Most important publications 

1. Tumukunde V, Medvedev MM, Tann CJ, Mambule I, Pitt C, Opondo C, Waiswa P, et al. Effectiveness of kangaroo mother care before clinical stabilization versus standard care among neonates at five hospitals in Uganda (OMWaNA): a parallel-group, individually randomized controlled trial and economic evaluation. The Lancet. 2024. This large trial was the first KMC trial on unstable newborns in Uganda. It demonstrated that KMC was safe and less costly for society and the health care system when used for small and vulnerable newborns. 

2. Walker D, Otieno P, Butrick E, Namazzi G, Achola K, Merai R, Otare C, Mubiri P, Ghosh R, Santos N, Miller L, Sloan NL, Waiswa P, Preterm Birth Initiative Kenya Uga. Effect of a quality improvement package for intrapartum and immediate newborn care on fresh stillbirth and neonatal mortality among preterm and low-birthweight babies in Kenya and a cluster [1] randomised facility-based trial. LANCET GLOBAL HEALTH 2020 8;8 1061-1070 This large trial, which I led in Uganda, tested a combination of training and quality improvement to reduce the mortality in premature babies in Kenya and Uganda. Premature infants in the intervention compared to the comparison hospitals had a roughly 30% lower chance to die at 28 days (odds ratio 0·66, 95% CI 0·54-0·81). The intervention is one of the few quality improvement initiatives that has successfully achieved improvements in mortality in Sub-Saharan Africa - probably because it had sufficient intensity, combined training and quality improvement, and included a data component indicating regular improvements. 

3. Waiswa P, Higgins BV, Mubiri P, Kirumbi L, Butrick E, Merai R, Sloan NL, Walker D, Preterm Birth Initiative Kenya and Uganda Implementation Research Collaborative. Pregnancy outcomes in facility deliveries in Kenya and Uganda: A large cross-sectional analysis of maternity registers illuminating opportunities for mortality prevention. PloS one 2020 15;6 e0233845- This additional analysis based on data from the preterm birth initiative indicated the high burden of perinatal mortality among facility birth in Kenya and Uganda. 1.6% of the 50.981 deliveries included in this study died before discharge. An additional 0.5% of deliveries were early stillbirths and 3.6% late stillbirths. Surprisingly, there was a very high mortality in relation to Caesarean section. As expected, morality was also higher after referral and higher among preterm birth. Strengthened register data in Kenya and Uganda highlight the need for renewed focus on improving care of preterm and low birthweight infants and expanding access to emergency obstetric care. 

4. Akuze J, Blencowe H, Waiswa P, Baschieri A, Gordeev VS, Kwesiga D, Fisker AB, Thysen SM, Rodrigues A, Biks GA, Abebe SM, Gelaye KA, Mengistu MY, Geremew BM, Delele TG, Tesega AK, Yitayew TA, Kasasa S, Galiwango E, Natukwatsa D, Kajungu D, Enuameh YA, Nettey OE, Dzabeng F, Amenga-Etego S, Newton SK, Tawiah C, Asante KP, Owusu-Agyei S, Alam N, Haider MM, Imam A, Mahmud K, Cousens S, Lawn JE, Every Newborn-INDEPTH Study Collaborative Group. Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn [1] INDEPTH study. The Lancet. Global health 2020 8;4 e555-e566 This large multi-country analysis – taking off from my long responsibility within the demographic and health surveillances network sited INDEPTH – compared the two interview methods to assess outcomes at birth, stillbirth and neonatal death. These interview methods, i9 a full pregnancy survey and a birth history with additional questions to assess pregnancy loss are typically implemented in household surveys. This work indicated that the full pregnancy history was leading to 20% higher rates of stillbirth compared to the birth history with additional questions on pregnancy loss. No difference in relation to neonatal mortality was observed. The full pregnancy history took 1.4 minutes longer to implement compared to the birth history module. Still, in view of the importance to measure stillbirth mortality this additional time will be well spent to attain better stillbirth data in high burden countries. 

5. Medvedev MM, Brotherton H, Gai A, Tann C, Gale C, Waiswa P, Elbourne D, Lawn JE, Allen E. Development and validation of a simplified score to predict neonatal mortality risk among neonates weighing 2000 g or less (NMR-2000): an analysis using data from the UK and The Gambia. LANCET CHILD & ADOLESCENT HEALTH 2020 4;4 299-311 Two different data sets, i) the UK National Neonatal Research Database from 187 neonatal units, and the ii) Early Kangaroo Mother Care Trial from data from the Edward Francis Small Teaching Hospital (EFSTH), Banjul, The Gambia were used to develop a score to predict neonatal mortality. Three indicators showed a good discrimination in relaton to mortality risk: birthweight, admission oxygen saturation, and highest level of respiratory support within 24 h of birth. The score requires further validation using a larger dataset from low-income and middle-income countries, but it has the potential to improve individual- and population-level neonatal care resource allocation. 

6. Waiswa P, Manzi F, Mbaruku G, Rowe AK, Marx M, Tomson G, Marchant T, Willey BA, Schellenberg J, Peterson S, Hanson C, EQUIP study team. Effects of the EQUIP quasi-experimental study testing a collaborative quality improvement approach for maternal and newborn health care in Tanzania and Uganda. Implementation science : IS 2017 12;1 89- Times cited 32 I coordinated the EQUIP quasi-experimental trial – a FP-7 EU funded study – which was testing a systemic quality improvement approach implemented in Uganda. We implemented quality improvement at community and health facility level. Our quality improvement approach was able to improve two of the four primary outcomes. Results from thus study are now increasingly used to shape the quality improvement approach in low and middle income countries. 

7. Namazzi G, Okuga M, Tetui M, Muhumuza Kananura R, Kakaire A, Namutamba S, Mutebi A, Namusoke Kiwanuka S, Ekirapa-Kiracho E, Waiswa P. Working with community health workers to improve maternal and newborn health outcomes: implementation and scale-up lessons from eastern Uganda. Global health action 2017 10;sup4 1345495- One of my main research interests is to examine the impact of community health workers in improving maternal and newborn health. This paper analysed implementation challenges of a community health worker intervention including training, supervision, and motivation. This mixed method study indicated that knowledge among Community Health workers improved, but not consistently and not in regard to all important aspects of maternal and newborn health – pointing to the need of continuous education. Community Health Workers expect a competitive renumeration as well as travel refunds or bicycles to support their work 

8. Lawn, JE, Blencowe, H, Waiswa, P., Amouzou, A, Mathers, C, Hogan, D. Flenady, V, Frøen, JF, Qureshi, ZU, Calderwood, C, Shiekh, S, Jassir, FB, You, D, McClure, E M, Mathai, M and Cousens, S (2016) 'Stillbirths: rates, risk factors, and acceleration towards 2030', The Lancet, 387(10018), pp. 587-603. I participated in the important and highly cited Lancet series which estimated the global burden of stillbirth. We estimated that 2.6 million third trimester stillbirths occurred in 2015 (uncertainty range 2.4-3.0 million). Our analysis suggested that the number of stillbirths has reduced more slowly than has maternal mortality or mortality in children younger than 5 years, which were explicitly targeted in the Millennium Development Goals. The burden was in particular high in Africa and in areas affected by conflict – these countries will have to more than double present progress to reach the target on no more than 12 stillbirths per 1000 birth. We also highlighted the need to records and register all births, stillbirths, neonatal, and maternal deaths in a health facility. Improved data alone will not save lives but provide a way to target interventions to reach more than 7000 women every day worldwide who experience the reality of stillbirth. 

9. Sewankambo N, Tumwine JK, Tomson G, Obua C, Bwanga F, Waiswa P, Katabira E, Akuffo H, Persson KE, Peterson S. Enabling dynamic partnerships through joint degrees between low- and high-income countries for capacity development in global health research: experience from the Karolinska Institutet/Makerere University partnership. PLoS medicine 2015 12;2 e1001784- This important analysis paper described the partnership between Karolinska Institutet and Makerere University for research capacity building with the potential to increase research capacity in both settings. The paper highlights the main achievements, particular the high academic productivity of this collaboration resulting in 44 graduated PhD students and over 500 papers with mostly Ugandan first authors. The partnership also led to a strong engagement with the national health structures, including the Ministry of health and has built a strong group of Ugandan researchers building their own research groups and attracting further international funding.

PUBLICATIONS OF PROF PETER WAISWA

General Articles and Book Chapters