Dec 09-11: Tugende! Exploring Usability Studies and Diagnostic Insights Across Uganda

Hi everyone, Tugende! (Let’s go!)

Our second week has been filled with incredible moments as the Ekyaalo Diagnostics team continues its journey across Uganda. We’ve delved deeper into the realities of healthcare delivery, explored the stunning countryside, and connected with some truly inspiring professionals and communities. From conducting usability studies in rural Healthcare Level IV centers to meeting with pathologists and lab technicians in Mbarara, every experience has enriched our understanding of breast cancer diagnostics and how we can improve access in Uganda.

Photo Gallery from our 12/09 Travels!

Monday, December 09, 2024

Where: Kazo & Bwizibwera (HCIVs)

What: Usability studies at Healthcare Level IV centers

On Monday, our team split into two groups to conduct usability studies at Healthcare Level IV centers in Kazo and Bwizibwera. As we traveled through the rolling hills of the Ugandan countryside, we were struck by the beauty of the region and the warmth of the local communities. We even took a break to play football with some of the locals - an unforgettable moment that brought smiles all around.

At these centers, we learned about how healthcare services are delivered and the unique challenges faced by medical officers and lab technicians. These insights highlighted critical areas where Ekyaalo Diagnostics can make a real difference.

Key Insights from Kazo & Bwizibwera:

• Breast health concerns are often flagged during outpatient and maternal care but lack systematic tracking and tailored data collection.

• Medical officers expressed optimism about deploying fine needle aspiration cytology (FNAC) at the HCIV level but identified resource gaps, including certain cytology stains and aspiration tools.

• Patients manage their own health books.

• Many breast cancer cases are referred directly to Mbarara, though FNAC delays (up to a year) remain a significant barrier.

• Lab staff valued usability features like eyepiece cameras, emphasizing their potential to streamline diagnostics and easier setup.

Photo Gallery from our 12/10 Travels!

Tuesday, December 10, 2024

Where: Mbarara Regional Referral Hospital and Mbarara Municipal HC IV

What: Pathology insights, usability studies, and some hands-on fun

Tuesday was a highlight of our journey as we spent the day at Mbarara Regional Referral Hospital, where we were honored to meet Dr. Mitala, one of our principal investigators, advisors, and strongest supporters. It was inspiring to connect with him and other talented pathologists and lab technicians, including Habert and the Municipal HC IV, who offered their expertise and enthusiasm for our work.

Beyond the usability and accuracy studies, we had the unique opportunity to gain hands-on experience with a medical student pathology exam - a challenging, but fascinating way to understand the rigor of pathology education in Uganda!

Highlights from Mbarara:

• FNAC with Diff-Quik staining emerged as the preferred technique for its speed and simplicity, though service delays for equipment remain a hurdle.

• Pathologists emphasized the need for AI tools to focus on clear, actionable outputs - e.g., flagging easy cases for efficiency while aiding in more complex diagnoses.

• Collaboration between healthcare centers and regional referral hospitals is critical for smooth patient transitions, and creating trust at the HCIV level is essential to reduce unnecessary repeat procedures.

Photo Gallery from our 12/11 Travels!

Wednesday, December 11, 2024

Where: Kabuyanda & Rwekubo (HCIVs)

What: Usability studies continue in the Isingiro district

On Wednesday, our teams split once again to visit two more HCIV centers in Kabuyanda and Rwekubo. Both centers were nestled in the countryside, and the journey offered breathtaking views of Uganda’s mountains and lush greenery. The Kabuyanda center was perched on a hill, providing a stunning backdrop, while the Rwekubo center was essentially a “super” HCIV with aspirations of upgrading to HC Level V.

These visits allowed us to dive deeper into how supplies are managed, the challenges faced with resource allocation, and how healthcare is delivered in rural areas. Talking with the locals further illuminated the importance of tailoring our solutions to their specific needs.

Key Insights from Rwekubo & Kabuyanda:

• The lab hub system efficiently manages samples (even though not for breast cancer), but turnaround times (up to two weeks) are still a challenge.

• Medical officers were confident in their ability to adopt FNAC but noted the absence of needles and reliance on international organizations for equipment and supplies.

• Community outreach campaigns and mobile health units play a vital role in raising awareness and bringing women into the system for screening.

• While effective, the mobile units rely heavily on external support and might not provide sustainable solutions for local training and capacity building.

• Lab technicians showed a preference for tools like eyepiece cameras, underscoring the importance of intuitive, accessible technology.

Our Main Takeaways

As we reflect on these three days, a few key themes emerge:

• Streamlining Referrals: Tailoring referral processes to capture breast health concerns at the HCIV level is crucial.

• Collaborative Solutions: Rural centers are eager to adopt new diagnostic tools, but targeted training and sustainable resource allocation are crucial.

• Resource Gaps: Addressing shortages in training, equipment, and service is essential to empower HCIV staff.

• AI Usability: Designing intuitive, reliable interfaces that align with existing workflows will enhance adoption and user satisfaction.

• Community Engagement: Campaigns and mobile health units are essential for raising awareness but must be complemented by efforts to build local capacity. This might be a new approach for our solution concept and potential pilot study.

We are incredibly grateful for the opportunity to connect with healthcare professionals, engage with the local community, and explore the beauty of Uganda. Each step of this journey brings us closer to our goal of improving breast cancer diagnostics in underserved areas.

Siiba bulungi! (Have a nice day!)

– The Ekyaalo Diagnostics Team