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
Dr. Angelina Mwesige Kakooza, Associate Professor of Paediatrics in the Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences (MakCHS) received the 2025 TWAS-Fayzah M. Al-Kharafi Award in Medical Sciences. She was recognised for her research on neurodevelopmental disorders – particularly epilepsy, cerebral palsy, and nodding syndrome – and for advancing policy and research, mentorship, as well as local community interventions to enhance children’s health.
The award was given at the recent 17th General Conference of The World Academy of Sciences (TWAS) held in Rio de Janeiro, Brazil under the theme ‘Building a Sustainable Future: The Role of Science, Technology, and Innovation for Global Development.’ Organized in partnership with the Brazilian Academy of Sciences (BAS) and TWAS, the conference brought together leading scientists, policymakers, and institutional leaders from across the global South and beyond.
In her remarks after receiving the award, Dr. Kakooza said, “This award highlights the importance of neurodevelopmental disorders which are a great health problem worldwide, often diagnosed late and treated poorly,” said Kakooza. “It affirms my contribution to science in Africa, strengthens advocacy for gender equity in science and education and makes me a role model for others, increasing my influence in the scientific community.”
Dr. Angelina Kakooza Mwesige is a Ugandan scholar with over 25years teaching experience whose research focuses on neurodevelopmental disorders in children centred on their epidemiology, early screening, identification and community based interventions in Uganda. Her current areas of research cover studies on early detection and interventions for young infants at high risk of neurodevelopmental delay and disability in Nepal and Uganda; development of community engagement projects to empower adolescents living with epilepsy in Uganda reduce stigma in their communities; as well as development and testing of an interactive epilepsy smart phone application to improve resilience among them.
TWAS is a global merit-based science academy based in Trieste, Italy, and administered as a UNESCO Programme Unit. Read more here: https://twas.org/
In July this year, I joined a study tour to Imvepi Refugee Settlement in Uganda’s West Nile region under the RISK-WASH Project, led by Dr. Richard Mugambe. Established in 2017 in what is now Terego District, Imvepi is one of several settlements created to host people fleeing conflict in neighbouring South Sudan. Now home to more than 60,000 refugees, it reflects Uganda’s progressive refugee policy, anchored in the 2006 Refugee Act, which promotes the integration of displaced families within host communities, allocates land for livelihoods, and ensures access to national services. It remains a model both commendable and instructive for the region.
With nearly two million refugees and asylum seekers, most of whom are women and children, Uganda stands among the world’s leading examples of inclusive, community-based refugee protection. The RISK-WASH Project, implemented by the Makerere University School of Public Health (MakSPH) in collaboration with IHE-Delft, BRAC, and icddr,b, with support from the Dutch Ministry of Foreign Affairs, organised the three-day visit. The project builds evidence for better Water, Sanitation, and Hygiene (WASH) decision-making in humanitarian settings, developing practical tools to assess how exposure to unsafe water, poor sanitation, and environmental hazards affects the health of both displaced and host populations.
In Imvepi, that evidence takes human form. Water points run dry under intense demand or drought; latrines overflow during rains; fragile health systems strain to contain preventable diseases that flourish in such conditions. One nurse may attend to hundreds of patients in a single day, treating malaria, respiratory infections, and diarrhoeal diseases directly linked to inadequate WASH infrastructure. The images linger long after one leaves, especially when reflecting on the media’s role in shaping refugee narratives. What struck me most was how such realities are often reduced to statistics or fleeting headlines that reveal little about the lives behind them. I left Imvepi convinced that we, in the media, must not only report but listen differently.
When we cover refugees, we often begin with numbers. Yet behind every statistic is a heartbeat and a history the news cycle rarely pauses to hear. Refugee health, perhaps the most human measure of displacement, is still too often framed as a crisis rather than a continuum of resilience, policy, and rights. The World Health Organisation’s World Reports on the Health of Refugees and Migrants reminds us that refugees frequently experience poorer health outcomes than host populations, not because they are inherently vulnerable, but because access to care is often obstructed by law, language, and logistics. Health, like truth, then, becomes interestingly dependent on who is allowed to speak and who is heard.
It was in this spirit that, on October 3, 2025, we convened the Media Training Workshop on Refugee Health and Migration Reporting at MakSPH. The one-day seminar brought together twenty journalists from Kampala, Kyaka II, Adjumani, and other refugee-hosting districts. Our goal was not to add another humanitarian angle to the news but to rethink how the media can report with depth, ethics, and empathy. Working with partners such as Africa Humanitarian Action, Emesco Development Foundation, and Farmamundi, we explored the subtle power the media wields to either dignify or diminish, to clarify or distort, the lived realities of refugees, particularly in the realm of health.
During my session, “Refugee Health Reporting as Empowerment: Negotiating Accuracy, Dignity, and Context,” I invited participants to view journalism through the lens of Paulo Freire, the celebrated Brazilian transformative educator who wrote the Pedagogy of the Oppressed while in exile in 1970. Through his influential work, Freire argued that oppression persists when those in power control language and narrative, when others are spoken for rather than heard. Liberation begins, he said, when people “name their world.” That principle remains profoundly relevant to our craft as journalism and communications practitioners. Refugees must not remain objects of our storytelling; they are its subjects. Journalism, in its truest public function, becomes liberating only when it is dialogic, when we report with people, not merely about them.
This transformation begins with accuracy. In Uganda, refugees share the same health system as host communities, one already strained by staff shortages, drug stock-outs, and donor fatigue. Yet many stories stop at official statements or NGO press releases. Limited access, shrinking newsroom budgets, and bureaucratic gatekeeping tempt journalists to rely on polished humanitarian narratives. But when we do, we risk becoming megaphones for the powerful. Accuracy demands courage, the willingness to verify, to cross-check, and to step beyond curated camp tours. In refugee reporting, truth is not just a professional standard; it is an act of respect.
Still, truth without dignity can harm. Too often, images of refugees serve as shorthand for despair—dust, hunger, tents. Such imagery may evoke sympathy, but it often strips away humanity. From practice, I have seen journalists lower their lenses before asking names. I have also seen how a small shift in approach, say seeking consent, giving space, and listening before photographing, can restore dignity to both subject and story. Words matter too. Calling someone an “illegal immigrant” or describing an “influx” of refugees turns people into problems. Language should humanise, not flatten. To describe refugees as mothers, health workers, or students is to reassert their agency and affirm our shared humanity, something Freire would have deeply valued today.
And no story exists in isolation. Every health headline in a settlement echoes across systems of policy, climate, economics, and gender. A cholera outbreak in Kyangwali is not merely a medical event or isolated incident; it may be showing broken sanitation infrastructure and the politics of aid, which may result in a national disease outbreak. Context is the soul of credibility. Without it, even accurate stories can mislead. In Imvepi, I saw first-hand that refugees’ health challenges are inseparable from Uganda’s own development journey, from how budgets are made to how global partners value African hospitality. The more connections we draw, the closer we come to the truth.
By the close of the workshop, it was evident that empowerment in journalism is not a slogan but a discipline. It demands patience, humility, and persistence. It calls for the co-production of stories, revisiting them, verifying them, and allowing refugees to narrate their realities. It also calls on institutions to invest and fund field reporting, train correspondents in trauma-sensitive and peace journalism, and protect journalists pursuing uncomfortable truths. Without such support, even good intentions dissolve into soundbites.
I often return to Freire’s words of wisdom: “To speak a true word is to transform the world.” This means that words are not just passive descriptions but powerful tools for action and social change, especially when they are paired with critical reflection and a commitment to praxis (work and action). Refugee health journalism, at its best, is precisely that kind of speech: accurate, dignified, and deeply contextual. It is not merely charity reporting; it is solidarity reporting. For anyone, given the wrong circumstances, can become a refugee. And solidarity, unlike sympathy, does not look down; it stands beside. When we write from that conviction, our stories do more than inform. They humanise, connect, and remind us that telling the truth well is, in itself, an act of justice.
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