As Sweden continues to phase out its support in research to public universities in Uganda, we cought up with the Dr. Roy Mayega - a beneficiary of Sweden's support both at PhD and post-doc level. He is currently the head of an innovation lab called the Resilient Africa Network (RAN) within Makerere University's School of Public Health. Here is what he had to share with us.
Andrew: Can you tell us about who you are and what you do?
Dr Mayega: My name is Roy William Mayega and I am a Lecturer at the School of Public Health at the College of Health Sciences, Makerere University. I am a career researcher and I work under the Department of Epidemiology and Biostatistics. I teach both graduate and undergraduate students.
I am also the head of an innovation lab called "Resilient Africa Network" that is based within the School of Public Health in Makerere University. Among several other initiatives, the lab is currently working with UN Women on a project on Gender Based Violence (GBV) that helps youth to develop innovative ideas on how they can combat GBV in Uganda. This project is funded by Sweden.
Andrew: Tell us about your PhD program.
Dr Mayega: I studied my PhD under the "sandwich model" between Makerere University and Karolinska Institutet between December 2010 and May 2014, funded under Sida Phase IV Research Program. My research was on Type 2 Diabetes perceptions, risk factors and how health systems can approach it in Uganda. I was inspired to carry out research on non-communicable diseases by Prof. Stefan Peterson and Prof. David Guwatudde in 2010, especially considering that there were limited studies on them in Uganda by that time. My PhD consisted of 4 sub-studies: two on the risk factors of type 2 diabetes in Uganda, one on the primary care tests used to screen for it and another on community perceptions.
Andrew: Do you feel that your PhD program has benefitted Uganda as a country?
Dr Mayega: Definitely. My research contributed to the establishment of the Self-Management of Type 2 Diabetes program (SMART 2D) funded by the European Union to the tune of 700, 000 Euros from 2015 to 2019. In this project we went back to the study area in Iganga to implement interventions at the Makerere University site for population-based health and demographic surveys (DSS). My study directly contributed to development of the intervention package. The DSS supports several studies and generates important population data to inform policy. It receives core support from Sweden as well. We are now in the pilot stages of establishing a long-term cohort to monitor how Type 2 Diabetes at its associated risk factors can be tracked over the lifecycle in the communities. Following the publication of our pioneering work in this area in a local newsletter, Pfizer picked interest and has supported the equipping of the field lab to pre-process samples with a USD 40 000 grant. Sweden also funded my post-doc, which I started in 2015. More importantly, we have continually shared our findings with the Ministry of Health NCD Technical Working Group and the information generated from our studies has contributed to changing the policy discourse regarding what needs to be done for NCDs.
Andrew: How have your PhD and Post-Doc programs helped you in the advancement of your career?
Dr Mayega: The support I received from Sweden helped me to become a more independent researcher. I now have research management skills and I am able to write grant proposals to source funding for research and projects. I am able to design credible and potentially informative studies. I have been able to network with others working in the area of non-communicable diseases. It has also enabled me to pass on knowledge to both masters and PhD students. I am currently supervising 5 Masters students and 2 PhD students. So far, I have supervised 21 Masters students to completion.
Andrew: Tell us about the Innovation Lab that you work for.
Dr Mayega: Resilient Africa Network (RAN) was started in 2012 as a 5-year project that was funded by USAID. The Network was started to help communities come up with innovations that would improve their resilience to livelihood-related shocks and stresses. Our research on innovations program mainly focused on health, production, agriculture, youth livelihoods, water and sanitation and household income. We set up studies to identify what drives resilience in communities, and from this information identified key potential entry points for innovation. We have supported 342 innovators to develop their ideas. In the project, 80% of the innovations are social while 20% are commercial innovations. The RAN continues to act as a space to incubate these ideas and support some of them to scale. Makerere University has used this support to build synergies with other partners like UN Women and UNDP. Through the support of the UNDP, we have also developed an online course on disaster resilience leadership mainly targeting mid-level managers.
Our lab is multi and cross-disciplinary and regularly interacts with other colleges like Humanities, Agriculture, Veterinary Medicine, Computing, Technology and Business at Makerere University. The various skill sets help us to develop complete innovations that can contribute to change in communities. We also run courses in Technology Assisted Teaching and Learning and we are working to strengthen the innovation ecosystem in Makerere University.
Andrew: Since you completed your PhD program, how has Makerere University benefited from your expertise?
Dr Mayega: As you may know, Sweden's support to research in Makerere University has finally led to the Government of Uganda starting an innovation fund worth 8.1 million USD annually for innovation research at the University. As the School of Public Health is responsible for over 30% of the research output of the University (with over 60% of this research being supported by Sweden), I was identified as someone who could contribute to ensuring that these funds are utilized well.
I helped the university to develop calls for proposals for this fund and I used my experience and templates from both our work with Sweden and RAN to ensure that the funds is utilized and managed well. Sweden supported the Directorate of Research and Graduate Training to develop grant guidelines for their support and we are adopting several of these same guidelines for our innovation fund. Sweden's support has ensured that the internal ecosystems are mature enough to manage this grant support.
We are also in the process of developing ideas to collaborate with Karolinska Institutet to help Uganda reach its targets for the Sustainable Development Goals and the Agenda 2030, by working towards establishing a Centre of Excellence in Sustainable Health.
Andrew: How has your research work impacted the health sector in Uganda?
Dr Mayega: My research helped the health sector to establish baseline statistics on non-communicable diseases and their associated risk factors in the country, and especially to understand whether there is indeed a problem. I have since been invited to sit on the Technical Working Group on Non-Communicable Diseases at the Ministry of Health, which designed the national Non-Communicable Diseases risk factor survey. I have communicated my findings widely to increase the urgency for response. We have shared with the NCD Desk Officer at the Ministry of Health our intervention research findings, which included recommending a package of eight components that can be integrated into primary care to improve prevention and care for type 2 diabetes. This package for example includes a recommendation on what basic drugs for diabetes are needed at health centers and how health centers can manage client information better. I have also helped the sector identify what tasks can be carried out by nurses when there are no doctors available.
I have written a manual on health education for NCDs, which was drafted as part of my post-doctoral research. We hope to have this operational soon. I have also drafted an information leaflet that can be distributed at health centers. The leaflet I designed was inspired by similar leaflets I saw while I was in Sweden. I have also contributed to the development of national guidelines on nutrition and diet.
The NCD desk at the Ministry of Health has also recently been upgraded to a full Department with an Assistant Commissioner being recruited. We believe our research helped to provide information that contributed to building the case for the importance of NCDs in the country.
Andrew: What personal challenges do you feel you are facing despite the completion of your PhD and postdoctoral research?
Dr Mayega: Unfortunately, the funding available for Non-Communicable diseases at the Ministry of Health is less than 1% of their budget. Because of this, the NCD policy and guidelines have not yet been rolled out nationally as would be desired. Treatment guidelines and communication materials haven't been fully rolled due to lack of financial support – yet we have all the information needed.
There is still low awareness at the level of Health Center II and III of what they can do to identify type 2 diabetes and its risk factors, from simple tests like blood pressure. There is also a need for the education sector and other sectors pertinent to NCDs like Agriculture to step in and play a bigger role by providing lifestyle education. It is also important to establish individualization of care for persons with NCDs and for health centers to identify and follow up people at risk.
Andrew: Aside from your professional achievements, have you been able to benefit from the support you received from Sweden in any other way?
Dr Mayega: I learned how to conduct business like research that is systematic and time bound from my time working in Sweden. I value time more and ensure completion of my tasks in a timely manner. I now try to share this work ethic with my students so that they meet their deliverables in time. The learning culture in Sweden also encourages students to learn in smaller groups before reporting back to the collective. I have tried to implement this in my classes as well.
I have also developed online courses with the support of UNDP. We have also implemented a multi and cross-disciplinary approach to research where we have established research groups with apprentices that come from different disciplines. There is now a Diabetes and NCD Research Group at the School of Public Health and I have contributed to its development with the ideas learnt from the research groups in Sweden.
I was also impressed by the commitment of supervisors in Sweden to assist their students. Supervisors would make an effort and even travel long distances to assist their students in their research. This helped me make more efficient presentations on my research that provided all the necessary information needed by the University. The learning support system in Sweden is superb and centres on the student – I have been working to transfer some of these lessons back to the School of Public Health, to improve the learning experience for our students.
At our innovation lab, we have copied Sweden by establishing a room where supervisors and students can interact. I feel like I am now a better supervisor.
Andrew: Do you have anything else you would like to share with us?
Dr Mayega: I would like to thank you for all the support Makerere University has received from Sweden over the years. I hope that Makerere can continue to collaborate with Sweden in other ways as Sweden's support has made it easier to push through policy change at the University and in the sector.
I believe it is important to translate innovation into action and results, and would be happy to work with Sweden in the area of research translation. There is a need for more innovation spaces in Uganda to support co-creation and incubation of ideas. Every college in Makerere University needs an innovation lab to stimulate social and technological innovations.
There is also a need to build the private sector innovation ecosystems and to connect researchers to partners who can help them scale their innovations. I would be glad to continue to work with Sweden in this area.
The research leadership skills I received from Sweden have built my capacity which led to Makerere University selecting me to coordinate the Government's Research and Innovation Fund at Makerere University. I am eternally grateful to Sweden for this!
Compiled by Andrew Byaruhanga, Communications Officer - Embassy of Sweden in Kampala
Diabetes and prediabetes Fliers.pdf
