My PhD study and the CARTA experience

By Stephen Ojiambo Wandera, Cohort 2 CARTA Fellow

I remember in 2012, I had interrupted nights answering questions for the preliminary screening for CARTA fellowship. I would wake up in the middle of the night to continue from where I had left then go back to sleep. This was a hectic time for me but I needed to do a PhD. Finally, I answered all questions and submitted. Few months later, I received an email from the CARTA secretariat awarding me a CARTA fellowship.

In the award letter, the aspect of Joint Advanced Seminars (JAS) moved me. I looked forward to attending them. What I needed was state of the art training in scientific writing. This was critical for my future success and career as a researcher. I had learnt to aim high from my childhood. This time round, my mission was to be an academic, “a young African professor by age 40”. To say the least, JAS made a huge impact in my career.

My journey through the CARTA JASes

JAS 1 in Nairobi Kenya helped me to reshape and refine my research idea. Initially, I wanted to investigate how “intergenerational support is associated with access to healthcare among older people”. I realized that it was a narrow aspect. I broadened it to focus on “Healthcare access inequalities among older people in Uganda”. The ESEO team gave immense support and hands on experience in building a strong theoretical foundation for this work.

JAS 2 at the School of Public Health, University of the Witwatersrand (2012), was another building block. During this time, I concretized data analysis skills using NVIVO. I am using NVIVO to analyze qualitative data. This is a useful skill for a lifetime. I have started transferring these skills and competencies to graduate students at Makerere University.

JAS 3 at the University of Ibadan, Nigeria (2013) was an incredible landmark. I had an opportunity to interface with advanced and senior statisticians: Jonathan Levin and Max Petzold; and to write and present two journal articles from my PhD research. The input and comments from CARTA Cohort 2 members was a great addition. The inspiration and feedback from the facilitators (Prof. Uche, Dr. Funke and Dr.Izugbara) were very helpful. I managed to submit these two papers during and after JAS 3. I acknowledge the support from Prof. Donald Cole and Prof. Max Petzold for their support to reviewing my manuscripts.

JAS 4 held at Safari Park Hotel in Nairobi Kenya was incredible. We got inspiration from a number of facilitators. I will never forget Prof. Nangulu’s story of a persistent mentor and academic, who has risen through the ranks to become professor at age 46. This was very important to me because it shows that goals, however difficult they are achievable. Everything is possible to them that believe and say it out. You remain challenged to stay focused knowing that you have a great cloud of witnesses to your confessions and aspirations. Bringing Cohorts 2 and 5 in the same venue for their JAS 4 and JAS 1 respectively is a brilliant idea. It gave me an opportunity to look back and reflect on where we have come from in the CARTA program.

Where do I go from here?

CARTA has really made my future brighter. I look forward to becoming a professor by age 40. It sounds over-ambitious but I have learnt over time that to achieve more in life, you have to set a very high target and aspiration for yourself. I intend to engage in research and publishing on the issues affecting the African continent including population ageing, inequalities in health and access to healthcare, and gender-based violence. I have to build capacity to apply for and win research grants while at Makerere University (JAS 4 is an answer to this need). In addition, I will build the capacity of other researchers through the Health Access Research Consult, registered in 2012. As a way of giving back to the community, I intend to do a transfer project by setting up an NGO to support older people’s health needs in Uganda.

Finally, I wish to acknowledge CARTA funders for supporting us as a Cohort. In particular, I am grateful to the Wellcome Trust (UK), the Department for International Development (DfID), and Carnegie Corporation of New York, Ford Foundation, Google.Org, Swedish International Development Cooperation Agency (Sida), and MacArthur Foundation. In addition, I appreciate the contribution of German Academic Exchange Service (DAAD) for additional funding, Population Association of America (PAA, 2014) for the travel award to Boston, where I presented a paper on disability. The CARTA facilitators & secretariat and cohort 2 fellows have been a great resource to me. To my supervisors, who have included: Professor James Ntozi, Dr. Betty Kwagala, Dr. Isabella Aboderin, thank you for your mentorship and supervision. All things are possible for them that believe and work towards them.

CARTA Program: Setting Standards in Research and Training in Africa

By Paul Ruto, Associate Researcher, United States International University in Nairobi Kenya.

This year’s CARTA fellows’ conference was perfect timing for me. The diverse participants at this conference brought in rich knowledge and experience. The participants had high expectations - but I had no doubts since the CARTA program upholds high standards. The organization of the conference was professionally done from the setup of the room, choice of presenters and facilitators, strict time-keeping, conference evaluation forms and the materials given to all participants.

The highlights was presentations from the PhD fellows who depicted high quality research. From health issues, communicable and non-communicable diseases, to sexual behaviors across different countries, it was evident that time and resources was invested in each research. Moreover, the PhD trainees’ good presentations was a reflection of the high quality of research they had undertaken. I only wished we had more time to delve deeper into their findings.

Presentation after presentation, I developed the urge to hear even more. If time was extended a little bit, I am sure that presenters and participants would have more time for detailed presentation, questions and interaction especially on emerging interesting topics such as football, risky sexual behaviors, food security, brucellosis, contrimoxazole and the mathematical model. I believe many in the academics field can benefit from such conferences. There was so much to learn, including PhD training and supervision, research methodology, presentations and much more. For published/ accessed papers, it will add value for participants to access these even prior to the presentations as this would even stimulate more academic discussions.

That said and done, the CARTA fellows were very warm, welcoming, humorous, displayed diverse culture, and were able to articulate their findings. CARTA fellows proved that quality research can be used to solve societal problems!

Regardless of the country, background or discipline, quality is key and CARTA is setting the standards in PhD training in Africa 

Wide Breadth of Research Displayed at the 2nd CARTA Fellows’ Conference

A wide breadth of research was displayed during the 2015 CARTA fellows’ conference held in Nairobi, Kenya alongside two Joint Advanced Seminars (JASes) for CARTA fellows. CARTA organizes a conference during the last JAS for every cohort of fellows to offer them an opportunity to present on their research to a wide audience that is drawn from various institutions and various scholars.

The fellows’ conference helps fulfil the vision of CARTA of building a vibrant African academy that is able to lead world class multidisciplinary research that makes a positive impact on public and population health. They are held annually during the JAS 4, the final JAS for CARTA fellows. The presentations at this years’ conference were a clear display of quality work being done by the students and an indication of growth towards becoming research leaders in Africa. They tackled a number of topics on health ranging from non-communicable to infectious diseases; HIV, family planning, food security, malaria, and health of the aging, environmental health related issues and knowledge, attitudes and practices in health.

“The wide variety of issues being addressed by the fellows through their presentations is a true reflection of the depth and breadth of the programme,” said Chima Izugbara, Director of Research and Capacity Strengthening Division at APHRC.

Did you know that brucellosis is a significant and neglected public health problem among human population living in livestock keeping and the risk is being aggravated by consumption of unpasteurized milk products? And that investment in the education of the slum households may, in the long term, contribute to reduction in the prevalence of food insecurity? These are some of the findings from papers presented at the conference.

The depth of research presented is a confirmation of CARTA’s aims to foster vibrant and viable multidisciplinary research hubs at African universities and creating locally-trained internationally- recognized researchers on areas of health and population in Africa. Participants drawn from CARTA partner institutions and Jomo Kenyatta University of Technology, University of Nairobi, Moi University, Kenyatta University, United States International University and Daystar University are some of the institutions from which a section of the conference participants were drawn.

“The conference was very informative. I loved so much the medical related presentations. They were well researched and used current data and information. I would not mind being part of such a conference anytime it is held,” remarked Judith Otele Karimi an epidemiologist from Daystar University and Quality Assurance and Benefits officer at the National Hospital and Insurance Fund in Kenya.

Being Single Puts You at Higher Risk of Brucellosis

A study conducted by Gabriel Tumwine, a CARTA fellow at Makerere University in Uganda, has revealed that human brucellosis is a significant public health problem among pastoralists, yet it has been neglected by researchers. The risk of being infected by this disease is aggravated by consumption of unpasteurized milk products. Brucellosis popularly known as the milk disease is a bacterial disease caused by Brucella abortus. The disease leads to spontaneous abortion in infected cattle and is transmissible to humans.

In humans, the symptoms of the disease are strikingly similar to those of malaria with fever, headache, malaise, and vomiting. Aware that brucellosis remains a neglected zoonotic disease in Uganda, Gabriel Tumwine, a Cohort 2 CARTA Fellow, led a cross-sectional study to determine the sero-prevalence and risk factors associated with human brucellosis in communities where livestock rearing is a common practice. The country-wide study revealed that individuals that are in agro-pastoral communities and consume milk and milk products are at higher risk.

Gabriel Tumwine, Cohort 2 CARTA Fellow

According to the study results, in Uganda, human Brucella sero-prevalence was at 17.0% and is higher among males at 20.5%. Sex, age, occupation, religion, education levels, knowledge of the disease, keeping animals at home, processing local milk products, slaughter of animals, handling of abortus, assisting animals giving birth, drinking of animal’s urine and sharing water points with animals were not significantly associated with brucellosis.

Being single puts you at a higher risk of getting this disease. This is because, according to the study, of the lifestyle that single people adopt. Single people tend to eat food that is easy to prepare. Milk and milk products that have been locally processed are readily available and need little time to prepare and hence an option for many single people. Moreover, single people, in many communities are often charged with the responsibility of looking after animals in livestock keeping areas and most cases end up consuming unpasteurized milk products. These put single people at a higher risk of acquiring Brucella abortus.

The study recommends that there is a need to initiate screening and early treatment of infected humans and a much higher need of awareness creation amongst the public about brucellosis.

Second Cohort Hails Program’s Success

After four years of hard work, 19 fellows completed their journey in the CARTA program. The journey that began in 2012 officially came to an end and was celebrated in style by the fellows, facilitators and CARTA consortium partners. The Cohort 2 CARTA fellows expressed their appreciation of the program’s contribution to their career development. During a Town Hall meeting with the CARTA Director, Dr. Alex Ezeh and CARTA program staff, the fellows expressed their gratitude for the CARTA program and the people behind this great idea. This meeting marked the end of the fourth and last Joint Advanced Seminars (JAS) for the cohort 2 fellows who were in Nairobi.

Cohort 2 fellows with CARTA leadership at the end of JAS 4 in March 2015, Nairobi, Kenya.

To most of the fellows, the CARTA program has put them on the right track academically. They have had an opportunity to interact and be mentored by a number of academics drawn from across Africa and the Global North. The fellows have had, compared to other PhD students anywhere in Africa and even the world, an opportunity to spend more uninterrupted time with a number of facilitators via the JAS training model that is fully residential. Unlike many other PhD students in other universities in Africa, CARTA fellows unanimously agreed that they have been nurtured on critical areas needed to become research leaders in any areas of population and public health.

‘Publish or perish’ a common refrain in the research world is an issue of the past for CARTA fellows as each of them has published during their journey in CARTA. Some of the fellows never had an idea of how to go about publishing but CARTA has made this happen just within the four years of interaction. The fellows said that through CARTA they have published in peer reviewed journals and with other scholars as either lead authors or co-authors.

Researchers also need to be able to attract grants in order to continue with their work.

For this cohort of CARTA fellows, they testified that the proposal writing training they underwent through CARTA has made a great impact in their lives. Most of them are now able to write winning proposals and have attracted grant from various donors either as Principal Investigators (PIs) of co-Principal Investigators (Co-PIs). To the fellows, CARTA program is uniquely structured and has the interest of the African continent at heart.

Mwamtobe Peter Mpasho, University of Witwatersrand: “I am the first in my family to get a PhD and I would not have done so if it was not for the CARTA fellowship”. 

Nyondo Alinane Linda, University of Malawi: “CARTA should not underestimate its contribution to research policy in Africa and its ability to develop research leaders for Africa”.

Fagbamigbe Adeniyi Francis, University of Ibadan: “I was selected for a post-doc position without an interview. This is due to my good profile which I have developed through the CARTA fellowship program”.

Longwe Herbert Hudson Thulasoni, University of Malawi: “Being a CARTA fellow can open many opportunities. In a recent interview for my current job, I was asked to define what CARTA is and I got the job”!

Wells Utembe, University of Witwatersrand: “I have moved from writing one conference paper to nine! That’s a huge improvement! I no longer hide my CV. And I owe it all to CARTA.”

Oluwatoba Olufunke Abiodun, University of Ibadan: “We are the output and outcome of your proposal. CARTA has given us an opportunity to know each other, network and even do joint research”.

4 CARTA Fellows awarded Post-doctoral Fellowships

4 CARTA Fellows awarded Post-doctoral Fellowships

The Consortium for Advanced Research Training in Africa (CARTA) has awarded its first ever post-doctoral fellowships to CARTA fellows who have completed the PhD fellowship program. The awards announced yesterday saw four fellows awarded the fellowships competitively. CARTA aims at securing the future and fostering the career growth of its high-achieving graduates and thus the post-doctoral fellowships are a good way to ensure this is turned into a reality.

The post-doctoral fellowships will offer the awardees the opportunity to build specific skills, expand their networks, encounter research leadership and role models, receive strong mentoring and learn the demands of community and public engagement. The fellowships will run for a maximum of 12 months and are tenable at any African CARTA partner-institution or associated research institutes.

The fellows will undertake their post-doctoral fellowships at institutions they had identified and each has been assigned a mentor prior to this award who will work with them to help them build their skills.

The four CARTA fellows who were awarded the post-doctoral fellows are as follows:

Linda Alinane Nyondo

Linda Alinane Nyondo is a Cohort 2 CARTA fellow of the School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi. Nyondo will undertake her post- doctoral fellowship at the Malawi Liverpool Wellcome (MLW) Trust Clinical Research Programme. She will be mentored and supervised by Dr. Anja Terlouw. “I am very excited with this award. Once again, I am thankful to CARTA for this opportunity to advance my career,” said an elated Nyondo when she received her award letter.

Sulaimon Adedokun

Sulaimon Adedokun is a Cohort 1 CARTA fellows who undertook his PhD studies at the Obafemi Awololo University in Nigeria. He will be undertaking his post-doctoral fellowship at University of Warwick, University of Warwick, Coventry, United Kingdom. Adedokun will be mentored and supervised by Dr. Olalekan A. Uthman, Assistant Professor in Research Systems at the Centre for Applied Health Research and Delivery (CAHRD) at the University of Warwick and Liverpool School of Tropical Medicine. “I wish to express my appreciation to CARTA for this great opportunity. I promise to make maximum use of this opportunity and keep the flag of CARTA flying,” remarked Adedokun upon receiving his award letter”.

Banjo Olufunmilayo

Banjo Olufunmilayo is a Cohort 3 CARTA fellow who did her PhD at the Obafemi Awololo University in Nigeria. She will be undertaking her post-doctoral fellowship at the Demography and Population Studies Programme, School of Social Sciences, University of Witwatersrand, Johannesburg, South Africa. Banjo will be mentored and supervised by Professor Clifford Odimegwu from the same school. “I am sincerely grateful to CARTA for this rare opportunity and a platform to move on in the pursuit of my academic career. I promise to abide by the terms of the contract as much as I see God helping me. I am indeed very grateful,” said Banjo.

Joshua Akinyemi

Joshua Akinyemi is a Cohort 1 CARTA fellow who did his PhD studies at the University of Ibadan, Nigeria. He will undertake his post-doctoral fellowship at the University of Witwatersrand, Johannesburg, South Africa. As a Post-Doctoral Fellow, Akinyemi will be supervised by Professor Clifford Odimegwu of the Demography and Population Studies Programme, School of Social Sciences, University of Witwatersrand. “I am so humbled by the opportunity offered to me by CARTA. I will do my best to make judicious use of the opportunity,” remarked Akinyemi. 

What’s driving young people to have transactional sex in Malawi’s slums

By Steve Mphatso Kamndaya, University of the Witwatersrand and Caroline Kabiru, the African Population and Health Research Center

Transactional sex, or the exchange of sex for money or other material goods, is one of the drivers behind the high risk of sexually transmitted infections (STIs) and unintended pregnancies among young women living in urban slums of Malawi.

The drivers that push young men and women to engage in transactional sex have been widely studied. The findings suggest that as a result of the economic stress associated with earning low wages and widespread youth unemployment, young women are inclined to use sex to generate income for their basic needs.

Although these studies provide useful insights on transactional sex, relatively little is known about transactional sex from the perspective of young women and men living in urban slums.

Our study is one of the first to look at how young men and young women understand the structural factors that promote transactional sex among their peers. It explored how material deprivation and a desire for fashionable goods may lead to decisions to engage in transactional sex.

Malawi’s HIV landscape

Malawi is a low-income country, with 91% of its 16 million people living on less than US$2 per day. According to the most recent statistics, HIV prevalence peaked in 1999 at 16.4% and declined steadily to 10.6% in 2010. HIV prevalence was higher among females. Although there has not been any national representative survey since 2010 to estimate HIV prevalence, last year it was estimated that 1.1 million Malawians are living with HIV.

The national figure masks significant rural-urban differences. Urban prevalence, at 17.4%, is nearly double that of rural areas, which sits at 9%. One-fifth of the country’s population is classified as urban.

Urbanisation in Malawi is linked to concentrations of poverty – about 65% of the urban population live in urban slums. Young people living in these slums are considered an at-risk population for STIs, including HIV, and unintended pregnancy.

The study used data from five focus group discussions and 12 in-depth interviews undertaken with a total of 60 young men and young women between the ages of 18 and 23 years living in two urban slums of Blantyre, the country’s capital. The study was conducted over a six month period from December 2012 to May 2013.

Reasons for engaging in transactional sex

The young people’s narratives suggested that acute economic pressure, lack of housing, and food insecurity combined with a desire for fashion influenced their decisions to engage in transactional sex.

Describing how the lack of housing may influence young women to engage in transactional sex, a 22-year old young woman whom we will call Nasiyato said:

When a girl lacks housing and she wants to find a place to sleep, or she does not have rent, she is mostly found in a bar as she does not have a place to live. She will have sex with a guy [in order to have a roof over her head for the night] and then does the same thing the next day.

As narrated by Naje (not her real name), lack of housing was also perceived to motivate young men’s decisions to engage in transactional sex with older women.

Young men here sometimes sleep with older women, just because they want to stay [and sleep] at a decent place. Several young men get STIs in the process.

Food insecurity was another reason given for engaging in transactional sex. It gave them a “visa” for eating on that particular day.

Nagama, a 19-year-old mother of two children, explained that the need to alleviate her family’s health needs routinely resulted in her engaging in transactional sex.

It usually happens when my child is very sick and I have no means to go to (a private) clinic and there is no money. Something tells me: Why am I rejecting the men? After all my child will be better … When my mother or my child is sick you ask him to help. Just know that you will have sex. Otherwise, next time he will refuse to help you. And it goes on.

Although material deprivation was cited as an important reason for young people to engage in transactional sex, the young men and women also spoke of sex as a means to meet their aspirations and desires for fashionable goods.

Selina, a 20-year-old female who was unmarried said “everything was fashion nowadays”.

When I get a skin (skinny) jean, others want to have theirs as well and will accept any man for sex, be [he] older, to get money for a skin jean.

Young men also reported that they exploited young women’s desire for fashionable goods to lure them into having sex.

The implications

Our research demonstrates that material deprivation and consumerism may be important factors in the types of sexual relationships that young people have.

These findings suggest that a new generation of structural interventions addressing the unique needs of vulnerable groups of young people, particularly those in urban slums, should be considered to reduce sexual and reproductive health risks.

About the Authors

Steve Mphatso Kamndaya is a Cohort 1 CARTA fellow pursuing his PhD studies at the School of Public Health at University of the Witwatersrand

Caroline Kabiru is a Research Scientist at The African Population and Health Research Center

CARTA Partner Universities ​Top Global Research Citation Ranking

Eight out of the nine universities participating in the Consortium for Advanced Research Training in Africa (CARTA) program emerged amongst the top 100 list of the Journals Consortium's 2015 rankings, with six topping their country lists. The Journals Consotium (JC) ranking rates universities in the world according to the number of research publications and citations emerging from them. The rankings are based on data collected over a period of five years. The 2015 ranking rated the universities' outputs in the last five years (2010 to 2014) as well as their visibility on the internet.

Research output and publication citations are important matrix to any university as it is a testament to the institution’s contribution to academic world. Below is how the institutions were ranked

Institution	Position in Africa	Position in Country
University of Nairobi	4	1 (Kenya)
University of Witwatersrand	6	4 (South Africa)
University of Ibadan	8	1 (Nigeria)
Makerere University	12	1 (Uganda)
Obafemi Awololo University	24	5 (Nigeria)
University of Dar Es Salam	39	1 (Tanzania)
Moi University	47	3 (Kenya)
University of Malawi	61	1 (Malawi)
University of Rwanda	106	1 (Rwanda)

CARTA’s vision is to be the catalyst for the emergence of a vibrant African academy able to lead world-class multidisciplinary research that makes a positive impact on population and public health. To do this, the CARTA PhD training program has research publication as one of the critical output for the CARTA fellows.

During the fellowship period, the fellows are usually taken through rigorous writing process and this has yielded positive results. The fellows collectively have published over 210 papers in peer reviewed high impact journals and continuously thrive to do their best.

Uganda Christian University visits APHRC Campus

A team of staff from Uganda Christian University led by Prof. Christopher Byaruhanga, Dean of School of Research and Postgraduate Studies, came for a tour of the African Population and Health Research Center.

This tour aimed at sharing what the University does and looking into possibilities of the university partnering with the Center to deliver training and research in line with the University’s mandate and the Canter’s areas of focus and expertise.

“APHRC has in the last 15 years generating research evidence on population and health issues. APHRC’s vision is to be a global center of excellence, consistently generating and delivering scientific evidence for policy and action on population, health, and education in Africa,” remarked Prof. Peter Ngure, CARTA Program Manager while sharing with the team about the CARTA program.

From left: Prof Peter Ngure (APHRC); Justus Musasiah (APHRC); Hamilton B. Mbokureeba (UCU); Dr. Uzziah Matte Kiriaghe (UCU); Prof. Christopher Byruhanga (UCU) and Dr. Peninah Masibo (APHRC)

Uganda Christian University had an opportunity to present to APHRC staff from the Research Capacity Strengthening what the University’s mandate is and what it is they do in research and postgraduate studies.

The University through its representation at the visit expressed their intention of hosting APHRC Trainings next year and possibly collaborating in gender based violence research.

According to the dean of School of Research and Postgraduate Studies at the University, Prof. Byaruhanga, APHRC cannot be applauded enough for initiating and facilitating cutting-edge doctoral and post-doctoral trainings including CARTA and ADDRF.