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Mukisa, Ronald
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HOW TO ENGAGE A COMMUNITY AND IMPROVE CHILDRENS ORAL HEALTH Macnab, Andrew John; Mukisa, Ronald
Proceedings of the International Conference on Applied Science and Health No 3 (2018)
Publisher : Proceedings of the International Conference on Applied Science and Health

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Background: Globally, gingivitis (gum inflammation) and dental caries (tooth decay) have a negative impact on the health and quality of life of children. Those from disadvantaged populations suffer disproportionally from poor oral health, yet much of the pathology and associated pain and suffering is preventable if children are taught simple and inexpensive practices that can improve their oral health. The World Health Organization (WHO) has called for more programs to improve children’s oral health worldwide. Aims: To summarize how readily implemented school-based programs can provide knowledge and teach health practices that promote behaviors that can enable children to improve their oral health through better hygiene and a reduced incidence of gum disease and caries. Results: The WHO Health Promoting School (HPS) program model is well suited to address poor oral health. The model begins with community dialogue to establish understanding of the cause, adverse effects and approaches to prevention. Next teachers are helped to establish, sustain and evaluate an intervention in the local school. Intervention is based on the two core components of WHO HPS programs; first, teachers add health-related curriculum and visual aid production to classroom activities, and second, opportunities are added for children to participate in health-related practices while at school, for example tooth brushing or tooth stick sessions to clean their teeth after the lunch break. Conclusions: Poor oral health is an example of a worldwide public health issue of central importance to children where school-based intervention has been shown to have benefits, through changes in behaviors achieved through teaching a combination of simple factual knowledge and inexpensive health practices.
TEACHERS AS AGENTS OF CHANGE: SCHOOL-BASED DIAGNOSIS AND TREATMENT OF MALARIA POSITIVELY IMPACTS CHILD MORBIDITY Mukisa, Ronald; Macnab, Andrew; Mutabazi, Sharif; Steed, Rachel
Proceedings of the International Conference on Applied Science and Health No 1 (2017)
Publisher : Proceedings of the International Conference on Applied Science and Health

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Background: Teachers in developing countries traditionally send home children found sick in class. Yet infection due to malaria is the principal reason a child will miss school in sub-Saharan Africa and the leading cause of death in school-aged children. Rapid diagnostic testing (RDT) and treatment with artemesinin combination therapy (ACT) is the management for malaria recommended by the World Health Organization (WHO) but RDT/ACT are not available in schools. Aims: To evaluate the impact on child morbidity from malaria of engaging teachers to provide RDT and administer ACT in primary schools in rural Uganda, using duration of absence from school as a surrogate measure of morbidity. Methods: This was a 2 year project.Pre-intervention (year 1) we trained teachers to identify probable infectious illness, conduct RDT, and administer ACT; conducted baseline evaluation of malaria knowledge, and monitored days of absence from school. Intervention (year 2) trained volunteer teachers administered RDT to children found to be sick at school and treated those positive with ADT; data collection was ongoing. Results: Teacher administered RDT/ACT was implemented and sustained in 4 rural schools (grades primary 1-5). Teachers participated willingly. Year 1 (pre-intervention) 953 of 1764 pupils were sent home due to illness; mean duration of absence from class was 6.5 (SD 3.17) school days. Year 2: (intervention with RDT/ACT) 1066 of 1774 pupils were identified as sick, 765/1066 (67.5%) tested positive by RDT for malaria and received ACT and their duration of absence fell to 0.59 (SD 0.64) school days (p<0.001); and overall absence decreased to 2.55 days from 6.5 in year 1 (p<0.001). Conclusion: RDT/ACT use by teachers as a school-based health practice is novel and reduced child morbidity significantly. Our model of engaging and training teachers represents a community empowerment approach applicable to other low-resource settings worldwide where malaria is endemic and morbidity high. 
HEALTH PROMOTION IN LOW AND MIDDLE INCOME COUNTRIES: ‘YOUTH CHAMPIONS’ AS AGENTS OF CHANGE Mukisa, Ronald; Macnab, Andrew J; Stothers, Lynn
Proceedings of the International Conference on Applied Science and Health No 2 (2017)
Publisher : Proceedings of the International Conference on Applied Science and Health

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Background: Health promotion includes a wide range of social and environmental interventions that enable people to increase control over their own health. The aim is to achieve health literacy, where people have the knowledge they need to make healthy choices and the skills and daily practices necessary to improve their health, and can access information that helps to reduce the risk of illness or injury. Health promotion programs traditionally use adult experts or teachers to deliver the information and practices promoted, but in school-based programs WHO advocates the involvement of youth to make program content and delivery relevant and interesting to school children. Aims: To summarize how youth leaders (‘champions’) can contribute to school and community based programs through their involvement in the design of school-based health promotion and by engaging and motivating the target population. Methods: Summary of the HPS literature and experience of youth involvement in our school programs in Africa Results: Schools are settings where important health knowledge and behaviours can be promoted. Teachers have a central role in creating an environment that fosters health learning, but the efficacy of health promotion is improved when youth are included in program design and delivery. Youth champions have a special ability to connect with the target audience in schools and by using the pupils ‘language’ and idioms make the knowledge and practices being shared relevant and accessible. Trained youth can champion individual messages or take on a variety of roles in health promotion initiatives. Youth champions have contributed to the success of programs that have promoted hand washing, oral health, improved nutrition, malaria prevention, sexual health and HIV/Aids prevention Youth involved as champions have an important opportunity to learn as well as to contribute; potentially, many educators, health care providers and leaders of tomorrow will emerge from among them.. Conclusion: Youth who act as champions and peer to peer counsellors have a unique contribution to make in school-based health promotion. As measured by long term retention of knowledge and sustained changes in behavior, school-based health promotion is improved when youth are included as ‘messengers’ and pupils help select the ‘messages’ promoted. 
The Use of Photo-Essay to Report Advances in Applied Science and Health Macnab, Andrew John; Mukisa, Ronald; Stothers, Lynn
Global Health Management Journal Vol 2, No 2 (2018)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: In the applied health and science disciples there is an expectation that project work is reported through a publication. The conventional papers written to do this follow a structure that includes sections providing background, methods, results and a discussion or conclusion, supported by figures and tables. Sometimes photographs are included, and with more on-line publications the opportunities have increased for these to be available in full color. Borrowing from the field of photojournalism photo-essays are now a publication option where a series of images are used to tell the story; these are often related to health and well-being.Aims: To summarize the methodology used to effectively combine a series of images with a brief text, and short reference list to create a visually engaging and informative short report.Guidelines: Images are taken throughout the project with consent obtained from those whose images will be recognisable. Creative licence is used to compile representative images into a sequence that conveys the background, method, results and outcome(s) of the project. Images need to be of high resolution; editing for light, colour and contrast, and cropping is allowed to increase their clarity and relevance. The ethics of photojournalism apply making inappropriate manipulation of images or erroneous captions unacceptable.Conclusions: Photo-essays are a novel and informative way to report on an applied health, social or scientific topic. The format is an excellent one to use for a brief report, or to prepare a research presentation for a scientific meeting.Keywords: Photograph, Photojournalism, Photo-manipulation.
The UN Sustainable Development Goals; using WHO ‘Health Promoting Schools’ to create change. Macnab, Andrew John; Mukisa, Ronald
Global Health Management Journal Vol 1, No 1 (2017)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Not required for photo essay
Engaging schools in diagnosis and treatment of malaria: Evidence of sustained impact on morbidity and behavior Macnab, Andrew John; Mukisa, Ronald; Mutabazi, Sharif; Steed, Rachel
Global Health Management Journal Vol 1, No 2 (2017)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background:  In low and middle income countries (LMICs) teachers send home children found sick in class devolving subsequent care to parents; where malaria is endemic, morbidity is high as the most parents fail to access WHO-endorsed rapid diagnostic testing (RDT and prompt treatment with artemisinin combination therapy (ACT). Consequently malaria is the principal reason a child misses school; so, we trained teachers to use RDT to evaluate all sick pupils and give ACT promptly to those positive.Aims: Pre, intra and post intervention evaluation of impact of using the WHO Health Promoting School (HPS) model to empower teachers to provide RDT and ACT and engage and inform pupils about malaria in 4 schools in rural Uganda.Methods: Documenting duration of absence from school as a surrogate measure for morbidity and change in children’s knowledge and reported behaviors regarding malaria. Pre-intervention (year 1) baseline evaluation of days of absence and children’s malaria knowledge/behavior; Intervention (year 2) trained teachers administered RDT in all sick children and treated those positive with ADT; Post-intervention (end of year 3) after schools independently continued RDT/ACT and education on malaria.Results: Pre-intervention <1:5 pupils had basic knowledge about malaria (caused by mosquitos; can be prevented; requires rapid diagnosis and prompt medication). In year 1: 953 of 1764 pupils were sent home due to illness. Mean duration of absence was 6.5 (SD 3.17) school days. In year 2: 1066 of 1774 pupils were sick, all had RDT, 765/1066 (68%) tested positive and received ACT; their duration of absence fell to 0.59 (SD 0.64) school days (p<0.001). By year 2 all children knew the signs and symptoms of malaria and had essential epidemiological knowledge. Twelve months post intervention the universality of this knowledge had been sustained and the whole-school focus on malaria continued. Children reported better health, more consistent attendance and improved academic achievement, and had become proactive in prevention strategies; 6% fewer tested positive for malaria; and key health knowledge was being passed to new pupils.Conclusion: Teacher administered RDT/ACT reduced child morbidity from malaria significantly; essential knowledge was generated and new health practices acquired that changed behaviors. Our WHO HPS model is applicable to other LMICs where malaria is endemic and morbidity high. 
Co-Authors Macnab, Andrew Macnab, Andrew J Macnab, Andrew John Mutabazi, Sharif Mutabazi, Sharif Steed, Rachel Steed, Rachel Stothers, Lynn Stothers, Lynn