Health
BMGF Program Officer Sambisa Pays Courtesy Call to Mak
Kampala -Uganda: Makerere University acting Deputy Vice Chancellor Finance & Administration, Prof. Tonny J. Oyana on Monday July 4th 2022 received Dr. William Sambisa from the Bill and Melinda Gates Foundation (BMGF) in company of the Dean, Makerere University School of Public Health (MakSPH) Prof. Rhoda Wanyenze.
Dr Sambisa, who is also the Program Officer for the COVID-19 Response and Shaping Policy in Eastern, Central and Western Africa (COVID Assessment project), a Bill and Melinda Gates Foundation funded project at MakSPH was on a 3-days visit to Makerere University as part of the evaluation of the project as it comes to an end.
The project has been implemented in partnership with several universities from the eastern, central, and western Africa including the University of Cheikh Anta Diop Dakar, Senegal; the University of Ibadan, Nigeria; the University of Kinshasa, DRC; and the University of Ghana.
This project sought to assess and curate the response to the COVID-19 pandemic in Africa and the outcomes in terms of COVID-19 control and continuity of essential non-COVID-19 health services within the COVID-19 period, to inform the COVID-19 response and recovery as well as health system resilience to future disease outbreaks in Africa.
Prof. Wanyenze is the Principal Investigator of the COVID Assessment project for Uganda. She has been working alongside Dr. Suzanne Kiwanuka Dr. Suzan Kizito, Steven Ndugwa Kabwama and Dr. Rawlance Ndejjo, among others.
Speaking at the Vice Chancellor’s office, Prof. Rhoda Wanyenze said the School of Public Health was grateful for the partnerships with the BMGF that have impacted a lot of lives and influenced policy changes in Uganda and beyond. She thanked Bill and Melinda for their generosity and support towards research in Africa and capacity building.
“We have several grants from the Bill and Melinda Gates Foundation. We are proud that we are partnering with you for impactful research and meaningful capacity building. BMGF supports the Digital Health Payments initiative project, the Covid-19 assessment which is coming to an end, Performance Monitoring for Action (PMA), a project fueling a data revolution to guide family planning programs, and the Leadership for Malaria eradication that is equipping endemic country scientists, implementers and leaders of National Malaria Control Programs (NMCPs) with adequate skills with a view of obtaining the ultimate goal of global malaria eradication,” said Prof Wanyenze.
She added that; “We are talking with William to explore the establishment of a Centre for Health Security at Makerere University because we are in the Congo basis belt which has the largest number of disease outbreaks globally.”
On his part, the Acting Deputy Vice Chancellor Finance and Administration who represented Prof. Barnabas Nawangwe, the Vice Chancellor, Prof. Tonny Oyana said it was a great gesture for Makerere University to receive the BMGF support to various university research and capacity building projects citing that such partnerships need to be leveraged on in the next century.
“I am well informed that you have been generous to Makerere University through the School of Public Health. I am told the funding portfolio has increased under several projects. We are now celebrating 100 years of existence. Our main celebrations will be in October this year. So, we have come a long way and the BMGF are part of the Makerere University story and I hope that we can consolidate our gains with that funding support. When you go back, please tell Bill and Melinda that the Management of Makerere University is very grateful for your contribution and we should continue working together. Please do visit us again,” said Prof. Oyana.
Prof. Oyana also shared about the iconic university building Administration Block, the second oldest building in Makerere University, currently under reconstruction that was burnt to ruins on November 20, 2020. The Main Building, in the style of British architecture of the 1940s, had high white walls and blue-shuttered windows before the fire that broke out. It is a symbol of higher education in Uganda and Africa. Efforts are underway to maintain its exact architectural design and structure.
In appreciation, Dr. William Sambisa said he was excited to visit Makerere University and impressed by its position in research in Africa and beyond. He empathized with Makerere University for the loss of the iconic building during the fire.
“It is a pleasure working with Makerere University. This is my first time I set foot in this great institution. When we were growing up in Zimbabwe, we heard about Makerere, its academic stature and its role in activism those days. Sometimes you say I have read and heard about this Giant of Africa, I would like to be there,” said Dr. Sambisa.
He added that; “We have begun a journey. We are creating good foundational pillars, for the next growth of the institution itself and the way you will influence Africa in research and capacity building. If we are saying we want to rely on African institutions, are we putting adequate resources to build them? Are we holding them in that journey aspect of it? It would be unfair to drop this investment.”
The Dean Prof. Rhoda Wanyenze led Dr. Sambisa on a guided tour to the Main Campus and inspected the construction site for the new home of MakSPH.
Based on research led by Max Bobholz and colleagues from Makerere University in Uganda, Essentia Institute of Rural Health, and the Medical College of Wisconsin in the United States.
Adolescence is meant to be a time of holistic growth and self-discovery, but for many Ugandan teenagers, this period is becoming a season of silent mental health struggles. A new study published in PLOS Global Public Health has uncovered a silent but growing crisis: nearly one in five Ugandan secondary school students in the study areas have signs of an emotional disorder. These conditions included anxiety, depression, post-traumatic stress disorder (PTSD), and adjustment disorders often involving excessive worry, sadness, fear, or mood instability. Also, one in 20 adolescents exhibited behavioral issues ranging from attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder to substance use and other risky behaviors like alcohol use.
The study, led by Max Bobholz, a PhD candidate in Public and Community Health at the Medical College of Wisconsin, surveyed a sample of 1,953 students aged 10 to 18 years enrolled in eight secondary schools in Iganga district in Eastern Uganda and Mukono district in Central Uganda. This was one of the most comprehensive efforts yet to understand the prevalence and drivers of mental health challenges among school-going Ugandan adolescents.
“We are looking at a generation facing a complex blend of stressors, namely, academic, social, and emotional,” says Bobholz. “Our findings show that certain groups are especially vulnerable, and schools need to be equipped to respond.”
This study results, published on June 12, 2025 was funded by the Swedish International Development Cooperation Agency (SIDA), a government agency of the Swedish Ministry for Foreign Affairs, through the Makerere University Postdoctoral Fellowship to one of the investigators, Dr. Catherine Abbo. Other researchers included Julia Dickson-Gomez, Arthur Kiconco, Abdul R. Shour, Simon Kasasa, Laura D. Cassidy, and Ronald Anguzu.
According to the study, girls bear a higher emotional burden. Researchers found that female students had nearly two times higher odds of suffering from emotional disorders such as anxiety or depression than their male peers.
Dr. Catherine Abbo, an Adolescent Psychiatrist and Associate Professor at Makerere University, attributes this to both biological and socio-cultural factors. “Puberty brings hormonal shifts that can heighten emotional sensitivity,” she explains. “But just as importantly, Ugandan girls often face intense pressure to conform to gender roles while also navigating issues like body image, harassment, and future uncertainty.” The researchers are calling for gender-sensitive mental health interventions, particularly in schools, where early support could help mitigate long-term mental health issues.
Higher associations in older teens?
Age also emerged as a key associated factor, with each additional year increasing the odds of behavioral disorders by 20%. “As adolescents grow older, they are more prone to risk-taking, impulsivity, and resistance to authority,” explains Dr. Simon Kasasa, a senior lecturer and biostatistician at Makerere University School of Public Health.
“Combine that with academic pressure and identity-related stress, and it’s no surprise we’re seeing more conduct issues in late adolescence,” Dr. Ronald Anguzu, an Assistant Professor in the Institute for Health and Humanity at the Medical College of Wisconsin, added. This study raises critical questions about whether and how Ugandan secondary schools support older students as they transition toward adulthood.
The unseen influence of family mental health
The study also found that adolescents with a family history of mental illness had twice the odds of exhibiting behavioral problems compared to those without such a history.
“This speaks to the intersection of genetics and environment,” says Bobholz. “Living in a household with people affected by mental illness can mean instability, stigma, and lack of emotional support, all of which weigh heavily on a developing mind.”
The authors recommend that school mental health screening include family mental health history and advocate for greater collaboration between education and health sectors to support at-risk households.
Private schools: High marks, higher stress?
Interestingly, students in private schools had 1.4 times the odds of experiencing emotional disorders compared to those in public schools. Private schools, often seen as academic havens, may inadvertently be cultivating high-pressure environments. “There’s an assumption that better facilities mean better well-being,” says Dr. Abbo. “But intense academic competition, social isolation, and a lack of trained counselors can create emotional pressure cookers.”
Previous research in 47 secondary schools across five districts (Rakai, Kyotera, Masaka, Lwengo, and Kalungu) in southwestern Uganda found that economic and family support helped reduce absenteeism among adolescent girls in secondary schools. However, this support did not significantly improve behavior or reduce grade repetition. The region, which includes districts like Rakai and Masaka, also faces a higher burden of HIV, adding to the challenges young people experience.
Meanwhile, a review of data from 42 primary schools in Luwero District identified school-based mental health interventions such as cognitive behavioral therapy and mindset-building approaches as being particularly effective. Researchers now suggest that integrating these strategies, along with efforts to reduce school violence, could go a long way in improving the mental health of Ugandan adolescents.
A-Level pressure: Academic ambition meets mental health strain
The study also found a correlation between advanced (A’level) education and increased risk of emotional disorders. “We selected one school district from each region based on population and past academic performance. As these students prepare for university or the job market, the pressure to succeed becomes enormous,” says Kasasa. “They’re facing a future full of uncertainty, with very little structured mental health support to help them cope.”
A wake-up call for Uganda’s education and health systems
The authors of this study assert the urgent need for school-based mental health programs, especially in private and A-level institutions. These programs should offer routine screening, emotional support, and training for teachers to recognize warning signs of mental health disorders.
Importantly, this study adds weight to calls for a national adolescent mental health policy, tailored to Uganda’s context, with interventions that bridge health, education, and social services.
“Our data shows that mental health challenges are not a fringe issue,” says Bobholz. “They are widespread, significant, and deeply tied to school, home, and society.”
The COVID-19 school closures between 2020 and 2022 deepened feelings of isolation and financial strain, with out-of-school adolescents reporting depression rates as high as 21.5% to 50% higher than their peers who remained in class, according to research published in February 2025. Yet Uganda invests less than 1% of its health budget in mental health, with just one psychiatrist per million people, leaving many teens to cope through cheap alcohol used by 28% of urban youth or untrained healers, as reported by the government paper The New Vision in April 2025. With only 26% of students completing lower secondary school and 35% of the population under age 24, these mental health challenges now pose a serious threat to the country’s future.
Mercy Akankunda of Proven Foundation, a Ugandan NGO supporting vulnerable groups, warns that mental health struggles are quietly eroding the well-being of the country’s youth, over 12 million strong and making up 35% of the population. “These teens are not just statistics. They are the future of Uganda, she asserts. If Uganda hopes to reap the dividends of its young population, addressing adolescent mental health must become and remain a national priority, not just for treatment, but for prevention, resilience, and hope.
Reference:
Bobholz, M., Dickson-Gomez, J., Abbo, C., Kiconco, A., Shour, A.R., Kasasa, S., Cassidy, L.D., & Anguzu, R. (2025). Correlates of behavioral and emotional disorders among school-going adolescents in Uganda. PLOS Global Public Health. Read the study here
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