Study Design, Setting, and Population

This was a cross-sectional study conducted from June to August 2022. The study included allied health professional training institutions offering courses in Clinical Medicine and Community Health and Diploma in Pharmacy; universities offering bachelor’s degrees in medicine and surgery (MBChB), pharmacy, nursing and dental surgery (BDS); and nursing training institutions offering certificate and diploma courses in nursing and midwifery. Of the 64 allied health training institutions recognized by Allied Health Professional Council (AHPC) in 2022, 23 offer diploma courses in clinical medicine and community health and/or pharmacy (AHPC 2022). There are 87 recognized nursing training institutions by Uganda Nurses and Midwives Council (UNMC) in 2022 (UNMC 2022). These include 11 government, 27 faith based, 34 private nursing schools, and 15 universities. The accredited universities offering medical courses in Uganda include six [6] public universities (Busitema University, Gulu University, Soroti University, Kabale University, Makerere University, and Mbarara University of Science and Technology) and five [5] private universities (Clarke International University, Kampala International University, Uganda Martyrs University, St. Augustine International University, and Islamic University In Uganda). All these 11 universities offer MBChB, two [2] offer BDS, three [3] offer Bachelor of Pharmacy, and six [6] offer Bachelor of Nursing.

The study population included deans/heads of department for the universities and principals/tutors from the allied and nurses training institutions. The study also involved review of curricula for the different health professional training institutions. In addition to the respondents from academic institutions, the study also included key informants (KIs) from policy and regulatory bodies, pharmaceutical industry, importers and distributors of pharmaceuticals, professional councils/societies, examination boards, and hospitals.

All registered and recognized health training institutions by relevant accrediting bodies and pharmaceutical industry and distributors and importers with Qualified Person for Pharmacovigilance (QPPV) were included in the study. Hospitals which actively participate in the reporting of ADRs were also included. The other institutions were included by virtue of their role in regulation of training and practice of healthcare professionals in the country. Health professionals’ training institutions that were in existence for less than 3 years or had not graduated students were excluded from the study.

Sample Size and Sampling Procedure Training Institutions

The study targeted review of at least two curricula per program from the different institutions to determine the extent of coverage of PV content in the curricula. As shown in Table 1, a total of 37 curricula from 10 training institutions were reviewed, and interviews were held with 18 deans/heads of departments and principals/tutors. The number of curricula reviewed represented 100% of Bachelor of Pharmacy and BDS curricula, about 67% of Bachelor of Nursing curricula and 36% of MBChB curricula. For diploma and certificate courses, they offer national curricula, all of which were reviewed. Only two universities offer institution specific curriculum for diploma in pharmacy and clinical medicine which were also reviewed. The institutions were sampled based on a combination of both convenient and purposive sampling. The institutions offering programs of interest were purposively selected, while those offering more programs of interest and near each other were conveniently selected. The deans/heads of departments and principals/tutors were purposively selected based on their knowledge and influence in curriculum development to identify challenges in PV training at their institutions.

Table 1 Selected institutions Key Informants

A total of 13 KIs were purposively selected to identify challenges in PV training, knowledge, and skills gaps among graduates and generate perspectives on opportunities for improvement and incorporation of PV into the curricula of health professional programs. These included KIs from professional councils/associations (3), Uganda Allied Health Examination Board (UAHEB) (1), Uganda Nurses and Midwives Examinations Board (UNMEB) (1), NDA (1), pharmaceutical distributors and importers (2), pharmaceutical industry (2), hospitals (2), and MOH pharmacy department (1). Views on PV knowledge and skills gaps were only sought from nine (9) of the 13 KIs responsible for PV in their institutions.

Data Collection Tools, Methods, and Analysis

A questionnaire, data abstraction checklist, and an interview guide were used to collect data. The questionnaire was administered to deans/heads of department and principals of the training institutions. The data abstraction checklist was used to extract details of pharmacovigilance content in the curriculum. The interview guide was administered to the key informants. The tools were pre-tested prior to the data collection process to ensure validity and clarity of the questions. Questions found to be ambiguous were revised prior to actual data collection. The pre-test acted as part of orientation and training of research assistants. The pre-test was conducted in non-participating institutions, and results of the pre-test were excluded from the final analysis. Prior to the data collection, letters and emails were written to the participants seeking for their participation in the study. Those that accepted to participate were further briefed on the day of the study about the study and oral consent sought from them before administration of the tools. The questionnaire and interviews took about 30 min to complete.

Data obtained were sorted, coded, and entered into Microsoft Excel spreadsheet for analysis. Descriptive statistics, i.e. percentage and frequency, were used to summarize data obtained. Other qualitative data were transcribed and reported verbatim. Emerging quotes from the interviews were highlighted and marked for referencing.