Outside the biomedical box of integrated care research. Meet some of our new RESPOND-AFRICA staff
The RESPOND-AFRICA consortium is made up of a range of diverse professionals from Europe and Africa. They are working on several different projects all aimed at improving health outcomes for people living with chronic diseases such as diabetes, hypertension, and HIV in Africa. They are experts in unique activities that range from infectious disease care, non-communicable diseases care, project management, implementation, social science, or health economics. Have you ever wondered what it takes to be involved in a large global health program including multi-country randomised control trials? We have interviewed some of our new RESPOND-AFRICA members who are both on the ground and behind the scenes to give you an idea. Follow along in our series documenting some of our RESPOND-AFRICA consortium members!
Interviewee name: Josephine Birungi
Role in RESPOND-AFRICA: Project Lead
Projects involved within RESPOND-AFRICA: MOCCA and INTE-AFRICA
Where they are based: MRC/UVRI & LSHTM- Uganda Research Unit in Entebbe town
Past role/job: Research Manager at TASO Uganda
Who are you?
I am a medical doctor with over 15 years of experience in clinical care and research among HIV positive patients. I have worked with The AIDS Support Organisation (TASO) Uganda for over 10 years in various capacities and as part of the senior Management. Currently I lead a project that involves TASO and the Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) –Research Unit in Uganda. I am a Project lead and Co-investigator for a cluster- randomised control trial on Integration of HIV and Diabetes and hypertension care in 17 Public Health facilities in Uganda that begun in January 2019 and will be concluded in December, 2022. My previous work on HIV Self testing among the fishing communities contributed to the policy formulation in Uganda in 2017 – 2018.
I am also a mother of many children but two biological one (5.5 year old boy and 3.5 year old girl) who bring a lot of fun to my career/work. According to my little children, whenever they see me with a laptop, they know am doing homework and I have a teacher waiting to mark!
How has your journey helped you lead to this point in your career?
Early in my career as a junior doctor, while coordinating HIV care services at a rural clinic in Jinja town- Uganda, a researcher from United Kingdom, Prof Shabbar Jaffar led a research project involving patients who were receiving care from this very clinic. My role then was to link the service delivery team and the research team. I then picked interest in research and I was also given an opportunity by Prof Shabbar at the end of the study to spend three weeks at LSHTM doing writing of some of the research work. That is how it all begun.
Over time the prevalence of non-communicable diseases has been rising alongside the HIV burden, both of which are chronic conditions requiring chronic care models
How did you initially get involved in research?
Upon returning from the writing training at LSHTM, I was given a promotion to lead operations research at TASO with the aim of improving care. So I moved away from Medical coordinator to Program Officer research. I continued to be engaged in both operations research and collaborative research with other institutions. After two or three years I received a promotion to be a member of Senior Management with my role as head of Research (Research Manager). We however maintained the relationship with Prof Shabbar who then introduced me to RESPOND-AFRICA in 2017.
How has the field of integrated care, especially in sub–Saharan Africa, been changing?
Initially the health care systems in Africa have been used to acute care and there has been very little integration. However, over time the prevalence of non-communicable diseases has been rising alongside the HIV burden, both of which are chronic conditions requiring chronic care models. The ministry of health/policy makers in Africa are now beginning to change from vertical clinics for chronic conditions to integrated clinics because they realise that patients now present with more than one chronic condition and also because of the constraint of manpower (few health care workers). In Uganda, the country is now working towards integrating NCD care into HIV clinics, which was not the case 5 years back. The Uganda ministry of health has appreciated the research conducted by the RESPOND-AFRICA group and they are now using the evidence provided by MOCCA and our experience of implementing INTE-AFRICA to scale up integrated care.
I hope to continue engaging with various stakeholder; policy makers, patients, civil society leaders in addition to conducting high quality research
What areas of HIV and NCD research and/or project management do you think are being neglected?
I must say HIV has the lion’s share of the attention and most of the areas have been covered. The only area I would think of is that not so much has been done to support people ageing with HIV (persons >60years) in my country. For NCDs on the other hand, the neglected areas are many and they include: medicine and other commodities for NCDs, capacity building for health care workers, records management (inadequate/lack of health information systems- both electronic and manual in many of the health facilities) and there are inadequate education materials on NCDs compared to HIV. Last but not least, patient empowerment is minimal for patients with NCDs.
What do you hope to do in your role and as a member of the RESPOND-AFRICA consortium?
I hope to continue engaging with various stakeholder; policy makers, patients, civil society leaders in addition to conducting high quality research. As a member I would like to contribute more in developing fundable research ideas and encouraging implementation science.
Besides research and randomised control trials, what do you enjoy doing?
I enjoy spending time with my children, just watching them play and telling me all their interesting stories. I also like to sit beside water either at a swimming pool or a beach to cool off. In my me time, I pray and meditate