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This project aims to enhance family planning among refugees in the Nakivale refugee settlement in Uganda by involving men and promoting joint decision-making within couples. Uganda, hosting over 1.62 million refugees, faces challenges where unstable conditions raise the need for effective contraceptive use to avoid unintended pregnancies. Although there have been global advances, sub-Saharan Africa, including Uganda’s refugee populations, has one of the lowest contraceptive uptake rates. This project addresses the gap in male involvement in family planning, which is crucial for promoting women's health and achieving equitable reproductive health outcomes.

Guided by the Interdependence Model of Couple Communal Coping and Behavior Change by Lewis and colleagues, the project team is currently conducting an exploratory qualitative study in Nakivale. This study gathers insights on men’s involvement and couple dynamics in family planning through interviews and focus group discussions with African refugee men, women, religious leaders, healthcare providers, and settlement commanders. With additional support through the CGHE Impact Accelerator Grant, the team will implement a quantitative survey to understand the desires, availability, and utilization of family planning methods, and the factors influencing male involvement. Subsequently, community consultations will be conducted to adapt two evidence-based interventions for the local context: a couple-based sexual and reproductive health counseling program and a group antenatal care program using picture cards for low literacy populations.

This three-phased study will: 1) Quantitatively and qualitatively assess the family planning context among African refugee men and women in Nakivale; 2) Adapt existing interventions through community consultations to develop a male-engaged family planning program; and 3) Pilot test the intervention focusing on feasibility and acceptability. The pilot will involve six to eight sessions, initially targeting men and later including their female partners.

The outcome is a tailored, culturally relevant, male-engaged family planning intervention designed to foster joint decision-making and increase contraceptive use within the Nakivale refugee community. This initiative aims to empower both men and women, promoting equitable family planning decisions and improving overall health and well-being. By emphasizing community involvement and using a mixed-methods approach, this project aligns with the principles of the Empowering Women and Communities (EWC) challenge group and aspires to contribute to health equity and sustainable family planning practices in refugee settings.

This project aims to improve vaccine equity among children in urban Kenya and rural Uganda by developing a parent/caregiver-facing digital vaccine card and registry. Utilizing a mobile health (mHealth) approach, the proposed tool will provide access to children’s vaccination data via SMS text messaging, complementing existing health provider systems. The initiative addresses persistent data quality issues in sub-Saharan Africa due to reliance on paper-based records, which hinder accurate estimation and timeliness of vaccinations. The project involves three main phases: evaluating the current vaccination landscape, co-designing the digital vaccine card with stakeholder input, and implementing and assessing its feasibility and impact. By engaging the Kenyan and Ugandan Ministries of Health and local communities throughout the process, the project ensures sustainability and relevance, ultimately aiming to achieve better vaccine coverage and timeliness for vulnerable children.

The Trusted Faces, Familiar Places project, a collaborative effort between the University of Michigan and Universitas Syiah Kuala, aimed to enhance vaccine equity in Aceh, Indonesia by addressing trust and accessibility issues around vaccination services. Led by Abram Wagner and Harapan, the initiative deployed innovative methods to increase vaccination uptake in communities with low pediatric vaccination rates. The project's central strategy involved engaging local religious and community leaders in health conferences to promote vaccine information and culturally appropriate counseling. In tandem, a "vaccine-in-a-van" concept was implemented, bringing vaccination services to social and religious spaces to increase convenience and visibility. Over three years, districts in Aceh were randomized into different intervention groups, with a focus on training community health workers in vaccine administration and communication skills. The project sought to create a sustainable, community-integrated vaccination network by systematically approaching vaccine hesitancy and leveraging trusted local figures, ultimately aiming to establish a scalable model for other LMICs.

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Link to clinical trials page (clinicaltrials.gov)

The project "Assessing Flooding Impact of Households within the Rakai Cohort in Uganda" is a collaborative initiative between the University of Michigan and the Rakai Health Sciences Program (RHSP) aimed at validating and administering climate shock surveys to evaluate the impacts of extreme weather events, with a particular focus on flooding, on household health in southern Uganda. This study adapts climate shock surveys previously developed in Kenya and Bangladesh to assess climate risks, adaptation behaviors, and health outcomes related to respiratory and water-borne diseases.

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The project will enroll 500 households from the Rakai Community Cohort Study (RCCS) in a year-long nested longitudinal study to capture recent and future flooding impacts. Coordinated with research efforts in Kenya and Bangladesh, the project seeks to build climate change and health research capacity in Uganda and ultimately integrate the validated survey into global environmental surveillance systems, advancing a data-driven approach to developing environmental health interventions amidst climate risks.