She was astonished to have her child admitted in a room with about 5 others, all with respiratory complications requiring urgent interventions like a nebulizer; a device that delivers drugs in the form of mist inhaled into the lungs, and oxygen.
However, Dr. Suzanne Kiwanuka; a Senior Lecturer at the School of Public Health, Makerere University (MakSPH), was shocked when some of the parents opted to go home with their children in such conditions. Thinking she was missing something, an alarmed Dr. Kiwanuka inquired as to why anyone would want to get their child discharged in that state. She was even more shocked by the uniform response; the parents claimed they would rather go and do their best to manage the situation at home because healthcare at this facility was expensive and they could not afford it.
The parents were so desperate to avoid the costly healthcare that a decision, akin to surrendering the lives of their children to fate; something that is extremely difficult for any parent, came quite easily to this particular lot. Clearly, the current cost of healthcare in the country causes parents like these to make hard choices because the country does not have a universal system to cater for citizens’ needs.
Dr. Kiwanuka was relating this painful experience to an audience that had gathered at the launch of a book she had co-authored titled, UNIVERSAL HEALTH COVERAGE IN UGANDA: Looking Back and Forward to Speed Up the Progress, held on 3rd May 2018 at the Kampala Serena Hotel. The aforementioned experience inspired 3 years’ work that Dr. Kiwanuka and a team of nearly 30 people from different sectors, put in to producing this book which was also edited by Assoc. Prof. Freddie Ssengooba; who led the team, Prof. Elizeus Rutebemberwa and Dr. Elizabeth Ekirapa-Kiracho. All the editors are members of staff at MakSPH.
The book does not only concentrate on curative health care but also explores preventive health care options. It is localised to Uganda and thus offers solutions to how issues like financing can be dealt with in the face of tight budgets and competing demands.
The book writing was coordinated by MakSPH’s SPEED (Supporting Policy Engagement for Evidence-based Decision) Project with the main intention of capturing the status of Universal Health Coverage (UHC) readiness. The captured evidence past including the challenges and successes regarding the health sector over the last 10 to 15 years can be used to support health policy and systems developments for UHC agenda in Uganda and beyond.
The Team Leader speaks out about the genesis of this achievement
Relating the origin of this achievement to an expectant audience, Assoc. Prof. Ssengooba said he came across a call by the European Union to support Schools of Public Health to put up policies for their countries. It was quite late to apply; about 4 weeks to the deadline.
“I told colleagues that this looked like something we could get and I urged them to put in effort,” he added. “We were happy to emerge successful together with partners like the National Planning Authority, Uganda National Health Consumers Organisation and the Institute of Tropical Medicine in Europe.”
About the book which is a policy document, Assoc. Prof. Ssengooba noted that policy analysis is quite complicated because it requires working from where other scientists stopped and walking the delicate bridge of moving the science to the politicians and policy-makers. He added that the book has been a learning process for the whole team as they brainstormed on how they could expand coverage with the limited resources available.
“In Uganda, we’re expected to do miracles because unlike the US where a single person’s health budget is $7,000, here it is $11. So we decided that this new mission requires local thinking about ideas that can be put into practice. The book customizes lessons; not just best practice, but also how to fit into our own context,” he explained.
On behalf of his team, Assoc. Prof. Ssengooba thanked the Ministry of Health for documenting their practice over the last couple of years because this gave them a starting point in their work. He thanked the European Union (EU) for the 3 years generously apportioned to reflect and produce a good policy document. The EU Ambassador to Uganda was represented at the event by the Acting Head of Cooperation, Thomas Tiedemann.
President Uhuru is consulting with MakSPH over policy recommendations in the book
Assoc. Prof. Ssengooba also made an astounding revelation to the audience when he shared that part of his team had already been to Kenya to give technical support to President Uhuru Kenyatta in his quest to implement Universal Health Coverage for his country. This move stems from his campaign manifesto which highlighted “The Big Four”; an outline of four areas that he would focus on during his presidency, UHC being one of them.
“As you can see, this work is already being asked for, which is a way of saying that there is need for UHC research in the region. In seeking to implement his manifesto about UHC, President Kenyatta contacted the World Health Organisation and WHO directed him to us saying there are some people who are already doing this. We have been to Kenya at President Uhuru’s invitation and met an assembled pane of experts but we are still going back,” Assoc. Prof. Ssengooba said.
Speaking on behalf of the MakSPH Dean, Prof. Garimoi Orach expressed pride at the work done by Assoc. Prof. Ssengooba and his team as fellow members of staff.
“We pledge that we shall continue to support the Ministry of Health and we are grateful to the EU for this grant and to all institutions that supported this work,” Prof Orach said, before adding “We are also excited that the book is receiving attention in neighbouring countries. We are very proud indeed because this demonstrates that Makerere University is the institution to do business with.”
Uganda stands out among the countries that applied for EU funding
In his remarks, Mr. Thomas Tiedemann commended the team that put together this book and revealed that Uganda stands out among all the countries with Schools of Public Health that applied for funding to develop UHC policies. He congratulated MakSPH upon this achievement and thanked the SPEED project for the great work done in coordinating the writing. The UHC agenda is not only tailored to Uganda but to other developing countries aiming at attaining universal health coverage as well.
“It pains to hear of things like unavailability of high quality cancer treatment. The book launched today is calling upon government to invest more both in curative and preventive healthcare. With this book, we are hoping that a lot of lessons will be drawn for Uganda with the aim of generating evidence-based policy,” Mr. Tiedemann said.
Ministry of Health should utilize Makerere University
In his speech, the Acting Deputy Vice Chancellor (Finance and Administration), Prof. William Bazeyo who represented the Vice Chancellor, Prof. Barnabas Nawangwe called upon the Ministry of Health to take advantage of the specialised human resource at the University in situations of policy implementation or disease outbreaks.
“Makerere has always done research as its mandate and we have shared several policy documents from these findings with the Ministry of Health. We have done work with the malaria policy, the health insurance policy, HIV, circumcision and some work around sector training. Where you find it difficult to implement, talk to us and we shall walk with you,” Prof Bazeyo said.
“We may not have the resources but we shall look to our partners to work with you to achieve any agenda,” he added, in address to the Minister of State for Primary Health Care, Hon Sarah Opendi, who represented the Minister of Health, Hon. Ruth Aceng.
Prof. Bazeyo also thanked the EU for supporting the institution to address the country’s development needs. He thanked Assoc. Prof. Ssengooba who was in the 1st cohort of students taught at MakSPH for being exemplary and shared that the College of Health Sciences (CHS) to which MakSPH belongs, contributes 80% to Makerere University’s research.
“90% of this research is funded by donors. At the moment, the university is ranked number 2 in Africa in research despite the challenges but we want to visit you Honourable Minister because we know that if you support our budget, we shall become number one,” Prof. Bazeyo appealed.
The Principal CHS, Prof. Charles Ibingira also informed the Minister that the college has the capacity to train human resource for the health sector for the whole country and the diaspora.
“You need to think about utilising the college because we provide accountability,” he added, explaining that the university is the leading research institution in the country and can be used to solve many key issues in the health sector. He also talked about plans by CHS to spearhead a think tank that will contribute to the management of health issues in the country and region at large.
Prof. Ibingira equally expressed his exhilaration about the book and he thanked Assoc. Prof. Ssengooba and his team for delivering.
“I am very excited on this occasion where we are delivering on our promises and I am grateful to everyone who has made sure that the work is well-packaged. I humbly beg though that the information in the book will lead us to achieving UHC. This book strengthens the relevance of Makerere University and alerts us to the changing needs of health workers. It is an analysis of the different health policies in Uganda and a valuable asset to all partners engaged in seeing to UHC,” Prof Ibingira pointed out.
Government to commit 1% towards research
Speaking as Chief Guest at the launch, Hon. Opendi informed the audience that Government was committing to give 1% of the national budget towards research in the country, a move that comes at the right time when the health sector is re-positioning itself. She added that this commitment does not come easy since the country is resource-constrained alongside competing demands.
Hon. Opendi however added that the government was making progress with the implementation of the National Health Insurance Scheme. She acknowledged the proposal by Prof. Ibingira to set up a think tank and expressed her Ministry’s willingness to seeking guidance from it. She commended the book authors for focusing on other factors around health including prevention and human resource.
Authors speak about the book
One of the lead authors, Prof. Rutebemberwa also noted that whereas Uganda’s history over the years has been dotted with attempts to improve UHC, the advocates were usually not sure about what exactly should be covered.
Dr. Kiwanuka on the other hand noted that there is need to move away from the thinking that a good health sector only refers to functional hospitals.
“Everyone needs to be healthy enough not to go to hospital in the first place and that is what Universal Health Coverage is about,” she pointed out.
According to Assoc. Prof. Ssengooba, the target audiences for this book are the policymakers, health funders, civil societies who engage and teach people about health, and the media. He also noted that the population is spending a lot of their money on health, which calls for the government to invest more in prevention than cure.
He said the book also explores alternative ways in which all other sectors can support the achievement of UHC. For example when enforcement of traffic rules is tightened; as was the case along Masaka Road leading to reduced accidents, the burden to treat patients from accidents will reduce.
Speaking on the implementation of the policy, co-author Dr. Ekirapa-Kiracho shared that the team would continue to come up with policy briefs that will be issued to different stakeholders.
The book perfectly captures the adage that what we do today has been influenced by what was done yesterday. It examines previous attempts at addressing UHC and integrates them into the current health situation while taking into account the financial and political situation in the country to see how best the policy can be implemented going forward.
Article by Agnes Namaganda, Communications Office, MakSPH
Rotary International President visits Mak
Rotary International President Shekhar Mehta has appreciated Makerere University for supporting and carrying forward the newly introduced programme aimed at advancing peace on the African Continent. Launched in January 2020, the Rotary Peace Centre at Makerere University runs a postgraduate diploma programme in Peace-building and Conflict Transformation. The hands-on program entails coursework that addresses topics including human rights, governance, and the role of the media in conflict. Other studies focus on refugees and migration, as well as resource and identity-based conflicts.
At a high level meeting held with the University leadership on 15th September 2021 at CTF1, President Shekhar Mehta said Rotary International was proud to be partnering with Makerere to promote peace on the African Continent. “The mere absence of war does not translate into total peace. Besides war, there are many other factors undermining peaceful co-existence. It is our duty to address these issues so as to create harmony in our communities. Through the Rotary Peace Centres across the globe, we are undertaking a number of initiatives aimed at promoting peace. Since 2002, the Rotary Peace Centres have trained more than 1,300 fellows who are working to advance peace in more than 115 countries. We are happy to work with Makerere University to foster peace and development on the African Continent,” he noted. President Shekhar Mehta, who was on a three-day tour of Rotary projects in Uganda, was visiting Makerere for the first time since the University won the bid to host the International Rotary Peace Centre, the first of its kind on the African Continent.
President Shekhar Mehta, who was in company of past and current Governors of Districts 9213 and 9214, said peace was a necessary catalyst for the progress of humanity and general development of nation states across the globe. Elected for the 2021-22 term, President Shekhar Mehta, through his year theme Serve to Change Lives, asks Rotarians to participate in service projects where they can make a difference in their communities and the people who live in them. Since he joined Rotary in 1984 as a member of the Rotary Club of Calcutta-Mahanagar, West Bengal, India, President Shekhar Mehta has led many major service initiatives in India and South Asia, including among others, constructing 500 homes for Tsunami survivors at Andaman and Nicobar Islands, and starting the Shelter Kit programme in India which has served about 20 disasters and benefited about 75,000 disaster victims.
Delivering her remarks, the Chairperson Council, Mrs. Lorna Magara appreciated Rotary International for entrusting Makerere University with the mandate to host the first rotary peace centre on the African Continent. “Choosing to house the Centre at Makerere University shows Rotary International’s trust and confidence in Makerere and her vision for building for the future. We are grateful for the opportunity to contribute to the advancement of Rotary International’s agenda. We also sincerely appreciate Rotarians all over the world who have committed funds to support the Rotary Peace Centre at Makerere University,” she noted. Similarly, she appreciated The Rotary Foundation (TRF) of Canada for setting up an endowment fund for the Peace Centre. “This will go a long way in ensuring the sustainability of the Peace Centre at Makerere University. The fund will help in the Capstone week where Fellows will present their social initiatives. These initiatives will showcase how the Rotary Peace Centre contributes to positive peace initiatives all over the world.”
In his remarks, the Vice Chancellor, Prof. Barnabas Nawangwe informed the President that the decision to establish the first Rotary Peace Centre in Africa at Makerere University was welcomed with ‘excitement and gratefulness’. “We consider this to be a vote of confidence in our efforts in the peace and conflict resolution agenda. We extend our appreciation to Rotarians in Uganda and beyond for selflessly supporting this noble cause.” The Vice Chancellor appreciated the leadership of the College of Humanities and Social Sciences at Makerere, and the Director of the Centre, Dr Helen Nambalirwa Nkabala for their tireless efforts in ensuring the centre achieves the intended objective.
By the end of this year, the Centre will have hosted two cohorts of peace fellows. The first cohort was at Makerere University between February and May, 2021. Currently, these Peace fellows are carrying out their peace initiatives in their communities. The second cohort will report on September 27, 2021. In both cohorts, Peace Fellows were chosen from 20 countries and by the end of the year, the Centre will have had a total of 36 Fellows.
Intentionality Key to Nurturing More Women Leaders
The Gender Mainstreaming Directorate (GMD), Makerere University on 14th September 2021 presented findings from phase one of the study on Enhancing Women’s Participation and Visibility in Leadership and Decision-Making Organs of Public Universities in Uganda through Action Research. The study team led by the Director GMD and Principal Investigator (PI), Dr. Euzobia Mugisha Baine also consists of Assoc. Prof. Consolata Kabonesa, Dr. Anna Ninsiima, Ms. Frances Nyachwo, Ms. Susan Mbabazi and Mr. Eric Tumwesigye.
The team is also made of coordinators from participating Universities such as Busitema University-Ms. Elizabeth Birabwa, Kabale University-Sr. Dr. Eva Tumusiime, Mbarara University of Science and Technology (MUST)-Dr. Specioza Twinamasiko, Muni University-Ms. Amandru Stella Wawa, and Gulu Univeristy-Sr. Rosalba Aciro.
Funded by the Government of Uganda through the Makerere University Research and Innovations Fund (Mak-RIF), the study was inspired by the fact that women are persistently few in numbers as staff, more so in leadership and decision-making organs of Ugandan Public Universities. “This is despite all the various efforts at national and international levels; the numbers are not growing as fast as needed to meet development goals of the country” explained Dr. Euzobia.
Based on this background, the study team therefore sought to conduct a situational analysis of the gender terrain of the six public universities to obtain baseline information encompassing the composition of governance and leadership organs and senior staff by sex, as well as a needs assessment and profiles of potential mentors and mentees.
Furthermore, the team sought to explore the capacity to conduct gender-responsive research as well as the role of male staff engagement in gender equity interventions within the universities as the drivers of development.
Dr. Mugisha-Baine shared that results of the baseline would then be used to design participatory training manuals or guides on gender and leadership. The manuals would cover; Institutionalized mentorship, How to conduct gender-responsive research, gender and equity budgeting, among others.
“Within these manuals, we shall have a male staff engagement strategy in gender equity interventions in universities” she explained.
The development of the aforementioned materials would then be followed by their adoption and use to build capacity for women not only in leadership of participating and other public university but also beyond. “We shall periodically evaluate whether the capacity we have built has influenced women’s participation in leadership and decision-making organs of the university” supplemented the PI.
The capacity building trainings for women, it is envisaged, will lay the foundation for the formation of a functional Uganda University Women’s Think Tank, starting with the six participating universities. Dr. Mugisha Baine added that through this Think Tank, a monitoring and tracking system for gender representation in recruitment, promotion, retention/turnover and leadership of public universities shall be established and maintained.
At the conclusion of phase one, the study team had drafted participatory training manuals in gender and leadership with content on; gender specific critical analysis of the leadership spectrum of public universities, positioning of individual women within the institutional framework and strategies for their advancement, gender equity advocacy in the university setting, institutional mentorship, building capacity in conducting gender-responsive research, among others.
“This content will be validated by the participating universities before the actual research training is conducted” added the PI.
On behalf of the research team, Dr. Mugisha Baine thanked the Government of Uganda for providing the resources that facilitated phase one of the study and prayed that the Mak-RIF Grants Management Committee (GMC) would support the next phase of capacity building.
Speaking on behalf of the Mak-RIF GMC Chairperson, Prof. William Bazeyo, Dr. Helen Nambalirwa Nkabala thanked and congratulated the team led by the Director GMD upon the milestones registered in the critical research.
“We are very proud of that work that is being done by all researchers in Mak-RIF and we would like to most sincerely thank Management for all the support throughout this process” she remarked.
Dr. Nkabala encouraged the research team to continue disseminating and using the findings for the furtherance of gender mainstreaming, particularly through the aspect of male staff engagement in gender equity interventions.
Prior to delivering the keynote address of the day, the Executive Director National Council for Higher Education (NCHE) Prof. Mary Okwakol thanked the Vice Chancellor, Prof. Barnabas Nawangwe for inviting her to the important forum, noting that women’s participation in decision making and governance is a priority area of the Uganda Gender Policy 2007.
She commended Makerere University for being at the forefront of gender mainstreaming in Uganda, noting that this prominence was one of the reasons why the Gender in Education Policy 2007 provides for replicating the institution’s strategy in all other Higher Education Institutions.
Prof. Okwakol whose keynote address was punctuated incisive personal examples reaffirmed the statistics that women are generally not visible in leadership of Universities. That notwithstanding, in instances where they rise to leadership and decision-making positions, they are regularly subject to roles traditionally deemed as women’s inconsiderate of their managerial seniority and experience.
She nevertheless rallied the women to play their respective roles in enhancing participation and visibility at a personal level. The following were some of the strategies she proposed; work hard to acquire academic credentials so as to compete favourably with men, acquire necessary administrative training and experience, network among women, join professional networks as well as do research and publish.
On joining professional networks, she shared her personal experience as a young zoologist who joined UNESCO’s Tropical Biology and Fertility Programme. “Within a short time I was appointed Coordinator for Africa and after two years, I was elected as a Member of the International Board of Management. After serving for two years, I became Vice Chairperson of that Board and finally I became Chairperson of that International Board.”
At the institutional level, Prof. Okwakol appealed to the Chairperson Council and Vice Chancellor to proactively recruit women who meet the requirements for leadership positions even if it means actively seeking out the reluctant ones. In this regard, she shared that it would be useful for the university to develop a database of women and their qualifications to ease this process.
She shared that NCHE has in recognition of female underrepresentation at every level in Higher Education approved the establishment of a Gender and Equity Unit with the aim of promoting inclusive gender participation in the sub-sector.
“This unit has been placed under the Directorate of Quality Assurance and Accreditation which implies that as we look out for and regulate quality, gender will be a very important aspect of that regulation” she reassured.
Prof. Okwakol concluded by urging participants to read the; Third National Development Plan (NDPIII), Uganda Vision 2040, and Sustainable Development Goals (SDGs) noting that there is no way all three can be achieved while women are left behind because they each make a case for inclusion of the female gender.
“What we are addressing here are historical injustices” said Prof. Barnabas Nawangwe as he commenced his remarks, “And in the case of Makerere University, it is well known that the institution started as a male-only institution and we all know the original motto was ‘Let us be men’” he added.
Citing examples from history such as; Marie Curie – one of the smartest physicists, Hatshepsut, Nefertiti and Cleopatra – prominent Pharaohs of Egypt, George Eliot, Rosa Luxemburg and Hypatia – all great philosophers as well as Chancellor Angela Merkel – first female Chancellor of Germany, the Vice Chancellor said there is no plausible argument that there are things women cannot do as well as their male counterparts.
He said it was against this knowledge and in a bid to correct historical injustices that Makerere University pioneered initiatives such as putting in place affirmative action for girls, establishing a Gender Mainstreaming Directorate as well as a School of Women and Gender Studies. The Vice Chancellor nevertheless stressed the need to go beyond pioneering to protecting these gains through legislation. “Historically we have seen that discrimination can only be addressed by laws and policies.”
Prof. Nawangwe thanked the Government for providing funds to support Mak-RIF as well as the Funds GMC and Secretariat for ensuring that these funds are put to good use. He equally thanked the Chairperson of Council, Mrs. Lorna Magara for her not only her support but also sparing time to attend a good number of the research dissemination events.
Delivering the concluding remarks, Mrs. Magara acknowledged that the study was timely and relevant the contemporary University, as one of the critical drivers of the national and international development agenda. She therefore reechoed the Vice Chancellor’s thanks to the Government of Uganda for generously supporting the University’s research through Mak-RIF.
Turning to the keynote speaker she said, “I thank Prof. Okwakol for ardently discussing the critical issues affecting the female gender, the strategies to overcome the challenges, including sharing her inspiring personal experiences.”
Mrs. Magara equally thanked Prof. Okwakol for her very instructional analysis, providing mentorship guidance with the resultant impact of enhancing the female gender in decision-making positions. In the same breath she congratulated the PI and her team upon successfully concluding phase one of the project.
“Phase one has generated insights in understanding the status of women in leadership in public universities, the legal and policy framework and its implications on women’s visibility, the institutional mentoring systems and the gaps therein” she observed.
The Chairperson of Council acknowledged that the challenge of underrepresentation of women in leadership roles cannot be resolved at an individual level. She therefore advocated for broad based strategies that can address deep-seated structural and cultural biases facing women. “These include developing mentorship networks, enacting laws and policies that address the imbalances and providing training programmes to address the leadership gaps.”
She therefore pledged the University Council’s unwavering support to the Gender Mainstreaming Programme by ensuring an enabling policy environment that facilitates gender-responsive teaching, learning, research innovation and community service.
The research dissemination was moderated by the Principal Public Relations Officer (PRO), Ms. Ritah Namisango and the Director Communications, Learning and Knowledge Management, ResilientAfrica Network (RAN) and PRO Mak-RIF, Ms. Harriet Adong.
Section Editors & Associate Editors Wanted-CABI Agriculture & Biosciences Journal
The CABI Agriculture and Biosciences Journal (CABI A&B) is still in search of both Associate Editors to join the CABI A&B Editorial Board, as well as a Regional Editor-in-Chief to lead for Africa in addition to serving as a Section Editor in the area of either Environmental and SOIL SCIENCE, AGROECOLOGY, OR AQUACULTURE AND FISHERIES. Ideally CABI wants Section Editors (SE) who are prominent members of their research communities, with high-level established positions at a research institution, with a strong, current record of international collaborations and publication, with an H-index of at least 25. For Associate Editors (AE) we hope for researchers who have with established positions at a research institution (e.g., not post-docs or Ph.D. candidates), with a strong growing record of international collaborations and publication (e.g., around 8 publications in the past two years), and have an H-index of at least 15.
Very importantly, CABI hopes for SEs and AEs who are good communicators and are passionate about serving and building the journal to be an outlet for both large and small steps of sound science that will improve the lives and livelihoods of people worldwide.
Please see Downloads for the CABI EDITORIAL DIRECTORY
Interested applicants should email PHILIPPA J. BENSON, PH.D. MANAGING EDITOR | _CABI A&B | P.BENSON[at]CABI.ORG