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The 2020 COVID-19 Non-Pharmaceutical Containment Measures – Adherence and Impact on Livelihoods in Rural Uganda

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By Dr. Dan Kajungu and MUCHAP/IMHDSS Team

Uganda is currently experiencing a second wave of the COVID-19 pandemic with an upsurge of cases. The country registered an 81% increase in the number of COVID-19 cases between March and April 2021, which indicates resurgence or another wave in the pandemic. From 200 cases per day in April, now the country is recording over 500 cases per day. The vaccines uptake has improved only recently, and the population has ignored the Ministry of Health (MoH) Standard Operating Procedures (SOPs) meant to contain transmission. Since March 2021, when the COVID-19 AstraZeneca vaccine was introduced, about 541,569 persons have so far been vaccinated.

On 6th June, new control measures were announced to mitigate the transmission. The Makerere University Centre for Health and Population Research (MUCHAP) which runs a longitudinal population-based cohort of Iganga and Mayuge districts (Iganga Mayuge Health and Demographic Surveillance Site) conducted a community survey to understand how citizens responded to the non-pharmaceutical interventional measures, and the impact on their livelihood. This survey was part of the routine community surveys that a typical health and demographic surveillance site conducts to understand the population dynamics in population cohorts. The hybrid survey involved about 2,000 households in rural and peri-urban settings using a questionnaire that adopted some questions from the Wellcome Trust COVID-19 tool. It was a hybrid of on-phone and physical interviews conducted between July and August 2020 right after the relaxation of restriction in Uganda. Community based surveys provide information on what to expect when piloting and implementing interventions in populations. In addition to the demographic and household characteristics, questions sought to understand the extent of community adherence to COVID-19 control measures and probed about the impact on socio-economic and access to health services.

Adherence to preventive measures: The survey found that 94% of the respondents adhered to COVID-19 non-medical control measures that were enforceable by security personnel. It was different for non-pharmaceutical measures that were largely dependent on individual enforcement or discipline and this averaged at 43% of the respondents. Six in ten respondents reported doing most of their work from home and half (50%) avoided seeking medical care at health facilities during lockdown.

The non-pharmaceutical guidelines included using preventive actions like social-distancing, hand washing with soap, the use of alcohol-based hand sanitizing gels as well as wearing of face masks. Citizens were encouraged to stay at home with the exception of essential workers who rendered critical services. Some community members could not adhere, not because they do not take it as a priority but because of the cost implications.

Socio-economic impact: There was change in the living arrangement in 12% of the households mostly because someone moved out or into the household. Community members reported a reduction (64%) in the income for household members with some experiencing a complete stop in earnings (6%). Residents in rural settings reported more reduction in income compared to Peri-urban residents (78% vs 74%). There are seemingly unique circumstances that need to be considered as interventions and decisions are made. For instance, it should not be surprising that a household cannot afford to have a bar of soap, a face mask, an alcohol-based hand sanitizing gel and social distance because of the living structures. In some cases, even accessing water is a luxury for some homes. There are some homesteads that are unable to grow food or earn an income from selling cash crops because they leased their pieces of land for large scale sugarcane growing 3 or 4 years ago, with just a house and a few feet of compound to spare. Unfortunately, such individuals have no access to social media where they can express their predicament.

The survey further found out that during the 2020 lockdown period, there was a general increase in violence against men, children, and women. There were cases of child neglect as well as marital problems. The survey found that 53% of the respondents reported increase in marital problems, while violence against women during the lockdown was reported by 51% of the respondents and was more common among rural residents compared to their Peri-urban counterparts. Residents could not access what they considered essential needs like transport and education services, which were directly affected by government directives and other community services. Communication was the most affected essential service reported.

Access to Health Services: 26% of the interviewed community members who were on daily medication due to a chronic or long-term condition reported running out of drugs during lockdown. Non-affordability due to the cost was the main reason in 54% of respondents, while 19% reported cases of stock-outs at both public and private health facilities and 10% were restricted by lockdown measures.

In another review of the immunisation records at Busowubi Health Centre III in Iganga district, it was clear that during the lockdown, utilisation of immunization services was severely affected (manuscript is undergoing peer review). Children did not complete their scheduled vaccine doses which calls for catch up vaccination drives. People could not go to health facilities because of fear of acquiring infection and restricted movements of boda-boda.

Please see Downloads for the detailed report.

Mark Wamai

Agriculture & Environment

Makerere Hosts Inaugural Falling Walls Lab Competition as Innovators Pitch Solutions to National Challenges

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Students and researchers from Makerere University and other institutions pitched 12 innovations addressing challenges in healthcare, clean energy, agriculture, waste management and community resilience during the inaugural Falling Walls Lab Kampala, held at the School of Public Health Auditorium, Makerere University.

The competition brought together emerging innovators to present solutions to practical challenges through a three minute pitch, followed by questions from a panel of judges.

Modelled on the Falling Walls format that originated in Berlin, the event required each participant to identify a “wall” a problem or barrier, and demonstrate how their innovation seeks to break it down.

Mudhasi wins with newborn jaundice screening device

Andrew Mudhasi of Makerere University emerged as the overall winner with a score of 90 per cent for a low cost medical device designed to improve newborn jaundice screening across different skin tones.

Overall competition winner Andrew Mudhasi (left) receives his first Place award certificate for his innovation

Mudhasi explained that the device uses optical sensor technology and a skin tone targeting algorithm to provide a rapid reading, with the aim of helping nurses and clinicians identify jaundice more efficiently.

During questions from the jury, Mudhasi said the device had not yet been tested on actual babies but had undergone laboratory testing using simulated skin tones.

He reported an accuracy rate of 94 per cent when the device was compared with laboratory spectrophotometers.

The innovation is intended initially for use in clinics and hospitals, with Mudhasi saying the team is also considering a version that could eventually allow mothers to screen babies at home.

Mudhasi’s innovation has previously received recognition at the African Business Concept Challenge and the iF Design Student Award, according to his presentation.

Rhonda’s innovation tackles diaper waste

Rhoda John of the University of Nairobi emerged in second place with 89.6 per cent for an innovation addressing the problem of used diaper waste.

Rhondah John pitches her innovation repurposing diaper waste into soil moisture retention

Under the theme “Breaking the wall of diaper waste and drug soils,” Rhonda explained that her team extracts sodium polyacrylate, the absorbent polymer found in diapers, and replaces the sodium with potassium.

The resulting potassium based superabsorbent material is designed to act as a “water battery” in soil by absorbing and retaining water for plants during dry periods.

John said testing showed a 99 per cent increase in germination and a 23 per cent increase in drought resistance.

The innovation also seeks to reduce the amount of used diapers ending up in landfills and the environmental effects associated with their decomposition.

During the question and answer session, John explained that her team was working with government environmental officials in Nairobi on a pilot collection system to address the challenge of gathering used diapers at scale.

Mahera takes third place with herbal peptic ulcer treatment

Stuart Mahera of Makerere University finished third with 86.2 per cent for a herbal formulation targeting peptic ulcers.

Stuart Mayira (left) receives his 3rd Place award certicate at the school of Public Health Auditorium.

Presenting under the theme “Breaking the wall of Nature and Modern Medicine,” Mahera argued that conventional treatment for peptic ulcers can involve multiple medicines and may be associated with side effects and antimicrobial resistance.

His proposed formulation, MARAC capsules, is intended as a monotherapy, combining properties required for peptic-ulcer treatment in a single capsule.

Mahera said his team had carried out quality control work, including characterisation and dose quantification, and had conducted preclinical trials on laboratory mice.

He also told the jury that an application had been submitted to the National Drug Authority as the team awaits the next stage of the regulatory process.

According to Mahera, the proposed seven day treatment would cost about Shs21,000, compared with the existing 14 day treatment approach.

Innovators present solutions to practical challenges

The remaining presentations covered a wide range of challenges.

Esther Nakungu of Utamu University presented Agri-Track, a digital record keeping solution intended to improve visibility, accountability and management of farm operations and financial information.

Dr. Jimmy Chachiga, a Makerere University participant, presented a solar photovoltaic cooker with a heat storage system designed to provide a cleaner and more reliable cooking option during both sunny and non sunny periods.

His presentation focused on reducing dependence on biomass fuels and addressing the challenges associated with intermittent solar energy.

Abdul Noor Luttamaguzi, a PhD student and senior government fisheries officer, presented a mobile application aimed at helping fish farmers and extension officers report, track and manage disease outbreaks.

Henry Duke Tamale presented a herbal cream targeting antibiotic resistant biofilm infections associated with diabetic foot ulcers.

Marvin Seruwu proposed adapting existing near infrared brain monitoring technology to help detect extra-axial brain bleeds in health facilities where access to CT and MRI equipment is limited.

His proposal seeks to repurpose existing technology towards a diagnostic need that could be particularly important in settings where advanced imaging facilities are not readily available.

Kennedy Kisame presented a poultry alert and diagnosis system combining satellite weather information with computer vision disease detection. The proposed system could be accessed through a smartphone application, SMS or USSD, making it potentially usable by farmers with limited internet access.

Frank Atwiine proposed a solar powered mobile diagnostic van designed to bring ultrasound and other diagnostic services closer to rural communities.

Johnson Makmot, a software and blockchain developer, presented a platform that combines GPS tracking and blockchain-based tokens to incentivise and verify plastic-waste collection in Kampala.

Dr. Nelson Ndugu, from a partner university, presented an artificial intelligence tool designed to translate agricultural research publications into local Ugandan languages and generate voice notes for radio-based extension delivery.

The final presentation came from Dr. Juliet Akola, a Ugandan post doctoral researcher at Mangosuthu University of Technology in South Africa.

Akola presented a community digital resilience initiative focused on mapping risks in Kampala’s informal settlements, including flooding, fire, poor sanitation, waste management and inadequate infrastructure.

Her proposal seeks to combine local community knowledge with geographical information systems and link identified risks to action plans involving municipalities and other stakeholders.

Nawangwe calls for more investment in innovation

Closing the event, Prof. Nawangwe congratulated all the participants and described their presentations as an important beginning for Makerere University, Uganda and the wider region.

Vice Chancellor, Prof. Banabas Nawangwe giving his remarks

Drawing on his experience attending the Falling Walls conference in Berlin, the Vice Chancellor said initiatives of this nature are important because innovation will play a major role in determining the future of countries.

He encouraged participants to make their pitches more precise by clearly identifying the problem they are addressing, explaining their proposed solution and demonstrating what they have already achieved.

Prof. Nawangwe also welcomed the participation of innovators from other universities and countries, noting that the Kampala event had attracted participants beyond Makerere.

He thanked the Africa Office of the Falling Walls Foundation for its role in bringing the initiative to Makerere and encouraged continued support for innovation.

The Vice Chancellor further linked innovation to Uganda’s growing youth population and the need to develop home-grown solutions to address challenges such as youth unemployment.

The inaugural Falling Walls Lab Kampala ultimately provided a platform for innovators to move ideas beyond the classroom and laboratory and demonstrate how research, technology and creativity can be applied to challenges affecting communities.

PositionWinnerInstitutionScore
1stAndrew MudhasiMakerere University90%
2ndRhoda JohnUniversity of Nairobi89.6%
3rdStuart MaheraMakerere University86.2%

Allan Ainematsiko

My name is Ainematsiko Allan. I am a student of Makerere University and currently in my final year. I am pursuing a Bachelors in Journalism and Communication.

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Health

From Evidence to Impact; How the MNCH Centre is Advancing RMNCAH in Uganda e-Post 135

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Stakeholders that took part in the VectorCam Uganda Mid-Review Dissemination Meeting pose for a group photo on 27th August 2026. Makerere University School of Public Health (MakSPH) Auditorium, Kampala Uganda, East Africa.

Research has the greatest value when it moves beyond publication to improve lives.

At Makerere University’s Centre of Excellence for Maternal, Newborn and Child Health (MNCH Centre) housed at Makerere University School of Public Health, research, partnerships and innovation are being translated into action to strengthen reproductive, maternal, newborn, child and adolescent health (RMNCAH) in Uganda and beyond.

Welcome to the September MNCH Centre e-Post 135.

This month, we spotlight how evidence is informing action across reproductive, maternal, newborn, child and adolescent health (RMNCAH) at the centre.

Explore how Centre researchers and partners are advancing innovations to reduce early perinatal mortality, how Makerere University through the Centre and WHO are strengthening capacity to monitor health inequalities, and how the Centre and its partners are leveraging AI to strengthen health systems and improve malaria surveillance.

Discover what these innovations could mean for scale, stronger health systems and greater impact.

 Explore the September edition here: https://mnh.musph.ac.ug/newsletter/

Mak Editor

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Engineering, Art & Tech

Makerere’s CEDAT Hosts Groundbreaking LIVWA Workshop on Advanced Climate Modelling for Lake Victoria Water Level Management

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By Harriet Musinguzi

As part of the Lake Victoria Improved Water Level Management through Advanced Modelling (LIVWA) Project, newly developed tools were unveiled during a dissemination workshop hosted by the College of Engineering, Design, Art and Technology (CEDAT) on August 26th, 2026. The project seeks to develop advanced hydrological and climate models to enhance water level management in Lake Victoria, East Africa’s largest freshwater resource.

The tools were designed to integrate remote sensing and reanalysis climate datasets with advanced hydrological modeling, enabling researchers and policymakers to better predict fluctuations in water levels in the lake. By combining historical data with AI and Machine Learning forecasting, the models aim to provide actionable insights for sustainable water resource management. Click here for details

Alex Isemaghendera

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