Phoebe Nabunya

BEHS (MUK), ADHSM (IUIU), MPH (MUK), MSc
(IHE-Delft) & Advanced Field Epidemiology Fellow
(UPHFP)
Email: bomoda@musph.ac.ug / omobob@gmail.com
Telephone: +256782152194

Host Site: Ministry of Health, Uganda National
Expanded Program on Immunization.

Host Mentor: Dr. Alfred Driwale

ABOUT THE FELLOW

Bob Omoda Amodan holds a Master of Public Health Degree from Makerere University, School of Public Health. Before joining the fellowship program, he pursued another Masters in Sanitation from the Netherlands. Bob has worked with both government and nongovernmental establishments for over 10 years. He has implemented and managed several public health interventions ranging from surveillance, improving institutional and household WASH services, immunization, Nutrition, HIV, neglected tropical diseases, and malaria in Busia, Teso, Karamoja and West Nile sub-regions in Uganda. The practical aspects critically linking the above-mentioned public health programs with epidemiology/ surveillance, and scientific communication were clear gaps exhibited during his career before he joined this fellowship program. The fellowship has made Bob gain advanced outbreak detection and investigation skills, multitasking abilities, policy briefs and funding proposal development, scientific writing, presentation and publication skills, rapid management/leadership and technical capacity building abilities, operational and strategic planning, clear and timely documentation, healthcare systems strengthening, coordination and advocacy skills. Additionally, Bob is proud of the strong research methods, large database management and analysis (Epi info, STATA, SPSS), and GIS mapping skills, among others. Whereas Bob has written and published a number of manuscripts, bulletin, and newspaper articles, he is also a scientific reviewer in PLoS ONE, BMC Public health and Journal of Public health in Africa. In addition, Bob is a very interesting presenter, who has made presentations in both national and international conferences, including NFEC, PEPFAR summit, E. African FETP conference, FETP international Nights, IANPHI webinar and ICEID. Notably, he got a best presenter award in the East African FETP conferences on COVID-19 in November 2020. Bob’s supervisors and peers recognize that he is a hardworking, jolly, outgoing, respectful, and above-all, honest person. He speaks his mind easily, and has very strong team-work and negotiation skills. Following his accomplishments in the fellowship program, Bob has no doubt that he will excel as a Public health specialist and Epidemiologist for enhanced global health security.

  Achievements at the Host Site

The Uganda National Expanded Program on Immunization (UNEPI) is a national program that mainly targets infants and women of childbearing age. Immunization is among the most successful and cost-effective public health interventions in preventing a child from dying before celebrating his or her first birthday. It is a priority intervention within Uganda’s minimum health care package, which directly contributes to the Ministry of Health vision and goal. The program offers the following services:

1. Routine Immunization services which are provided through static (health facilities), outreaches services (strategic community based monthly post).
2. Supplemental Immunization Activities (SIAs) which are organized periodically to interrupt the transmission and spread of diseases like measles or polio eradication and MNT elimination.
3. Accelerated routine immunization.
4. Surveillance and Outbreak responseTo support the role of UNEPI, I was involved in the following:
   • I joined UNEPI during COVID-19 outbreak. One of first roles was participating in the development of the National guidelines for management of COVID-19 in April, and June 2020 revised version.
   • To increase access and demand for immunization services in the country, the fellow took lead in the understanding the Knowledge, attitudes and barrier to uptake of COVID-19 vaccine among Ugandans in February 2021 before the vaccine became available. The findings were presented to the National Risk communication and vaccine committee. It was impactful in such a way that our recommendations were received for inclusion in the Information, education, and communication materials for COVID-19 vaccine. He also wrote two newspaper articles, titled: “Rush for a COVID-19 vaccine when it becomes available to the public” And “Access to vaccines is a human right”. All those articles emphasized that government will provide COVID-19 vaccine and people should demand for the service. This study resulted in written products such as:
   • A report -submitted to the UPHFP.
   • Manuscript titled: “Knowledge, Attitudes and Barriers to Uptake of COVID-19 vaccine in Uganda, February, 2021”. Authors. Bob Omoda Amodan, Patricia Thiwe Okumu, John Kamulegeya, Alex Ndyabakira, Geoffrey Amanya, Daniel Jacob Emong, Aggrey Byaruhanga, Job Morukileng, Alfred Driwale, Alex Riolexus Ario, Julie R. Harris, Under journal review
   • Conference presentation titled: “Knowledge, Attitudes and Barriers to Uptake of COVID-19 vaccine in Uganda, February, 2021”. Presented at FETP international nights on 26 May 2021; at PEPFAR science summit on 11 June 2021; and at The International Association of National Public Health Institutes (IANPHI) webinar on 28 September 2021. To ensure availability of potent and effective vaccines for the public and building EPI management capacity at all levels, the fellow was involved in giving support supervision for COVID-19 vaccination campaigns in Kapchorwa, Terego, Tororo and Soroti districts in between June to December 2021. During this activity, the fellow was involved in giving technical support ranging from cold chain maintenance, microplanning, social mobilizations and demand creation, and administration of the vaccine.
   • Following the isolation of Circulating vaccine derived polio virus in Kampala sewage, national polio campaign was recommended. In this activity, the fellow supported districts of Mbale, Budaka, and Pallisa on Polio vaccination preparedness in December 2021.

    

Fellowship program specific achievements

1. Outbreak investigations and response

The fellow led and participated in several outbreak investigations. First, a measles outbreak was reported in Nakivale refugee settlement, Isingiro district in March 2020. He was asked to co-lead the investigation, which later discovered that the outbreak was due to overcrowding at the reception centre of the refugee settlement.In May 2020, the fellow was involved in the investigation of the first community transmission case of COVID-19 in Masindi district. During this outbreak investigation the findings concluded that the index case could have got the infection from the track drivers since he was always involved police night patrol on the highway. The recommendations for this investigation were presented to the IMT for COVID-19. Indeed, the fellow went ahead to build capacity and manage contact tracing and establishment of a community-based surveillance system using Health Assistants. His experiences in this task are well documented in one of his manuscripts and EPI bulletins. This investigation resulted into written products such as:

• Report, the investigation report was written and submitted to UPHFP
• Epi-bulletin, titled: “Contact Tracing and Community-Based Surveillance for COVID-19 Using Health Assistants, Masindi District, Uganda, May 2020” published in the UNIPH bulletin Volume 5| Issue 4| October – December 2020
• Manuscript, titled: “Contact Tracing and Community-Based Surveillance for COVID-19 Using Health Assistants, Masindi District, Uganda”. Authors: BO Amodan, I Akusekera, G Amanya, J Namayanja, D Kadobera, A Driwale, L Bulage, AR Ario, JR Harris”, Under peer review in JPHA
• Conference presentation titled: “Contact Tracing and Community-Based Surveillance for COVID-19 Using Health Assistants, Masindi District, Uganda”. presented during the East Africa FETPs Conference, November 18, 2020

Makerere University Kampala requested the UPHFP to nominate two fellows to support and coordinate an International Citizen Project (ICP) to assess adherence to preventive measures and their impact on the COVID-19 outbreak in low- and middle-income countries. Bob was asked to lead the project. During this task, he successfully implemented the project, and resulted into the following written products:

• Epi-bulletin, titled: “Level and determinants of adherence to COVID-19 preventive measures in the first stage of the outbreak, Uganda” published in the UNIPH bulletin Volume 5| Issue 3| July – September 2020
• Epibulletin, titled: “Level and determinants of adherence to and satisfaction with use of face masks as one of the COVID-19 preventive measures in the first stage of the outbreak, Uganda” published in the UNIPH bulletin Volume 6| Issue 1| Jan – Mar 2021
• Manuscript, titled: “Level and determinants of adherence to COVID-19 preventive measures in the first stage of the outbreak, Uganda”. Authors: Bob Omoda Amodan, Lilian Bulage, Elizabeth Katana, Alex R. Ario, Joseph N. Siewe Fodjo, Robert Colebunders and Rhoda K. Wanyenze”, published in International Journal environmental research and Public health (IJERPH). DOI: 10.3390/ijerph17238810
• Manuscript, titled: “Level and determinants of adherence to and satisfaction with use of face masks as one of the COVID-19 preventive measures in the first stage of the outbreak, Uganda”. Authors: Bob Omoda Amodan, Lilian Bulage, Elizabeth Katana, Alex R. Ario, Joseph N. Siewe Fodjo, Robert Colebunders and Rhoda K. Wanyenze”, Accepted and yet to be published in Journal interventional epidemiology and Public health (IJIEPH).
• Co-authored Manuscript, titled: “Factors associated with access to food and essential medicines among Ugandans during the COVID-19 lockdown: a cross-sectional study”. Authors: Elizabeth Katana, Bob Omoda Amodan, Lilian Bulage, Alex R. Ario, Joseph N. Siewe Fodjo, Robert Colebunders and Rhoda K. Wanyenze”, Accepted and yet to be published in Journal interventional epidemiology and Public health (IJIEPH). DOI: 10.11604/JIEPH.supp.2021.4.2.1147
• Co-authored Manuscript, titled: “Violence and discrimination among Ugandan residents during the COVID-19 lockdown”. Authors: Elizabeth Katana, Bob Omoda Amodan, Lilian Bulage, Alex R. Ario, Joseph N. Siewe Fodjo, Robert Colebunders and Rhoda K. Wanyenze”, Published in BMC Public health. DOI: https://doi. org/10.1186/s12889-021-10532-2
• Co-authored Manuscript, titled: “Adults’ Acceptance of COVID-19 Vaccine for Children in Selected Lower- and Middle-Income Countries”. Authors: Suzanna Awang Bono, Ching Sin Siau, Won Sun Chen, Wah Yun Low, Edlaine Faria de Moura Villela, Supa Pengpid, Bob Omoda Amodan, Mina C. Hosseinipour, Housseini Dolo, Joseph N. Siewe Fodjo, and Robert Colebunders, Published in Vaccines. DOI: https://doi. org/10.3390/vaccines10010011
• Co-authored Manuscript, titled: “Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low and Middle- Income Countries”. Authors: Authors: Suzanna Awang Bono, Ching Sin Siau, Won Sun Chen, Wah Yun Low, Edlaine Faria de Moura Villela, Supa Pengpid, Bob Omoda Amodan, Mina C. Hosseinipour, Housseini Dolo, Joseph N. Siewe Fodjo, and Robert Colebunders, Accepted and yet to be published in vaccines. DOI: 10.3390/ vaccines9050515
• Conference presentation titled: “Level and determinants of adherence to and satisfaction to COVID-19 preventive measures in the first stage of the outbreak, Uganda”. presented at the 6th National Field Epidemiology Conference, 2020 and the East Africa FETPs Conference, November 18, 2020. The fellow supported an investigation of COVID-19 outbreak among health workers in Abim district in September 2020. The findings indicated that there was a low COVID-19 suspicion index, and poor IPC compliance among health workers, and delayed laboratory turnaround time. In the same month, the fellow led the investigation of scabies outbreak in the same district. During his investigation, he found that the outbreak was associated with overcrowding, inadequate knowledge on scabies prevention and treatment, sharing of bathing materials and bathing in the stream. Recommendations were made to the national task force, and world vision to inform response to the outbreak. The other important outbreak investigations that the fellow led was the COVID-19 outbreak among Indian residents in Buikwe and Bugiri district in April 2021. This investigation found that the outbreak was imported from India, and it was the beginning of the second wave of COVID-19 in Uganda. Whereas the fellow did not do the genome sequencing samples of the cases, this investigation pointed out the likely importation of the Delta variant.

As part of the national response team, the fellow has also been involved in many other disease/ event responses, including:

• Risk mapping, and population movement/connectivity across boarders’ patterns for COVID-19 along the Tanzania and Rwanda borders with Uganda in June 2020
• COVID-19 case data reconciliation and capacity building of surveillance stakeholders in investigation and reporting of COVID-19 in August 2020
• Malaria outbreak detection capacity building of district staff in western Uganda in September 2020
• Assessment to understand experiences, perceptions & attitude towards ANC and iCCM services in Adjumani and Moyo, December 2020
• Understanding the driving factors of malaria deaths at community and facilities in Agago district in May 2021
• Preparedness assessment and population movement/connectivity across boarders’ patterns for Plague along the DR Congo with Uganda in August 2021

2. Epidemiological Study

The fellow conducted an EPI study entitled: “Factors associated with mental and psychosocial wellbeing of healthcare workers in refugee settings during COVID-19 pandemic in Uganda, 2020” from 3 to 17 September 2020.

Background: Uganda hosts over 1.4 million refugees, with over 90% of them coming from South Sudan and Demographic Republic of Congo. Twelve (12) districts of Uganda host refugees. COVID-19 was reported in many refugee settlements. Uganda’s refugee settlements, which hosts 18 quarantine centers were also integrated into local communities. Several of the preventive strategies currently proposed by the WHO such as isolation and social distancing were not feasible or difficult to implement in refugee settlements because of overcrowding and other associated factors. HCWs working in refugee settlements are at high risk of acquiring COVID-19 infection. Moreover, they can transmit the infection while still asymptomatic to patients who are at high risk of severe COVID-19 disease because of underlying diseases or because of old age. It was therefore critical to assess the mental and psychosocial wellbeing of HCWs in order to identify their needs, and provide supportive interventions to reduce the impact of COVID-19 on their psychosocial state.

Methods: The fellow conducted a cross sectional study among Doctors, Clinical Officers, Nurses, Laboratory staff, Health Inspectors, Health Assistants, Public Health Officers, Dentists, Health educators, Radiographers, Counsellors, Records Assistants, Theatre staff, Stores staff and Cleaners in 35 health care facilities from 7 refugee settlements across the country. The primary outcome measure was the mental and psychosocial wellbeing of HCWs during the COVID-19 pandemic, which was assessed using the Hospital Anxiety and Depression Scale for the diagnosis of anxiety and depression.

Results: In total, 346 healthcare workers participated in the assessment, with mean age of 30.5±6.4. Almost half (n=165, 48%) of the respondents were in the age group of 25-29 years, and 144 (42%) were catholics. Among 346 respondents, 174 (50.3%) were female, 188 (54%) were lining with partners, and 105 (30%) were nurses or midwives. In this study the fellow found that A quarter (22%) of the respondents had anxiety, and half (49%) had depression. Overall, over half (55%) of the respndents had either anxiety or depression or both, indicating poor mental and psychosocial wellbeing. There was a significant difference in mental and psychosocial wellbeing in all the 7 refugee settlements (X2=14.18, p=0.03). During multivariate analysis, living far away from HCF (aOR: 2.56, 95% CI: 1.17–5.59), experienced flu in the past two weeks (aOR: 2.42, 95% CI: 1.21–4.82), and giving triage services at health facility (aOR: 2.19, 95% CI: 1.19–4.00) increased odds of having anxiety among healthcare workers. Having workmates who always respected basic rules of handwashing (aOR: 0.08, 95% CI: 0.01–0.47) decreased odds of having anxiety among healthcare workers. During multivariate analysis, not living with partner (aOR: 0.62, 95% CI: 0.39–0.99), and giving clerking services at the health facility (aOR: 0.53, 95% CI: 0.32–0.86) decreased odds of having depression among healthcare workers.During modelling, the crude and adjusted odds ratios of depression among those giving clerking services at the health facility increased by over 10%, indicating that its effects on the outcome was distorted by confounding variables, including having had a running nose. The final model controlled for confounding, and later assessed for interaction on multiplicative scale.The effect of interaction among the statistically significant variables was tested using the sex as the main predictor variable for depression. The tests for interaction indicated there was no statistically significant effect (p>0.05) on depression.

Conclusion: The study recommeded that there was need for healthcare workers to have job rotational

shifts, get accomodation within health facilities, and adopt staying with partners and family memebers to improve on their mental health status. He further recommended that trainings and on job monitoring of IPC should be scaled up, inaddition to having dedicated counselling service provision at the health facility. The mental and psychosocial wellbeing of healthcare workers study among refugees resulted in the following products:

• A report –submitted to the UPHFP.
• Manuscripts, titled: “Factors associated with mental and psychosocial wellbeing of healthcare workers in refugee settings during COVID-19 pandemic in Uganda, 2020”. Authors: Bob Omoda Amodan, Patricia Okumu Thiwe, Lilian Bulage, Daniel Kadobera, Alex Riolexus Ario, Julie R. Harris, under internal review

3. HIV Study Project There was little information known about the birth outcomes experienced by HIV positive pregnant mothers who attended ANC and maternity in Rwenzori sub region between January to December 2020. The fellow therefore established the factors associated with birth outcomes among pregnant women in Rwenzori region, Uganda. The study involved data abstraction from the ANC, maternity and ART registers. This study found that 23% HIV positive mothers had pre-term birth, 6% had still birth, 10% had low birth weight babies, and 5% had intrauterine growth restrictions. Additionally, the study revealed that level or ownership of healthcare facility, type of residence, number of ANC visits, parity, time to ART initiation, current ART regimen, and WHO staging were significantly associated with pre-term birth. The study also indicated that mother’s age, gestational age, number of ANC visits, mother’s weight, and birth weight were significantly associated with stillbirths. Furthermore, mothers age, number of ANC visits, birth weight, and current ART regimen were associated with stillbirths. LASTLY, the study showed that mothers age, residence, and mothers’ weight, was associated with intrauterine growth restriction. The HIV study resulted into written products such as described below:

• A report –submitted to the UPHFP.
• Manuscript, titled: “Birth outcomes of infants born to pregnant women living with HIV in Rwenzori region, Uganda, Jul 2021”. Authors: Bob Omoda Amodan, Job Morukileng, Aggrey Byaruhanga, Peter Ohms Oumo, Daniel Kadobera, Lilian Bulage, Peter Elyanu, Alex Riolexus Ario, Julie R. Harris. Still in first draft.
  4. Descriptive Analysis At the fellowship program, analysis of surveillance data is one of the critical tasks. In this task, the fellow conducted a descriptive analysis titled: “Trends of Key Surveillance Performance Indicators of Acute Flaccid Paralysis, Uganda, 2015−2020”

  Background: Polio (or Poliomyelitis) is disease caused most commonly by wild poliovirus (WPV). Poliovirus infection can cause irreversible paralytic disease, presenting as Acute Flaccid Paralysis (AFP). A sensitive AFP surveillance system, in which AFP cases are evaluated to determine if they are true AFP or non-polio AFP (NPAFP), is key for tracking polio eradication. Sensitivity is defined by meeting an annual NPAFP rate/100,000 population <15 years of ≥4/100,000, and an annual stool adequacy (SA) rate (defined as ≥80% of AFP cases with 2 adequate stool samples collected ≥24 hours apart ≤14 days after onset of paralysis and arriving at the laboratory in good condition). We describe Uganda’s AFP surveillance performance between 2015-2020, based on the WHO-recommended indicators.

  Methods: We performed a descriptive analysis of national AFP surveillance data, 2015-2020. We evaluated proportion of AFP cases reported that were true AFP, and changes in NPAFP and stool adequacy (SA) rate over the study period. We evaluated the trends in achieving the targeted NPAFP and SA rates from 2015-2020. We used QGIS to illustrate patterns in NPAFP and SA rates across districts and subregions.

  Results: Among 3,605 AFP cases reported and investigated countrywide from 2015-2020, 3,475 (96%) were true AFP cases. District reporting was near-complete (97-100% each year). Overall, the mean NPAFP rate changed from 3.1/100,000 in 2015 to 2.1/100,000 in 2020. Less than 40% of districts met the NPAFP target rate in all years. The proportion of districts achieving the NPAFP target rate of ≥4/100,000 significantly declined from 35% in 2015 to 20% in 2020 (OR=0.5; 95% CI: 0.3-0.8). The mean annual SA rate nationally was 88% from 2015-2020. Only 66% of districts achieved the SA target rate of ≥80% in the study period. The proportion of districts with SA rate ≥80% significantly increased from 68% to 80% between 2015 and 2020 (OR=1.9; 95% CI: 1.1-3.4).

  Conclusion: The SA rate was achieved and improved over time from 2015-2020. Most districts reported AFP cases. However, there was a decline in the NPAFP rate from 2015-2020 and few districts achieved the target rate. The suboptimal AFP surveillance system performance leaves the country at risk of missing ongoing poliovirus transmission. The fellow recommended that a further study to understand the causes of suboptimal performance. In addition, he recommended health worker training on active AFP searches, intensified supportive supervision, and periodic review meetings with districts to assess AFP surveillance performance.The descriptive analysis of AFP surveillance data resulted in written products and a Quality Improvement project as described below:

  • A report -submitted to the UPHFP.
  • Poster presentation, titled: “Trends of Key Surveillance Performance Indicators of Acute Flaccid Paralysis, Uganda, 2015−2020” presented the 7th National Field Epidemiology Conference on 29 October 2021.
  • Manuscript titled: “Trends of Key Surveillance Performance Indicators of Acute Flaccid Paralysis, Uganda, 2015−2020”. Authors: Bob Omoda Amodan, Annet Kisakye, Patricia Thiwe Okumu, Sherry Rita Ahirirwe, Daniel Kadobera, Alfred Driwale, Alex Riolexus Ario, Under journal review
  • Epi-bulletin, titled: “Trends of Key Surveillance Performance Indicators of Acute Flaccid Paralysis, Uganda, 2015−2020”, published in the UNIPH Epi-bulletin Volume 6| Issue 2| April – June 2021
  • Quality Improvement (QI) projectThe above descriptive analysis of AFP surveillance data informed the design of the fellow’s quality improvement project, titled: “Improving Acute flaccid paralysis (AFP) surveillance in Pallisa district: June−September, 2021”After the descriptive analysis, Pallisa district was one of the districts that did not met all the key AFP surveillance requirements (i.e. Annualized Non-polio AFP Rate of at least 4 per 100,000 children under 15 years of age and Stool adequacy rate of at least 80%). The fellow thereafter designed a Quality Improvement project that aimed at improving AFP surveillance in Pallisa district from June to September 2021. The fellow aimed at increasing the NPAFP rate from 1.06 to 4 per 100,000; Stool adequacy rate from 33% to 80%; and reporting rate from 50% to 90% between July 2021 to September 2021. The fellow supported the project improvement team to undertake the following sets of activities:

  Conducted a district entry meeting: This involved all the DHT members. The main purpose of this activity was to create stakeholder buy-in for the project and communicate its modalities.

  Orientation of health information assistants and surveillance focal persons: The health workers including health information assistants and surveillance focal persons were oriented on AFP surveillance.

  Problem identification and analysis: This was done in order to identify the root causes of the poor AFP surveillance and hence develop targeted interventions for causing improvement. The following were the root causes of the sub-optimal AFP surveillance performance:

  • Poor motivation among VHTs and health workers on AFP surveillance
  • Knowledge gaps among surveillance focal persons
  • Poor attitude among the staff Lack of transport
  • Presence myths and stigma on AFP
  • Inadequate funding
  • Inadequate specimen collection containers
  • Lack of weekly or daily active search

  Logistics and supplies support: I supported the district surveillance officer to distribute HMIS tools necessary to support AFP surveillance data compilation and reporting. He also gave support supervision and mentorship to health workers on data management, and further ensured feedback and review meetings were held.

  The fellow reported that the QI project was successful as indicated below: The non-polio AFP rate stagnated at 1.06 per 100,000 children <15 years for the first two months of the project intervention, and later increased to 2.11 in August and later 2.64 per 100,000 children <15 years in September 2021. The stool adequacy rate stagnated at 33% for the first two months of the project intervention, and later increased to 100% in August and September 2021. Additionally, the reporting rate stagnated at 50% for the first two months of the project intervention, and later increased to 100% in August and September 2021. The fellow would like to share a few lessons learnt as follows:

  • Setting targets on number of AFP cases identified by each healthcare facility surveillance focal point person will increase participation and thus high NP-AFP rate
  • Training of VHTs and setting up of community-based surveillance systems, and availing of AFP case definitions improved AFP surveillance
  • A specialized training on stool sample collection, and transportation improved stool adequacy surveillance performance indicators
  • Liaison of healthcare facility surveillance focal point persons with HCF in-charges to conduct continuous medical education (CMEs) at facility level increased vigilance and knowledge of AFP surveillance
  • Conduct active record search for AFP on weekly basis by healthcare facility surveillance focal point persons improved AFP surveillance

  The fellow also recommends the following to improve AFP surveillance:

  • There is need for the Ministry of Health and WHO to train health staff, intensify supportive supervision, and hold review and feedback meetings with districts.
  • Healthcare facility surveillance focal point persons should conduct regular community sensitizations (among churches, traditional healing and burial sites) on AFP reporting and referral
  • WHO should ensure timely payment of transport and per diem refunds of the health workers transporting the samples
  • Strengthen community-based surveillance systems for AFP case identification and reporting
  • The District and Healthcare facility surveillance focal point persons should hold monthly review meetings
  • Partners and MoH should incentivise AFP surveillance at health facility level, not just at district only
  5. Newspaper Articles The follow published 2 articles in the local newspaper: They included:  “Rush for a COVID-19 vaccine when it becomes available to the public” published on 03 February 2021  “Access to vaccines is a human
  6. Policy Brief The fellow has been taking lead in developing a yellow fever vaccination policy brief. The policy is in its final stages of drafting.

   

Summary of Epidemiological Study: 

 Title: Spatial distribution of cases in Bugweri district, during a malaria outbreak June 2020

Background: 

Methods: 

Results:

Conclusion:

Key lessons learnt during the fellowship

• Logically conducting an outbreak detection and investigation
• Multitasking with high levels of efficiency
• How to develop impacting policy briefs and funding proposals/ concepts
• Excellent scientific writing, presentation and publication
• How to design and implement quality improvement projects
• Capacity building and healthcare systems strengthening
• Large database management and analysis (Epi info, STATA, SPSS), and GIS mapping

Next Steps

• To Look out for critical and fast running epidemiology and disease surveillance jobs and contracts
• To continue accomplishing research articles drafted during the fellowship, and engage further in global health security interventions and research
• To continue supporting the FETP intermediate mentees
• To make sure that there is linkage between all public health programs and epidemiology/ global health security

Pictorial