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New study: 46% of Women in Uganda say they had unintended pregnancies in 2021

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Women in Uganda continue to report high levels of unintended pregnancies. Results from Phase 2 cross-sectional survey of the Performance Monitoring for Action -PMA Uganda project at Makerere University School of Public Health (MakSPH) show that 46 percent of pregnancies in 2021 were unintended.

Of the 2,159 women of ages 15-49 from across the 141 enumeration areas (villages) in 15 sub regions of Uganda interviewed by the study team, at least 54% said their current/ recent pregnancy was intended.

The women were asked whether they were pregnant by intention of their most recent birth or current pregnancy. 33% said they wanted a pregnancy later while a total of 13% said they wanted no more children but ended up getting pregnant.

The proportion of those who had unintended pregnancy varied from the those that were in urban and rural areas. For instance, a whopping 48.5% of those who had unintended pregnancies were rural based women while 35.9% were in urban areas.

Also, results show that more than 50% of women who said they never wanted to be pregnant or wished to delay child birth were aged 35 and above. A higher proportion (more than 60%) of women who experienced unintended pregnancy in 2021 were teenagers aged between 15 and 19.

MakSPH, PMA Uganda project  Co-Principal Investigator Dr. Simon Peter Kibira
MakSPH, PMA Uganda project Co-Principal Investigator Dr. Simon Peter Kibira addressing media after the dissemination of the results at Golden Tulip Hotel in Kampala.

The enumeration areas are sampled by the Uganda Bureau of statistics (UBOS). The survey was conducted together with the Ministry of Health, supported by Jhpiego, a Johns Hopkins University Affiliate, MakSPH and the Uganda Bureau of Statistics – UBOS and the overall technical guidance from the Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health.

At MakSPH, PMA Uganda project is led by Principal Investigator Dr. Fredrick Makumbi and Co-Principal Investigator Dr. Simon Peter Kibira. The results were released on February 15, during a stakeholder breakfast engagement meeting at Golden Tulip in Kampala.

For trends in use of contraceptives among married women, the prevalence stands at 50.2%. “It is the first time we are hitting this indicator and the modern method of family planning standing at 43%. So, we are rising though not first enough given the Covid-19 implications for the last 1-3 years. But it is amazing that we have had some adoption from the Ministry of Health and the implementing partners and the results show that at least, there is progress,” says Dr. Simon Peter Kibira, the PMA Uganda Co-Principal Investigator.

Dr. Kibira cites that among a few challenges Uganda has faced is the struggle with the quality of services provided. For instance, data shows that only 43% of women were told about the side effects of a modern contraceptive method they were using, how to cope up with them, and the availability of other alternative methods.

“This is not a good indicator and we still have a long way to go around that,” he says.    

The survey interrogated service delivery points offering Family Planning services in 255 public health facilities and 118 private facilities that included 46 hospitals, 58 Health Center 4s and 96 Health Center IIIs and 55 Health Center 2s.

There was a general drop in stock outs for family planning services. For instance, Oral contraceptive pills in public health facilities stood at 48% in 2021 down from 68% in 2020.

According to the Principal Investigator Dr. Fredrick Makumbi the study team assessed availability of family planning services largely in public health facilities because they are many and can give stable statistics.

PMA Uganda project Principal Investigator Dr. Fredrick Makumbi presenting results of the PMA family planning survey 2021
PMA Uganda project Principal Investigator Dr. Fredrick Makumbi presenting results of the PMA family planning survey 2021

“Implant stockouts were very common compared to the IUDs which had lower use. What about Oral contraceptive pills stockouts, I daresay nearly half of the facilities were stocked out either at the time of the survey or in the past three months,” Dr. Makumbi.

The reasons advanced for stock out of FP commodities in Public Service Delivery Points, a higher percentage (46%) of the facilities said they had ordered but not received shipment. At least 20% said they had ordered but not received right quantities while 9% said there was unexpected increased consumption and just 2.8% said they lacked stock due to COVID-19 disruption.

“For as long as Family Planning partners, Ministry of Health and the rest as mobilizing and creating awareness, people are coming and using the methods and particularly in this study 9% said they did not have enough pills,” Dr. Makumbi says.

In terms of education background, the study noticed a difference in women of primary and secondary levels of education in terms of contraceptive use.

“The highly educated have a significantly high proportion of use of modern planning methods implying that education is key, factor and we need to make sure that women, men and couples using family planning are educated,” says Dr. Kibira.

The Uganda Family Planning Costed Implementation Plan, 2015–2020, launched by the government in November 2014 sought to increase the modern contraceptive prevalence rate among married women to 50 percent by 2020. This target was however not met.

According to Dr. Kibira, we have not yet reached it even in 2022 currently at 47.7%. “We are still struggling a little bit and if we work on that we, shall make sure that we hit on the target of 50%, and that’s for 2020. Much as we set a conservative target, there are adaptations we have seen otherwise we wouldn’t see any usage of family planning methods during Covid-19,” he said.  

He adds that what has contributed to the high prevalence rate for contraceptives has been   the use of modern methods and therefore the adaptations by the Ministry of Health and other implementing partners worked citing that if they did not work, Uganda would have seen worse indicators.

“Regardless of the effects of Covid-19, I am glad we had good indicators. I think this Covid-19 situation could have been a speed jump because couples stayed at home hence exposed to having more sex and that would lead them to take on the modern family planning method. And sometimes you have the challenges and the same challenge propel you to better indicators,” he noted.

In each of the 141 numeration areas the research team interviewed all eligible women aged 15 and 49 years in 35 households.

“We interview and we ask them issues about sex, and if there is any form of pregnancy control method being used. If someone says condom, implants or any other method, we don’t go ahead to interrogate why they are using that method. We are actually interested in asking, if you are not using, then why are you not using,” says Dr. Kibira.  

There are various family planning methods and women / couples should be at liberty to choose with full information at the facility where you are receiving the method, for example among the pills, injectables, IUDs.

Notably Dr. Kibira asserts that implants and IUDs are long acting reversible methods and they are the most active compared to the short-term methods that are recommendable for people who want longer time delays for example space for 5 years.

He adds that; “The beauty with long term methods is that they are cheaper, effective and offer long years of protection and it should be ideal that people use what is ideal to their needs either short term and long term and it’s a choice.”

Dr. Makumbi says each development partner has a role to play in ensuring access to family planning services to Ugandans. “I think everyone of us has an opportunity to play their role, we generate evidence, we work with Ministry of Health, implementing partners, Population Council and everybody so that we can have evidence-informed decisions and that can make a significant difference and I am glad to see members of parliament who can help us support when all this information comes to parliament.”

Dr. Charles Ayume the Chair of the Committee on Health in Parliament of Uganda interacts with journalists after the release of the findings of PMA results at Golden Tulip Hotel in Kampala
Dr. Charles Ayume the Chair of the Committee on Health in Parliament of Uganda interacts with journalists after the release of the findings of PMA results at Golden Tulip Hotel in Kampala

Dr. Charles Ayume the Chair of the Committee on Health in Parliament of Uganda said they (committee) were extremely happy to engaging in a dissemination of PMA results citing that it sharpens the way they tackle issues on the floor of parliament.

“We really want a parliament that articulates issues based on evidence and very strong data. We do not only represent our constituencies, we are also dutybound to represent the views of health workers on the floor of parliament and good enough we have health workers on the committee,” said Dr. Ayume.

Adding that; “this is where data is produced. But then fortunately or unfortunately the policies are made on the floor of parliament. So if you don’t arm us well, then we do a poor job on the floor. We pledge total support.”

Davidson Ndyabahika

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College of Health Sciences Inspires Future Health Professionals at Career Fair

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Prof. Bruce Kirenga addresses the senior six students and their teachers on 10th July 2026. Makerere University College of Health Sciences (MakCHS) Career Fair for Ngora High School and Wiggins Secondary School guiding senior six science students on careers in health sciences and introducing them to the wide range of academic programmes offered by the College, 10th July 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.

The Makerere University College of Health Sciences (MakCHS) on July 10, 2026, welcomed senior six science students from Ngora High School and Wiggins Secondary School to an inspiring Career Fair aimed at guiding them on careers in health sciences and introducing them to the wide range of academic programmes offered by the College.

The event brought together students pursuing Physics, Chemistry, Biology (PCB) and Biology, Chemistry, Mathematics (BCM), providing them with a unique opportunity to interact with the College leadership, tour laboratories and teaching facilities, and learn first-hand about careers in medicine and other health science disciplines.

Welcoming the students, the College Principal, Prof. Bruce Kirenga, described the College of Health Sciences as one of Africa’s oldest and most distinguished medical schools, with a legacy spanning more than a century.

“We started in 1924, making us one of the oldest medical schools on the continent. You have made the right decision to visit Makerere, and we are delighted to welcome you,” he said.

Prof. Kirenga commended the school administrators and teachers for organizing the visit, noting that exposing learners to university environments early helps them make informed career choices. He explained that the College introduced the Open Day concept after receiving numerous requests from schools seeking career guidance visits.

Prof. Bruce Kirenga. Makerere University College of Health Sciences (MakCHS) Career Fair for Ngora High School and Wiggins Secondary School guiding senior six science students on careers in health sciences and introducing them to the wide range of academic programmes offered by the College, 10th July 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Prof. Bruce Kirenga.

He congratulated the students for choosing science subjects, describing science as the foundation for solving society’s most pressing challenges.

“You have already made one of the most important decisions by choosing to become scientists. Even more importantly, you have chosen life sciences—a field dedicated to preserving and improving life,” he remarked.

The Principal emphasized that careers in life sciences extend far beyond medicine, encouraging students to remain open-minded as they consider their future.

“Everything that has life requires professionals to keep it healthy—from human beings and animals to crops and the environment. The opportunities are immense, including agriculture, veterinary medicine, biomedical sciences, public health and many other emerging fields.”

A section of senior six students and their students at the career fair. Makerere University College of Health Sciences (MakCHS) Career Fair for Ngora High School and Wiggins Secondary School guiding senior six science students on careers in health sciences and introducing them to the wide range of academic programmes offered by the College, 10th July 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
A section of senior six students and their students at the career fair.

He also advised students not to limit themselves to only one academic programme during university applications, recalling instances where highly qualified students narrowly missed admission because they selected only one course.

“Remain open to the opportunities available. Medicine is an excellent profession, but there are many other programmes that are equally rewarding and are shaping the future of healthcare and scientific innovation,” he said.

Prof. Kirenga further encouraged the students to embrace lifelong learning, reminding them that scientific knowledge remains valuable regardless of the career path they eventually pursue.

Addressing the students, the Dean of the School of Medicine, Prof. Annette Nakimuli, acknowledged the growing competition for admission into medical programmes and urged learners to work hard while keeping an open mind about the diverse opportunities available within health sciences.

Prof. Annettee Nakimuli. Makerere University College of Health Sciences (MakCHS) Career Fair for Ngora High School and Wiggins Secondary School guiding senior six science students on careers in health sciences and introducing them to the wide range of academic programmes offered by the College, 10th July 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Prof. Annettee Nakimuli.

She explained that admission into the Bachelor of Medicine and Bachelor of Surgery (MBChB) programme has become increasingly competitive due to the rising number of high-performing applicants.

“This year we witnessed unprecedented competition for government sponsorship, with many applicants scoring triple A at Advanced Level and outstanding grades at Ordinary Level. That tells you that you must prepare yourselves to excel academically,” she said.

Prof. Nakimuli noted that while many students aspire to become medical doctors, the health sector today offers numerous innovative programmes that are equally important.

“There are many programmes that parents, teachers and students are still not familiar with. Biomedical Engineering, for example, is one of the exciting fields driving the future of healthcare, yet many students overlook it because they focus only on medicine.”

Students and Teachers pose for a group photo with CHS staff. Makerere University College of Health Sciences (MakCHS) Career Fair for Ngora High School and Wiggins Secondary School guiding senior six science students on careers in health sciences and introducing them to the wide range of academic programmes offered by the College, 10th July 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Students and Teachers pose for a group photo with CHS staff.

She encouraged students to explore emerging disciplines that combine medicine, engineering, technology and research, noting that the future of healthcare increasingly depends on multidisciplinary professionals.

The Dean also introduced students to the structure of the School of Medicine, explaining that it comprises twelve academic departments and two specialised units covering a broad spectrum of clinical disciplines, including Internal Medicine, Surgery, Obstetrics and Gynaecology, Orthopaedics, Ophthalmology, Ear, Nose and Throat (ENT), Family Medicine, Anaesthesia and Critical Care, among others.

She explained that students are trained by specialists across these disciplines to become competent general practitioners before pursuing further specialization.

Prof. Erisa Mwaka, the Chair of the Department of Human Anatomy, shared with the students about the School of Biomedical Sciences (SBS). He said the school is one of the four schools that make up the Makerere University College of Health Sciences (MakCHS). As the foundation of medical education, the School provides students with a comprehensive understanding of the biological and molecular sciences that underpin modern healthcare, disease prevention, diagnosis and treatment.

Prof. Erisa Mwaka with students in one of the teaching spaces. Makerere University College of Health Sciences (MakCHS) Career Fair for Ngora High School and Wiggins Secondary School guiding senior six science students on careers in health sciences and introducing them to the wide range of academic programmes offered by the College, 10th July 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Prof. Erisa Mwaka with students in one of the teaching spaces.

The School comprises several departments, including:

  • Human Anatomy
  • Biochemistry
  • Physiology
  • Pharmacology and Therapeutics
  • Pathology
  • Microbiology
  • Medical Illustration

The School offers undergraduate programmes such as the Bachelor of Science in Biomedical Sciences, which equips students with strong laboratory, research and analytical skills, and the Bachelor of Science in Biomedical Engineering, an interdisciplinary programme that integrates engineering, medicine and technology to develop innovative healthcare solutions.

At postgraduate level, the School offers a wide range of master’s and doctoral programmes, including Human Anatomy, Physiology, Pharmacology, Bioinformatics, Immunology and Clinical Microbiology, Health Bioethics, Medical Illustration, Pathology and other biomedical specializations that prepare graduates for careers in research, academia, diagnostics, biotechnology and the pharmaceutical industry. The school also offers a wide range of diploma courses.

Dr. Isaac Magulu Kimbowa from the Department of Pharmacology and Therapeutics (Right) and colleagues interact with the students. Makerere University College of Health Sciences (MakCHS) Career Fair for Ngora High School and Wiggins Secondary School guiding senior six science students on careers in health sciences and introducing them to the wide range of academic programmes offered by the College, 10th July 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Dr. Isaac Magulu Kimbowa from the Department of Pharmacology and Therapeutics (Right) and colleagues interact with the students.

Throughout the Career Fair, students interacted with faculty members, toured laboratories and learning facilities, and received guidance on university admission, academic programmes and career prospects within the health sciences.

The Career Fair forms part of the College’s broader outreach programme aimed at nurturing the next generation of healthcare professionals by exposing learners to university life and equipping them with the information needed to make informed academic and career decisions.

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Betty Kyakuwa
Betty Kyakuwa

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Makerere University Promotes Prof. Peter Waiswa to Full Professor

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Congratulations Prof. Peter Waiswa. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.

By Joseph Odoi

Makerere University has promoted Prof. Peter Waiswa from the rank of Associate Professor to Full Professor of Health Policy, Planning and Management at the School of Public Health, following the decision of the Appointments Board at its 811th meeting held on 10th July 2026.

The promotion recognises his outstanding contributions to the University’s core functions of teaching and learning, research and innovation, institutional development, mentorship, leadership, and service to society.

Throughout his academic career, Prof. Waiswa has distinguished himself as a leading scholar in implementation science, health systems strengthening, policy and health services research. His work has influenced practice and decision-making in Uganda, across Africa, and globally.

His research has strengthened the connection between evidence generation, policy development, and implementation of health programmes, particularly in resource-limited settings where stronger health systems are critical to improving population health outcomes.

Reflecting on the promotion, Prof. Peter Waiswa described the recognition as a collective achievement, acknowledging the contribution of his students, colleagues, partners, and communities that have supported his journey.

“I am deeply grateful to Makerere University for this promotion. This is not a personal achievement, but a recognition of the collective work of my students, colleagues, partners, and the communities we serve.  

We must build systems, mentor the next generation, and work with government to deliver evidence-based results so that no one is left behind. The journey continues’ ’he emphasized of the task ahead

A Public Health Scholar with Continental and Global Influence

Prof. Waiswa is recognised as one of Sub-Saharan Africa’s leading public health researchers, with a research portfolio that has shaped health systems thinking and practice.

According to Google Scholar data, Prof. Waiswa has accumulated 17,701 citations, with an H-index of 57 and an i10-index of 209. Since 2021, his work has received 10,649 citations, including more than 2,400 citations in 2025, reflecting the growing global relevance of his scholarly work.

In 2020, Expertscape ranked Prof. Waiswa among the top 0.22 percent of global authors on infant mortality, recognising his contribution to advancing knowledge in child health and survival.

Leading Research, Innovation and Health Systems Transformation

Prof. Waiswa has led major multi-sectoral research and implementation science initiatives that have contributed to strengthening health systems in Uganda, Africa, and globally.

Between 2021 and 2024, he led a multi-sectoral team across 28 Anglophone and Francophone African countries through the Digital Health Payment Initiative and Research (DHPI-R) for campaign health workers. The research is strengthening accountability in health campaigns, informing policy discussions with global partners including WHO, UNICEF, and the Gates Foundation, and contributed to the establishment of Digital Health Payment Initiative Centres at Makerere University, Uganda, and the University of Dakar, Senegal.

In 2025, Prof. Waiswa led a team in implementing the Uganda Newborn Programme, one of the country’s major health systems strengthening initiatives, supporting more than 120,000 newborns and sick newborns through a regional and life-course approach.

Prof. Peter Waiswa grew up in Naigobya Village, Luuka District, Uganda where early experiences shaped his lifelong dedication to improving health. Witnessing newborn and community health challenges inspired his commitment to building resilient, equitable health systems.

Building the Next Generation of Researchers

Beyond his research contributions, Prof. Waiswa has played a significant role in mentorship and capacity building. He has mentored numerous PhD graduates and emerging researchers who are now contributing to health programmes, academia, and policy across Africa and the globe.

In 2025, he was elected a Fellow of the African Academy of Sciences in recognition of his transformative contributions to research and innovation in women’s health, maternal, newborn and child health, and health policy.

Driving Future Health Innovations

As of 2026, Prof. Waiswa, in collaboration with researchers from Johns Hopkins University, Makerere University, and Mbarara University of Science and Technology (MUST), is leading the Ekyaalo Diagnostics project — a low-cost, AI-powered innovation designed to reduce delays in breast cancer diagnosis and improve access to timely care, especially for women in hard-to-reach communities.

Global Leadership and Institutional Contributions

Prof. Waiswa serves in several global and national advisory roles, contributing to health policy, implementation, and systems strengthening. His roles include membership on WHO Guideline Development Groups, the WHO–UNICEF Informal Technical Advisory Group on norms for small and/or sick newborn care, the Lancet Commission on Evidence-Based Implementation in Global Health, and other global health platforms.

He also leads Makerere University’s Centre of Excellence for Maternal, Newborn and Child Health and heads the INDEPTH Network Maternal, Newborn and Child Health Working Group.

To engage with Prof. Peter Waiswa visit: https://peterwaiswa.com/

Mak Editor

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MakSPH 2025 Annual Report: A Defining Year of Growth, Partnership and Public Health Impact

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Cover page of the MakSPH 2025 Annual Report. Makerere University School of Public Health, Kampala Uganda, East Africa.

The Makerere University School of Public Health 2025 Annual Report documents a defining year in the School’s institutional journey. Effective January 2025, MakSPH attained stand-alone status within Makerere University, recognising seven decades of growth in public health training, research, policy engagement and community service. The transition gives the School greater focus and institutional agility to respond to Uganda’s and Africa’s evolving health priorities.

During the 2024/2025 academic year, MakSPH had more than 1,000 students across 12 degree programmes and different years of study. It presented 269 graduands at Makerere University’s 75th Graduation Ceremony, more than 80 per cent at graduate level, while 12 doctoral candidates successfully defended their studies. Training remained closely connected to practice through eight district field-training sites and student participation in outbreak response, disease surveillance and community-based public health action.

The School produced more than 350 peer-reviewed publications. Its evidence informed national and global action across HIV, tuberculosis, maternal and newborn health, antimicrobial resistance, health systems, climate change, urban health, injuries and noncommunicable diseases. MakSPH’s contribution to the PURPOSE 1 trial supported evidence showing more than 99 per cent protection from twice-yearly injectable lenacapavir, while locally led programmes expanded HIV screening, prevention and referral services for underserved populations.

This work was sustained through partnerships with government, communities, funders, universities and implementation agencies. MakSPH’s research and training network extended across more than 35 African countries, while longstanding collaborations were renewed and new institutional relationships established. Strong research governance, unqualified audits and positive due-diligence assessments continued to reinforce partner confidence in the School’s ability to manage complex national and multi-country programmes with accountability.

Construction of the new MakSPH building on Makerere University Main Campus advanced during 2025, with completion targeted for 2026. Designed as a modern public health hub, the facility will expand teaching and specialised laboratory space, strengthen digital learning and research, and provide improved environments for students, faculty, innovation and collaboration.

These achievements reflect the shared contribution of faculty, staff, students and partners. Guided by its 2025–2030 Strategic Plan, MakSPH remains committed to training public health leaders, generating evidence that informs policy and practice, strengthening health systems and improving health in Uganda, across Africa and beyond.

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John Okeya

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