Health
Health Experts meet at MakCHS to discuss Health Professions Education
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.
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.
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.
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.
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 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.
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.
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:
- 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
- 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
- Collaboration and networks across universities (south-to-south, within and across countries, north-south), with training hospitals and communities
- 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
- 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
- Standards, Quality Assurance and Regulation: Adequately resources and effective regulatory structures and systems—address issues of curricular and examinations standardization and implementation
- Research: Modeling of health workforce needs to inform planning and a review of the state of health in Uganda
- Arrange a follow-up stakeholder meeting to synthesize and follow-up on the actions
Health
Makerere University Public Health students recount hands-on experience in Ebola case finding in Uganda
On Tuesday January 14, 2025, under the radiant rays of the Ugandan sun, Laura Silovsky crossed the stage at Makerere University’s 75th Graduation Ceremony to receive her master’s degree in Public Health Disaster Management (MDM). Hers is a story of passion, dedication, and curiosity to rewrite the narrative of global education. Among 1,813 master’s graduates, Laura’s story stood out, as a blend of refugee roots, firefighting bravery, and a drive to decolonize learning.
Laura’s journey began long before her arrival in Kampala. Born in the UK to a father who fled from Czechoslovakia’s dictatorship in the 1970s, she grew up understanding displacement intimately. “My father was a refugee. Why would I fear refugees?” she once asked during her research fieldwork in Uganda’s West Nile, where her empathy bridged divides.
“People in Uganda may not expect that a muzungu could be the child of a refugee, but my family experienced displacement from (what was then) Czechoslovakia as well as the effects of the protracted conflict in Northern Ireland. Fortunate to have been born in the UK, I was raised to appreciate that disasters can affect anyone, anywhere, anytime.
After studying Sustainable Development at the University of Edinburgh, I worked on a behavior change project tackling non-communicable diseases in Scotland,” Laura says.
Her journey twisted through battling Australia’s bushfires and volunteering in a COVID pandemic, but it was Uganda’s welcoming refugee policies and Makerere University’s academic excellence that pulled her in next.
“In 2020, I relocated to Australia, just after the worst bushfires since records began and before the COVID-19 pandemic. The following two years, I qualified as a firefighter and supported bushfire recovery by volunteering with a community-based organization. After gaining some insight into these different disasters, I made the decision to return to higher education, and so I applied for the MDM programme at Makerere in 2022,” says Laura.
Armed with experience in emergency response, Laura was drawn to the field’s multidisciplinary nature and was convinced she needed to expand her expertise beyond immediate recovery efforts. She aimed to explore the full disaster management cycle and the intricate connection between health and environment.
“I needed to combine gaining academic knowledge with developing practical skills, so the field placement offered within the master’s degree in Public Health Disaster Management programme was a major motivator for me,” she shared.
The love for Uganda
Studying at the University of Edinburgh, Laura took a class in Kiswahili, that included a field-based short course on the Tanzanian shores of Lake Victoria. This experience sparked a desire to spend more time in the region, but she knew she needed to expand her skill set in order to genuinely add value to an organisation, if she was on the continent.
“I hoped studying at an East African university would teach me invaluable soft skills needed to work more effectively as an international team member. Makerere University School of Public Health (MakSPH) has a strong reputation, and I wanted to study somewhere that was locally grounded but globally recognized. Uganda’s progressive refugee policies were an added incentive to learn from experts here,” Laura says.
Laura’s intentional choice to decolonize her education
“I came to Uganda to learn from the experts here,” Laura declared, rejecting Eurocentric frameworks. “A big factor for me wanting to study at Makerere University was to decolonize my education, to recognize that the knowledge about responding to public health disasters and supporting refugees is here in Uganda,” she says.
She adds, “When I first arrived, I was quite vocal with my classmates about wanting to challenge that bias and truly acknowledge the wealth of knowledge within institutions like Makerere. The expertise here is invaluable, and I was intentional about decolonizing my education.”
At MakSPH, Laura immersed herself in courses like epidemiology, struggled briefly with statistics, but thrived on critical discussion groups and consultation with lecturers.
Collaborating with classmates from Uganda and across East Africa, she learned Luganda phrases and Somali proverbs, and built a “family” united by late-night study sessions and shared ambitions.
Beyond expectations
For Laura, studying at MakSPH was the best decision she could have made. She is still struck by the faculties’ wealth of academic and professional experience in public health and disaster management.
“I anticipated the programme would focus on applying the knowledge we gain to real-world scenarios. Of course, there were cultural differences that took me time to adjust to. I am grateful to faculty members such as Prof. Christopher Garimoi Orach, for his dedication and support, Prof. Elizeus Rutembemberwa for leading by example and valuing students’ time, and Dr. Justine Bukenya and Dr. Simon Kibira for offering their extensive support as my dissertation supervisors.”
The Fieldwork Attachment that Transformed Laura’s Research Experience
At Rhino Camp refugee settlement in West Nile, Laura’s work took on new meaning. Partnering with the Uganda Red Cross Society, she helped digitize data tools and walked long distances through Tika Zone, inspecting latrines and speaking with South Sudanese girls about their challenges in managing their menstrual health through their project that focused on schools.
“That experience in West Nile influenced my own research ideas, and it was a privilege to later return to Rhino Camp for data collection. I will always remember the long days walking with my research assistants through villages and being graciously welcomed by so many respondents,” she recalls, noting that the experiences crystallized her resolve to advocate for refugee dignity globally.
Life in Kampala
Life in Kampala, with its vibrant energy and unique challenges, was truly a ‘full sensory experience’ for Laura. “My parents live in a small village, so Edinburgh felt like a big city when I moved there. And Edinburgh is much smaller and quieter than Kampala! But on weekends, I loved going downtown to shop at Owino Market or heading to Kyadondo Rugby Club for some pork.”
These spaces were perfect for Laura, offering new cultural experiences, including matooke, a starchy dish not found in the UK, which is mainly eaten in Uganda as a local delicacy and staple meal. Despite the differences in culture, sharing meals with classmates provided Laura with a comforting sense of connection.
Back to academics, navigating the university administrative processes wasn’t seamless initially for Laura, though. She says administrative hurdles such as paper-based systems, could change for the university to comfortably enjoy its strong reputation.
She recalls, right at the beginning, when she couldn’t find sufficient information online to support her to complete her application to join Makerere University. However, she later received support from the University’s International Office that deals with the welfare of international students.
Other university officials, from finance, librarians, program administrators, to academic registrars, played a key role in supporting her in her research and postgraduate training. “The system relies on dedicated individuals,” she noted, calling for digital reforms while praising MakSPH’s “atmosphere of innovation.”
“From my experience, such as when obtaining my transcript, the system relies heavily on individual staff members working around these administrative challenges. I’m grateful for those who helped me navigate this, and I’m interested to see how the university continues its digital transition, as it could greatly streamline processes in the future,” says Laura.
A Bittersweet Graduation Day
On graduation day, Laura’s pride mingled with melancholy. Watching families cheer on graduates, she reflected on classmates sidelined by finances or family crises.
Having gone through the course and interacted with Ugandan students, Laura hints on the common financial and personal challenges preventing many from graduating: family illness, new children, sponsorship falling through.
“I know so many of my classmates had worked so hard and were almost over the finish line but, due to financial challenges or other commitments at home, it wasn’t possible for them to graduate this year,” she says.
“For me, I was able to make the choice to pursue this program before having children, so I had fewer responsibilities at home, and I had also been saving for many years to get the money to pay tuition. Because I knew I had the money for tuition before I started, I could focus on studying. As you know, the reality for many people is that that’s not always possible.
“Small supports can transform student experiences,” Laura emphasized, advocating for systemic empathy. She sees great potential for more pastoral support at the university, citing peers from UCU and Kyambogo who benefited from accommodations like private breastfeeding spaces and flexible deadlines in special circumstances. Such initiatives, alongside financial aid, could significantly improve student welfare.
Still, the ceremony’s electric energy—watched via livestream by her parents in Europe—symbolized hope. “Uganda taught me that collaboration transcends borders,” she reflected.
“You could feel this sense of how hard everyone had worked to reach up to that point and that this was really an opportunity for them to celebrate, particularly by having family and friends around to be able to see. I love the PhD awards, when you see the PhD students coming out and their families rushing up to greet them. To me, that’s the best part of the ceremony, because a PhD requires so much work and commitment, and I think it’s really emotional to see everyone share this moment with their support networks,” she says.
Adding that; “…I was so grateful that the ceremony was streamed online. My family were watching live at home in Europe and it was so special that they could see me on camera and participate in the ceremony that way as well.”
Laura noted striking similarities between Makerere and Edinburgh’s ceremonies, especially the moment when students were asked to turn and thank their families, an emotional and powerful tradition.
Looking Ahead
Now in Tanzania, Laura eyes roles with international NGOs, armed with Ugandan-taught pragmatism and a zeal to challenge Europe’s refugee policies. “MakSPH gifted me more than a degree—it reshaped my worldview,” she says.
“As a muzungu with a Ugandan postgraduate education, I feel privileged to have benefitted from different educational perspectives, and I hope that the skills and knowledge I acquired during my time at Makerere will help me to secure a role with an international NGO. After witnessing the incredible support that Uganda provides to refugees, I also hope to advocate for more dignified policies concerning refugees in Europe,” she shares.
“There’s a spirit of innovation and dedication at Makerere, particularly when passionate lecturers like Prof. Orach, Dr. Roy Mayega, or Dr. Victoria Nankabirwa engaged students through discussion and sharing lived experiences. You could really see a different level of engagement within the students as well. Overall, I’ve had such a fantastic experience at Makerere University.”
“I wouldn’t change a thing,” she smiles.“Except maybe convince more Europeans to study here. Africa’s wisdom is the future.”
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