Centre for Public Health and Health Systems

Our research aims for excellence and impact, with a focus on continuing the research themes of our existing partnerships: community engagement, health promotion and prevention, and primary care through investing in teaching, research training and placement opportunities.

Public Health aims to build the academic, research and employability capacity of students. We provide opportunity for knowledge sharing among junior and senior academic staff; and enthuse and propel junior researchers to become experts to tackle future global health challenges - particularly through the development of both primary health care and the community development workforce globally. This will allow NTU to develop a more diverse and broader range of research, learning and teaching opportunities for students and staff from overseas and the UK.

One of the five ambitions of the 2015-2020 strategy at NTU is Connecting Globally by providing support for internationally competitive and visible research activities; developing a number of key research programmes which are aligned to real-world needs and challenges and which harness multidisciplinary expertise across and beyond NTU.

Central to our partnership is a multidisciplinary approach which embraces diversity in research and personnel. Through this multidisciplinary approach, our work is designed to integrate recognised innovative approaches to global issues in order to inform policies and practice.

Our success, so far, demonstrates that deep and trusted partnership builds and sustains long term collaborations with global South Higher Education Institutions (HEIs) which allows sharing and integration of best practices in teaching and research; facilitating future collaborative research and development project opportunities; and raising the internationalisation and modernisation profiles of our institutions.

Over the last eight years, we have had a formal collaboration between Nottingham Trent University’s School of Social Sciences in the UK and Makerere University School of Public Health (MakSPH) in Uganda. The focus of our collaboration is on training, community service, research and capacity building in Uganda and UK.

The collaboration between the 2 universities has developed their work under two Memorandums of Understanding (MoUs) since 2012, and been well supported by both Schools and the respective Deans. Our partnership has been successful in enhancing existing research environments at both institutions and delivering significant research grant capture.

The collaboration with Makerere University (MAK) in Uganda  was expanded following the signing of a University-wide Memorandum of Understanding (MOU) between the two institutions on Friday 4th May 2018.  Further connections have been made in the areas of Law and Gender Studies, and it is hoped that the expansion of the MOU will now help facilitate further research links across the University

The NTU – MakSPH collaboration specific achievements include:

• supported 5 MA Public Health students from NTU in their research / primary data collection including 2 who did their three month placement at MakSPH in 2016 and 2017;
• supporting collaborative visits of staff and students- so far, we have had over 10 guest seminars among students / faculty at NTU and MakSPH; no students from MakSPH have been able to travel to the UK however.
• supervision of 1 NTU PhD student which is ongoing (2016-2019, where the data will be collected in Uganda);
• organised an international symposium on community health workers and the sustainable development goals in Uganda (http://chwsymposium.musph.ac.ug/)  with THET / DFID funding. The conference was attended by over 450 participants from 22 countries in February 2017. 100 abstracts from this symposium were published in BMC Proceedings Journal (https://bmcproc.biomedcentral.com/articles/supplements/volume-11-supplement-6)
• best poster award at the THET conference in London in October 2016 that the partners attended together;
• participation in the Health Systems Global Conference in Vancouver, November 2016 which included post graduate students; we are planning to attend the Health Systems Global Conference in October 2018 in Liverpool;
• a publication in Globalization and Health in 2016 describing our work (https://www.ncbi.nlm.nih.gov/pubmed/27036632) and the second Masters student to undertake her dissertation research in Uganda has just published her work  in Globalisation and Health, January 2018. (https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-018-0326-0
• NTU supports the Makerere University Environmental Health Students’ Association (MUEHSA) in Uganda student conferences through staff and Dean support
• contributing to the THET policy paper In our Mutual Interest 2017
• NTU will be supporting MakSPH in hosting in 3rd International Federation of Environmental Health (IFEH) Academic and 16th MUEHSA Annual Scientific Conference to be held in Kampala in April 2019.

The collaboration’s funded research activities have been mainly under the Health Partnership Scheme (HPS) funded by the UK Department for International Development (DFID) through the Tropical Health Education Trust (THET). Our current research project on working with community health workers in Wakiso district Uganda with a focus on training, supervision and motivation, has been successful and has recently been awarded additional funding to promote sustainability, scale-up and access in Uganda.

Our previous THET supported Health Partnership Scheme (HPS) project was in one sub county (Ssisa - 94,238 population) in Wakiso district. However, the current project is supporting CHWs in 3 additional sub counties of Kasanje (29,008 people), Katabi (105,669 people) and Bussi (15,827 people) therefore the reach of our work has greatly expanded. Bussi sub county is made of small islands on Lake Victoria with limited access to health facilities therefore supporting this community in enhancing health of the population. Such island communities have been shown in national surveys to have worse health indicators than mainland areas across the country.

Our interactions with members of the Wakiso district health team showed that they were extremely pleased that the successful work implemented in Ssisa was to benefit other sub counties in the district. Indeed, the District Health Officer and his colleagues were happy that the new sub counties were to benefit from training, supervision, non-financial incentives, and motorcycles to enhance their transport. The projects forthcoming activity of health promotion among groups of women and people with disability has also been appreciated by various national and local stakeholders including the Ministry of Health.

This is because these groups are often neglected hence services of CHWs (and other health workforce) not reaching them. Given that the project has involved 510 CHWs, their services are expected to have a wider reach in Wakiso district especially among the rural populations in these areas. Indeed, the inhabitants of the rural communities greatly benefit from services of CHWs given that they are usually poor hence cannot afford to seek health care from private health facilities. In addition, there are few public health facilities in these communities therefore transport challenges in seeking health care are profound. Therefore, CHWs in such poor communities greatly support the health system.

We have also attracted other substantial funding through the:

• British Academy International Partnerships and Mobility grant (September 2016 –December 2017) for joint seminars on reverse knowledge innovation in the Sociology of Global Health and Development in collaboration with the University of Ouagadougou in Burkina Faso, MakSPH, Uganda and Wolaita Sodo University in Ethiopia;
• As a collaborative partner with MakSPH and 3 other countries (Belgium, France, South-Africa) through EU Horizon 2020 Framework Programme Jan 2017-December 2021:  Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research (SPICES Project ID:  SEP-210347333) to tackle cardiovascular diseases and its risk factors.

We are currently awaiting decision on an application to the Erasmus Plus International Credit Mobility (ICM) Fund, which will build on our existing partnership by embedding staff and student mobility systematically in our partnership activities. This is key for bi-directional knowledge transfer as it will establish the framework and exemplar model for future commitment and investment from both institutions and sector beneficiaries. Thus, enabling sustainability of our partnership and expansion of our networks.

This mobility credit will enable the generation of capacity and capability in critical and primary research and data that will impact the Ugandan Health Plan with reference to primary healthcare systems providing Ugandan and UK expertise to be developed for working in low income settings, and meeting the public health challenges such as high burden of communicable and non-communicable diseases, both at this time and in the future.

The desired impacts on our students is to enhance their research capacity and professional development. For our staff, the mobility would improve their professional development, strengthen our partnership and expand our networks. This will enable NTU and MakSPH to advance our partnership activities around strengthening primary health care systems in Uganda; and foster knowledge sharing to influence primary care practices in the UK. Through our publications and other dissemination activities, outcomes from this mobility have the potential to inform global policy and practice.

This exemplar and newly established training and mobility framework will provide for the development of the research capacity and the opportunity for international comparative work to be undertaken, in particular through the exchange of staff and students in the UK (NTU) and Uganda (MakSPH). In particular, we will measure and explore the students’ experiences during their time at NTU and MakSPH that will help towards future exchange. We will also continue to evaluate the partnership between the two institutions through ongoing engagements with students and staff of NTU and MakSPH.

Makerere University (Mak), the oldest and largest university in Uganda, has developed a strong long-term strategic Plan from 2008/09 – 2018/19. This plan indicates the importance of internationalisation as a core function of the university that is essential in achieving stronger primary care health systems, and enabling Uganda’s Strategic National Health Plan. Internationalisation at Mak is therefore fully supported by the university management, with an existent international office. NTU’s existing partnership with Makerere University School of Public Health (MakSPH) is a vibrant example of NTU’s strategic plan in practice which is informed by, and responds to, local priorities in Uganda through our key research areas: community engagement; health promotion and prevention; and strengthening primary health care systems.

Through support from NTU as part of the Connecting Globally Strategy outward Master’s student mobility (5 students) has been achieved mainly through the placement module, Professional Practice in Public Health and Dissertation modules on the MAPH at NTU and the impact on their learning has been profound and led to one student undertaking a PhD and publication.  Dr Gibson and Dr Musoke (partnership leads at both institutions) exchange learning and teaching activities when research or School funding has enabled this.

• School of Public Health, Makerere University, Kampala, Uganda
• Tropical Health Education Trust (THET) Grants (Awarded 2017 (x2), 2016, 2014, 2012)
• c3 Collaborating for Health
• University of Ouga2, Burkina Faso
• University of Minnesota, Duluth, College of Education and Human Service Professions
• Mount Kenya University, Nairobi, Kenya;
• Strathmore Business School, Nairobi, Kenya
• United States International University, Nairobi, Kenya
• University of Malawi, Faculty of Social Sciences, Chancellors College

• THET Scale Up & Sustainability Grant, December 2017-December 2018 £119,712.08 Strengthening the Community Health Worker programme for health improvement in Wakiso District, Uganda.  Lead PI
• Horizon 2020 SPICES Project (Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research ): to evaluate the impact of a comprehensive CVD prevention and control program on the livelihood of patients and their households in five settings: a rural & semi-urban community in a low-income country (Uganda), middle income (South Africa) and vulnerable groups in three high-income countries (Belgium, France and United Kingdom) as well as identify and compare the barriers and facilitators of the intervention across the different study contexts Lead PI for: Health Promotion and Prevention  Work Package; and Dissemination Strategy; £512,082. Lead of consortium Professor Hilde Bastien, University of Antwerp January 2017-December 2021
• THET (Tropical Health Education Trust) APL14 Sustainability & Scale Up Grant Dec 2017-December 2018 £119,712.08
• NTU Global Strategic Partnerships Fund East Africa Hub, January 2018- July 2018 £5,000
• NTU Global Strategic Partnerships Fund East Africa Hub, January 2017- July 2017 £4,412.
• British Academy International Partnerships & Mobility Grant, September 2016 –December 2017, £8752 Collaboration for reverse innovation within the knowledge base of the sociology of global health and development   Joint seminars on reverse knowledge innovation in the Sociology of Global Health and Development in collaboration with the University of Ouagadougou in Burkina Faso, MakSPH, Uganda and Wolaita Sodo University in Ethiopia.
• THET Knowledge & Sustainability Grant Sept 2016-March 2017 £9,954.06  3-day symposium Contribution of Community Health Workers in attainment of the Sustainable Development Goals. This symposium was held in Kampala part funded by THET. Lead PI
• THET Health Partnerships Scheme Grant 'Strengthening the Community Health Worker programme for health improvement in Wakiso District, Uganda'  November 2014- March 2017 £166,440. Joint Project with School of Social Sciences (Public Health) NTU, School of Public Health, Makerere University Kampala, Uganda, Ministry of Health, Uganda and c3 Collaborating for Health, London. Lead UK PI
• ‘Increasing the uptake of Bowel Cancer Screening in Black and Minority Ethnic (BME) communities in Nottingham City – an exploratory study’; Co-Investigator with Dr Jason Pandya Wood, Dr Jatinder Sandhu, Prof. Jennie Fleming and Yesmean Khalil for Nottingham City CCG April- December 2014 £15,000
• Invited and funded to Participate in the PACE-Net+ Bremen Conference and Think-Tanks (around tackling Non-Communicable Diseases) from 9-11 September 2015. The conference brought together selected international experts to identify and update priority and innovation areas for future joint EU-Pacific cooperation and activities.

Current PhD Projects

DOS

• Scaling-up Sustainable Models of Community Interventions and Outcomes for CVD Health Promotion and prevention   2018-2021 currently appointing Funded by Horizon 2020 SPICES Project
• Cultural and health beliefs as a causative factor for diabetes management: Black-African community in the UK 2015-2018 Completed successfully July 2018 Dr Damilola Oyewole
• Identifying the barriers to a strategic joint approach for the implementation of multilevel cancer interventions in Africa. 2016-2019 Deborah Ilaboya
• Exploring factors influencing healthcare policy development and implementation as a driver in achieving patient safety in Nigeria.2015-2018 Pauline Odeyemi

Second Supervisor

• The impact of Islamophobia on the socio-economic experiences and health outcomes of Muslim communities in the UKI 2016-2019 Yesmean Khalil
• Developing a frame-work of patient safety in Kurdistan (North-Iraq): The role of regulation and its enforcement" joint supervision with Law School.

• Ilaboya, D., Gibson, L., Musoke, D. ‘Perceived barriers to early detection of breast cancer in Wakiso District, Uganda using a socioecological approach’ Globalization and Health 2018 14:9 Published 23 January 2018
• Gibson, L.,  Mukama, T. Musoke, D., Ndejjo, R.,  Ssemugabo, C. Abstracts from the 1st International Symposium on Community Health Workers  BMC Proceedings 2017 11(Suppl 6):10  Published on: 19 September 2017
• (https://bmcproc.biomedcentral.com/articles/supplements/volume-11-supplement-6
• Musoke, D., Gibson, L., Mukama, T., Khalil, Y. Ssempebwa, J. ‘Nottingham Trent University and Makerere University School of Public Health Partnership; experiences of co-learning and supporting the healthcare system in Uganda’ Globalization and Health Jan 2016 12:11

Invited Speakers / Conferences

• Invited keynote speaker at the Uganda / UK Health Alliance  UK East Africa Health Improvement & Investment Summit ‘Scale Up And Sustainability of a Health System Strengthening Programme in Wakiso and Districts in Uganda Using a Partnership Approach’ 23rd March 2018 (See Report  page 19 http://ukeastafricasummit.uukha.org/wp-content/uploads/2017/10/summit%20report%20small.pdf)
• Invited Panel Chair and Lead on session ‘Professional Practice in Low resource countries ’THET Annual Conference, London October 2017
• International symposium on community health workers and the sustainable development goals in Uganda (http://chwsymposium.musph.ac.ug/)  with THET / DFID funding. The conference was attended by over 450 participants from 22 countries in February 2017.
• Gibson,L.’ Community Development and Patient safety’ SymHealth2017International Conference onHealthcare in a Globalizing World(Enriching Healthcare Delivery through an Interdisciplinary Approach) Invited Keynote Speaker Symbiosis University, Pune, India May, 2017
• Gibson, L.  Resilient and responsive health systems for a changing world  ‘Challenging the Structural Determinants of Health to enable resilience in primary healthcare systems Conference paper HSR2016 Fourth Global Symposium on Health Systems Research Vancouver, November 2016
• David Musoke1, Linda Gibson 2, TrasiasMukama T 1 , Charles Ssemugabo1 , RawlanceNdejjo1&Yesmean Khalil  Experiences of strengthening the Community Health Workers programme for health improvement in Wakiso district, Uganda Poster Presentation THET Annual Conference, October 2016 Winner of Best Poster Award
• Gibson, L.  ‘Community mobilization & Engagement in the context of Uganda: lessons learned, reverse learning’ Staff Seminar, Partnership Visit, Department of Applied Human Sciences, University of Minnesota, Duluth, USA Sept 2016
• Gibson, L. ‘'Strengthening the Community Health Worker programme for health improvement in Wakiso District, Uganda' : Learning Points’ Invited THET Webinar Presentation, March 2016
• Musoke, D., Gibson, L. 'Strengthening the Community Health Worker programme for health improvement in Wakiso District, Uganda'THET Annual Conference September 2015
• Gibson, L ‘Global Health Agendas: Upstream/Downstream Journeys’ ’ Master in Public Health, Invited Guest Seminar Department of Social Work, University of Ravensburg Weingarten, July 2015
• Gibson, L. Challenging the structural determinants of health to enable resilience for our communities Makerere University Environmental Health Student Association (MUEHSA) 12th Annual scientific conference April,2015 Invited Keynote
• Gibson, L. ‘21st Century Health Dynamics: Understanding the Millenium Development goals in Practice’ Master in Public Health, Invited Guest Seminar Department of Social Work, University of Ravensburg Weingarten, July 2014
• Gibson, L.  ‘Building a rights based movement for health in the UK: Partnerships, agendas and co-development.’ A case study of People’s Health Movement UK Guest Seminar Centre for Primary Care, Institute of Population Health, University of Manchester, June, 2014
• Gibson, L. Social Justice in Global Health: science & technology and/or social relations? Master in Public Health, Invited Guest Seminar Department of Social Work, University of Ravensburg Weingarten, July 2013