Uganda has made notable progress in increasing coverage of Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) services over the past two decades, but overall progress remains uneven due to inadequate investment and funding for health, fragmented and disorganized healthcare systems, gaps in evidence-based policy, and weaknesses in policy implementation.
In an effort to catalyze policy improvement in Africa, the International Development Research Centre (IDRC) of Canada and the Malaysia-based United Nations University International Institute of Global Health (UNU-IIGH) have agreed to co-fund a program of work aimed at promoting Maternal, Newborn, Sexual and Reproductive Health (MNSRH) policy improvement and development in five African countries, including Uganda.
On Wednesday 18th January 2023, a partner engagement meeting was held in Kampala to conduct a situational analysis of the Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) services in Uganda and discuss challenges in policy formulation, implementation, and evaluation.
In his opening remarks, Prof. Charles Ibingira highlighted the challenges in policy formulation, implementation, and evaluation in RMNCAH services.
“Our targeted outputs are; updated/improved versions of existing policies, or new policies, an improved MNSRH research-policy-practice system (including better coordination and communication between commissioners, producers, and users of research), case studies of catalyzing policy improvement in Africa – CPIA model, and two structured courses for a cohort of young professionals in policy analysis and implementation research,” Prof. Ibingira highlighted.
Prof. Charles Ibingira, the team lead on the project takes notes during the RMNCAH partner’s engagement.
The session was moderated by Professor Elizeus Rutebemberwa, the Deputy Dean, School of Public Health assisted by Dr. Josaphat Byamugisha, of Obstetrics & Gynecology and the Director, Makerere University Health Services with assistance from Professor Lynn Atuyambe.
Professor Elizeus Rutebemberwa, the Deputy Dean, School of Public Health moderates the session.
According to Dr. Sarah Byakika, the Commissioner Health Services Planning, Financing, and Policy at the Ministry of Health, there is a need to evaluate program indicators on a regular basis.
“The challenge is that when it comes to monitoring and evaluation, and following up on why we are not achieving targets, there is a big gap. We produce annual sector performance reports but don’t give time to reviewing this performance. People always just go back home and wait for the next report,” remarked Byakika.
Further adding; “We are good at designing policies but are struggling when it comes to learning from them.”
Dr. Sarah Byakika, the Commissioner Health Services Planning, Financing, and Policy at the Ministry of Health.
Dr. Moses Walakira, the family planning program specialist at the United Nations Population Fund (UNFPA) decried the absence of a joint multi-sectoral action plan when it comes to addressing RMNCAH issues.
“How do we work collaboratively to address structural barriers? Who are the gatekeepers? And how do we target them together? Harmonization of perspectives and commitments at different levels is so important, otherwise, we shall remain fragmented in our policy implementation,” said Dr. Walakira.
Dr. Moses Walakira, the family planning programme specialist at the United Nations Population Fund (UNFPA).
Ms. Friday Madinah, a Senior Youth Officer from the Ministry of Gender, Labour and Social Development, advises that when dealing with issues related to young people, women, children, and people with disabilities, the Ministry of Health should involve the Ministry of Gender, Labour, and Social Development, as they also have the necessary linkages and structures to assist in implementing these policies.
Ms. Friday Madinah, a Senior Youth Officer from the Ministry of Gender, Labour, and Social Development speaking at the event.
“When issues of young people, women, children and even those of people with disabilities are being handled, it is mostly the Ministry of Health taking charge yet we at the Ministry of Gender, Labour and Social Development also have the linkages and structures to help in implementing these policies. Please bring us on board, and make use of our competencies in these areas,” says Madinah.
Dr. Olive Sentumbwe, Family Health, and Population Adviser, at the World Health Organization (WHO), also underscores the need for a platform for the RMNCAH team to utilize in discussions with the other key players in regard to the kind of support they can provide.
Dr. Olive Sentumbwe, Family Health and Population Adviser, at the World Health Organization (WHO) speaks at the partners engagement.
“The platform is crucial when it comes to accountability; following up/asking other sectors, and Ministries whether our policies and action points are being implemented. We also need different platforms at the different levels of government so there is an understanding of policies and their implementation processes by the different beneficiaries,” she said.
According to Dr. Jessica Nsungwa, the Commissioner for Maternal and Child Health at the Ministry of Health of Uganda, accountability ought to be mutual in order for policies to be successful.
“Government should be accountable to its people, but the people also need to be accountable to the government. For example, we bought a bunch of COVID-19 vaccines using government money but people refused to come for them and some of those doses ended up expiring,” Dr. Nsungwa attests.
Dr. Jessica Nsungwa, the Commissioner for Maternal and Child Health at the Ministry of Health of Uganda.
The Minister of Health Dr. Jane Ruth Aceng reported in June 2022 that 2.6 million doses of the COVID-19 vaccine expired due to a lack of interest and misinformation. This highlights the need to improve cooperation and coordination between the public, private sectors, and community to improve access to maternal, newborn, sexual, and reproductive health.
Participants holding a discussion at the RMNCAH partners’ engagement meeting.
Hon. Dr. Bhoka Didi George, a public health specialist, area MP for Obongi County in Obongi District, and a member of the Committee on Health in Parliament reminded the team that the current public health law in Uganda is obsolete, dating back to the 1930s.
“From a legal and regulatory framework point of view, there is a lot of room for improvement. What we have is a national policy, not a law. Therefore, we cannot hold the government accountable in case they fail to deliver on Maternal, Newborn, Sexual, and Reproductive Health for example. We need an enabling legal and regulatory framework,” Hon. Dr. Bhoka.
Hon. Dr. Bhoka Didi George, a public health specialist, area MP for Obongi County in Obongi District, and a member of the Committee on Health in Parliament.
Dr. Richard Mugahi Adyeeri, the Assistant Commissioner Ministry of Health in charge of Reproductive Health advises the localization of policies to suit Uganda’s population needs at the implementation of RMNCAH services.
“One district with five million people, but only one DHO [District Health Officer] can’t have the same issues as a district with only 60,000 people for example. Let us have policies that are not only culturally, but also socially sound,” Dr. Mugahi said.
Dr. Richard Mugahi Adyeeri, the Assistant Commissioner Ministry of Health in charge of Reproductive Health.
Prof. Ibingira stresses that the engagement was quite central to the responsibility of individual stakeholders, which is proper service delivery for the health improvement of Ugandans.
“You have given us a lot of information on the issues we are tasked with, regarding policy formulation and implementation. We are now going to do the analysis by looking at the different existing policies so we can come up with strategies instrumental to accelerating policy improvement. We hope a lot is going to change, and that other countries will learn from us. Thank you very much,” Prof. Ibingira.
The CPIA partnership operates in five countries and is coordinated by the UNU-IIGH, which leads to the conceptualization and evaluation of the program’s model. Makerere University leads the implementation of the CPIA model and operational plan in Uganda, and the project aims to benefit staff and students through visiting fellowships, internships, and Ph.D. research opportunities.
A joint study between Makerere University School of Public Health (MakSPH) and The Open University, UK, is investigating a possible link between maize cultivation and malaria risk in Uganda, as evidence increasingly points to livelihoods and everyday economic activities as key drivers of transmission of the disease.
The research initiative was advanced during a stakeholders’ workshop held on April 15, 2026, at MakSPH’s Resilient Africa Network in Kololo, where a team led by Assoc. Prof. David Musoke of Makerere University and Dr. Kevin Deane of The Open University presented ongoing and previous findings on the social determinants of malaria. The meeting brought together academics, policymakers, and practitioners to examine how agricultural practices, particularly maize farming, may be shaping malaria patterns in both rural and urban settings in Uganda.
The work builds on a growing body of research linking malaria to economic activity. One such study, led by the two researchers and published in Global Public Health in December 2025, found that livelihood activities such as farming, livestock keeping, and night-time work significantly influence malaria exposure. The study identified agriculture, especially maize cultivation near homes, as a key factor associated with increased mosquito density and heightened infection risk.
Assoc. Prof. David Musoke presents research findings on how livelihoods, including maize cultivation near homes, may influence malaria exposure during a stakeholder workshop at the Resilient Africa Network, Kololo, on April 15, 2026.
At the workshop, Dr. Musoke said the new inquiry reflects a broader shift in how malaria is understood, outlining how livelihoods, particularly agriculture, shape exposure through multiple pathways, from crop production and water use to the timing of daily activities that coincide with peak mosquito biting hours. These patterns, he argued, extend risk beyond what conventional interventions, such as insecticide-treated nets and indoor spraying, are designed to address.
Uganda remains one of the countries most affected by malaria, with the disease accounting for a significant share of outpatient visits, hospital admissions, and deaths. It is consistently ranked among the leading causes of illness and mortality, particularly among children under five and pregnant women. Despite sustained investment in prevention and treatment, including widespread distribution of insecticide-treated nets and indoor residual spraying, transmission remains high in many parts of the country. This persistence has increasingly drawn attention to factors beyond conventional interventions, including the role of livelihoods, environment, and everyday exposure to mosquitoes.
Maize grown close to homes, with damp ground conditions, may increase exposure to malaria in rural communities.
“As researchers, our role is to generate evidence, and that evidence should inform decision-making,” Dr. Musoke said. “We do not work in isolation. What we hear from stakeholders matters. We are bringing together different sectors, disciplines, and institutions because this work is still in progress, and we intend to build it collaboratively. Increasingly, research requires not just academics, but policymakers, implementers, and communities to be part of the process.”
The collaboration with The Open University has been central. Dr. Deane said the idea of examining the relationship between maize and malaria emerged from several years of joint research on social determinants with MakSPH. He pointed to a gap in malaria research, which has largely focused on biomedical and indoor interventions, while overlooking the role of livelihoods and outdoor exposure.
Assoc. Prof. David Musoke (left), Dr. Paul Mulumba (centre), a Health Inspector in Wakiso District, and Dr. Kevin Deane (right) share insights during the workshop at the Resilient Africa Network, Kololo, on April 15, 2026.
“We cannot continue relying solely on bed nets, spraying, and treatment,” Dr. Deane said. “These remain essential, but they are not sufficient for elimination. There is significant outdoor malaria transmission, particularly among adults, and that is linked to how people live and work.”
He added that maize presents a complex case. As one of Uganda’s most widely grown staple crops, it is central to both food security and household income, making it impractical to separate farming from living spaces. This, he said, underscores the need to better understand the relationship and develop responses grounded in evidence and local realities.
Evidence presented during the workshop drew on both community experiences and existing scientific literature. Prior qualitative research by the team found that mosquito populations increase during maize growing seasons, particularly in the evenings. Scientific studies also show that maize pollen can enhance mosquito survival and longevity, potentially increasing their capacity to transmit malaria.
Dr. Kevin Deane of The Open University emphasised the need to move beyond conventional malaria interventions to better understand how livelihoods and everyday activities shape exposure during the stakeholder workshop in Kololo, Kampala, on April 15, 2026.
Previous work in Wakiso district further situates maize within a wider set of risk factors. Findings show that agriculture, including crop production and animal husbandry, can create conditions that support mosquito breeding through stagnant water, water storage practices, and environmental changes. These risks are compounded by outdoor activities in the early morning and evening, when exposure is highest. The research also points to the growing role of urban agriculture, which is bringing crop cultivation and potential mosquito habitats closer to residential spaces, altering traditional patterns of transmission.
Ms. Doreen Nabwire Wamboka, in-charge at Namayumba Epicentre Health Centre III in Wakiso District, said the discussions challenged long-held assumptions that malaria is a “well-understood” condition.
“I used to think malaria had been fully researched, that we already knew what we needed to know,” she noted. “I now see that what has been studied is the conventional side of it. There are emerging factors we have not paid attention to. This work is opening up new ways of thinking, even about things we take for granted, like the crops we grow around our homes. We treat malaria as ordinary, yet it is still one of the most common conditions. Understanding these connections could change how we approach the disease.”
Ms. Doreen Nabwire Wamboka, In-charge at Namayumba Epicentre Health Centre III in Wakiso District, engages in a co-creation session as a fellow participant looks on during the stakeholder workshop in Kololo on April 15, 2026, underscoring the need for collaborative approaches to design interventions to tackle malaria.
The initiative will now combine spatial analysis, entomological studies, and community-based research to better understand how maize cultivation influences malaria risk. It will also involve farmers and other stakeholders in shaping potential interventions, reflecting a broader shift toward co-produced solutions.
The workshop, funded by The Open University, marked an important step in refining this research agenda. As the work progresses, its findings could inform policy and practice not only in Uganda, but also in other malaria-endemic countries where maize is widely cultivated. For now, the research signals a shift from isolated interventions to a more integrated understanding of how livelihoods and environments drive malaria transmission.
Update: Application deadline extended to 30th April 2026
Makerere University School of Public Health (MakSPH) is pleased to announce the Certificate Course in Water, Sanitation and Hygiene (CWASH) – 2026.
This intensive and practical short course is designed to strengthen the knowledge, skills, and attitudes of professionals involved in the planning, implementation, and management of Water, Sanitation and Hygiene (WASH) services. The programme responds to the growing demand for competent WASH practitioners in local government, non-governmental organisations, and the private sector.
Course Highlights
Duration: 8 weeks (01 June – 24 July 2026)
Mode: Day programme (classroom-based learning and field attachment)
Fees:
UGX 900,000 (Ugandans / East African Community)
USD 500 (International participants)
Application deadline:Thursday, 30 April 2026
Who Should Apply?
Practising officers in the WASH sector
Environmental Health workers seeking Continuous Professional Development (CPD)
Applicants with at least UACE (or equivalent) and one year of WASH-related work experience
Attached to this announcement, interested persons will find:
The course flier, providing comprehensive programme details, and
The application form, which should be completed and returned to MakSPH together with the required supporting documents.
For full course details, application procedures, and contact information, please carefully review the attached documents. Eligible and interested applicants are strongly encouraged to apply before the deadline and take advantage of this opportunity to build practical competence in WASH service delivery.
Makerere’s School of Public Health (MakSPH) is expanding faster than it can house itself. It now hosts more than 1,000 students, runs programmes across multiple countries, and anchors a large share of the University’s research output. Yet parts of its operation still spill into rented space, costing over $113,000 a year, because the infrastructure has not kept pace with its growth.
That constraint sits uneasily with the School’s economic weight. Health research accounts for more than half of Makerere University’s academic output, making it one of the University’s most productive engines. As Vice Chancellor Barnabas Nawangwe put it, “An educated population is a healthy population, and an educated and healthy population is a prosperous population.”
Beyond the university, health is not just a social outcome but a driver of economic performance. Healthier populations are more productive, more resilient, and less costly to sustain. Investments in public health, whether in prevention, systems, or infrastructure, raise an economy’s productive capacity, not just improve outcomes.
A construction worker undertakes metal fabrication works at the Makerere University School of Public Health (MakSPH) building site.
Institutions that generate public health knowledge and train professionals are not peripheral to growth; they are part of its foundation.
It is this logic that is shaping how Makerere’s School of Public Health is positioning itself. At its centre is a new, unfinished complex on the University’s main campus, intended to anchor the School’s next phase as a regional hub for research, training, and policy support. But like much of the system it supports, it is being built gradually, in a “build-as-you-go” approach constrained as much by funding realities as by design.
Construction of Phase II of the MakSPH complex is now at an advanced stage, with progress recorded across all sections of the site. As of March 2026, Phase 2B is nearing completion at 98%, while Phase 2A stands at 89%, and Phase 2C at 69%, each tracking close to or slightly ahead of planned targets. Current works are concentrated on interior finishes—including tiling, terrazzo installation, and external rendering—as well as preparations for lift installation, signaling a transition from structural works to final detailing. The project team is working toward a practical completion date of August 31, 2026, with timelines calibrated to align with broader resource flows and implementation considerations.
Six years ago, in February 2020, construction began on what will be the new home of the School of Public Health. The building, a permanent, purpose-built public health facility on Makerere’s main campus, will accommodate a growing student body, provide space for doctoral and postdoctoral fellows, and strengthen the University’s ability to respond to Africa’s most pressing public health challenges.
Professor David Serwadda, Professor Emeritus at Makerere University and Chair of the MakSPH Infrastructure Fundraising Committee, said the construction journey reflects the School’s “ambition, intent, and courage”—a bold step despite limited resources. He was speaking at a public lecture on health financing held at Makerere University on April 9, 2026.
But the ambition behind the project is not modest. “We are not building for today—we are building for the future,” said Professor David Serwadda, reflecting on a decision that shaped the entire construction effort. “We need to build for the next 100 years.”
Professor David Serwadda, Professor Emeritus at Makerere University and Chair of the MakSPH Infrastructure Fundraising Committee, speaks at a public lecture on health financing for Uganda’s future, held on April 9, 2026.
That long view helps explain both the scale of the project and the risks taken to start it. When construction began, the School did not have the full funding. “We started with about a third of the required budget,” Serwadda said.
The approach was not without setbacks. A major grant from USAID, worth over a million dollars, was later withdrawn, midway through the construction, due to the closure of USAID. “We received what is called a ‘Dear John letter,’” he recalled. “At that moment, we felt the situation was a major blow, almost terminal for the project.”
But the project did not stop. It adjusted. “We said, let us continue, piecemeal,’” he said. “Finish the auditorium first, use it, and keep building the rest.”
“We have come a long way as the School of Public Health,” said Professor Rhoda Wanyenze, the Dean. “We are proud of that history, but we also recognize that it comes with responsibility.”
Professor Rhoda Wanyenze, Dean of the Makerere University School of Public Health, speaks at a public lecture on health financing for Uganda’s future, held on April 9, 2026.
She argued that responsibility is no longer confined to Uganda. With ongoing collaborative work in more than 25 African countries currently, the Dean says this is “a responsibility to provide leadership in public health not only in Uganda but across the continent.”
The scale of that growth has been visible from what was once a small training unit in the Faculty of Medicine in the 1950s, which has expanded into 12 academic programmes and more than 1,000 students.
“When I came back for my public health training, we were about 40 students,” she said. “Now, we have more than 1,000.” “Public health is growing and evolving,” Wanyenze said. “And we are doing our best to develop the skills needed for this changing landscape.”
That includes new areas such as health informatics and data science, driven by the digitisation of health systems and the growing role of data in decision-making and AI. The School is already coordinating regional platforms on digital health, linking multiple countries in shared learning and practice.
But this growth has outpaced the physical systems needed to sustain it. For the University leadership, the implications extend beyond infrastructure.
“One of the most effective ways to invest in health in Uganda is to invest properly in Makerere University,” said Vice Chancellor Barnabas Nawangwe. “We must recognize Makerere as a research-led university with a special national role—not fund it like any other institution or department. Makerere is one of the government’s greatest assets. Invest in her, and the returns will exceed expectations.”
Professor Nawangwe hailed Dr. Ramathan Ggoobi, the Permanent Secretary to the Treasury, who delivered a keynote on investing in health for Uganda’s future in view of Vision 2040. “I wish to thank Dr. Ramathan Ggoobi and his team for their personal intervention in allocating resources in next year’s budget to complete the new School of Public Health building. That support is deeply appreciated,” he said.
Vice Chancellor Professor Barnabas Nawangwe speaks at a public lecture on health financing for Uganda’s future on April 9, 2026.
Uganda’s progress in health outcomes is evident, but uneven. Life expectancy has risen significantly from about 50 years in 2000 to roughly 68.8 years in 2024, according to the Permanent Secretary to the Treasury, Ramathan Ggoobi. Yet the gains sit alongside persistent financial strain on households. About 4% of Ugandans still spend more than a quarter of their consumption on healthcare, pushing many into poverty as a result of illness.
For Ggoobi, this points to a structural gap that recurrent government spending alone cannot close. “We must mobilise long-term domestic capital without adding fiscal risk,” he argued, pointing to the need for more sustainable financing mechanisms. Central to this is the gradual design and rollout of a national health insurance scheme. Evidence from countries such as Rwanda, Kenya, and Ghana suggests that well-structured contributory models can expand coverage while reducing catastrophic out-of-pocket spending.
“My Ministry and the School of Public Health must be partners. … Evidence framed in fiscal terms drives policy,” said Ggoobi, stressing the need for locally grounded solutions. “What works in Ghana might not work here. We need a model that fits Uganda.”
Uganda’s current macroeconomic conditions, relatively low inflation, currency stability, and expanding private credit may provide a window to move in that direction.