Time is flying by so quickly! For the past two weeks we have been working with participating women on photography. So far everyone has loved taking photos, although we are having some charging challenges (it can be hard to re-charge the digital cameras in some communities). We have also been doing more activity based sessions where we go and weed gardens, dig, make charcoal, weave baskets etc. Everyone has found these conversations less narrow in focus but more valuable for context and lived experiences. For example, we talked about the difficulty in walking long distances and then working with a baby on your back, but when babies are young and you need to breastfeed there are no other options. And women talked about how nice it was to feel close to the baby even when they are working. When women are interested, I try to give as much information as possible about the Canadian context but without children of my own, I sometimes find it difficult to really share that knowledge.
For Seba, Charity and I, we all feel so lucky that we have been able to speak with so many people. Community members, Health care workers, passionate key informants etc. Right now the government Dr.’s are on strike. The context in which health care is delivered is incredibly complex, but we were consistently humbled by the passion and dedication of everyone we have talked to.
In the next few weeks, we have some remaining Health Centers to visit and hospital data to enter!
Grace Asaasira is a very experienced Ugandan researcher. She has been working with IHACC for the past 5 years. She completed her diploma in gender and development studies and is now pursuing a Bachelor’s in community psychology at Makerere University. Her research interests are primarily in domestic violence and gender roles in Uganda. She has been an amazing team member and conducted surveys and focus group discussions for this work. We are so excited to have her as part of the team!
Mackenzie is a first year student in the Master of Public Health and International Development Studies program at the University of Guelph, where she completed an Honours Bachelor of Biomedical Science with a minor in Nutritional and Nutraceutical Science in 2016. As part of her undergraduate research, Mackenzie worked in Cambodia studying the sodium intake of rural Cambodians. This has shaped her interest in Global Health and Nutrition.
As part of her Masters, Mackenzie is traveling to Southwestern Uganda to examine how national recommendations for antenatal care are being implemented at the community level by health care facilities to elicit understanding and compliance in women receiving care. The project aims to understand national, community and individual levels of maternal nutritional care. Using qualitative data obtained through focus group discussions and key informant interviews, the objectives of the project are to improve efficiency and delivery of antenatal care, as well as improving other areas of maternal nutrition services in the region.
This week we finished our focus group discussions and Phiny (MSc. Student from Makerere University) joined us! With the Batwa Development Program we had selected 3 communities to work with reflecting different experiences and access to formal maternal health services. We (Grace, Phiny, Seba, Charity and Nia) visited each community three times and had themed discussions on general maternal health experiences, health seeking behavior and traditional medicines and maternal health practices. It was very humbling listening to so many women speak about their experiences. We also loved learning local herbs and traditional practices related to maternal health. I am always in awe of how strong, resilient, knowledgeable and poignant women are. I am so appreciative of these opportunities to learn.
We absolutely loved the opportunity to work and get to know everyone. It was really nice to go back each week and pick up where we left off!
Now we are focusing on hospital data entry and meeting with the 10 women working with us on the in-depth experience study. Yesterday we hung out with Abias. For the next few weeks she will be taking photos to capture important aspects of maternal health. Next week we will be giving out the remaining cameras to the other women participating!
Bakiga women talking about maternal health in SW Uganda
Demonstration of herb preparation
Abias explaining some of her photos to Seba and Phiny
Written by Nia King, BSc and research assistant from the University of Guelph
Originally posted here
About two weeks ago I arrived in Uganda to work as a research assistant alongside Kate Patterson (PhD candidate), investigating rural maternal health and working to develop a knowledge translation strategy for IHACC Uganda. We are staying at the Monkey House, and have been joined by a wide variety of interesting visitors, including a group of external hospital auditors, tropical health students from the London School of Tropical Health and Medicine, two Americans who have spent the past two years driving in a camper van across Africa, and Dr. Kellerman, founder of Bwindi Community Hospital. This has made for a very lively and fun living environment!
With the quantitative maternal health surveys having been completed this past summer, we are now working with local research associates Seba, Charity, and Grace to conduct qualitative focus group discussions and individual interviews with mothers and fathers in Batwa and Bakiga communities throughout the Kanungu District. As the primary focus of Kate’s research is Indigenous maternal health, we are conducting repeated weekly focus group discussions with women in three Batwa settlements, chosen to capture the variety in geographies and access to healthcare. By spending approximately six hours discussing with each group of women, we are starting to capture and understand many of the nuances related to maternal health in rural Uganda. In addition to these focus groups, we have conducted focus group discussions with Batwa men and Bakiga (non-Indigenous) women. Kate has also been working with 9 Batwa women conducting repeated individual interviews to gather personal narratives surrounding maternal health. Through these various engagements, we have met many amazing women throughout the past couple weeks and look forward to providing them with a platform to voice their challenges and concerns. Our findings are intended to inform maternal health programs and delivery at the Bwindi Community Hospital and surrounding healthcare facilities.
When not in the communities, we have had the opportunity to partake in several hikes, including one that leads to a ridge overlooking the Ugandan and Democratic Republic of Congo border. Kate was also amazing and arranged a birthday party (including a homemade banana-nutella cake) for me last week, which made spending my birthday away from home extra special.
Overall our work is progressing smoothly here. I am so lucky to have the opportunity to live in this amazing part of the world and to learn from all of Kate’s experience. I look forward to the next two weeks—the time here is flying and pretty soon I’ll be hopping on a plane back home!
I cannot believe I have already been in Uganda for 6 weeks!
My first week in Kampala was great. I got to meet with Dr. Lwasa from Makerere University (and a member of my doctoral committee) in person! I also had a chance to catch up with Jamen and Grace key Indigenous Health and Adaptation to Climate Change team members.
After getting all the logistics and planning out of the way with Jamen and Grace, I made my way down to Buhoma (with a token stop at the equator!). Upon arrival in Buhoma I met with key collaborators at Bwindi Community Hospital, the Batwa Development Program, and Dr. Scott Kellermann (the founder/funder of both organizations). I am so lucky that I get to work with such amazing partners and see the changes they are making in the lives of those who live in their communities!
For the past few weeks I have worked with Charity and Seba to enroll 10 women in a qualitative interview study lasting 3 months. So far we have met with each woman at least twice. These are going so well, much better than I had anticipated. All the women are so thoughtful, articulate and engaging.
We have also identified and contacted all health center IIIs, IVs and Hospitals in the District. We have conducted interviews with midwives and maternal health at 8 centers so far. It has been an amazing opportunity to meet with many different people and see so much of Kanungu District.
Next week I am expecting Nia, Grace and Phiny to join me!
Maternity ward with bed nets at a Health IV
Kitariro Women’s craft and gathering place
Batwa woman looking showing us her fields
Charity demonstrating a birthing position
Goat stew at community lunch
ANC day at a Health Centre IV
Originally posted here
Written by Mackenzie Wilson, MPH student, University of Guelph
After six weeks spent in Buhoma, I have arrived back in Kampala. Reflecting on my time in Buhoma, it feels like a whirlwind of meeting new people, incredible learning experiences and long, busy days of research! It is hard to believe the bulk of the field work is done and I am beginning to wrap up my time in Uganda. In total, I conducted 8 focus group discussions in different communities within Kanugu District, including both Batwa and Bakiga women, concerning their perspectives and experiences surrounding antenatal care. Beyond this, I coordinated and carried out 3 key informant interviews with individuals working at different health care facilities in the district. I had not previously had experience leading focus group discussions or interviews, but with the help of my supervisor, I learned quickly and improved with each successive discussion. Interacting with the women, listening to their perspectives and thoughts surrounding antenatal care and nutrition, which often inevitably extended beyond these topics, was both an emotional and enlightening experience.
Having spoken to numerous women and learning of the predominant concerns they held, the importance of sharing my preliminary findings became more apparent. The bridge between research and practice is not always one that is easily navigated, but our research team wanted to ensure the work being done was shared in a timely manner with those who could use it to create an immediate impact. Given time did not permit a complete analysis of the findings, a presentation was compiled highlighting some of the preliminary trends from both the maternal health survey and focus group discussions being conducted. The presentation was delivered to hospital staff at Bwindi Community Hospital, the hospital which we were working alongside. I also had the opportunity to discuss my findings in more depth with the head of antenatal care at the hospital. We brainstormed and bounced ideas back and forth about strategies to overcome the barriers that were presented in the focus group discussions and possible ways forward. Now, in Kampala, only a few meetings remain with our contacts at Makerere University and the Ministry of Health to summarize our time in Buhoma and to disseminate some of the initial findings.
While I have had the opportunity to conduct focus groups and gather research for my prospective practicum project, this has not gone without the opportunity to explore. While in Buhoma, I had the chance to go gorilla trekking, spend a few evenings at the fancy lodges surrounding Bwindi Impenetrable National Park and hiked Mount Sabyinyo. Although not a necessity of my work here, these small adventures and relaxing evenings served as good mental health breaks as the research and cultural differences experienced while here could be taxing. Though my time in Uganda is quickly coming to a close, my return to Canada will not be indicative of the end of my practicum. I will be trading in the rolling green hills of Southwestern Uganda for a library cubicle in which I will compile my findings in a report with the hopes of publication, but more practically, in a format that can be sent to key stakeholders in Uganda.
Originally posted here
Written by Mackenzie Wilson, MPH student, University of Guelph
For my practicum project, I have come to Uganda to conduct research on maternal health, focusing on that of the Batwa in Southwestern Uganda. The project will examine how national recommendations for nutritional antenatal care are being implemented at the community level by health care facilities (Bwindi Community Hospital) to elicit understanding and compliance in the women receiving care. Through this, the project aims to understand national, community and individual levels of maternal nutritional care. Using qualitative data obtained through focus group discussions and key informant interviews, the objective of the project is to improve efficiency and delivery of necessary nutritional antenatal care as well as improving other areas of maternal nutrition services in the region.
I left Canada on April 16th, and since have spent two weeks in the city of Kampala, and just recently arrived in Buhoma. This is the home base from which the research for my project will be conducted. During my time in Kampala, I worked with research partners the University of Guelph had previously established, and began to network with individuals with an expertise in Maternal Health and Nutrition. I met with individuals from Makerere University and the Ministry of Health. My experience in Kampala was incredible, I was amazed at the ability to quickly connect with influential individuals, and I became excited at the potential for my project, envisioning the impact it could have with the connections in the Ministry of Health I had formed. While I’ve gained a breadth of insight working with key actors in Maternal Health in Uganda, this has not been without experiencing the intricacies of conducting research. During these first few weeks a research plan was formulated, ethics approval was obtained and translations were made of the necessary documents.
This past week has been filled with preparations for the larger survey that is being administered, as well as my individual project. I met with key individuals at Bwindi Community Hospital to understand their interests in Maternal Health and Nutrition, and how we can best align our research to facilitate a positive outcome for all those involved. I am looking forward to moving forward with the project in the weeks to come!