FRESH AIR pages Global bridges

Chronic respiratory disease is a huge, growing, but under-reported problem in Africa. Following a survey in rural Uganda, which found 16% of the adult population had COPD, we developed a lung health awareness programme aiming to prevent chronic respiratory disease. 

A two-year train-the-trainer programme was conducted by healthcare workers in Masindi District. Strategy and preliminary education materials were co-developed in a series of meetings with stakeholders including clinicians and community members. Educational materials covered: “What is lung health?”, “How lungs get damaged”, “Smoking cessation” and “Preventing harm by reducing exposure to biomass smoke”. These materials were approved by the Ministry of Health. Local radio messages were designed and broadcast. We administered knowledge questionnaires before and after training for both healthcare workers (HCWs) and the community health workers (CHWs). 

Specifically, the project aimed to:

  • Develop a cascading and sustainable ‘train-the-trainers’ module used to train Masindi district CHWs and HCWs in improving lung health.
  • Create with CHWs educational materials that they can use with their local communities.
  • Train CHWs and HCWs in supporting people to stop using tobacco through interventions that are adapted to the local cultural and economic conditions and are feasible to implement in the context of Masindi District.
  • Provide on-going support to CHWs using mobile telephone technology.
  • Integrate these activities into a larger IPCRG supported programme to improve lung health.
  • Identify and share the learning from the project in order to build capacity for interventions that facilitate stopping tobacco use in other low- and middle-income countries (LMICs).
  • Contribute to developing the evidence-base on effectiveness and cost-effectiveness of interventions to facilitate stopping tobacco use in LMICs.


Over 15,000 people have been educated directly and thousands more through mass media messages. Knowledge questionnaires administered to 1261 people in the community confirmed awareness of lung health. 

This novel lung health programme illustrates how communities may be empowered to reduce their risks of developing chronic lung disease and is a model for addressing the rising tide of non-communicable diseases.

Preventing Lung Disease in Rural Uganda – A Train the Trainer Programme

“I think the most important thing is that they should be owner of their problem and understand their problem, awareness and look for a solution and we will help them.” – Dr Frederik van Gemert

Download education material developed

Funding Organisations