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Steven Ndugwa Kabwama
BSc. (Food Science & Technology) (Mak), MSc PH (SDU),
+256753024727
snkabwama@gmail.com, skabwama@musph.ac.ug
Host Mentor
Dr. Sheila Ndyanabangi
Principal Medical Officer,
Mental Health and Substance Abuse, Ministry of Health
Academic Mentor
Dr. David Guwatudde
Associate Professor, Makerere University School of Public Health |
ABOUT THE FELLOW
Steven Ndugwa Kabwama, holds a BSc in Food Science & Technology and MSc Public Health. He previously worked on several value-chain enhancement projects. For example he worked as a Project Facilitator with Save the Children & JOBS International in Nakasongola District, Uganda, which aimed at improving nutrition, food security and farmers’ incomes through establishing food-based micro-enterprises.
He later worked as a Research Assistant at the Presidential Initiative on Banana Industrial Development which aimed at improving the livelihoods of farmers involved in the banana value chain. In 2011, he was the recipient of the Danish State Scholarship at the University of Southern Denmark to pursue his MSc Public Health (Global Health Specialization).
After completing the degree, he was hired to work as a Research Assistant at the University of Southern Denmark, where he was an instructor and tutor for advanced epidemiology and applied biostatistics. He was also a course coordinator for the introductory course in epidemiology and biostatistics for new students. From the work he did there, he published a paper on the association between HIV/AIDS related knowledge and perception of risk for infection. Steven’s interest is quantitative analysis and translation of data into information.
Achievements at the host site
Steven was based at the Mental Health and Control of Substance Abuse section, Ministry of Health for his field placement. The section is involved in activities related to policy formulation on mental health and control of substances of abuse such as tobacco, alcohol and other substances.
- Coordinated drafting of the Uganda Alcohol Control Policy and Alcohol Control Bill. This entailed the coordination of the inputs of various stakeholders and ensuring that the policy is furnished with latest data and statistics on alcohol use and its effects in Uganda.
- Participated in drafting of the regulations to guide the implementation of the newly passed Uganda Tobacco Control Act 2015.
- Analyzed national survey data on alcohol and tobacco use. The data on alcohol use were added to the Alcohol Control Policy while the data on tobacco use will be added to the Tobacco Control Policy and the Tobacco Control Strategic plan. From this work, Steven has published two papers in peer reviewed journals: the alcohol paper in Global Health Action, and the Tobacco paper in BMC Tobacco Induced Diseases. From this work he also presented a paper at the National Field Epidemiology conference 2016.
- He analyzed data from the Global Adult Tobacco Survey.
Steven also won a TEPHINET Non-Communicable Diseases mini grant which he used to implement his final project. The project was a baseline survey about the attitudes, awareness and practices related to the Uganda Tobacco Control Act 2015. This project was embedded into a bigger project to assess compliance with Uganda’s Tobacco Control law in hospitality establishments in Kampala. Findings from this project were disseminated to civil society organizations and other partners involved in tobacco control to inform implementation of the new law.
Program specific achievements
Steven was involved in a number of outbreak investigations and response.
- Led in investigating a large typhoid outbreak that affected Kampala and neighboring districts in 2015. From the investigation, he prepared an abstract that was presented at the EIS Conference in Atlanta 2015. From this work, he led the drafting of a manuscript that was peer reviewed and published in BMC Public Health journal.
- Led in investigation of a mysterious bleeding illness in Hoima and Buliisa Districts. From this work he developed an abstract that was presented at the AFENET conference in Abuja, 2016, and again at the 2nd National Field Epidemiology Conference 2016. From this work still, he developed a manuscript that was reviewed, cleared and submitted to PLoS One for publication.
- PHFP FETP-2015/2017 Summary Report of Fellows’ Achievements 6 Public Health Fellowship Program Leadership For Health to assess compliance with Uganda’s Tobacco Control law in hospitality establishments in Kampala. Findings from this project were disseminated to civil society organizations and other partners involved in tobacco control to inform implementation of the new law. Program specific achievements Steven was involved in a number of outbreak investigations and response.
- Led in investigating a large typhoid outbreak that affected Kampala and neighboring districts in 2015. From the investigation, he prepared an abstract that was presented at the EIS Conference in Atlanta 2015. From this work, he led the drafting of a manuscript that was peer reviewed and published in BMC Public Health journal.
- Led in investigation of a mysterious bleeding illness in Hoima and Buliisa Districts. From this work he developed an abstract that was presented at the AFENET conference in Abuja, 2016, and again at the 2nd National Field Epidemiology Conference 2016. From this work still, he developed a manuscript that was reviewed, cleared and submitted to PLoS One for publication.
- Led an evaluation of the Acute Flaccid Paralysis surveillance system for the districts in Uganda bordering South Sudan. The rationale of the evaluation was because there have been previous importations of Wild Polio Virus from neighboring countries into Uganda, porous borders and the insecurity in South Sudan.
- He also led the investigation of an outbreak of Rift Valley Fever virus in Kabale District in Southwestern Uganda.
He wrote a newspaper article about why the government was right in passing a law banning the smoking of Shisha. The article was published in The New Vision on August 11 2015.
Planned Study Summary: Awareness, Attitudes and Current Practices Related to Uganda’s Tobacco Control Act 2015 in Restaurants and Bars in Kampala City – Findings from a Baseline Survey
Introduction: On 19 September 2015 the President of Uganda signed the Tobacco Control Bill 2014 into the Tobacco Control Act 2015. This study sought to assess attitudes and awareness about the Act and current practices related to tobacco use and tobacco smoke exposure in public places prior to implementation to provide baseline information for assessment of impact.
Methods: The study involved 216 interviews and observations from 218 randomly selected establishments around Kampala City. A structured questionnaire was used to guide observations and interviews.
Results: 61.5% of respondents were either unaware about the law or had a misconstrued message and 72.3% didn’t know it required them to make establishments 100% smoke-free. Among respondents that self-acknowledged having sufficient information, 70.2% got it from media such as Radio, TV and print media. 39.4% agreed that the law would lead to financial losses and 37.9% felt clientele loss would hamper implementation. In 50% of establishments, tobacco products were allowed to be smoked on premises and 63% of these had designated smoking zones. 26.6% had in-door smoking and 39% had smell of tobacco smoke on premises. 11% had visible tobacco promotion and sponsorship signs.
Discussion and Conclusions: Although the new law has come into force, the public is still not very aware about it. For it to achieve its objectives, it needs to be disseminated especially through media to people to know what’s required of them. Also, business owners’ fears of economic consequences of enforcing the law need to be allayed. It’s meant to promote public health and economic losses (if any) are small compared to the disease burden from inhalation tobacco smoke. The Act bans designated smoking zones and the public needs to be educated on their ineffectiveness in protection against tobacco smoke exposure. No-smoking signs deter initiation of smoking where it is prohibited and the public should be encouraged to institute them. Owners of public places need to be educated on the meaning of a public place being 100% smoke free and the banning of tobacco advertising, promotion or sponsorship as stipulated in the law.
Lessons learned over the duration of the fellowship and next steps
- Steven acquired skills in outbreak investigation, control and response. Specific skills he acquired include the formulation of proper case definitions, analysis of line-list data to generate testable hypotheses and the development of analytical studies to test hypotheses.
- He also learnt how to utilize outbreak investigation findings to inform public health action. Steven acquired skills in policy analysis and policy development. These are skills he acquired as he worked on the development of the alcohol policy and engagement in the development of regulations to guide implementation of the Tobacco Control Act 2015. He also acquired skills in data analysis. Steven had to analyze national data on alcohol and obacco use.
- He analyzed data from the WHO STEPS survey and the Global Adult Tobacco Survey. He generated information that was added to the alcohol and tobacco control policies that were being developed by the program. Steven also acquired skills in scientific writing. From the survey data he analyzed, he wrote two papers that were submitted and published in peer reviewed journals. He also learnt how to write and coordinate with other researchers while writing.
- In addition, he also acquired skills in the critical review of scientific content. He also gained skills in scientific oral communication. From the presentations he made at national and international conferences, he acquired skills in scientific oral presentation. His next step is to grow a career as an epidemiologist where he will be able to use data about the distribution of disease in order to inform public health interventions.
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