Uganda's National drug regulatory authority and the Iganga Mayuge HDSS have partnered to improve community-led pharmacovigilance

The Iganga-Mayuge Health and Demographic Surveillance Site (IMHDSS) which is managed by Makerere University Centre for Health and Population Research (MUCHAP) has partnered with the Uganda National Drug Authority (NDA) to implement a community dialogue and sensitization campaign to improve reporting of suspected adverse drug reactions by patients and healthcare workers in Iganga and Mayuge districts community. The campaign was launched in December 2016 in Iganga town attended by district technical and political leadership, health managers and their healthcare teams, religious and cultural leaders, Sub-County leaders, drug shop operators, clinics, pharmacies and nurses in boarding schools from both Iganga and Mayuge.

The role of patients as key contributors in pharmacovigilance (drug safety monitoring) is now fully acknowledged globally (EU pharmacovigilance legislation mandates patient reporting). Where patient reporting is operational (EMEA and Netherlands), it has been identified to facilitate faster signal detection and current methods used in pharmacovigilance need to optimise use of the information reported from patients.

This initiative will help provide information on the factors that drive patient reporting in our communities to guide NDA efforts towards improving patient involvement in drug safety monitoring, including the further development of a patient-specific form, development of a severity grading and evolution of the database structure and the signal detection methods.

Dr. Dan Kajungu, the Executive Director of Makerere University Centre for Health and Population Research (MUCHAP)-IMHDSS emphasized that community dialogues have worked in other public health areas and in a number of countries. It is hoped that this imitative will improve reporting of suspected adverse drug reactions a practice that is working in some European countries. Once the community members and healthcare providers are provided with the avenues of reporting these events, there is no reason why it cannot be possible in Africa.

He added that "there is a big problem of under reporting suspected adverse drug reactions in Africa and Uganda in particular even with the presence of too many drugs in the health ecosystem from the public and private health sector. Therefore, communities in Iganga and Mayuge Districts will be engaged in the community dialogue for four months about drugs, their positive effects and the possible side/negative effects. These will inform the NDA on how best to help and empower the patients (or community members) to report the suspected adverse reactions due to the drugs"

Dr. Dan Kajungu presenting results of the baseline study He further revealed that community dialogues and sensitization activities will be conducted beginning January till June 2017. A baseline knowledge attitude and perceptions study was done whose evidence was used to come up with the proper message that will guide the dialogues. A similar end line survey will be conducted to study the effect of the community dialogues and sensitization campaign. Different avenues of communication will be adopted like radio talk shows, adverts, distribution of community leaflets among others to dialogue, sensitize and improve awareness of community members and healthcare workers about the reporting of suspected adverse drug reactions.

The baseline KAP survey among patients and healthcare workers conducted within the framework of the IMHDSS in collaboration with the NDA indicated that 56% of the respondents from the community knew that drugs have a potential of causing negative effects. With 1,037 randomly selected households and 327 healthcare providers interviewed in Iganga and Mayuge Districts, the survey also reveals that only 34% had actually ever reported an adverse drug effect in their professional life.

CAO-Iganga Mr. Mukasa M. Joseph launching the community dialogue toolkit The Chief Administrative Officer (CAO)-Iganga Mr. Mukasa Maira Joseph who is also MUCHAP Board Member commissioned the launch and said that researchers coming up with these interventions in the community will contribute a lot to improving the health conditions of the people. He also noted that health workers have a role of informing patients with all the required information regarding complete dosage of the drug, and informing patients that medicine cures but can also cause harm.

The Iganga distrct health Officer (DHO), Dr. Muwanguzi David applauded the work of MUCHAP-IMHDSS for carrying out evidence based surveys vital for improving health care delivery to improve community wellbeing and supporting policy making. He also noted that many researches done at the organization had benefited his office and officers as well as the community.

A group photo of community leaders after the workshop