The UK Team after meeting with Prof. James Tumwine (in the center) at Makerere University College of Health Sciences
Development of a Centre for Evidence-Based Medicine at Makerere University College of Health Sciences in Uganda : The role of a Health Partnership
The past few decades have been marked by unprecedented interest in evidence based medicine (EBM) and a focus upon the use of innovative methods and protocols to provide valid and reliable information for healthcare (Greenhalgh, 2010). Therefore, healthcare decisions are increasingly being based upon research derived evidence, rather than on expert opinion or clinical experience alone (Greenhalgh, 2010). Evidence-Based health care has been indicated as the most appropriate way of ensuring that patients receive the most effective care possible (Greenhalgh, 2010).
The use of evidence based health care treatments in low income countries could be argued as being controversial in a sense that treatments are typically developed and transported from high-resource, “western” countries or contexts, which are culturally and contextually distinct (World Health Organization, 2010). However, it’s arguable that efforts to address the treatment gap in low income countries should build and benefit from evidence in other settings including treatments developed in high-resource countries.
To adequately address the substantial health treatment gap in low income countries, there is a need to encourage scientific research that evaluates the efficacy of health treatments in low income countries, according to the criteria of evidence-based medicine. If this could be achieved, we would have strong supporting evidence for the treatment of health disorders that revolves chiefly around well-controlled clinical trials, including placebo-controlled trials (World Health Organization, 2010). Given the need for both fidelity and adaptation of evidence based treatments in low income countries, it could be critical to work collaboratively with several stakeholders in both high and low income countries to make culture-specific applications for those applying the evidence based medicine paradigm.
The above argument allowed for the thinking behind thedevelopment of a Centre for Evidence-Based Medicine at Makerere University College of Health Sciences in Uganda, in partnership with The Royal Society of Medicine and The Uganda Diaspora Health Foundation (UDHF), the Centre for Evidence-Based Medicine at Oxford University and supported by the Tropical Health & Education Trust. The overall aim of this partnership is to assess the need for a collaborative training Programme aimed at improved Evidence Based Medicine knowledge and skills among Makerere University College of Health Sciences students and faculty, as well as how to address these gaps innovatively and by building on student led partnership.
The project will be implemented under 2 phases including; (1) Enhancing research skills training through the Training of Trainers model. There will also be a pilot project where tablets will be given to medical students to improve their communication skills and access to evidence based research during the Community Based Education and Services programme, an off-campus learning course, which combines educational and clinical/ community objectives, and which provides real life experiences for students.
Tablet devices will give them remote access to e resources, to practice protocols for common conditions, to reference information that can assist with diagnostic and intervention approaches, and access to platforms for supervision, so that students can communicate with faculty even when in remote areas. The second Phase will be the Monitoring and Evaluation of the project objectives and goals.
In conclusion as our funders eloquently said that for over twenty-five years, THET has supported and developed the health partnership approach as a basis for health workforce strengthening. THET’s experience shows that partnership projects, such as this one, are an effective means to exchange professional experiences and approaches. Drawing on the expertise available in the UK and Uganda, peer to peer collaboration can play a crucial role in assessing organisational capacities and point to innovative ways to address gaps.
This article was co-authored by:
Moses Mulimira – Post Graduate Research student in Evidence-Based Health Care Studies – Oxford University; Co- Founder: Uganda Diaspora Health Foundation
Mariam NamulindwaAligawesa – Co–Vice Chair at Butabika link – East London NHS Foundation Trust; Co-Founder: Uganda Diaspora Health Foundation
Edward Kakooza – Makerere University College of Health Sciences
Lalitha Bhagavatheeswaran – Head ,Global Health, Royal Society of Medicine
Find out more about the MSc in EBHC.
- Greenhalgh, T ( 2010); How to Read a Paper: The Basics of Evidence-Based Medicine (4th ed); John Wiley & Sons
- World Health Organization: mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings. Geneva; 2010.