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The University of Ibadan is celebrating the doctorate of nine CARTA fellows whose degrees were awarded in mid-November. This brings the total number of CARTA graduates from the University to 21 with another 15 in the fellowship pipeline. The fellows work at different departments and schools within the university and are strengthening the fields of economics, epidemiology and medical statistics, periodontology and community dentistry, and environmental health sciences, in line with the multi-disciplinary approach of CARTA.

CARTA has supported its African partner institutions to strengthen the institutional facilities that support research and to mainstream various program interventions with the aim to enhance the quality of doctoral training at institutional levels. Through this, the University of Ibadan renovated the postgraduate library and seminar rooms with CARTA’s support and has reviewed the PhD curricula across the university to adopt the JASes to the needs of each school. They have also developed a library reference manual and built the capacity of staff members on the use of the manual. So far, 66 faculty members from UI have attended CARTA’s Supervisors Workshops and 24 faculty and administrative staff have participated in the FAS workshops.
Babatunde Adedokun, a Cohort One Graduate from the University of Ibadan and one of the facilitators of the JAS 3 says that “It is gratifying to see the dividends of the incredibly impactful CARTA program. We must take full advantage of the opportunities it provides for networking, capacity building and mentoring among other possibilities,” he said.

In this Q & A, we talk to Enock Chisati, our Cohort Seven Graduate,  from Kamuzu University of Health Sciences. He tells us about his research interests in health, wellness, and fitness, the greatest lessons he has drawn as a researcher, and what he has his eyes set on for the future. Read on. 

Tell us about your current research interests: What questions/problems are you exploring? What are some of the findings that your work has revealed?
My research interests are focused on understanding the beneficial effects of exercise on the underlying mechanics of human physiology to guide the treatment and prevention of lifestyle diseases and chronic conditions. I also take interest in investigating strategies for sports injury prevention and treatment in low-income settings where there are not enough sports and exercise personnel to attend to injured athletes.

My PhD research focussed on developing an effective exercise design as therapy for reduced bone mineral density resulting from antiretroviral therapy (ART) in people living with HIV. Findings of the research reveal that maximal strength exercise training with high loads performed twice a week for at least twelve weeks significantly improves bone mineral density and strength of people living with HIV with bone mineral density deficiencies. These results suggest that maximal strength training could be used as a therapy for osteoporosis among people living with HIV and receiving ART. Using exercise as therapy seems to be an attractive safe and effective alternative strategy that might be used to manage bone loss resulting from ART in people living with HIV.

Currently, I am working on a project called “The Football Nurse” with colleagues from the University of Cape Town and the FIFA medical department. This is a pilot project aimed at developing a community-based task-sharing approach (Football Nurse) to actively recruit and train nurses as pitch side responders in grassroots women’s football in low-income settings where there are not enough sports and exercise medicine personnel (Physiotherapists, Doctors, Exercise Scientists). Since nurses are currently in higher numbers compared to other healthcare workers at the grassroots of low-income settings, involving them in sports and exercise medicine practice may provide an effective, affordable, and sustainable solution to bridge the treatment gap that female football players currently face and allow safer participation in football activities for all, at all levels.

As a researcher, how did you overcome practical issues such as contact, communication, connectivity? What are the solutions relating to carrying out Community Public Engagement (CPE) during the Covid-19 pandemic?

I completed data collection for my PhD work when Covid – 19 was not at its peak. However, as we plan to conduct the “Football Nurse” project, we will follow Covid – 19 preventative measures during the project. To overcome challenges with communication, we plan to use phone contacts as well as zoom meetings where possible. In addition, we have planned to develop a cloud-based platform/technology to compile and store research data.

What are the greatest lessons you have drawn as a researcher and are there any opportunities you have seen emerge from the pandemic?
As a researcher, the pandemic has taught me to be innovative and accept challenges. Innovation in the sense that I have searched for alternative ways of achieving my set research objectives without compromising on the quality of the research. The pandemic has made me to always have plan B for whatever I do as a researcher.
I have also learned that life does not stop with Covid – 19. As researchers, we need to accept this pandemic as a challenge and find alternative ways of progressing with our investigations without compromising the science and ethics of research.

What’s next for your career? What issues are you going to focus on in your upcoming research projects?
While focusing on the “Football Nurse” project, I also intend to investigate health related physical fitness of Covid – 19 patients living with HIV pre and post-discharge in low-income settings since physical inactivity has been reported to be associated with severe Covid – 19 outcomes in high-income settings. Development and evaluation of a national anti-doping awareness program for athletes and athlete support personnel in Malawian contact sports is also something I plan to focus on in the near future.

This article is part of our #CARTA100 series as we celebrate surpassing 100 CARTA graduates.

 

December 02, 2021, 3.30 pm to 5.30 pm EAT, 2.30 pm to 4.30 pm CAT, 1.30 pm to 3.30 pm WAT

Register here

Doctoral students have a strong desire to complete their degrees in good time, but they may face obstacles along the way that could impede their progress. Women and men may encounter different challenges in their PhD journey arising from societal expectations and traditional gender roles.

The difficulties they may have to face in scheduling their research and academic programs are related to critical events, such as childbearing and other caregiving responsibilities, as well as the continuing strain between academic and home obligations. As a consequence, research has shown that women take six months longer to complete their PhDs and have fewer papers accepted for publication during their doctoral studies, compared to their male counterparts. Hence, factors such as family, employment, marital status, and economic concerns, have a great impact in shaping women’s education and research.

To address these imbalances, a gender-responsive PhD program is required, one that takes into account women’s gender roles, which are likely to influence their journey and completion of their doctoral degrees.

In this round table conversation, the panelists will discuss what it takes for women to pursue their PhD in Africa, what opportunities they have today as compared to the past, the challenges they have to bear, and the benefits they stand to gain through their PhD journey.

Meet the Panelists

Macellina Ijadunola

Macellina Ijadunola is a Public Health Physician and Associate Professor of Public Health at Obafemi Awolowo University (O.A.U), Ile-Ife. Her career in Public Health research and teaching spans twelve years.  She is a cohort six CARTA graduate upon completion of her Ph.D in 2019. Her Ph.D research and training have led to her collaborative efforts with fellows and mentors in the CARTA network within and outside O.A.U in Reproductive Health and Social Epidemiology research. Her current funded researches are in social epidemiological and implementation science research on mental health, behavioral and reproductive health challenges of women who experience intimate partner violence during the COVID-19 pandemic. She also engages in research among vulnerable populations such as adolescents living in Skipped Generation Households in Africa, specifically Nigeria.

John Alonge

Dr. Ayodele John Alonge is a Lecturer at the Department of Library, Archival and Information Studies, University of Ibadan, Nigeria. Dr Alonge is a Certified Librarian of Nigeria (CLN). He is the Webmaster & Social media coordinator for the Association for Information Science and Technology (ASIS&T) Africa Chapter. He served as Emerging Technology Librarian at the University of Ibadan Library for more than 7 years. He worked as a Librarian and Archivist at KPMG Nigeria for more than 4 years. He also served as Regional Adviser -Sub-Saharan Africa Region for Emerald Group Publishing, the United Kingdom for 4 years. He served as the Coordinator of the Nigeria Library Association (NLA) Digital Communication Crew with the responsibility of managing the website and social media platforms of the association (2017-2021).
During the COVID lockdown, Dr. Alonge led social research titled the chronicles of Researcher in COVID-19 lockdown in Africa; he is also trained over 1000 university students as a Social Responsibly through the Checheskyboard platform on Telegram.

Rose Opiyo
Dr. Rose Opiyo is a Public Health Nutrition specialist. She holds a PhD in Human Nutrition (University of Nairobi), MSc in Applied Human Nutrition (University of Nairobi), and a Bachelor of Education in Home Economics (Kenyatta University). Her research areas of interest are maternal and child nutrition, school child nutrition, Nutrition and HIV/AIDS, nutrition-non-communicable disease link, omega-3 fatty acids, and food security. Currently, Dr. Opiyo teaches Public Health Nutrition for Community Health Course (HCH 402: Community Health) and Master of Public Health (HCH 612: Nutrition) as well as coordinating the teaching of HIV/AIDS common course (CCS 010: HIV/AIDS) for undergraduates at the University of Nairobi.

Stephen Wandera

Stephen Wandera is a Population Scientist by training. He is a Lecturer and Head of the Department of Population Studies, Makerere University, Kampala, Uganda. He holds an Msc. in Population and Reproductive Health and a Bsc. in Population Studies. His research focuses on inequalities in access to and utilization of health services by older people. He also investigates sexual and gender-based violence in Uganda among adults and children. His PhD thesis investigated the “Disparities in Access to Healthcare among Older Persons in Uganda’ using mixed methods research paradigm.

In this Q & A, we talk to CARTA graduate Jepchichir Kiplagat where she shares in detail her current research interests, her experience of carrying out research and teaching amidst the pandemic.

Tell us about your current research interests: What questions/problems are you exploring? What are some of the findings that your work has revealed?
I am working in the area of HIV and aging and currently identifying areas of health systems strengthening to meet the needs of older adults living with HIV. Following my PhD work, interviews and focus group discussions with older adults identified several challenges faced when seeking HIV care as an older person. Among them was the high pill burden, the visits to multiple care providers to seek care for multiple conditions a patient is suffering from, To mitigate against some of the challenges, I am asking the following question – how can the healthcare system be modified to meet the needs of the aging HIV populations? The needs we are specifically focusing on are the increased risk of comorbidities and age-related conditions.

As a researcher, how did you overcome practical issues such as contact, communication, connectivity? What are the solutions relating to carrying out CPE during the Covid-19 pandemic?
The COVID-19 pandemic has affected all cycles of life, researchers ones not excluded. While virtual meetings – conference calls and zoom meetings have made things manageable, the face-to-face meetings that cement trust in collaboration has been weakened. As part of continuous professional development, I applied and was accepted to an Implementation Sciences training of 2020 hosted by GACD. This is a 2-week training normally held in person. However, in the 2020 class, we held it virtually. There were challenges with this type of training as groups of 5 people were able to network and no more about each other, and limited networking and interaction with other groups. Various reunion meetings have been held thereafter to keep people connected alongside opening a LinkedIn group for people to share ideas and have discussions. While the internet and access to computers to communicate has not been an issue to me, there are times persons that are looking out to connect do not themselves have access to these key requirements for online/virtual communication.

What are the greatest lessons you have drawn as a researcher and are there any opportunities you have seen emerge from the pandemic?
During the pandemic, I had an opportunity to work with a team from all over the globe on a book focusing on HIV and aging in Africa. I led a team of three in developing a book chapter that is currently under review in Springer. I noted that while there was limited time working from home (as a result of competing priorities – parenting and caregiving and accomplishing formal work), using little time to engage in the activities that promote my research career is key to remaining active in research.

What’s next for your career? What issues are you going to focus on in your upcoming research projects?
I am currently a research Fogarty Fellow with the Northern Pacific Global Health consortium program http://fogartyfellows.org/. Through this fellowship, I am conducting research and will be assessing the feasibility and acceptability of integrating hypertension and diabetes care and management into the HIV care platform. We are doing this with the hypothesis that older adults will have better engagement in care when HIV and other comorbidities care is integrated and ultimately better health outcomes for older adults living with HIV. If the data from this project shows that it is feasible and acceptable to integrate care, then my next steps will be to do an implementation science research on measuring the quality of life among older adults living with HIV with the hope of identifying ways of measuring a 4th 90 in the UNAIDS 90-90-90 targets for HIV.

Kiplagat is a Cohort Five Graduate from Moi University, Kenya.

This article is part of our #CARTA100 series as we celebrate surpassing 100 CARTA graduates.

 

Pharmacovigilance Protocols in Sub-Saharan Africa: A Round Table Discussion

Date: Wednesday, October 27, 2021, 3.00 to 5.00 pm EAT

Register here: https://us06web.zoom.us/webinar/register/WN_5oyetvddToqhlzJCQhhT_w

When a drug or vaccine is approved for use, healthcare organizations monitor it regularly to ensure that it is both safe and effective. The potency of this supervision is primarily determined by each nation’s healthcare system and medical practices. A successful strategy for recognizing and reporting any unwelcome medical occurrences after using a pharmaceutical medication is crucial. Adverse product quality, severe drug responses, and medication errors all lead to a high morbidity and mortality rate. This is where pharmacovigilance is essential.

New medicines and vaccines are being specifically developed for usage in Sub-Saharan Africa. However, in many of the target nations, the introduction of new medications is not supported by pharmacovigilance protocols to monitor medicine safety, with information on the safety profile dependent on existing substandard systems.

Hence, pharmacovigilance needs to be improved in Sub-Saharan Africa, as many of its nations lack the infrastructure and resources to monitor medication and vaccine safety, and healthcare providers in these areas are frequently unaware of safety reporting obligations. With the rapid discovery/innovation of various COVID-19 vaccines, the need for stronger pharmacovigilance system is a priority

In this round table discussion, the panelists will discuss pharmacovigilance protocols in Sub-Saharan Africa. In essence, why it is necessary to manage drug safety and why pharmacovigilance needs to be improved, especially with the recent introductions of various types of COVID-19 vaccines. In addition, they will discuss the role pharmacovigilance can play in reducing vaccine hesitancy seen in most Sub-Saharan countries. They will also explore the challenges and concerns of the healthcare system in Sub-Saharan Africa in managing pharmacovigilance.

Panelists

Frider Chimimba- Chairperson of Pharmacy and Medicines Regulatory Authority (PMRA), Malawi

Mrs. Frider Chimimba, was one of the pharmacists involved in setting up the National Pharmacovigilance Centre in Malawi in 2015, in collaboration with the National Regulatory Authority (PMRA). With a small team of four Pharmacists, they successfully managed to meet the requirements for Malawi to become a full member of the WHO International Drug Safety Monitoring Programme in March 2019.

She is also involved in research work focusing on Pharmacovigilance related baseline and drug utilization studies. From 2016, under PMPB, she has been involved in the project titled “Strengthening Pharmacovigilance in Malawi” in collaboration with GSK and conducting nationwide training of post-service healthcare workers on Pharmacovigilance under Global Fund.

She is a trained Pharmacist from the University of Dar-es-Salaam, Tanzania and for over twenty years worked with different organizations in Community pharmacy in Malawi. In 2006, she obtained an MSc in Pharmaceutical Services and Medicines Control at the University of Bradford UK, followed by MSc Clinical Research at Cranfield University, UK in 2013.

Dr. Helen Ndagije – Director Product Safety of the National Drug Authority, Uganda

Dr. Helen Ndagije, a pharmacist and clinical epidemiologist, is the Director of Product Safety at the National Drug Authority in Uganda. She is the President of the African Society of Pharmacovigilance, holds a master’s in business administration and a doctorate in public health. She is known for having introduced a decentralized system of pharmacovigilance in Uganda. She has also been the Vice-Chairperson of the African Vaccine Regulator’s Forum(AVAREF), a network that has seen the regulatory system for clinical trials of medicines and vaccines uplifted in the last 10 years. The WHO supported the AVAREF initiative of the 24 member countries meets annually and the last meeting was hosted by Uganda.

In August 2014, Helen also participated as a member of the expert panel to advise WHO of the ethical considerations for the use of unregistered interventions for the Ebola Viral Disease. She is also a member of the Tuberculosis Technical Expert group and various such other groups. Currently, Helen is also part of the East African Community Pharmacovigilance Expert working group.

Previously, Helen was a clinical trial manager for a project by the Medical Research Council in Uganda; Development of Anti-retroviral Therapy, after her excellent performance and completion of a phase II microbicide project in Uganda.

Henry Zakumumpa- CARTA Graduate

Henry Zakumumpa is a Health Systems Researcher at Makerere University and has specialized in HIV and health systems with his academic background being in the social sciences. His PhD research focused on the sustainability of antiretroviral therapy (ART) scale-up implementation in Uganda and was jointly supervised by Johns Hopkins University, Bloomberg School of Public Health, and Makerere University. In early 2017, Henry was a Carnegie Corporation of New York Fellow at Michigan State University.
Henry is a two-time fellow of The German Academic Exchange Service (DAAD) at the University of Kassel (2010) and the University of Oldenburg (2009). He has been Principal and Co-Investigator on
research projects funded by Bill & Melinda Gates Foundation, USAID, WHO, Wellcome Trust (UK) and Population Council (US). Henry has published extensively on differentiated HIV service delivery in esteemed international journals such as Implementation Science, Global Health Action, BMC Health Services Research and Global Health Research and Policy.

Felix Khuluza- CARTA Graduate
Dr. Felix Khuluza, is a registered pharmacist, health economist and pharmaceutical supply chain specialist. He has over eight years of experience in conducting research on the pharmaceutical supply chain and Quality of Medicines in Malawi. Dr. Khuluza is a holder of PhD in Pharmacy from the University of Malawi, a Master of Health Economics from the University of Queensland-Australia and an honors degree in Pharmacy from the University of Malawi. He is a CARTA fellow and EDCTP fellow.
He has been engaged by the Ministry of Health and Pharmacy and Medicines Regulatory Authority (PMRA) in reviewing and drafting of laws, policies and regulations related to the pharmacy profession in Malawi. His career has been shared between hospital pharmacy, retail pharmacy and pharmacy education. In pharmacy education, he is involved in undergraduate and postgraduate training of students with the University of Malawi, and supervision of postgraduate students registered with international universities.
Dr. Khuluza is the current head of the Pharmacy Department at Kamuzu University of Health Sciences (formerly College of Medicine-University of Malawi). He has won several research and academic grants including CARTA re-entry grant and EDCTP early career awards.

Moderator: Johan Ellenius- UMC

Johan Ellenius joined Uppsala Monitoring Centre in 2012. Before that he was a senior lecturer and programme director at Karolinska Institutet in Stockholm for eight years. A background in Computer Science and a strong interest in medical science and research led to him to obtaining a PhD in medical informatics at Uppsala University in 2000. Johan Ellenius has numerous scientific publications and patents in methods using machine learning such as artificial neural networks for addressing issues in clinical decision support.

At UMC, he serves as a team manager and senior researcher, focusing on various aspects of data analysis in both structured and unstructured information, guided by the overall vision of safer patients. His primary research interest is within the field of medical decision support.

The climax of the Joint Advanced Seminar (JAS) 4 is the conference in which CARTA fellows attending the JAS4 present key scholarly achievements out of their PhD work. The purpose of this conference is to; Showcase progress, achievements and innovations from CARTA PhD fellows, disseminate PhD research findings, provide mentorship and networking opportunities, and broaden and strengthen training and research. This year CARTA held its 8th annual conference in which 27 fellows presented abstracts from their PhD work. For the first time, the conference this year was held virtually due to travel restrictions associated with the COVID-19 pandemic.

The key feature of this conference is that the organizing committee makes sure it mimics an international conference arrangement with a multidisciplinary audience made up of CARTA fellows from other cohorts, CARTA graduates, CARTA facilitators and other invited guests from the host university and other CARTA partner institutions. This arrangement gives fellows the confidence to present their scholarly work in subsequent conferences. The other feature is that a conference call is shared and fellows respond by submitting an abstract in the requested format and the conference organizing committee offers support to make sure the abstract book is produced and shared in the desired format.  As a host institution, at Makerere University we are confident that this conference publicizes the rigor of the CARTA PhD fellowship as fellows combine skills acquired across the different JASes into a single dissemination package.

Due to COVID-19 restrictions, JAS 4 was one of its kind since it was held virtually with a mixture of online classes and in-country residential training. The exposure to the use of online learning tools such as google classroom and google chats throughout the JAS was a great and timely opportunity for me to learn since we have transitioned to teaching online in my institution.  However, at first, navigating through google classroom was not easy for me, and sometimes I experienced unstable internet that interrupted learning. 

The residential training was quite exciting. It offered a protected time away from work and home to focus on the JAS activities.  In addition, I enjoyed in-person interaction and discussion with other fellows in my country, something I had greatly missed during the online remote training. 

The whole JAS 4 experience was a very intriguing one for me. During the 7 weeks, I was privileged to get exposed to various sessions such as being an educator, policy influencer, academic leadership, being a researcher among others. These courses equipped me with critical skills and knowledge that will be very useful for my doctoral journey and career life in academia.  My most memorable experience was working together online to develop a multidisciplinary proposal with a team put together within a very short time under very difficult circumstances. The virtual conference provided an opportunity to connect, learn and network. Drawing from these experiences, I am confident that the relationship and networks developed through the team and during the entire CARTA program will yield extensive collaboration and partnership in the future. 

The facilitators were passionate, committed, and offered a high level of expertise during the sessions. The learning objectives for each session were well communicated and timely feedback on questions and assignments were provided. The synchronous sessions were very engaging, reflective and I learned a lot. Overall, JAS 4 was very beneficial to me and the skills and knowledge gained will be useful to my entire career. 

The CARTA fellowship has contributed immensely to my career and academic progression. At the time I was awarded the fellowship, I had only eight (8) publications most of which were published in local journals.  From the period of the fellowship up to this time, the publications increased to twenty-three (23) with all the additional articles published in reputable international journals. Such journals include BMC Public Health, BMC Pregnancy and Childbirth, BMC Health Services Research, Archives of Public Health, Malaria Journal, Plos One, BMJ Global Health, Maternal and Child Nutrition, Elsevier and Taylor and Francis. In fact, one of the articles titled “Incomplete Childhood Immunization in Nigeria: A Multilevel Analysis of Individual and Contextual Factors” published by BMC Public Health was cited by BBC News at this link: https://www.bbc.com/news/health-41280113

Based on the quality of my publications, I have been invited as a reviewer by different journals and as a guest presenter at international conferences. The fellowship assisted me in improving my research skill to such an extent that I have developed the courage to publish in high-impact factor journals. Apart from the progress made in the area of publication, I was able to attend various knowledge-building workshops, seminars and trainings particularly during my postdoctoral fellowship at the University of Warwick, United Kingdom. I had the opportunity of receiving trainings in prestigious institutions such as University College, London (UCL), University of Cambridge, University of Bristol and Imperial College. I also had the opportunity to present my research findings at international conferences such as the European Population Conference, Population Association of America Conference, Society for Social Medicine Conference, Mixed Methods International Research Association Conference and International Festival of Public Health Conference. It is noteworthy to state here that through the fellowship, the number of workshops, seminars, training programmes and conferences that I attended amounted to fifty-two (52)! Bearing in mind that before the commencement of my fellowship, the total number of seminars, workshops and conferences which I attended was just four (4).

In addition, the fellowship has facilitated my being honoured with international awards. Such awards include: Visiting Research Fellowship at Watson Institute for International Studies, Brown University, USA; DELTAS Africa Fellowship awarded by the African Academy of Sciences (AAS) and Alliance for Accelerating Excellence in Science in Africa (AESA); Postdoctoral Fellowship awarded by CARTA and hosted at Warwick Medical School, University of Warwick, United Kingdom; Carnegie Fund for Conference Attendance awarded by Institute of International Education (IIE), USA and; Travel Grant for Conference Attendance awarded by Population Association of America (PAA).

 

Adedokun Sulaimon Taiwo  (Cohort One Graduate, Obafemi Awolowo University)
Department of Demography and Social Statistics
Obafemi Awolowo University
Nigeria

The three-week in-country residential training for the JAS 4 began on August, 23. This is the second phase of the training where the fellows who are from different countries including Rwanda, Kenya, Uganda, Nigeria, South Africa, and Malawi are accommodated at a common facility in their home countries to maximize protected time.

Our partner, Makerere University has hosted JAS1 and JAS4 concurrently for the last couple of years until 2020 when the COVID-19 pandemic turned things around. This year, was the first time that the JAS4 was held separately and virtually. The organising team and the facilitators, both local and international, worked tirelessly to adapt the curriculum to online learning, and to put together appropriate materials for this mode of delivery through the Google Classroom. The fellows have also had daily virtual meetings with their facilitators.

Early career researchers often face significant barriers to progress in their careers and for this reason, the fellows are taken through sessions in Research Leadership that will help them navigate barriers along the way. As part of the transition to research independence, the fellows need to build on their research communication, mentorship and networking skills in addition to looking out for funding opportunities and managing the grants awarded.

The educator role sessions on the other hand, help the fellows to build their knowledge and skills in designing and facilitating learning while the Policy influencer role provides them with an understanding of the factors that influence decision-makers in making change, and under what circumstances research can contribute towards changes made by decision-makers such as politicians, health service managers, senior faculty, directors of research institutions, leaders of communities.
Besides, the Leadership Role sessions provide the fellows with the experience of preparing a research proposal that is relevant to them as Early Career Researchers. They are taken through the whole process from the beginning of an idea through to having a proposal ready for submission. With the feedback they receive after review they will be in a good position to develop their proposal further with a view to submitting it for funding.

27 fellows have been participating in the trainings. In the third week, they take part in a three-week in-country residential training. During this phase, the fellows are accommodated in a common facility within their country to maximize protected time.

The aim of the JASes as offered by CARTA is to ensure that the fellows graduate from their PhDs with critical skills that will enhance their careers make them compelling applicants and help them generate resources for their institutions while building their research portfolios.

The JAS4 will conclude in September with fellows submitting a conference abstract.

John Bosco Isunju is a CARTA focal person at Makerere University and is central to the planning of the Joint Advanced Seminar 4. He spoke to us about what goes into it.

Tell us about the Joint Advanced Seminar 4 (JAS4). What is it about and what do CARTA fellows stand to gain in the process?
From JAS4, Fellows acquire a range of competencies and skills that contribute to their professional development such as grant application and teamwork, critical thinking, research leadership and management, as well as skills in curriculum development, pedagogy and learning theories. They are triggered to revisit their career path planning by reviewing their professional development plans. Also, Fellows acquire skills on how to translate knowledge, communicate science and influence policy. These skills help the Fellows to impact society and to generate evidence for decision-making.

What goes into the successful execution of the JAS 4? And what role does Makerere University play?
Like any other JAS, successful execution of JAS4 requires early planning, teamwork and support from the CARTA secretariat. It is key that training schedules are prepared on time and require consultations with the Fellows and facilitators to ensure their availability and commitment, and this might require several adjustments in the training schedule. Logistics also need to be organized on time to make sure Fellows and Facilitators’ needs are addressed as individual needs might vary.
The JAS 4 coordinators at the University review the curriculum and session planning, and preparation of appropriate materials. They also restructure the timetable to accommodate the concerns of facilitators, Fellows, experts, as they also factor in different time zones.
In addition, they plan meetings internally as Makerere University JAS4 organizing committee, engages in joint planning meetings with CARTA Secretariat, engage with CARTA Fellows during town hall meetings, facilitator-training sessions with the online learning experts, participate in weekly meetings with session leads and facilitators, distribute tasks and responsibilities and share feedback in the weekly meetings.
They attend all sessions to provide support to facilitators, coordinating IT support, setting up and sending out invitations for different sessions. They also monitor participation of Fellows and submission of assignments, and reaching out to Fellows whose performance of tasks is sub-optimal.

What are the opportunities that you have seen emerge from this seminar virtually?
The process of preparing for JAS4 has helped both facilitators and Fellows to get exposed to online platforms, tools and resources to enhance teaching, learning and assessment. These learnings will certainly be applied in our daily work as academics as we adapt and improve the online teaching, learning and assessment at our institutions. Also, reviewing the curriculum and adapting it to online mode of delivery has helped us to include content for competencies that are critical for virtual engagements, and to cut back on those that require physical presence. In so doing, we have been able to deliver JAS 4 entirely online, without compromising the attainment of its objectives.

Have you encountered any hurdles and how did you overcome them?
As it appeared more time was required to convert the JAS from physical to virtual. In such cases, we had to find suitable alternatives.
We faced challenges in designing online materials and also using Classroom as an online platform. A number of facilitators had not designed materials for online delivery before or used Google Classroom. In some cases facilitators became frustrated. However, the CARTA secretariat hired an e-learning consultant who took us through the process with weekly meetings to encourage and follow up on progress by the facilitators.
Keeping up with all the IT-related demands of online delivery, such as creating and sharing out zoom links, creating discussion groups, allocating host rights, maintaining class muted to avoid distractions and any other trouble shootings were a little too demanding. We contracted an IT expert to support the team.
There were also challenges with fellows accessing Classroom and making sure they are actively involved in discussions and submit assignments on time. We solved this by having to upload guidelines for fellows within Classroom. We also had to have increased online presence during the JAS4 so as to remind fellows to respond to chats and work on assignments and guide those having challenges.

Do you think by now the fellows have fully embraced doing their seminars online?
Certainly. Delivering JAS 4 entirely online has been a great learning opportunity for the organizing team, Facilitators and Fellows. All of these have gained new skills. The sessions were designed in such a manner that a lot of the teaching/learning occurs asynchronously by making materials available on google sites. The synchronous sessions were kept short and meant to elaborate whatever needed further explanation. We also made sure that the first 3 weeks of the JAS had less activity and this gave fellows and facilitators enough time to get used to the online platform. We believe this helped in the delivery and acquisition of the intended competencies.

JAS 4 has been a unique experience for me. The lead-in was quite challenging, the questions around scheduling, direction of the COVID pandemic, recovering personally from experiencing COVID, and post-illness sequelae. But there was the motivation of ticking off this final stage, the promise of meeting the entire cohort again and further learning from what can only be described as a truly inspiring and skilled mix of teachers and facilitators.

Finding out JAS 4 was going to run in-country and via blended learning platforms was something of a disappointment. But I have absolutely enjoyed the structure of the programme. It was valuable to have the initial phase of online-only interaction then this intensive phase. Google classrooms was something of a challenge to navigate with its jamboard and comment sections. However, the facilitators were great at structuring the content and keeping us learners on track.

On the whole JAS 4 has been a positive experience. The residential phase has been great so far. Because I am situated in Ibadan, I would have wished we went somewhere else perhaps Abeokuta or Lagos, a place where I would be physically beyond the reach of my responsibilities. But the hotel has been excellent, my colleagues have been a great support and the sessions have been top-notch.

The experience has been invaluable to my doctoral and wider academic journey. The sessions on philosophy and structure of teaching, teaching techniques, use of software have been very useful. I believe the quality of my teaching and presentations will be significantly improved by this learning. JAS 4 like all other JAS sessions has also been quite useful from a motivational perspective.

The genesis
I had just received an acceptance letter to pursue a largely online postgraduate diploma in Medical education, which was to begin in 2014, and I was actively working on what would have been my project and a deliverable of the course. To rest my mind from the engaging task, I decided to do an occasional sorting of the contents in one of my handbags. That’s when I stumbled on a piece of paper that had a website handwritten in thick ink – www.cartafrica.org, population health PhD. My mind rushed back to the day when I tore a piece of paper from a newspaper I was reading and wrote the website down.
I stopped sorting my handbag and returned to my laptop, this time, to visit the website. It was a call for applications for a fellowship to pursue a PhD in population health. Meeting all the preliminary requirements, I embarked on putting together an application, and in a few days, I submitted it ahead of the deadline. I continued working on the other offer to study medical education.

The process
A few months later, I received an email from CARTA stating that I had passed the preliminary steps and had more tasks to complete in order to be accepted. I diligently worked on all the tasks and finally received an offer for the fellowship and an invitation to attend JAS 1 for a month from 10th March 2014. This was a very confusing time for me. Leaving my young children behind, having left them for 12 months in 2010-2011 when I went to pursue an MSc in Audiology. The offer broke my heart. I consulted my then 10-year-old daughter and 9-year-old son. They both were strongly encouraging. When I asked them why I should pursue it, one of them said that “so you can be an example to us.” With those words, my fate was sealed, and never did I look back.

The problem to solve
Upon graduating with my MMed in ENT, I returned to work at a public national referral hospital that served over 60% of Rwandans. I observed that hearing loss caused by chronic ear infections was a common cause for care-seeking. Unfortunately, even after meticulous surgery, some patients still complained about hearing loss. The country did not offer audiology services at that time, and therefore there was nothing we could do. We needed to address the preventable causes of hearing loss. I engaged policymakers to help address the issue and scale up prevention, but they needed evidence – “hospital data means nothing, we need data.” The finality in this statement was the turning point for me. In my pursuit to provide data, CARTA happened.

CARTA
Being a CARTA fellow was an enriching experience. Networking with peers, peer reviews of academic work, and many other activities organized by CARTA made even the most difficult moments manageable. CARTA provided experienced trainers, supervisors, and didactic resources to ensure a smooth learning environment. I benefitted from teacher replacement and residential sessions that allowed me to dedicate my attention to my studies. I had very knowledgeable supervisors who were readily available and guided me at every step, and still, take an interest in my professional growth even after graduating.

Contribution
The majority of causes of hearing loss in children are preventable, the most common being ear infections. From my PhD work entitled The burden and care-seeking practices for ear infections in children under five in a district of Kigali city, Rwanda, we now know that up to 5% of children under 5 in a district in Kigali have chronic ear infections, and this could be higher in rural settings. We also know that there is overall low awareness of ear infections among parents and nurses in primary health care facilities. Consequently, from this data, other studies, and persistent advocacy, Rwanda recognizes that ear and hearing health is a priority. In January 2019, a National Ear and Hearing care Strategy was commissioned to address it.

The journey
It was a pleasantly grueling seven years of studies, a half of which I cannot honestly account for. After an extremely thorough, engaging, and very informative JAS 1, my research concept changed. I applied to study at Makerere University, worked on a new concept, and obtained full registration within six months. I was able to collect data and have two papers published within two years of full registration. While this was a major milestone, I was stalled by many unforeseen circumstances outside my control. The main challenge was difficulty identifying an examiner, given my particular area of study. I submitted my Thesis for examination on 25th July 2019 and defended it on 21st January 2021.
Delays did not deter my resolve to raise awareness about prevention, early identification, and management of hearing loss, set up a facility to provide comprehensive ENT and audiology services and continue training the future generation of problem-solving health professionals. Planning is underway to perform a midterm review of the implementation of the National strategy on ear and hearing care. While the problem of hearing loss is not nearly solved, I am gratified to know that it is now recognized and prioritized both in paper and in practice. I owe all this to CARTA, which helped me gather the needed data and empowered me to look beyond challenges to seek solutions.