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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

Health

International Coordination Office Newsletter, Issue 1 Jan–Jun 2025

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Cover page of the Makerere University College of Health Sciences International Coordination Office Newsletter, Issue 1 (January–June 2025). Kampala Uganda, East Africa.

Dear Readers

We welcome you to our first edition of the international academic mobility newsletter from Makerere University College of Health Sciences. In this edition, we share the highlights of various academic mobility programs at MakCHS, experiences of several students and staff who have been able to travel, study and experience new cultures and skills aimed at increasing their competitiveness in the Global market. We also share challenges and improvements to improve student and staff academic mobility experiences.

Internationalization of higher education is defined by the OECD (1999) as the integration of an international/intercultural dimension into all the activities of a university, including teaching, research and service functions. This is in line with the Makerere University vision 2030 to become a research-led university. This cross-border movement of faculty in higher education has been attracting scholarly attention for decades since knowledge is borderless (Shen et al., 2022). Therefore, internationalization increases global higher education and impacts the world university rankings, with a goal of increasing international recruitment of the best and brightest students and scholars. These international academic mobilities offered at MakCHS involve a broad range of activities like attending conferences, visiting research partners abroad and longer stays in other countries for research purposes.

MakCHS has many academic partners with long-standing bilateral relations and agreements that go beyond academic mobility and thus has overtime developed procedures and quality control mechanisms to support academic mobility. The coordination of these academic mobilities is handled at the International Coordination Office. The office is also responsible for the administration and making sure that students and faculty have a memorable experience. It is also responsible for monitoring and reporting tasks and managing the organizational support and coordination, incoming participants’ comprehensive insurance coverage, registrations, social activities and guided city tours for incomings etc.

We look forward to learning with you, celebrating progress, and charting our next steps—together, as we build for the future.

Enjoy your reading

Dr. Mark Kaddumukasa
Associate Professor

PROGRAM DIRECTOR

View the newsletter using the link below:
ICO Newsletter 2025 Issue 1

Mak Editor

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IDI launches the Sewankambo Training Program for Global Health Security in Africa

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Prof. Sarah Ssali and Dr. Charles Olaro (Centre) with officials and fellows at the Infectious Diseases Institute (IDI) on 27th October 2025. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.

On 27th November 2025 the Makerere University Infectious Diseases Institute (IDI) unveiled the second cohort of fellows—marking a significant step forward in strengthening global health security across the region. The cohort brings together five exceptional emerging scientists whose research areas reflect the continent’s most urgent health priorities. They include Mr. Dickson Aruhomukama in Antimicrobial Resistance (AMR); Dr. Rodgers Ayebare in Case Management, Infection Prevention and Control; Mr. Julius Okwir in Epidemic Intelligence and Community Health; Dr. Robert Zavuga in Vaccines and Medical Counter Measures; and Ms. Phionah Tushabe in Planetary Health, Water, Sanitation and Hygiene (WASH). Their selection marks a new chapter in nurturing homegrown expertise capable of safeguarding Africa’s health systems for generations to come.

The Acting Vice Chancellor, Prof. Sarah Ssali while presiding over the event emphasized the significance of launching the Sewankambo Training Program for Global Health Security as a milestone not only for IDI but for Makerere University and the continent at large. She highlighted the urgency of strengthening Africa’s capacity to predict, prevent, and respond to emerging epidemics, noting the rapid rise in zoonotic disease outbreaks and the persistent weaknesses exposed by crises like Ebola and COVID-19. She celebrated the legacy of Prof. Nelson Sewankambo and the scholars shaped by his leadership, stressing that the program embodies the university’s commitment to producing transformative health leaders grounded in multidisciplinary expertise and One Health principles.

Prof. Sarah Ssali. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Prof. Sarah Ssali.

She also called for stronger collaboration across colleges—particularly with the College of Veterinary Medicine, Animal Resources and Biosecurity (CoVAB)’s Center for Biosecurity and the College of Health Sciences (CHS) to ensure that scarce scientific resources are fully utilized and that future health professionals are prepared for an evolving global landscape. In closing, she reaffirmed Makerere University’s dedication to advancing research excellence, nurturing responsible stewardship, and upholding the values that define the Sewankambo legacy.

Prof. Buyinza Mukadasi. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Prof. Buyinza Mukadasi.

The Academic Registrar Prof. Buyinza Mukadasi also conveyed his heartfelt congratulations to IDI and Prof. Nelson Sewankambo upon this remarkable milestone. He reflected on his recent engagements with the Institute—most notably the launch of the African Centre of Excellence in Bioinformatics—and expressed his admiration for the world-class research emerging from IDI, including publications in leading journals such as The Lancet and Nature. He noted that Makerere takes great pride in IDI’s work across multiple initiatives, from THRiVE to ongoing research collaborations, and wished the newly launched fellows a rewarding and impactful journey in research.

The Deputy Principal CHS, Prof. Richard Idro congratulated the new cohort and welcomed them into what he fondly referred to as “the cookhouse,” where future scientific leaders are shaped. Drawing from his own formative encounters with Prof. Nelson Sewankambo, he reflected on the deep mentorship culture that has defined generations of clinicians and researchers at Makerere—sharing stories of being challenged, supported, and pushed toward excellence. He reminded the fellows that their research will influence health policy and clinical practice far beyond individual patients, carrying long-term implications for national and global health.

Prof. Richard Idro. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Prof. Richard Idro.

Prof. Idro also acknowledged the critical challenges facing clinical disciplines, especially the constraints of promotion pathways that disadvantage highly skilled specialists without PhDs. He appealed for reforms to safeguard the future of key fields like anesthesia and surgery. Closing his remarks, he celebrated the College’s 100-year legacy, expressed gratitude for the university’s continued support, and invited alumni and partners to contribute ideas that will shape the next century of innovation, training, and service.

Dr. Charles Olaro, the Director General of Health Services, highlighted the essential role of academia in strengthening Uganda’s global health security, noting how recent outbreaks—from COVID-19 to Ebola—have revealed both the country’s progress and remaining gaps. He emphasized that programs like the Sewankambo Training Program are vital for building resilient health systems, advancing research, and shaping policies that can respond swiftly and effectively to public health threats.

Dr. Charles Olaro. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Dr. Charles Olaro.

Reflecting on the strong collaboration between the Ministry of Health and institutions such as Makerere University and IDI, he pointed out how research emerging from academia continually informs national policy, including work presented at recent conferences on non-communicable diseases and community health. Dr. Olaro congratulated the new cohort, reminding them that their work carries significant responsibility, as their research and leadership will influence health outcomes far beyond individual clinical care. He also underscored the need for stronger regional capacity, improved emergency response systems, and sustained mentorship to ensure that communities across Uganda—and the region—benefit from timely, coordinated outbreak preparedness.

In his address, Prof. Nelson Sewankambo commended the achievements of the first cohort and challenged the new fellows to uphold—and even surpass—the high standards already set. Reflecting on the rigorous selection process, he reminded the cohort that they were chosen because they demonstrated exceptional promise in a highly competitive field. He noted that the launch of this program comes at a particularly critical moment, as Africa CDC has just established a new Division for Health Security and Sovereignty, even as global financing for health research continues to decline. This, he said, makes the commitment to sustaining the program both bold and necessary.

Prof. Nelson Sewankambo. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Prof. Nelson Sewankambo.

Prof. Sewankambo also addressed concerns about the future of clinical scholars at Makerere, arguing that rigid promotion policies risk driving away talented specialists who are vital to the university’s mission. Emphasizing that “it is wise people who change direction when it is necessary,” he urged university leadership to protect pathways that allow clinicians to grow, serve, and undertake PhDs without being pushed out of the system. His message underscored both the responsibility carried by the new fellows and the collective duty to safeguard the future of medical education and research.

Dr. Andrew Kambugu, Executive Director (ED) of IDI, warmly welcomed all guests and reflected on the Institute’s long-standing culture of adaptation and innovation in response to Africa’s evolving health challenges. He celebrated the presence of Prof. Nelson Sewankambo—honoring his legacy as a founder, mentor, and active research collaborator—and acknowledged the strength of Cohort One as a living example of what the program can produce.

Dr. Andrew Kambugu. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Dr. Andrew Kambugu.

The ED emphasized that the Sewankambo Program stands on three pillars: rigorous selection, structured support with clear accountability, and strong alignment with national health priorities. He reminded the new fellows that IDI itself was born from the principle “adapt or perish,” and urged them to carry forward that spirit as they confront emerging threats like antimicrobial resistance and disease outbreaks across the continent. He also reflected on the power of mentorship, sharing personal experiences that illustrated how deeply mentorship can shape a scientific career. In closing, he expressed confidence that the five new fellows will honor the name they bear and continue building a legacy that inspires future generations.

Prof. Harriet Mayanja-Kizza reminded the newly selected fellows that while this achievement is significant, it marks only the beginning of a demanding but deeply meaningful journey. She expressed pride in the diversity of the cohort—drawn from ten African countries—and noted with delight that one of the brightest candidates emerged from the smallest country represented.

Prof. Harriet Mayanja-Kizza. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Prof. Harriet Mayanja-Kizza.

Reflecting on the evolution of impactful careers, she encouraged young people to embrace emerging fields such as bioinformatics, biotechnology, AI, molecular biology, and biostatistics, which she believes will define the future of science and global health. Prof. Mayanja spoke passionately about the diseases the fellows will tackle, highlighting the severe threat of antimicrobial resistance, the persistent burden of malaria, the dangers of resurfacing viral infections, and the transformative power of immunization. She urged the fellows to stay grounded, stay committed, and embrace the modern, data-driven tools now shaping global health research. In closing, she celebrated their potential to make a global impact and welcomed them formally into a field where their work will shape healthier futures for generations to come.

Prof. Ponsiano Ochama, one of the pioneers from the first cohort, reflected on the journey of the Sewankambo clinical scholarship from its early days in the “cookhouse” to the strong, structured program it has become. He recounted how the scholarship began as a mentorship-driven initiative aimed at nurturing future researchers and how sustained advocacy eventually removed barriers that once limited clinical scholars’ progression.

Prof. Ponsiano Ochama. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Prof. Ponsiano Ochama.

Prof. Ochama shared the impactful work he and his colleagues have since undertaken—highlighting, for example, a national study on hepatitis B mother-to-child transmission that shaped recent Ministry of Health policy. He encouraged the incoming cohort to embrace the program fully, assuring them that the “cookhouse” experience will transform them into strong, skilled scientists whose work will influence health policy and improve lives across the country.

Dr. Byonanebye Dathan, Deputy Head of the Global Health Security Department, outlined the strong rationale behind the Sewankambo Global Health Security Program, noting Africa’s rising burden of zoonotic and viral hemorrhagic fevers and the continent’s limited capacity for early detection and response. He emphasized that despite competing health priorities—HIV, TB, malaria, maternal health—there remain significant gaps in surveillance systems, workforce capacity, and research preparedness.

Dr. Byonanebye Dathan. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Dr. Byonanebye Dathan.

The program, he said, is designed to fill these gaps by strengthening research training, developing a skilled outbreak response workforce, and building a network of experts across Africa capable of generating evidence that directly informs policy and improves health systems. Dr. Dathan highlighted the rigorous selection process, the program’s alignment with WHO and national public health frameworks, and its integration of emerging technologies such as AI and machine learning. He affirmed that the fellows will receive structured mentorship, leadership development, and hands-on experience using existing data and real-world outbreak response systems—ensuring that their work leads not only to publications, but to meaningful impact across the continent.

Dr. Francis Kakooza, Acting Head of Global Health Security, traced the remarkable evolution of IDI’s Global Health Security work over the past decade, from its early CDC-funded surveillance efforts in 2015 to its expansion into biosecurity, AMR, epidemic research, policy development, and regional outbreak support. He highlighted IDI’s role in major national initiatives—including COVID-19 response, vaccination rollouts, risk management, lab accreditation, and the establishment of Regional Emergency Operations Centers—as well as its growing continental footprint through partnerships with Africa CDC, Mastercard Foundation, and Resolve to Save Lives.

Dr. Francis Kakooza (Centre) joins officials in cutting cake to celebrate the launch. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Dr. Francis Kakooza (Centre) joins officials in cutting cake to celebrate the launch.

Dr. Kakooza emphasized that the launch of the Prof. Nelson Sewankambo Global Health Security PhD Program is the culmination of years of investment in strengthening African research capacity and supporting fellows whose work is already shaping policy. He expressed gratitude to all partners, mentors, and leaders who contributed to the program’s development, acknowledged the rigorous selection that yielded five fellows from ten countries, and reaffirmed IDI’s commitment to nurturing a new generation of scientists equipped to protect the continent from infectious disease threats.

Cohort 2 PhD fellows cut cake as officials applaud. Makerere University Infectious Diseases Institute (IDI) unveils second cohort of PhD Fellows and launch of Sewankambo Training Program for Global Health Security, 27th November 2025, Makerere University, Kampala Uganda, East Africa.
Cohort 2 PhD fellows cut cake as officials applaud.

Eve Nakyanzi

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Sanger Prize 2026: Call for Applications Open

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Sanger Prize 2026: Call for Applications Open. Photo: Wellcome Sanger Institute.

The Sanger Prize 2026 is now open for applications, and will be until the 9th January 2026. Further details and a link to the application form can be found here: https://www.sanger.ac.uk/about/study/the-sanger-prize-competition-2026/

The main Sanger Prize page has been updated with additional information and testimonials from previous winners, please do take a look at it here:  https://www.sanger.ac.uk/about/study/the-sanger-prize/

The Sanger Prize presents a wonderful opportunity for genomics students in low and middle income countries, therefore the prize administrators are keen for the application information to reach as many eligible people as possible. 

Mak Editor

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