Health
Mak Researcher Designs “COVID Alphabet” for Awareness and Behavioral Change
By Joseph Odoi
With the increasingly worrying situation of the novel coronavirus and its devastating global effect, Makerere University has once again taken an institutional lead by designing a behavioral change communication model to support government efforts in fighting against the pandemic. The COVID Alphabet (A-Z of COVID in Uganda) was developed by Dr. Gloria Seruwagi, a lecturer at Makerere University’s College of Humanities and Social Sciences (CHUSS) and School of Public Health (MakSPH).
While briefing journalists during the model’s unveiling at Makerere University on February 17th, 2021, Dr. Seruwagi shared that she got the inspiration to design the simple and relatable evidence-based product after conducting a series of COVID-19 studies in different communities including the REFLECT study in humanitarian contexts and ALERTs study in different informal settlements within Kampala.
“If somebody wants to know what the key issues are about COVID-19 in Uganda, they can look at this Alphabet and have it all at a glance, without having to go through the long process of reading a 4 or 15-page document. This is not just an alphabet for learning phonetics or numbers. It is a Know, Think and Act (KTA) tool packed with nuggets of information” Dr. Seruwagi emphasized.
The COVID Alphabet is not only easy on the eye and deliberately simple but is also factual and anchored in research. It should resonate with anyone at any level – from the busy policymaker or program manager to someone outside Uganda in need of quick facts.
The Alphabet also speaks to today’s virtual workplace teams, community leaders, and any person on the street or at home. It contains critical study findings compressed into a quick and concise summary of the COVID trajectory, experiences, and outcomes. It also gives key pointers on key population groups, sectors, mitigation strategies, and action points for different stakeholders.
The Alphabet begins by stating that Awareness of COVID-19 is high but Adherence extremely low. It then flags up the increasingly urgent need for effective Behavioral change messages now more than ever, even more than knowledge-only messages. Community transmissions are on the rise; as is prevention complacency while Deaths, infection and recovery from COVID-19 remain shrouded in mystery.
Uganda continues to face another battle of the serious infodemic challenge with myths, falsehoods and risky perceptions being plenty. Enforcement fatigue has become more pronounced with relaxation of some restrictions and unfortunately Fatigue from the enforcement side is coinciding with high community transmission. The Alphabet acknowledges the important role and success registered by Government-led approaches; however, it shows that these more community support and leadership.
Hand washing is listed as a more feasible prevention measure compared to sanitizing, social distancing, wearing masks and staying at home. This is in harmony with research carried out by other studies which showed that hand washing was the most adhered to guideline at the peak of COVID-19 as most households had hand washing points.
Dr. Seruwagi says adds that Infection control has largely been well managed at public places and offices compared to communities. And while the model recognizes that mass distribution of Masks did not reach everybody; mask use among those who have is low, inconsistent and improper.
This also alludes to study findings which found a lot of negative face mask practices including chin-masking, sharing masks, wearing ill-fitting masks, keeping them in pockets and back or not having a mask at all. Moving forward, Seruwagi advises the government to not only give out masks but revitalize enforcement of SOPs, reminding people of the dangers and health risks posed by the pandemic.
Norms and culture are both drivers and barriers to compliance. This alphabet statement agrees with research findings which show that the practice of hand washing with soap was much higher in Muslim communities because it’s in tandem with their beliefs and socio-cultural practices. The model also highlights the need to Optimally leverage existing community structures, systems and resources for compliance.
Since the outbreak of COVID-19, Psychosocial and mental health challenges that have taken on new and more complex forms. And while the need for social networks and connections is very important, Dr Seruwagi also recommends that Quiet spaces and isolation should be championed as positive and potentially productive.
This is in line with trying to get the community avoid unnecessary movement and avoid or behave responsibly while in public gatherings. It will enable communities to not feel punitively restricted but rather appreciate the protective effect of measures such as curfews.
In terms of Reproductive health, the Alphabet shows that services are severely constrained and products very scarce, inaccessible or expensive. Related to this is that the pandemic has worsened SRH outcomes, especially among adolescents and youth since the advent of the pandemic.
Teenage pregnancies and transactional sex by children and youth have increased; calling for parents, teachers, leaders and other stakeholders to act. ‘’If we are saying that there is a lot of teenage pregnancies and transactional sex by adolescents, what should teachers do, what are parents doing to protect their children?” she remarked in a call for action.
Dr. Seruwagi’s landmark model then turns to the country’s globally lauded success in refugee-hosting. It highlights the Uganda’s porous borders and high refugee population, noting that this comes with daily interaction across borders and some of this interaction risky with potential for disease transmission and other risks beyond health for example security risks.
The model shows that Violence of various forms increased during COVID-19; and everyone was affected including men and children. In some of the studies conducted, Violence against Men (VAM) is emerging as a key theme but the Ugandan culture largely operates in a culture of silence and there are not enough or effective services addressing male survivors of violence – most interventions have focused more on women. Moreover, child protection systems were rendered more fragile by the pandemic.
All these services and intervention points need strengthening. The Willingness and resourcefulness of community leaders needs to be harnessed and effectively utilized. And Dr Seruwagi says that the timing is a good one in terms of policy implementation, with the recent launch of the Community Engagement Strategy where VHTs, community leaders and other local structures are critically positioned to make a significant contribution if well-resourced and supported. It mentions Xanic and resilient approaches for COVID-19 while also highlight children, adolescents and Youth as a severely-affected but largely “invisible” group during Uganda’s the first wave.
Finally, the model recognizes the role of technology like Zoom meetings and while it acknowledges that virtual spaces are the ‘new normal’, Dr Seruwagi calls for a thorough and ongoing review on their safety and impact on productivity or team cohesion. “For example, the people delivering essential services needed during these difficult COVID times might, themselves, be in serious need of mental health and psychosocial support or specific workplace provisions,” she said.
Dr. Seruwagi implored leaders, teachers, parents, civil society organizations, policymakers and all health stakeholders to pick an action point from each Alphabet letter to implement if COVID-19 is to be countered. “As a country we already crossed a line where infections were managed at facility level. With the current community spread, let’s reflect on this COVID Alphabet and let each person pick at least one action point”. She called upon senior policymakers and BCC specialists to take up the model as guiding tool to support the national response.
The COVID Alphabet is the first of its kind in Africa and has attracted media attention with different people describing it as factual, precise, simple and easy to understand.
Article originally published on MakSPH
On 27th November 2025 the Makerere University Infectious Diseases Institute (IDI) unveiled the second cohort of fellows—marking a significant step forward in strengthening global health security across the region. The cohort brings together five exceptional emerging scientists whose research areas reflect the continent’s most urgent health priorities. They include Mr. Dickson Aruhomukama in Antimicrobial Resistance (AMR); Dr. Rodgers Ayebare in Case Management, Infection Prevention and Control; Mr. Julius Okwir in Epidemic Intelligence and Community Health; Dr. Robert Zavuga in Vaccines and Medical Counter Measures; and Ms. Phionah Tushabe in Planetary Health, Water, Sanitation and Hygiene (WASH). Their selection marks a new chapter in nurturing homegrown expertise capable of safeguarding Africa’s health systems for generations to come.
The Acting Vice Chancellor, Prof. Sarah Ssali while presiding over the event emphasized the significance of launching the Sewankambo Training Program for Global Health Security as a milestone not only for IDI but for Makerere University and the continent at large. She highlighted the urgency of strengthening Africa’s capacity to predict, prevent, and respond to emerging epidemics, noting the rapid rise in zoonotic disease outbreaks and the persistent weaknesses exposed by crises like Ebola and COVID-19. She celebrated the legacy of Prof. Nelson Sewankambo and the scholars shaped by his leadership, stressing that the program embodies the university’s commitment to producing transformative health leaders grounded in multidisciplinary expertise and One Health principles.
She also called for stronger collaboration across colleges—particularly with the College of Veterinary Medicine, Animal Resources and Biosecurity (CoVAB)’s Center for Biosecurity and the College of Health Sciences (CHS) to ensure that scarce scientific resources are fully utilized and that future health professionals are prepared for an evolving global landscape. In closing, she reaffirmed Makerere University’s dedication to advancing research excellence, nurturing responsible stewardship, and upholding the values that define the Sewankambo legacy.
The Academic Registrar Prof. Buyinza Mukadasi also conveyed his heartfelt congratulations to IDI and Prof. Nelson Sewankambo upon this remarkable milestone. He reflected on his recent engagements with the Institute—most notably the launch of the African Centre of Excellence in Bioinformatics—and expressed his admiration for the world-class research emerging from IDI, including publications in leading journals such as The Lancet and Nature. He noted that Makerere takes great pride in IDI’s work across multiple initiatives, from THRiVE to ongoing research collaborations, and wished the newly launched fellows a rewarding and impactful journey in research.
The Deputy Principal CHS, Prof. Richard Idro congratulated the new cohort and welcomed them into what he fondly referred to as “the cookhouse,” where future scientific leaders are shaped. Drawing from his own formative encounters with Prof. Nelson Sewankambo, he reflected on the deep mentorship culture that has defined generations of clinicians and researchers at Makerere—sharing stories of being challenged, supported, and pushed toward excellence. He reminded the fellows that their research will influence health policy and clinical practice far beyond individual patients, carrying long-term implications for national and global health.
Prof. Idro also acknowledged the critical challenges facing clinical disciplines, especially the constraints of promotion pathways that disadvantage highly skilled specialists without PhDs. He appealed for reforms to safeguard the future of key fields like anesthesia and surgery. Closing his remarks, he celebrated the College’s 100-year legacy, expressed gratitude for the university’s continued support, and invited alumni and partners to contribute ideas that will shape the next century of innovation, training, and service.
Dr. Charles Olaro, the Director General of Health Services, highlighted the essential role of academia in strengthening Uganda’s global health security, noting how recent outbreaks—from COVID-19 to Ebola—have revealed both the country’s progress and remaining gaps. He emphasized that programs like the Sewankambo Training Program are vital for building resilient health systems, advancing research, and shaping policies that can respond swiftly and effectively to public health threats.
Reflecting on the strong collaboration between the Ministry of Health and institutions such as Makerere University and IDI, he pointed out how research emerging from academia continually informs national policy, including work presented at recent conferences on non-communicable diseases and community health. Dr. Olaro congratulated the new cohort, reminding them that their work carries significant responsibility, as their research and leadership will influence health outcomes far beyond individual clinical care. He also underscored the need for stronger regional capacity, improved emergency response systems, and sustained mentorship to ensure that communities across Uganda—and the region—benefit from timely, coordinated outbreak preparedness.
In his address, Prof. Nelson Sewankambo commended the achievements of the first cohort and challenged the new fellows to uphold—and even surpass—the high standards already set. Reflecting on the rigorous selection process, he reminded the cohort that they were chosen because they demonstrated exceptional promise in a highly competitive field. He noted that the launch of this program comes at a particularly critical moment, as Africa CDC has just established a new Division for Health Security and Sovereignty, even as global financing for health research continues to decline. This, he said, makes the commitment to sustaining the program both bold and necessary.
Prof. Sewankambo also addressed concerns about the future of clinical scholars at Makerere, arguing that rigid promotion policies risk driving away talented specialists who are vital to the university’s mission. Emphasizing that “it is wise people who change direction when it is necessary,” he urged university leadership to protect pathways that allow clinicians to grow, serve, and undertake PhDs without being pushed out of the system. His message underscored both the responsibility carried by the new fellows and the collective duty to safeguard the future of medical education and research.
Dr. Andrew Kambugu, Executive Director (ED) of IDI, warmly welcomed all guests and reflected on the Institute’s long-standing culture of adaptation and innovation in response to Africa’s evolving health challenges. He celebrated the presence of Prof. Nelson Sewankambo—honoring his legacy as a founder, mentor, and active research collaborator—and acknowledged the strength of Cohort One as a living example of what the program can produce.
The ED emphasized that the Sewankambo Program stands on three pillars: rigorous selection, structured support with clear accountability, and strong alignment with national health priorities. He reminded the new fellows that IDI itself was born from the principle “adapt or perish,” and urged them to carry forward that spirit as they confront emerging threats like antimicrobial resistance and disease outbreaks across the continent. He also reflected on the power of mentorship, sharing personal experiences that illustrated how deeply mentorship can shape a scientific career. In closing, he expressed confidence that the five new fellows will honor the name they bear and continue building a legacy that inspires future generations.
Prof. Harriet Mayanja-Kizza reminded the newly selected fellows that while this achievement is significant, it marks only the beginning of a demanding but deeply meaningful journey. She expressed pride in the diversity of the cohort—drawn from ten African countries—and noted with delight that one of the brightest candidates emerged from the smallest country represented.
Reflecting on the evolution of impactful careers, she encouraged young people to embrace emerging fields such as bioinformatics, biotechnology, AI, molecular biology, and biostatistics, which she believes will define the future of science and global health. Prof. Mayanja spoke passionately about the diseases the fellows will tackle, highlighting the severe threat of antimicrobial resistance, the persistent burden of malaria, the dangers of resurfacing viral infections, and the transformative power of immunization. She urged the fellows to stay grounded, stay committed, and embrace the modern, data-driven tools now shaping global health research. In closing, she celebrated their potential to make a global impact and welcomed them formally into a field where their work will shape healthier futures for generations to come.
Prof. Ponsiano Ochama, one of the pioneers from the first cohort, reflected on the journey of the Sewankambo clinical scholarship from its early days in the “cookhouse” to the strong, structured program it has become. He recounted how the scholarship began as a mentorship-driven initiative aimed at nurturing future researchers and how sustained advocacy eventually removed barriers that once limited clinical scholars’ progression.
Prof. Ochama shared the impactful work he and his colleagues have since undertaken—highlighting, for example, a national study on hepatitis B mother-to-child transmission that shaped recent Ministry of Health policy. He encouraged the incoming cohort to embrace the program fully, assuring them that the “cookhouse” experience will transform them into strong, skilled scientists whose work will influence health policy and improve lives across the country.
Dr. Byonanebye Dathan, Deputy Head of the Global Health Security Department, outlined the strong rationale behind the Sewankambo Global Health Security Program, noting Africa’s rising burden of zoonotic and viral hemorrhagic fevers and the continent’s limited capacity for early detection and response. He emphasized that despite competing health priorities—HIV, TB, malaria, maternal health—there remain significant gaps in surveillance systems, workforce capacity, and research preparedness.
The program, he said, is designed to fill these gaps by strengthening research training, developing a skilled outbreak response workforce, and building a network of experts across Africa capable of generating evidence that directly informs policy and improves health systems. Dr. Dathan highlighted the rigorous selection process, the program’s alignment with WHO and national public health frameworks, and its integration of emerging technologies such as AI and machine learning. He affirmed that the fellows will receive structured mentorship, leadership development, and hands-on experience using existing data and real-world outbreak response systems—ensuring that their work leads not only to publications, but to meaningful impact across the continent.
Dr. Francis Kakooza, Acting Head of Global Health Security, traced the remarkable evolution of IDI’s Global Health Security work over the past decade, from its early CDC-funded surveillance efforts in 2015 to its expansion into biosecurity, AMR, epidemic research, policy development, and regional outbreak support. He highlighted IDI’s role in major national initiatives—including COVID-19 response, vaccination rollouts, risk management, lab accreditation, and the establishment of Regional Emergency Operations Centers—as well as its growing continental footprint through partnerships with Africa CDC, Mastercard Foundation, and Resolve to Save Lives.
Dr. Kakooza emphasized that the launch of the Prof. Nelson Sewankambo Global Health Security PhD Program is the culmination of years of investment in strengthening African research capacity and supporting fellows whose work is already shaping policy. He expressed gratitude to all partners, mentors, and leaders who contributed to the program’s development, acknowledged the rigorous selection that yielded five fellows from ten countries, and reaffirmed IDI’s commitment to nurturing a new generation of scientists equipped to protect the continent from infectious disease threats.
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