‘Strong Links and Heightened Connectivity’: Bidirectional learning Amidst COVID-19

The Kampala–Cambridge partnership was established in 2014, with the aim of improving maternal and neonatal outcomes, building on a longer standing maternal health research partnership between Makerere and Cambridge Universities. This initial partnership was developed between staff at the Rosie Hospital and the Department of Obstetrics and Gynaecology in Cambridge, and Makerere University Department of Obstetrics and Mulago National Referral Hospital (now Mulago Specialised Women and Neonatal Hospital and Kawempe National Referral Hospital) in Kampala.

In 2019, we developed a second strand to the partnership, focusing on antimicrobial stewardship (AMS) and infection prevention and control (IPC) activities. The goal has been to reduce healthcare-associated infections on the obstetric and neonatal wards, through increased skills and knowledge. There have been bidirectional visits, workshops, data collection, co-authoring an academic textbook, and consistent communication between partners.

Unsurprisingly, the arrival of COVID-19 led to changes in partnership plans and activity, such as postponed visits. However, the pandemic has reinforced the value of health partnerships such as ours. Before the arrival of the pandemic, the partnership already had projects in motion centered around improvements in IPC. In February, Ronald Onegwa (pharmacist), established onsite alcohol gel production at Kawempe National Referral Hospital. The gel has been vital in the hospital’s efforts to combat COVID-19. The timely arrival and installation of hand hygiene posters around the hospital in early March, combined with a heightened sense of awareness due to the pandemic, has led to a significant increase in good hand hygiene practices among staff and patients.

Soon after the virus emerged, the partnership immediately began responding. After consulting with partners in Kampala, the partnership applied for THET’s Health Worker Action Fund. Ugandan partners requested that funds go to sustaining increased levels of alcohol gel production, which was in high demand among staff and patients.

Partners also highlighted the need for PPE, specifically scrubs. The aim has been to minimize infection within the hospital, particularly among staff in priority areas. The scrubs will help reduce infection transmission. The partnership has also shared guidance for establishing safe practice in the new donning and doffing areas. It was key that scrubs and alcohol gel components were locally sourced, in order to get them quickly and to support the local economy.

“COVID-19 has instilled a behaviour change in our patients and staff on the importance of using alcohol gel in mitigating the spread of infections, COVID-19 inclusive. The local production of alcohol gel and the installation of the dispensers within our joint [. .] partnership [. .] was a timely blessing to us as a hospital, because we couldn’t imagine if they weren’t in place how difficult life would now be. Their existence has built confidence and reduced anxiety among the healthcare workers.” – Ronald Onegwa, Pharmacist

It is also important to highlight the bi-directional support this partnership offers all members, be they based in Cambridge or Kampala. All continue to engage in regular video conference calls, facilitated by CGHP. This platform serves as a forum for knowledge exchange, sharing resources and experiences relating to the management of COVID-19. With incredible honesty and compassion, both junior and senior healthcare professionals discuss and explore the realities of the pandemic.

We believe that such strong links and heightened connectivity will continue to guide us through the response and recovery phases of the pandemic. Funding streams such as the Health Worker Action Fund have enabled the partnership to support healthcare staff in Kampala in responding to the pandemic safely and effectively. In addition, it has further stimulated bi-directional sharing and learning which undeniably leads to improved outcomes in both Uganda and within the NHS.

– Kampala–Cambridge partnership team