Positioning Africa's public health doctoral students to lead societal transformation and development.

The public health context is becoming increasingly more complex requiring highly trained professionals equipped with knowledge, competencies and tools to address or transform current and future challenges. Doctoral degree training offers an opportunity to build the capacity to detect and respond to such dynamic health challenges. In this paper, we discuss how Africa's public health doctoral students can be better positioned for the different career pathways to provide leadership on complex health and development challenges. Public health PhD graduates can take up careers in academia, civil service, private sector and civil society, among others. To thrive in these pathways, PhD training should equip them with knowledge, skills and competencies in leadership, creativity and social competence among others. To produce career-ready PhD graduates, there is need to rethink training curricula to build critical skills for diverse career pathways, introduce students to entrepreneurship, and enhance linkages between universities and industry. Experiential learning, exposure to networks and partnerships, postdoctoral programmes and mentorship and exchange programmes can further equip PhD students with key knowledge, skills and competencies. For students to position themselves for the different careers, they ought to plan their careers early, albeit with flexibility. Students should build their soft skills and embrace technology among other transferable competencies. By identifying potential career pathways and being positioned for these early, Africa can produce transformative PhD students on a path for success not just for themselves but for society at large, including in new environments such as that created by COVID-19.

Prevalence and determinants of occupational Injuries among welders in small scale metal workshops in Wakiso District, Uganda.

BACKGROUND: Injuries are a public health concern accounting for 2.78 million fatalities globally. Welders are exposec to a broad range of injuries (e.g. cuts, burns, eye injuries, skin irritations, and musculoskeletal disorders) and yet, there is paucity of information on context specific determinants to inform injury prevention and control. This study determined the factors associated with occupational injuries among welders in Uganda. METHODS: A cross-sectional study was conducted among welders in Wakiso District, Uganda. Pretested and translated questionnaires were used to collect data from 327 randomly selected respondents using face to face interviews. 2 parishes were purposively selected, and 20 metal workshops were systematically selected in each parish. Descriptive statistics and adjusted odds ratios were computed. RESULTS: A high prevalence 287 (87.8%) of self-reported occupational injuries was found among welding workers with cuts/burns 242 (84.3%) and eye injuries 180 (62.7%) reported as the most sustained injuries. Occupational injuries were associated with being a causal labourer with informal training (AOR 4.70 (2.03-10.84)) and working for longer hours (AOR 2.63 (1.26-5.51)). Those with more work experience were less likely to be involved in occupational injuries (AOR 0.30 (0.11-0.84)). CONCLUSIONS: The prevalence of occupational injuries among small-scale welding workers was high and this was associated with learning their trade at work and working for longer hours. Mitigation measures that focus on safety at workplace, advocating for capacity training, and enforcement of workplace regulations should be instituted.

State of pedestrian road safety in Uganda: a qualitative study of existing interventions.

BACKGROUND: Pedestrians in Uganda account for 40% of road traffic fatalities and 25% of serious injuries annually. We explored the current pedestrian road traffic injury interventions in Uganda to understand why pedestrian injuries and deaths continue despite the presence of interventions. METHODS: We conducted a qualitative study that involved a desk review of road safety policy, regulatory documents, and reports. We supplemented the document review with 14 key informant interviews and 4 focus group discussions with participants involved in road safety. Qualitative thematic content analysis was done using ATLAS. ti 7 software. RESULTS: Five thematic topics emerged. Specifically, Uganda had a Non-Motorized Transport Policy whose implementation revealed several gaps. The needs of pedestrians and contextual evidence were ignored in road systems. The key programmatic challenges in pedestrian road safety management included inadequate funding, lack of political support, and lack of stakeholder collaboration. There was no evidence of plans for monitoring and evaluation of the various pedestrian road safety interventions. CONCLUSION: The research revealed low prioritization of pedestrian needs in the design, implementation, and evaluation of pedestrian road safety interventions. Addressing Uganda's pedestrian needs requires concerted efforts to coordinate all road safety activities, political commitment, and budgetary support at all levels.

The state of emergency medical services and acute health facility care in Uganda: findings from a National Cross-Sectional Survey.

BACKGROUND: There is limited information on the state of emergency medical services (EMS) in Uganda. The available evidence is from studies that focused on either assessing EMS capacity and gaps at the national level especially in Kampala or identifying risk factors for specific emergency medical conditions (e.g., injuries). In this study, we sought to provide a snapshot of the state of EMS in Uganda by assessing the pre-hospital and hospital emergency care capacity at both national and sub-national (district) levels. METHODS: We conducted a cross-sectional national survey administering structured questionnaires to EMS providers and policy makers from 38 randomly selected districts across seven of the 14 health regions of Uganda. This resulted in a study sample of 111 health facilities and 52 pre-hospital service providers. We collected data on six pillars of EMS whose frequencies and percentages were calculated and qualitatively compared for different levels of the health care system. RESULTS: At the time of this study, Uganda did not have any EMS policy or guidelines. In addition, there was no functional toll-free number for emergency response in the country. However, Ministry of Health reported that a taskforce had been set up to lead development of EMS policy, guidelines, and standards including establishment of a toll-free emergency number. At the sub-national level, ambulances lacked the products and supplies needed to provide pre-hospital care, and mainly functioned as emergency transport vehicles, with no capacity for medical care. Only 16 (30.8%) of the 52 pre-hospital providers assessed had standard ambulances with required equipment, medicines, and personnel. The rest of the service providers had improvised ambulances that were not equipped to provide pre-hospital care. Traffic police and bystanders were the first responders to the majority (> 90%) of the emergency cases. CONCLUSION: Our findings reveal weaknesses at every level of what should be a critical component in the health care system - one that deals with the ability to treat life-threatening conditions in a time sensitive manner. The Ministry of Health needs to speed up efforts to provide policies and guidelines, and to increase investments for the creation of a functional EMS in Uganda.

Estimating the burden of road traffic crashes in Uganda using police and health sector data sources.

BACKGROUND: In many low-income countries, estimates of road injury burden are derived from police reports, and may not represent the complete picture of the burden in these countries. As a result, WHO and the Global Burden of Diseases, Injuries and Risk Factors Project often use complex models to generate country-specific estimates. Although such estimates inform prevention targets, they may be limited by the incompleteness of the data and the assumptions used in the models. In this cross-sectional study, we provide an alternative approach to estimating road traffic injury burden for Uganda for the year 2016 using data from multiple data sources (the police, health facilities and mortuaries). METHODS: A digitised data collection tool was used to extract crash and injury information from files in 32 police stations, 31 health facilities and 4 mortuaries in Uganda. We estimated crash and injury burden using weights generated as inverse of the product of the probabilities of selection of police regions and stations. RESULTS: We estimated that 25 729 crashes occurred on Ugandan roads in 2016, involving 59 077 individuals with 7558 fatalities. This is more than twice the number of fatalities reported by the police for 2016 (3502) but lower than the estimate from the 2018 Global Status Report (12 036). Pedestrians accounted for the greatest proportion of the fatalities 2455 (32.5%), followed by motorcyclists 1357 (18%). CONCLUSIONS: Using both police and health sector data gives more robust estimates for the road traffic burden in Uganda than using either source alone.