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
This week, world leaders, negotiators and researchers are gathered in Antalya, Türkiye, for COP31, the United Nations climate conference, seeking to turn years of climate commitments into action countries can finance and implement. Among them is Dr. John Bosco Isunju, a climate and health researcher at Makerere University School of Public Health, named among TIME’s 100 most influential climate leaders in 2024.
Dr. Isunju led the School’s technical support to the Ministry of Health for Uganda’s 2023 Climate Change Health Vulnerability and Adaptation Assessment (VAA) and the subsequent development of the Health National Adaptation Plan (H-NAP) 2025–2030. The assessment covered 716 health facilities across 43 districts, documenting vulnerabilities that helped shape the country’s priorities for protecting healthcare from climate hazards.
That experience speaks directly to the task before the 9–20 November summit. With “Dynamic and Resilient Health Systems” among the COP31 Presidency’s Action Agenda priorities, the conference is seeking practical solutions and financing to keep services functioning through climate shocks. Adaptation, the practical changes needed to cope with a changing climate, must ultimately reach the facilities where people seek care.
Protecting facilities from floods and drought also safeguards the public investment behind them, giving Uganda’s adaptation effort an economic significance alongside its importance to patients. In a 27 October 2026 statement ahead of COP31, UN Climate Change Executive Secretary Simon Stiell placed climate action within that wider calculation of public benefit.
“More governments are taking climate action right across their economies, to bank the vast benefits of clean energy and climate resilience,” he said. “Almost every major economy, and many medium-sized and smaller economies, now see climate action as a central driver of economic growth, jobs, and affordable and secure energy.”
On 21 October, nearly three weeks before the Antalya talks, the H-NAP was before Ugandan parliamentarians in Kampala. Convened by the Ministry of Health and Parliamentary Forum on Climate Change Uganda, with support from Regenerate Africa and the Clinton Health Access Initiative, the engagement examined the plan and Parliament’s role in securing funding, scrutinising implementation and ensuring accountability.
Presenting the VAA, Dr. Isunju explained that the team examined the hazards facing each area, the extent of exposure and the weaknesses that made services vulnerable. They also considered the communities the facilities served. A flood could turn an already difficult journey to treatment into one that patients and staff could no longer make, as seen in many parts of Uganda, including Kasese.
“Either health workers will not work, or communities will not be able to access care, or outreaches will not be possible because roads are cut off,” he told legislators.
Uganda’s H-NAP grew out of commitments made at COP26 in Glasgow in 2021 to assess health vulnerabilities and develop an adaptation response. The Ministry of Health commissioned the School to undertake the VAA in 2023, with Rockefeller Foundation funding supporting both the assessment and the plan’s development. Developed through stakeholder consultation, with WHO technical support and contributions from other partners, the plan was launched on 22 August 2024.
What the assessment found
The VAA found that drought and floods were disrupting the conditions needed to deliver care. Nearly half of the assessed facilities reported drought exposure, while about two in five reported floods. Among the 284 facilities reporting flood exposure, 141 (about half) said health professionals had been unable to arrive at or leave their workplaces, and 198 (about seven in ten) reported shortages of safe water. Because districts were selected for their history of hazards, these findings describe the assessed facilities and cannot be treated as national estimates.
The H-NAP responds across ten components of the health system, including leadership, workforce training, risk monitoring and sustainable financing. Its proposed actions include revising infrastructure standards and using weather and disease information to warn of health risks earlier. Protecting care requires investment in buildings alongside the people and systems that make them function.
“A significant proportion of healthcare facilities lack water management and safety plans to address contamination risks,” the H-NAP states. “They lack water safety plans and contingency plans for monitoring and reducing contaminants as well as on-site water purification equipment.” Such gaps can leave facilities unable to maintain hygiene, clean equipment and provide treatment safely when water supplies fail or become contaminated.
The H-NAP already includes a budget, giving implementation a basis for resource mobilisation. The UN climate secretariat’s 2026 report on national adaptation plans across sectors identifies the difficulty of turning priorities into fundable projects. It recommends costing specific interventions and securing delivery partners, steps that can help advance Uganda’s health adaptation priorities.
At household level, climate pressures on livelihoods can leave families less able to get care or keep children in school, as community consultations showed.
“Their problems are interconnected. If climate, for example, affects their livelihoods, it directly impacts their health, because that means when they fall sick they can’t get care, and they can’t take their children to school, so things are all interconnected,” Dr. Isunju said.
The Ministry’s Focal Point for Climate Change and Health, Dr. Didacus Namanya, told MPs that resilience, the ability to withstand disruption and keep providing care, must inform how services are built and managed.
“So, our vision in the H-NAP is to have a responsive, adaptive, and resilient health system. Adaptive, we are talking about adaptation. These impacts will not stop; they will continue coming, but we must develop our adaptive capacity. The way we build our health facilities, the way we tackle the disease burden, we must be highly adaptive,” he said.
Dr. Namanya called for district-specific assessments, noting the different conditions in Nakasongola and Bududa, and described an ongoing review of infrastructure design standards. Dr. Isunju reported that guidelines for coordinating climate and health action across institutions were undergoing approval.
A partnership announced in October 2025 by the Rockefeller Foundation and the International Development Research Centre is helping the School and the Clinton Health Access Initiative, working with the Ministry of Health, build an investment case for H-NAP implementation. A separate Ministry of Health and Global Green Growth Institute initiative, begun in June 2026, is advancing climate-resilient water, sanitation and hygiene standards, investment plans for health facilities and the government’s capacity to deliver improvements.
Questions for Antalya
Legislators sought evidence of what implementation had delivered. Terego East MP Hon. Wilfred Babanga Erima asked how much of the plan had been implemented, how many facilities had been audited and refitted for climate resilience, and how funding was divided between domestic and donor sources. Hon. Shafiga Wanyenya, Vice Chairperson of Parliament’s Committee on Climate Change, proposed joint follow-up with the health committee and regular progress reviews.
“Our role is to ask the difficult questions and also identify implementation gaps, to advocate for the vulnerable communities and ensure that the national commitments translate into tangible improvements in the lives of our people,” Hon. Wanyenya said.
Those questions belong in Antalya too. The Yearbook of Global Climate Action 2026 identifies gaps in global data for assessing whether health systems are becoming more resilient, underlining the importance of tracking what adaptation efforts deliver for health.
The COP31 health programme links implementation of the Belém Health Action Plan with a financing framework intended to help turn health priorities into investable projects. Launched on 9 November, the Antalya Initiative for Health Resilience provides a platform for countries to share practical experience. The COP28 adaptation framework sets targets for climate-resilient health services by 2030 and progressively beyond, alongside national adaptation planning by 2030 and multi-hazard early-warning systems by 2027.
The H-NAP gives Uganda a practical agenda for that next stage. It calls for climate and health priorities to enter government budgets and for proposals capable of attracting finance. It also identifies academic partnerships as a route to research and capacity-building funds. Annual reviews would then assess progress and guide subsequent work.
As negotiations continue in Antalya, the next test is whether decisions there, and action at home, help keep care available, on the road to a health facility, and at the water point on which safe treatment depends.
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