Health
Ugandan Legislators applaud MakSPH for Road Safety & Injuries Research
Published
4 years agoon

Members of Parliament under the Parliamentary Forum on Road Safety (PAFROS) have commended research efforts by the Makerere University School of Public Health’s Trauma and Disability Unit (TRIAD) for its leadership in injury and prevention research. The legislators signed a commitment to support all efforts aimed at improving road safety in Uganda.
The legislators said this while at an engagement meeting with researchers at MakSPH that took place on Thursday 17th February 2022 at Sheraton Hotel. In a well-attended session, the research team shared evidence from a number of publications that have influenced policy, and over 10-11 years, and the several achievements the School has achieved in collaboration with partners both national and international.

The 2014 WHO Global Health Estimates show high burden of injuries with over five million people dying of injuries every year. Mr. Frederick Oporia, a PhD fellow says nearly every six seconds, someone dies from an injury leaving over 50 million people with disabilities.
Despite this, there is insufficient research capacity to drive prevention and management of these injuries which makes multidisciplinary approach in handling multidisciplinary nature of injuries.

TRIAD’s main objective is to contribute to the reduction of injury burden in Uganda by strengthening research capacity on injuries and their medical, social and economic consequences both at Individual, community and National level.
There are various kinds of injuries that range from being intentional and non-intentional. Some of these include violence, burns, poisoning, drowning, falls and road traffic crashes. In all these injuries, road traffic contributes the highest burden 24% hence a big problem.
Currently, TRIAD focuses on mobility, Road Traffic Injury prevention, drowning prevention, childhood injury prevention and emergency Trauma Care and emergency medical services.
“When we compare HIV, tuberculosis and Malaria rates, we see that injuries alone almost double what these other Disease claim and it’s a problem we need to tackle,” says Oporia.
Goal 3 of the Sustainable Development Goals (SDGs) seeks to ensure health and well-being for all, at every stage of life. Equally so, the UN Decade of Action included road safety in the framework of Sustainable Development Goals with an ambition to halve road traffic deaths and injuries by 2020.
The 2011-2020 decade of action for road safety was premised on five pillars that included road safety management, safer roads and mobility, safer vehicles, safer road users, and post-crash response.
However, trends analysis in the Uganda Police Reports show that Uganda instead increased road traffic crashes. The SDG Goal 11 that commits UN member States to make cities and human settlements inclusive, safe, resilient and sustainable ambitiously states that by 2030, the member states should be able to provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons.

The Road safety performance review report of 2018 show that Uganda’s road safety management is managed in the Ministry of Works and Transport under the Directorate of Road Transport. Some of the road transport legislations include, the Traffic and Road Safety Act (Amended) 2020, the Uganda National Roads Authority Act, 2006, the Uganda Road Fund Act, 2008, the National Road Safety Policy, 2014 and the Non-Motorized Transport policy, 2012.

Speaking to the legislators, Esther Bayiga Zziwa, a PhD fellow at MakSPH’s TRIAD unit says however that Uganda has legislative gaps in majority of the risk factors for instance, while Uganda has national drink-driving law in place, and drink – driving based on Blood Alcohol Content (BAC) or equivalent breath alcohol concentration (BrAC), the BAC limit for the general population is way higher than the global standard. The global standard is at below 5 gram per blood liter. However, in Uganda, the law puts it at 7 gram per blood liter which is high. Ms. Bayiga says there is a need to handle this back to the global level.
Uganda has a national motorcycle helmet law in place which applies to motorcycle drivers and adult passengers and to all road types an engine type. However, the law does not require helmets to be properly fastened as well as meet the national and or international standards.
“Helmets standards for motorcyclists put up by Uganda National Bureau of Standards (UNBS) need to make sure that those ones on market meet the standards and if you are found wearing a fake helmet, you are not better off than one not wearing any because in case of a crash, it will damage your head instead of protecting it, and people need to fasten their Helmets for better effectiveness,” says Bayiga.
Research on road safety has found that behaviour interventions area not as effective as environmental, legislative and enforcement actions. Bayiga says the Behavioural component alone cannot be effective. She recommends a multipronged approach that includes bbehavioural, environmental modification, enforcement and legislation in road safety regulation.
Uganda lacks a national child restraint law based on age, weight, height or a combination of these factors that would restrict children under a certain age-height from sitting in the front seat.
“In Uganda, even here in Kampala, those who can afford cars do not buy child safety seats for their babies and the children are carried by other adults and do not have a seat on their own. However, in case of a clash, those are the first ones that fall off the car because of their body mass and can’t survive with the normal seat,” Bayiga says.

According to Bayiga, other countries have the regulations but; “Our law does not take account any with regarding children, and probably some people think cannot afford, but this can not be compared to the lives and value of children, they too need safe seat because every life matters and a law should be put in place to address this.”
Hon. Linda Irene Mugisa, the Fort portal City Woman MP and member of the Road Safety Forum acknowledges the role of legislators to make laws and policies that would protect Ugandans.

“We have a big role of sensitizing the masses. Right now, we have very many youths who are earning income through riding boda-bodas. And the unfortunate part of this is that most of these youths have not gone through training and most of them are riding illegally because some cannot afford the driving permits. As members of parliament we feel we should advocate for the reduction in the amount of money a rider requires in order to acquire a driving permit,” says Hon. Linda.
Juliet Bashiisha Agasha, the Woman MP for Mitooma District said she was impressed by the dialogue and was excited to learn that indeed, the Trauma, Injury and Disability Unit at Makerere University School of Public Health was the only unit in Uganda that focuses on research of injury and prevention.

According to Hon. Agasha, there are many unqualified drivers on Uganda’s road who commit a lot of traffic offenses and sometimes walk away without punishment due to lack of monitoring systems. She also says most drivers lack good training and that some simply acquire driving permits without ever going to the driving schools.
“If we can have the measures that can monitor whoever makes a mistake, and then they charge accordingly, I know as Ugandans, we fear fines very much. The moment they fine you today, I don’t think tomorrow you can repeat the same mistake,” says Hon. Agasha.
She advocates for more cameras to track traffic crimes in order to improve road safety. “In fact, you find someone who is driving without a seatbelt and when he senses a traffic person, that is when he remembers that seatbelts are supposed to be used. So there is a lot of effort that we have to put in in order to reduce on road accidents especially on these motorcycles. You find a big group of motorcycles driving when there are red lights and they don’t mind whether there is red or green for them they keep moving. But if they can be controlled or sensitized about dangers of a vehicle that coming from a different direction, I believe we can reduce on the road accidents,” says Hon. Agasha.
The MP for Iki-Iki County in Budaka district, Robert Kasolo agrees that using technology in enforcement of traffic order is the way to go. He expresses concern that cameras in Uganda are largely not for road traffic law enforcement but for security reasons. “But I think that would be the ideal situation. In developed countries, cameras are part of the gadgets for enforcing traffic laws. We need to move in that direction. Policemen cannot be everywhere. But a camera can record a wider area and can be a source of evidence,” says Hon. Kasolo, who also doubles as Vice Chairperson of the Physical Infrastructure Committee of Parliament.

Tonny Ayo, the Member of Parliament for Kwania County, and Vice chairperson Parliamentary committee on Road Safety wants the Uganda Police Traffic department to begin to use the cameras both within the cities and high ways to bring drivers to book.
“One of our concerns of ensuring that people follow the traffic regulations and laws is that government put in place the cameras on streets and highways and we have spent money on this and the purpose was not only to deal with crime and terrorism but one of them was enforcement of traffic rules and regulations which unfortunately as a Forum as parliament and a public are wondering why government cannot come up to enforce this,” says Hon. Ayo.

He opines that; “When you drive along highways and roads within Kampala, the reckless driving of high speed, the bad overtaking, we expected that cameras could take stock of what is happening. We are calling on government to move in to ask police to begin to use these cameras to enforce the laws.”
According to Hon. Ayo, using video and pictorial evidence from the cameras, government will go a long way in collecting huge non-tax revenue through fines of traffic offenders.
“If we do this consistently for 6 months, then we are going to see discipline by the motorist in in this country and I think by the decade plan of action we were supposed to have reduced road crashes and injuries in the country by half by 2020. Now we are in 2022, and instead of reducing, the crashes and injuries have increased. That means now we need to act because we have noticed that sensitization and talking to people,” says Hon. Ayo.
Dr. Olive Chifefe Kobusingye, an accident & emergency surgeon, injury epidemiologist at MakSPH says TRIAD’s biggest concern is road safety and accessible for all road users. She ads that this can be achieved through good road designs.
“Designing for all road users not just for motorists. Making sure that there is space to accommodate pedestrians, cyclists, motorcyclists and accommodate those that are using wheel chairs for instance and to pay attention to the size of the population so that we in the design cater for heavy pedestrian presence, those spaces are adequate for them,” says Dr. Kobusingye.

In addition to the design, Dr. Kobusingye also agrees with the legislators on the need to increase enforcement of traffic regulations in Uganda to ensure road safety.
“There are areas where we need to enforce for instance where there is limited access to motorized traffic. These are all provided for in the non-motorized transport policy. So, the implementation of that policy is key to ensuring that transportation is safe, its accessible, its affordable and that its equitable that we do not prioritize certain types of road users over others,” Dr. Kobusingye observes.

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Health
Holistic Retirement Planning includes Psychological, Emotional & Social well-being across all Career Stages
Published
1 week agoon
January 12, 2026By
Mak Editor
The Makerere University Retirement Benefits Scheme (MURBS) on Thursday, 8 January 2026 organised a Member Sensitisation Session on “Understanding Identity Shifts; Developing Routines; Sustaining Motivation and Purpose”. The session focused on holistic retirement planning, emphasising that readiness for life after work goes beyond finances to include psychological, emotional, and social well-being across all career stages—from early career to post-retirement.
The session featured a keynote presentation by Professor Seggane Musisi, who highlighted how work-related titles and roles often shape personal identity, and how retirement can trigger a sense of loss if individuals are unprepared to redefine themselves. Members were encouraged to consciously design a post-work identity grounded in values, purpose, and community contribution.
Participants learned practical strategies for:
- Preparing early for retirement at different career stages;
- Developing healthy, meaningful routines that support mental stability and productivity;
- Sustaining motivation and purpose beyond formal employment;
- Managing stress, maintaining physical and mental health, and nurturing social connections; and
- Balancing family responsibilities with personal well-being.
The discussion also addressed cultural realities of retirement in Uganda, including family expectations, social obligations, and financial pressures. Special attention was given to age-related challenges such as dementia, depression, and chronic illness, underscoring the importance of preventive health care, emotional resilience, and timely professional support.
Overall, the session reinforced the message that retirement is a lifelong transition, not a one-time event. Members were encouraged to plan early, adapt continuously, and intentionally design a fulfilling, purposeful life beyond work—psychologically, socially, and financially.
To view the session, please click the embedded video below. Further below is the presentation.
Health
Kampala at a Crossroads: What New Research Reveals About Mobility, Governance, and the City’s Public Health Risks
Published
2 weeks agoon
January 8, 2026
Every day in Kampala, millions of people inch through gridlock, dodge swarming boda-bodas threading through narrow gaps in traffic, inhale dangerously polluted air, and walk along streets rarely designed for pedestrians. These conditions, and more, are often dismissed as ordinary transport frustrations. Yet researchers at Makerere University School of Public Health (MakSPH) are examining how such everyday realities translate into public health outcomes, shaped not simply by congestion, but by governance, policy, and power. Their work forms part of a multi-country project investigating the political economy of urban mobility in three African cities.

Co-led by Dr. Aloysius Ssennyonjo, the Principal Investigator and health systems and governance researcher at MakSPH, together with Uganda’s Country Principal Investigator, Dr. Esther Bayiga-Zziwa, a road safety and injury epidemiologist, and Co-Principal Investigator Dr. Jimmy Osuret, an injury prevention researcher, the project titled The Political Economy of Urban Mobility Policies and Their Health Implications in African Cities (PUMA) applies a political economy lens to understand how political interests, institutional arrangements, and power dynamics shape mobility systems and their consequences for public health in Kampala, Kigali, and Lilongwe.
To note, political economy analysis examines how public decisions are shaped by the interplay of politics, interests, institutions, and resources, in short, who has influence, who controls what, and how money and power circulate within a system. In Kampala, a capital of nearly two million residents whose daytime population swells with commuters, this lens helps explain why some transport options attract funding and enforcement while others are tolerated, neglected, or contested. These choices are not just technical, but reflect competing interests and priorities, with consequences for safety, equity, and the everyday well-being of those moving through the city.

Now, through the NIHR-funded project, the Ugandan team is currently working with colleagues from the University of Rwanda, led by Professor David Tumusiime, and Kamuzu University of Health Sciences in Malawi, led by Dr. Dominic Nkhoma. The research partnership aims to generate evidence that can strengthen mobility governance and improve public health outcomes across the three African cities above, with advisory support for the research consortium from the University of Antwerp in Belgium and Canterbury Christ Church University in the UK.
Explaining the project’s rationale for the Politics of Urban Mobility, or PUMA, during the 2025 Universal Health Coverage Day webinar held on December 12 under the theme “Mobility, Costs, and Politics: How Urban Systems Shape Access and Progress Towards Universal Health Coverage in African Cities,” Principal Investigator Dr. Ssennyonjo said Africa is urbanising at an unprecedented pace. Projections show that by 2050, nearly 60% of the continent’s population will live in cities, a shift that is intensifying transport pressures and increasingly turning everyday mobility into a public health risk.

“Rapid urbanisation has created multiple challenges: transport systems are under strain, risks and vulnerabilities are rising, and opportunities for healthy behaviours such as walking are often limited. Access to livelihoods is also affected, with broad implications for health,” Ssennyonjo noted, adding: “Crucially, these issues are shaped by political and governance dynamics, yet few initiatives explicitly address them. This gap motivated our focus on the politics and governance of urban mobility.”

He mentioned that health outcomes are shaped by social, economic, and environmental factors, with transport costs, risks, and stress often posing greater barriers than medical fees alone to achieving affordable health for all. He noted that the PUMA project brings together multidisciplinary teams to study how governance and political dynamics shape urban mobility, public health, and development, a perspective reflected in Prof. Julius Kiiza’s observation that effective urban development relies on coordinated action by diverse stakeholders across sectors to improve health outcomes, though emphasising the primacy of politics.
“Uganda and Singapore had comparable levels of underdevelopment in the 1960s. Under Lee Kuan Yew, Singapore embarked on a deliberate nation-building project. Today, it is among the smartest cities globally, outperforming many Western cities in clean government, mobility, and liveability. Why are we lagging behind? The answer, I argue, lies largely in the nature of our politics,” Prof. Julius Kiiza cogently argued.
He intimated that the result has been cities that are “unreliable, unsafe, unsmart, and chaotic,” noting that claims of inclusive urban development often ring hollow. “I have argued, and repeat here, that boda bodas as a symbol of inclusivity represent a false model of inclusion. We must interrogate this and invest in better urban transport systems and wider, well-planned highways,” he affirmed.

Prof. Kiiza urged policymakers and practitioners to move beyond piecemeal technical fixes and instead treat urban mobility as a governance challenge requiring coordinated, cross-sector action. He stressed the importance of aligning transport planning with public health, housing, employment, and skills development, arguing that safer, more liveable cities depend on institutions that work together and are accountable to the public. Such reforms, he noted, demand sustained political commitment and inclusive dialogue across government, academia, civil society, and the private sector, precisely the terrain the PUMA project is engaging, by convening stakeholders and shaping a shared research agenda around Uganda and the continent’s urban mobility challenge.

Indeed, on November 21, 2025, the Ugandan team convened a national stakeholder workshop in Kampala, bringing together a wide range of stakeholders. Opening the workshop, Assoc. Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management (HPPM) at MakSPH, commended the team for highlighting what she described as a long-underexplored dimension of Uganda’s urban health landscape: mobility and its governance.
Reflecting on her own experience, she noted how boda-bodas have become increasingly indispensable for millions seeking quick, flexible transport, but also carry complex health, safety, and economic implications that demand multisectoral attention, calling for a balanced, evidence-driven dialogue that recognises their value while also addressing the infrastructural and policy gaps that shape mobility systems in Uganda’s rapidly growing cities.
“I sometimes use boda-bodas,” Assoc. Prof. Suzanne Kiwanuka said. “They are necessary when you need to move quickly during heavy traffic. Yet we all know how unsafe they can be. This PUMA initiative is timely to generate evidence not only on the politics of urban mobility and its health implications, but also its economic consequences.”

Notably, road traffic crashes remain one of Uganda’s most urgent public health threats today. The recent Uganda Police Force Annual Crime Report 2024 recorded 5,144 road deaths, a seven per cent rise from 2023, with motorcyclists accounting for nearly half of all fatalities. In Kampala, pedestrians, cyclists, and motorcycle riders constitute 94 per cent of all fatal crashes, according to the Kampala Capital City Authority. Thousands more suffer life-altering injuries each year.
Still, evidence from MakSPH, through its Centre for Trauma, Injury and Disability Prevention (C-TRIAD) and the Johns Hopkins International Injury Research Unit (JH-IIRU) under the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS), shows that the design and use of city roads are worsening the risk environment. Between 2021 and 2023, the team conducted more than one million roadside observations across Kampala, finding that while only five per cent of vehicles are officially recorded as speeding, those that do travel at an average of 57 km/h, well above safe limits for dense urban corridors, making city roads increasingly unsafe.

The World Health Organization (WHO) guidelines, cited in the report, recommend speed limits of 30 km/h on community roads and in urban areas where pedestrians, cyclists, and other vulnerable road users share space with motorised traffic, and 50 km/h on major urban roads. Yet the findings show that six in ten vehicles on community roads exceed these limits, heightening risks for those least protected and underscoring the need for lower-speed zones, traffic-calming measures such as speed humps and raised crossings, and consistent enforcement of traffic regulations.
For the PUMA team in Uganda, the writing on the wall shows that these rising injuries coincide with worsening congestion and rapid urbanisation, yet city mobility policies within Kampala remain heavily oriented toward road expansion and vehicular flow, with limited attention to safety, health protection, or non-motorised transport. This policy imbalance, then, explains why daily commuting remains hazardous and why progress on safer streets has been slow.

The study uses a three-tiered approach that combines policy analysis, regional evidence, and local experiences to examine how mobility decisions are made in Kampala, Kigali, and Lilongwe, who holds authority, and how these processes affect public health and equity. This is strengthened by structured co-creation workshops with practitioners, policymakers, and community actors, which reveal how governance functions in practice, often diverging from what is written on paper.
In parallel, the research team is conducting a continent-wide review of academic and grey literature to map regional trends, gaps, and the broader forces shaping African mobility systems. Together, these streams enable the researchers to compare cities, identify shared challenges, and build a grounded analytical framework for improving mobility governance across Africa.
In Kampala, preliminary findings by the MakSPH PUMA research team show a city governed by many mobility policies but marked by weak mobility governance. The team shared that Kampala operates under a dense mix of frameworks, from the National Integrated Transport Master Plan and National Urban Policy to road safety, climate, and KCCA development plans. While these documents acknowledge congestion, urbanisation, and road injury risks, they also reveal overlapping mandates, blurred institutional roles, and limited coordination authority.

Key government Ministries, Departments, and Agencies (MDAs) actors include the Ministry of Works and Transport, KCCA, the Ministry of Lands, the Office of the Prime Minister, and the Ministry of Finance, with the Ministry of Health conspicuously absent despite clear health implications. Policy attention, according to the early findings, remains heavily skewed toward road transport, leaving non-motorised mobility and major health pathways, noise exposure, psychosocial stress, community severance, heat, and mobility independence largely unaddressed.
Governance realities are further shaped by political processes, including electoral cycles, informal negotiations with transport unions, selective regulation of boda-bodas, and heavy reliance on development partners that often influence what is prioritised and implemented. Together, these dynamics help explain stalled master plans, inconsistent enforcement, and resistance to progressive interventions. While the PUMA research remains at a preliminary stage currently, the emerging findings underscore the need for an integrated, multisectoral mobility agenda that places health at the centre of Kampala’s transport policy and practice.

Health
How People Earn a Living is Contributing to Malaria Risk in Uganda, Study Finds
Published
2 weeks agoon
January 5, 2026
Livelihood activities such as farming, livestock keeping, construction, and night-time work significantly increase malaria risk in Uganda, according to new research by Dr Kevin Deane, a development economist at The Open University, UK, and Dr Edwinah Atusingwize and Dr David Musoke, a Research Associate and Associate Professor of Environmental Health at Makerere University School of Public Health, respectively.
The study, Livelihoods as a key social determinant of malaria: Qualitative evidence from Uganda, published on December 2, 2025, in the journal Global Public Health, examines how everyday economic activities shape exposure to malaria, often undermining conventional prevention measures such as insecticide-treated nets and indoor residual spraying. The findings are based on qualitative fieldwork conducted in June 2024 in Busiro County, Wakiso District, a peri-urban area with persistently high malaria transmission in Uganda.
Using a qualitative design, the researchers conducted 14 key informant interviews, 10 focus group discussions, and 11 in-depth interviews with households recently affected by malaria, engaging 100 participants from communities, health services, local government, and civil society across Kajjansi, Kasanje, and Katabi Town Councils, as well as Bussi Sub-County, in Busiro South. Their analysis, guided by the Dahlgren–Whitehead social determinants of health model, enabled the researchers to situate malaria risk within the broader social, economic, and environmental conditions shaping how people live and work.

In their findings, participants linked malaria exposure to agricultural practices, among which is maize cultivation near homes, which was associated with increased mosquito density during the rainy season. “One of the most common crops cultivated in Uganda, which many rely on as staple foods, creates environments in which mosquitoes are attracted to and thrive, often in settings where maize is grown near homes in rural areas and urban areas. This increases mosquito density around homes and contributes to increased outdoor biting and the number of mosquitoes entering houses,” the study argues.
Its authors say this poses a difficult policy challenge because maize is central to household food security, leaving few practical options for reducing exposure. They argue that proposals to keep maize away from homes are often unrealistic for families with limited land or those farming in urban areas, while targeted control during flowering periods may have limited impact given mosquitoes’ ability to travel beyond cultivation sites.

Beyond crop farming, the study reports that livestock rearing, especially zero-grazing cattle kept close to houses, attracts mosquitoes into household compounds. Other livelihood activities, including construction and brick-making, created stagnant water-filled pits that served as breeding sites, while night-time livelihoods, such as street vending, guarding, fishing, bar work, and brick burning, among others, prolonged outdoor exposure during peak mosquito biting hours. Gender further shaped risk, with women’s livelihoods and caregiving responsibilities frequently exposing young children alongside them.
“The evidence we present illustrates the unintended health consequences of development strategies intended to promote key livelihood activities, food security, and poverty reduction. There are no straightforward solutions given the complexity of these relationships and the importance of these livelihoods for many households,” the authors assert.
They conclude that malaria elimination efforts will fall short unless livelihoods and development activities are explicitly integrated into malaria prevention strategies, calling for stronger alignment between public health, agriculture, urban development, and economic policy.
Please see below for the study:
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