Makerere University School of Public Health, through its Centre for the Prevention of Trauma, Injury and Disability, contributed to the Global Status Report on Drowning Prevention 2024, the first comprehensive global assessment of drowning burden, risk factors, and country-level responses.

Published by the World Health Organisation, the report estimates that approximately 300,000 people died from drowning in 2021, with the highest burden in low- and middle-income countries, which account for 92% of deaths. The African Region records the highest mortality rate, underscoring the urgency of targeted interventions. Children and young people remain the most affected, with drowning ranking among the leading causes of death for those under 15 years.

While global drowning rates have declined by 38% since 2000, progress remains uneven and insufficient to meet broader development targets. The report highlights critical gaps in national responses, including limited multisectoral coordination, weak policy and legislative frameworks, and inadequate integration of key preventive measures such as swimming and water safety education.

It further identifies persistent data limitations, with many countries lacking detailed information on where and how drowning occurs, constraining the design of targeted interventions. At the same time, the report notes progress in selected areas, including early warning systems and community-based disaster risk management.

MakSPH’s contribution to this global evidence base reflects its role in advancing research, strengthening data systems, and supporting context-specific approaches to injury prevention. Through its Centre, the School continues to inform policy and practice, contributing to efforts to reduce drowning risks and improve population health outcomes in Uganda and similar settings.

The full report can be accessed below:

View on MakSPH

Makerere University School of Public Health, through its Center for the Prevention of Trauma, Injury and Disability, contributed to the Global Strategy for Drowning Prevention (2025–2035): Turning the Tide on a Leading Killer, a landmark framework guiding coordinated global action to reduce drowning.

Developed through the Global Alliance for Drowning Prevention, a multi-agency platform hosted by the World Health Organization, the strategy identifies drowning as a leading yet preventable cause of death, responsible for over 300,000 deaths annually. The burden falls disproportionately on low- and middle-income countries, particularly among children and young people.

The strategy sets a global target of reducing drowning deaths by 35% by 2035 and outlines six strategic pillars, including governance, multisectoral coordination, data systems, advocacy, financing, and research. It also prioritises ten evidence-based interventions such as strengthening supervision, improving water safety and swimming skills, enhancing rescue capacity, and enforcing safety regulations.

MakSPH’s inclusion in the Global Alliance for Drowning Prevention reflects its contribution to advancing research, policy engagement, and capacity strengthening in injury prevention. Through its Centre, the School supports the generation and application of context-specific evidence, positioning itself as a key contributor to global efforts to reduce drowning and strengthen community resilience.

The full document can be accessed below:

View on MakSPH

_{By Dan Kajungu}

In many low- and middle-income countries, mortality data remains a critical gap in public health planning, often leaving a significant portion of the population “invisible” in official records. In Uganda, where national death registration completeness has historically hovered around a mere 20%, Makerere University Centre for Health and Population Research (MUCHAP) is leading a transformative initiative. By leveraging the infrastructure of the Health and Demographic Surveillance System (HDSS), MUCHAP has demonstrated how academic research frameworks can be integrated into national systems to strengthen Civil Registration and Vital Statistics (CRVS).

A Bridge between research and governance

The core of this success lies in the collaboration between Makerere University’s infrastructure and government agencies, specifically the National Identification and Registration Authority (NIRA). This partnership, supported by the Uganda National Public Health Institute (UNPHI) and international partners like the Bloomberg Philanthropies Data for Health Initiative at the CDC Foundation, aimed at aligning local death recording practices with the legal requirements of the Registration of Persons Act (ROPA) 2015.

By utilizing the existing MUCHAP Iganga Mayuge HDSS platform, which has monitored births and deaths in the Iganga and Mayuge districts since 2005, the project demonstrated the use of a decentralized notification process. This model utilises Village Health Teams (VHTs) who already serve as HDSS scouts and part of the Ministry of Health systems as official death notifiers. These VHTs assist households in completing official NIRA notification forms at the household/community level, which are then verified by local leaders and submitted to District Registration Offices.

Impact: From 20% to over 70% completeness

The results of this collaboration have been profound. In the pilot sub counties in the districts of Iganga and Mayuge, death registration completeness reached 73–79%, a dramatic improvement over the prevailing national estimates. During the study period, 2,992 deaths were officially registered within the national CRVS system.

Key drivers of this success included:

• Reduced barriers: Decentralization brought the registration process closer to home, with an average travel distance of only 4–5 km for notification, compared to the significant distances previously required to reach district offices.
• Cost savings: Families reported that the community-based process eliminated unofficial fees and high transportation costs, facilitating essential cultural and legal tasks like property inheritance and appointing heirs.
• Advanced surveillance: The project proved that local health personnel could successfully conduct verbal autopsies (VA) in non-HDSS settings, providing critical data on causes of death that were previously unavailable for home-based deaths.

Sustainability and future potential

The MUCHAP-IMHDSS model is designed for long-term sustainability and national scalability. By embedding these tasks within the routine activities of VHTs and local leaders, the process becomes streamlined and cost-effective over time. The project also highlights that community sensitization is vital to maintaining trust and ensuring high participation rates, particularly in rural areas.

Looking forward, this initiative serves as a scalable blueprint for the rest of Uganda and other low-resource settings. Future engagements are expected to focus on:

1. National scale-up: Applying the lessons learned from Iganga and Mayuge to the entire country to close the mortality surveillance data gap.
2. Integration with health systems: Linking the CRVS data with broader health information systems to enhance pandemic preparedness and routine public health actions.
3. Regional leadership: Aligning with the Africa CDC’s initiative to strengthen mortality surveillance across the continent, positioning Uganda’s university-led model as a regional gold standard.

The HDSS-CRVS integration Project Leader Dr. Dan Kajungu who is the Executive Director of MUCHAP emphasised that “through this work, Makerere University has again proved that academic infrastructure is not just for research, but a vital engine for building resilient national governance and health systems”. This work was disseminated at the 2026 CRVS Research Forum in Bangkok, Thailand and can be accessed at https://shorturl.at/8JLTd

Dan Kajungu Msc PhD is the Executive Director MUCHAP