Health
Makerere Marks World Drowning Prevention Day
By Joseph Odoi
On 27th July, 2021, Makerere University joined the rest of the world to mark the 1st International Drowning Prevention Day. This follows a historic resolution by UN Assembly to declare 25th July the World Drowning Prevention Day.
This day was set aside to raise awareness about the devastating effects of drowning on families and communities globally.
According to WHO Data, an estimated 236,000 people drown every year, and drowning is among the ten leading causes of death for children aged 5-14 years. More than 90% of drowning deaths occur in Low- and-Middle-Income-Countries (LMICs), with Africa being among the most affected region.
While moderating Uganda’s webinar to mark this day under the Ugandan theme ‘Drowning: recognizing the silent burden and a call to action’, Dr. Olive Kobusingye, a Senior Research Fellow and Head of the TRauma, Injury And Disability (TRIAD) unit at Makerere University School of Public Health in a special way welcomed over 100 participants to the zoom session. She remarked that drowning is a big problem which affects many different types of people adding that it is preventable with good planning and investments at national and community levels.
‘’Nationally, we need to plan systems for gathering data, we need a work plan, resources, agencies and people mandated to prevent drowning. At the community level we need sensitization about the risk of drowning, we need people to report drownings when they happen, and we need them to participate in prevention efforts for the community (e.g. sensitization campaigns) and individuals (e.g. always wearing a life jacket when on water and heeding weather forecasts and warnings on dangerous waves on lakes)’’ Dr. Kobusingye explained.
Citing multi-sectoral approach, Dr. Kobusingye stressed the importance of different sectors working together to prevent drowning.
‘’Multiple sectors need to work together to bring about effective drowning prevention, but so far every sector is on their own. Some of the key sectors are not engaged at all. The lack of consensus around a common strategy and plan means that little action is taken’’ she added.
Moving forward, Dr. Kobusingye advised government to prioritize the fishing industry by providing leadership, coordination capacity and working with the private sectors to prevent drowning.
Presenting findings of a two-phased countrywide survey on drowning at the webinar, Frederick Oporia, a Research Associate and PhD Fellow at Makerere University School of Public Health revealed that drowning is among the silent leading causes of injury-related deaths in the country, and the most affected are fishing communities.
Highlights of the findings
Frederick noted that in the first phase, a total of 1,435 fatal and non-fatal drowning cases were recorded in administrative sources of 60 districts; 1009 (70%) in lakeside districts and 426 (30%) in non-lakeside districts.
’’In the seond phase, further exploration in just 14 districts out of the 60 was done. This phase involved community interviews. Through these interviews, a total of 2,066 new drownings were found, a number far higher than what was found recorded in administrative offices of 60 districts’’. he cited
Regarding demographics, he said fatal victims were predominantly male (85%), and mostly among the young adults with the average age of 24 years. Almost half (48%) of these drownings were related to an occupational activity. The study found that there was gross under-reporting of drowning incidents, partly because of the belief of most communities that drowning is ‘a will of God’ and so there’s no need to report what God has decided.
The majority (95%) of the people who drowned from a boating-related activity were not wearing a life jacket at the time of the incident.
To address these cases, Frederick revealed that MakSPH together with different stakeholders have developed the first ever National Water Safety and Drowning Prevention Strategy for Uganda. The strategy is hoped to guide all the efforts on drowning prevention in the country. As part of this strategy, he emphasized the importance of installing barriers to control access to high risk water sources, teaching children survival swimming skills, sensitization in communities to enhance behavioral change, safe boating and shipping regulations, training of first responders in safe search, rescue and resuscitation, building resilience and managing flood risks among others
In efforts to prevent drowning, Henry Ategeka, Principal Marines Inspector at the Ministry of Works and Transport revealed that the ministry has been donating some life jackets to police marines and some communities in dire need. He also said that there are plans by the government to strengthen laws around navigation to promote safety on Uganda’s water bodies.
As part of these plans, CP Ubaldo Bamunoba, the Commandant Marine Police said the country is in the process of unveiling a water safety strategy to curb drowning.
Mr. Ubaldo further revealed that his department is establishing several rescue centers at all major water bodies to support the rapid rescue operations. He also pointed out capacity building and marine training as one of the key mechanisms needed towards drowning prevention.
Mr. Sowed Suwagudde, Assistant Commissioner International Transboundary Water Resources at the Ministry of Water and Environment also stressed the need for partners to work together. “Water cuts across a number of sectors and if we are going to have success for our strategy, we will need to bring them all on board because they interact with the water environment.”
In his remarks, the WHO Uganda Country Office Representative, Dr. Fatunmbi Bayo Segun congratulated Uganda for marking the first ever World Drowning Prevention Day, adding that 2.5million drowning deaths in the last decade should remind everyone about the seriousness of the neglected injury. Moving forward, he emphasized the need for a multi-sectoral approach in reducing the burden of drowning.
In her closing remarks, the Minister of State for Relief, Disaster Preparedness and Refugees–Hon. Esther Anyakun acknowledged drowning as one of the leading causes of death, not just in Uganda but worldwide. She highlighted drowning as a silent burden with huge economic implications on the country thus calling for a multi-sectoral approach to counter it. She equally thanked Makerere University for taking lead in co-designing Uganda’s first drowning prevention strategy.
The webinar organised by Ministry of Water and Environment in Partnership with Makerere University attracted over 100 participants including policy makers, technical experts, researchers, civil society organizations, and researchers. Among issues discussed in a Q&A Session were causes of drowning, perceptions, laws, data, and policies around drowning. At this webinar, it was agreed by all participants that tackling drowning, a neglected injury needs a multi-sectoral approach where different sectors work together.
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Kampala at a Crossroads: What New Research Reveals About Mobility, Governance, and the City’s Public Health Risks
Every day in Kampala, millions of people inch through gridlock, dodge swarming boda-bodas threading through narrow gaps in traffic, inhale dangerously polluted air, and walk along streets rarely designed for pedestrians. These conditions, and more, are often dismissed as ordinary transport frustrations. Yet researchers at Makerere University School of Public Health (MakSPH) are examining how such everyday realities translate into public health outcomes, shaped not simply by congestion, but by governance, policy, and power. Their work forms part of a multi-country project investigating the political economy of urban mobility in three African cities.
Co-led by Dr. Aloysius Ssennyonjo, the Principal Investigator and health systems and governance researcher at MakSPH, together with Uganda’s Country Principal Investigator, Dr. Esther Bayiga-Zziwa, a road safety and injury epidemiologist, and Co-Principal Investigator Dr. Jimmy Osuret, an injury prevention researcher, the project titled The Political Economy of Urban Mobility Policies and Their Health Implications in African Cities (PUMA) applies a political economy lens to understand how political interests, institutional arrangements, and power dynamics shape mobility systems and their consequences for public health in Kampala, Kigali, and Lilongwe.
To note, political economy analysis examines how public decisions are shaped by the interplay of politics, interests, institutions, and resources, in short, who has influence, who controls what, and how money and power circulate within a system. In Kampala, a capital of nearly two million residents whose daytime population swells with commuters, this lens helps explain why some transport options attract funding and enforcement while others are tolerated, neglected, or contested. These choices are not just technical, but reflect competing interests and priorities, with consequences for safety, equity, and the everyday well-being of those moving through the city.
Now, through the NIHR-funded project, the Ugandan team is currently working with colleagues from the University of Rwanda, led by Professor David Tumusiime, and Kamuzu University of Health Sciences in Malawi, led by Dr. Dominic Nkhoma. The research partnership aims to generate evidence that can strengthen mobility governance and improve public health outcomes across the three African cities above, with advisory support for the research consortium from the University of Antwerp in Belgium and Canterbury Christ Church University in the UK.
Explaining the project’s rationale for the Politics of Urban Mobility, or PUMA, during the 2025 Universal Health Coverage Day webinar held on December 12 under the theme “Mobility, Costs, and Politics: How Urban Systems Shape Access and Progress Towards Universal Health Coverage in African Cities,” Principal Investigator Dr. Ssennyonjo said Africa is urbanising at an unprecedented pace. Projections show that by 2050, nearly 60% of the continent’s population will live in cities, a shift that is intensifying transport pressures and increasingly turning everyday mobility into a public health risk.
“Rapid urbanisation has created multiple challenges: transport systems are under strain, risks and vulnerabilities are rising, and opportunities for healthy behaviours such as walking are often limited. Access to livelihoods is also affected, with broad implications for health,” Ssennyonjo noted, adding: “Crucially, these issues are shaped by political and governance dynamics, yet few initiatives explicitly address them. This gap motivated our focus on the politics and governance of urban mobility.”
He mentioned that health outcomes are shaped by social, economic, and environmental factors, with transport costs, risks, and stress often posing greater barriers than medical fees alone to achieving affordable health for all. He noted that the PUMA project brings together multidisciplinary teams to study how governance and political dynamics shape urban mobility, public health, and development, a perspective reflected in Prof. Julius Kiiza’s observation that effective urban development relies on coordinated action by diverse stakeholders across sectors to improve health outcomes, though emphasising the primacy of politics.
“Uganda and Singapore had comparable levels of underdevelopment in the 1960s. Under Lee Kuan Yew, Singapore embarked on a deliberate nation-building project. Today, it is among the smartest cities globally, outperforming many Western cities in clean government, mobility, and liveability. Why are we lagging behind? The answer, I argue, lies largely in the nature of our politics,” Prof. Julius Kiiza cogently argued.
He intimated that the result has been cities that are “unreliable, unsafe, unsmart, and chaotic,” noting that claims of inclusive urban development often ring hollow. “I have argued, and repeat here, that boda bodas as a symbol of inclusivity represent a false model of inclusion. We must interrogate this and invest in better urban transport systems and wider, well-planned highways,” he affirmed.
Prof. Kiiza urged policymakers and practitioners to move beyond piecemeal technical fixes and instead treat urban mobility as a governance challenge requiring coordinated, cross-sector action. He stressed the importance of aligning transport planning with public health, housing, employment, and skills development, arguing that safer, more liveable cities depend on institutions that work together and are accountable to the public. Such reforms, he noted, demand sustained political commitment and inclusive dialogue across government, academia, civil society, and the private sector, precisely the terrain the PUMA project is engaging, by convening stakeholders and shaping a shared research agenda around Uganda and the continent’s urban mobility challenge.
Indeed, on November 21, 2025, the Ugandan team convened a national stakeholder workshop in Kampala, bringing together a wide range of stakeholders. Opening the workshop, Assoc. Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management (HPPM) at MakSPH, commended the team for highlighting what she described as a long-underexplored dimension of Uganda’s urban health landscape: mobility and its governance.
Reflecting on her own experience, she noted how boda-bodas have become increasingly indispensable for millions seeking quick, flexible transport, but also carry complex health, safety, and economic implications that demand multisectoral attention, calling for a balanced, evidence-driven dialogue that recognises their value while also addressing the infrastructural and policy gaps that shape mobility systems in Uganda’s rapidly growing cities.
“I sometimes use boda-bodas,” Assoc. Prof. Suzanne Kiwanuka said. “They are necessary when you need to move quickly during heavy traffic. Yet we all know how unsafe they can be. This PUMA initiative is timely to generate evidence not only on the politics of urban mobility and its health implications, but also its economic consequences.”
Notably, road traffic crashes remain one of Uganda’s most urgent public health threats today. The recent Uganda Police Force Annual Crime Report 2024 recorded 5,144 road deaths, a seven per cent rise from 2023, with motorcyclists accounting for nearly half of all fatalities. In Kampala, pedestrians, cyclists, and motorcycle riders constitute 94 per cent of all fatal crashes, according to the Kampala Capital City Authority. Thousands more suffer life-altering injuries each year.
Still, evidence from MakSPH, through its Centre for Trauma, Injury and Disability Prevention (C-TRIAD) and the Johns Hopkins International Injury Research Unit (JH-IIRU) under the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS), shows that the design and use of city roads are worsening the risk environment. Between 2021 and 2023, the team conducted more than one million roadside observations across Kampala, finding that while only five per cent of vehicles are officially recorded as speeding, those that do travel at an average of 57 km/h, well above safe limits for dense urban corridors, making city roads increasingly unsafe.
The World Health Organization (WHO) guidelines, cited in the report, recommend speed limits of 30 km/h on community roads and in urban areas where pedestrians, cyclists, and other vulnerable road users share space with motorised traffic, and 50 km/h on major urban roads. Yet the findings show that six in ten vehicles on community roads exceed these limits, heightening risks for those least protected and underscoring the need for lower-speed zones, traffic-calming measures such as speed humps and raised crossings, and consistent enforcement of traffic regulations.
For the PUMA team in Uganda, the writing on the wall shows that these rising injuries coincide with worsening congestion and rapid urbanisation, yet city mobility policies within Kampala remain heavily oriented toward road expansion and vehicular flow, with limited attention to safety, health protection, or non-motorised transport. This policy imbalance, then, explains why daily commuting remains hazardous and why progress on safer streets has been slow.
The study uses a three-tiered approach that combines policy analysis, regional evidence, and local experiences to examine how mobility decisions are made in Kampala, Kigali, and Lilongwe, who holds authority, and how these processes affect public health and equity. This is strengthened by structured co-creation workshops with practitioners, policymakers, and community actors, which reveal how governance functions in practice, often diverging from what is written on paper.
In parallel, the research team is conducting a continent-wide review of academic and grey literature to map regional trends, gaps, and the broader forces shaping African mobility systems. Together, these streams enable the researchers to compare cities, identify shared challenges, and build a grounded analytical framework for improving mobility governance across Africa.
In Kampala, preliminary findings by the MakSPH PUMA research team show a city governed by many mobility policies but marked by weak mobility governance. The team shared that Kampala operates under a dense mix of frameworks, from the National Integrated Transport Master Plan and National Urban Policy to road safety, climate, and KCCA development plans. While these documents acknowledge congestion, urbanisation, and road injury risks, they also reveal overlapping mandates, blurred institutional roles, and limited coordination authority.
Key government Ministries, Departments, and Agencies (MDAs) actors include the Ministry of Works and Transport, KCCA, the Ministry of Lands, the Office of the Prime Minister, and the Ministry of Finance, with the Ministry of Health conspicuously absent despite clear health implications. Policy attention, according to the early findings, remains heavily skewed toward road transport, leaving non-motorised mobility and major health pathways, noise exposure, psychosocial stress, community severance, heat, and mobility independence largely unaddressed.
Governance realities are further shaped by political processes, including electoral cycles, informal negotiations with transport unions, selective regulation of boda-bodas, and heavy reliance on development partners that often influence what is prioritised and implemented. Together, these dynamics help explain stalled master plans, inconsistent enforcement, and resistance to progressive interventions. While the PUMA research remains at a preliminary stage currently, the emerging findings underscore the need for an integrated, multisectoral mobility agenda that places health at the centre of Kampala’s transport policy and practice.
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