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University of Salford and Teams4U Partnership: Uganda

With its numerous and diverse cultures, Winston Churchill wrote “Uganda is truly the Pearl of Africa” and went on to say “The Kingdom of Uganda is a fairy tale. The scenery is different, the climate is different and most of all, the people are different from anything elsewhere to be seen in the whole range of Africa….what message I bring back…concentrate on Uganda”. Over one hundred years later this is still true, and Uganda, relatively untouched by tourism, retains a taste of Authentic Africa.

The University of Salford has been working with charity Teams4U for over eight years. Recently, the University’s partnership with Teams4U has been developed to allow students to gain hands-on experience of delivering a public health intervention programme in rural Uganda, learning how to break down cultural barriers and to communicate with the people they serve in order to make the programme a success. Students on our BSc Public Health and Health Promotion course have the opportunity to take a subsidised ten day trip to Uganda (the student pays £200 towards the cost).

The Teams4U Uganda programme is the brainchild of honorary Salford graduate Dr Dave Cooke, who wondered if physical activity could help primary school children to achieve better results at school. Since it began, the programme has evolved and changed to tackle some of the underlying issues that lock communities in a cycle of poverty.

Small changes make a big difference

The experience of handing a football to a child that has never touched a ball is something that is difficult to describe. Before the programme began, children in rural primary schools in the Kumi district of Uganda didn’t have PE lessons; with class sizes at over 100 children per teacher, finding an activity that they could all take part in was difficult. To make matters worse, the budget for most schools is just £1.50 per child for the whole year, meaning they can’t afford basic sports equipment like footballs. Often the schools aren’t funded at all – the money just ‘disappears’.

The concept of the programme is simple, but the impact on the children is profound – headteachers have even said they felt inspired to change the way they teach as a result. However, this is where students can get involved in vital research, as many questions still need answering: does the experience of the teachers of the programme change their attitudes to physical activity? Does the donation of balls for football, netball and other activities have an impact on physical activity and sports in the schools?

Breaking the cycle of poverty

The programme also revealed other barriers to education that children in the community face. While both girls and boys are often kept off school to help out at home or work in the fields, girls in particular are not always encouraged to attend school. To add to this, we found that a big problem keeping girls from school was the lack of feminine hygiene products and limited access to water, meaning that they were missing up to a quarter of their schooling.

Keen to break the cycle of poverty where children drop out of school, girls have babies very young and have large families that they can’t support, the team set up two separate programmes to tackle these issues. The first, ‘Develop with Dignity’, provides washable pads for girls to use, meaning they now feel comfortable going to school on their period. Secondly, we organised educational sessions with parents, children and community leaders to discuss the importance of staying in school.

*Girls receiving washable menstrual pads and underwear*

Again, research is needed to understand exactly how these interventions work: does the intervention increase school attendance, for girls in particular? Are parents and the community more aware of the importance of education?

Join a trip to Uganda

You can join in and help run the sports and Develop with Dignity programmes. If you come as part of the BSc Public Health and Health Promotion, you can also help us do research to evaluate the programme.

Our volunteers often find that while they go to Uganda with the intention of serving, they end up gaining more than they give: the experience of sharing time with children who get so much joy from the simple gift of your time and attention.

Find out more

Watch this video about the University of Salford’s public health and health promotion opportunities in Uganda

To find out more about the other public health and health promotion work that the University of Salford and Teams4U have carried out in Uganda, go to our related blog posts

Find out more about Teams4U and Develop with Dignity

MSc Public Health Facebook Live

If you’re interested in studying MSc Public Health at the University of Salford, join us on Facebook on Wednesday 12 July to see our live interview with the Programme Leads and Admissions Tutor from our MSc Public Health course. Dr Anna Cooper and Dr Margaret Coffey will answer questions about the course, the modules you will study and how it could help with your career.

For a limited time we are also offering two students the opportunity to receive a 50% reduction in the course fees for the MSc Public Health (closing date Monday 7th August). You can find out more about this on our website

The Facebook Live session starts at 3.00pm (GMT) on Wednesday 12 July, simply join our Facebook page and watch. If you aren’t able to join us, the session will be recorded for you to watch at a time that suits you.

Brief review of Making Every Contact Count conference – Health Education England

By Anna Cooper, Jess Brooke and Penny Cook

On the 27^th January over 200 people congregated at the University of Salford for the MECC conference run by Health Education England with support from Public Health England. The conference started off with a welcome and a bit of a dance (as we are told is tradition in some other conferences), but it proved to set the scene for what was an informative but also welcoming event. Sir Stephen Moss in his forward outlines MECC as ‘enables the systematic delivery of consistent and simple lifestyle advice, helping people to make positive changes that will improve their health and wellbeing.’

To start there was a bit of a race through some of the evidence, policy and local level examples of MECC. Shirley Cramer outlined the definition of the wider workforce and next steps, but also the importance of the workers’ situation in the community that they serve, while Sir Stephen Moss talked about changing the culture to embed MECC into everyday practice. Dr Charles Alessi reiterated the important message of ‘don’t let there be more missed opportunities when we could be doing something’. Dr Paul Chadwick reminded us that we need to reflect on our own behaviour and motivations as health practitioners, since MECC relies on us having the confidence to raise sensitive issues. A challenge of MECC is gaining consistent evaluation to explore the impact due to the diverse nature and content on the brief interventions; what is clear is that it can impact communities – as shown by Professor Kate Arden in Wigan.

The keynote session was followed with presentations on examples of tools kits, those produced at both a local and national level. There were examples provided by Claire Cheminade, the Public Health Wider Workforce lead in Wessex and Sally James the Public Health Workforce Specialist for the west midlands, which showed how MECC is embedded across all areas right from training of the new workforce. Nigel Smith and Mandy Harling used the session to help launch the ‘MECC: quality checklist for training resources’ and ‘MECC: implementation guide’, developed by Public Health England and Health Education England.

On breaking out for the session before and after lunch there was a chance to hear about more examples, but also look at settings and behaviour change, to help with understanding the theory and practice. During lunch there was an opportunity to take a seat in the MECC cinema where a short film was shown which illustrated different people who have undertaken MECC training and put it into practice successfully. In the afternoon, one of the workshops, titled ‘NICE Guidelines and Behaviour Change Approaches’ was led by Dr Paul Chadwick. This included an interesting lecture and some useful group work. It enabled attendees to consider how their own behaviour and beliefs could impact on the implementation of MECC in their setting.

As part of @SalfordPH involvement throughout the day, eight of the MSc public health students (as pictured below), were on hand to support the event staff and delegates with their day. Additionally Penny and Anna chaired the initial sessions around “what the system is saying about MECC and why it is important” and “Implementing MECC”.

This also provided our students with the chance to hear from some leading experts in this area and be able to hear examples of how what we talk about in lectures relates to worked examples. Our thanks go to each of the students for taking the time to support the day.

Although MECC is going through a difficult time in many local areas in relation to funding, it is clear from this day there are many people who carry out the premise of MECC in their everyday working and it is something we can all be more aware of doing.

Double jeopardy: childhood neglect in children with FASD

Alcohol and pregnancy are a dangerous mix. The physical effects of alcohol on a developing foetus are well known and potentially devastating. It is known to impact physical development – causing stunted growth, craniofacial abnormalities, reduced head and brain size, sight and hearing problems, and limb and organ defects. Foetal alcohol exposure causes problems in cognitive and psychological functions such as learning, speech and language, memory, attention, inhibition, social cognition, planning, motor skills, attachment, and behaviour. The name given to the range of outcomes caused by prenatal exposure to alcohol is foetal alcohol spectrum disorder (FASD).

Double jeopardy: adding childhood neglect

Children who are exposed to alcohol prenatally are also at risk of what has been described as a case of double jeopardy: they are much more likely to experience adverse environmental experiences during the first months and years of development. These experiences can include neglect of daily care, abandonment, and emotional, sexual and physical abuse. The effects of such experiences can compound the effects of prenatal alcohol exposure, as they impact development in a similar way. Maltreatment such as neglect and abuse, especially if this is prolonged and lasts beyond the first six months of life, can have a significant impact on attachment, cognitive, psychological and social development and even physical growth.

By D Sharon Pruitt [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

To make matters worse, children who suffer maltreatment during early childhood miss out on normal attachment development. This can seriously impact their own parenting skills as adults, and lead to dysfunctional attachment behaviour if and when they become parents themselves. Those who suffer from foetal alcohol spectrum disorders are more likely to develop alcohol misuse issues, and are more likely to be involved in risky sexual behaviours. This can increase the risk of unplanned pregnancies, and so the cycle can be self-perpetuating.

Forthcoming research on FASD and neglect

The effects of a) prenatal alcohol exposure and b) early childhood maltreatment are well documented, but there is a surprising lack of research into their combined effects. My research will address this gap, first of all by conducting a systematic review into all published studies into the combined effects of prenatal alcohol exposure and early childhood maltreatment. I am currently writing up the results of this review for publication. It found only six articles on the subject, four of which used experimental methods to assess the impact of both issues. The main finding of these four articles is that speech and language deficits are more likely in children with both issues, compared to children with one or the other.

PhD STudent Alan Price (PTEH1512 © www.philtragen.com)

There are several other aspects of cognitive development that are yet to be addressed in this population, and so the next stage of my research will assess deficits in social cognition and executive function – two of the most prominent areas of deficit in children with foetal alcohol spectrum disorders and in children with a history of maltreatment. I aim to study these deficits using a combination of caregiver reports and behavioural tasks conducted in a lab at the University of Salford. I am also planning to incorporate a measure of brain activity using functional near infra-red spectroscopy (fNIRS) – a non-invasive technology that uses light waves on the near infra-red spectrum to measure blood movement in the cerebral cortex – the outer layer of the brain. This technology is especially useful in samples of young children, and this will be the first time fNIRS will have been used in this population.

I am currently in the process of applying for ethical approval, and hope to begin data collection soon.

By Salford University PhD student Alan Price

Twitter: @alandavidprice1

Email: A.D.Price1@edu.salford.ac.uk