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Health Experts meet at MakCHS to discuss Health Professions Education

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On 17th June 2022, health experts met at Makerere University College of Health Sciences (MakCHS) for a half-day symposium, Makerere@100: Advancing Health Professions Education in Uganda’Theaim of the symposium hosted by Health Professions Education Partnership Initiative (HEPI) in collaboration with The African Center for Global Health and Social Transformation (ACHEST) was ‘to take a look at Health Professions Education (HPE), the past, the present and future in Uganda’. In addition, the symposium was also intended to keep abreast of emerging issues and new trends in a globalised world. The meeting was attended by academia, government institution officials, civil society, researchers and students.

Professor Damalie Nakanjako (R) welcomes participants to the Symposium.
Professor Damalie Nakanjako (R) welcomes participants to the Symposium.

Welcoming participants to the symposium, Professor Damalie Nakanjako – Principal, MakCHS reiterated the aim of the meeting, ‘to review the past, present and future health professions education in Uganda’. Professor Nakanjako stressed the importance of balancing teaching, service delivery and teaching as the three legs of the stable African stool and foundations of HPE. She traced the history of the college since establishment in 1924 as the oldest health training institution in the region and highlighting the major milestones and innovations of MakCHS. ‘The college has a long and distinguished history in health education: it has been involved in health innovations, research, case management, modeling impact and has addressed: infectious diseases and non-communicable diseases” she added. Prof. Nakanjako thanked HEPI and ACHEST for the support given to MakCHS in organising the symposium. The Principal invited the Chief Guest to give his opening remarks.

The Chief Guest, Professor Buyinza Mukadasi represented the DVCAA Professor Umar Kakumba.
The Chief Guest, Professor Buyinza Mukadasi represented the DVCAA Professor Umar Kakumba.

Professor Mukadasi Buyinza – Director, Research and Graduate Training at Makerere University represented the First Deputy Vice Chancellor/ Academic Affairs, Prof. Umar Kakumba as Chief Guest. In his remarks, Professor Buyinza commended MakCHS for organising the symposium bringing together senior and junior health professionals noting that, ‘There is need to build sustainable health profession networks that serve as forums to share innovative ideas and learning’. He added ‘quality should be considered a priority and we need to focus on professionalism, inclusiveness, communication, etc. in order to promote health education’. Professor Buyinza highlighted the role of Makerere University as we celebrate 100 years noting that during the pandemic, Makerere University responded adequately in a multitude of areas: and advised that moving forward with  lessons from the pandemic, we must promote fundamental health education. He applauded the champions behind the HEPI and ACHEST  who supported the meeting noting “this is great because for sure times have changed with the Covid-19 pandemic has been a great lesson calling for different approaches in order to strike a balance and this can only be possible with partnerships”. Professor Buyinza called on government and partners to increase funding for health professions education adding that “Investment in education of training of health workers with a weak mindset, will not give us the quality health care and service we require thus a positive attitude among health professionals should be part of their education”. He reiterated that new emerging issues like tele-medicine are here to stay and thus health professionals should be equipped with the competencies to handle them. He also encouraged that we must give back to society and MakCHS is challenged to remain as leader in training health workers. Prof. Buyinza officially opened the meeting thanking the organisers and wished the participants fruitful deliberations noting that he looks forward to receiving the report from the symposium.

Professor Sarah Kiguli, Principal Investigator – HEPI speaks on behalf of the Health Professions Education Symposium organisers.
Professor Sarah Kiguli, Principal Investigator – HEPI speaks on behalf of the Health Professions Education Symposium organisers.

Speaking on behalf of the organisers, Professor Sarah Kiguli, Principal Investigator – HEPI welcomed participants to the symposium thanking them for accepting the invitations. She thanked Professor Francis Omaswa, Executive Director – ACHEST for the proposal to hold the symposium and agreeing to partner with MakCHS is hosting the meeting. “I thank previous leaders on whose work we are building what we do today. We can’t advance HPE without strong partnerships: We need to establish and sustain the collaborations”, Professor Kiguli added. She also highlighted the objectives and successes of the HEPI Project so-far.

Deliberations at the meeting were aligned along two panel discussions preceded by keynote speeches by preeminent health professionals; Professor Francis Omaswa and Professor Nelson Sewankambo.

Professor Francis Omaswa, Executive Director – ACHEST delivers his keynote address.
Professor Francis Omaswa, Executive Director – ACHEST delivers his keynote address.

In his keynote speech titled, ‘The Global Health Workforce Crisis: the role of Academic Institutions’, Professor Francis Omaswa shared the global statistics for health professions training and patient ratio noting that it’s not a good picture. He highlighted that populations globally are living longer and require health services. However, in the global north there are less young people to train as health professionals thus recruiters are looking to the global south, Africa and Asia are most affecting because our trained health workers are migrating due of poor pay. On Africa Uganda specifically he said “there are shortages in Africa but our professionals are recruited to serve elsewhere. We don’t have money to employ health workers despite the increasing population”. Professor Omaswa gave the critical success factors for better health services and HPE in Africa including: Political Commitment and good governance; Workforce planning and Enabling Environment.  He also proposed key competencies for today’s health work, these are: Work where services are most needed; Respond to health needs of community; Deliver quality care; Clinical excellence; Be leaders and change agents; Self-directed learners and Effective communicators. Professor Omaswa advised that there must be strong link between the health system and health profession education institutions adding ‘stop grumbling and start acting, when we act together we will go much further and achieve more. Let this symposium be the beginning of us as change agents’.

Panelists L-R: Professor Elsie Kiguli-Malwadde, Professor Francis Omaswa, Professor Jehu Iputo and Professor Joel Okullo.
Panelists L-R: Professor Elsie Kiguli-Malwadde, Professor Francis Omaswa, Professor Jehu Iputo and Professor Joel Okullo.

Panelists to discuss Professor Omaswa’s presentation were Professor Elsie Kiguli-Malwadde, ACHEST; Professor Jehu Iputo (Busitema University); Professor Joel Okullo (Uganda Medical and Dental Practitioners Council, Professor Sarah Kiguli (HEPI/MakCHS) and Representative from National Council for Higher Education. A key issue raised from the panel discussion was the need for a link between stakeholders in the HPE sector and a call for education institutions to plan their teaching programmes in response to the health sector.

In his keynote speech titled “Health Professions Education (HPE) in Uganda, past present and future”, Professor Nelson Sewankambo noted that the current curriculum is old and doesn’t reflect health & disease prevention adding that we need to strike a balance between curative, health services & disease prevention. Prof. Sewankambo urged lecturers and staff in health institutions to help the young generation, students in particular, “let’s take the young people by hand to strengthen the future generation, we are not doing what we are supposed to do”, he added. Professor Sewankambo also called for closer working relationships between teaching hospitals and health profession training institutions and echoed Professor Omaswa’s call that staff stop lamenting and get to work.

Professor Josephine Namboze (L) and Professor Francis Omaswa (R) chat during a break.
Professor Josephine Namboze (L) and Professor Francis Omaswa (R) chat during a break.

Panelists to discuss Professor Sewankambo’s presentation were Professor Josephine Namboze, the first female doctor trained at Makerere University; Dr. Safina Museene, Ministry of Education and Sports; Professor Pius Okongo, Health Service Commission and Ms. Elizabeth Ekong Namukombe, Uganda Nurses and Midwives Council. Key issues raised from the panel discussion was a call for research to inform planning for health institutions; revision of establishments at health institutions and job evaluation to reflect current developments; and partnerships between institutions rather than competition.

Professor Rhoda Wanyenze presents the wrap-up and way forward at the Health Professions Education Symposium 2022.
Professor Rhoda Wanyenze presents the wrap-up and way forward at the Health Professions Education Symposium 2022.

A wrap-up and way forward from the meeting was presented by Professor Rhoda Wanyenze, Dean – School of Public Health. Professor Wanyenze advised that competencies for health professionals need a critical revision calling for skills aligned to current environment for the products from health training institutions. “When we train people are who are knowledgeable with a lot of theory it’s only as good as having critics, however we need to train skilled people in the health sector”, she added. She highlighted the following issues for consideration as next steps:

  1. Need for a national Strategy and Plan: Informed by the National Health Policy and Plan as well as emerging issues in health e.g. move towards healthier societies, revitalizing Primary Health Care to drive UHC and comprehensively address health determinants.
    • a. Address the numbers, cadre mix and quality with attention to current gaps in development of some professions e.g. nursing, dental, pharmacy, among others
    • b. Network with relevant bodies to address the issues within the Qualifications Framework and MOH HRH Plan
    • c. Integrate linkages between Health, Education and other relevant sectors in line with the NDP move towards multi-sectoral collaboration
  2. Strengthen Health Training Institutions
    • a. Teaching infrastructure including space, laboratories, simulation and community labs (need collaborations with communities and other organizations for student hands-on learning), and to streamline agreements between teaching institutions and teaching hospitals.
    • b. Curriculum aligned to competencies—streamline issues of standardization of curricular within the country and the EAC region, and move beyond knowledge and skills to professionalism and transformative leadership in competences, and integrate the critical components of health promotion and prevention
    • c. Trainers: Numbers, mix of disciplines and expertise and quality: Comprehensive training and capabilities in teaching, research and community service as well as leadership and governance; need Education Units to support trainers and Research Units to support research management
    • d. Explore inter-sectoral/Interdisciplinary programs—break the silos to appropriately prepare the trainees to work across disciplines and sectors.
    • e. Governance and Systems Leadership: Functional, effective and efficient systems with relevant networks for health professional training
    • f. Teaching institutions systems for appointments and promotion need a review of the definition of scholarship—beyond PhDs and publications to critical grounding in disciplines, professionalism and leadership in the field
    • g. Collaborate with relevant structures within Health, Education and Finance to address the issue of scholarships for graduate students
  3. Collaboration and networks across universities (south-to-south, within and across countries, north-south), with training hospitals and communities
  4. Financing: Review and streamline models and level of financing for health training institutions and related regulatory structures such as the Professional Councils
    • a. Joint training, research and service collaborations
    • b. VC, Deans Forums across universities for experience sharing and joint learning
  5. Health professionals Forum: Annual meeting to share experiences and learnings, and joint planning as well as engagement and negotiations to improve health professions education in Uganda
  6. Standards, Quality Assurance and Regulation: Adequately resources and effective regulatory structures and systems—address issues of curricular and examinations standardization and implementation
  7. Research: Modeling of health workforce needs to inform planning and a review of the state of health in Uganda
  8. Arrange a follow-up stakeholder meeting to synthesize and follow-up on the actions

Zaam Ssali

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New Study Identifies Optimal Waist Cut-Off for Metabolic Syndrome in Ugandan Women

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New study conducted in Wakiso district has determined the ideal waist circumference for detecting metabolic syndrome among Ugandan women. Study findings closely align with the International Diabetes Federation (IDF) cut-off for predicting ill health risks. Funded by Government of Uganda through the Makerere University Research and Innovation Fund (MakRIF) and the Strengthening Education and Training Capacity in Sexual and Reproductive Health and Rights (SET-SRHR) Project in Uganda, Kampala, East Africa.

A new study conducted in Wakiso district has determined the ideal waist circumference for detecting metabolic syndrome among Ugandan women. Study findings closely align with the International Diabetes Federation (IDF) cut-off for predicting ill health risks.

The researchers at Makerere University’s School of Public Health (MakSPH) aimed to establish an ethnically appropriate waist circumference cut-off point for Ugandan women to enhance early detection and prediction of metabolic syndrome. About 2 in 10 of the women studied in Wakiso district, Uganda, suffer from metabolic syndrome, which is associated with diabetes and heart disease.

Findings indicated that for women aged 18–49 years in the Wakiso district, 80.3 cm is the optimal waist measurement to flag potential metabolic syndrome risks.

The threshold increases with age:

• 79.9 cm for young women (25-34 years)

• 85.6 cm for mid-life (35-44 years)

• 91.1 cm for pre-menopausal women (45-49 years)

Unlike the Body Mass Index (BMI), a calculated measure of weight relative to height used to assess an individual’s weight status and potential health risks, waist measurement better detects dangerous abdominal fat linked to diabetes and heart disease.

Dr. David Lubogo, a lead researcher on this study and Senior Lecturer in the Department of Community Health and Behavioral Sciences at Makerere School of Public Health, noted that with hormonal and physiological changes making women particularly vulnerable during reproductive years, these Uganda-specific benchmarks will help clinics identify at-risk patients earlier, using just a measuring tape.

“Our findings confirm waist measurement as a powerful, low-cost tool for preventive care. While aligning with global standards, we have refined thresholds for Uganda’s context,” Dr. David Lubogo notes.

A cross-sectional study was carried out in Wakiso District from June to August 2021, involving 697 randomly selected women aged 15–49. Participants had lived in Wakiso for at least a year and underwent physical, biochemical, and anthropometric tests to help determine the prevalence of metabolic syndrome (MetS). “We excluded pregnant and postpartum women, alcoholics, smokers, and those with chronic or infectious diseases to ensure accurate results,” explained Dr. David Lubogo.

The study, published in PLOS Global Public Health, underscores the importance of age-sensitive screening in tackling metabolic diseases in sub-Saharan Africa. In response, health officials in the study area should explore practical ways to weave these findings into everyday programs for community health screening.

The study was funded by the Government of Uganda through the Makerere University Research and Innovation Fund (MakRIF) and the Strengthening Education and Training Capacity in Sexual and Reproductive Health and Rights (SET-SRHR) Project in Uganda. Other investigators included Dr. Henry Wamani, Dr. Roy William Mayega, and Professor Christopher Garimoi Orach.

The Research Team. New study conducted in Wakiso district has determined the ideal waist circumference for detecting metabolic syndrome among Ugandan women. Study findings closely align with the International Diabetes Federation (IDF) cut-off for predicting ill health risks. Funded by Government of Uganda through the Makerere University Research and Innovation Fund (MakRIF) and the Strengthening Education and Training Capacity in Sexual and Reproductive Health and Rights (SET-SRHR) Project in Uganda, Kampala, East Africa.
The Research Team: Dr. David Lubogo, Dr. Henry Wamani, Dr. Roy William Mayega and Prof. Christopher G. Orach.

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Davidson Ndyabahika

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Makerere University Launches Social Innovation in Health Initiative Community of Practice

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Prof. Barnabas Nawangwe (2nd R) presents a certificate to a participant (R) as Dr. Phyllis Awor (L) and Mr. Tomas Lundström (2nd L) witness on 9th April 2025. Makerere University official launch of Social Innovation in Health Initiative Community of Practice (SIHICOP)—a new platform designed to connect local health innovators with policymakers, donors, and researchers, School of Public Health with support of the Swedish Embassy and the World Health Organization’s TDR program, 9th April 2025, 6th National Social Innovation in Health Stakeholders’ Workshop at Hotel Africana in Kampala, Uganda, East Africa.

Kampala, 09 April 2025Makerere University has officially launched the Social Innovation in Health Initiative Community of Practice (SIHICOP)—a new platform designed to connect local health innovators with policymakers, donors, and researchers. The goal: to turn scattered success stories into a powerful, nationwide movement that reimagines healthcare from the ground up.

The launch, held during the 6th National Social Innovation in Health Stakeholders’ Workshop at Hotel Africana in Kampala, drew a dynamic mix of changemakers, health innovators, academics, donors, and government leaders, all rallying around one idea: that equitable, sustainable healthcare must be rooted in communities.

While Uganda has made notable progress, cutting under-five deaths by 66% since 2000, challenges remain. Fifty out of every 1,000 children still die before their fifth birthday. Nearly half suffer from stunting due to malnutrition. In rural areas, pregnant women walk for hours to reach clinics. Across the country, hospitals battle frequent drug shortages.

Dr. Phyllis Awor, Director of the SIHI Uganda Hub at Makerere University’s School of Public Health (MakSPH), emphasized the critical role of social innovation in closing healthcare gaps. “Half of Ugandan children lack basic vaccinations, and 40% face stunting. These challenges demand creative, inclusive solutions co-created with communities,” she said.

“We’ve spent a decade identifying, studying, and strengthening grassroots innovations. Through our six-month fellowship program, we train innovators in monitoring and evaluation, research, communication, impact assessment, and fundraising so their work doesn’t just survive but scales,” she said. “Today, we’re awarding them completion certificates and launching them into a vibrant community of practice.”

Dr. Awor, who is also a Lecturer and Researcher maintains Social Innovation is about solving these real problems with real people. With the support of the Swedish Embassy and the World Health Organization’s TDR program, SIHICOP, she says, will foster peer learning, capacity-building, and scaling of innovations like mobile health platforms and community-based maternal care.

Dr. Phyllis Awor, Director of the SIHI Uganda Hub at Makerere University’s School of Public Health (MakSPH) speaks during the launch. Makerere University official launch of Social Innovation in Health Initiative Community of Practice (SIHICOP)—a new platform designed to connect local health innovators with policymakers, donors, and researchers, School of Public Health with support of the Swedish Embassy and the World Health Organization’s TDR program, 9th April 2025, 6th National Social Innovation in Health Stakeholders’ Workshop at Hotel Africana in Kampala, Uganda, East Africa.
Dr. Phyllis Awor, Director of the SIHI Uganda Hub at Makerere University’s School of Public Health (MakSPH) speaks during the launch.

Since 2017, Uganda’s SIHI hub has supported 30 homegrown innovations, impacting tens of thousands of lives. “We’ve identified 21 standout solutions so far,” Dr. Awor shared. “But if we want them to go national, we need enabling policies.”

Globally, SIHI was founded in 2014 to bring together innovators, communities, policymakers, and academics across the Global South. With 15 hubs, including Uganda’s, SIHI has documented over 200 innovations and 40 case studies that demonstrate the power of grassroots solutions to improve health systems.

Dr. Olaro Charles, Uganda’s Acting Director General of Health Services, acknowledged that bureaucracy often stifles good ideas. “Sometimes, a small change in how you look at a problem can produce the best and most marketable solution,” he said.

He spoke from experience. As a clinician, Dr. Olaro led efforts to curb drug theft and stockouts by tightening distribution and boosting accountability. “It’s not like people walk off with whole boxes,” he explained. “But if you have 300 employees and each takes just one dose… that adds up. We introduced medicine returns, round-the-clock pharmacies, and ward-level audits. At first, there was resistance, but it worked.”

Dr. Olaro Charles, Uganda’s Acting Director General of Health Services, Ministry of Health Uganda speaks to Innovators during the launch of the SIHICOP. Makerere University official launch of Social Innovation in Health Initiative Community of Practice (SIHICOP)—a new platform designed to connect local health innovators with policymakers, donors, and researchers, School of Public Health with support of the Swedish Embassy and the World Health Organization’s TDR program, 9th April 2025, 6th National Social Innovation in Health Stakeholders’ Workshop at Hotel Africana in Kampala, Uganda, East Africa.
Dr. Olaro Charles, Uganda’s Acting Director General of Health Services, Ministry of Health Uganda speaks to Innovators during the launch of the SIHICOP.

Another one of his most memorable innovations was setting up a neonatal unit for premature babies while he was a Medical Superintendent. “I remember a baby who weighed less than a kilo, barely six months old, and survived. We pushed survival rates to 85%. Eventually, we ran out of space. We began asking ourselves: Where had these children been going before? Previously, these children may have died within the community. These are innovations that create real, tangible impact. And I’m sure many of the things you’re doing here are creating similar results.”

He urged the Fellows to treat their innovations like living systems: “If they survive infant mortality, they’ll live longer. These ideas deserve to grow.”

Mr. Tomas Lundström, Health Counsellor at the Swedish Embassy, spoke with deep conviction about Sweden’s long-standing investment in Uganda’s future. “For decades, Sweden has believed in Uganda’s greatest asset, its people,” he said. “Through Sida, we funded the training of over 500 Makerere staff for PhDs. I didn’t start it. I didn’t train your PhDs. The Swedish taxpayers actually funded the training. Now that wasn’t just investment; it was transformation. It’s one reason Makerere is the powerhouse it is today.”

Lundström also shared a memory that continues to shape his view of development. While inspecting UNICEF projects in Zambia in 1998, he recalled visiting five villages where only one had shown some success. A driver suggested they visit the last village, the 5th. “We went. No one was there. We waited, then a man came running, covered in dirt. He was the village chief,” Lundström recounted. “He said something I’ve never forgotten: ‘Thomas, when the rainy season comes, we can’t take pregnant women to the clinic. Do you know where I can learn to build a bridge’?”

Mr. Tomas Lundström, Health Counsellor at the Swedish Embassy. Makerere University official launch of Social Innovation in Health Initiative Community of Practice (SIHICOP)—a new platform designed to connect local health innovators with policymakers, donors, and researchers, School of Public Health with support of the Swedish Embassy and the World Health Organization’s TDR program, 9th April 2025, 6th National Social Innovation in Health Stakeholders’ Workshop at Hotel Africana in Kampala, Uganda, East Africa.
Mr. Tomas Lundström, Health Counsellor at the Swedish Embassy.

“That was different from what I usually hear—‘Can we have some money?’ Real change doesn’t come from handouts. It starts within communities.”

But Lundström warned that international aid is under strain. “We’ve already lost a lot of funding from U.S. and other donors. Ukraine, Sudan—global crises are pulling resources away. We must get creative. We must find new ways to secure resources.”

Still, he was optimistic. “We’re seriously considering continued support for another year. We’re also pushing for deeper collaboration between Makerere and Karolinska Institutet. But it’s up to you too,” he said.

He praised Dr. Phyllis Awor and her team: “What sets them apart is not just competence, but passion. She doesn’t do this because it’s her job; she does it because she believes in it. Because everyone deserves a fair chance, a seat at the table, a bit of hope.”

Makerere University Vice Chancellor, Professor Barnabas Nawangwe, echoed those sentiments, describing the School of Public Health as the university’s “engine of change.” He noted that the School contributes to nearly 30% of all university publications—and brings in 40% of its research funding.

“That’s no accident,” he said. “Public health is critical. Without health, there is no progress. That’s why donors invest in public health issues.”

Makerere University Vice Chancellor, Professor Barnabas Nawangwe. Makerere University official launch of Social Innovation in Health Initiative Community of Practice (SIHICOP)—a new platform designed to connect local health innovators with policymakers, donors, and researchers, School of Public Health with support of the Swedish Embassy and the World Health Organization’s TDR program, 9th April 2025, 6th National Social Innovation in Health Stakeholders’ Workshop at Hotel Africana in Kampala, Uganda, East Africa.
Makerere University Vice Chancellor, Professor Barnabas Nawangwe.

He described the social innovation initiative as a model for how academia and communities can work together, not just to publish but to transform lives. “When global rankings name Makerere the most community-impactful university, they’re recognizing what happens when scholars step beyond lecture halls. This is what happens when researchers dig deep into the ground to cultivate solutions that transcend national boundaries.

The Vice Chancellor also paid tribute to Sweden’s role in that transformation. “We cannot thank the people of Sweden enough. Their support through Sida trained over 500 of our staff to the PhD level—the largest staff development initiative I’ve seen at any university, anywhere. It came when we needed it most, after the war. That’s why Makerere stands today as a leading research institution in Africa.”

He congratulated the 2024/25 Fellows, praising their inspiring journeys, and commended Dr. Awor and her remarkable team of researchers for achieving what only world-class institutions can: “melding razor-sharp academia with the wisdom of villages, policy muscle with frontline innovations.”

SIHI innovators and researchers in a group photo with the Makerere University Vice Chancellor, Professor Barnabas Nawangwe, Mr. Tomas Lundström, Health Counsellor at the Swedish Embassy and Dr. Phyllis Awor, Director of the SIHI Uganda Hub at Hotel Africana. Makerere University official launch of Social Innovation in Health Initiative Community of Practice (SIHICOP)—a new platform designed to connect local health innovators with policymakers, donors, and researchers, School of Public Health with support of the Swedish Embassy and the World Health Organization’s TDR program, 9th April 2025, 6th National Social Innovation in Health Stakeholders’ Workshop at Hotel Africana in Kampala, Uganda, East Africa.
SIHI innovators and researchers in a group photo with the Makerere University Vice Chancellor, Professor Barnabas Nawangwe, Mr. Tomas Lundström, Health Counsellor at the Swedish Embassy and Dr. Phyllis Awor, Director of the SIHI Uganda Hub at Hotel Africana.

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Davidson Ndyabahika

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Uganda Newborn Programme Shifts the Paradigm of Newborn Care

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A newborn baby in an incubator in Neonatal Care Unit. Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies national health systems strengthening initiative the Uganda Newborn Programme (UNP) launched 2022. Program uses regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions. Achievements 2025. Kampala, East Africa.

By Joseph Odoi

Every newborn deserves the best start to life. Yet, in Uganda, the burden of newborn morbidity and mortality remains high. The newborn mortality rate stands at 22 deaths per 1000 live births (UDHS 2022). According to most recent UN annual estimates, Uganda records 62,000 deaths around the time of birth. Of these, 32,000 are neonatal deaths, 26,000 are stillbirths and 4,800 are maternal deaths. Majority of the newborn deaths occur within the first week after delivery- a period considered very vulnerable for both the mother and baby.

Uganda’s high fertility rate translates to about 1.7 million births per year; and of these 250,000 babies need special newborn care as they are either born too small or fall sick within the first month of life. This has placed a huge burden on the country and strained the already limited investment for neonatal care.

Despite national efforts, newborn deaths continue to account for nearly half of all under-five deaths in Uganda, according to the Uganda Demographic and Health Survey (UDHS) 2022.

To contribute to addressing this challenge, a coalition of institutions namely; Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies launched a national health systems strengthening initiative known as the Uganda Newborn Programme (UNP) in 2022. This program uses a regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions.

According to Dr. Monica Okuga, the Uganda Newborn Programme Coordinator at Makerere University School of Public Health (MakSPH), the Uganda Newborn Programme (UNP) made huge strides in providing quality newborn care in 36 health facilities across the three regions of Uganda.

Uganda New Born Programme Achievements

‘’Under the UNP, there have been so far many achievements. Institutional neonatal mortality rate has reduced in the facilities where the program is implemented and this has contributed to overall reduction in neonatal mortality in the regions. For example, Institutional neonatal mortality reduced to 7/1000 and 2/1000 live births by the end of Year 2, down from the baseline rates of 8.4/1000 and 11.9/1000 in Bunyoro and Tooro, representing reductions of 16.7% and 85.3% respectively’’ Dr. Okuga stated.

Dr. Monica Okuga, the Uganda Newborn Programme Coordinator at Makerere University School of Public Health (MakSPH). Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies national health systems strengthening initiative the Uganda Newborn Programme (UNP) launched 2022. Program uses regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions. Achievements 2025. Kampala, East Africa.
Dr. Monica Okuga, the Uganda Newborn Programme Coordinator at Makerere University School of Public Health (MakSPH).

Dr. Okuga further explained that, ‘’Overall asphyxia case fatality rates across program areas have also reduced from 8.9% to 5%; adherence to infection prevention and control measures has improved across the facilities; and the quality of newborn care provided has also improved.

In addition to revamping many newborn care units, Dr. Okuga revealed that the programme supported the construction of newborn care units, citing Kyegegwa Hospital, Buliisa General Hospital, Masindi General Hospital, and Kyangwali HCIV.

In line with the SDGs programme objectives, specifically SDG 3; Good Health and Well-Being, Makerere University School of Public Health, together with partners including the National Planning Authority (NPA), UNICEF, FHI360, and the Ministry of Health, produced the Situation Analysis of Newborn Health in Uganda-2023 update.

Situation Analysis of Newborn Health in Uganda 2023 Report cover page. Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies national health systems strengthening initiative the Uganda Newborn Programme (UNP) launched 2022. Program uses regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions. Achievements 2025. Kampala, East Africa.
Situation Analysis of Newborn Health in Uganda 2023 Report cover page.

This document has now been taken up by the Ministry of Health and is being used to develop a strategy for implementing the suggested recommendations therein, as well as costing the investment for improving newborn health in Uganda.

The previous newborn situation analysis was conducted 17 years ago in 2008’’ she explained of programme contribution at a multi-sectoral level

Dr. Gertrude Namazzi (project technical advisor) and Assoc. Prof. Peter Waiswa (project PI) from Makerere University School of Public Health displaying the National Situation Analysis of Newborn Health in Uganda 2023 Report. Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies national health systems strengthening initiative the Uganda Newborn Programme (UNP) launched 2022. Program uses regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions. Achievements 2025. Kampala, East Africa.
Dr. Gertrude Namazzi (project technical advisor) and Assoc. Prof. Peter Waiswa (project PI) from Makerere University School of Public Health displaying the National Situation Analysis of Newborn Health in Uganda 2023 Report.

Establishment of Uganda’s First Breast Milk Bank

Still under this programme, the first ever Breast Milk bank was established at Nsambya hospital with other donor milk satellite sites at Mengo, Rubaga, Kibuli and Naguru hospitals in Kampala. This donor breast milk has benefited over 275 babies across Kampala and its neighboring districts.

An inside view of Uganda’s first-ever breast milk bank at Nsambya Hospital. Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies national health systems strengthening initiative the Uganda Newborn Programme (UNP) launched 2022. Program uses regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions. Achievements 2025. Kampala, East Africa.
An inside view of Uganda’s first-ever breast milk bank at Nsambya Hospital.

Hospital-to-Home (H2H) Initiative

Another innovation that has been scaled up through the programme is the Hospital to Home (H2H) initiative by Adara Uganda. While many newborn interventions focus primarily on in-hospital care, the Uganda Newborn Programme, in partnership with Adara Development Uganda, pioneered the Hospital-to-Home (H2H) Model, extending its newborn care continuum to the household level. This innovative model ensures that high-risk newborns continue to receive vital support after hospital discharge, addressing the gaps in follow-up care that are common in low-resource settings.

 According to Beatrice Niyonshaba, Deputy Director of Maternal, Newborn, and Child Health at Adara Development; “In Uganda, many families struggle to return for follow-up visits due to cost, transport challenges, and lack of caregiver awareness. The H2H model addresses this by involving caregivers early, equipping them with knowledge on newborn danger signs, and ensuring post-discharge follow-up through community health systems like village health teams.”

Ms. Beatrice Niyonshaba, Deputy Director of Maternal, Newborn, and Child Health at Adara Development. Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies national health systems strengthening initiative the Uganda Newborn Programme (UNP) launched 2022. Program uses regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions. Achievements 2025. Kampala, East Africa.
Ms. Beatrice Niyonshaba, Deputy Director of Maternal, Newborn, and Child Health at Adara Development.

She adds, “The model not only reduces post-discharge mortality but also builds trust and ownership among families, which is critical but often an overlooked aspect of newborn survival in low-income settings. ‘’We also run regular community sensitization and awareness initiatives about the causes and survivability of small and sick newborns, preventative measures, as well as the services”. The model was initially piloted at Kiwoko Hospital, with strong support from both healthcare staff and the community. This phase allowed for continuous refinement and strengthening of the model, ensuring it met the needs of both families and healthcare providers.’’ Ms. Niyonshaba explained of the H2H Model uniqueness

Cornety Nakiganda Kivumbi, H2H Programme Lead, joyfully carrying one of the twins during a home visit to H2H beneficiary Ms. Rehema in Kiwoko. She was accompanied by the H2H Programme team, including Nasuuna Jesca (VHT) and Seela Margret. Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies national health systems strengthening initiative the Uganda Newborn Programme (UNP) launched 2022. Program uses regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions. Achievements 2025. Kampala, East Africa.
Cornety Nakiganda Kivumbi, H2H Programme Lead, joyfully carrying one of the twins during a home visit to H2H beneficiary Ms. Rehema in Kiwoko. She was accompanied by the H2H Programme team, including Nasuuna Jesca (VHT) and Seela Margret.

Currently, the model is being implemented in Nakaseke hospital, a government facility. This will provide insights for scale up to other government facilities. The programme has seen tremendous success due to the engagement and motivation of CHWs, who are provided with incentives, extensive training, and ongoing support. Regular check-ins and monthly meetings ensure these workers remain accountable and connected to the Programme’s objectives.

Challenges in Newborn Care

According to Dr. Monica Okuga and Prof. Peter Waiswa, the Uganda Newborn Programme team lead from MakSPH, in spite of the many achievements, several challenges persist. They explain that many health facilities in Uganda were built without infrastructure to support Newborn Care Units (NCUs). There are no standard floor plans for these units. In many facilities, the neonatal care units are housed in improvised rooms, while in some cases, completely new NCUs are built.

However, even where NCUs are present, they are often let down by an unstable power supply, despite the fact that most equipment in the NCUs require consistent electricity to function. In addition, there are other health system challenges such as insufficient drug supplies from the government, inadequate staffing, and the low involvement of medical officers in neonatal care. Internal rotation of already trained nurses to other units further worsens the situation. Other issues include untimely or late referrals of mothers and babies, as well as challenges with the low quality of data produced in these units.

In terms of lessons learnt while implementing the UNP, The Uganda Newborn Programme team observed and noted several key lessons during the implementation of the programme

  • The importance of leadership engagement in the uptake of interventions is very critical. The leaders to be engaged not only include those at the facility level but also those at the district level. The support of political district leaders such as the Chief Administrative Officer (CAO) is also very crucial. One way of engagement is through sharing performance dashboards with key indicators to the District Health Officers (DHOs), CAO, and Health Facility In-charges.
  • There is a need for continuous engagement of district leadership for sustainability in public health facilities, especially the human resource aspect for established Newborn Care Units (NCUs).
  • There is a need to intervene across the board/spectrum of the health system. Addressing one challenge, for example, the provision of equipment, may not result in the required benefits without addressing human resources and skills.
  • Using a regional approach to care, which includes all hospitals and high-volume health centres, is a more rapid and cost-effective way to scale up maternal and newborn care. It also improves access, quality, and referral, thus reducing unnecessary mortality.
  • Regional Local Maternity and Neonatal Systems (LMNS) provide avenues/platforms to share lessons and share feedback to teams/facilities on gaps identified.
  • Targeted mentorships not only maintain skills but also support teams in innovating for problem-solving.
  • Continuous engagement of medical officers in facilities creates buy-in and brings them on board to support and bridge gaps in newborn care in the neonatal care units.

In terms of sustainability, the team stated that the programme’s design took into account the potential for continuation beyond the initial funding from ELMA Philanthropies. From the outset, the Ministry of Health was actively involved in the co-creation of the programme. The programme also made effective use of existing staff and infrastructure to enhance the quality of newborn care. While there was occasional catalytic provisions of drugs and equipment, the programme primarily relied on the government’s drug supply and delivery systems to ensure long-term sustainability.

About The Uganda Newborn Programme (UNP)

The Uganda Newborn Programme (UNP) has been actively working since its launch in July 2022, with the goal of significantly improving the care for small and sick newborns across the country. With support from ELMA Philanthropies, the programme has brought together a consortium of partners, including Makerere University School of Public Health, Baylor Uganda, Adara Uganda, and Nsambya Hospital, in collaboration with the Ministry of Health.

The programme is focusing on 20 high-burden districts across three regions of Uganda ie Western, Kampala, and North-Central, serving approximately 1.5 million births annually. Since its inception, the programme has been making strides in enhancing the capacity of health facilities, including the refurbishment and equipping of 30 specialized neonatal care units. These units are designed to meet the needs of small and sick newborns, in line with the National Essential Newborn Care (NEST) Toolkit.

Key activities that have been rolled out include

  1. Training and mentorship of Health Workers; More than 800 health workers have been trained and mentored in essential neonatal care practices such as neonatal resuscitation, Kangaroo Mother Care (KMC), Continuous Positive Airway Pressure (CPAP), and infection prevention and control. This has significantly improved the clinical competencies of healthcare providers in the management of small and sick newborns.
  2. Strengthening Infection Prevention and Control; The programme has focused on improving infection control measures at hospitals, which is critical in managing the high rates of sepsis and other infections among newborns.
  3. Effective implementation of newborn resuscitation and warm transport: This includes establishing standardized protocols and providing essential equipment like mabu bags plus masks, CPAP machines
  4. Improving Data Utilization; Efforts have also been made to ensure that health workers are using data-driven evidence for decision-making. Monthly perinatal death audits and support for data quality review have allowed for continuous improvement in service delivery.
  5. Enhanced Postnatal Care; Community-based postnatal care using Village Health Teams (VHTs) being trained to conduct home visits for newborns discharged from neonatal units. This helps ensure that infants receive timely follow-up care in the critical days after discharge.

The programme is set to run up to July 2025, and by then, it aims to have reached 120,000 small and sick newborns, helping to reduce newborn mortality by 40% in the target regions.

Mak Editor

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