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Govt. Asked to Scale up Successes in Buikwe, Mukono CVDs Interventions to the Rest of the Country

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Africa continues to record the highest prevalence of hypertension globally. Studies show that Uganda’s hypertension prevalence stands at 26.4% and public health experts are worried that rising prevalence of noncommunicable diseases (NCDs) should be curbed lest it contributes to the disease burden.

In Africa, just like other low- and middle-income countries, the burden of disease is transitioning from infectious diseases to NCDs and the World Health Organisation predicts that they are likely to become a major health system challenge in Africa as they are predicted to become the leading cause of death in the region by 2030.

Studies estimate Uganda’s NCDs prevalence at 33 in every 100 people die of cardiovascular diseases (CVDs). The prevalence of hypertension for instance among adults stands at 26.4% with the highest prevalence in central Uganda (28.5%) which hosts Mukono and Buikwe districts.

In Mukono and Buikwe districts, among persons aged 15 years and above, the age standardized prevalence of hypertension is 27.2%.

Makerere University School of Public Health has for close to three (03) years now been impacting the communities in Mukono and Buikwe districts through its project; Cardiovascular Disease prevention program -Scaling -up Packages for Interventions for Cardiovascular diseases prevention in selected sites in Europe and sub-Saharan Africa (SPICES) Uganda.

The SPICES project focuses on prevention of diseases of the heart and blood vessels. The project has conducted a comprehensive study  at both health facility level and community level where a number of community workers and health workers from randomly selected villages and health facilities in Mukono and Buikwe have been trained in cardiovascular disease prevention and control.  

So far, a total of 366 health workers and 80 community health workers (CHWs/VHTs) received training. In addition, the project provided the health centers with equipment to support screening and management of cardiovascular diseases. The project team has, with support of health facilities been involved in screening CVD risk, care and management as well as health promotion and profiling at community level.

As a result of this intervention, there are higher volumes of hypertension and diabetes patients being received as a result of sensitization by the community health workers. There are also reports of changes in behavior in lifestyles especially diet and physical activity as well as improved patient health seeking behaviors for chronic services.

For instance, while presenting results at a dissemination workshop held on December 8th 2021 at Colline Hotel in Mukono district, Dr. Geofrey Musinguzi, the Principal Investigator of the SPICES Project expressed that the project has had significant impact in terms of knowledge changes, and in terms of profiles.

SPICES project Principal Investigator Dr. Geofrey Musinguzi in an interview with journalists immediately after the dissemination in Mukono on Wednesday.
SPICES project Principal Investigator Dr. Geofrey Musinguzi in an interview with journalists immediately after the dissemination in Mukono on Wednesday. 

“Much as the prevalence of smoking didn’t seem to change, there was a change in frequency of smoking. For example, those who were smoking daily, we saw a reduction from 2018/19 to 2021,” says Dr. Musinguzi.

He adds that there was a significant difference in passive smoking. “Passive smoking is as dangerous as active smoking. At the baseline, people were smoking and exposing their love ones to tobacco but when they were trained from the health facilities and from the community on the dangers of smoking and passive smoking. So, we have seen an attitude of people in families where people are smoking, of if they can’t avoid smoking, doing it away from their families.”

Arising out of the successes of the project so far, Dr. Rhoda Wanyenze, Professor and Dean of Makerere University School of Public Health (MakSPH) has asked government and the Ministry of Health in particular to support noncommunicable diseases care in the districts of Mukono and Buikwe.

Prof. Wanyenze who is also co-principal investigator of the project SPICES project intervention in Mukono and Buikwe could be used as a yardstick to pick lessons for the Ministry of Health to extend the services to other parts of the country.

Dr. Rhoda Wanyenze, Professor and Dean of Makerere University School of Public Health (MakSPH) and SPICES project Co-Principal Investigator
Dr. Rhoda Wanyenze, Professor and Dean of Makerere University School of Public Health (MakSPH) and SPICES project Co-Principal Investigator.

“We can use this as a learning hub so that we can also get the other regions that do not have the standard for NCD care at the level that we have in these districts. Let us maintain it because it is an opportunity for us to show that it is doable, that we can do something about NCDs and that others can learn something from these districts and facilities and we can do better across the country,” Professor Wanyenze said.

Tereza Ssenjova, a resident of Busabala Mukono said; “I used to be diagnosed with fever, yet I did not have it. Not until recently through SPICES screening that I was told I have high blood pressure and diabetes.”

Prof. Wanyenze urged for the Ministry of Health to rally Ugandans, the leadership at all levels to aggressively advocate for a safer population by preventing and reducing cardiovascular diseases.

“Please do speak about NCDs like the way we speak about COVID-19 lately and the way we have been speaking about other diseases. Encourage people to screen. If there is an opportunity, why not have a machine around you in your place so that you can encourage people to screen periodically. Think of how you can creatively encourage the communities to screen, so that we can discover these diseases early and be able to do something,” says Prof. Wanyenze.

Dr. Gerald Mutungi, assistant Commissioner Health Services- Non-Communicable Diseases (NCDs) department at the Ministry of Health admits that cardiovascular diseases are on a rise but hastens to add that they can be prevented.

“What we have found out is that the communities, once educated, sensitized can come for screening, but also can follow some of the guidelines given to prevent cardiovascular diseases. This has been shown and we have the data now,” Dr. Mutungi says.

Dr. Gerald Mutungi, the Assistant Commissioner, Non-Communicable Diseases Department, Ministry of Health
Dr. Gerald Mutungi, the Assistant Commissioner, Non-Communicable Diseases Department, Ministry of Health

Dr. Mutungi welcomes the results and noted that government will scale-up the interventions.

“We are in evidence-based policy and decision making. This is going to influence our policy. We had already started sensitizing VHTs but we were not sure that actually they can play a big role in prevention of cardiovascular diseases. Now this study is showing that yes, they can. We thought they could only support in distributing bed nets, simple things but they have shown us that they can do a lot in prevention and control of diseases,” he said.

Dr. Musinguzi said the project has had a multi-component intervention including health promotion, screening, training among others.

“We think that this intervention can reach many people. I gave an example of the talking T-Shirt. It has the modifiable risk factors. ‘don’t smoke’, ‘do more exercise’, ‘reduce/avoid alcohol,’ ‘maintain a healthy weight’, ‘go for checkup’ ‘control stress’, ‘eat healthy diet’ among others. In fact, we got reports from VHTs that the messages were received by the population. So, we think all ways of delivering messages must be explored to be able to enhance awareness about CVDs and other NCDs,” Dr. Musinguzi contends.

Hajat Fatuma Ndisaba Nabitaka, the Resident District Commissioner for Mukono district
Hajat Fatuma Ndisaba Nabitaka, the Resident District Commissioner for Mukono district.

hailed the SPICES project team for the “wonderful research” and requested the project to include Buvuma and Kayunga districts on the study scope.

“I thank you so much for training the VHTs and our health workers around Mukono and Buikwe districts. This is very good,” said Hajat Nabitaka.

She underscores the need for continued sensitization of the population with a view of changing mindsets to be able to fully realise the benefits.

“Some people think these are diseases of the rich people. Not knowing that even a child in primary school can get diabetes. Not knowing that even an ordinary person in community can get pressure due to the various stress factors. Let us utilize the VHTs to solve many problems including social societal problems such as stress,” Hajat Nabitaka.

Dr. Rawlance Ndejjo, the SPICES Project coordinator said the project has been able to enroll 23 health facilities where it has greatly impacted lives.

He adds that the dissemination is; “a great opportunity to share what we have been doing in field with the rest of the world.”

Dr. Rawlance Ndejjo, the SPICES Project coordinator
Dr. Rawlance Ndejjo, the SPICES Project coordinator

Some health facilities have have adopted strategies to acquire hypertension and diabetes drugs, and all enrolled facilities are now able to identify and manage Type 1 diabetes, unlike in the past.

SPICES project is currently implemented in Uganda, South Africa, France, Belgium and the United Kingdom. It is an implementation science project funded by the European Commission through the Horizon2020 research and innovation.

Mukono and Buikwe district Health workers and community health workers (CHWs/VHTs) in a group photo with SPICES project Principal Investigator Dr. Geofrey Musinguzi and Dr. Gerald Mutungi, the Assistant Commissioner, Non-Communicable Diseases Department, Ministry of Health.
Mukono and Buikwe district Health workers and community health workers (CHWs/VHTs) in a group photo with SPICES project Principal Investigator Dr. Geofrey Musinguzi and Dr. Gerald Mutungi, the Assistant Commissioner, Non-Communicable Diseases Department, Ministry of Health at a Dissemination workshop on December 8th 2021 at Colline Hotel, Mukono.

Article originally published on MakSPH website.

Davidson Ndyabahika

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A New Cohort Joins MakSPH’s Public Health Community

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Newly-admitted students pose with MakSPH Dean Prof. Rhoda Wanyenze during orientation for the 2026/2027 academic year at the MakSPH Auditorium. Orientation for newly admitted students-75 students in the Bachelor of Environmental Health Science, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research for the 2026/2027 academic, 7th August 2026, Makerere University School of Public Health (MakSPH) Auditorium, Main Campus, Kampala Uganda, East Africa.

Every academic year, a new group of students enters Makerere University School of Public Health (MakSPH) with different professional backgrounds, questions and ambitions. For the School, each cohort adds to a growing community of professionals and researchers shaping public health practice, policy and research in Uganda and beyond.

On Friday, 7 August 2026, MakSPH held its orientation for newly admitted students for the 2026/2027 academic year at the MakSPH Auditorium. The orientation introduced students to the School’s academic programmes, leadership, departments, academic administration, student support services and expectations for university life.

For this academic year, ending July 2027, Makerere University admitted more than 370 students to academic programmes hosted at MakSPH. The intake comprised 75 students in the Bachelor of Environmental Health Science, the School’s only bachelor’s programme, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research.

Dean Prof. Rhoda Wanyenze (centre) with MakSPH staff, student leaders and new students during orientation for the 2026/2027 academic year. Orientation for newly admitted students-75 students in the Bachelor of Environmental Health Science, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research for the 2026/2027 academic, 7th August 2026, Makerere University School of Public Health (MakSPH) Auditorium, Main Campus, Kampala Uganda, East Africa.
Dean Prof. Rhoda Wanyenze (centre) with MakSPH staff, student leaders and new students during orientation for the 2026/2027 academic year.

The master’s intake includes 103 students in the Master of Public Health by Distance Education, the highest enrolment for the year, followed by 59 in the Master of Public Health Full-Time. The remaining students joined programmes in Biostatistics, Environmental and Occupational Health, Health Informatics, Health Services Research, Monitoring and Evaluation, Nutrition, and Public Health Disaster Management. Together, the programmes reflect the breadth of knowledge and skills needed to address public health challenges and bring together students pursuing further training from diverse professional backgrounds.

Welcoming the new cohort, MakSPH Dean Prof. Rhoda Wanyenze urged students to approach their studies with purpose, discipline, and resilience, and focus on what they would be able to do with the knowledge and skills they acquire.

“Please find time to enjoy your journey. I know you’re looking ahead to exams and so many other pressures, but let this journey also be one that you enjoy in terms of what you learn and how you grow, so that you leave here better, not because of the paper that you took but because of the capability that you pick up during your time with us.”

MakSPH Dean Prof. Rhoda Wanyenze addresses new students at orientation for the 2026/2027 academic year, 7 August 2026, MakSPH Auditorium, urging them to value capability over paper. Orientation for newly admitted students-75 students in the Bachelor of Environmental Health Science, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research for the 2026/2027 academic, 7th August 2026, Makerere University School of Public Health (MakSPH) Auditorium, Main Campus, Kampala Uganda, East Africa.
MakSPH Dean Prof. Rhoda Wanyenze addresses new students at orientation for the 2026/2027 academic year, 7 August 2026, MakSPH Auditorium, urging them to value capability over paper.

The Dean’s message speaks to the different reasons students are beginning their journeys at MakSPH. For some, the opportunity is to build on professional experience and strengthen their capacity in roles they already hold. Among them is Dr. Judith Nalukwago, a dental surgeon, former 85th Vice Guild President of Makerere University, and Makindye Division III Lord Councillor, who serves as Executive Secretary for Education, Gender and Public Health at City Hall and the Office of the Lord Mayor.

“I am back here to study a Master’s in Public Health. I am very excited. I have a clinical background and have been practising as a clinician, and it has been a joyful experience. But when I joined the journey of leadership, there were challenges because, as Executive Secretary for Public Health in Kampala, we deal with everyday people’s health challenges,” said Dr. Nalukwago, adding:

“Now I am in management and leadership, and that posed a challenge to me as an individual. I asked myself, what course can I do to add to my skills? Where can I gain skills that can help me overcome this challenge while I am dealing with people? And I remembered that we have the School of Public Health at Makerere University.”

Watch: Dr. Judith Nalukwago on why she returned to MakSPH for a Master’s in Public Health:


Her experience during the Ebola response, when she served on the task force, further highlighted the need for broader public health knowledge. She said the training would strengthen her ability to contribute to policy and public health management, particularly in her role at City Hall, where councillors develop policies, bylaws, and ordinances.

For Mr. John Othieno, the motivation is similarly grounded in applying his training to practical problems. A Software Engineering graduate who previously completed a Master’s in Health Informatics at MakSPH, he has returned to pursue a PhD under the Department of Health Policy, Planning and Management. His research focuses on using technology and health informatics to address health-system challenges, including the adoption of picture archiving and communication systems for managing healthcare imaging and data. He said he wants his research to produce solutions that can be applied beyond academia.

“I purposed that, in my academic journey, I would not do research for the sake of having it gather dust on the shelves, but that it would actually be actionable research that can be translated into action, into solutions for our population,” he said.

Watch: Mr. John Othieno on why he returned to MakSPH to pursue a PhD in Public Health:


Nalukwago and Othieno reflect the diverse professional backgrounds that come together at MakSPH, where training, research, and community engagement have been central to the School’s work for over seven decades. Their journeys point to a sustained impact on public health education, seen not only in enrolment and graduate numbers but in the skills and expertise those graduates carry into policy, research, and health systems across Uganda and the region. At the close of the 2024/2025 academic year, MakSPH enrolled 1,140 students across 12 degree programmes, more than 90 percent of them in postgraduate training.

At Makerere University’s 76th Graduation Ceremony on 25 February 2026, MakSPH presented 231 graduates, comprising seven doctoral, 195 master’s and 29 bachelor’s graduates, adding to the health workforce within the region. Among the graduates was Dr. Harriet Aber, who completed her PhD on child substance use in Uganda’s health system and shared her experience with the new cohort during the orientation. She spoke candidly about the demands of postgraduate study and the need to remain positive through its challenges.

Dr. Harriet Aber, a MakSPH PhD graduate, shares her postgraduate journey with new students at orientation, 7 August 2026, MakSPH Auditorium, urging them to maintain a positive attitude through the challenges ahead. Orientation for newly admitted students-75 students in the Bachelor of Environmental Health Science, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research for the 2026/2027 academic, 7th August 2026, Makerere University School of Public Health (MakSPH) Auditorium, Main Campus, Kampala Uganda, East Africa.
Dr. Harriet Aber, a MakSPH PhD graduate, shares her postgraduate journey with new students at orientation, 7 August 2026, MakSPH Auditorium, urging them to maintain a positive attitude through the challenges ahead.

“It’s not a rosy journey. You’re going to have so many moments where you celebrate, where you’re happy about something, but there are also several moments when maybe you’re stuck with the paper, you have to respond to comments, the proposal is not moving, the concept is not clear. Throughout all those processes, one of the things that you just have to maintain is having a positive attitude,” Aber affirmed.

Her experience offered the new cohort a glimpse of the journey ahead, while Prof. Wanyenze’s message focused on how they could make the most of it. The Dean urged students to plan ahead, pursue research opportunities, think independently, and use artificial intelligence responsibly, while seeking mentorship and making full use of the support and opportunities available at the School.

“Our students are our colleagues, and they are our future workmates. Many of them have ended up staying with us. And I know many of you are going to stay with us in the School,” the Dean said, urging students to take seriously the relationships they build with their classmates and faculty, because “we are a network that’s bound together in the same profession.”

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John Okeya

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NIH/Fogarty Director Visits MakCHS, Underscores Impact of Research Training and Health Partnerships

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Officials pose for a group photo with Dr. Steven Schiff during his visit to CHS on 5th August 2026. Makerere University College of Health Sciences (MakCHS) hosts Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, 5th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.

On 5th August 2026, Makerere University College of Health Sciences (MakCHS) hosted the Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, for a visit highlighting the College’s research, training and institutional partnerships supported through the National Institutes of Health (NIH)/Fogarty International Center.

The visit included engagements at MakCHS and Mulago National Referral Hospital, bringing together College leadership, Directors of teaching hospitals affiliated with MakCHS, research investigators and trainees. In attendance were Dr. Joseph Kagaayi who represented the Dean of the Makerere University School of Public Health, Dr. Elias Kumbakumba, Dean of the School of Health Sciences at Mbarara University of Science and Technology (MUST) and Dr. Cissy Kityo Mutuluuza, Executive Director, Joint Clinical Research Centre (JCRC).

A key focus of the visit was the impact of D43 research training programmes supported by NIH/FIC. Principal Investigators presented examples of how the programmes have strengthened research capacity, developed new scientific expertise, supported postgraduate training and contributed to health research and policy in Uganda.

Welcoming Dr. Schiff, Professor Bruce Kirenga, Principal-MakCHS provided an overview of the College, its history, academic programmes, research priorities and extensive network of teaching and research sites. The College, Uganda’s premier centres for health professional education, currently brings together four schools: the School of Medicine, School of Biomedical Sciences, School of Health Sciences, School of Dentistry, alongside a range of research centres and specialised programmes.

Professor Kirenga highlighted the growing breadth of research at MakCHS, including infectious diseases, non-communicable diseases, translational medicine, population health, mental health, digital health, implementation science, biomedical sciences, genomics, bioinformatics and data science.

Prof. Bruce Kirenga (Standing) makes his remarks. Makerere University College of Health Sciences (MakCHS) hosts Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, 5th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Prof. Bruce Kirenga (Standing) makes his remarks.
CURRENT D43 PROJECTS AT MAKCHS
No.Award TitlePrincipal Investigator
1Reducing the Impact of Rheumatic Heart Disease across the Life Span: The Impact ProgramProf. Nelson Sewankambo
2Enhancing Research capacity for Sickle Cell Disease and related NCDs across the Lifespan in Uganda. “Enrich Project”Prof. Sarah Kiguli
3Scaling Up advanced genomics and bioinformatics Research training in paediatric HIV/AIDS in Uganda – SURGEDr. Kyobe, Samuel
4Training in Malaria Epidemiology, Translational Research, and Implementation Science to Strengthen Malaria Policy and Control in UgandaProf. Moses Robert Kamya
5Strengthening behavioral and social science research capacity to address overlapping stigma, social and psychological challenges among people with HIV in UgandaProf. Moses Robert Kamya
6Training in non-communicable diseases epidemiological, data science and Implementation Science research to strengthen evidence-based interventions, policy and control in UgandaAssoc. Prof. Bruce James Kirenga
7Building Implementation Science Capacity at Makerere University to Strengthen the Response to the HIV/AIDS Epidemic in UgandaProf. Moses Robert Kamya
8Training in Malaria Epidemiology, Translational Research, and Implementation Science to Strengthen Malaria Policy and Control in UgandaProf. Moses Robert Kamya
9Harnessing Health Data Science capacity to strengthen evidence-based interventions, policy and response to the HIV/AIDS Epidemic in Uganda (H-DATA)Prof. David Patrick Kateete

From research training to real-world impact

Presentations from D43 Principal Investigators demonstrated how sustained NIH/FIC investment has supported researchers at different stages of their careers while contributing to evidence that can inform health programmes and policy.

In malaria research, trainees have been involved in studies examining the effectiveness of interventions such as insecticide-treated bed nets and the immunological consequences of reduced malaria transmission. Researchers are also investigating how malaria risk and immunity change when transmission is interrupted, generating evidence that can help inform strategies for sustaining the gains made through malaria control.

The implementation science portfolio provided another example of research translating into measurable health outcomes. One study examining enhanced counselling and peer support among young people living with HIV in south-western Uganda reported improvements in HIV-related outcomes, demonstrating the potential of locally-led research to strengthen service delivery.

Researchers in behavioural and social sciences have also been supported to investigate mental health and other health outcomes, illustrating the multidisciplinary nature of MakCHS research and the importance of combining biomedical, clinical and social science approaches.

Building capacity in specialised and emerging fields

The presentations also showcased the role of NIH/FIC-supported programmes in creating expertise in areas that were previously limited or unavailable within Uganda.

A programme focused on HIV research among pregnant women, children and adolescents has supported postgraduate and short-course training in areas including clinical trial design, pharmacokinetics, biostatistics, behavioural science, regulatory and ethical considerations, and implementation science.

Other programmes have contributed to the development of expertise in bioinformatics, genomics and data science, including the establishment and strengthening of postgraduate programmes. Researchers are increasingly applying artificial intelligence and machine learning to complex biomedical and HIV datasets, with the goal of generating evidence that can be translated into policy and practice.

Dr. Cissy Kityo Mutuluuza, Executive Director of the JCRC highlighted emerging work in gene and cell therapy under the NIH/FIC supported project Building Gene Therapy Capacity in Uganda implemented at JCRC. She explained that the programme includes efforts to establish sustainable research and training capacity for HIV cure research in Uganda. The programme brings together institutions in Uganda and international partners, with an emphasis on developing locally relevant expertise, infrastructure and research capability.

Dr. Cissy Kityo Mutuluuza (Standing) highlights JCRC's work. Makerere University College of Health Sciences (MakCHS) hosts Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, 5th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Dr. Cissy Kityo Mutuluuza (Standing) highlights JCRC’s work.

Strengthening institutions and developing future leaders

Beyond individual research projects, speakers emphasised the broader institutional impact of Fogarty-supported training.

Over the years, NIH/FIC-supported collaborations have contributed to the development of postgraduate programmes, research laboratories, specialised scientific disciplines and networks of researchers across Uganda. Trainees have progressed into academic and research leadership positions, with some becoming professors, programme leaders and advisors contributing to national health initiatives.

The programmes have also supported short courses, mentorship, international research placements and collaborations designed to enable Ugandan scientists to develop advanced skills and return to strengthen research and training at home.

Presenters stressed the importance of moving beyond individual training to building institutions capable of sustaining research programmes, mentoring future scientists, managing complex studies and translating findings into health interventions.

Research serving Uganda’s health system

The visit also underscored the close relationship between MakCHS research and Uganda’s health system. Researchers and faculty contribute to national programmes in areas including HIV, tuberculosis, malaria, vaccines, maternal and child health and other public health priorities.

Evidence generated through research has helped inform national guidelines, programmes and policy discussions, while College researchers and teaching hospitals continue to provide expertise during public health emergencies and disease outbreaks.

The speakers noted that partnerships such as those supported by NIH/FIC are most valuable when they create lasting local capacity — enabling Ugandan institutions and scientists to generate and use evidence to address the country’s health priorities.

A partnership built on shared learning

Dr. Steven Schiff makes his presentation. Makerere University College of Health Sciences (MakCHS) hosts Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, 5th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Dr. Steven Schiff makes his presentation.

In his engagement with the College, Dr. Schiff reflected on the longstanding relationship between NIH/Fogarty-supported programmes and Ugandan researchers. He acknowledged the depth of expertise and experience that has developed through years of collaboration and emphasised the value of partnerships that support scientific exchange and capacity building in both directions.

Dr. Schiff noted that the presentations demonstrated impact of the partnerships which extends well beyond the number of people trained. Investments in researchers have helped establish new academic programmes, strengthen laboratories and research infrastructure, expand multidisciplinary collaborations and create a growing generation of scientists able to lead research in Uganda and internationally.

The visit therefore provided an opportunity not only to showcase ongoing work, but also to reflect on the evolution of research capacity at MakCHS and its contribution to Uganda’s health priorities.

As MakCHS continues to expand its research portfolio into emerging areas such as artificial intelligence, genomics, precision medicine, translational science and advanced therapeutics, the College reaffirmed the importance of strategic partnerships in developing the people, systems and infrastructure needed to turn scientific discoveries into improved health outcomes.

Zaam Ssali
Zaam Ssali

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AFRHiCARE Shares Evidence and Co-Creates Solutions to Strengthen Uganda’s First-Referral Hospitals

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Stakeholders pose for a group photo during the AFRHiCARE Meeting held on 13th August 2026. Makerere University School of Public Health (MakSPH) Wellcome Trust through a 2023–2029 Discovery Award-funded Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative stakeholders from five first-referral hospitals in Uganda meeting to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care, 13th August 2026, Kabira Country Club, Kampala Uganda, East Africa.

The Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative on August 13, 2026 brought together stakeholders from five first-referral hospitals in Uganda to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care.

Funded by the Wellcome Trust through a 2023–2029 Discovery Award, AFRHiCARE is a partnership between Makerere University, the University of the Witwatersrand, the KEMRI-Wellcome Trust Research Programme and the University of Oxford. The initiative seeks to generate evidence to inform the future development of first-referral hospitals, with a focus on service delivery, health workforce dynamics, leadership, management, governance and technology.

In Uganda, the study is being implemented at Kawolo Hospital, St. Joseph’s Hospital Naggalama, Adjumani Hospital, Kiryandongo Hospital and Masindi Hospital. The hospitals play a critical role within the Primary Health Care (PHC) system, linking lower-level health facilities to higher-level referral services.

The stakeholder meeting provided an opportunity for the participating hospitals and other stakeholders to move beyond receiving research findings to interrogating the evidence, sharing experiences and identifying actions that can be implemented at hospital, district and national levels. This approach is central to AFRHiCARE, which uses stakeholder engagement to promote cross-learning and support hospitals to develop quality improvement actions.

Evidence from the health workforce

One of the key areas presented was the status of the health workforce across the five hospitals. The first-round assessment surveyed 609 frontline health workers. It examined staffing, job satisfaction and professional quality of life.

Some of the AFRHiCARE Stakeholders in a group discussion. Makerere University School of Public Health (MakSPH) Wellcome Trust through a 2023–2029 Discovery Award-funded Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative stakeholders from five first-referral hospitals in Uganda meeting to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care, 13th August 2026, Kabira Country Club, Kampala Uganda, East Africa.
Some of the AFRHiCARE Stakeholders in a group discussion.

The findings show a significant staffing gap. Against the 2023 staffing norm of 343 staff, all five hospitals were operating at less than half of the recommended level. Masindi Hospital had the largest gap, operating at 37.6% of the norm, while Adjumani, Kiryandongo, Kawolo and Naggalama were at 48.1%, 48.7%, 44.9% and 44.6%, respectively.

However, the findings suggest that staff retention is relatively good in the public hospitals. The main challenge appears to be recruitment and filling vacant positions rather than widespread staff turnover.

Health workers identified promotion, workload and salary as the lowest-rated aspects of their jobs across the five hospitals. Overall job satisfaction ranged from 59% in Masindi to 71% in Naggalama.

Despite these challenges, the findings reveal strong commitment among health workers. Compassion satisfaction was high, with many reporting pride in their work. At the same time, workload emerged as a major concern.

Strong relationships among colleagues were also identified as a key strength, suggesting that teamwork and peer support remain important sources of resilience within the hospitals.

Strengthening hospitals within the health system

Speaking during the dissemination, Dr. Raymond Tweheyo, Co-Principal Investigator and Research Manager for AFRHiCARE Uganda, noted that first-referral hospitals have often been neglected in critical areas, including staffing, financing, infrastructure, leadership, management and governance.

Dr. Raymond Tweheyo. Makerere University School of Public Health (MakSPH) Wellcome Trust through a 2023–2029 Discovery Award-funded Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative stakeholders from five first-referral hospitals in Uganda meeting to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care, 13th August 2026, Kabira Country Club, Kampala Uganda, East Africa.
Dr. Raymond Tweheyo.

He said these gaps affect hospitals’ ability to deliver services effectively and respond to the needs of the communities they serve.

Dr. Tweheyo re-echoed a message from the Principal Investigator, Professor Frederick Ssengooba, on the importance of situating the district hospital at the apex of the PHC network. This perspective recognises that challenges experienced at district hospitals may be linked to weaknesses elsewhere in the health system.

For example, weak referral systems, shortages of health workers and capacity challenges at lower-level facilities can increase pressure on first-referral hospitals. Addressing these problems therefore requires system-level solutions involving multiple actors.

The AFRHiCARE protocol similarly identifies persistent challenges around resource constraints, service delivery, workforce wellbeing, leadership and management, governance, technology and the ability of hospitals to meet changing community needs.

Dr. Raymond Tweheyo makes his presentation. Makerere University School of Public Health (MakSPH) Wellcome Trust through a 2023–2029 Discovery Award-funded Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative stakeholders from five first-referral hospitals in Uganda meeting to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care, 13th August 2026, Kabira Country Club, Kampala Uganda, East Africa.
Dr. Raymond Tweheyo makes his presentation.

From research to action

Participants discussed priorities including filling critical staffing gaps, improving transparency and equity around promotion, addressing excessive workloads, strengthening referral systems and reducing the pressure created when patients bypass lower-level facilities. The meeting also considered which challenges can be addressed by hospitals and which require action from district authorities and the Ministry of Health.

Betty Kyakuwa
Betty Kyakuwa

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