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East Africa’s high maternal death rate

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Judith Awino died on her 25th birthday as she gave birth, on a dusty roadside, to her second child.

She had endured a long and difficult labour but was unable to get admitted to hospital because of a nurses’ strike.

Her baby also died.

Judith Awino’s identity card

Her short life symbolises the tragedy behind the high maternal death rate in Kenya where the maternity system faces extreme pressure.

Whereas Kenya’s overall crude death rate is on a par with Europe, its maternal death rate in 2015 was 43 times higher than that seen in high-income countries?—?with 510 women dying in every 100,000 live births.

And that picture is not just restricted to Kenya.

Across Africa, countries are unlikely to hit the Sustainable Development Goal to significantly reduce preventable maternal deaths.

A team from the University of Leeds, Makerere University in Uganda and the Catholic University of Eastern Africa is investigating a new approach to improving maternal health. It is funded by the UK’s Global Challenges Research Fund (GCRF), money from the UK’s aid budget with the aim of bringing the best research to target the big, intractable problems facing the world.

The UK Government believes research excellence is achieved by people from different academic backgrounds working in collaboration and across borders.

The project in Kenya has researchers with a medical humanities background working alongside medical and public health specialists, bringing fresh insight into why maternal death rates are high.

One of the issues that’s emerged is that a high proportion of pregnant women seek maternity care very late in their pregnancy.

Jane Plastow, Professor of African Theatre in the School of English and History at Leeds, said her approach is to use drama-based workshops to allow women and their families to feel at ease in speaking about their experiences or to act out what has happened to them.

Theatre-based workshop

Professor Plastow said: “We have been able to show that there are good reasons why many poor women are not able or willing to interact with health professionals and these need to be much better understood and taken into account if services are to respond well.

“The research is revealing that the challenges facing women are immense. Most people using the public health service are poor and live in remote villages, and for many it was impossible or costly to access antenatal care.”

She also commented that people felt ambulances could not be relied on. The women spoke about being treated badly when they went for antenatal advice or went into labour?—?with feelings that nurses would be dismissive, disparaging or judgmental, particularly if they regarded the patients as poor or illiterate.

Maternity units were reportedly overwhelmed, with many women not being assessed quickly enough. Both hospitals and rural clinics lacked blood products and equipment.

The research is suggesting that women have become more vulnerable because of the changes in the support they get from their families, sometimes with women under pressure to return to work days after giving birth.

Shane Doyle, Professor of African History at Leeds who is leading the project, said: “One of our goals is to encourage hospitals to adapt their maternal health provision in light of this research, so that, for example, greater attention is devoted to ongoing care and delivery and discharge.”

The researchers are working with Kenyan TV to reveal the problems faced by poorer women and it will feature the case of Judith Awino.

The project will also look at the relationship between patients and healthcare staff who often work under extreme pressure.

Professor Doyle added: “One of our aims is to show that this cross-cutting research opens up a fresh understanding of the experiences of pregnant women and health care workers.

“Kenya has attempted to improve the maternal death rate by introducing free maternity services and opening new hospitals but they’ve not had the impact that was hoped.

“Research that understands the socio-cultural issues and health issues in maternal death rates is likely to suggest more sustainable ways of tackling the problem.”

The University of Leeds has been hugely successful in securing support from the Global Challenges Research Fund. It was established in 2016 and over five years will allocate a total of £1.5 billion to UK science with the aim, the Government said, of ensuring Britain meets its “…moral obligation to the world’s poorest.”

The UK Medical Research Council awarded the GCRF grant. Dr Mark Palmer, Director of International Relations at the MRC, said: “Improving on maternal and neonatal health is a major global health challenge that we are committed to tackling.

“This research is pivotal to better understanding why maternal death rates are so high, taking a multidisciplinary approach to gain insight into how to help pregnant women, along with the healthcare workers and communities that support them. The findings could lead to positive changes and better outcomes for maternal health around the world.”

The University of Leeds is involved in 70-plus projects financed through the fund covering a range of issue from equipping scientists in the developing world with technology to safely make vaccines, low-cost endoscopy for stomach cancer and the ways people can protect themselves from the kidnapping epidemic in Mexico.

Find out more about the University of Leeds and GCRF.

Other GCRF stories:

Improving the forecasting of tropical storms in Africa

Tackling viral diseases

Rebuilding fractured societies

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Vice Chancellor Updates Media on Medical Drones, Road Safety Research & Various Issues

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Prof. Buyinza Mukadasi (Centre) with Dr. Andrew Kambugu (Left) and Dr. Fredrick Oporia (Right) at the Press Briefing on 29th May 2025. Press Conference featuring Infectious Diseases Institute—the IDI Medical Drone Programme and Kampala Status Summary 2023 on Road Safety Risk Factors, conducted under the Bloomberg Philanthropies Initiative for Global Road Safety. This collaborative effort between the Johns Hopkins International Injury Research Unit and our Trauma, Injury, and Disability Unit (TRIAD) Makerere University School of Public Health (MakSPH), Senior Common Room, Main Builing, Makerere University, Kampala Uganda, East Africa.

The Acting Vice Chancellor, Prof. Buyinza Mukadasi on Thursday 29th May, 2025 held a press conference to update members of the Media on the Infectious Diseases Institute (IDI) Medical Drone Programme, and the Kampala Status Summary 2023 on Road Safety Risk Factors, conducted under the Bloomberg Philanthropies Initiative for Global Road Safety, a collaborative effort between the Johns Hopkins International Injury Research Unit and the Trauma, Injury, and Disability (TRIAD) Unit at Makerere University School of Public Health (MakSPH). Also presented were updates on; Digital Certification of Academic Transcripts, Digital Supervision of Graduate Students, Inclusive e-Learning and Smart Classrooms, and Launch of the Artificial Intelligence (AI) Laboratory at the College of Computing and Information Sciences (CoCIS).

The event held in the Senior Common Room, Main Building, was on behalf of the Vice Chancellor, Prof. Barnabas Nawangwe presided over by the Acting (Ag.) DVC AA and substantive Academic Registrar, Prof. Buyinza Mukadasi. Presentations were made by Executive Director of the Infectious Diseases Institute (IDI), Dr. Andrew Kambugu and Head of the Trauma, Injuries, and Disability (TRIAD) Unit, Dr. Fredrick Oporia. Dr. Jimmy Osuret and Dr. Esther Bayiga from TRIAD supplemented Dr. Oporia’s presentation. In attendance were; the Director for ICT Support (DICTS)-Mr. Samuel Mugabi, Deputy Chief – Public Relations-Ms. Betty Kyakuwa, Deputy Chief Security Officer-Mr. Musa Mulindwa and other university officials.

The proceedings of the Press Conference follow below;

Vice Chancellors’ Press Statement

Good morning colleagues, members of the press,

It is my pleasure to welcome you to this important media briefing, where we share compelling findings from two groundbreaking studies that reflect Makerere University‘s ongoing commitment to impactful research, innovation, and community transformation.

The first is a pioneering initiative led by the Infectious Diseases Institute—the IDI Medical Drone Programme. This project explores the use of drone technology to deliver lifesaving HIV medications and test samples to hard-to-reach populations, particularly in Kalangala District and the West Nile region. The study demonstrates how drones can overcome logistical barriers, reduce costs, and enhance access to critical healthcare in some of Uganda’s most underserved communities.

The second study is the Kampala Status Summary 2023 on Road Safety Risk Factors, conducted under the Bloomberg Philanthropies Initiative for Global Road Safety. This collaborative effort between the Johns Hopkins International Injury Research Unit and our Trauma, Injury, and Disability Unit here at Makerere University presents over two years of data on vehicle speed and helmet use in Kampala. It provides vital insights into the human behaviours and systemic gaps contributing to road traffic injuries and fatalities—particularly among vulnerable road users. The study also offers evidence-based recommendations for enforcement, planning, and public health messaging aimed at making Kampala’s roads safer for all.

We are proud to support this kind of research that not only advances knowledge but also drives tangible improvements in public health and safety.

Before I invite the researchers to present their findings, allow me to briefly highlight some transformative developments in the areas of academic registry and ICT advancement here at Makerere University:

  1. Digital Certification of Academic Transcripts:
    • Alumni can now certify their transcripts digitally through the Makerere Academic Records System (Mak-ARS https://makars.mak.ac.ug/), eliminating the need for physical visits. This user-friendly platform allows access from anywhere in the world, supported by comprehensive video tutorials and public communications.
  2. Digital Supervision of Graduate Students
    • We have introduced the Research Information Management System (Mak-RIMS), piloted at the College of Agriculture and Environmental Sciences, to streamline the supervision of Master’s and PhD research. This initiative enhances accountability, timely feedback, and is now being rolled out university-wide to improve graduation rates.
  3. Inclusive eLearning and Smart Classrooms
    • Through support from development partners and the Government of Uganda, we are establishing multimedia studios and smart classrooms across our colleges. These state-of-the-art facilities are designed to produce professional, accessible learning content, including tools tailored for students with visual and auditory disabilities. This aligns with our goal of equitable, globally competitive education.
  4. Launch of the AI Laboratory at CoCIS:
    • The newly launched Artificial Intelligence Laboratory will spearhead the development of AI-enabled solutions tailored to Uganda’s socio-economic needs, including localized assistive eLearning tools and context-sensitive curriculum development.

These initiatives are part of our broader vision to transform Makerere University into a research-led, inclusive, and globally relevant institution.

Detailed Presentations

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Prof. Aina Visits Mak, Evaluates CECAP II Progress

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Prof. Omotade Akin Aina (Left) receives the Makerere Souvenir Book from Prof. Tonny Oyana as Prof. Julius Kikooma (2nd Right) and Mr. Charles Lwanga (Right) witness. Prof. Omotade Akin Aina-Carnegie Corporation of New York meeting to discuss progress of Consolidating Early Career Academics Programme (CECAP) phase II, which focuses on fostering academic development and research among early-career academics, 23rd May 2025, Main Building, Makerere University, Kampala Uganda, East Africa.

The Senior Program Director, Higher Education and Research in Africa, International Program, Carnegie Corporation of New York, Prof. Omotade Akin Aina on 23rd May 2025 visited Makerere University during his short trip to Kampala. Prof. Aina was received on behalf of the Vice Chancellor, Prof. Barnabas Nawangwe by Prof. Tony Oyana, Principal of the College of Computing and Information Sciences (CoCIS).

During his visit, Prof. Aina met with the Project Implementation Committee, representatives from the Consolidating Early Career Academics Programme (CECAP) phase I Fellowship Cohort, and current Fellows of phase II. The meeting discussed the progress of CECAP II, which focuses on fostering academic development and research among early-career academics.

Left to Ritght: Dr. Jesca Nakavuma and Prof. Julius Kikooma alongside Prof. Omotade Akin Aina during the meeting. Prof. Omotade Akin Aina-Carnegie Corporation of New York meeting to discuss progress of Consolidating Early Career Academics Programme (CECAP) phase II, which focuses on fostering academic development and research among early-career academics, 23rd May 2025, Main Building, Makerere University, Kampala Uganda, East Africa.
Left to Ritght: Dr. Jesca Nakavuma and Prof. Julius Kikooma alongside Prof. Omotade Akin Aina during the meeting.

CECAP II is being implemented by Makerere University in collaboration with four other Ugandan public universities, including; Busitema University, Gulu University, Kyambogo University and Mbarara University of Science and Technology. Prof. Mukadasi Buyinza, the Project Principal Investigator was represented at the meeting by the Director of Graduate Training, Prof. Julius Kikooma.

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Directorate of Graduate Equips Schools and Colleges with Training in Philosophy of Methods

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By Moses Lutaaya

The Directorate of Graduate Training at Makerere University has equipped several Senior ranking lecturers with expert knowledge in a Training of Trainers’ workshop on “Philosophy of Methods”.

In his remarks at the opening of a 3-day training workshop at Level4 Conference Hall – Senate Building, the Director of Graduate Training Prof. Julius Kikooma said, “The teaching of Philosophy of Methods gives all participants the fundamentals to extend knowledge to other learners, hence its importance in upholding the Makerere University values.”

Kikooma urged and challenged the participants to also attend and actively participate in the follow up of learners’ training of students, stating that the PhD students need support as the directorate continues to coordinate the curriculum of PhD by-research that was approved by the senate recently.

“To holistically implement the senate approved PhD curriculum, we are coordinating capacity building trainings of all stake holders in a structured approach with the different units of the University. Many more trainings including Training of Trainers in advanced research methods course are on the way.”

He further urged the participants to be intentional in their teaching profession and in whatever they were doing, adding “Apart from focusing on practices as teachers and researchers, we can engage in wider philosophical debates in our research areas so that we are relevant in the society and in the empowerment of PhD research students.”

 The participants for the Philosophy of Methods training were from College of Humanities and Social Sciences, College of Education and External Studies, Makerere University Business School among others.

During the same training, Dr. Dickson Kanakulya stressed the need to train senior lecturers in the Philosophy of Methods, saying, “The biggest connection is that societal problems require concrete research to find solutions. Our challenge in Africa is that we employ a short barrow approach to find solutions to problems. This cannot work. We need consistent researchers to solve problems. Lasting solutions to societal issues can only be got through training such as Philosophy of Methods, where researchers come up with new models for societal solutions.”

Prof. Julius Kikooma pose for a photo with participants and facilitators.

Dr. Kanakulya said that Makerere University remains the biggest research University in Africa and philosophy of Methods helps to come up with good research tools that produce good research outputs. “Research has shown that the higher the number of PhD researchers in any given country, the higher the levels of development of that country e.g. the USA, China etc., adding that research is not limited to only medicinal or agricultural related issues.”

He said philosophy of methods, encourages philosophical creativity in research, “It is meant to bring out philosophical generation of concepts, theories and ideas. It is meant to encourage students to question the existing philosophical assumptions and status quo in a given field of knowledge such that new philosophical concepts are created.”

 For successful rollout of government programs like the National Development Plan 4, Dr. Kanakulya said that Philosophy of Methods training needs to be integrated into such systems. “Philosophy of Methods focuses on ethical thinking aspects. For example, for a better rollout of the Parish Development Model, we need implementers to be ethical.” He added.

 Prof. Sulait Tumwiine, the associate Dean of Faculty of Graduate Studies and Research at MUBS said, “This is a discussion where new ideas are shared to guide and gauge applicability in the current knowledge diversity coupled with lots of technological development including Artificial Intelligence and Chat GPT.”

He added, “As professors of Universities, we need to understand how we leverage on what comes up so that it does not take our space, but also appreciate how we can support growth of knowledge. The Philosophy of Methods training is the answer.”

 Dr. Jim Spire Ssentongo highlighted that Philosophy uses more of the critical mind than Science. He added that philosophy is more of speculation of the mind.

“Sustainability of philosophy Education encourages us to continue training. Philosophy being the oldest discipline retained special status in the academia as a pinnacle of pursuit of knowledge. All disciplines have major elements of philosophy citing examples in the philosophy of Mathematics and Physics.

Dr. Spire added, “If you do not understand philosophy, you cannot deeply investigate anything because philosophy is the reality of understanding everything. Philosophy is the basis of understanding what knowledge is and how it is arrived at.”

Also participating in the workshop was Prof. Joseph Ntaayi from MUBS, in his remarks he said PhD students need the philosophy of methods training to understand how to best to create knowledge. He added that ontological and epistemological questions that lead to good research design methods can only be answered by this training.

Dr. Robert Kakuru, a Lecturer in the College of Humanities and Social Sciences said that the Philosophy of Methods training is needed by every graduate student as well as supervisors to critically determine the choice of methods to use in academic research. For example, “If one wants to use a questionnaire as an interview approach, one should understand, why that approach and yet without this training, the why cannot be answered.” He added.

The Philosophy of Methods training was organized by Directorate of Graduate Training with funding support from the Consortium for Advanced Research Training in Africa (CARTA).

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