Connect with us

Health

Address Drivers of Non-compliance to COVID-19 Guidelines, Researchers Urge Government

Published

on

By Joseph Odoi

Makerere University researchers and local leaders have asked government and other key stakeholders in refugee management to address community drivers of non-compliance to COVID-19 guidelines as increased cases continue to be registered across the country.

This call was made at the dissemination event of a study conducted by Makerere University titled Refugee Lived Experiences, Compliance and Thinking (REFLECT) in COVID-19. The REFLECT dissemination was undertaken at multiple sites in Kisenyi (Kampala), Kyaka II Refugee Settlement (Kyegegwa) and Adjumani (West Nile) on 14th December 2020.

The REFLECT study observed that compliance levels around COVID-19 guidelines drastically declined between May-August 2020 and continue going down despite increased infections from community transmission. The stakeholders at this event cautioned that addressing the drivers of non-compliance was necessary in light of the overwhelmed health system, currently ongoing political campaigns and massive social gatherings in the Christmas season and beyond.

Since March 2020 the Uganda government and its partners have conducted a fairly successful awareness campaign on the prevention of COVID-19. However, this knowledge has not translated into sustainable behavioural change and while there was strict observance of COVID-19 at the start of the pandemic, compliance has drastically dropped due to a number of reasons. This is why all prevention efforts should now focus on addressing the barriers to non-compliance as the country enters into the second wave and peak period of COVID-19 transmissions.

A study conducted from among 2,092 people in refugee settlements in Uganda has found a serious disconnect between the high knowledge levels and levels of compliance with the recommended COVID-19 preventive measures. A total of 13 settlements were considered for this study including Kisenyi in Kampala, Kyaka II in Kyegegwa district and 11 settlements in Adjumani district, West Nile.

Some of the stakeholders at the REFLECT dissemination in Kisenyi, Kampala. They include community leaders from Somali, Ethiopian and Eritrean communities; officials from National Water & Sewerage Cooperation (NWSC), NGOs, politicians and law enforcement
Some of the stakeholders at the REFLECT dissemination in Kisenyi, Kampala. They include community leaders from Somali, Ethiopian and Eritrean communities; officials from National Water & Sewerage Cooperation (NWSC), NGOs, politicians and law enforcement

Presenting findings of the study at Kyaka II Refugee Settlement in Kyegegwa, South-Western Uganda, the research team led by Dr Gloria Seruwagi observed that compliance levels had declined over time (between March/April and July/August); unfortunately coinciding with increasing number of COVID-19 cases and deaths.

Inappropriate use of masks was found prevalent in some of the study sites – including sharing of masks, and only wearing them when the refugees meet the Police. Researchers say these practices constitute a source of risk for infection, rather than being protective.

Scarcity of Facemasks

Sifa Mubalama, a Woman Councillor in Kyaka II while speaking to study investigators at Kyaka II Refugee Settlement in Kyegegwa, South-Western Uganda late last year, revealed that there is non-compliance to COVID-19 guidelines due to inadequate masks and materials at the settlement.

 “We were all given one mask each in Kyaka II settlement which you have to wash often and use again, hence becoming too old getting torn after some time. There is also inconsistent supply of soap and water. Because of this, some of the community members have not been washing their hands consistently’’ Mubalama revealed.

Sifa Mubalama, the woman counsellor in Kyaka II at the dissemination event.
Sifa Mubalama, the woman counsellor in Kyaka II at the dissemination event.

According to Mubalama, each family gets Shs. 22,000 every month, which is she says is not adequate to sustain the families. As a result, majority refugees go out in the communities to do manual work, to supplement on the income citing that this puts their lives at risk of COVID-19 infection.

Mubalama further contends that children in the settlements were not adhering to the Standard Operating Procedures (SOPs) because their parents were not.

“It would be easier to implement these guidelines if the parents were adhering to them. Because the parents are not adhering to the guidelines, most children are also not. It’s really important that if we are to implement the SOPs, it should start from the parent,” she said.

According to Happy Peter Christopher, the Kyegegwa Sub County Speaker, ever since the lockdown restrictions were eased, the refugees abandoned following the COVID-19 guidelines like social distancing, wearing masks, sanitizing or frequent washing of hands with soap. 

“People are not putting on masks and are careless. Refugees also buy food from the nationals and there are intermarriages. So, the spread of COVID-19 is very possible. For us we would like, if possible, to ask government to bring back the total lockdown so that we are protected”.

He also reported that, up to now, some areas in Kyegegwa had still not received the government distributed masks and called upon government to deliver masks to all refugees and also add more efforts in enforcing SOPs.

It is against this background that researchers at Makerere University and local leaders have appealed to government and other stakeholders in the refugee management to address the community drivers of non-compliance to COVID-19 guidelines as cases continue to surge in Kyaka II refugee settlement in the South Western district of Kyegegwa.

Government has been asked to address the drivers of non-compliance, as a necessity in light of the overwhelmed health system, by the currently ongoing political campaigns and the massive social gatherings during the festivities.

Dr. Misaki Wayengera the Chairperson of the Scientific Advisory Committee on the COVID-19 Taskforce in the Ministry of Health explained why some districts did not get enough masks, saying there was an urgency to distribute to candidates returning to school.

“We intended to distribute masks to the entire 139 districts of Uganda. However, this was not possible because we opened up schools. As the Ministry [of Health], we had to negotiate with the Ministry of Education to prioritise the candidate students who were going to school; every student receiving 2 masks. As a result, we have not been able to distribute masks across the entire country,” he explained.

Dr Misaki Wayengera (1st right)  the Chair of the Scientific Advisory Committee , National Covid-19 Taskforce in the Ministry of Health and Dr  Gloria Seruwagi
Dr Misaki Wayengera (1st right)  the Chair of the Scientific Advisory Committee , National Covid-19 Taskforce in the Ministry of Health and Dr  Gloria Seruwagi Photo by New Vision

According to Dr. Wayengera, there is a need for all stakeholders dealing with refugees to appreciate that they are equally susceptible to COVID-19 like any other person.

“In terms of providing support, we must ensure that we provide things like masks, soap, sanitizers and also educational materials around the SOPs,” he said.

Adding that; “there are targeted efforts to make sure that we roll out Rapid Diagnostic Tests to make sure that we can screen the populations especially as children go back to school, we screen them but most importantly know who is infected and pull them out from the community”.

Dr Misaki Wayengera (1st left) Chair of the Scientific Advisory Committee -COVID-19 Taskforce in the Ministry of Health, speaking to the Media
Dr Misaki Wayengera (1st left) Chair of the Scientific Advisory Committee -COVID-19 Taskforce in the Ministry of Health, speaking to the Media

Discussion of Study Results  

Dr. Gloria Seruwagi, also the Principal Investigator notes that whereas more than half (about 60 percent) of the members of the refugee community are well informed about COVID-19; up to 40% were found to have knowledge gaps on the nature, transmission, symptoms and dangers of COVID-19.

The study results also showed that between 1-40% of the refugee population across the different study sites adopt at least one risk behaviour likely to lead to transmission of COVID-19 including behaviours related to hygiene and social interactions including related to hygiene, congestion, and physical activity.

While men appeared more knowledgeable about the virus compared to women and children, women were found to be more compliant than men. Also, refugees who were Muslims were more compliant to COVID-19 guidelines compared to their Christian counterparts while younger refugees appeared more knowledgeable about COVID-19 than the elderly.

A wide knowledge gap was found among the children and adolescents, with up to 75% not fully knowledgeable on causes, transmission, risk/protective factors and management of Covid-19.

The Myths

Study results show that refugee communities had a belief that Africans have immunity against COVID-19; and that COVID-19 is not real but is instead a fabrication of scientists and politicians; and that their religious faith would protect them.

On threats and opportunities towards compliance, social media and the diaspora were reported as the key knowledge agents among refugee communities whose effect is divisive by simultaneously encouraging both compliance and non-compliance.

While a lot of information about COVID-19 has been provided by government and other stakeholders including implementing partners from civil society, UN bodies and local leadership, researchers revealed that children, youths and s the elderly and people with disabilities were not particularly targeted with appropriate information; and had largely not been reached.

Children and COVID-19

During the investigations, researchers found that despite government and other key and agencies churning out COVID-19 related information, it largely focused on adults and missed out children and adolescents.

“The fact that they (children and adolescents) have not been targeted means that no one has even given them masks. The masks which are on the market are all big and if a child wears it, it is going to fall down. We decided to channel some of the study resources into making customised and re-usable masks for some of the older children,” explains Dr. Gloria Seruwagi.

Children putting on masks donated by REFLECT Project during the dissemination exercise at Kyaka II, Kyegegwa district in South Western
Children putting on masks donated by REFLECT Project during the dissemination exercise at Kyaka II, Kyegegwa district in South Western

Behavioural change messages needed

The REFLECT study team observed during the study that there was a great and urgent need for engaging leadership at all levels as well as developing Behavioral change messages to positively influence behavior.

Some of the REFLECT Study SBCC Materials at the Dissemination Event in Kyaka II, which were translated into the local languages
Some of the REFLECT Study SBCC Materials at the Dissemination Event in Kyaka II, which were translated into the local languages

During the dissemination exercise, the REFLECT Study Team donated masks to support the refugees “walk the compliance talk” in the fight against COVID-19. 

The study team physically sensitised and demonstrated to the refugees on proper wearing of masks. They strongly discouraged the improper use of masks including “chin” masking, partial masking, inconsistent masking, sharing of masks as well as wearing ill-fitting masks.

Dr. Gloria Seruwagi handing over masks to the Chairman of Kyaka II Refugee Settlement in Kyegegwa
Dr. Gloria Seruwagi handing over masks to the Chairman of Kyaka II Refugee Settlement in Kyegegwa

On the whole, researchers applauded government and development partners’ efforts on undertaking a largely successful awareness campaign around COVID-19.

They note however that this awareness has not translated into positive change, emphasising the need for more effort towards behavioural change, building on from the COVID awareness campaign.

A REFLECT SBCC poster translated by the Somali refugee community in Kisenyi, Kampala
A REFLECT SBCC poster translated by the Somali refugee community in Kisenyi, Kampala

The research team recommends thus;

  1. Government and all stakeholders should focus on addressing the drivers of non-compliance and enforcement fatigue. These drivers include:
  • Reviewing the feasibility of interventions: Guidelines like physical distancing are not feasible in crowded refugee settings and need to be revisited. For crowded settings emphasis needs to be put on some guidelines and not others, for example handwashing and consistently wearing fitting face masks instead of physical distancing or sanitizing.
  • Debunk myths and negative perceptions: Majority of the community has not fully bought into the seriousness of COVID-19 and think it is not only a joke but is also a political and monetary ploy advanced by politicians, some scientists, supremacists or population control enthusiasts. These myths need to be debunked and instead replaced with factual information about COVID-19.
  • More profiling of COVID-19 trends and cases should be undertaken for behavioural change impact. This is because more than 90% of study participants had not seen a single COVID case. However, stigma and other potentially related dilemmas should be carefully managed.
  • Leaders, implementers and enforcers of COVID-19 guidelines should be consistent and “walk the talk”. This is especially needed now with the political campaign season where masses are gathering and politicians are not leading by example.
  • The issue of livelihoods and food security must be resolved as a key bottleneck to compliance.
  • Culture: Local leaders, cultural leaders and grassroots organisations should be recognised and engaged more in behavioural change campaigns – for instance to engage their communities identify alternative social norms for greetings, for showing love and kindness etc., without put their lives at risk.
  1. The timeliness and critical role of the recently launched 2020 Community Health Engagement Strategy (CES) should be leveraged whereby:
  • Local health system capacity is strengthened to effectively take up the implementation and enforcement of SOPs for COVID-19 prevention.
  • Community health systems and other enforcement structures are equipped with knowledge, skills, supplies and adequate infrastructure.
  1. Key sociodemographic factors and COVID-19 risk should guide tailored impact messaging and other interventions.
  2. Children, adolescents and youth should be effectively targeted in COVID-19 interventions. They need awareness, products (e.g. fitting face masks), visibility, voice and protection from the effects of COVID-19 including being witnesses and victims of different forms of violence.
  3. The awareness message found high among adults should be reinforced and consolidated – equitably this time.

“We believe that these are low-cost interventions but which will bring about high impact in a very short time and reverse not only the trend of COVID-19 transmission but also its negative effects across the health socioeconomic spectrum” Dr Seruwagi said.

Kyegegwa Authorities Speak Out

Jethro Aldrine, the Kyegegwa District Assistant Resident District Commissioner said government was committed to inclusive dissemination of information on MOH SOPs in order to mitigate the spread of the pandemic.

“As the COVID-19 district task force, we move from door to door to sensitize people on COVID-19 including children,” he disclosed.

He also noted that government was also sensitising the masses through radio stations to create awareness that COVID-19 is real and needs to be prevented. He thanked the REFLECT Project for carrying out the study that will help the district fight the current pandemic.

At a radio talk show conducted jointly with the study team, district officials and refugee community leaders, Mr Thomas Mugweri the Surveillance Officer in the District Health Office of Kyegegwa District Local Government also thanked the REFLECT Study Team for giving it new direction.  

“While we as a district have been massively sensitizing on awareness, now we know that people are not using the message they know about COVID. We are now going to start using all our behavioural change techniques to make sure that we bring out the desired behavioural change,” observed Mugweri

He urged the politicians to stop recklessly endangering the masses by calling them to campaign rallies and instead called upon them to donate masks and lead by example through observing COVID SOPs during their campaigns.

The REFLECT study PI Dr Gloria Seruwagi after a joint radio talk show in Kyegegwa with COVID taskforce leaders at the refugee settlement village, district and national levels
The REFLECT study PI Dr Gloria Seruwagi after a joint radio talk show in Kyegegwa with COVID taskforce leaders at the refugee settlement village, district and national levels

Youth Voices on COVID-19 in Refugee Settings 

As part of increasing the visibility and voice of young people in COVID-19, the REFLECT Study organised an engagement session with children, adolescents and youth during the dissemination. The engagement sessions were led by Francis Kinuthia Kariuki and Grace Ssekasala of Centre for Health and Social Economic Improvement (CHASE-i) who were supported by Catherine Nakidde Lubowa and Dr Gloria Seruwagi the study PI.

Some of the adolescents at the REFLECT engagement session in Kyaka II Refugee Settlement
Some of the adolescents at the REFLECT engagement session in Kyaka II Refugee Settlement

During this exercise, the REFLECT Team discussed Coronavirus and it emerged that a number of issues are affecting the children and youth which needed to be addressed alongside COVID-19 prevention. Most critical, children and adolescents reported defilement, rape – leading to teenage pregnancies and a lot of other SRH challenges that affected their sexual health.

Many confessed they lacked information on menstruation hygiene products which citing that some of their families could not afford. Others decried inaccessibility of contraception despite being sexually active and access to youth-friendly counselling on SRH matters affecting them.  

Both male and female youths agreed that the high level of teenage pregnancies has been attributed to high poverty levels and being out of school. ‘’Sex is being used as a tool for economic gain and survival. This is not limited to the girl child only – two cases were reported where boys are being married by older women who lure them with money and soft life’’ explained Mr. Francis Kinuthia   from his engagement with adolescent boys and youth.  

Engaging South Sudanese children and youth with the COVID-19 prevention message in Adjumani, West Nile
Engaging South Sudanese children and youth with the COVID-19 prevention message in Adjumani, West Nile

Mental health issues were reported to be affecting adolescents largely boys who expressed worry about their future especially, now, that schools had been closed, and they are in a foreign country.

 Increasing crime rates were also reported and, following unemployment plus school closure, majority youths especially males have now resorted to drugs and substance abuse.

 In regard to COVID-19 the adolescents in general reported that they had experienced the negative effect of the pandemic in their lives such as reduction on monthly hand-outs, harassment by police and enforcers of COVID -19 guidelines, increased domestic violence, SGBV, teenage pregnancy, increased levels of drug and substance abuse, poor mental health and high cost of living among others.

 Asked what could be done to solve some the challenges they were facing; youth recommended the following;

  • Establishment of skill development centres to empower them and make them less dependent on hand-outs
  • Creation of employment opportunities by authorities
  • Identification, support and nurturing talent among them refugees and youths
  • Constant supply of sanitary towels/pads and other SRH products including contraception
  • Health education on contraception methods and having in place youth-friendly services at health facilities
  • Continuous awareness campaign on COVID-19 which involve youth and punitive policies or by-laws to severely punish the perpetrators of teenage pregnancies, rape and child marriages.

The dissemination attracted members of the academia from Makerere, Gulu and other universities, central and district Government representatives, Refugee Representatives including their leadership from OPM, Refugee Welfare Committees (RWC), Village Health Teams (VHT), Youth, Women and Sub-County representatives, local politicians, Development and Implementing Partners like Save the Children, Red Cross Society, UNHCR, Nsamizi Institute for Social Development and the Private Sector.

REFLECT Co-Investigators Dr Betty Okot, Andrew Masaba (LWF) and Brian Luswata from the Ministry of Health (MoH) engage the community on radio talk show in Adjumani, West Nile
REFLECT Co-Investigators Dr Betty Okot, Andrew Masaba (LWF) and Brian Luswata from the Ministry of Health (MoH) engage the community on radio talk show in Adjumani, West Nile

Research Team

The REFLECT Study is funded by Elrha/R2HC (Research for Health in Humanitarian Crises) supported by UKAID, Wellcome and National Institute for Health Research (NIHR). The Study Team is led by Dr. Gloria Seruwagi.

The full team has Prof. Stephen Lawoko of Gulu University, Dr. Denis Muhangi, Dr.  Eric Awich Ochen, Dr. Betty Okot  all from Makerere University, Andrew Masaba of Lutheran World Federation (LWF), Dunstan Ddamulira from Agency for Cooperation and Research in Development (ACORD and John Mary Ssekate from the National Association of Social Workers of Uganda (NASWU) Others are Brian Luswata and Joshua Kayiwa all from the Ministry of Health and Catherine Nakidde Lubowa, the Project Coordinator.

Article originally posted on MakSPH

Mark Wamai

Health

MakSPH Champions Leadership Boost for Wakiso Health Managers

Published

on

A group photo of delegates during the Leadership and Management dissemination workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating outcomes of a major leadership and management strengthening initiative in Wakiso District, Central Uganda. The one-year project, part of the Global Health Partnerships programme funded by NHS England implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.

On April 23, 2025, Makerere University School of Public Health (MakSPH) convened district leaders, health managers, and project partners to disseminate the outcomes of a major leadership and management strengthening initiative in Wakiso District, Central Uganda. The one-year project, part of the Global Health Partnerships programme funded by NHS England, was implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health.

Launched in 2024, the project titled Strengthening Leadership and Management Among Local Government Health Managers in Wakiso District, aimed to co-design and pilot a leadership and management training tailored to the realities of Uganda’s decentralised health system. The intervention, led by Makerere University’s Dr. David Musoke and Nottingham Trent University’s Prof. Linda Gibson, through the over 15-year-old NTU-Mak Partnership impacting lives in Wakiso, began with a field visit to over 60 public health facilities in the district, a needs assessment within these facilities to identify key priority gaps, and a baseline survey with the health in-charges to establish the initial status of key indicators.

“We have been very fortunate to work with a supportive local government in Wakiso, from the top leadership down. While many projects struggle to engage district teams, our longstanding relationship with Wakiso made collaboration seamless. Although this was our first initiative specifically focused on leadership and management, we hope it will serve as a stepping stone for even more impactful work in the future,” Dr. David Musoke, a Senior Lecturer at Makerere University and the Uganda Project Lead, said during the dissemination workshop, highlighting the key success factors for the leadership and management project.

Dr. David Musoke speaking during the dissemination workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating outcomes of a major leadership and management strengthening initiative in Wakiso District, Central Uganda. The one-year project, part of the Global Health Partnerships programme funded by NHS England implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
Dr. David Musoke speaking during the dissemination workshop on April 23, 2025.

Initial results from the needs assessment and baseline on leadership and management competencies conducted among Wakiso District health facility supervisors early last year by the project team and shared during the three-day workshop in June 2024, held in Kampala, which kickstarted the six-month structured fellowship programme for 53 health managers in Wakiso, had found critical capacity gaps. Using a tool evaluating 17 leadership and 33 management competencies, only 40% of the managers met the 80% benchmark for leadership, scoring highest in cognitive skills, while just 33% met the required management standard, performing best in self-management and lowest in quality management.

Then, the health facility managers with postgraduate training, longer service, and strong team dynamics, showed overall better performance. While working relationships with subordinates and the district leadership were largely positive, performance was hampered by systemic challenges such as limited resources, low motivation, and weak teamwork. Overall, the study also pointed to a misalignment of expectations between the District Local Government and the Health Ministry, underscoring the need to strengthen coordination to improve services.

The result of this mismatch was to the effect that, as of this time last year, Wakiso District ranked among the bottom 10 on the national health league table, which is an annual Ministry of Health assessment of district performance across key service delivery and patient satisfaction indicators. This was despite Wakiso being Uganda’s most populous district, with over 3.4 million residents today, as it continued to struggle to deliver essential health services to the public. The 2022/2023 Annual Health Sector Performance Report also flagged persistent challenges, including frequent transfers of facility in-charges, overstretched management structures, and weak internal communication and coordination.

A group photo with the Wakiso district health managers during the dissemination workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating outcomes of a major leadership and management strengthening initiative in Wakiso District, Central Uganda. The one-year project, part of the Global Health Partnerships programme funded by NHS England implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
A group photo with the Wakiso district health managers during the dissemination workshop on April 23, 2025.

It was this stark reality that informed the leadership and management intervention in Wakiso. Officiating the dissemination of the project outcomes, Dr. Sarah Byakika, Commissioner for Planning, Financing, and Policy at the Ministry of Health and a member of the National Oversight Mechanism for the programme, commended the remarkable progress made in just six months, citing visible improvements across the district as a direct result of the intervention.

“I have been involved with this programme right from its inception, and I’m proud that Uganda became one of its major beneficiaries,” Dr. Byakika said with gratitude, commending the strong collaboration between the Ministry of Health, Makerere University, Nottingham Trent University, Nottingham University Hospitals, Wakiso District and the development partners for supporting the initiative. She emphasised the value of this partnership in strengthening leadership and management competencies among Wakiso District health managers to address critical performance gaps in health service delivery.

Dr. Sarah Byakika awarding a certificate to the Cohort President, Mr. Mathias Sserwanga, the In-charge of Namulonge Health Centre III in Nansana Municipality during the workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating outcomes of a major leadership and management strengthening initiative in Wakiso District, Central Uganda. The one-year project, part of the Global Health Partnerships programme funded by NHS England implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
Dr. Sarah Byakika awarding a certificate to the Cohort President, Mr. Mathias Sserwanga, the In-charge of Namulonge Health Centre III in Nansana Municipality during the workshop on April 23, 2025.

“Wakiso is Uganda’s largest and most populous district, yet it has long underperformed on key health indices. Despite its semi-urban nature, it faces enormous health service delivery challenges, partly due to the overwhelming burden on its District Health Officer, who oversees more than 60 public and over 340 private health facilities. Many of these private facilities open and close frequently, complicating service oversight,” Dr. Byakika observed with concern.

Her sentiments were echoed by the District Health Officer, Dr. Emmanuel Mukisa, in a message delivered by Wakiso District Biostatistician, Mr. Frank Kakande. He noted that the project had contributed to a noticeable shift in the district’s health system performance, with visible improvements in leadership, communication, and accountability among facility in-charges beginning to translate into better overall health service delivery outcomes.

“You cannot talk about management without addressing performance: they go hand in hand. As someone who sits at the centre of district health data, I can confidently say that performance has improved. During the most recent national local government performance assessment, where I participated in the evaluation, Wakiso District’s health department ranked 18th out of 146 districts. That health ranking is a major achievement. We have consistently performed poorly in the past, but this time, we made significant progress,” Mr. Kakande told the attentive audience, speaking with an air of relief and satisfaction.

Mr. Kakande speaking during the dissemination event at Makerere University School of Public Health on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating outcomes of a major leadership and management strengthening initiative in Wakiso District, Central Uganda. The one-year project, part of the Global Health Partnerships programme funded by NHS England implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
Mr. Kakande speaking during the dissemination event at Makerere University School of Public Health on April 23, 2025.

The Wakiso District Biostatistician credited part of this progress within the district, from the poor performance last year, to the leadership training and mentorship delivered through the project, citing visible improvements across key health indicators. He stressed the need to sustain this momentum through continued mentorship, internal capacity strengthening, and consistent application of the skills acquired by health managers, particularly in tackling persistent management challenges such as absenteeism, delegation, and accountability.

Last week, I held a performance review at Kakiri Health Centre III, and the improvements were clear. These management skills are making a difference. You can see the change across indicators. But what matters now is sustainability. The support provided through supervision and mentorship was essential. But it’s up to us to keep the fire burning. We have learned a lot: communication skills, problem-solving, time management, and decision-making. Managers are now communicating better. Even issues like absenteeism are being addressed through proper reporting and action,” Mr. Kakande said.

Earlier, Dr. Musoke, presenting the overall project overview and success, explained that based on initial findings from the baseline and needs assessment, the team co-designed and delivered a structured six-month capacity-building programme targeting 60 health facility in-charges in Wakiso District. The programme blended in-person and virtual sessions, combining practical training with one-on-one mentorship, and included an exchange component between Uganda and the UK to promote international exposure and peer learning. This allowed the health managers to apply new skills to strengthen health outcomes in Wakiso.

“This project rightly focused on addressing gaps in leadership and management. I advocated for including this component in the programme, because our national health review missions consistently show that poor performance often stems from weak leadership and management,” Dr. Byakika affirmed, adding that: “I am pleased to see that nearly all public facilities in Wakiso participated. While the project had a short implementation window, the evaluation already shows encouraging results. Health managers feel more empowered, motivated, and aware of their roles. That’s a significant step.”  

For her part, Dr. Sheba Gitta, Uganda Country Director for Global Health Partnerships, formerly Tropical Health and Education Trust, applauded the leadership and management capacity-building initiative in Wakiso as a timely, locally driven intervention. She underscored the value of two-way learning between Uganda and the UK health systems through the programme, noting that Global Health Partnerships works closely with the Ministry of Health to ensure all funded initiatives align with Uganda’s national development priorities.

Dr. Sheba Gitta (right) sharing with Prof. Linda Gibson during the dissemination workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating outcomes of a major leadership and management strengthening initiative in Wakiso District, Central Uganda. The one-year project, part of the Global Health Partnerships programme funded by NHS England implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
Dr. Sheba Gitta (right) sharing with Prof. Linda Gibson during the dissemination workshop on April 23, 2025.

“What excites me most is that this was not a pre-packaged programme imported from the UK. The training was co-created by partners, based on local realities and needs. That approach reflects strong collaboration between Makerere University School of Public Health and Nottingham Trent University. I thank Prof. Linda Gibson for her continued commitment and Dr. David Musoke for his proactive leadership in bringing this programme to life. Your consistency and quality of work continue to stand out,” Dr. Gitta shared.

While commending the progress made, she cautioned against “pilotism”, as a tendency for promising projects to end prematurely, calling for the model to be scaled up nationally. To support sustainability, she stressed the importance of documenting the training process, outcomes, and costs to inform ministry-level decision-making and long-term adoption.

Dr. Gitta joined Prof. Linda Gibson, the UK Lead for the Project, to encourage the trained managers to become champions of leadership within their facilities and districts, ensuring that the impact of the programme endures beyond its current cycle. She also thanked NHS England and the UK Government for their trust and investment in Uganda’s health system.

John Okeya

Continue Reading

Health

Makerere-Incubated Safe Bangle Technologies Wins Prestigious World Summit Award for Innovation Against GBV

Published

on

A Woman putting on the Real-Time Domestic Violence Reporting Bracelet. Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda, Safe Bangle Technologies roll out of a real-time domestic violence reporting bracelet. Kampala Uganda, East Africa.

By Joseph Odoi

In a groundbreaking achievement, SafeBangle Technologies, an innovation incubated at Makerere University, has won the prestigious World Summit Award 2025 for its groundbreaking contribution to the fight against gender-based violence (GBV) in Africa. This remarkable honor comes in recognition of the development and implementation of a real-time domestic violence reporting bracelet.

The award was presented to the SafeBangle team that was represented by Saul Kabali, Messach Luminsa, and Janet Christine Nabaloga from SafeBangle Technologies at the WSA Global Congress in Hyderabad, India, where Uganda’s innovation potential was proudly showcased on a global stage.

The award was conferred in the Inclusion & Empowerment category for Safe Bangle’s cutting-edge solution; a wearable safety bracelet designed to address the pressing challenge of gender-based violence (GBV) across Africa.

The SafeBangle is a smartwatch-like, real-time domestic violence reporting bracelet that allows users to send SMS alerts via a single button press. Its core mission is to create a safer, more secure environment for women and children in Africa through innovative, affordable tech solutions.

According to Saul Kabali and Messach Luminsa, the innovators behind SafeBangle from SafeBangle Technologies, hosted at the Resilient African Network Lab. This award is very timely and a recognition that cements the importance of community rooted technology.

The team further stated that ‘’This award is a powerful affirmation of our mission and refuels our commitment to empowering Ugandan women and girls through innovation and technology. It influences our next steps by opening doors to new partnerships, increasing our credibility, and accelerating efforts to scale the SafeBangle nationally. We’re now more equipped to positively impact the daily lives of Ugandan women and girls through our SafeBangle bracelet.

To further the innovation, the team has called upon government to support the Safe Bangle Innovation

‘’Governments can support us by providing funding, facilitating policy support, and creating collaborative platforms for innovation. NGOs can help with grassroots outreach, and connect us to potential donors and funders interested in solving Sexual and Gender Based Violence amongst vulnerable communities; and tech partners can enhance scalability through infrastructure, data insights, and capacity building.

Moving forward, the team emphasized the importance of uniting innovation, partnership, and purpose to scale impact. “As we empower communities, invest in local solutions, and promote collaboration, we can transform how technology protects and uplifts women and girls across Uganda,” added the award-winning team.

The Story Behind the Safe Bangle Bracelet Innovation

According to the Safe Bangle innovators  Saul Kabali and Messach Luminsa , ‘’The inspiration behind SafeBangle came from a deeply personal place. ‘’We heard countless stories of women who couldn’t call for help during moments of danger. We were deeply affected by the story of Aisha, a young woman in a rural village who was attacked while walking home alone at night. With no way to call for help, she felt helpless and vulnerable. This incident made us realize the critical need for immediate reporting alert tools, accessible to women like Aisha. We knew technology could play a crucial role and this incident awakened a strong desire in us to create a solution’’

How the SafeBangle Real-time Domestic Violence Reporting Bracelet works. Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda, Safe Bangle Technologies roll out of a real-time domestic violence reporting bracelet. Kampala Uganda, East Africa.
How the SafeBangle Real-time Domestic Violence Reporting Bracelet works.

To Makerere University School of Public Health’s Dr. Juliet Kiguli, who collaborated closely with the team during the rollout of the bracelet, this award is a vote of confidence in the work of Makerere University, whose core function focuses on teaching, learning, community engagement, research, and innovation, all contributing to the university’s efforts in addressing domestic violence.

‘’The award-winning innovation stems from the findings of a longitudinal study led by the Makerere University School of Public Health.

While carrying out a study after the Covid-19 Pandemic, we identified gaps when it comes to reporting and response to Gender Based Violence (GBV) among women in informal settlements. Therefore, we used to incorporate the SafeBangle intervention to solve the problem of lack of affordable and immediate reporting mechanisms for violence using a bracelet that reports violence in real time

We’re excited about the progress so far, and with this recognition, we hope that more like-minded partners will join us to scale this initiative and ultimately help make the world a safer place for all.” Added Dr Kiguli of the Safe Bangle innovation potential

The research team, comprising Dr. Juliet Kiguli (Principal Investigator), Dr. Roy Mayega (Deputy Chief of Party, RAN), and Dr. Agnes Nyabigambo (Study Coordinator), piloted the bracelet under the PEER (Partnerships for Enhanced Engagement in Research) program with support from USAID and the National Academies of Sciences.

A consortium of partners, including SafeBangle Technologies, Makerere School of Public Health/RAN , the Medical College of Wisconsin, and Somero Uganda, implemented the rollout of the Domestic Violence Real-Time Reporting Bracelet. The initiative was supported by USAID and the National Academy of Sciences in Washington, DC. Key contributors to the project included Dr Juliet Kiguli Roy Mayega from Makerere University School of Public Health, Dr. Kelly Robbins, Dr. Lina Stankute-Alexander, Dr. Brent Wells, Dr. Melissa Trimble, and Uganda’s Dr. Gloria Kasozi at USAID. Wisconsin Madison Medical University’s Prof. Julia Dickson-Gomez was also a collaborator.

In terms of the acceptability of the SafeBangle innovation as a solution to GBV, the team has piloted the technology with more than 1,000 users, resulting in a 63% reduction in response times

During the event, SafeBangle Team participated in the “Equity by Design” panel, sharing insights on inclusive technology development with global experts including Dorothy Gordon, Abhishek Singh from India’s Ministry of Electronics and IT, Baroness Beeban Kidron, and representatives from UNESCO and WE Hub.

About SafeBangle Technologies

SafeBangle Technologies is a Ugandan social enterprise hosted at Resilient African Network Lab focused on addressing gender-based violence through innovative safety solutions. The company combines wearable technology with an interactive web platform to provide real-time reporting of violence and physical assaults, even in areas without internet connectivity. Founded in 2018, SafeBangle operates with a mission to make safety accessible and affordable for vulnerable populations, especially women and children.

Mak Editor

Continue Reading

Health

Call For Applications: Masters Support in Reducing Stroke Risk Factors 2025/2026

Published

on

An elevated shot of the School of Health Sciences and School of Medicine Building, College of Health Sciences (CHS), Makerere University. Mulago Campus, Kampala Uganda, East Africa.

A Targeted Self-Management Intervention for Reducing Stroke Risk Factors in High Risk Ugandans: Grant Number: R01NS118544.

Reducing Stroke Risk Factors in High Risk Ugandan Training Program.

CALL FOR APPLICATIONS FOR MASTERS SUPPORT IN REDUCING STROKE RISK FACTORS.

The Makerere University College of Health Sciences and Case Western Reserve University, partnering with Mbarara University of Science and Technology are implementing a five-year project, “A targeted self-management Intervention for Reducing Stroke Risk Factors in High Risk Ugandans”.

The program is funded by the National Institute of Health (NIH), the National Institute of Neurological Disorders and Stroke (NINDS). One aspect of the program is to provide advanced degree training to qualified candidates with an interest in pursuing clinical and research careers in Stroke. Trainees will be expected to develop and maintain a productive career devoted to Stroke Research, Clinical Practice, and Prevention. We are aiming at growing Research Capacity in Stroke Risk Reduction and training the next generation of Stroke health in Sub-Saharan Africa.

The Project is soliciting for applications for Masters Research thesis support in stroke-related research at Makerere University and Mbarara University, cohort 5, 2025/2026.

Selection criteria

  • Should be a Masters’ student of the following courses; MMED in Internal Medicine, Paediatrics, Surgery and Neurosurgery, Psychiatry, Family Medicine, Public Health, Master of Health Services Research, MSc. Clinical Epidemiology and Biostatistics, Nursing or Masters in the Basic Sciences (Physiology, Anatomy, Biochemistry or any other related field).
  • Should have completed at least one year of their Masters training in the courses listed above.
  • Demonstrated interest in Stroke and Neurological diseases, care and prevention and commitment to develop and maintain a productive career and devoted to Stroke, Clinical Practice and Prevention.

Research Programs

The following are the broad brain health research priority areas (THEMES) and applicants are encouraged to develop research concepts in the areas of; Applicants are not limited to these themes, they can propose other areas.

  • The epidemiology of Stroke and associated risk factors.
  • Stroke risk factors and outcomes (mortality, morbidity) for stroke, stroke genetics, and preventive measures in among adults.
  • Stroke in childhood and its associated factors, preventative measures etc.
  • Stroke epidemiology and other stroke related topics.
  • Stroke interventions and rehabilitation

In addition to a formal masters’ program, trainees will receive training in bio-ethics, Good Clinical Practice, behavioral sciences research, data and statistical analysis and research management.

The review criteria for applicants will be as follows:

  • Relevance to program objectives
  • Quality of research and research project approach
  • Feasibility of study
  • Mentors and mentoring plan; in your mentoring plan, please include who are the mentors, what training they will provide and how often they propose to meet with the candidate.
  • Ethics and human subjects’ protection.

Application Process

Applicants should submit an application letter accompanied with a detailed curriculum vitae, two recommendation letters from Professional referees or mentors and a 2-page concept or an approved full proposal describing your project and addressing Stroke Risk Factors or a stroke-related problem.

A soft copy should be submitted to the Training Coordinator, Reducing Stroke Project.

Email: reducingstroke@gmail.com. The closing date for the Receipt of applications is 12th June 2025.

For more information, inquiries, and additional advice on developing concepts, please contact the following:

Makerere University College of Health Sciences

Prof. Elly Katabira: katabira@infocom.co.ug

Dr. Mark Kaddumukasa:  kaddumark@yahoo.co.uk

Mbarara University

Ms. Josephine N Najjuma: najjumajosephine@yahoo.co.uk

Only short-listed candidates will be contacted for Interviews.

Mak Editor

Continue Reading

Trending