The Minister of Health-Hon. Dr. Jane Ruth Aceng washes her hands after the CCP launch on 16th September 2020 using the Touchless Handwashing Kit (TW-20) developed with support from the Government of Uganda through Mak-RIF
As Uganda continues to fight tirelessly to control the spread of COVID-19, results from a field-based survey in Kampala’s informal settlements have indicated that citizens have abandoned hand hygiene, a key pillar in stopping the spread of a virus.
To beat the virus today and ensure better health outcomes beyond the pandemic, hand hygiene, especially through handwashing with soap have been emphasized as a top priority.
Dr. Gloria Seruwagi, a behavioural scientist at Makerere University School of Public Health has observed that some of the set Standard Operating Procedures such as physical distancing, regular sanitizing and use of face masks are less likely to be followed and implemented due to congestion in the settlements.
Community and local government leaders at the ALERTs study Validation and Co-Design Workshop on COVID-19 in Kampala slums. 5th Left is the Project PI Dr. Gloria Seruwagi
While presenting an overview of results from the study, Dr. Seruwagi said Ugandans had gone back to their old ways and abandoned best hygiene practices such as handwashing, which is critical in the fight against COVID-19.
“Residents say they can’t afford masks and those who have them say masks make breathing uncomfortable. Sanitizing is a luxury to most people in Bwaise and Kataba communities. While the practice of handwashing was feasible and adhered to at the beginning of March, it has drastically dropped by up to 92.6%.
Dr. Seruwagi, who is also the Study Principal Investigator observed that residents of Ki-Mombasa and Kabalagala-Kataba still have a major infodemic challenge of misinformation surrounding COVID-19, also exacerbated by multiple power centres and enforcers who locals say give confusing messages and seemed to have an uncoordinated response strategy.
“The community told us that everyone seems to be a “little king” in enforcing COVID SOPs and guidelines – from the police to Division leaders, food distributors, VHTs and local village leaders. They were not working in harmony and were giving different, sometimes confusing, messages and instructions. This greatly contributed to confusion and partly resulted in community noncompliance” she said.
Dr Gloria Seruwagi, Principal Investigator of ALERTs Study, at the Validation and Co-Design event.
According to Hilda Namakula, ALERTs study Co-Investigator people living in informal settlements had vast knowledge of COVID-19 signs, symptoms and how it is spread.
For instance, in this study, up to 82% mentioned high fever as a symptom while 80.2% mentioned sore throat as a symptom. Meanwhile 80.8% knew that sneezing and coughing were symptoms and 78% mentioned body pain.
Despite this knowledge, Namakula contends that communities have multiple – and sometimes contradictory – sources of information which affect their adherence to the preventive measures.
“In Kampala, TV takes lead as the main information source at 78%, social media 14%. Other sources include radio, family members and neighbors. In addition to multiple information sources, multiple enforcement authorities in Ki-Mombasa and Kabalagala-Kataba have contributed to confusion on which information to follow.’’ said Ms. Namakula.
In a bid to establish reasons for non-compliance to COVID-19 SOPs such as physical distancing or staying home, researchers also found that livelihoods and the need to make a living were the most common explanatory factors.
“Other reasons for non-compliance include perceptions that COVID-19 is a political ploy, declining enforcement and multiple implementers with confusing messages and warring power centres. Moreover, in their power struggles, the different actors who were enforcing SOPs were themselves not adhering for example by wearing masks” Namakula added.
According to the study, communities reported lot of myths and misconceptions about COVID-19 as key drivers of high risk behaviour. For example; people living in Kampala’s informal settlements believe that taking alcohol reduces the risk of infection (16.8%); that sunbathing protects against COVID-19 (47.9%); and that Africans are immune by virtue of their skin Colour (46.5%).
Hilda Namakula a Co-Investigator of the ALERTs study presenting the Key Findings at the ALERTs Validation and Co-Design Event
Following the survey findings, Makerere University researchers underscored the need for sustainable community-led interventions to minimize the pandemic implications. The researchers observe that the current efforts to contain the pandemic cannot yield better results unless there is harmony and consistency in messages shared out.
The project team set out to engage health workers and community leaders of Ki-Mombasa Bwaise and Kabalagala-Kataba slum communities to jointly co-design tailored interventions on Thursday 17th December 2020. The engagement climaxed with a dialogue held at Makerere University Central Teaching Facility (CTF-1) with key stakeholders in attendance, including representatives from Makerere University, Kampala Capital City Authority (KCCA), Division and political leaders, Village Health Teams (VHTs), community, administrative leaders, religious leaders among others.
Following presentation of findings, there was consensus from all participants that it was still possible to reverse the non-adherence and high-risk behaviour.
The stakeholders identified priority areas for interventions underscoring the need for community leaders (Village Chairperson, VHTs) to be at the forefront. The co-design process comprised proposals for re-adaptation of some existing interventions or focusing more on some than others (e.g. emphasising wearing facemasks vs. social distancing); and practical ways for operationalizing the Community Engagement Strategy (CES) amidst increasing community transmission; designing a community behavioural change communication component; as well as undertaking joint rigorous resource mobilisation at the next phase to implement some of the proposed interventions.
Mr. Henry Bwire, an official from Kawempe Division, gives input in the co-design process
Government of Uganda through the Ministry of Health launched the National Community Engagement Strategy (CES) for COVID-19 Response in October 2020. This strategy arose from the need to stem the wide spread community transmission amidst low levels of compliance to the COVID-19 SOPs.
This strategy puts responsibility to community individuals, local leaders, households and communities to take charge and ensure optimal compliance. The CES also spells out the key role of VHTs, other local leaders the roles of the proposed village health Taskforce (VTF) and expected outcomes.
Catherine Nakidde, Co-Investigator on the ALERTs Study, presenting on the National Community Engagement Strategy (CES)
This study is funded by the Government of Uganda, through the Makerere University Research and Innovation Fund (MakRIF). The ALERTs study is dual-pronged and phased in implementation that combines an innovative citizen science approach with a participatory project co-design phase.
Ms. Carol Kamugira, a Mak-RIF representative applauded the research team for being innovative and bringing community members to devise community-led sustainable solutions in the fight against the coronavirus.
“It is the first time I have seen this kind of arrangement, bringing real community members to co-design interventions here at the university. Such interventions will be successful because they came from the people concerned and who will monitor the process. As the RIF we are very proud of Dr Seruwagi and her team and that is why we are here to support such meaningful studies. The government gave us resources, we advertised and received many research proposals. The proposal for this research was among those selected for funding because it was strong and very innovative,” Ms. Kamugira said.
She hailed the Uganda Government for the support rendered towards research and other training needs at Makerere University.
Ms. Carol Kamugira, the Mak-RIF Engagement Officer, gives her remarks at the event
Other Key Findings
• The living arrangements in the informal settlements affect people’s adherence to SOPs like social distancing –emphasis should be on encouraging them to adhere to the other more plausible measures like hand washing or wearing masks.
• The participants reported doing the following often: the washing of hands with water (38.3%); washing hands with water and soap (33%); covering the mouth while sneezing/coughing (28.5%); using a mask while in a public place (32.2%); consumption of fruits (25.8%); regular drinking of water (35.5%).
• A big proportion of the study participants knew that chronic illness increases the risk of death from COVID-19 (81%); and that those infected with the disease should be isolated (93%).
• While children living in informal settlements were aware of COVID-19, they are generally not adhering to the SOPs because it is believed that their age group is not at risk.
• COVID-19 has increased levels of violence, including violence against children and SGBV. It has also significantly contributed to increased cases of defilement, early marriages, teenage pregnancy and pimping children for transactional sex. For example, forced sex among the respondents during lockdown was reported at 2% and slapping 4%.
• The study also revealed that some men are survivors of violence whose condition has been worsened by COVID through not having an income source and depending on their wives who job is commercial sex work (CSW). Other men are clients of CSWs who target them claiming nonpayment; or their husbands who don’t want clients sleeping with their partner.
• Study findings also highlight some adults, including parents, local leaders and law enforcement officers as being more collusive than supportive in cases involving violence against children.
• Local duty bearers and key stakeholders in child protection such as social workers and police officers need more support to effectively undertake their roles in child protection and wellbeing.
• Schools remain both a cognitive and physical safe space for children. The closure of schools presented heightened vulnerability for children as they became more exposed, over prolonged periods of time, to multiple rights violation including lack of food and all forms of violence. Nearly all children in study sites are not benefitting much from the Education Continuity Programme and most caregivers were not in position to support learning during school closure. Children wanted to return to school and worried about an uncertain future.
• There is also evidence of belief of the politicization of COVID-19 for example the impression that the related measures are intended to curtail the activities of the opposition politicians.
• Slum communities reported limited knowledge and access to COVID-19 testing services in their communities or within Kampala as a whole.
Recommendations:
The researchers recommend that, building on from its massively successful awareness campaign on COVID-19, government should now work on addressing the barriers of non-compliance; emphasising personal responsibility and the community’s own contribution in the fight against COVID-19.
Moving forward, the researchers recommend that:
1. Government and all stakeholders should focus on addressing the drivers of non-compliance and enforcement fatigue. These drivers include:
The feasibility of interventions: Guidelines like physical distancing are not feasible in crowded informal or slum settings and need to be revisited. Emphasis should be placed on feasible ones like hand washing and masking.
Myths and negative perceptions: Majority of the community has not fully bought into the seriousness ofCOVID-19 and think it is not only a joke but is also a political and monetary ploy advanced by politicians, some scientists and supremacists or population control enthusiasts. These myths need to be addressed.
Shielding community from the reality of COVID as cases are managed out of the community. More profiling of COVID-19 trends and cases should be undertaken for behavioural change impact. 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”.
2. The issue of livelihoods and food security must be resolved as a key bottleneck to compliance.
3. Innovative multi-sectoral and tailored approaches should be adopted to address COVID-19 effects, including violence against children, men and women.
4. Children and adolescents should be effectively targeted in COVID-19 interventions. They need awareness, products (e.g. fitting face masks), voice and protection from the effects of COVID-19 including being witnesses and victims of different forms of violence.
5. Local and community leader 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 putting their lives at risk.
6. The timeliness and critical role of the recently launched Community Engagement Strategy should be leveraged. Local health system capacity should be strengthened and equipped to effectively take up the implementation and enforcement of SOPs for COVID-19 prevention. Equip community health systems and other enforcement structures with the knowledge, required supplies and supportive infrastructure.
In this dissemination, Makerere University researchers and slum community leaders and journalists engaged in co- designing behavioural change interventions to address COVID-19. The results of these sessions will form the final part of the ALERTs study objectives and will be presented in its final reporting. However, some of the suggested “quick” solutions from the groups include:
Involvement of women in sensitization drives around COVID-19
Preventive treatment of suspected cases
Skilling of Youth at Village Level
Health Education
Incorporating church leaders in the fight against COVID-19
Politicians should incorporate COVID-19 Messages in their campaigns
There is need for VHT support to counter community Spread
Cultural leaders should join the sensitization
Incorporate Youth Leaders in awareness
Have local leaders and Police enforcing directives
Incorporate NGOs in the fight against COVID-19
Employ musicians in COVID-19 since they have a huge following
There is need to incorporate drama and plays with key messages highlighting COVID-19 dangers and how to fight it.
The total number of study participants was 807 in two slum communities of Kampala i.e. Kataba-Kabalagala-Kataba in Makindye and Ki-Mombasa Bwaise in Kawempe Division.
Makerere University School of Public Health, in collaboration with Jhpiego, invites applications for 49 short-term positions under the Scaling the Optimal Use of Multiple ACTs to Prevent Antimalarial Drug Resistance (STOP-AMDR) Project.
The short-term assignments will support data collection in Buikwe and Busia districts, with some national-level activities. Applicants are encouraged to review the requirements for their preferred position before applying.
Makerere University School of Public Health (MakSPH), through the Africa-Europe Cluster of Research Excellence (CoRE) for Preparedness and Response to Pandemics and Shocks, has shared findings from its study of Uganda’s Mpox response with stakeholders in Kasese, Amuru, Nakasongola and Mayuge districts to strengthen district preparedness for future outbreaks.
The Africa-Europe CoRE is a partnership co-led by MakSPH and the Centre for Research on the Epidemiology of Disasters at UCLouvain, Belgium. It brings together universities in Africa and Europe to strengthen research, training and preparedness for pandemics and other public health shocks.
The district-level dissemination meetings, held from 10 to 14 August 2026, brought together more than 100 local government, health and security officials, Village Health Teams, implementing partners and community representatives. The meetings enabled stakeholders to validate the district-level findings, identify practical actions and provide feedback for the study’s final analysis and national dissemination.
Mr. Philliam Jabim shares the Mpox response study findings with participants during the dissemination meeting in Nakasongola District on 12 August 2026.
Uganda confirmed its first two Mpox cases on 24 July 2024 at Bwera Hospital in Kasese District. The Ministry of Health declared an outbreak on 2 August 2024. As documented in the study, the response involved health workers, communities, local governments, security agencies, political leaders, and implementing partners.
In response to the outbreak, a MakSPH research team led by Prof. Rhoda Wanyenze, Dr. Rawlance Ndejjo, Dr. Steven Kabwama and Mr. Douglas Bulafu conducted a study in May 2025 to assess Uganda’s Mpox response, including its policies, interventions, strategies and challenges, and generate lessons to inform recovery and strengthen preparedness for future public health emergencies.
Using purposive sampling, the research team conducted 20 key informant interviews and five focus group discussions in each of the four districts, drawing perspectives from western Uganda in Kasese, northern Uganda in Amuru, central Uganda in Nakasongola and eastern Uganda in Mayuge.
Participants and the MakSPH research team at the Mpox response study dissemination meeting in Nakasongola District on 12 August 2026.
The study, titled Assessment of the Mpox Response in Uganda: Documenting Challenges, Lessons and Innovations to Strengthen Emergency Preparedness and Response Capacities, was funded by the Government of Uganda through the Makerere UniversityResearch and Innovation Fund (Mak-RIF).
“This study is helping us move beyond recounting the Mpox response to identifying the actions that districts and national partners can take before the next outbreak. By validating the findings with stakeholders who led and experienced the response, we are ensuring that the evidence reflects local realities and can inform stronger surveillance, risk communication, coordination and community engagement,” said Mr. Bulafu, who led the MakSPH team during the dissemination meeting in Amuru.
Mr. Douglas Bulafu engages participants during the Mpox response study dissemination meeting in Amuru District on 10 August 2026.
In Amuru, the 10 August meeting brought together over 25 stakeholders from the district health team, political leadership, security agencies, Village Health Teams, implementing partners and the community. On the same day, a second MakSPH team, led by Mr. Keneth Sebukeera and Mr. Filimin Niyongabo, convened stakeholders in Kasese for a parallel validation meeting. The consultations then continued in Nakasongola on 12 August and concluded in Mayuge on 14 August, extending the study’s engagement across all four districts.
Across the districts, stakeholders said the results reflected their experience during the outbreak. They pointed to strengths in leadership, coordination, community engagement and partner support, while also describing gaps in documentation, logistics, diagnostic access, staffing, risk communication, public trust and continuity of essential health services.
They also noted inconsistent implementation of the World Health Organization (WHO) 7-1-7 target, which calls for detecting a suspected outbreak within seven days, notifying public health authorities within one day and completing early response actions within seven days.
The MakSPH research team, led by Mr. Keneth Sebukeera and Mr. Filimin Niyongabo, with participants during the Mpox response study dissemination meeting in Kasese District on 10 August 2026.
In Kasese, stakeholders highlighted gaps in documentation, financial and logistical resources, and human resources. They identified Village Health Teams and grassroots, religious and cultural leaders as important resources for community surveillance and risk communication. They called for stronger collaboration between technical and non-technical leaders, engagement with traditional healers, greater use of local radio for public sensitisation, and better facilitation of district epidemic response teams to reach distant communities.
Amuru participants called for proactive preparedness in the border district, citing misinformation and rumours as barriers to risk communication. They urged timely, accurate information from health workers and other authorities; training in disease surveillance and grant writing to strengthen capacity and resource mobilisation; and compassionate care, psychosocial support and community awareness to reduce stigma and support survivor reintegration.
During the meeting in Nakasongola, stakeholders identified Community Health Workers and Community Health Extension Workers as potential resources for strengthening community surveillance and addressing workforce shortages. Given the district’s position around Lake Kyoga and along the Kampala-South Sudan transit corridor, they also called for stronger documentation, note-taking and reporting, accurate real-time information, closer communication with the Ministry of Health, and collaboration among technical, political, religious and community leaders.
Ms. Eunice Vivian Asingo, Senior Nursing Officer at Nakasongola Health Centre IV, contributes to the discussion during the Mpox response study dissemination meeting in Nakasongola District on 12 August 2026.
Ms. Eunice Vivian Asingo, Senior Nursing Officer at Nakasongola Health Centre IV, called for a permanent, adequately resourced outbreak-management centre to help protect routine services during future epidemics. “We appeal for better facilities to manage epidemics and outbreaks. At Nakasongola Health Centre IV, spaces previously used for outbreak management have been repurposed for other services, and we have limited staff. During the Mpox response, colleagues assigned to manage patients later returned to the general team, creating fear among staff already under pressure,” she said.
In Mayuge, Dr. Basembeza highlighted leadership, coordination and surveillance structures operating from district to community level as important factors in the response. He said the structures enabled the district to receive and respond quickly to community alerts. “Whenever there is a rumour or an alert, we are able to respond. Within 20 minutes, we had a response because of the structure we have,” Dr. Basembeza said.
Based on the findings, the research team recommends increased preparedness financing, stronger community engagement, decentralised diagnostic services through stronger district laboratory capacity, and improved health information and research systems.
Across the four districts, stakeholders reaffirmed that trusted community structures and coordinated action across sectors are essential to strengthening outbreak preparedness.
Every academic year, a new group of students enters Makerere University School of Public Health (MakSPH) with different professional backgrounds, questions and ambitions. For the School, each cohort adds to a growing community of professionals and researchers shaping public health practice, policy and research in Uganda and beyond.
On Friday, 7 August 2026, MakSPH held its orientation for newly admitted students for the 2026/2027 academic year at the MakSPH Auditorium. The orientation introduced students to the School’s academic programmes, leadership, departments, academic administration, student support services and expectations for university life.
For this academic year, ending July 2027, Makerere University admitted more than 370 students to academic programmes hosted at MakSPH. The intake comprised 75 students in the Bachelor of Environmental Health Science, the School’s only bachelor’s programme, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research.
Dean Prof. Rhoda Wanyenze (centre) with MakSPH staff, student leaders and new students during orientation for the 2026/2027 academic year.
The master’s intake includes 103 students in the Master of Public Health by Distance Education, the highest enrolment for the year, followed by 59 in the Master of Public Health Full-Time. The remaining students joined programmes in Biostatistics, Environmental and Occupational Health, Health Informatics, Health Services Research, Monitoring and Evaluation, Nutrition, and Public Health Disaster Management. Together, the programmes reflect the breadth of knowledge and skills needed to address public health challenges and bring together students pursuing further training from diverse professional backgrounds.
Welcoming the new cohort, MakSPH Dean Prof. Rhoda Wanyenze urged students to approach their studies with purpose, discipline, and resilience, and focus on what they would be able to do with the knowledge and skills they acquire.
“Please find time to enjoy your journey. I know you’re looking ahead to exams and so many other pressures, but let this journey also be one that you enjoy in terms of what you learn and how you grow, so that you leave here better, not because of the paper that you took but because of the capability that you pick up during your time with us.”
MakSPH Dean Prof. Rhoda Wanyenze addresses new students at orientation for the 2026/2027 academic year, 7 August 2026, MakSPH Auditorium, urging them to value capability over paper.
The Dean’s message speaks to the different reasons students are beginning their journeys at MakSPH. For some, the opportunity is to build on professional experience and strengthen their capacity in roles they already hold. Among them is Dr. Judith Nalukwago, a dental surgeon, former 85th Vice Guild President of Makerere University, and Makindye Division III Lord Councillor, who serves as Executive Secretary for Education, Gender and Public Health at City Hall and the Office of the Lord Mayor.
“I am back here to study a Master’s in Public Health. I am very excited. I have a clinical background and have been practising as a clinician, and it has been a joyful experience. But when I joined the journey of leadership, there were challenges because, as Executive Secretary for Public Health in Kampala, we deal with everyday people’s health challenges,” said Dr. Nalukwago, adding:
“Now I am in management and leadership, and that posed a challenge to me as an individual. I asked myself, what course can I do to add to my skills? Where can I gain skills that can help me overcome this challenge while I am dealing with people? And I remembered that we have the School of Public Health at Makerere University.”
Watch: Dr. Judith Nalukwago on why she returned to MakSPH for a Master’s in Public Health:
Her experience during the Ebola response, when she served on the task force, further highlighted the need for broader public health knowledge. She said the training would strengthen her ability to contribute to policy and public health management, particularly in her role at City Hall, where councillors develop policies, bylaws, and ordinances.
For Mr. John Othieno, the motivation is similarly grounded in applying his training to practical problems. A Software Engineering graduate who previously completed a Master’s in Health Informatics at MakSPH, he has returned to pursue a PhD under the Department of Health Policy, Planning and Management. His research focuses on using technology and health informatics to address health-system challenges, including the adoption of picture archiving and communication systems for managing healthcare imaging and data. He said he wants his research to produce solutions that can be applied beyond academia.
“I purposed that, in my academic journey, I would not do research for the sake of having it gather dust on the shelves, but that it would actually be actionable research that can be translated into action, into solutions for our population,” he said.
Watch: Mr. John Othieno on why he returned to MakSPH to pursue a PhD in Public Health:
Nalukwago and Othieno reflect the diverse professional backgrounds that come together at MakSPH, where training, research, and community engagement have been central to the School’s work for over seven decades. Their journeys point to a sustained impact on public health education, seen not only in enrolment and graduate numbers but in the skills and expertise those graduates carry into policy, research, and health systems across Uganda and the region. At the close of the 2024/2025 academic year, MakSPH enrolled 1,140 students across 12 degree programmes, more than 90 percent of them in postgraduate training.
At Makerere University’s 76th Graduation Ceremony on 25 February 2026, MakSPH presented 231 graduates, comprising seven doctoral, 195 master’s and 29 bachelor’s graduates, adding to the health workforce within the region. Among the graduates was Dr. Harriet Aber, who completed her PhD on child substance use in Uganda’s health system and shared her experience with the new cohort during the orientation. She spoke candidly about the demands of postgraduate study and the need to remain positive through its challenges.
Dr. Harriet Aber, a MakSPH PhD graduate, shares her postgraduate journey with new students at orientation, 7 August 2026, MakSPH Auditorium, urging them to maintain a positive attitude through the challenges ahead.
“It’s not a rosy journey. You’re going to have so many moments where you celebrate, where you’re happy about something, but there are also several moments when maybe you’re stuck with the paper, you have to respond to comments, the proposal is not moving, the concept is not clear. Throughout all those processes, one of the things that you just have to maintain is having a positive attitude,” Aber affirmed.
Her experience offered the new cohort a glimpse of the journey ahead, while Prof. Wanyenze’s message focused on how they could make the most of it. The Dean urged students to plan ahead, pursue research opportunities, think independently, and use artificial intelligence responsibly, while seeking mentorship and making full use of the support and opportunities available at the School.
“Our students are our colleagues, and they are our future workmates. Many of them have ended up staying with us. And I know many of you are going to stay with us in the School,” the Dean said, urging students to take seriously the relationships they build with their classmates and faculty, because “we are a network that’s bound together in the same profession.”
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