BRIGHT Network is pleased to announce the awards of the 2024/2025 BRIGHT Grant Call. Out of 62 proposals submitted, five proposals were selected for funding. The awards can be viewed below. 

Developing a HEARTS-Based Strategy for Integrated Management of Hypertension, Diabetes Mellitus, and HIV in Eastern Uganda: A Feasibility, Acceptability, and Effectiveness Study 

Principal Investigator: Kanyike Andrew Marvin 
Organization: Busitema University, Uganda 
Location: Mbale, Uganda 

Project Overview 

The escalating prevalence of chronic non-communicable diseases (NCDs), especially hypertension (HTN) and diabetes mellitus (DM), is a public health concern in Low- and Middle-income countries (LMICs). A national survey revealed a high prevalence of HTN (26.4%) and DM (1.4%) in Uganda. The healthcare systems in LMICs are ill-equipped to handle NCDs; however, they have built robust HIV care infrastructures that share chronic care delivery with NCDs. Integrating NCD management into HIV care is a commendable approach with positive results but with limited implementation. The World Health Organization’s HEARTS (Healthy lifestyle counseling, Evidence-based treatment protocols, Access to essential medicines and technologies, Risk-based care, Team-based care, Systems for monitoring) packages is an evidence-based framework that has improved outcomes for HTN and DM among the general population in primary care settings. It could be explored for integration of HTN and DM in HIV care settings.

The main objective of this study is to develop and pilot the feasibility, acceptability, and effectiveness of a contextually informed HEARTS-based strategy for integrated management of HTN and DM in HIV care at Mbale Regional Referral Hospital, with a well-established large HIV clinic in Eastern Uganda.

The study team believes that the HEARTS-based strategy by employing innovative implementation science frameworks, the Capability, Opportunity, Motivation Behavioral change (COM-B) model, and the Behavioral Change Wheel (BCW) will be effective to address integration barriers in strategy development. 

The Epidemiology of Triple Burden of Malnutrition and Introducing Iron Dense Porridge to Prevent Iron Deficiency Anemia among Mother-child Pairs in Ethiopia

Principal Investigator: Melese Linger Endalifer 
Organization: Debre Markos University, Ethiopia 
Location: East Gojjam, Ethiopia 

Project Overview 

Ethiopia is a country affected with single forms malnutrition in the past decades and now it’s under nutrition transition. Currently Ethiopia suffered from double and triple burden of malnutrition at household, community and country level. More than half of children age 6-59 months (57%) and 24% of women age 15-49 were anemic in Ethiopia. Previously plentiful studies assessed under nutrition in children age less than five years old; but none of them conducted study on the magnitude of triple burden of malnutrition in Ethiopia. Furthermore, the predictors identified before are only from human health perspectives. They didn’t consider environmental and animal health related predictors of malnutrition. Even though the magnitude of anemia among children age 6 to 59 months was 57%; little nutrition intervention was implemented before.  

This study aims to address five linked objectives, which are listed below:

1. To assess the prevalence of triple burden of malnutrition among mother-child pair in East Gojjam;

2. To identify the predictors of triple burden of malnutrition from the perspectives of animal health, human, and environmental health;

3. To develop homemade iron dense semi liquid (Porridge) from red teff;

4. To assess the effect of iron dense semi liquid (Porridge) food on hemoglobin level of children age less than two years old;

5. To design a strategy to scale up the practice of consuming of iron dense semi liquid (Porridge) for the large population.

Overall, the key development output of this project is expected to be developing homemade iron dense semi liquid (Porridge) as nutrition intervention in context of Ethiopia to reverse iron deficiency anemia. 

Effectiveness, Acceptability, and Feasibility of Handheld Point-of-Care Ultrasound for Improving Maternal and Newborn Health in Rural Health Facilities of Ethiopia: A Quasi Experimental Study

Principal Investigator: Tesfanesh Lemma Demisse 
Organization: Debre Berhan University, Ethiopia 
Location: Amhara, Ethiopia 

Project Overview

Despite advancements in maternal and newborn healthcare globally, maternal mortality, stillbirths, and neonatal deaths persist as significant challenges, particularly in low- and middle-income countries (LMICs). Ethiopia faces alarmingly high rates of these adverse outcomes, with preventable deaths occurring due to limited access to quality maternity care, including ultrasound services. While the World Health Organization recommends early ultrasound scans in pregnancy, access in LMICs remains constrained by cost and personnel shortages. In Ethiopia, rural women encounter additional barriers, such as distance and mobility issues, limiting access to ultrasound services. Addressing this gap, affordable and portable ultrasound solutions like the Butterfly IQ+ point of care ultrasound (POCUS) offer promise. However, evidence on its effectiveness in obstetric use, especially in rural Ethiopia, is lacking. 

The research team seeks to assess the effectiveness, acceptability, and feasibility of using the Butterfly IQ+ handheld ultrasound in rural Ethiopian health facilities to improve maternal and newborn health outcomes. The study objectives include evaluating the impact of handheld ultrasound on perinatal and maternal outcomes, assessing its effect on maternal healthcare service utilization, and exploring healthcare providers' views on acceptability and feasibility. A quasi-experimental study with a mixed-method approach will be conducted in the North Shewa zone, Amhara region, Ethiopia.  

The primary outcome will be perinatal death, with secondary outcomes including maternal healthcare service utilization and overall maternal satisfaction. Additionally, the acceptability and feasibility of the Butterfly IQ+ ultrasound will be qualitatively assessed.  

Assessing the Pharmaceutical System Capabilities and Capacity to Manufacture, Procure and Distribute Essential Medicines in Uganda

Principal Investigator: Samuel Baker Obakiro 
Organization: Busitema University, Uganda 
Location: Uganda 

Project Overview 

Access to essential medicines is a fundamental human right. However, over two billion people worldwide do not access essential medicines with the greatest burden in low- and middle-income countries. In Uganda, inefficient pharmaceutical supply chain systems limit access to essential medicines. However, the main bottlenecks faced are not well understood. Therefore, although there are pharmaceutical systems in Uganda, their capacities and capabilities need to be evaluated to inform evidence-based interventions that are tailored to the Ugandan setting.

In this study, the researchers will (1) assess the enablers and barriers for local pharmaceutical manufacturing of essential medicines in Uganda; (2) evaluate the distribution networks and mechanisms for effective delivery of essential medicines to health facilities in Uganda; (3) explore the experiences and perceptions of communities on the utilization of pharmaceutical information systems regarding essential medicines.

This project will initiate local research on factors affecting primary health care medicines access including the evidence on availability, affordability, resistances and prices monitoring in Uganda. Built on, but more comprehensive than, the “WHO Medicine Prices and Availability” collaborative initiative, the project will collect data on medicine availability including essential medicines but also generics and branded medicines throughout Uganda based on multistage drug-shops/pharmacies sampling. 

Introducing a Brief Trans-Diagnostic Psychological Intervention for Trauma Counselling among Adolescents and Youth Living with HIV 

Principal Investigator: Francisca Ongecha Owuor 
Organization: Kenyatta University, Kenya 
Location: Kiambu, Kenya 

Project Overview 

Trauma is a common comorbid mental disorder that disproportionally affect people living with HIV and is associated with loss to follow up, non-adherence to treatment, HIV disease progression, and a high viral load. It is more common in adolescents and youth who are also vulnerable to HIV infections. WHO underlines the need for mental health screening and psychosocial support for adolescents and youth living with HIV (AYHIV). However, there is limited integration of these services in the care of AYHIV leading to poor HIV outcomes. A presidential taskforce on mental health in Kenya discovered glaring deficiencies in the care competencies of health care providers in the country’s primary health facilities. Although there is limited evidence on the effectiveness of transdiagnostic interventions anchored on Cognitive Behavior Therapy (CBT) in the care of AYHIV, these interventions have proven effective in managing psychological distress in people living with HIV. Therefore, there is a need to understand the potential benefits of integrating these interventions in trauma-based care of AYHIV.

This study aims to investigate the availability of trauma-based care services in primary healthcare services; to examine the competency of healthcare providers in the provision of informed trauma mental health services to AYHIV; and to determine the effectiveness of peer-to-peer brief transdiagnostic psychosocial support as a means of providing informed-trauma care among AYHIV.

The study team proposes the adoption of a briefer, modular CBT-based transdiagnostic intervention for AYHIV in Kenya, and anticipates that this project will showcase the need to uptake peer-to-peer psychosocial support for AYHIV at the primary health facilities.