GANDHI graduate team member Kira Battle, Doctor of Physical Therapy student, class of 2018, has been awarded Bass Connections Follow-on Student Research Funding for 2017 to investigate physical rehabilitation and transitional care in Uganda as a member of GANDHI in collaboration with the Duke Global Neurosurgery and Neuroscience (DGNN). Congratulations, Kira!
GANDHI graduate team member Kira Battle, Doctor of Physical Therapy student, class of 2018, has been accepted to present at the World Confederation for Physical Therapy Congress 2017 in Cape Town, South Africa. Kira will present her team’s work as a poster presentation titled, “Physical Rehabilitation in Acute Care Settings of Low- and Middle- Income Countries: A Mixed Methods Systematic Review.”
GANDHI team member Jackie Xu, a sophomore studying public policy, and two other sophomore students, David Wohlever Sanchez, also majoring in public policy, and Qiang Zhang, majoring in political science, won the Duke Global Challenge finals. Oxford’s Global Challenges was brought to Duke by Duke Innovation & Entrepreneurship Initiative and the Social Entrepreneurship Accelerator at Duke. Of the 21 teams to participate from Duke, 6 were selected for the Duke finals. Jackie and her team will be traveling to Oxford to represent Duke and participate in the international Global Challenge finals at the end of April.
Christa Preston, director and co-founder of EmbraceKulture, and GANDHI-Child and Adolescent team member Anna Martin co-authored a blog post on UNESCO’s International Institute for Educational Planning Learning Portal. Check out the article here to learn about how EmbraceKulture trains Ugandan teachers to develop the skills of students with disabilities. EmbraceKulture is a Ugandan non-profit whose mission is “to create a more inclusive world where all children are embraced for what makes them unique.”
GANDHI’s Child and Adolescent-focused team will present, “Pediatric Post-Surgical Community Resource Geospatial Mapping in Uganda,” as an oral presentation at AcademyHealth’s 2017 Annual Research Meeting June 25-27th in New Orleans, Louisiana.
Project Abstract: Pediatric Post-Surgical Community Resource Geospatial Mapping in Uganda
There is a striking unmet need for surgical intervention in low and middle income countries, where 85% of children develop a surgical need by 15 years of age. According to previous geospatial analyses in Uganda, the need for surgery among children is highest in the Northern and Western regions. Many pediatric surgical conditions carry the risk of lifelong disability often requiring post-surgical care. However, even if surgery is provided, the availability of resources to successfully transition school-aged children (5-15 years) from hospital to home after acute surgical care in Uganda is poorly understood. Therefore, the objective of this study was to geospatially analyze the distribution of post-surgical, community-based services for school-aged children in Uganda.
We utilized a geographic information system analysis of children in the nationwide household survey that assessed surgical need in Uganda (Surgeons OverSeas Assessment of Surgical Need (SOSAS)), and post-surgical community resources (ArcGIS software). Identification of post-surgical community resources took place between June and October 2016 through database and google searches, which yielded four major domains for post-surgical community resources for school-aged children in Uganda. In an effort to provide clear policy directions for gaps in the provision of postoperative care among children needing surgery in low-income countries, geospatial analyses of pediatric surgical needs and community-based rehabilitation resources may demonstrate areas in need. The objective of this study was to determine the geographic distribution of available community-based rehabilitations services for school-aged children in Uganda. In addition, we analyzed spatial data to evaluate the correlation between geographic access to rehabilitation services and surgical needs among school-aged children in Uganda.
SOSAS Uganda interviewed a random sample of 1,082 children 5 to 15 years (median age 9.5 years, interquartile range 7.1, 12.0) and collected met and unmet surgical need for each child. Additionally, all service providers for each of the four domains were eligible.
We identified 129 resources in including: 43 rehabilitation service centers, 10 assistive device and technology providers, 28 social and family support services, and 48 school re-entry programs. Services were more prevalent in urban locations than in remote areas and are clustered in the Central region, with the majority in Kampala. Layered with SOSAS data, the highest unmet surgical need and unmet community reintegration services were found in the Northern region.
Uganda is a low-resource setting with vast opportunities for healthcare providers to connect children with available rehabilitation and recovery services post-surgery. Enhanced transitional care can provide specific support to maximize community, family, and school reintegration. The lack of pediatric post-surgical community reintegration services in the Northern and Western regions where unmet surgical needs are highest are promising areas for future research and health systems strengthening.
Implications for Policy or Practice:
In order to strengthen hospital-to-home transitional care for pediatric post-surgical patients, healthcare providers, social workers, and government officials entrusted with decision- making on behalf of this population must be aware of where community resources are available and where to target future initiatives for improving community re-integration.
Brittney Sullivan, PhD, MS, CPNP, a graduate team member of the GANDHI-Child and Adolescent team, will complete a post-doctoral fellowship at Harvard Medical School in the Department of Global Health and Social Medicine, working closely with the Infectious Disease and Social Change Program under the mentorship of Mercedes Becerra, ScD. The focus of the post-doctoral fellowship is to gain additional skills in pediatric drug-resistant tuberculosis research.
Dr. Sullivan was one of two individuals to receive the Robert Wood Johnson Foundation Future of Nursing Scholars (FNS) post-doctoral award for $50,000 over two years of a fellowship position. This award will help fund Dr. Sullivan’s post-doctoral training and research. Dr. Sullivan was eligible for this award as was one of 16 individuals in the first FNS cohort to complete her PhD within three years. Dr. Sullivan will graduate with her PhD in Nursing and a doctoral certificate in Global Health this May from the Duke University School of Nursing.
Congratulations, Dr. Sullivan!
Joseph Lunyera, MBChB, a Postdoctoral Associate at Duke Division of General Internal Medicine (Duke GIM) met with GANDHI’s Children and Adolescent-focused team to talk about opportunities to improve hospital-to-home transitions in Uganda. Dr. Lunyera was born and raised in Uganda. His primary work at Duke is with the Jackson Heart Study.
GANDHI has received funding from Duke University’s Bass Connections for a second year. The goal for next year’s project work is to:
“To grow the Alliance in both breath (number of countries) and depth (research in phase I countries), and continue to engage faculty, external collaborators and students across learner levels in international mixed methods research committed to health system strengthening to support the transition home from the hospital for adults newly living with disability to achieve their greatest quality of life.”
We look forward to continuing our current projects and expanding with our future work.