Abstract
Background“Grand challenges” in global health have focused on discovery and development of technologies to save lives. The “grander challenge” involves building institutions, systems, capacity and demand to effectively deliver strategies to improve health. In 2008, Makerere University began a radical institutional change to bring together four schools under one College of Health Sciences. This paper’s objective is to demonstrate how its leadership in training, research, and services can improve health in Uganda and internationally, which lies at the core of the College’s vision.MethodsA comprehensive needs assessment involved five task forces that identified MakCHS’s contribution to the Ugandan government health priorities. Data were collected through analysis of key documents; systematic review of MakCHS publications and grants; surveys of patients, students and faculty; and key informant interviews of the College’s major stakeholders. Four pilot projects were conducted to demonstrate how the College can translate research into policy and practice, extend integrated outreach community-based education and service, and work with communities and key stakeholders to address their priority health problems.ResultsMakCHS inputs to the health sector include more than 600 health professionals graduating per year through 23 degree programs, many of whom assume leadership positions. MakCHS contributions to processes include strengthened approaches to engaging communities, standardized clinical care procedures, and evidence-informed policy development. Outputs include the largest number of outpatients and inpatient admissions in Uganda. From 2005-2009, MakCHS also produced 837 peer-reviewed research publications (67% in priority areas). Outcomes include an expanded knowledge pool, and contributions to coverage of health services and healthy behaviors. Impacts include discovery and applications of global significance, such as the use of nevirapine to prevent HIV transmission in childbirth and male circumcision for HIV prevention. Pilot projects have applied innovative demand and supply incentives to create a rapid increase in safe deliveries (3-fold increase after 3 months), and increased quality and use of HIV services with positive collateral improvements on non-HIV health services at community clinics.ConclusionMakCHS has made substantial contributions to improving health in Uganda, and shows great potential to enhance this in its new transformational role – a model for other Universities.
Highlights
In 2003, the Grand Challenges in Global Health initiative was launched to promote the scientific or technological innovation that would remove critical barriers to solving important health problems in the developing world with a high likelihood of global impact and and affordable technologies are already well known [4,5], yet many developing countries are failing to meet the Millennium Development Goals (MDGs) to improve the survival and wellbeing of children and adults in developing countries [6]
We propose that Grander Challenges in global health involve how to build the systems, institutions, innovations, and human resource capacity and demand needed to sustain the delivery of effective strategies that improve health outcomes on a large scale
We look across the findings of the task forces and pilot projects, and draw upon the findings concerning the historical role played by the schools, as well as the more recent results that are emerging from the formation of the College
Summary
In 2003, the Grand Challenges in Global Health initiative was launched to promote the scientific or technological innovation that would remove critical barriers to solving important health problems in the developing world with a high likelihood of global impact and and affordable technologies are already well known [4,5], yet many developing countries are failing to meet the Millennium Development Goals (MDGs) to improve the survival and wellbeing of children and adults in developing countries [6]. The Bill and Melinda Gates Foundation, one of the sponsors of the Grand Challenges in Global Health initiative, provided a two year learning grant to a Makerere University – Johns Hopkins University collaboration in 2009 to demonstrate how investment in a University – the Makerere University College of Health Sciences (MakCHS) – can improve health outcomes in Uganda and the East Africa region. We have formulated this opportunity as a Grander Challenge, and in this paper, report on how MakCHS is pursuing the challenge, through a comprehensive needs assessment and series of strategic pilot projects
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
