General
Book on Universal Health Coverage in Uganda Launched: President Uhuru Engaging Mak Researchers on Kenya’s Plans
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
General
Ambassador of Sweden to Uganda calls for full involvement of men and boys in achieving Gender Equality
The Ambassador of Sweden to Uganda Her Excellence Maria Håkansson has emphasized the need to fully engage men and boys in all the initiatives geared towards achieving Gender Equality in Uganda and other parts of the world. She said this on 28th November 2023 at a press conference organized by the Embassy of Sweden in close collaboration with Makerere University Gender Mainstreaming Directorate, UN Women and United Nations Population Fund (UNFPA) to unveil the National Orange Pledge campaign and officially launch the 16 Days of Activism against Gender-Based Violence.
The press conference was headlined by a Ugandan rapper and record producer Daniel Lubwama Kigozi, popularly known by his stage name Navio and his fellow from Sweden Jason Michael Bosak Diakité popularly known as Timbuktu. Over 200 students both male and female from Makerere University and other institutions of higher learning attended the press conference at Makerere University Rugby Grounds.
According to Her Excellence Maria Håkansson, Gender Equality cannot be achieved without involving men and boys to take their responsibilities and be the drivers of change. “For real change to happen, we need to change attitudes and norms that might cause Gender Based Violence, one of the social ills in Uganda and an extreme of gender inequality that occurs at all levels of society,” she said.
Referring to the national survey conducted in 2020, the Ambassador was concerned about the escalating burden of gender based violence in Uganda when she said, “the Survey highlighted that 95% of women and girls experience physical or sexual violence since the age of 15.”
She therefore emphasized the Global 16 Days of Activism as key international movement to increase awareness and advocate for an end to Gender Based Violence. The Ambassador also mentioned that preventing and responding to Gender Based Violence is a cornerstone for Sweden’s commitment to promote democracy, human rights and gender equality and this is done as an investment in a society that upholds the principles of equality, dignity and justice.
She acknowledged the full participation of university students in all campaigns and activities geared towards achieving gender equality as well as ending Gender Based Violence when she said, “You are the leaders of tomorrow and you have an opportunity to build a future where everyone can thrive. So please use today to take an active stand against Gender Based Violence.”
Every year Uganda joins the rest of the world to enhance the global campaigns on 16 Days of Activism against Gender-Based Violence and also add a voice to the call for an end to violence against women and girls. These campaigns run from 25th November (the International Day for the Elimination of Violence against Women) until 10th December of the Human Rights Day.
The United Nations Secretary-General’s UNiTE by 2030 initiative calls for global action to increase awareness, galvanize advocacy efforts and share knowledge and innovations to help end all types of violence against women and girls. This year 2023, the UNiTE campaign theme is; Invest to Prevent Violence against Women & Girls.
Over the years, Makerere University through its Gender Mainstreaming Directorate and School of Women and Gender in partnership with UN Women and many other partners have been at the fore front to support the campaign on 16 Days of Activism against Gender Based Violence in Uganda. This has been done through debates, theatre forums, student dialogues, thematic artistic presentations, media exposures, drama and music skits presentation, and student peer led discussions and quarterly competitions.
This year 2023, the University in partnership with the Embassy of Sweden, UN Women and United Nations Population Fund (UNFPA) unveiled the Orange Pledge. According to Eric Tumwesigye the Senior Gender Specialist at Makerere University Gender Mainstreaming Directorate, this campaign calls upon government, policymakers, activists, civil societies, academicians, students and all members of community from all parts of the country to make their heartfelt pledges towards ending Gender Based Violence in Uganda and the rest of the world.
The UN Women Country Representative Paulina Chiwangu recognized the investment Makerere University, the Embassy of Sweden and UNFPA have made to end violence against women and girls. “Thanks to our collective efforts, the silence that used to shroud violence against women has now been broken” said.
In the same spirit, she acknowledged the progress Makerere University has made in establishing and implementation of the University’s Policy and Regulations against Sexual Harassment to protect students and staff from potential abuses of power and conflict of interest. She also applauded the increased support and training for students and the strengthened mechanisms for investigations that allow students and staff to anonymously report sexual misconduct.
“We are however, aware that despite this, sexual harassment is still happening in the university and that not many students report to the authorities when they experience it. It is therefore, our humble appeal to the university leadership to continue monitoring the implementation of the Policy and Regulations Against Sexual Harassment, take all allegations of sexual harassment and violence seriously, ensure that all personnel have information on available support services and take action to ensure that perpetrators are held accountable.”
Reaffirming the University’s position in fighting GBV and particularly sexual harassment, the Vice Chancellor of Makerere University Prof. Barnabas Nawangwe was highlighted the various measures Makerere University has put in place to prevent and respond to Gender Based Violence. To him, the Policy and Regulations against Sexual Harassment; the appointment and capacity building for the Vice Chancellor’s Roster of 100 eminent people from the various colleges and administrative units; recruitment and training of the Gender Mainstreaming Programme Student Peer Trainers and setting up Sexual Harassment Investigation Committees are bigger milestones to celebrate.
He appreciated the move by the Gender Mainstreaming Directorate and all the partners to embrace entertainment and artistry as a critical advocacy and awareness tool to reach several communities especially the youth.
“We firmly believe in the transformative power of music and the arts in promoting social change. Music and art does serve as a powerful medium to advocate for the world free from violence especially violence against women,” said to Mr. Dainel Alemu, the UNFPA Deputy Country Representative.
“It is heartening to see artists like Navio taking a stand and using their influence to challenge harmful norms. As we revel in the beats and melodies, let us not forget he underlying message that everyone , regardless of gender, has a role to play in fostering a world where everyone is free from shackles of gender based violence,” he added.
Speaking at the Press Conference at Makerere University Rugby Grounds, Navio said that for the 20 years he has been an activist of Gender Based Violence, he has faced the reality of many young girls and women in Uganda being victims of sex and physical abuse. He therefore sent a huge condemnation to men especially artists that who are perpetrators of Gender Based Violence and called for serious government action and clear policies and laws against such injustices.
Navio applauded the women and men who have stood tall over the years to fight against Gender Based Violence in Uganda when he said, “ As we launch the 16 days activism in Uganda and through these pledges we are making, let us be accountable for our actions. For long in our cultures, men have considered force and violence as power and protection. They have been tough to their children hence instilling fear to the extent that the children cannot freely interact with them on serious matters such as abuse and torture.”
He applauded all families that have adopted the new parenting model of free conversations and interaction hence encouraging children to freely open up whenever they have challenges. Navio also acknowledged the role of his mother Mrs Maggie Kigozi as a human rights activist and a champion in fighting against Gender Based Violence in Uganda.
Jason Michael Bosak Diakité popularly known as Timbuktu from Sweden appreciated the wider platform provided by the music industry globally for artists to act as role models and champion of change. The rapper highlighted the need to respect women for their roles and support towards community development.
“I am a son and it is extremely important for me to respect my mother and all women. Also being a father to a beautiful daughter, I am always eager and looking forward to seeing the best future for her. I want daught to grow up in the world where she is able to feel safe and be allowed to freely associate without being discriminated or threatened because of her gender,” he said.
By Bernard Buteera
On Saturday 2nd December 2023, all roads led to Achukudu Community Primary School in Napak District, Karamoja sub-region, as the Scholars and Alumni of Mastercard Foundation at Makerere University commemorated their Scholars’ Annual Day of Community Service (Giveback). The 2023 Scholars Annual Day of Community Service was held at Achukudu Community Primary School, Napak District in the Karamoja sub-region. Established in 2013, Achukudu Community School serves two ethnic communities—The Iteso and Karamojong.
With a total population of 1,097 pupils only three government-paid teachers, and nine community-paid teachers, the School faces a plethora of challenges. Key among the challenges is the lack of Classrooms, decent Ventilated Pit Latrines, and Desks. Therefore when the Scholars identified the School as one that deserved to be given a gift of a classroom block, it was a befitting choice!
The Scholars with support from the alumni, the Program Team, Members of the Steering Committee, and partners of the Scholars Program at Makerere University intervened by constructing a two-classroom block, which was supervised by one of the alumni who is an Engineer. Alongside the classroom block, the Scholars also provided 40 desks, helping the school meet UNEB Center eligibility criteria.
While presiding over the event, the area member of Parliament, Hon. John Bosco Ngoya, thanked the Scholars and alumni community at Makerere University for supporting the young pupils of Achukudu Primary School and the entire community by gifting them with a two-classroom block.
“Thank you Scholars and alumni of Mastercard Foundation at Makerere University for the Christmas gift of a classroom block to the young people and the entire community of Achukudu. This classroom block will go a long way in improving the learning environment of the young children of Achukudu primary school.” Hon. Ngoya pointed out.
Hon. Ngoya called upon other people to emulate the Scholars and alumni of the Mastercard Foundation in embracing the spirit of giving back to the vulnerable people in the community. On his part, he donated One Million Five hundred shillings (1,500,000/=) to help the School purchase more desks, and he had earlier contributed One million shillings (1,000,000/=) towards the construction of the classroom block.
The District Education Officer (DEO) for Napak District, Ms. Joyce Nakoya, praised the Scholars Community for embracing and practicing the spirit of giving back to other people at an early age.
“Thank you Scholars and alumni of the Mastercard Foundation at Makerere for embracing the spirit of giving back to other people at such an early age. If all people gave back to the less privileged in our communities, we would have a better world for everyone.” Ms. Nakoya pointed out.
Ms. Nakoya further pointed out every child deserves to study in a decent environment, therefore it was a befitting cause for the Scholars to construct a classroom block for the young pupils of Achukudu community primary school, who were studying in open grass thatched classrooms.
The Program Manager of the Mastercard Foundation Scholars Program at Makerere University, Ms. Jolly Okumu who led the team of Scholars, alumni, and staff to Karamoja thanked the community of Achukudu for supporting the Scholars to deliver the class block by contributing to the construction sand.
“We come here today to join with you as a community driven by a shared commitment to education, empowerment, and ethos of giving back. Today is a historic occasion as we celebrate the completion and commissioning of the classroom block, which is a remarkable testament to the transformative power of education and our unwavering spirit of community service.” Ms. Jolly remarked.
The President of the Scholars Association, Mr. Godfrey Okello, thanked all the Scholars and alumni, and all stakeholders who contributed to the construction of the classroom block, which was a dream that became a reality.
“I would like to thank my colleagues and people of goodwill who supported us to realize our dream of constructing this classroom for our young brothers and sisters of Achukudu Primary School. Together we can make a difference in the lives of our fellow young people in Uganda and Africa as a whole.” Mr. Okello remarked.
The Headteacher of the School, Mr. Eryebu Raymond, who was visibly very excited was full of praises for Scholars and alumni of the Mastercard Foundation, for what he termed as an iconic classroom block they had gifted to his School.
“This day is very special to us, we will not see this day again. We are delighted to receive the Scholars and alumni of Mastercard Foundation from Makerere University, thank you for considering supporting our School” Mr. Eryebu excitedly remarked.
The Headteacher revealed that one of the major challenges the school was facing was an acute shortage of classrooms for his 1,097 pupils. He was therefore grateful to Mastercard Foundation Scholars for choosing to construct a two-class block for the School.
“This donation of a classroom block and Desks is a testament to your commitment to education and empowering the lives of the vulnerable people in the community. This classroom block and desks will go a long way in improving the quality of teaching and learning at our school.” Mr. Eryebu further remarked.
The 2023 Scholars Annual Day of Community Service (Giveback) was punctuated with a lot of joy, pomp, and fanfare, as the pupils and the entire community of Achukudu danced and ululated at the commissioning of the classroom block. The construction of the classroom block and purchase of desks for Achukudu Community Primary School was made possible by generous contributions by the Scholars, alumni, the Program Team, and members of the Steering Committee.
Among the Partners who made financial contributions towards the class block construction included; DFCU Bank, Post Bank, URA, Katumba Estates, Footsteps Furniture Ltd, and Sion Travels Ltd.
The Scholars and Alumni Day of Community Service (Give back) is an annual event, where Scholars and alumni of the Mastercard Foundation go out into the community to give back by providing solutions to challenges that a particular community is facing. Over the years Scholars have given back to the communities in numerous ways that range from offering professional services and erecting major projects like classroom blocks.
Bernard Buteera is the Communications and Public Relations Officer of the Mastercard Foundation Scholars Program at Makerere University.
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