ICHAD Celebrates its 10th Anniversary, and the Lives it Has Changed in Sub-Saharan Africa

Global; Public Health; Research; Students

Photos: Thomas Malkowicz/Washington University

​​​​​​​When Scovia Nassaazi was 12 years old, her family agreed to participate in a pilot research program led by a U.S. scholar to open savings accounts for children in the small Ugandan towns where they lived.  The account was used to help pay her school fees and encourage savings by her mother, who contributed to the account when she could. Twenty years later, Nassaazi works as a study coordinator for the International Center for Child Health and Development (ICHAD), based at the Brown School and led by that same scholar, Fred Ssewamala, the William E. Gordon Distinguished Professor. This fall, she will enroll as an MSW student at the Brown School.

“I can say the pilot project began a new chapter in both my life and my family’s life as well,” said Nassaazi, who also heads qualitative interviews and translation for the center.

The success of the pilot also opened a new chapter for ICHAD, which has expanded to secure millions of dollars of grants for its more than 10 research projects and now employs over 60 staff in the U.S., Uganda, and other parts of Africa. This week, Nassaazi traveled to St. Louis as ICHAD celebrates its 10th year of research and training in Uganda and other parts of sub-Saharan Africa. Over the week of April 10 and the next months, the celebration will bring together scientists, staff, collaborators, partners, students, trainees, and other participants around the globe.

“I am very proud of our research achievements,” said Ssewamala, who brought ICHAD with him in 2017, when he moved to the Brown School from Columbia University. “I’m also proud of the more than 20 African students we have brought to the US for training, and several American students we have offered opportunities to train with us on the African continent, many of whom were being exposed practically for the first time to the issues there.”

Those issues include both poverty and HIV, which was first reported in Uganda and continues to ravage the nation and its children. ICHAD’s most recent projects have studied the impact of child savings accounts and other economic empowerment interventions in Uganda, such as financial literacy and income-generating workshops. The projects include studies of:​

  • The long-term effects on suppression of HIV viral loads among adolescents
  • ​The physical and mental health functioning of adolescents orphaned by HIV/AIDS
  • HIV stigma and shame among adolescents
  • Factors associated with HIV disclosure and stigma among adolescents 
  • Using a method borrowed from engineering to look at what combination of intervention components will yield the best results for children and families

 Ssewamala got the idea of child savings accounts while studying as a graduate student at the Brown School with Michael Sherraden​, George Warren Brown Distinguished University Professor, who pioneered the accounts in the U.S. Ssewamala took the idea to Uganda and expanded account-related research to include its impact on mental health and HIV-related outcomes. That connection is noted by Proscovia Nabunya, assistant professor,  a co-director of ICHAD who has been with the center since its beginning in 2004. She was a graduate student in Uganda at the time and Ssewamala hired her as the first project coordinator.

“What stands out is our ability to take this idea and adopt it in a limited resource setting in Uganda.  We’re still doing it,” she said. It’s been particularly striking to see children and families opening bank accounts – previously open only to the rich in Uganda. “Seeing them going to the bank for the first time, it’s always amazing, because it was beyond their expectations and now it’s a reality,” she said. “The money they are saving they are using to pay for school, and start income-generating activity. For someone to have that kind of cushion makes a huge difference. Now they can go to high school, and it’s a stress reliever for parents.” Many go on to become teachers in the community, while others, like Nassaazi, take their education to a higher level. 

The center’s other interventions have focused on strengthening family relationships, communication, support, stressors, and child behavioral health.  “When you support the child, you support the family,” Nabunya said.

The other co-director of ICHAD is Ozge Sensoy Bahar, research assistant professor, who joined the faculty just before Ssewamala came to the Brown School in 2017. “I am really proud of the exponential growth of ICHAD since it came to WashU,” she said. “We’ve reached so many children and families, schools and clinics in Uganda. It’s hard to understand the real impact until you go there and go to a school and see the excitement of children welcoming you or when 40-50 school directors show up to hear about your next project.  That commitment doesn’t happen if your work is not impactful and you are not respectful of the people.”

“We’ve always been committed to mentoring young people, and encouraging their next step in academic education,” she said, noting that ICHAD has structured four training programs funded by the National Institutes of Health, to train the next generation of scholars in global health. 

Impact on people has always been the focus of ICHAD, Ssewamala said. “We address poverty and financial instability head-on through innovative applied research, capacity-building opportunities for a new generation of researchers; raising awareness and influencing public policy. We do not simply work with numbers, but real human beings, who will be directly affected by our work.” 

One of those people is Flavia Namuwonge, a PhD student at the Brown School. She is another mentee of the Center who is coordinating a study assessing economic empowerment intervention in Uganda to determine which of its strategies works best to promote adherence to sustained HIV viral su​ppression among children. She came to the Brown School in 2022, the first time she had lived outside Uganda. “Being in the U.S. had never crossed my mind,” she recalled. She is particularly interested in research that can improve the lives of women in Uganda, where they have traditionally been considered subordinate citizens.​

“This work has opened up opportunities for me to learn finance and, human resources.  It has changed ​my life and the life of my family,” whom she supports financially. “They live a better life and they’re proud of their daughter in the United States.,” she added recalling that upon learning about her opportunity to work and study at the Brown School, her mother said “I’m going to die a happy woman.”  Namuwonge, like many of those whose lives have improved, credits ICHAD and Ssewamala.

“All it brings me is joy,” she said. ​​