Health

Study to Address the Social drivers of Mental Illness Launched in Uganda by Kennesaw State University & Makerere University

Published

4 years ago

March 10, 2022

TOPOWA Project PI-Dr. Monica Swahn (7th R) and Co-PI-Dr. Catherine Abbo (5th R) with the Project Team at the Launch on 8th March 2022 in Kampala.

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.

Some of the beneficiaries of the TOPOWA Project attend a tailoring course.

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”

Dr. Swahn, the Principal Investigator, and also Professor and Dean of the Wellstar College of Health and Human Services at KSU

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.”

Some of the young women beneficiaries of the project entertain visitors at the Bwaise UYDEL site

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.

Dr. Catherine Abbo, an Associate Professor of Psychiatry at Makerere University College of Health Sciences, and Co-Investigator of the TOPOWA study.

“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.

Executive Director of UYDEL, Rogers Kasirye.

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.

TOPOWA Study PI Prof. Monica Swahn interracts with Makerere University School of Public Health team. In the photo, Dr. JB Isunju, Mr. Charles Ssemugabo and Ezekiel Musasizi.

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

Related Topics:Africa CHS CoVID girls GSU Kampala KSU MakSPH Mental Health Project sleep slums TOPOWA track Uganda UYDEL Women youth

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Health

The silent teachers: why body donation matters

Published

4 days ago

June 5, 2026

Mak Editor

Assoc. Prof. Erisa Sabakaki Mwaka, Consultant Orthopaedic Surgeon and Chair, Department of Anatomy, College of Health Sciences (CHS). Makerere University, Kampala Uganda, East Africa.

_{By Assoc. Prof. Erisa Mwaka and Joyce Nabukalu-Kiwanuka}

In every hospital, there is a moment when knowledge becomes a matter of life and death. A doctor must know where to place an incision, how to avoid damaging major organs, how to identify a nerve, how to deliver a baby safely, how to interpret a scan, or how to explain disease to a worried family. That knowledge does not begin in the operating theatre, it begins much earlier, in the anatomy laboratory.

For generations, the study of the human body has been the foundation of medical education. The regular use of human bodies for medical training purposes began in the late Middle Ages and spread during the 18th and 19th centuries. Initially, anatomists depended on gallows, poor houses, mental asylums, or jails as sources of bodies. However, the 1960s and 1970s saw the emergence of wilful body donation. Before students become doctors, surgeons, dentists, nurses, physiotherapists, radiographers, and other health professionals, they must first understand the human body in its real form. They must learn not only from books and diagrams, but from the body itself. This is why cadavers, though silent, remain the most important teachers in medical education. In simple terms, a cadaver is a dead human body used by health professions students to study anatomy; and Anatomy is the study of the physical structure and organization of the human body, both at macroscopic and microscopic levels.

As the Department of Anatomy at Makerere University College of Health Sciences prepares to commemorate the “silent teachers” whose bodies are used for medical education on June 11, 2026, Uganda is invited to reflect on a subject that is rarely discussed in the public domain, willed body donation. Body donation simply means a person willfully donates their body for educational purposes after death, and consent to it in life. This is a sensitive topic, but it is also a deeply human one. It touches our beliefs, families, culture, understanding of death, and responsibility to future generations.This commemoration ceremony is not symbolic but, it is a public statement that the contribution of silent teachers is sacred, educational, and deeply appreciated.

To donate one’s body after death is not an ordinary decision; it is an altruistic act of extraordinary generosity. It is a final gift to society. It allows health professions students to learn and appreciate the human body before they treat living patients. Cadavers are therefore not “specimens”, they are silent teachers and partners in medical education who continue to serve humanity even after death. Learning anatomy using a cadaver helps students to understand and appreciate the complexity of the human body, appreciate its natural variations, and develop the confidence and competence needed to serve the public. Students are also taught laboratory etiquette that emphasises dignity, empathy, and utmost respect for the cadavers, which attributes they carry into the clinical years when they interface with hospital patients.

In Uganda, where the demand for health workers continues to grow, medical education must be strengthened at every level. Our country needs well-trained doctors and health professionals who can serve in hospitals, health centres, universities, research institutions, and communities. But good training requires good teaching resources. One of these resources are the silent teachers who never complain, but impart immeasurable knowledge to future health professionals. Modern technology has introduced many useful tools into medical education. Students can now learn from videos, computer applications, digital images, plastic models, three-dimensional models, and virtual platforms. These tools are important and should be embraced, however, they cannot completely replace learning from the real human body. A cadaver teaches what a diagram cannot fully show; the true position of organs, the texture of tissues, the relationship between structures, and the natural differences that exist from one person to another. More importantly, cadaver-based learning teaches respect. It reminds students that medicine is not simply a technical profession, it is a calling rooted in human dignity. The first lesson students learn in the anatomy laboratory is that the body before them belonged to a person who had a name, a family, a story, and a life. That lesson shapes how they later treat patients.

Currently, most, if not all universities in Uganda, and similar settings in Africa use unclaimed bodies for learning Anatomy. The use of cadavers in Uganda is governed by the Penal Code (Anatomy Rules) of 1957 that permits public hospitals to transfer bodies unclaimed for at least 14 days to a medical training institution like Makerere University. Unfortunately, these cadavers are used without the consent of the deceased because most of them are unknown and with no known relatives to claim them. Many opponents to the use of unclaimed bodies opine that the practice is unethical. There is a global push toward ethical use of cadavers in medical education, where a person consents and bequeathes his/her body for medical education when still alive. For this practice to be sustainable, there is a need for a well regulated body donation program. Unfortunately, the concept of willful body donation is still not well understood by many people, and neither has it been a topic of public debate. Further, there are lots of myths surrounding death and dying in Africa, including Uganda that have hindered the establishment of successful body donation programs. Willingness to donate bodies for medical education is however, influenced by several factors including cultural and religious beliefs, respect for the dead and the need to fulfil burial rites, fear for mutilation and disrespect, to mention a few. These concerns are real and should not be dismissed. But they should be addressed with accurate information, openness, and utmost respect.

It is important to understand that body donation does not mean that a person is forgotten. On the contrary, it creates a legacy. A body donor may teach hundreds of future health professionals, in that way, one person’s final act of generosity can touch and save countless lives. This is kind of patriotism is largely unkown in Uganda and we do not speak about enough. We often talk about serving our country through leadership, business, farming, teaching, parenting, or community service. But there is also service beyond life. Body donation is one way of saying: “Even when I am gone, let me contribute to the health of my people.”

Currently, Uganda now has more than 15 universities training medical students and the demand for cadavers for learning anatomy is on the rise. Actually, the supply of cadavers cannot fulfil the demand, and medical educationists need to find alternative source of cadavers. Wilful body donation is the answer.

Uganda needs a national conversation on body donation. There is a need for deliberative public engagement involving various stakeholder including the public, religious and cultural leaders, civic leaders, the media, educationists, health professionals, medical training institutions, etc.

This commemoration ceremony will involve inter-denominational prayers for the silent teachers, and a reflection of their contribution to healthcare in Uganda. We hope this ceremony will provoke public debate on a subject that is hitherto considered a taboo by many. We talked about some of these issues last year, in the first ever such ceremony in Uganda, and have received several requests for more information on the procedure for donating one’s body for teaching purposes upon death. Like President Obama’s said, “yes we can”, an the dialogue starts from you and me. You are all invited for the commemoration ceremony at 9.00 am on June 11, 2026, at the Makerere University School of Public Health auditorium on main campus.

To donate one’s body is to give a final lesson, a final service, and a lasting gift to the nation.

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Health

Makerere Health Services Guidance on Ebola Virus Disease (EVD)

Published

1 week ago

June 1, 2026

Mak Editor

How to protect yourself and your loved ones from Ebola. Ministry of Health, Kampala Uganda, East Africa.

The Democratic Republic of Congo (DRC) and Uganda recently reported an outbreak of Ebola Virus Disease (EVD), which is a serious and often deadly disease caused by a person being infected by the Ebola virus.

The virus spreads through direct contact with body fluids such as blood, saliva, faeces, vomit, urine, sweat or genital fluids from a person who is infected with EVD.

The symptoms of EVD usually develop after 8 – 10 days from contact with an infected person and may include fatigue, high fever, headache, sore throat, muscle and joint pains, vomiting and diarrhea and in severe cases, bleeding.

What should we do as the Makerere University community?

The Chief, Makerere Health Services, Prof. J.K. Byamugisha advises as follows:

Avoid unnecessary contact such as shaking hands, hugging etc.
Place alcohol disinfectants or hand washing equipment at all entry points within the University and ensure everyone is using them.
Students should sit in single-person chairs while in class, avoiding contact with their neighbours.
Do not sit too close to one another especially in frequently crowded places such as classrooms, library or any other waiting area.
While at the University Hospital, wash hands a the gate, use alcohol disinfectant at the reception.
All patients should have a maximum of one caretaker – others can check on them by calling.
Avoid bringing luggage to the University Hospital.
Target to do as instructed by the health worker.
For further information and guidance on Ebola, please call Dr. Charles Basigara on Tel: 0702 966652 and Sr. Eunice Namubiru on Tel: 0779 950978 (Contact persons for the University Health Services)

Additionally, always look out for and ensure full compliance with Ministry of Health (MoH) Infection Prevention and Control measures such as the one below.

How to report suspected Ebola cases to Health Authorities. Ministry of Health, Kampala Uganda, East Africa. — ***How to report suspected Ebola cases to Health Authorities.***

Please find attached detailed communications from Prof. Byamugisha and
the Permanent Secretary Ministry of Health.

Makerere-Health-Services-Ebola-Virus-Disease-Memo-28-May-2026 Download

Ministry of Health Circular on Mass Gatherings Download

Health

Call for Applications: Masters Support in Self-Management Intervention for Reducing Epilepsy Burden

Published

2 weeks ago

May 25, 2026

Mak Editor

An aerial photo of the College of Health Sciences (CHS), Makerere University showing Left to Right: The Sir Albert Cook Memorial Library, School of Biomedical Sciences, Davies Lecture Theatre, School of Public Health, Mulago Specialised Women and Neonatal Hospital (MSWNH)-Background Left and Nakasero Hill-Background Right, Kampala Uganda, East Africa.

The Makerere University College of Health Sciences and Case Western Reserve University, partnering with Mbarara University of Science and Technology, are implementing a five-year project titled “Self-management Intervention for Reducing Epilepsy Burden Among Adult Ugandans with Epilepsy.”

The program is funded by the National Institute of Health (NIH) and the National Institute of Neurological Disorders and Stroke (NINDS). One aspect of the program is to provide advanced degree training to qualified candidates interested in pursuing clinical and research careers in Epilepsy. We aim to grow epilepsy research capacity, including self-management approaches, in SSA.

The Project is soliciting applications for Master’s Research thesis support focusing on epilepsy-related research at Makerere University and Mbarara University, cohort 3, 2026/2027.

Selection criteria

Should be a Master’s student of the following courses: MMED in Internal Medicine, Paediatrics, Surgery and Neurosurgery, Psychiatry, Family Medicine, Public Health, Master of Health Services Research, MSc. Clinical Epidemiology and Biostatistics, Nursing, or a Master’s in the Basic Sciences (Physiology, Anatomy, Biochemistry, or any other related field).
Should have completed at least one year of their Master’s training in the courses listed above.
Demonstrated interest in Epilepsy and Neurological diseases, care and prevention, and commitment to develop and maintain a productive career, and devoted to Epilepsy, Clinical Practice, and Prevention.

Research Programs:

The following are the broad Epilepsy research priority areas (THEMES), and applicants are encouraged to develop research concepts in the areas of: Applicants are not limited to these themes; they can propose other areas.

The epidemiology of Epilepsy and associated risk factors.

Determining the factors affecting the quality of life, risk factors, and outcomes (mortality, morbidity) for Epilepsy, epilepsy genetics, and preventive measures among adults.
Epilepsy in childhood and its associated factors, preventative measures etc.
Epilepsy epidemiology and other Epilepsy related topics.
Epilepsy interventions and rehabilitation

In addition to a formal master’s program, trainees will receive training in bio-ethics, Good Clinical Practice, behavioral sciences research, data and statistical analysis, and research management.

The review criteria for applicants will be as follows:

· Relevance to program objectives

Quality of research and research project approach
Feasibility of study
Mentors and mentoring plan; in your mentoring plan, please include who the mentors are, what training they will provide, and how often they propose to meet with the candidate.
Ethics and human subjects’ protection.

Application Process

Applicants should submit an application letter accompanied by a detailed curriculum vitae, two recommendation letters from Professional referees or mentors, and a 2-page concept or an approved full proposal describing your project and addressing Self-Management Intervention for Reducing Epilepsy Burden Among Adults or an epilepsy-related problem.

For more information, inquiries, and additional advice on developing concepts, don’t hesitate to get in touch with the following:

Makerere University College of Health Sciences

Prof. Mark Kaddumukasa: kaddumark@yahoo.co.uk

Mbarara University

Ms. Josephine N Najjuma: najjumajosephine@yahoo.co.uk

Only short-listed candidates will be contacted for Interviews.

A soft copy should be submitted to the Administrator of the Epilepsy Project. Email: smireb2@gmail.com; Closing date for the Receipt of applications is 5^th July 2026.