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
Makerere University, through the College of Health Sciences (CHS), hosted the Sickle Cell Disease Stakeholders’ Engagement Meeting on 24th October 2025. The event was organized by the Center of Excellence for Sickle Cell Disease and Neglected Tropical Diseases, in partnership with Enhancing Research Capacity for Sickle Cell Disease and Related Non-Communicable Diseases Across the Lifespan in Uganda (ENRICH) and the Sickle Pan Africa Research Consortium (SPARCo). The meeting brought together a diverse group of stakeholders, including religious leaders from the Catholic Medical Bureau, Protestant Medical Bureau, and the Uganda Muslim Supreme Council, as well as members of academia and public health practitioners.
During the Stakeholders’ Engagement Meeting held under the theme; Addressing Sickle Cell Disease in Schools and Communities, panelists emphasized the importance of early detection and effective communication in managing the disease. One of the speakers highlighted the critical role of medical interns as the first point of contact in identifying symptoms such as unexplained anemia and limb swelling, urging them to take detailed patient histories for timely diagnosis and referral. Another panelist, Ms. Penina Agaba, a lecturer at the Makerere University, underscored the need to translate data-driven research into simple, accessible formats for policymakers and community leaders. She noted that findings should be communicated in local languages through channels such as workshops, radio programs, and community meetings to ensure wider understanding and practical policy action.
In her remarks, Dr. Rosemary Byanyima, the Executive Director of Mulago National Specialised Hospital, shared her personal and professional commitment to improving the management of sickle cell disease in Uganda. A sickle cell warrior herself, Dr. Byanyima revealed that Mulago is planning to establish a medical campus that will offer specialized care, including hip replacements for patients suffering from sickle cell disease. She also noted that the hospital has supported the establishment of several service centers in Mukono General Hospital, Pallisa District, and Kayunga, aimed at bringing services closer to the communities. Dr. Byanyima urged all stakeholders to work together to raise awareness, increase testing, and encourage early healthcare seeking among those affected by the disease.
The panel discussions at the Sickle Cell Disease Stakeholders’ Engagement Meeting underscored the shared responsibility of all sectors in creating a more inclusive and informed society for people living with the condition. The conversations, moderated by Dr. Deo Munube and Ms. Evelyn Mwesigwa, explored how schools, faith institutions, and communities can work together to support those affected. Speakers emphasized the need for inclusive school policies that accommodate children with sickle cell disease—such as allowing extra clothing, flexible restroom access, and special exam arrangements—alongside guidance and counseling services to combat stigma and nurture self-esteem. They also stressed the importance of honesty from parents in disclosing their children’s health conditions to enable appropriate care.
From a broader perspective, panelists like Mr. Kajiiko Shafik from the Uganda Muslim Supreme Council highlighted the potential of faith-based structures to advance community sensitization and advocacy. The discussions collectively called for greater collaboration between the Ministries of Education and Health, improved psychosocial support, and stronger legal and policy frameworks to ensure that every child and adult living with sickle cell disease can thrive in a compassionate and supportive environment.
In her closing remarks, Dr. Sarah Kiguli, the Director of the Centre of Excellence for Sickle Cell Disease and Neglected Tropical Diseases at Makerere University, expressed gratitude to all stakeholders for their active participation and thoughtful contributions. She noted her optimism about the existing systems that can be leveraged to strengthen collaboration and awareness efforts, saying, “I’m happy that there are systems already in place that we can use to engage everyone on this cause.” Dr. Kiguli emphasized the importance of collective responsibility in the fight against sickle cell disease, adding, “It is impossible for us here in Makerere to reach everyone, but I love the message of ‘train the trainers’ so that sensitisation work can be efficient and far-reaching.”
Makerere University’s continued commitment to public health research extends beyond academia into real community impact. Through the College of Health Sciences, the University has strengthened partnerships with the Ministry of Health and regional hospitals to enhance early screening, diagnosis, and management of Sickle Cell Disease. Recent efforts include supporting the expansion of the national Sickle Cell Registry and developing community-based counselling programs to raise awareness at the grassroots level. Despite progress, Uganda still faces significant gaps in screening and treatment, with thousands of children born each year with the condition remaining undiagnosed. Makerere’s initiatives, therefore, aim to bridge these gaps through research, training, and collaboration with government, faith-based, and cultural institutions to ensure that no child or family faces Sickle Cell Disease in silence.
STOCKHOLM — Makerere University and Karolinska Institutet (KI-Mak) marked 25 years of collaboration on Oct. 15, 2025, with a hybrid forum on research equity, highlighting lessons for universities striving toward fair and sustainable global partnerships.
The event, part of the Global Conversations on Sustainable Health, explored the theme, “Exploring Power Dynamics & Equity in Partnerships.” Scholars, policymakers, and university leaders gathered to discuss how institutions can build collaborations grounded in trust, shared ownership, and mutual respect.
Organized by the Centre of Excellence for Sustainable Health (CESH), a joint initiative between Makerere University and Karolinska Institutet, the forum reflected on how equitable partnerships drive progress toward the 2030 Sustainable Development Goals.
Hours before the event, Sweden’s Ambassador to Uganda, H.E. Maria Håkansson, posted on X (formerly Twitter):
“The partnership between Makerere University and Karolinska Institutet is both dynamic and exemplary in how many years of development cooperation can lay the foundation for mutually beneficial relations between institutions in Sweden and Uganda.”
Equity, Trust, and Warmth at the Core
Panelists navigated questions of power, agency, and mutual respect. Policymakers, researchers, and academics agreed that successful partnerships depend not only on fairness but also on warmth, the human connection that sustains collaboration and ensures initiatives respond meaningfully to local realities.
Dr. Andreas Göthenberg, executive director of the Swedish Foundation for International Cooperation in Research and Higher Education (STINT), recalled that earlier models often reduced African researchers to “data farmers” in one-directional projects led from the North.
“We now support balanced research collaborations, not capacity building alone,” he said.
Over the past decade, he added, STINT has seen a surge of high-quality proposals from African researchers seeking genuine collaboration.
“When partners bring different expertise and learn from each other, that is when collaborations work well,” he said. “Institutions with fewer resources can now do very advanced things; that’s a real game changer.”
Göthenberg said Africa’s rapid advances in microfinancing, cloud computing, and even space research show that “technology development means institutions with fewer resources can still do very advanced things,” offering lessons for innovation systems in Europe.
Why Equitable Partnerships Matter
Professors Rhoda Wanyenze and Stefan Swartling Peterson have argued that traditional models often concentrate leadership and funding in the Global North, thereby limiting the agency of Southern partners.
Their work from long-term collaborations in Ethiopia, Uganda, Lao PDR, and Vietnam shows that shifting leadership to where research occurs strengthens local capacity and aligns agendas with community needs.
They demonstrate that equity relies on mutual trust, transparency, and shared decision-making, principles that transform funding into a tool for empowerment rather than dependency. Joint PhD programs, reciprocal staff exchanges, and twinned supervision models have further enabled two-way knowledge flow and reduced brain drain.
“Partnerships grounded in reciprocity, inclusion, and respect are not only ethically sound but also more effective,” Wanyenze said. “They build local ownership, lasting capacity, and context-driven innovation.”
Championing South-to-South Knowledge Exchange
Associate Professor Caroline Wamala-Larsson, director of the SPIDER program at Stockholm University, underscored that the Global South must set its research agendas.
“The agenda must be set by Southern institutions. Swedish institutions act as collaborators, not directors,” she said.
She cited projects in Uganda, Tanzania, Rwanda, Bolivia, and Mozambique where South-to-South learning has flourished.
“Bolivians traveled to Tanzania to share source codes from a research management system. Now, the University of Dar es Salaam wants to adopt it,” she said. “Solutions developed within the South often fit local contexts better than Northern models.”
Wamala-Larsson added that innovation and digital transformation have strengthened institutional systems. “We need new funders, private sector partners, and universities to participate equally.” Respect for each partner’s contribution is essential for sustainability,” she said.
Adapting to a Changing Global Landscape
Shifting global priorities and limited funding are reshaping how universities collaborate. Ms. Brenda Wagaba, partnerships officer at Makerere University, noted that while funding remains limited, the Government of Uganda, for instance, has taken steps to support local research through the Research and Innovation Fund. “The government started setting aside money for university research even before the recent cuts,” she said.
“Now, with those cuts, the need for sustained domestic investment is even greater.” She added that such initiatives strengthen the confidence of Southern partners to engage as equal contributors in global collaborations.
Dr. Rawlance Ndejjo, a Makerere University researcher, said local initiatives could help sustain momentum. “Local funding opportunities allow countries to find resources for research and partnerships. Such efforts can improve equity through bottom-up collaborations,” he said.
Göthenberg noted that new opportunities lie in multidisciplinary work. “Many of the challenges we face today demand broadly defined solutions,” he said. “Multidisciplinary projects lead to broader societal impact and stronger partnerships.”
He also pointed to Africa’s demographic advantage: “With its young population and rapid innovation, Africa is driving technological development in ways that can benefit both continents.”
Equitable Partnerships Deliver Results
Wagaba said engaging communities early is key to success. “When we engage communities early, we can bridge the gap between large-scale interventions and local acceptance. Whether it’s water, vaccines, or health infrastructure, success depends on understanding immediate community priorities,” she said.
She cautioned that top-down projects often fail to deliver lasting impact.
“You may build a vaccine plant or develop a vaccine, but if a community’s immediate need is safe water, your intervention will falter,” she said, adding that warmth, respect, and open communication are as critical as technical expertise.
Makerere Vice Chancellor Prof. Barnabas Nawangwe highlighted tangible results from Sweden’s long-term support.
“Under the SIDA program, 500 PhD students were trained, all of whom returned to Uganda,” he said. “The program made them feel at home while gaining knowledge abroad. Without mutual respect, equity will always face challenges.”
Prof. Annika Östman Wernerson, president of Karolinska Institutet, said sustainable partnerships depend on continuous engagement.
“Every collaboration begins with people meeting. Warmth and curiosity are crucial between individuals and institutions,” she said. “Equity is not static; it requires continuous work. Trust and transparency are critical.”
A Global Model for Sustainable Partnerships
The 25-year collaboration between Makerere University and Karolinska Institutet demonstrates how long-term, equitable partnerships can strengthen research systems and inform policy.
As Nawangwe put it:
“Students return home, communities benefit, and research informs global health policy. This is a model of how equity and trust drive sustainable partnerships.”
The Makerere–Karolinska (KI-Mak) partnership shows how universities, funders, and governments can work together fairly and Like many others working in this field, the Center recognises that there is still much to learn and discuss about how partnerships can continue to evolve through openness, dialogue, and shared reflection.
As Makerere and Karolinska look to 2030, their renewed agreements promise more than ceremonial goodwill. The two universities will intensify exchanges between students and faculty, expand joint research, share academic output, and organise lectures, conferences, and workshops. They will also open new paths for training, scientific collaboration, and shared learning. After 25 years, the partnership has proven that long-term cooperation can endure and excel with mutual respect, steady investment, and a clear purpose.
Dr. Angelina Mwesige Kakooza, Associate Professor of Paediatrics in the Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences (MakCHS) received the 2025 TWAS-Fayzah M. Al-Kharafi Award in Medical Sciences. She was recognised for her research on neurodevelopmental disorders – particularly epilepsy, cerebral palsy, and nodding syndrome – and for advancing policy and research, mentorship, as well as local community interventions to enhance children’s health.
The award was given at the recent 17th General Conference of The World Academy of Sciences (TWAS) held in Rio de Janeiro, Brazil under the theme ‘Building a Sustainable Future: The Role of Science, Technology, and Innovation for Global Development.’ Organized in partnership with the Brazilian Academy of Sciences (BAS) and TWAS, the conference brought together leading scientists, policymakers, and institutional leaders from across the global South and beyond.
In her remarks after receiving the award, Dr. Kakooza said, “This award highlights the importance of neurodevelopmental disorders which are a great health problem worldwide, often diagnosed late and treated poorly,” said Kakooza. “It affirms my contribution to science in Africa, strengthens advocacy for gender equity in science and education and makes me a role model for others, increasing my influence in the scientific community.”
Dr. Angelina Kakooza Mwesige is a Ugandan scholar with over 25years teaching experience whose research focuses on neurodevelopmental disorders in children centred on their epidemiology, early screening, identification and community based interventions in Uganda. Her current areas of research cover studies on early detection and interventions for young infants at high risk of neurodevelopmental delay and disability in Nepal and Uganda; development of community engagement projects to empower adolescents living with epilepsy in Uganda reduce stigma in their communities; as well as development and testing of an interactive epilepsy smart phone application to improve resilience among them.
TWAS is a global merit-based science academy based in Trieste, Italy, and administered as a UNESCO Programme Unit. Read more here: https://twas.org/
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