Health Psychologist, Dr Amy Burton, reports on her Change Exchange visit to Uganda

Health Psychology in Action: Global Health

Our Health Psychologist, Dr Amy Burton, spent some time working in Africa at the beginning of April. Amy was selected by The Change Exchange to work as a Behaviour Change Consultant for the Royal College of Obstetrics and Gynaecology partnership with Kitovu Hospital, Uganda. The Change Exchange is funded by The Tropical Health and Education Trust (THET) in association with the Department for International Development (DFID) and The Global Health Exchange. The project places behavioural scientists into health partnerships to evaluate and seek to improve projects aimed at changing healthcare practice in low and middle income countries.

Amy blogs on her experiences:

I heard about The Change Exchange project in two ways: a recent issue of The Psychologist and a visit to Staffordshire University by Jo Hart, one of the project leads. As a recently qualified and HCPC registered Health Psychologist I was keen to put my skills into practice and was excited about the challenge of taking myself out of my comfort zone by working in a low income country (something I have never done before!). Over 45 psychologists applied for the project and I was one of the lucky few to be chosen to take part.

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The Change Exchange Team

My first encounter with the rest of the team was a group meeting on a rainy March day in Manchester. This was my first opportunity to hear about the project I would be working on and to meet my colleagues Nisha Sharma and Fiona Gillison. We were appointed to work with an RCOG project based in the Masaka region of Uganda. The Excellence in Obstetric Skills Course trains local health workers in essential skills with the aim of improving care for mothers and babies and reducing the incidence of obstetric fistula (the development of a hole between the vagina and rectum or bladder often caused by prolonged obstructed labour that results in women being incontinent).

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Kitovu Health Care Complex

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The Fistula Ward

As behavioural scientists, Nisha and I were keen to understand how behaviour change techniques were being employed within the course. We therefore spent some time observing the RCOG obstetric skills course and the “train the trainer” course (to teach Ugandan health care professionals how to teach their colleagues obstetric emergency skills) and coding them for known behaviour change techniques. We had the opportunity to be ‘practice’ patients and learnt a lot about obstetric care!

We were also interested in how the Ugandan health care professionals perceived the course and what barriers they felt they would experience when putting their new knowledge and skills into practice. To explore this we conducted four focus groups with the course delegates to learn about their experiences and ideas.

Amy and Nisha with the RCOG Faculty and 'Train-the-Trainer' Graduates

Amy and Nisha with the RCOG Faculty and ‘Train-the-Trainer’ Graduates

In addition, I travelled with Nisha and the RCOG clinical lead to visit several previous delegates in their health centres and witness how the behaviours learnt on the course were being put into practice. This was an eye opening experience and gave me the opportunity to see first-hand how health centres work in Uganda.

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A Health Centre in the Masaka District

I am currently working with my colleagues at The Change Exchange to produce an interim report for the RCOG based on the data we collected during our visit. Nisha and Fiona will be returning to Kitovu in June to conduct more work with the RCOG and hopefully put some of our report recommendations into practice. I am sad to not be returning to Kitovu but I will continue to be involved with the project from the UK.

Working on this project has been an exciting, enlightening and eye opening experience and I very much hope to have more opportunities to put my health psychology and behavioural science knowledge into practice in low income countries in the future.

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