suubi4Cancer seeks to identify confirmed and suspected cancer cases among a cohort of more than 3,000 youth (ages 10 to 24) living with HIV/AIDS in Uganda. The Suubi4Cancer team recently received an amendment to: 1) include questions related to the impact of COVID-19 on participant well-being and on healthcare provision; 2) expand the inclusion criteria to include any recent suspected cancer cases; and 3) approach referral centers for information on suspected cancer cases to confirm the diagnosis. In October, the study team contacted all 35 health facilities to inform them of the updated inclusion criteria, which resulted in one additional suspected case. The team is getting ready to start the qualitative interviews.
Dr. Proscovia Nabunya leads the weekly Zoom meeting for the Suubi4Stigma study team members in the U.S. and Uganda.
Suubi4Stigma
Suubi4Stigma study examines the feasibility, acceptability and preliminary impact of two evidence-based interventions, Group Cognitive Behavioral Therapy (G-CBT) and Multiple Family Group (MFG), to address HIV/AIDS associated stigma among adolescents (aged 10-14 years) living with HIV in Uganda. This month, the study received IRB approval from Uganda Virus Research Institute (UVRI) and additional approval from Washington University and Uganda National Council for Science and Technology is currently being sought. Following the IRB approval, the team contacted potential health clinics to obtain information, including location status (rural, semi-Urban, or urban), and number of children living with HIV that are on ART in each of the health centers. The team also finalized the MFG Facilitators’ Manual, the qualitative interview protocols, and updated the Regulatory Binder. The team is currently working on the G-CBT manual and, over the next few months, will conduct visits to selected health facilities to introduce the study.
Kisa Kya Maria playground in Kampala, Uganda.
Suubi+Adherence-R2
The Suubi+Adherence-R2 study seeks to examine the long-term impact of the Suubi+Adherence intervention on HIV viral suppression, and to explore the long-term impact of the intervention on key HIV treatment adherence outcomes for youth living with HIV, including their ability to access and refill prescribed medication, adherence to prescribed daily medication routines, and their engagement in HIV care such as keeping medical appointments. The study officially began on September 1, 2020 and the team continues to work with local implementing partners, including Reach the Youth-Uganda, the Diocese of Masaka, and Mildmay-Uganda to lay the groundwork for study implementation. This includes contacting participants from round one of the Suubi+Adherence study, finalizing assessment tools and other documents for the IRB submission, and preparing a Manual of Procedures for all field operations. The team has so far been able to trace about 88% (n=588) of the expected 671 participants. The outreach efforts are ongoing.
BasicNeeds staff conduct a baseline assessment with an ANZANSI Family Program caregiver in Tamale, Northern Ghana.
ANZANSI Study
The ANZANSI Family Program seeks to pilot test the feasibility of an innovative combination intervention–Family Economic Empowerment and Multiple Family Group (MFG)–amongst adolescent girls at risk of dropping out of school and migrating for work in Northern Ghana. All participating families (100 families in total) have completed baseline assessments. In October, the BasicNeeds team worked on completing bank partnership agreements for Child Development Accounts and began opening Child Development Accounts for 50 families in the treatment group.
A parent peer presents to participants of the Amaka Amasanyufu Program at Nsambya Primary School in Kyotera district, Uganda.
SMART Africa
The SMART Africa studies examine the impact and implementation of an evidence-based Multiple Family Group (MFG) intervention for children experiencing behavioral problems and their families in Uganda, Kenya, and Ghana. During the month of October, the Uganda team continued supervising the delivery of MFG sessions 14, 15, and 16 in four schools. To protect against COVID-19, the three sessions were delivered by community health workers and parent peers, and spread out across one day to minimize contact between the research team and study participants. Even during these uncertain times, 87% of the families have completed the remaining sessions. Following completion of the sessions in each school, the team conducted 16-week follow-up interviews, with 89% retention rate.
The Kenya team has been hard at work completing data collection. In March, the team completed the delivery of the MFG intervention before the country shutdown. Currently, the team is contacting families participating in the study to schedule the 16-week follow-up assessments. The team hopes to complete data collection soon and begin the data cleaning and analysis processes.
The Ghana team is currently delivering the MFG intervention to families and expects to complete these sessions by the end of October. The team has been working hard to deliver the MFG sessions while adhering to COVID-19 safety protocols. The team holds concurrent sessions with smaller groups of families in order to adhere to social distancing. Mask wearing, hand washing stations, and hand sanitizers are being utilized. The Ghana team is also working to coordinate qualitative interviews with the school health education program (SHEP) coordinators and head teachers. Apart from the MFG delivery, the Ghana team is also working on a manuscript titled “The Prevalence of Behavioral Disorders Among School-Aged Children in Northern Ghana” using baseline data from the study.
UPDATES FROM ICHAD AND SMART AFRICA TEAMS
“I started working at ICHAD as a foundation practicum student, supporting the ANZANSI family program, an ongoing project in my area of interest, and following my practicum, transitioned to a student study coordinator. It has been a rich learning experience, to be part of and experience everything from stakeholders’ engagement, participant recruitment, baseline assessment and now we are about to start the intervention implementation stage. Through this, I have learned from my supervisor and PI, Dr. Ozge Sensoy Bahar, the skills to facilitate diverse groups, lead and manage a team in times of crisis, harness different competencies to achieve a shared goal, and good communication skills. I have gained hands-on experience and a deeper understanding of the different aspects of implementing study interventions. This opportunity has allowed me to grow academically and professionally, while contributing to ground-breaking research efforts. I am grateful to my supervisor, Dr. Ozge, for her continued interest, support and contribution to my academic and professional growth.”
Portia Nartey, MSW Candidate
ICHAD U.S. Graduate Student Assistant
ICHAD Project Coordinator, Mr. Joshua Kiyingi and Ms. Phionah Namatovu (on Zoom) facilitate a one-day refresher training for ICHAD Uganda staff on how to prepare, organize and update a regulatory binder.
Public Health Speaker Series: Need for Global Women’s Leadership
ICHAD and the Brown School’s Public Health Program recently co-sponsored a presentation by Temitayo “Temi” Ifafore-Calfree, a Senior Private Sector Engagement Officer at the United States Agency for International Development (USAID). Ms. Ifafore-Calfree presented “Beyond 23: African Women Leaders are the Key for a 2030 Global Agenda” which examined the role of African women’s leadership in meeting the 2030 Sustainable Development Goals (SDGs) in health, agriculture, and political engagement and advocacy. She highlighted the fact that women represented 23% of delegates to the 73rd World Health Assembly in 2020, down from 31% in 2017. She encouraged participants to think about how to move beyond 23 and ensure women are being represented at the highest-levels of leadership. She also emphasized the importance of “following the money,” male engagement, and learning from African innovations. You can watch the full presentation here.
ICHAD Directors present at McDonnell International Scholars Academy Symposium
On October 15, 2020, ICHAD Founder and Director, Dr. Fred Ssewamala, ICHAD Affiliate Timothy Opobo, Executive Director of the AfriChild Center, and ICHAD Co-Director, Dr. Ozge Sensoy Bahar presented on “Challenges and Opportunities in Developing Child Savings Programs in Israel and Uganda” at a symposium hosted by McDonnell International Scholars Academy at Washington University in St. Louis. This virtual event featured presentations and a discussion about asset building for long-term child development and Child Saving Account programs in Israel and Uganda. Dr. Ssewamala’s presentation provided an overview of asset development interventions in Uganda, including results from some of the research studies ICHAD has implemented since 2004. These studies have shown that economic empowerment interventions help address poverty-related issues among people living in poverty and have led to improved mental health functioning, sexual risk-taking decisions, decisions about the future, educational and health outcomes among others. Mr. Opobo discussed the importance of taking this evidence-based data and working with policy makers at all levels to implement programs. He highlighted the relationships ICHAD and SMART Africa have established with policy makers, including with the First Lady’s Office, the Prime Minister, and Speaker of Parliament. Finally, Dr. Sensoy Bahar provided the concluding remarks summarizing the key points and next steps for both Israel and Uganda. You can watch the full presentation here.
ICHAD & SMART Africa Speaker Series: Orphanhood, Education, Poverty, HIV Prevention, and Youth - 25 Years in Rakai, Uganda
On October 20, 2020, ICHAD hosted the second Speaker Series for the 2020-21 season featuring Dr. John Santelli, MD, MPH, Professor of Population and Family Health and Pediatrics at the Mailman School of Public Health at Columbia University. Dr. Santelli presented on “Orphanhood, Education, Poverty, HIV Prevention, and Youth: 25 Years in Rakai, Uganda,” which explored several factors that attribute to the high rates of HIV among young people in Sub-Saharan Africa by looking at data collected over the course of 25 years among various communities in Rakai. Dr. Santelli also introduced the SSTAR (Structural and Social Transitions among Adolescents and Young Adults in Rakai) Project and discussed the role of social structural determinants (i.e. access to school, family structure, socio-economic status, etc.) and the timing of social transitions (i.e. marriage formation, school leaving, migration etc.) play in ensuring that prevention policies and programs are strengthened among the youth in Rakai, Uganda. Watch the presentation on YouTube.
CAPACITY BUILDING
ICHAD/SMART Africa Training Programs
The ICHAD/SMART Africa training programs consist of three NIH-funded training grants: LEAD Global Training Program (Co-Directors Dr. Fred Ssewamala and Dr. Patricia Cavazos-Rehg), Research Resilience Training (Co-Directors Dr. Fred Ssewamala, Dean Mary McKay, and Dr. Sean Joe), andCHILD-Global Research Fellows (Co-Directors Dr. Fred Ssewamala, Dean Mary McKay, and Dr. Noeline Nakasujja). The programs support early career researchers in domestic and global mental health, health disparities, and HIV/AIDS in the U.S. and Sub Saharan Africa to become independent researchers and leaders of multidisciplinary teams in resource-limited settings.
LEAD, RRT, and CHILD-GRF Applications Now Open!
Applications for ICHAD’s training programs are now open. All applications are completed online and have a deadline of January 4, 2021. Please see the flyer and visit each program website for eligibility and application requirements. Links to each application site are below. If you have questions about the programs, please contact Laura Peer at Lpeer@wustl.edu.
ICHAD is committed to continuing to support our trainees, even after the completion of a training period, or during the times between training sessions and meetings. In an effort to continue to connect our trainees and alumni with ongoing training, funding, and professional development opportunities, we have launched the Monthly Connection. The Connection contains extensive listings of opportunities from a range of sources and is emailed around the 15th of each month. We invite submissions to be included in the Connection so if you know of an event or opportunity that is aligned with the focus areas of our training programs, please send them to Laura Peer at Lpeer@wustl.edu. View the first edition of the Monthly Connectionhere.
FELLOWS CORNER
Esther Nanfuka is a CHILD-GRF Fellow and an assistant lecturer at Makerere University with a research focus on resilience among adolescents living with HIV. On September 17, 2020, Dr. Nanfuka defended her dissertation, “Resilience in Mobilising and Sustaining Access to Resources for Managing HIV: A Study of People on Antiretroviral Therapy in Uganda,” at Makerere University School of Social Sciences, Department of Social Work and Social Administration. Dr. Nanfuka’s dissertation committee consisted of Professor Andrew State (Chair), Dr. Denis Muhangi, Professor Stella Neema, Professor Julius Omona, Professor Peter Atekyereza, Professor Narathius Asingwire, Dr. David Kyaddondo, Dr. Gloria Kimuli, Professor Ruth Kutalek, and Dr. David Kawaa-Mafigiri, who also serves as her CHILD-GRF mentor. Her work with Dr. Mafigiri focuses on mental resilience in the face of suicidal ideation and anxiety: A qualitative study of adolescents living with HIV in Uganda. Dr. Nanfuka passed the viva voce with only minor edits. Congratulations, Dr. Nanfuka!
CHILD-GRF Fellow and SMART Africa-Uganda In-Country Principal Investigator Apollo Kivumbi, MBchB, MPH, was nominated to be an Early Career Researcher (ECR) with the Ethics for Mental Health Digital Innovation for Young People in Africa (EMDIYA) Network. The EMDIYA ECR is a formative grant in which Dr. Kivumbi and his colleagues are working towards a larger-scale project with a focus on the ethics of using IT platforms in support of the mental health of young people. Dr. Kivumbi notes, “Currently my main duties are completing formative work with young people, familiarizing myself with current mental health platforms in Uganda (both in use and under development), taking more ethics and digital courses, and participating in the bigger grant writing process.” Dr. Kivumbi is also in the process of completing his MMed in Psychiatry at Makerere University School of Medicine, College of Health Sciences. As a CHILD-GRF fellow, Dr. Kivumbi’s work focuses on cognitive training for attention deficit/hyperactivity disorder among HIV infected children in Uganda using computerized cognitive training, and his mentor is Dr. Fredrick Edward Makumbi. Congratulations to Dr. Kivumbi! We look forward to celebrating your accomplishments as an ECR and CHILD-GRF fellow!
SOCIAL CORNER
Congratulations!
Left: Congratulations to Joshua Kiyingi, SMART Africa and Kyaterekera Coordinator, and his new bride Irene Nakazibwe who were married on October 29!
Right: ICHAD-Uganda’s Project Driver, Sam Ssekiranda was introduced by his fiancée Tattoo Nakandi to her parents on October 4. Congratulations, Sam and Tattu!
Cultivating Social Connections
Despite the ongoing pandemic and its various restrictions, the ICHAD U.S. Team continues to find ways to connect both virtually and in-person for various social activities. Most recently, the team gathered for a socially distanced luncheon at a local park and met with new student team members. The team also met for an impromptu surprise Zoom birthday celebration for ICHAD Training Manager, Laura Peer. Laura continues to lead the closed ICHAD ZoomBa (Zoom + Zumba) sessions so team members can stay active while staying indoors.
The ICHAD U.S. Team (and families) get together for a social distanced luncheon at a local park.
The ICHAD U.S. Team celebrates the birthday of Training Program Manager, Laura Peer.
PUBLICATIONS
Congratulations to Dr. Proscovia Nabunya, William Byansi, Joelynn Muwanga, Christopher Damulira, Dr. Rachel Brathwaite, Flavia Namuwonge, Dr. Ozge Sensoy Bahar, and Dr. Fred M. Ssewamala, on the acceptance of their paper “Gender, HIV Knowledge and Prevention Attitudes Among Adolescents Living with HIV Participating in an Economic Empowerment Intervention in Uganda” for publication in AIDS Care.The paper examined gender, HIV general and clinical knowledge, and prevention attitudes among adolescent girls and boys living with HIV in Uganda. The study used data from 702 adolescents, randomly assigned to either a control arm receiving bolstered standard of care or the treatment arm receiving bolstered standard of care in addition to a family economic empowerment intervention to support medication adherence. Findings from the study revealed no gender differences in HIV knowledge and prevention attitudes at baseline. However, boys were more likely to report correct HIV general knowledge (d=0.21), clinical knowledge (d=0.48), and favorable prevention attitudes (d=0.27) than girls at the 12-months follow-up. Given the high prevalence of HIV among adolescents, especially girls, findings point to the need to develop and/or tailor existing programs and interventions to equip adolescent girls with comprehensive knowledge and prevention attitudes that are culturally appropriate to reduce HIV transmission and reinfection within this population.
UPCOMING EVENTS
6th Annual Global Health Week Global Health Center, Institute for Public Health, Washington University November 2-6, 2020, Central Time
Global Health Week is a university-wide event organized in partnership with all seven schools — Arts & Sciences, Brown School, McKelvey School of Engineering, Olin Business School, Sam Fox School of Design & Visual Arts, School of Law and School of Medicine — and brings together Washington University with the St. Louis community to engage around global health topics. Learn more and register here.
Global Health Center, Institute for Public Health, Washington University
November 6, 2020, 4:00-5:30 PM (CT)
The Global Health Center presents a panel discussion, “Let’s Talk Diverse Global Health Careers!,” organized by the Global Health Student Advisory Committee as part of Global Health Week, a university-wide event that brings together Washington University and the St. Louis community to engage around global health topics. ICHAD Co-Director, Dr. Proscovia Nabunya, will serve as a panelist for this event which will take place virtually via Zoom. Please register to attend. See flyer for more information.
Dr. Elijah Paintsil, MD, MBChB
ICHAD & SMART Africa Speaker Series
December 8, 2020, 3:00-4:00 (CT) - Virtual Zoom
The ICHAD & SMART Africa Speaker Series will host Dr. Elijah Paintsil, MD, MBChB, Professor of Pediatrics Infectious Diseases and the Professor of Public Health at Yale School of Public Health. Registration for the event will open soon on the Brown School Open Classroom website.
OPPORTUNITIES
ICHAD OPPORTUNITIES
LEAD Global Training Program - Postdoc Position
The T37 LEAD Global Training Program is accepting applications for a 1-2 year postdoctoral fellow. The LEAD Global Fellowship program supports trainees from underrepresented groups committed to conducting health disparities research, with a specific focus on global mental health prevention, intervention, services, and implementation research within resource-constrained settings. Eligible candidates should be a U.S. citizen, non-citizen national, or permanent resident, and be from a disadvantaged orunderrepresented population in biomedical, behavioral, clinical & social science research as outlined by the NIH. Applications will be accepted on a rolling basis and can be completed on the T37 LEAD Global Fellowship website at https://sites.wustl.edu/lead/apply/. For more information, contact Laura Peer at lpeer@wustl.edu.
CALL FOR PAPERS
The International Journal of Environmental Research and Public Health will publish a Special Issue on “Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings.” ICHAD Co-Director, Dr. Lindsay Stark, DrPh, and Dr. Ilana Seff, Associate Professor at the Brown School at Washington University will serve as Guest Editors. They are especially interested in promoting authors from lower middle income countries, and have a limited amount of vouchers to reduce publication fees. Read more about the International Journal of Environmental Research and Public Healthor submit a manuscript for the Special Issue online. The submission deadline is September 2021.
The Global Social Welfare Journal brings together research that informs the fields of global social work, social development, and social welfare policy and practice. It serves as an outlet for manuscripts and brief reports of interdisciplinary applied research that advance knowledge about global threats to the well-being of individuals, groups, families, and communities. Submissions will be accepted on a rolling basis and are reviewed by experts in the field. Read more about the Global Social Welfare Journalor submit a manuscript now through the Manuscript Submission Portal.
