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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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Call for Applications: Responsible Conduct of Research (RCR) Training Course

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An elevated shot of the School of Biomedical Sciences Building, College of Health Sciences (CHS), Makerere University. Kampala Uganda, East Africa

The Responsible Conduct of Research (RCR) Training Course, scheduled to take place from July 30th to August 1st, 2025, at the Makerere University College of Health Sciences’ Conference Room.

Background

The SUSTAIN: Advancing Makerere University Masters of Health Sciences in Bioethics program at Makerere University College of Health Sciences aims at developing and institutionalizing a mentorship program in research ethics that facilitates development of bioethics professionals and health researchers who are committed to the growth and application of research ethics in Uganda’s academic and research institutions to the highest possible degree. The Responsible Conduct of Research (RCR) course is one of the short courses that introduces trainees to a framework that involves application of established scientific, professional norms and ethical principles in the performance of all activities related to scientific research.

Course objectives

At the end of this course, trainees should be able to identify, manage and prevent research misconduct.

Course outline

Introduction to RCR; Introduction to Professionalism and Ethics; Human subject’s protection and regulatory framework in Uganda; Humane handling of animal research subjects; Conflict of interest;

Responsible laboratory practices; Mentor-mentee relationships; Collaborative research international, industry); Peer review; Research misconduct (including policies for handling misconduct); Community involvement during research in a low resource setting; Responsibility to society and environment; Responsible financial management; Data acquisition, management, sharing and ownership; Responsible authorship, publication and communication.

Target group

The Responsible Conduct of Research course is targeted at Researchers, Research administrators, Research assistants, Study coordinators, Graduate students and Student supervisors. Certificates will only be awarded to participants with 80% attendance.

Course fee: 205,000/=, or 56USD is payable.

The course fee will cater for meals and refreshments during the training period.

Payment & Registration procedure:

9030026194023, Stanbic Bank, Mulago, Makerere University Biomedical Research Center Limited

Dollar Currency:

9030026194147, Stanbic Bank, Mulago, Makerere University Biomedical Research Center Limited

Please Note: Share payment details on email/whatsup and a hardcopy deposit slip delivered on the first day of the training to Miriam Musazi, Department of anatomy, Bioethics Centre, Room C4,

Mob: +256 782 363 996/ +256 701 363 996, Email: mmusazi@gmail.com.

NB. Only those who will have paid by this date will be considered for the course

Venue: The training will take place at Makerere University College of Health Sciences’ Conference room

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Call For Applications: PhD Fellowship Training Position

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A newborn baby in an incubator in Neonatal Care Unit. Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies national health systems strengthening initiative the Uganda Newborn Programme (UNP) launched 2022. Program uses regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions. Achievements 2025. Kampala, East Africa.

Background:

Makerere University College of Health Sciences (MakCHS), Kampala, Uganda and Global Health Uganda (GHU); in collaboration with other research consortium partner institutions, including, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya; Training and Research Unit of Excellence (TRUE), Blantyre, Malawi; University of Bergen, Bergen, Norway; University of Amsterdam, The Netherlands; and Liverpool School of Tropical Medicine (LSTM), UK have been conducting clinical research on Malaria Chemoprevention. This research has focused on Malaria Chemoprevention in vulnerable patient populations, including children with severe anaemia, children with sickle cell anaemia and pregnant women. As an example, two of our recently completed studies are “The post-discharge malaria chemoprevention in children with severe anaemia [https://pubmed.ncbi.nlm.nih.gov/33264546/] and Malaria chemoprevention in children with sickle cell anaemia [https://pubmed.ncbi.nlm.nih.gov/39718172/]”.

With support from the UK Research and Innovation (UKRI) body, the consortium is expanding these studies to children with severe acute malnutrition, by conducting a large multi-centre randomized controlled trial entitled “Chemoprevention of malaria in the postdischarge management of children with severe acute malnutrition in Malawi and Uganda”.

In Uganda, the study will be conducted at one or two of their study sites in Jinja Regional Referral Hospital, Hoima Regional Referral Hospital or Kitgum General Hospital. Makerere University College of Health Sciences (MakCHS) and Uganda and Global Health Uganda (GHU) seek to appoint a full-time PhD Fellow, on this study. This will be a 4-year post, tenured at Makerere University and hosted at MakCHS.

Expectations of the PhD fellowship:

The PhD fellow will:

  • Be a part of the main trial team, and participate fully in its implementation. However, he/she will be expected to design and develop his/her PhD research project, nested in the main trial.
  • The area of study will be around “interactions between anaemia and severe acute malnutrition (SAM) in children or the interactions between malaria and severe acute malnutrition in children”.
  • Conduct rigorous research, leading to high quality scientific publications.
  • Submit a full research concept and obtain registration in the University by end of year-one. As such, there be an initial appointment for one year, renewable upon satisfactory performance.
  • Academic mentorship and supervision will be provided by the research consortium (see above – composed of national and international researchers).
  • Doctoral scholarly support and training environment, as well as didactic training in research methods and scientific writing skills will be provided by Makerere University.
  • The funding support will cover tuition and a competitive monthly stipend for 4 years, scientific conferences fees/travel and other research-related costs.

Prospective candidates must:

  • Hold Master’s of Medicine in Paediatrics and Child Health from a recognized university, and licensed to practice medicine in Uganda by the UMDPC.
  • Possess undergraduate training in Medicine and Surgery (MBChB/MBBS/MD).
  • Willingness to fully commit time and effort to their PhD studies, expected to start immediately
  • Candidate should not hold other/concurrent fellowships
  • Having publication experience will be an added advantage.
  • Be highly motivated and willing to commit to a career in research and academia.

Application procedure:

Interested applicants should submit their application and supportive documents – listed here below, in one PDF document, in an email titled “PDMC-SAM–PhD Fellowship Application” to hr@globalhealthuganda.org [and cc – chdc.desk@mak.ac.ug] by 25th July 2025. The documents should include the following:

  • An application letter (Max. 1 page)
  • Motivation statement (Max. 500 words)
  • CV (Max. 2 pages), including a list of publications
  • Two (2) recommendation letters
  • Academic transcripts and certificates for all university qualifications
  • A synopsis focusing on the proposed PhD research work, describing briefly what is already known/burden, challenges, the gaps and potential interventions (include references) [Max. 800 words].

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Makerere Hailed for Its Leadership in Health Policy and Knowledge Systems

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Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.

KAMPALA, July 9, 2025Makerere University has been hailed as a continental and global leader in health policy and systems research. This recognition came during the Partnerships for Stronger Knowledge Systems in Africa (KNOSA) Learning Forum, held July 8–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research.

Delegates from Uganda, Kenya, Ethiopia, and Somalia applauded Makerere’s role in advancing evidence-informed policymaking and strengthening national knowledge systems. The forum highlighted the institution’s trusted leadership, practical research, and commitment to driving real change.

Dr. Kumanan Rasanathan, Executive Director of the WHO Alliance, praised Makerere’s long-standing role in bridging research and policy:

“You are a shining beacon on the continent and for the world,” he said. “In this moment of crisis, where every health investment must be efficient and equitable, Makerere’s leadership matters more than ever.”

He emphasized the Alliance’s 25-year partnership with Makerere: “We know Makerere University very well. My predecessors have worked with the Alliance since its inception in the 1990s. Makerere has been especially instrumental in advancing the field of health policy and systems.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Dr. Kumanan Rasanathan, Executive Director of the WHO Alliance speaking at the KNOSA East Africa Learning Forum hosted by Makerere University in Kampala, Uganda.

Dr. Rasanathan called for a move away from siloed approaches toward more adaptive, coherent systems. He reaffirmed WHO’s commitment to supporting regional initiatives like KNOSA that are driving this shift across Africa.

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
The Vice Chancellor, Makerere University Professor Barnabas Nawangwe chats with H.E Rt. Hon. Kenneth M. Lusaka, EGH Governor Bungoma County, Kenya during the KNOSA East Africa Learning Forum at Makerere University in Kampala, Uganda on Wednesday, July 10, 2025.

In the face of current funding cuts, Dr. Christine Musanhu of the WHO Uganda Country Office echoed these sentiments with a stern call to action: “In times of uncertainty, we need national systems that not only generate evidence but also understand and communicate it in ways that drive real change.”

She warned of tightening budgets, citing an 11% cut (roughly $67 million) in global funding for Uganda’s public health programs. “We are being asked to do more with less,” she said, urging countries to reprogram resources towards high-impact, evidence-based interventions.
Adding that, “Evidence must go beyond routine data—it is a measure of transformation.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Dr. Christine Musanhu of the WHO Uganda Country Office encouraged participants attending the KNOSA East Africa Learning Forum at Makerere University in Kampala, Uganda to leave with shared purpose and concrete steps to advance the use of evidence for healthier communities.

This year’s KNOSA forum focused on sharing country-level progress, refining evaluation approaches, enhancing communication products, including scientific publications, and engaging more deliberately with Uganda’s wider policy and research ecosystem.

Makerere University Vice Chancellor Prof. Barnabas Nawangwe, while sharing the institutional vision, called for African universities to lead from the front in addressing health and development challenges: “We can do all the research in the world, but unless it moves beyond our laptops and lecture rooms into real decision-making spaces, it won’t change lives.”

He noted that Makerere contributes over 80% of Uganda’s academic output and praised MakSPH and the College of Health Sciences (MakCHS) for innovations that have shaped responses to HIV, Ebola, and COVID-19. “Our work, backed by partnerships with government and global collaborators, is proof that African universities must lead from the front.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Makerere University Vice Chancellor, Prof. Barnabas Nawangwe, applauds country teams and university partners during the KNOSA Learning Forum for their dedication to building a stronger, more resilient Africa. He emphasized the vital role of universities in low-income countries in driving socio-economic development.

Professor Nawangwe urged deeper collaboration within KNOSA: “Our continent is interconnected. We cannot afford to work in silos. We are stronger together.”

Dr. Aku Kwamie, the unit head at the WHO-Alliance, noted that there is a need for partners to shift their thinking regarding policy. She particularly shared three critical transitions to institutionalize evidence use: embedding knowledge within institutions, not just individuals; linking research directly to decision-making; and advancing from isolated academic work to system-level thinking. These shifts, she noted, are essential for embedding evidence into routine governance.

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Dr. Aku Kwamie, the unit head at the WHO-Alliance, during the the KNOSA East Africa Learning Forum hosted by Makerere University in Kampala, Uganda.

Professor Freddie Ssengooba, a Health Policy and Knowledge Systems expert at MakSPH, reaffirmed Makerere University’s regional leadership in the field and stressed the urgency for African countries to take full ownership of their health systems considering the shifting funding landscape:

“Health policy and knowledge systems research may not be as prominent as epidemiology or disease control,” he said, “but it’s central to how we harvest and connect knowledge with policy and resources. When the vaccine is here and the evidence is clear, that’s when they come to us, asking, “How do we achieve over 80% coverage?”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Professor Freddie Ssengooba, a Health Policy and Knowledge Systems expert at MakSPH speaking during the on-going KNOSA East Africa Learning Forum at Makerere University in Kampala, Uganda.

He praised KNOSA for helping elevate the field’s relevance: “There’s real appreciation for the work we do—not just with Uganda’s Ministry of Health, but across the region.”

Recalling the early collaboration with WHO, he said, “Back in 1997–98, a few of us, myself included, responded to an initial call and began what has now become a long-standing relationship with the WHO Alliance.”

“The Alliance is building capacity across Africa to ensure that research doesn’t stop at findings but goes on to shape decision-making and society,” he disclosed.

Professor Rhoda Wanyenze, the Dean of MakSPH, is currently ambitiously driving her colleagues, staff, and partners to embrace the culture of evidence use. She reiterated the School’s commitment to leading in evidence translation: “I’ve often told the Vice Chancellor—we at the School of Public Health are not in an ivory tower. We are deeply connected to real-world problems.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Professor Rhoda Wanyenze, Dean of Makerere University School of Public Health, delivers her remarks at the KNOSA East Africa Learning Forum in Kampala, Uganda. She highlighted the School’s deep engagement with policy and practice, noting that over 80% of staff serve on national, regional, or global technical committees—underscoring MakSPH’s commitment to producing grounded research that informs real-world solutions.

To her, the need for a clear framework to improve engagement with decision-makers and address uneven success in research translation has never been greater than now: “Yes, we publish in high-impact journals. But the question is, what change happened because of your evidence?”
“I would love to see the School lead in developing a framework that showcases what we’ve done well and identifies where we can grow.”

She also acknowledged Prof. Ssengooba’s influence in broadening the lens on knowledge management: “You’ve challenged us to think beyond institutions, to consider networks and systems. That’s a gap we must fill.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Participants of the KNOSA East Africa Learning Forum alongside members of the WHO Alliance for Health Policy and Systems Research in a group photo with Makerere University leadership at the Forum meeting in Kampala, Uganda.

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Davidson Ndyabahika

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