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 Researchers Find Psychological Therapy Effective in Improving Diabetes Care in Uganda
By Nelson Bahati
Researchers from Makerere University‘s School of Psychology have found that psychotherapy intervention can improve the well-being of adults living with Type II diabetes mellitus, opening the door for integrating psychosocial support into diabetes care in Uganda.
The findings were disseminated on 16 June 2026 during a research dissemination workshop held at the Physiology Lecture Theatre at the College of Health Sciences, Mulago Hospital.
Led by Professor Peter Baguma, the study titled “The Effectiveness of Cognitive Behavioural Therapy for Diabetes Distress, Depression, Health Anxiety, Quality of Life and Treatment Adherence among Adult Patients with Type II Diabetes Mellitus” investigated whether Cognitive Behavioural Therapy (CBT), a psychological treatment that has proven effective in Western countries, could also work in the Ugandan context.
Presenting the findings, Professor Baguma said the study was motivated by the growing burden of diabetes and the psychological challenges that often accompany the disease but are rarely addressed in routine healthcare.
“Diabetes affects many people in Uganda and across the world. It kills, and those who live with it face many challenges. While psychological interventions have been developed and applied in the Western world, we did not know whether these approaches could work in Uganda. That is why we decided to undertake this study,” he said.
He explained that Cognitive Behavioural Therapy focuses on changing negative thoughts and behaviours that affect people’s wellbeing and ability to manage chronic illnesses.
The researchers sought to determine whether CBT could reduce psychological distress among diabetes patients and improve treatment outcomes.
The controlled study involved 200 adult participants with Type II diabetes mellitus. One hundred participants received the CBT intervention while another 100 formed the control group. Participants in the intervention arm attended eight counselling sessions over four months, with each session lasting between one and one-and-a-half hours.
The therapy covered several modules, including psychoeducation on diabetes, cognitive restructuring, medication adherence, problem-solving, coping strategies, physical exercise, relaxation techniques and strategies for maintaining treatment.
According to Professor Baguma, the findings showed that psychotherapy significantly improved participants’ wellbeing.
“The group that received the intervention experienced reduced stress levels and lower blood sugar levels compared to those who did not receive the therapy. We conclude that CBT is effective and should be adopted as part of diabetes care,” he said.
The study also yielded another important discovery.
“We have discovered that CBT as practised in the Western world is somewhat narrow. Their manual contains only eight elements. In Africa, we found that three additional components are necessary: effective communication between patients and health workers, goal setting, and instilling hope among patients. We call this African CBT,” Professor Baguma explained.
He added that the findings had also revealed the need to incorporate psychosocial care into the management of chronic illnesses and to train healthcare workers to address the psychological dimensions of disease.
Professor Andrew Marcel Otim, one of the co-investigators and founder of the Uganda Diabetes Association, said the study had brought to the fore an aspect of diabetes care that has long been neglected.
“There have been many efforts to address the physiological effects of diabetes, but we have largely ignored the psychological part of the disease. Yet the psychological aspect is huge,” he said.
He added that, diabetes management should go beyond medication but rather intergrate other components of care.
“Education, nutrition, exercise and self-monitoring are extremely important. Even simply knowing what to do is a very powerful intervention. Psychological distress and depression can increase blood sugar levels, so we need to help patients remain calm and hopeful,” he said.
Drawing from his experience as a clinician and educator, Professor Otim encouraged people living with diabetes to embrace physical activity.
“I tell my students and my patients to put on some music, dance, sweat and enjoy themselves. Nutrition, education and exercise remain central to managing diabetes.”
Dr. Wilber Karugahe, a counselling psychologist at Makerere University‘s School of Psychology and one of the co-investigators, said the findings demonstrate the need to integrate psychological care into the management of chronic diseases.
“A lot of studies focus on physical illness and not the psychological conditions that accompany these illnesses. This study confirms that diabetes has a significant psychological aspect and that patients need psychological interventions as part of their care,” he said.
Explaining the essence of Cognitive Behavioural Therapy, Dr. Karugahe noted that the approach helps people restructure their thoughts and behaviours.
“Imagine putting a sticker on your fridge that reminds you that some foods are not good for you and that healthier options are better. That is CBT. It helps people change the way they think and behave, and it can be used to address many behavioural challenges.”
The dissemination workshop was also attended by officials from the Ministry of Health, including Mrs. Christine Ninsiima Ahimbisibwe, Senior Programme Officer for Mental Health and Substance Abuse Control, and Mrs. Patience Butesi from the Department of Mental Health and Drug and Substance Abuse.
Mrs. Ahimbisibwe welcomed the findings and emphasised the need to integrate the study’s recommendations into Uganda’s clinical guidelines to enable healthcare workers to provide psychosocial support to patients living with chronic illnesses such as diabetes.
The human impact of the intervention was perhaps best illustrated by testimonies from participants who underwent the psychosocial training.
Tebugulwa Josephine, a retired teacher and employee at Mulago National Referral Hospital, said the intervention restored hope in her life.
“When we first joined the programme, we thought we were moving dead people. But now we have hope. I have hope of reaching 90 years. We were taught how to exercise and take care of ourselves. Even our families no longer treat us as sick people because we can now walk and participate in daily activities.”
Another participant, Bunje Joice, described the intervention as life-changing.
“People had already given up on me and were waiting for me to die. I could hardly walk, but now I can walk long distances and my diabetes levels have improved. Physical exercise has become my first medicine.”
Kyomuhendo Kate said the programme helped her manage stress and improve her health.
“I was so stressed and my legs were swelling, but after attending the treatment sessions, I am now much better.”
Sebuliba Bernard said the training transformed how he manages his condition.
“They taught us how to exercise, how to live and how to eat. If we follow what we were taught, we can change our lives.”
Based on the findings, the researchers recommended scaling up the intervention to district, regional and national referral hospitals, integrating psychosocial interventions into the training of health workers, and undertaking policy reforms to strengthen mental health support for people living with chronic illnesses.
The study was funded by the Makerere University Research and Innovations Fund (Mak-RIF) and brought together researchers from psychology and medicine, including co-investigators: Dr. Fredrick Nakwagala, Dr. Wilber Karugahe and Dr. Anne Ampaire.
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