Health
Uganda’s Ministry of Health Embraces Family Planning Data, PMA Data to Influence Policy
Kampala, Uganda, Feb. 16, 2022 (MakSPH) – Commissioners at Ministry of Health in Uganda have applauded the Performance Monitory for Action -PMA Uganda project for its robust research in family planning.
Dr. Olaro Charles, the Director Health Services- Curative Services at the Ministry of Health says the Ministry is grateful for the work that PMA does, citing that it would cost government a lot of money since such work would require a consultant to do it.
“The data collected in this PMA survey inform monitoring and assessment, assessing the progress of the targets as we set in the Family Planning 2030 commitments and the costed implementation plan. I am happy that all of you were involved during the formulation and official launch of these commitments,” Dr. Olaro said at a recent dissemination of panel survey results for phase 2 at Golden Tulip Hotel in Kampala.
PMA Uganda, a Bill and Melinda Gates Foundation funded project at Makerere University School of Public Health (MakSPH), a leading public health institution in Uganda and within the East and Central Africa region uses innovative mobile technology to support low-cost, rapid-turnaround surveys monitoring key health and development indicators.
Between September and November last year, MakSPH-PMA project led by Principal Investigator Dr. Fredrick Makumbi and Co-Principal Investigator Dr. Simon Peter Kibira conducted a survey from 4,399 households where 4,346 females of ages 15-49 were interviewed. Also, data was collected in 384 health facilities and 2,370 client-exit interviews conducted.
According to the results, the trends in use of Contraception among all women of age 15-49 increased from 35% in 2020 to 40% in 2021 in all methods. On further analysis, those using modern methods of contraception increased from 29.5% to 34% while those using traditional methods of birth control rose slightly from 5.5% in 2021 to 5.9%.
“I am also happy to mention that I sit in the FP20 global committee, and as you know this is great not only for our country but as well as the region. From the first PMA survey, we were seeing the country making progress, however slow it is towards increasing modern contraceptive usage. As you all know the FP2030 objectives were launched and we need to be able to work. I will soon share with you the considerable plan, which is also a precursor for us to be able to achieve our Family Planning 2020,” said Dr. Olaro.
The Government of Uganda set an ambitious goal to increase the modern contraceptive prevalence rate to 50% by 2020. This however was not achieved. In acknowledging this, Dr. Olaro notes that there are still unsolved challenges with the quality of family planning services especially the counselling of users.
“If you go to back to our commitments, one of them is purposed to address this challenge. To address family planning misconceptions, government committed to improve counselling and in it, we provide what options are available, possible side effects and how we manage them, and how the users pick on a different component. So, with implementation and measurements, we shall be able to overcome the challenge,” says Dr. Olaro.
Hons. Catherine Namuddu, Sylivia Bahireira, Joel Ssebikaali, Charles Ayume, Hope Nakazibwe, Ronald Bagaga and Bayiga Rulume, all Members of the Health Committee of Parliament attended the dissemination.
Professor of Disease Control, Researcher, Public Health Expert and Dean, MakSPH, Dr. Rhoda Wanyenze says a lot of the work that done at MakSPH is geared towards ensuring equity and through evidence. According to Prof. Wanyenze, PMA program is one of the projects at MakSPH where researchers generate evidence and continue facilitating policy formulation.
“This program shows this because on the data we have generated, has to be used by all these stake holders here with us today. For example, we have just used the PMA data to inform Uganda’s FP2030 commitments and before that we were also looking at this data while implementing the costed development plan,” she said.
Speaking to an audience that had legislators under the umbrella of the Health Committee of Parliament, Professor Wanyenze said improving health requires holistic approach that includes several other sectors of development including education. She also appealed to the legislators and the sector planners to re-orient health by investing more in promotion of health and prevention of disease than focus only at treating people.
“We can also generate more evidence. You can tell us where it is that you need more evidence that you do not have so that we can work together to generate evidence. We are available and ready to work with you so you can make more evidence-based interventions,” she said.
In light of the Makerere University centenary celebrations, Dean Rhoda pledged continued generation of evidence that adds value.
Dr. Olaro paid emphasis on need for concerted efforts of Ministry of Health an its partners required to solve family planning challenges.
“We need to develop and adopt the use of innovative strategies to inform programming in an effort to address some, if not most of these challenges and I want to implore you to implement what works based on the findings,” Dr. Olaro said.
Further adding that; “These statistics that guide in programming should be progressively pursued and we are looking forward to continue good working relationships as we strive for better health of our communities in which we serve and live.”
Dr. Richard Mugahi Adyeeri, the Assistant Commissioner in charge of Reproductive and Infant Health said MoH appreciates Dean Rhoda’s comments especially the call for evidenced based Interventions and the ability of the ivory tower, to keep producing this evidence whenever it is needed.
“We also appreciate your comment about the partnership with education, given the fact that the determinants of health, some of them fall in education, others are housed in agriculture, and we need a total rethink of our post pandemic public health interventions,” Dr. Mugahi observes.
The Head of surveys at Uganda Bureau of Statistics (UBOS) Mr James Muwonge, while representing the Executive Director Dr. Chris Ndatira Mukiza congratulated MakSPH for pulling off this national survey and for having consistent data.
He encouraged research entities to continuously share information and best practices, as well as coordinate research efforts across different agencies. He also committed on behalf of UBOS to continue working together with MakSPH.
“The Dean has talked about the need to utilise information. There is a lot of information that is collected, but probably not much is being used but looking at the audience in here, I am encouraged and feel contented that the information is getting as far as the parliament because it influences policy and the fact that within the audience we have the policy makers, to me it is a testimony and really important,” said Muwonge.
National Population Council (NPC) Director General, Dr. Jotham Musinguzi said they advised Parliament on the need to invest in the population, reduce fertility in this country, and investments in education as a means to reduction of fertility.
NPC was established by the National Population Council, Act 485, 1994, to advise Government on all population matters. Dr. Musinguzi observes that if we do not reduce fertility fast enough, we will not be able to benefit from the demographic dividend.
“We have an opportunity now that Fredrick (Makumbi) and Simon (Kibira) have shown us that we can impact on contraceptive work, we can push it firmly, we need to make sure that education, health are working together so that the population moves from a pyramid that is very heavy at the bottom, to a pyramid that has a lot of people in the middle and these people get education, health and have skills,” he said.
In the last decade, Dr. Musinguzi says Uganda has been reducing on mortality and fertility rates citing that that’s when the country enters the realm of opportunity.
“I want say that this is something very important and we need to continue leaning to reproductive health and family planning especially use of contraceptives and through working with the Ministry of Health and other development partners. That is the only way we are going to achieve big impact on health, education of the population,” he said.
Dr. Betty Kyadondo, the head of Family Health Department at NPC noted that while there was an increase in the uptake of family planning services and that modern contraceptives, the country still needed to do more.
She says great attention to the issues of use of contraceptive by certain groups such as adolescents and men, that are largely under looked and misrepresented is important.
“They don’t get adequate counselling in times they need the service but we are seeing an increasing number of teenage pregnancy rates and if we don’t work with these young people, its risky and sensitive issue and many people are shy to talk about it but its high time we faced it and addressed sexually active adolescents about the use of family planning methods,” Dr. Kyadondo says.
She advances the need to leverage on the existing efforts in improving family planning service delivery such as human capital development program, community mobilisation and mindset change to reduce negativity and misconceptions about family planning, utilization of the parish development model through its pillars as well as integration of integrate technology into our family planning agenda.
Health
Makerere University Public Health students recount hands-on experience in Ebola case finding in Uganda
On Tuesday January 14, 2025, under the radiant rays of the Ugandan sun, Laura Silovsky crossed the stage at Makerere University’s 75th Graduation Ceremony to receive her master’s degree in Public Health Disaster Management (MDM). Hers is a story of passion, dedication, and curiosity to rewrite the narrative of global education. Among 1,813 master’s graduates, Laura’s story stood out, as a blend of refugee roots, firefighting bravery, and a drive to decolonize learning.
Laura’s journey began long before her arrival in Kampala. Born in the UK to a father who fled from Czechoslovakia’s dictatorship in the 1970s, she grew up understanding displacement intimately. “My father was a refugee. Why would I fear refugees?” she once asked during her research fieldwork in Uganda’s West Nile, where her empathy bridged divides.
“People in Uganda may not expect that a muzungu could be the child of a refugee, but my family experienced displacement from (what was then) Czechoslovakia as well as the effects of the protracted conflict in Northern Ireland. Fortunate to have been born in the UK, I was raised to appreciate that disasters can affect anyone, anywhere, anytime.
After studying Sustainable Development at the University of Edinburgh, I worked on a behavior change project tackling non-communicable diseases in Scotland,” Laura says.
Her journey twisted through battling Australia’s bushfires and volunteering in a COVID pandemic, but it was Uganda’s welcoming refugee policies and Makerere University’s academic excellence that pulled her in next.
“In 2020, I relocated to Australia, just after the worst bushfires since records began and before the COVID-19 pandemic. The following two years, I qualified as a firefighter and supported bushfire recovery by volunteering with a community-based organization. After gaining some insight into these different disasters, I made the decision to return to higher education, and so I applied for the MDM programme at Makerere in 2022,” says Laura.
Armed with experience in emergency response, Laura was drawn to the field’s multidisciplinary nature and was convinced she needed to expand her expertise beyond immediate recovery efforts. She aimed to explore the full disaster management cycle and the intricate connection between health and environment.
“I needed to combine gaining academic knowledge with developing practical skills, so the field placement offered within the master’s degree in Public Health Disaster Management programme was a major motivator for me,” she shared.
The love for Uganda
Studying at the University of Edinburgh, Laura took a class in Kiswahili, that included a field-based short course on the Tanzanian shores of Lake Victoria. This experience sparked a desire to spend more time in the region, but she knew she needed to expand her skill set in order to genuinely add value to an organisation, if she was on the continent.
“I hoped studying at an East African university would teach me invaluable soft skills needed to work more effectively as an international team member. Makerere University School of Public Health (MakSPH) has a strong reputation, and I wanted to study somewhere that was locally grounded but globally recognized. Uganda’s progressive refugee policies were an added incentive to learn from experts here,” Laura says.
Laura’s intentional choice to decolonize her education
“I came to Uganda to learn from the experts here,” Laura declared, rejecting Eurocentric frameworks. “A big factor for me wanting to study at Makerere University was to decolonize my education, to recognize that the knowledge about responding to public health disasters and supporting refugees is here in Uganda,” she says.
She adds, “When I first arrived, I was quite vocal with my classmates about wanting to challenge that bias and truly acknowledge the wealth of knowledge within institutions like Makerere. The expertise here is invaluable, and I was intentional about decolonizing my education.”
At MakSPH, Laura immersed herself in courses like epidemiology, struggled briefly with statistics, but thrived on critical discussion groups and consultation with lecturers.
Collaborating with classmates from Uganda and across East Africa, she learned Luganda phrases and Somali proverbs, and built a “family” united by late-night study sessions and shared ambitions.
Beyond expectations
For Laura, studying at MakSPH was the best decision she could have made. She is still struck by the faculties’ wealth of academic and professional experience in public health and disaster management.
“I anticipated the programme would focus on applying the knowledge we gain to real-world scenarios. Of course, there were cultural differences that took me time to adjust to. I am grateful to faculty members such as Prof. Christopher Garimoi Orach, for his dedication and support, Prof. Elizeus Rutembemberwa for leading by example and valuing students’ time, and Dr. Justine Bukenya and Dr. Simon Kibira for offering their extensive support as my dissertation supervisors.”
The Fieldwork Attachment that Transformed Laura’s Research Experience
At Rhino Camp refugee settlement in West Nile, Laura’s work took on new meaning. Partnering with the Uganda Red Cross Society, she helped digitize data tools and walked long distances through Tika Zone, inspecting latrines and speaking with South Sudanese girls about their challenges in managing their menstrual health through their project that focused on schools.
“That experience in West Nile influenced my own research ideas, and it was a privilege to later return to Rhino Camp for data collection. I will always remember the long days walking with my research assistants through villages and being graciously welcomed by so many respondents,” she recalls, noting that the experiences crystallized her resolve to advocate for refugee dignity globally.
Life in Kampala
Life in Kampala, with its vibrant energy and unique challenges, was truly a ‘full sensory experience’ for Laura. “My parents live in a small village, so Edinburgh felt like a big city when I moved there. And Edinburgh is much smaller and quieter than Kampala! But on weekends, I loved going downtown to shop at Owino Market or heading to Kyadondo Rugby Club for some pork.”
These spaces were perfect for Laura, offering new cultural experiences, including matooke, a starchy dish not found in the UK, which is mainly eaten in Uganda as a local delicacy and staple meal. Despite the differences in culture, sharing meals with classmates provided Laura with a comforting sense of connection.
Back to academics, navigating the university administrative processes wasn’t seamless initially for Laura, though. She says administrative hurdles such as paper-based systems, could change for the university to comfortably enjoy its strong reputation.
She recalls, right at the beginning, when she couldn’t find sufficient information online to support her to complete her application to join Makerere University. However, she later received support from the University’s International Office that deals with the welfare of international students.
Other university officials, from finance, librarians, program administrators, to academic registrars, played a key role in supporting her in her research and postgraduate training. “The system relies on dedicated individuals,” she noted, calling for digital reforms while praising MakSPH’s “atmosphere of innovation.”
“From my experience, such as when obtaining my transcript, the system relies heavily on individual staff members working around these administrative challenges. I’m grateful for those who helped me navigate this, and I’m interested to see how the university continues its digital transition, as it could greatly streamline processes in the future,” says Laura.
A Bittersweet Graduation Day
On graduation day, Laura’s pride mingled with melancholy. Watching families cheer on graduates, she reflected on classmates sidelined by finances or family crises.
Having gone through the course and interacted with Ugandan students, Laura hints on the common financial and personal challenges preventing many from graduating: family illness, new children, sponsorship falling through.
“I know so many of my classmates had worked so hard and were almost over the finish line but, due to financial challenges or other commitments at home, it wasn’t possible for them to graduate this year,” she says.
“For me, I was able to make the choice to pursue this program before having children, so I had fewer responsibilities at home, and I had also been saving for many years to get the money to pay tuition. Because I knew I had the money for tuition before I started, I could focus on studying. As you know, the reality for many people is that that’s not always possible.
“Small supports can transform student experiences,” Laura emphasized, advocating for systemic empathy. She sees great potential for more pastoral support at the university, citing peers from UCU and Kyambogo who benefited from accommodations like private breastfeeding spaces and flexible deadlines in special circumstances. Such initiatives, alongside financial aid, could significantly improve student welfare.
Still, the ceremony’s electric energy—watched via livestream by her parents in Europe—symbolized hope. “Uganda taught me that collaboration transcends borders,” she reflected.
“You could feel this sense of how hard everyone had worked to reach up to that point and that this was really an opportunity for them to celebrate, particularly by having family and friends around to be able to see. I love the PhD awards, when you see the PhD students coming out and their families rushing up to greet them. To me, that’s the best part of the ceremony, because a PhD requires so much work and commitment, and I think it’s really emotional to see everyone share this moment with their support networks,” she says.
Adding that; “…I was so grateful that the ceremony was streamed online. My family were watching live at home in Europe and it was so special that they could see me on camera and participate in the ceremony that way as well.”
Laura noted striking similarities between Makerere and Edinburgh’s ceremonies, especially the moment when students were asked to turn and thank their families, an emotional and powerful tradition.
Looking Ahead
Now in Tanzania, Laura eyes roles with international NGOs, armed with Ugandan-taught pragmatism and a zeal to challenge Europe’s refugee policies. “MakSPH gifted me more than a degree—it reshaped my worldview,” she says.
“As a muzungu with a Ugandan postgraduate education, I feel privileged to have benefitted from different educational perspectives, and I hope that the skills and knowledge I acquired during my time at Makerere will help me to secure a role with an international NGO. After witnessing the incredible support that Uganda provides to refugees, I also hope to advocate for more dignified policies concerning refugees in Europe,” she shares.
“There’s a spirit of innovation and dedication at Makerere, particularly when passionate lecturers like Prof. Orach, Dr. Roy Mayega, or Dr. Victoria Nankabirwa engaged students through discussion and sharing lived experiences. You could really see a different level of engagement within the students as well. Overall, I’ve had such a fantastic experience at Makerere University.”
“I wouldn’t change a thing,” she smiles.“Except maybe convince more Europeans to study here. Africa’s wisdom is the future.”
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