Health
Study to Address the Social drivers of Mental Illness Launched in Uganda by Kennesaw State University & Makerere University
A new 5-year study has been announced to determine the link between social drivers and mental health among young women who live in the slums of Kampala in Uganda. Kennesaw State University (KSU) received the five-year $3.3 million award from the National Institutes of Health (NIH) and has partnered with Makerere University to conduct this interdisciplinary project.
Mental illnesses are understudied, and scarce services lack evaluations, particularly in low-resource settings such as slums. In response to the vulnerable state of adolescent girls and young women in the urban slums, the team of researchers are implementing this five-year project named “TOPOWA” (The Onward Project On Well-being and Adversity), which means to “keep pushing forward and never giving up”, in the Luganda language.
Makerere University through the School of Public Health is teaming up with two U.S universities, Kennesaw State University (KSU) and Georgia State University (GSU) in the U.S. to implement the research component of the study. The Uganda Youth Development Link (UYDEL), a community-based organization in Kampala will lead the intervention components.
First of its kind, “the TOPOWA project will examine if a community-based intervention program comprised of vocational training, entrepreneurship and economic empowerment, team building through sports, and psychosocial support (“Socioeconomic Strengthening Targeted Training: “SeSTT”). leads to better mental health outcomes among disadvantaged women living in slums” said Dr. Monica Swahn, the Principal Investigator of the study.
The TOPOWA research project will focus on young women ages 18-24 years, the age period when most mental health symptoms are manifested and expressed. If the study shows that the intervention makes a difference in mental health outcomes (i.e., anxiety, depression, suicidality and substance use symptoms and disorders) for young women, it can address the tremendous unmet mental health needs in Uganda. The study will also increase the understanding of the community and neighborhood characteristics of the urban slums where the young women reside.
It was launched on Tuesday March 8, 2022, on International Women’s Day, a global holiday celebrating the social, economic, cultural, and political achievements of women. Speaking at the launch, Dr. Swahn, the Principal Investigator, and also Professor and Dean of the Wellstar College of Health and Human Services at KSU said “TOPOWA was in support of global action to advance gender equality and the empowerment of women and girls”
She also noted that this was a ground-breaking study, with investigators representing diverse expertise from three universities.
“Our TOPOWA project is ground-breaking because we look at the social drivers of mental illness and how to mitigate them. We conceived this project before the pandemic, but now with the pandemic, we know more than ever how mental health has been understudied and the growing scope of unmet need in the community,” she said. Dr. Swahn also added that, “We don’t have enough interventions for mental health in particularly among vulnerable populations in low-resource settings. So, what we have learnt post-COVID is that we need to find scalable interventions to better support mental health for women who live in poverty, particularly women who live in slums.”
Using a multicomponent 27-month, parallel prospective cohort design of young women, the study team will recruit 300 participants from three selected UYDEL study sites in Banda, Bwaise and Makindye to determine the pathways and mechanisms of mental health outcomes. The study will involve focus groups, a Photovoice project, community mapping, surveys, use of sleep wearables, saliva and stress reactivity to detect and determine stress levels of the young women.
The investigators will measure stress though threat reactivity in fear conditioning tests, ratio of salivary cortisol, dehydroepiandrosterone (DHEA) and α-amylase, and sleep quality by deploying Fitbit wearable sensors for each study participant as well measuring environmental stressors through geotrackers.
“We will ask these young women to wear these Fitbits. These will pick up on the measure of sleep. We know that when people are stressed, they have poor mental health, but also, they have poor sleep,” said Prof. Swahn. She adds that these Fitbit devices are worn just like a wrist watch. “They will give us a lot of insight to what happens at night when people are sleeping. The women may or may not be sleeping as well as they should. So again, it’s another marker of stress, their well-being and physical health. It really adds another important innovative component of the study. We looked for other studies across the sub-Saharan Africa and have not found any studies that use this technology in this type of setting so these gadgets will give us a lot of insight.”
Dr. Catherine Abbo, an Associate Professor of Psychiatry at Makerere University College of Health Sciences, and Co-Investigator of the TOPOWA study, says depression and other mental health issues are on the rise in Uganda, though they continue to go unrecognized.
“These women actually don’t even reach the clinic but people just suffer while they are in the communities. There are different anxiety disorders. So, the current estimates from the previous research shows about 1 in every 4 people have mental health issues,” Dr. Abbo says.
Asked about what could be the drivers of mental health in young adults, Dr. Abbo contends some of the drivers are psychosocial arising from the environment we live in while others maybe genetically predisposed.
“If you are going to live in an environment that is poverty stricken, you are going to live in an environment where you are not going to access education, you are not going to have support that you need to be mentally healthy, you become vulnerable to getting mental illness and that is the environmental aspect. And then we have individuals, who, because of their genetic makeup, may develop cause mental illness,” she said.
According to Dr. Abbo, the wearables are new technologies and that this is the first of its kind to be used in research in Uganda. “You know sometimes people go jogging and have phones that take the number of their steps, heart rate, so in the general population we have gadgets that can measure some aspects of body reactions but particularly in this case, it’s going to measure sleep patterns, that signify stress levels.”
Mr. Rogers Kasirye, UYDEL’s Executive Director, argues that many a time, intervention projects have been implemented among youth but they fail because of the inability to tackle underlying issues affecting the young people. He says this study to investigate the mental health status of the young women will go a long way in impacting the way such initiatives can be implemented to achieve greater success.
According to Mr. Kasirye, for over 25 years, UYDEL has worked with young people in the in the slums of Kampala and impacted many young people through their skilling and rehabilitation programs. He pointed out that that a majority of the young people in slums face a lot of challenges including poverty, lack of shelter while others have long lost contact with their families.
“But we don’t go beyond to investigate and support their psychosocial needs. From experience, some people who come to our facilities have alcohol and other problems. Many times, they are even failing to sleep. Some even come to the Centre and tell you that they have not had a meal. You know what it means to sleep on an empty stomach. Others say they lost contact with their families while others say they have been sexually abused and others raped. In other words, they have a mountain of psychosocial needs that must be addressed. With this project, we hope to track girls for several years to match the research findings with empowerment interventions,” said Mr. Kasirye.
Ms. Anna Kavuma, the Deputy Executive Director, UYDEL says the COVID-19 pandemic has had a toll on mental health issues among young women by increasing their vulnerability.
She notes that whereas the boys have equally been affected by the pandemic and could have pushed them to high stress levels, girls have a high level of vulnerability with responsibilities such as bringing up the children, dealing with pregnancies, accessing medical supplies as well as shelter.
“It’s quite difficult for the girls. It’s an understatement for me to say that they are not highly affected by mental issues in Uganda, that is why this project is coming in to understand that. For instance, if we gave young girls vocational skills and training in beauty and cosmetics, or any other vocational skilling, will it help reduce on these stresses that they have? Will it help address the underlying factors that they are facing? Will it help to improve the way they sleep? Will it help improve the stress levels? These are areas we are trying to study and we are hopeful that the results of the study will inform not only programming and practice but also inform policy environment as well,” said Nabulya.
The project’s intervention arm will look at skilling the adolescent girls and young women with the cost-effective beauty training, which the researchers say is also very easy to implement. Dr. Swahn, the PI noted, “We are hoping that if it’s shown to be effective, that is something that can be implemented in other communities and we know that many are offering vocational training but they have not been evaluated the way we are doing it with a very vigorous scientific protocol.
Dr. Rhoda Wanyenze, Professor and Dean, Makerere University School of Public Health thanked Prof. Swahn and UYDEL for partnering with MakSPH to implement this important project citing that the School was ready to work with the team.
“Mental health for young people is such an important area and very timely coming after the challenges and stress from the Coronavirus pandemic! We are excited to partner with you on this project,” said Prof. Wanyenze.
The TOPOWA Research Team is composed of nine investigators spanning two continents and three universities. The Project’s Principal Investigator (PI) is Dean and Professor Monica Swahn of Kennesaw State University. The Co-Investigators of the project include Dr. Cathy Abbo, Dr. Godfrey Bbosa, Dr. John Bosco Isunju, Charles Ssemugabo and Dr. Eddy Walakira from Makerere University, Dr. Ebony Glover from KSU and Dr. Rachel Culbreth and Dr. Karen Nielsen from GSU.
The Executive Director of UYDEL, Rogers Kasirye, leads the implementing partner whose mission is “to enhance socioeconomic transformation of disadvantaged young people through advocacy and skills development for self-reliance”.
The TOPOWA Project Advisory Board is composed of members from the Kampala City Government, the Ministry of Health, the Ministry of Gender Labour and Social Development as well as the Dean for the Makerere University School of Public Health.
Davidson Ndyabahika is the Communications Officer, MakSPH/TOPOWA Project
Article originally posted on MakSPH website
Professor Moses Kamya, Professor Nelson Sewankambo, Professor David Serwadda and Professor Moses Galukande, staff from the Makerere University College of Health Sciences (MakCHS) were recognised for their contribution to the health sector in Uganda and beyond. The recognition was at the 6th edition of the Heroes in Health Awards (HIHA) held on 14th November 2025 during the Africa Health Summit at Kololo Ceremonial Grounds, Kampala.
Professors Kamya, Sewankambo and Serwadda won the Excellence in Health Academia Award. The award is in recognition of their outstanding contribution to advancing health policy, practice and innovation through teaching, research and mentorship. HIHA organisers noted that the legacy of the three professors inspires the next generation of health leaders.
In comments from staff at MakCHS the professors are summed up as, ‘senior colleagues, teachers, and mentors for the lifelong dedication to strengthening health systems, advancing ground-breaking research shaping national policy, and training generations of public health leaders. Their work has elevated not only Makerere University, but the entire health sector in Uganda and beyond’.
Professor Moses Galukande received the Minister’s Special Recognition Award for his outstanding service and dedication to advancing health outcomes and innovation.
HIHA is an annual public-private partnership initiative launched in 2019 by the Ministry of Health in Uganda with support from Xtraordinary Media. It is a public choice award where members of the public nominate and vote for individuals, organizations, and programs making outstanding contributions to the health sector. The awards aim to recognize and celebrate unsung heroes across Uganda, including frontline health workers, innovators, researchers, policymakers, students, and community health champions. “Strengthening Health Systems, Empowering Communities through Self-Care and Sustainable Solutions,” emphasizing the importance of community engagement, innovation, and resilience in healthcare delivery was the theme for HIHA 2025.
Kampala, 11 November 2025 —Makerere University School of Public Health (MakSPH), the Ministry of Health (MoH) and Joint Medical Stores (JMS) have launched a project to boost Uganda’s health supply chain. Backed by the Gates Foundation, it aims to improve emergency deliveries and use data to ensure lasting resilience.
The intervention began on Thursday, 6 November, with the flag-off of emergency distribution of medicines and health supplies at JMS in Nsambya. Under a sub-award from MakSPH, JMS is leading warehousing, distribution, redistribution of essential commodities, reverse logistics, and technical support to health facilities, including digital training for over 1,100 facilities in the Integrated Online Ordering System. The operation aims to deliver USAID-supplied medicines that had remained in storage since donor support was suspended earlier this year, preventing expiry and restoring last-mile delivery across the country.
Building on this, MakSPH convened a stakeholder consultative workshop on Monday, 10 November, at Kabira Country Club to guide the research component of the initiative. Officials from the Ministry of Health, development partners, and health logistics experts reviewed the scope of a new study on strategic analytics to strengthen a sustainable and resilient health supply chain. The consultation focused on refining research questions to ensure alignment with national priorities and stakeholder needs.
Dr. Suzanne Kiwanuka, Associate Professor and Head of the Department of Health Policy, Planning, and Management (HPPM), stressed the need for practical, evidence-based collaboration.
“Our commitment is to make sure that whatever evidence we generate is useful. We want perspectives on governance, implementation, and the frontline, because when the supply chain isn’t functioning, a lot goes wrong,” said Prof. Kiwanuka.
The Ministry of Health has welcomed ongoing support from partners to stabilise the supply chain.
“I want to draw attention back to our 10-year health supply chain roadmap. Despite disruptions, we made important milestones in the first five years, and with support from Makerere University School of Public Health and the Gates Foundation, we are now focused on understanding challenges and building a resilient, sustainable supply chain,” said Dr. Ajulong Martha Grace, Assistant Commissioner, Pharmaceutical Supply Chain and Logistics.
Over the past decade, Uganda’s health supply chain has made steady progress under the 10-Year Roadmap for Health Supply Chain Self-Reliance (2021/22–2031/32), which sets out a vision for a self-reliant, efficient, and transparent system that ensures uninterrupted access to essential medicines. Efforts have focused on increasing financing, digitising logistics, strengthening local manufacturing, and expanding infrastructure.
Despite these gains, the system remains vulnerable. Limited financing, capacity gaps at subnational levels, and poor commodity reporting have contributed to stockouts and wastage. Heavy reliance on donor support, compounded with back-to-back shocks, has left Uganda’s health system exposed to shocks, such as the recent suspension of USAID support, which disrupted last-mile delivery to over 530 private not-for-profit health facilities.
Commodities worth more than UGX 79 billion have remained in storage, risking expiry and could potentially reverse service delivery gains. The Gates Foundation’s support comes at a critical moment to stabilise last-mile distribution while generating analytics to address deeper structural challenges.
“Before these financial disruptions, our public sector supply chain was already under intense pressure to meet rising last-mile demands. The current challenges are a critical opportunity to address long-standing bottlenecks, improve delivery of essential medicines, strengthen real-time monitoring, and build a more sustainable health system in Uganda,” said Timothy Musila, a Health Policy, Planning and Financing Specialist.
MakSPH, in partnership with the Ministry of Health, will carry out Strategic Systems Analytics to strengthen Uganda’s supply chain. The research will examine financing gaps, fiscal space, operational inefficiencies, and performance at the subnational and last-mile levels. This co-created evidence generation will also identify opportunities for sustainable financing and efficiency gains to reduce reliance on external aid and to guide reforms that ensure that essential medicines and products remain accessible to all Ugandans.
This work is spearheaded by Professor Rhoda Wanyenze, as the Principal Investigator, and Associate Professor Suzanne Kiwanuka, the Co-Principal Investigator/Research Technical Lead on the Makerere University side. Dr. Charles Olaro, Director General of Health Services at the Ministry of Health, is the focal person on a five-member steering committee overseeing the implementation. The team includes Pamela Achii, Procurement and Supply Chain Management Specialist at the Ministry, and Mr. Timothy Musila.
Health
JASH2025 wraps with the 23rd Matthew Lukwiya Memorial Lecture and Kampala Declaration Statement
The 19th Joint Annual Scientific Health Conference (JASH) and Inaugural National Annual Communicable and Non-Communicable Conference (NACNDC) held at Speke Resort Munyonyo ended on Friday 7th November, 2025 with the 23rd Matthew Lukwiya Memorial Lecture and a Kampala Declaration Statement.
The joint conference that began on 3rd November, 2025 themed, ‘Unified Action Against Communicable and Non-Communicable Diseases’ was organised by Makerere University College of Health Sciences (MakCHS), Makerere University School of Public Health (MakSPH) and Ministry of Health (MoH). The meeting brought together representatives from Central Government, Ministry of Health, academia, civil society, local governments, private sector, development partners, professional associations, local governments and communities.
Kampala Declaration Statement
Dr. David Musoke, Assoc. Professor at MakSPH who was Co-Chair of the Organising Committee delivered the Kampala Declaration which defined the priorities/commitments of the delegates from the dialogue at the conference.
The declaration highlighted the background of setting the priorities as thus: 1. Uganda’s dual disease burden from communicable diseases (CDs) alongside the growing rise of non-communicable diseases (NCDs). 2. The biological, social and clinical intersections between CDs and NCDs, which compete for limited resources. 3. Threats posed by antimicrobial resistance (AMR), climate-sensitive diseases, zoonotic spillovers, and emergency outbreaks such as Ebola, COVID-19, and Marburg. 4. Uganda’s commitment to Universal Health Coverage (UHC), the Africa CDC’s New Public Health Order, the Sustainable Development Goals (SDGs), the International Health Regulations (IHR), the International Covenant on Economic, Social and Cultural Rights, and the Global Health Security Agenda (GHSA). 5. The integration of health services at facility level continues to face challenges due to high patient-to-health worker ratios and inadequate infrastructure, which impede the delivery of comprehensive, timely, and quality healthcare services;
Emphasizing the need to involve all stakeholders—including from education, agriculture, environment, engineering, urban planning, gender, as well as community and religious leaders, and others—in the fight against communicable and non-communicable diseases; 6. The persistent challenges in access to healthcare across the country due to delays in diagnosis and treatment-seeking, and emphasizing the urgent need to strengthen early detection, ensure timely access to quality healthcare, and enhance community awareness about prompt medical attention; 7. Protection and promotion of human rights are fundamental to ensuring health, dignity, and well-being for all citizens, as these rights form the foundation of equitable access to quality healthcare services; 8. The global threat of antimicrobial resistance (AMR), now causing an estimated 700,000 deaths annually, and recognizing its strong link to self-medication, poor diagnostic capacity, and weak public health interventions; 9. Health policies and investments have focused more on curative than preventive care, underscoring the need to reinstate a strong prevention-oriented approach; 10. Many Ugandans remain inadequately informed about health issues affecting them and their role in promoting health within their communities; 11. Rapid industrialization, urbanization, and lifestyle changes are significantly contributing to the rising burden of NCDs;
The Kampala Declaration was presented as a shared call to action, a platform for sustained collaboration, and a blueprint for strengthening integrated and equitable health systems. The declaration is premised on the following priorities:
- Multisectoral Collaboration and One Health Approach: Affirmation of the requirement for involvement of the whole-of-society and whole-of-government approach to accelerate disease prevention, health promotion, and self-care through evidence-based awareness.
- Integrated, People-Centered Disease Prevention and Care: The urgent need to focus on people, not diseases, using a life-course approach and strengthening integrated service delivery across CDs and NCDs at all levels.
- Strengthened Data, Research, and Policy Translation: Recognition of the importance of timely, interoperable, and disaggregated data to inform policy, financing, and implementation decisions. In addition, commit to collaboration between academic institutions, policymakers, CSOs, and community influencers to bridge the gap between research and practice.
- Financing: Commit to advocate for increased domestic financing to progressively reduce dependence on external aid, ensuring predictable and sustainable resources for integrated disease prevention and care. Promote efficiency and accountability in health spending by strengthening budget tracking, performance-based financing, and public financial management systems. Support innovative financing mechanisms, including public-private partnerships, social health insurance, and community-based financing schemes to expand coverage and affordability.
Specific calls were directed to the various stakeholders respective to their mandates and roles.
Government of Uganda and the Ministry of Health: To accelerate implementation of integrated strategic plans for CDs, NCDs, and epidemic preparedness under a unified health systems approach; Institutionalize NACNDC–JASH as the official Annual Integrated National Health platform for disease dialogue and innovation, co-led by the Ministry of Health and academia; Mobilize domestic and international financing to strengthen primary healthcare, laboratory networks, and community systems; Enforce laws and policies aimed at preventing and controlling substance abuse nationwide.
Academia: Generate policy-relevant evidence and drive innovation in diagnostics, surveillance, and culturally appropriate care; Establish multidisciplinary working groups to connect research, clinical practice, and policy; Train health professionals in integrated, competency-based, and future-ready approaches; Create innovation hubs and partnerships linking academia, communities, and industry to co-develop scalable, people-centred solutions; Leverage technology and innovation to effectively address CDs and NCDs; and Prioritize locally led research focused on Uganda’s health realities, including NCDs, CDs, mental health, and climate-linked risks.
Development Partners and Donors: Align technical and financial support with Uganda’s integrated disease control priorities; Support the development of a national research agenda driven by local health needs; Strengthen health system resilience, digital transformation, and community-led interventions; and promote regional knowledge sharing, South-South collaboration, and local manufacturing of diagnostics and medicines.
Private Sector and Civil Society: Engage in public-private partnerships to expand access to diagnostics, care, and innovation; Champion community-responsive models for disease prevention; rehabilitation, and continuity of care; Strengthen advocacy, accountability, and public education through multimedia and grassroots platforms; Raise public awareness on mental health, sickle cell disease, asthma, and diabetes, integrating these services into primary care and reducing stigma and discrimination.
In view of the background, priorities and expected action from the stakeholders as highlighted above, the declaration also endorsed the development and dissemination of: a National Integrated Disease Control Strategy, informed by best practices and policy dialogues from this conference; a Multisectoral Action Framework guiding collaboration among health, education, agriculture, environment, and finance sectors; A Monitoring Mechanism to track implementation and institutionalize annual
reporting on disease integration; and the continuation of joint annual NACNDC and JASH conferences to sustain momentum.
Setting the Pace
Through the conference, keynote speakers delivered addresses which set pace for the dialogue by participants at the conference.
Dr. Queen Dube, Lead – Newborn Programme Implementation, Policies and Standards at the World Health Organisation (WHO), Geneva and Co-Chair of Every Woman, Every Newborn (EWENE) Country Implementation Group highlighted the reasons for rising disease burden of NCDs across sub-Saharan Africa including industrialization and urbanization; shifting dietary patterns; improved means of transport and communication which converts to less movement.
Dr. Dube noted that, the poorer one is, the higher the risk of one dying due to an illness either through communicable or non-communicable diseases. She stressed the importance for a unified action against diseases as opposed to fragmentations or silos by different working groups of various diseases. Duplication of efforts spreads thin the available resources, yet more efficiency and effectiveness could be enjoyed, she added.
Her call for action was, ‘health is interconnected, our response must be to; collaboration saves lives; and together, we can build a healthier, more resilent world’.
Delivering his keynote speech on the final day of the conference, Prof. Francis Omaswa, Founder and Director – African Centre for Global Health and Social Transformation (ACHEST) reminded the delegates that, ‘it is up-to us to achieve our goals provided we commit to do what is expected of us in the best possible way’.
He questioned why Africa continues to lag behind in the global health indices considering the professionals present on the continent. ‘Inclusiveness, equity and working together is the way forward’, he advised.
Prof. Omaswa reminded the delegates that Uganda in particular achieved in areas like HIV/AIDS control, therefore the means we used then must be employed in fighting communicable and non-communicable diseases. He heighted that, some of the means included leadership at all levels, working together, for monitoring and reporting, engagement of youth through the means they respond to among others.
‘Let no one go to sleep, each one of us is a leader at our levels of responsibility and we must make sure that there is coordination and supportive supervision within the health system’, Prof. Omaswa reiterated.
In his keynote speech, Dr. David Serwadda, a Professor in the Department of Disease Control and Environmental Health at MakSPH reminded researchers and academia the importance of their work to disease prevention and control. He stressed that the link between research and implementation is critical for a unified action, and there bridging the gap must be intentional.
23rd Dr. Matthew Lukwiya Memorial Lecture
Dr. Matthew Lukwiya is remembered for his leadership and selflessness as a Ugandan physician at the forefront during the Ebola virus disease outbreak in Uganda in 2000 until de succumbed to the disease. He was the supervisor at St. Mary’s Hospital Lacor, outside Gulu City, Uganda; Gulu district was an epicentre of the disease at the time.
As has been the case at the previous JASH conferences, the 23rd edition of the Matthew Lukwiya Memorial Lecture was held on the final day of the conference, themed, “Identified Critical Gaps in the Response to Outbreaks”.
The session convened leading scientists, policymakers, community and health professionals to reflect on lessons learnt from past epidemics and chart strategies for stronger preparedness, response and resilience across the health system.
The Way forward
At the end of the meeting, delegates were advised that information from the meeting will be shared through a link on the MakSPH website and abstracts will be published as well.
Prof. Rhoda Wanyenze, Dean-MakSPH who also represented Prof. Bruce Kirenga, Principal-MakCHS thanked all participants for attending the dual conference and willingness to share information in support of integrating to improve Uganda’ Health System. She also thanked the organising committee and partners for the support leading to a successful conference.
‘What is it that touched you at this conference, what are the takeaways and I implore you to reflect on the discussions and create a change. This is not business as usual and let us make change.’, the Dean said.
Prof. Wanyenze handed the baton to the School of Medicine who will work with the MoH in organising the conference in 2026.
Closing by the Permanent Secretary
The conference was officially closed by Dr. Diana Atwine, Permanent Secretary-MoH. She highlighted five points for all of us to remember as takeaway from the dialogue.
- All of us should innovate solutions for the challenges before us including innovative leadership. Uganda’s population growth remains high and the resources are not growing at same rate therefore challenges will continue to arise therefore innovation is necessary.
- Inculcate a culture and mindset change and remember health change begins with each of us.
- Integrate not verticalization because it is the right thing to do, leads to efficiency and gives results.
- As government continues to explore means of resource mobilisation, smart investments in high impact activities and priorities are critical.
- Call upon all of us, to implement the resolutions reached.
She thanked all stakeholders for the contributions made towards success of the conference.
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