Health
Makerere University Hospital Embarks on Expansion, to add 10 ICU beds
As Makerere University draws closer to marking 100 years, the institution’s Hospital has embarked on an expansion program to support Uganda’s critical care needs.
Construction projects are currently under way at the Bativa Road-based Makerere University Hospital to increase the hospital’s Emergency Department and ICU capacity.
The plan is to remodel the Doctors’ Residence/lower block of the University Hospital into a 10-bed ICU Unit at a cost of approximately Ugx400million.
Works have started with CK Associates, an Engineering firm in Uganda. Dr. Josephine Nabukenya, the then Acting Deputy Vice Chancellor (Finance and Administration) said Makerere University has a bigger dream for the health services and the university hospital in particular citing that there can be no other to do this than now due to the inspiration by the coronavirus pandemic.
“I am glad that we have come this far because we started dreaming three months ago but finally we are here. Indeed, the first costing when we came touring here with the actual users, the anesthetists, the money was supposed to be times two what Makerere was to offer, but because we were winding up the financial year and the University had no money, they said that we can work within the resources available and they tasked Estates and Works Department to go and see how best they could cut down as much as they could do,” said Dr. Nabukenya.
Dr. Nabukenya adds that the institution had engaged the Ministry of Finance, Planning and Economic Development to support the university to realize its dream of turning the hospital into a high-grade in provision of health services to the community.
Critical care medicine is a medical specialty that deals with recoverable acute life-threatening conditions. It spans early detection of potentially life-threatening conditions, to life support and intense monitoring, up to end-of-life care.
Provision of intensive care services therefore requires adequate set-up of hospital systems designed to support the critically ill patient, furnished with adequate supplies and equipment in appropriately sized space and environment by appropriately trained staff.
Dr. Josaphat Byamugisha, the University Hospital Director contends that due to the high cost of care as dictated by the severity of illness, services such as critical care are scarce in low-income countries with countries like Uganda which has approximately one bed per a million people.
“In order to provide affordable high-quality services, majority of Intensive Care Units in high income countries exist within large teaching hospitals or university-affiliated hospitals. It is therefore important that Makerere University Hospital establishes itself as one of the hospitals in the country with cutting edge critical care provision in the region,” Professor Byamugisha discloses.
Dr. Byamugisha says the COVID-19 pandemic has left Makerere University staff, students and general population exposed due to inadequate ICU bed numbers to cater for the surge.
Dr. Byamugisha who is also an Associate Professor of Obstetrics & Gynecology further contends that complementary to emergency and operation theatre activities that will allow for more training sites nursing and postgraduate students at school of medicine in Intensive care, the ICU will promote and improve research and collaboration in the field of critical care with key international partners.
Makerere University has committed to the contractor half of the required funds required for the job. Prof. Nabukenya assured the contractor that the university management and government would increase this funding to complete the project.
“With reality, I am sure they (management) will appreciate more and we can see how best to squeeze from what we have. So, like how procurement advised, let us start, let us not be discouraged because we have half the resources. Let us start with what we have, and definitely as management when we come and see that half of the resources have done half the work and the other half is not completed, then definitely we have to step up,” Prof. Nabukenya said.
She urged the contractor to start the work and support the realization of Makerere University dream. “The dream is quite huge. For the sake of not just the Makerere Community, but it will actually support the Ministry of Health or I will say the entire country. So, I think it’s the whole reason why they felt they would help us with the equipment to equip the building when it is done. So, we do a good job in terms of the building, they will not have an excuse to equip. Let us start as we continue with the negotiations.”
Charles Kironde, Director CK Associates hailed Makerere University for awarding them another construction project- University Hospital.
“I would want to say as the director stated, this a very sensitive project, but much as Estates had stated that we had done dental school before, we have also handled some hospitals in our previous works outside the university for KCCA and MOH, so we have a bit of experience with hospital construction and ICU wards and theatres, in the last 3-5 years we have done so be assured that we will give you quality work to the specifications that you want. At least that is for starters,” said Kironde.
Makerere University Hospital, with its 43-year history deeply embedded in the memory of generations has served not only as a center for providing healthcare services but also as a center for training, research.
Since 1978,the hospital plays a significant role in the lives of students, staff and the surrounding areas. It is a successor of the first health post, Makerere University Students Health Service or sick bay at the current Makerere University police post.
In 1972, when Idi Amin expelled Asians, the university acquired the premises formerly known as Nile Nursing Home. The university Sick Bay relocated to the new premises. On February 16, 1978, President Idi Amin visited the Sick Bay and elevated it to a hospital status.
The university formally launched its centenary celebrations at an event on November 25, where University Vice Chancellor and the chairperson Mak@100 Organizing Committee, Professor Prof. Barnabas Nawangwe and Daniel Kidega respectively called on members of the Makerere University community to get involved with the major milestone.
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Health
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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