Leocadia Kwagonza

Leocadia Kwagonza

BBLT (Mak), MPH (Mak), Field Epidemiology Fellow (PHFP) +256773374104/+256702346786
lkwagonza@musph.ac.ug / kwagonzaleo@gmail.com

Host Site

Uganda Cancer Institute

Host Mentors

Dr. Jackson Orem, Dr. Noleb Mugisha

Academic Mentor

Assoc Prof Henry Wabinga, MakCHS

ABOUT THE FELLOW

Leocadia Kwagonza holds a Master’s Degree in Public Health (MPH) from Makerere University School of Public Health and a Bachelor’s Degree in Biomedical Laboratory Technology (BBLT) of Makerere University. After her academic studies, Leocadia worked as Laboratory Administrator at Clinical Microbiology Laboratory in the department of Medical microbiology at Makerere University. Upon joining PHFP-FET in Jan 2016, Ms. Leocadia was attached to Uganda Cancer Institute (UCI) – the national cancer treatment centre that has the mandate to oversee cancer control activities in the country.

Achievements at the host site

While at UCI, Ms. Leocadia received comprehensive cancer training in cancer surveillance and planning. Since that training, Ms. Leocadia has participated in protocol development, training and support supervision of Health workers, baseline analysis of cancer situation in Mayuge for the establishment and strengthening of Mayuge Cancer Registry, a population based cancer registry. She also analysed surveillance data and evaluated data quality of the Kampala Cancer Registry. Besides cancer related activities. Other activities accomplished by Leocadia include:

Conducting a study to assess client satisfaction with cancer care services at Uganda Cancer Institute.
Coordinating a study on challenges faced by patients as they seek cancer treatment in Uganda.
Participated in the National Cancer Control Program as a member on the steering committee.

Program-specific achievements

Program Specific Achievements

Descriptive analysis of public health surveillance data: The epidemiologic characteristics of top five cancers in males and females in Kampala.
Led two outbreaks investigations:
- Outbreak of Yellow Fever in Central and South-western Uganda, February–May 2016
- A cluster of illness and deaths after eating the meat of a dead pig: Kagadi District, Western Uganda, November 2016
Participated in four outbreak investigations
- An Outbreak of Gastrointestinal Anthrax Following Consumption of Meat-Uganda, 2017
- Measles outbreak in Kampala July-to Dec 2017
- Cholera outbreak in Bulambuli March 2016
Published 3 articles in UNIPH quarterly Epi-bulletin
Published a policy brief on introduction of yellow fever vaccine into routine Immunization
Published a newspaper article in Uganda New Vision on road traffic injuries due to motorcycles “bodaboda” on 28th April 2016
Made five presentations at national conferences and 3 at international conferences.
- 2nd and 3rd National Field Epidemiology Conferences (NFEC), November, 2016, 2017 Kampala
- Joint Annual Scientific Health Conference (JASH), September 2016, Kampala
- African Field Epidemiology Network Conference (AFENET), August 2016, Abuja Nigeria
- TEPHINET Conference, August 2017, Chiang Mai, Thailand
- The 4th High-level ministerial meeting on Global Health Security Agenda (GHSA), Oct 2017, Kampala Uganda
Four Manuscript underwent peer review
Yellow fever outbreak in central and South-western Uganda: February-May 2016 (Submitted to BMC Infectious diseases journal)
- Comprehensive Knowledge of HIV Transmission among Fishing Communities of Lake Kyoga, Uganda, 2013
- Data Quality of Kampala cancer Registry
- Utilization of Kampala Cancer registry data
Conducted an epidemiological study: Client satisfaction with cancer care services at Uganda Cancer Institute.

Summary of Epidemiologic Study:

TITLE: Client satisfaction with cancer care services at Uganda Cancer Institute
Introduction: Patients’ judgment of hospital service quality and their feedback are essential in quality of care monitoring and improvement. Uganda Cancer Institute is the only public health institution that provides comprehensive cancer care services in the country. There is limited data on client satisfaction with services offered. We determined the level and factors associated with client satisfaction with cancer care services at Uganda Cancer Institute.

Methods: We conducted a cross sectional study on 365 cancer patients receiving treatment at the institute. We defined a satisfied client as a patient whose perception of service exceeded their expectations. The SERVQUAL instrument with five dimensions (Reliability, Empathy, Assurance, Responsiveness, and Tangible) was used. In addition, demographic and clinical information were collected using a standard questionnaire. STATA v13 was used for analysis.

Results: Client satisfaction was found to be at 32% (117/365). This varied substantially among clients who received private (11%, 7/64) and general services (36%, 111/304). Reasons for dissatisfaction included drug shortages, poor attitude among Health workers and lack of food for patients. Clients who received private services were less likely to be satisfied compared to clients who received general services (AOR=0.3, 95% CI: 0.13-0.70). Clients with formal employment (13%, 11/87) were also less likely to be satisfied with cancer services compared to 36% (60/165) of unemployed clients (AOR= 95% CI:0.15-0.64).

Conclusion: The level of client satisfaction with cancer services was low. Poor health worker attitude, drug shortages and lack of food for patients were the reasons for dissatisfaction. We recommend managers to promote good medical ethics and attitude of medical staff and doctors towards patients, and attract investors to build high-quality infrastructures to satisfy wealthier patients who choose to pay for the service.

Lessons learnt over the course of the fellowship

Key skills/competencies acquired:

Establishment and strengthening surveillance systems for both Communicable and Non Communicable Diseases.

Evaluation, analysis and interpretation of surveillance data for routine and humanitarian settings.
Practical skills in outbreak investigations and control.
Scientific writing and presentation skills to different audiences– Bulletins, abstracts, power point presentations (at National and International Conferences) and manuscripts.
Leadership and management and ability to train others in the field of field epidemiology.
Participating in building partnerships between various stakeholders: Ministry of Health, Makerere University School of Public Health, CDC and other Development Partners.
Grant writing skills

Next steps in career

Having acquired advanced skills in field epidemiology, my career plan is to become an established Field Epidemiologist in both non-communicable and communicable diseases. I also have the desire to transfer the knowledge and skills acquired to young people who seek a career in field epidemiology