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Medical Education Technology in Resource-Limited Settings
(intechopen, 2024) Pebalo Francis Pebolo; Ayikoru Jackline; Maxwell Opwonya; Raymond Otim; Felix Bongomin
The integration of information and communication technology (ICT) in medical
education is crucial to meet the evolving needs of the global population and ensure
competency among healthcare trainees. In low- and middle-income countries
(LMICs), where resources are limited, leveraging advanced ICTs has the potential
to revolutionize medical education by promoting student-centred learning through
asynchronous and distributed access. The recent introduction of artificial intelligence
(AI) = in medical education has transformed learning into a personalized experiences,
virtual simulations, and real-time feedback. Our experience with use of simple
technology in Uganda serves as a prime example of how innovative technologies are
being utilized to enhance medical education in a LMICs setting. Our experience in the
implementation of interactive displays in simulation training and the establishment
of low-cost content production studio has significantly improved trainings and learnings.
By integrating these technologies closer to the learning environment, students
can access information before or after interacting with their teachers, engage in
higher cognitive activities, and stimulate problem-solving skills. The success of these
initiatives demonstrates their potential for adoption to elevate the quality of medical
education in LMICs. Embracing ICT in medical training not only bridges educational
gaps but also fosters inclusive and equitable access to resources in LMICs.
Caesarean section rates in a tertiary teaching hospital in northern Uganda: a retrospective analysis using the robson ten group classification system
(BMC Pregnancy and Childbirth, 2024) Eric Ssennuni; Felix Bongomin; Elvis Akuma; Kizito Lukujja; Henry Kule; Keneth Opiro; Silvia Awor; Baifa Arwinyo; Sande Ojara; Jimmyy Opee; Ayikoru Jackline; Akello Jackline; Pebalo Francis Pebolo
Background: The Robson Ten Groups Classification System (RTGCS) is increasingly used to assess, monitor, and compare caesarean section (CS) rates within and between healthcare facilities. We evaluated the major contributing groups to the CS rate at Gulu Regional Referral Hospital (GRRH) in Northern Uganda using the RTGCS.
Methods: We conducted a retrospective analysis of all deliveries from June 2019 through July 2020 at GRRH, Gulu city, Uganda. We reviewed files of mothers and collected data on sociodemographic and obstetric variables. The outcome variables were Robson Ten Groups (1–10) based on parity, gestational age, foetal presentation, number of foetuses, the onset of labour, parity and lie, and history of CS.
Results: We reviewed medical records of 3,183 deliveries, with a mean age of 24.6 ± 5.7 years. The overall CS rate was 13.4% (n = 427). Most participants were in RTGCS groups 3 (43.3%, n = 185) and 1 (29.2%, n = 88). The most common indication for CS was prolonged labour (41.0%, n = 175), followed by foetal distress (19.9%, n = 85) and contracted pelvis (13.6%, n = 58).
Conclusion: Our study showed that GRRH patients had a low-risk obstetric population dominated by mothers in groups 3 and 1, which could explain the low overall CS rate of 13.4%. However, the rates of CS among low-risk populations are alarmingly high, and this is likely to cause an increase in CS rates in the future. We recommend group specific interventions through CS auditing to lower group-specific CS rates.
Trusted sources of information on COVID-19 vaccines during the pandemic in Uganda. A crosssectional study
(Research squares, 2023-10-17) Oloya, Johnson Nyeko; Alema, Nelson Onira; Okot, Christopher; Olal, Emmanuel; Ikoona, Eric Nzirakaindi; Oyat, Freddy Wathum Drinkwater; Steven, Baguma; Ochula, Denish Omoya; Olwedo, Patrick Odong; Pebolo, Francis Pebalo; Atim, Pamela Okot; Okot, Godfrey Smart; Nantale, Ritah; Aloyo, Judith; Kitara, David Lagoro
Background.
COVID-19 has dramatically impacted communities worldwide, especially in developing countries. To successfully control the COVID-19 pandemic, more than 80% vaccination coverage was required, and the flow of correct information to the population was critical. However, misinformation and disinformation could impact this, increasing COVID-19 vaccine hesitancy in some communities. Several studies have assessed the effect of misinformation and disinformation on COVID-19 vaccine acceptance
and other responses to the pandemic in the African continent. Thus, the most trusted sources of information on COVID-19 vaccines to the population is critical for successfully managing and controlling the pandemic. This study aimed to assess the most trusted sources of information on COVID-19 vaccines during the pandemic in northern Uganda.
Nodding syndrome in Ugandan children—clinical features, brain imaging and complications: a case series
(BMJ Open, 2013-04-08) Idro, Richard; Opoka, Robert Opika; Aanyu, Hellen T; Piloya-Were, Theresa; Namusoke, Hanifa; Musoke, Sarah Bonita; Nalugya, Joyce; Bangirana, Paul; Mwaka, Amos Deogratius; White, Steven; Chong, Kling; Atai-Omoruto, Anne D; Mworozi, Edison; Nankunda, Jolly; Kiguli, Sarah; Aceng, Jane Ruth; Tumwine, James K; Kakooza-Mwesige, Angelina
Objectives: Nodding syndrome is a devastating neurological disorder of uncertain aetiology affecting children in Africa. There is no diagnostic test, and risk factors and symptoms that would allow early diagnosis are poorly documented. This study aimed to describe the clinical, electrophysiological and brain imaging(MRI) features and complications of nodding syndrome in Ugandan children.
Design: Case series.
Participants: 22 children with nodding syndrome brought to Mulago National Referral Hospital for assessment. Outcome measures: Clinical features, physical and functional disabilities, EEG and brain MRI findings and a staging system with a progressive development of symptoms and complications.
Results: The median age of symptom onset was 6 (range 4–10) years and median duration of symptoms was 8.5 (range 2–11) years. 16 of 22 families reported multiple affected children. Physical manifestations and complications included stunting, wasting, lip changes and gross physical deformities. The bone age was delayed by 2 (range 1–6) years. There was peripheral muscle wasting and progressive generalised wasting. Four children had nodding as the only seizure type;18 in addition had myoclonic, absence and/or generalised tonic–clonic seizures developing 1–3 years after the onset of illness. Psychiatric manifestations
included wandering, aggression, depression and disordered perception. Cognitive assessment in three children demonstrated profound impairment. The EEG was abnormal in all, suggesting symptomatic generalised epilepsy in the majority. There were different degrees of cortical and cerebellar atrophy on brain MRI, but no hippocampal changes. Five stages with worsening physical, EEG and brain imaging features were identified: a prodrome, the development of head nodding and cognitive decline, other seizure types, multiple complications and severe disability.
Conclusions: Nodding syndrome is a neurological disorder that may be characterised as probably symptomatic generalised epilepsy. Clinical manifestations and complications develop in stages
Interrogating the agency and education of refugee children with disabilities in Northern Uganda: A critical capability approach
(National Children's Bureau and John Wiley & Sons Ltd., 2023-10-17) Monk, David; Walton, Elizabeth ; Madziva, Roda ; Opio, George ; Kruisselbrink, Annemaaike ; Openjuru, George Ladaah
This paper draws on empirical evidence from a 3-year
research project in Northern Uganda examining the
educational experiences of refugees with disabilities. The authors present the compounded and interrelated
challenges children with disabilities and their families face as they navigate their educational experiences and
seek out opportunities to live well. The authors seek to make a contribution towards improving educational experiences by first highlighting compounding challenges faced by refugee children living with disabilities and their families and related policy gaps that have ramifications for refugee children's access to education in particular, and second by expanding discourse about refugee children with disabilities agency in relation to these liminal gaps and the impact the gaps have for accessing education. The authors use Powell and McGrath's(in Skills for human development: Transforming vocational education and training, Routledge, 2019; Handbook of vocational education and training, Springer, 2019) concept of critical capabilities and relationality, to expand Klocker's (in Global perspectives on rural childhood and youth: Young rural lives, Routledge, 2007) notions of thick and thin agency and to interrogate refugee children living with disabilities' agency in relation to education opportunities and rights.