New IHACC Publication! Understanding weather and hospital admissions patterns to inform climate change adaptation strategies in the healthcare sector in Uganda


Bishop-Williams K.E., Berrang-Ford, L., Sargeant, J., Pearl, D.L., Lwasa, S., Namanya, D.B., Edge, V.E., Cunsolo, A., IHACC Research Team, Bwindi Community Hospital, Huang, Y., Ford, J., Garcia, P., Harper, S.L. (2018) Understanding weather and hospital admissions patterns to inform climate change adaptation strategies in the healthcare sector in UgandaInt Journal Environ Res Public Health 15(11): 2402.


Background: Season and weather are associated with many health outcomes, which can influence hospital admission rates. We examined associations between hospital admissions (all diagnoses) and local meteorological parameters in Southwestern Uganda, with the aim of supporting hospital planning and preparedness in the context of climate change. 

Methods: Hospital admissions data and meteorological data were collected from Bwindi Community Hospital and a satellite database of weather conditions, respectively (2011 to 2014). Descriptive statistics were used to describe admission patterns. A mixed-effects Poisson regression model was fitted to investigate associations between hospital admissions and season, precipitation, and temperature.
Results: Admission counts were highest for acute respiratory infections, malaria, and acute gastrointestinal illness, which are climate-sensitive diseases. Hospital admissions were 1.16 (95% CI: 1.04, 1.31; p = 0.008) times higher during extreme high temperatures (i.e., >95th percentile) on the day of admission. Hospital admissions association with season depended on year; admissions were higher in the dry season than the rainy season every year, except for 2014. 

Discussion: Effective adaptation strategy characteristics include being low-cost and quick and practical to implement at local scales. Herein, we illustrate how analyzing hospital data alongside meteorological parameters may inform climate-health planning in low-resource contexts.

Notes from the field: Sarah and Vivienne’s final days in Buhoma


Sarah MacVicar, an M.Sc. student from McGill University was in Uganda this summer conducting her thesis research with Vivienne Steele, a Research Assistant from the University of Guelph. Here is their last update from the field. Text and photos by Vivienne Steele and Sarah MacVicar.


We have wrapped up our seven weeks in the field and are now settling back into life in Canada. The final weeks were a flurry of data entry and sharing results with local partners but we managed to finish everything we needed to do.

Our biggest challenge was completing the data entry from the maternity records, but with some help from the wonderful records department staff, we were able to finish entering the complete set of records. The hospital IT staff were pleased with this contribution and we hope it will be helpful to a number of hospital staff in their research. One evening as we were working late entering records, we got the call we had been awaiting—there was a birth happening on the ward and we were invited to come and assist with the procedure! Cradling this brand new creature moments after it entered the world and tying off the umbilical cord put into perspective everything we have been working on. The experience made it starkly apparent why facility-based deliveries can be so important-- the mother bled profusely and the nurse was concerned about postpartum hemorrhaging. Fortunately the sutures held and the mother was able to sit up and meet her baby girl. As the nurse entered the birth information in the record, she asked for our names—we are now listed as having assisted during the birth on the very records we have spent weeks entering.

In our second last week in Buhoma our friend Levi from BDP guided us on the Batwa Experience tour. We headed up a steep mountain path and were welcomed by a traditional dance by several Batwa men and women, who then demonstrated honey-harvesting, hunting practices, and medicinal plant identification. Learning about the traditional way of life for the Batwa in the forest contrasted greatly with what we saw on our community visits to their new settlements. The preservation of traditional knowledge through the Batwa Experience is an important initiative, but it also reminded us how many traditional food sources were lost when the Batwa were evicted from the forest.

Another big highlight of our last two weeks in Buhoma was the chance to see some mountain gorillas! We got to watch a family of gorillas who were taking a break for a lunch snack on their way back into the park.

On our final day, we held a preliminary results sharing meeting at the hospital, where 40 BCH staff were in attendance. It was a great chance for us to give a summary of IHACC, our projects, the work we had been able to accomplish while at BCH, as well as next steps. We also gave an overview of the health records evaluation draft. Our presentation was well received, and the staff were eager to review the soft copies of the evaluation that we distributed. Many people offered some great feedback and questions about the direction of our research.

We will miss BCH, Bwindi and the many connections and friends we have made in Uganda. However, we are looking forward to continued collaboration with our Ugandan partners as we develop our projects over the coming months. We are very grateful to all who have helped us and feel fortunate to have had this experience. This time has reminded us both of the value of fieldwork; it has grounded our research in real-life experience and motivated us to make our research useful and relevant for BCH and the communities we have been working with.

IHACC project leads in Bwindi and Kampala to discuss next steps for IHACC in Uganda

IHACC team with Makerere University's Geography Department in Kampala  IHACC group discussion in BuhomaIHACC project leads Dr. James Ford, Dr. Lea Berrang-Ford, and Dr. Sherilee Harper were in Uganda this week with Dr. Shuaib Lwasa and Didacus Namanya for a series of project meetings in Buhoma and Kampala, and partner community visits in and around Bwindi.   The team first met with partners and collaborators in Buhoma last week to discuss and plan for future IHACC project work in Uganda. After successful and productive meetings there and visits to partnering Batwa communities and Bwindi Community Hospital (BCH), the team returned to Kampala for additional meetings before they head back to Canada.   In Kampala, the team was invited to speak on it experience with team building and mentorship through the IHACC project at the departmental meeting of Makerere University's Department of Geography. This was a great opportunity for the team to share experiences from the last 4 years of the project, and create new relationships for future research and collaboration.

A noteworthy output of these meetings is an invitation for Dr. Lwasa to come to Montreal for additional collaborative work at McGill University in the Fall with the Canadian IHACC team from Dr. Ford.

More to come from IHACC-Uganda as the project enters its final year! Dr. Berrang-Ford speaking on team building and mentorship at Makerere University

IHACC team speaking on team building and mentorship at Makerere University