Health
From Working as a Houseboy to Being the Best in School: Ssembuusi’s Story of Overcoming Hardships & Achieving Success
Published
3 years agoon

Against all odds, Allan Ssembuusi-Mayengo rose from a house boy to a First-Class student. In this episode of Makerere University’s week-long 73rd graduation ceremony slated to run from February 13-17, 2023 we present to you a story of a determined young man who never let his circumstances define him, and how he achieved the impossible through hard work, perseverance and the power of prayer. He will graduating as a second best in his class at Makerere School of Public Health (MakSPH) with a Cumulative Grade Point Average (CGPA) of 4.42.
With determination and a willingness to take on any job that came his way, Ssembuusi struggled through financial hardship to make a better life for himself. From selling water at the new taxi park to working as a phone repairman and even starting a mobile manicure and pedicure business, he used his entrepreneurial spirit to support himself through University, despite the challenges he faced he carved out a path to success, proving that with grit and perseverance, anything is possible.
Born on 15th February 1996 in Kyabiiri, Kibinge Subcounty, Bukomansimbi District in Greater Masaka to Wilson Mayengo and the late Sarah Nantongo, Ssembuusi is the 4th born in his family.
School life
For the better part of his childhood, Ssembuusi stayed with his step-mother Ms. Margret Namuddu in Kawanda, Wakiso District after a separation between his mother and father. His mother later passed away while he was in Senior four (S.4). With obstacles in his path he hopped from school to school sometimes to dodge school financial requirements.
As early as 2004, he had started school at Bituntu Church of Uganda Primary School in Masaka. He only completed his Primary One class before he was transferred back to Nalujja primary school in Kawempe in Kampala, where he had a short stint of two academic terms.
In 2005, his family shifted to Kawanda, a small town located north-west of Kampala, the Uganda’s capital town. While here, he completed his Primary Two (P.2) at Little Angels Primary School, a private school. The comfort was short lived as he would later relocate to Nakyessanja Church of Uganda Primary School from P.3 until he sat his Primary Leaving Examination -PLE in 2010.
“This was so hard for me, we didn’t even have lunch at school. In the morning, our step-mom would prepare for us tea with acoil bun (Mwana akaaba) bread of Shs. 100, and this would take us all day until our next meal in the evening. My stepmom always had dinner ready whenever we returned from school. It was hard being at school, seeing your colleagues going to the canteen to buy eats during break and lunch time when you are in class “eating shadows” but still I managed to perform well. I started being in the first position in class in P.3 up to when I finished P.7. All these challenges gave me determination and courage to work hard so that I get a better future,” recollects Ssembuusi.
While in P.3, Ssembuusi was top of his class in promotional examinations but he could not access his report card because his parents had failed to pay UShs 2,000 (approximately $0.54).
“While appearing at end of term School assembly, I was announced as being in the first position—the School administration used to announce the 1st, 2nd and 3rd place holders. We didn’t have that money at home so I didn’t pick my report. With this in mind however, I just reported to P.4 at the start of the next year. The headmaster however, came reading out names of those who didn’t pick their reports, and we were all taken back to P.3,” he says.
He recalls crying endlessly by this act but would only console himself knowing the situation back at home and that his father genuinely did not have the money; “We used to eat cassava flour with avocado. We had an Avocado tree at home and we would temporarily forget hunger in seasons the tree would, bear fruits. We would pick avocado and mash it as the sauce.”
As luck would have it, Ms. Grace Nakidde, his teacher provided him the required Ushs.2,000 that granted him access to his report, and then became officially promoted to the next class in 2006.
Ssembuusi, was frequently engaged in various household tasks, which caught the attention of a neighbor. At the age of 12, while in Primary Five, he went to work for this neighbor as a houseboy to earn money for school fees.
“At the time, we were paying around Ushs 10,000 (approximately $2.72), for remedial classes and Ushs 5,000 for lunch. I used to work day and night, but I stayed focused because I wanted to study. I would go to School barefooted. At P.7, I got 9 aggregates and this was the only first grade at my school.”
Ssembuusi’s excellent performance earned him a bursary to attend Central College Kawempe, a school owned by a relative of his employer. Despite this financial aid, he still had to pay for some school materials, which prompted him to continue working at home. “I would wash cars for our neighbor every day to buy books, but I still excelled and was the best in all three terms of S.1,” he said. However, due to the mistreatment he experienced as a houseboy, Ssembuusi confided in his parents, who then spoke to his employer. Unfortunately, this led to the loss of his bursary.
“Since my parents were unable to pay for my education at Central College Kawempe, they transferred me to Luteete Senior Secondary School in Luweero. I am grateful to Mrs. Kiwanuka who, through our shared faith at Elim Pentecostal church in Kawanda, connected me to Luteete where I was able to obtain a half bursary. This required me to raise Ushs 150,000 (approximately $40.82) on my own. Despite this, things were still difficult for me, as I often only had Ushs 20,000 (approximately $5.44) to last me through the entire term.”
Ssembuusi states that the school’s provision of lunch and supper helped him stay focused. He adds, “Sometimes I sold my lunch to afford necessities like books and pens, but I still excelled and remained the best throughout my stay, up to S.4. I scored 13 out of 8 aggregates, the best performance in the school’s 60-year history. I achieved it through hard work and prayer, even fasting dry for 3 days.”
After getting his Uganda Certificate of Education (UCE) results, Ssembusi moved to Wampeewo Ntakke Senior Secondary School along Gayaza Road with the help of his former head teacher Mr. Mike Ssekaggo. He says, “I scored 12 points in BCM/ICT and I remember getting a D1 in Biology Paper 3. I was also the founder and pioneer of the school’s Science Club.” After finishing S.6, he found a job as a porter at a construction site near his school. He adds, “Although students saw me working there, I was determined to survive. Later, my former head teacher helped me get a job as a canteen attendant at his school, where I stayed for 1 and a half years.”
Failing to join University and Resorting to Barber and Taxi Tout
Ssembuusi had always dreamed of going to university, but his journey was not an easy one., Despite sitting for his Uganda Advanced Certificate of Education (UACE) in 2016 with hope to join a university in 2017, he was not admitted to any of the institutions he applied to on his application forms. He lost that year of 2017 and decided to try again in 2018. “I had understood my points, and weights better and thought by trying on a Diploma, I would get admission. I applied for a diploma in Education at National Teachers College NTC Kaliro, but was not admitted once again”
Feeling defeated, Ssembuusi left his job as a canteen attendant and returned home, but struggled to find any opportunities. However, things still weren’t working out and he found himself living with his uncle who was a barber and taught him the trade. He also started working as a conductor on a taxi route from Jinja road-Kawanda-Matugga, where he used to meet his old teachers and colleagues. He felt like a failure, but still held on to hope for better opportunities.
“We used to ply the Jinja road route. I grew up on this route and so I had mastered it. While in this trade, I would meet my teachers, my former colleagues, the students I used to discuss for. For once, I felt like I was a total failure,” says Ssembuusi.

One day while operating as a taxi tout in Wandegeya, he bumped into an old friend, Jackline Nankya, who in 2020 graduated from MakSPH. They had studied together at Wampeewo Ntakke Senior Secondary School. Concerned about him she asked for his contact to check on him. Ssembuusi explained his situation and Jackline told him about the Government Loan Scheme program, a fund that awards study loans to Ugandan students seeking to pursue Higher Education but are financially constrained. She helped him apply for a course in Environmental Health Science, which he made his first choice, and also helped him apply for the Government Loan Scheme.
Ssembuusi was in a dilemma, he had even prepared to go to the United Arab Emirates to do “Kyeeyo” (cheap employment for immigrants to the developed world) with some sisters that were already there. His parents were excited about the prospect of him making money. “I didn’t tell them [parents] when I applied. I told them when I was admitted. I was in a dilemma and in fear of how my parents would react to me leaving an opportunity to work and provide for them.”
He sought advice from a few people, including his boss in the taxi business, before ultimately telling his parents. To his surprise, they were overjoyed when he finally shared his plans with them. They had the assumption that Makerere University was the only university in Uganda.
Life at MakSPH
Determined to succeed, Ssembuusi used all the money he made working in the taxi to buy the requirements needed for his first year. He was so passionate about his studies that he even joined a week before his colleagues and was voted unopposed as class representative. “This is where my journey to perform well started,” he says.
Adding that; “After our first lecture with Ms. Ruth Mubeezi, I felt deeply inspired. I approached her after class and shared my struggles with her. Her words of encouragement and assurance that I would be able to manage school, gave me the courage and determination to push forward. And that’s how I embarked on my journey towards achieving a first-class degree, starting off with a strong 4.6 GPA in my first semester.”

He commuted to school in his first semester, but during a brief holiday before the second semester, he decided to stop commuting and go back to his taxi business in the Old Taxi Park to earn money for accommodation. He was able to get some money and temporarily moved into Nkrumah Hall, one of the halls of residence for male students admitted to Makerere University, named after the great pan Africanist Nkwame Nkrumah of Ghana with a friend Kelvin Langat.
“I wanted to go back to work as a conductor to earn money for accommodation but it was the festive season so things didn’t work out. I decide to sell sugarcanes in Old Taxi Park because most people there, knew me. I used to contribute something and stay with him on the same bed before COVID came in and we had to leave campus,” a teary Ssembuusi recalls.
COVID-19 and Ssembuusi’s campus nail business
As the COVID-19 pandemic swept the world, it brought with it a host of challenges for students like Ssembuusi. With lockdowns in place and classes conducted online, Ssembuusi was forced to find ways to make ends meet. Like many students, Ssembuusi found himself struggling to afford the costs of accommodation, and everyday living expenses.
“I went to New Taxi Park (the old one was closed for renovation at this time) and sold water there. It was a tough moment, because I found so many classmates there boarding taxis to go about their business. I wanted to quit, but I also still wanted to survive,” he says.
The Student Loan Scheme is a cost sharing initiative. The Loan strictly covers the academic component, i.e., Tuition fees, Functional fees, Research fees, Aids and Appliances for Persons with Disabilities (PWDs). For Ssembusi’s case, the loan covered Ushs1.8m fees inclusive of functional fees and he is indebted to the loan scheme; “I am thankful for the Student Loan Scheme for enabling me to continue my education, however, they have not yet paid for my last three semesters, preventing me from accessing my transcript until the debt is fully cleared. Despite the delay in payments, they would still allow us to sit for exams with the assurance that they would pay later.”
It was during this time that Ssembuusi stumbled upon an unexpected opportunity. At a friend’s home, he discovered a salon offering manicures and pedicures. Intrigued, he asked the owner to teach him the trade, and soon found himself learning the skills needed to set up his own mobile manicure and pedicure business.
With the support of his classmates, Ssembuusi’s business quickly took off. Working on almost all of his female classmates, Ssembuusi found himself juggling the demands of her coursework and his business. But he was committed to making it work, and with the help of a loan from a friend, he was able to purchase the equipment he needed to keep his business running.
“I have been doing pedicure and manicure, and all my clients have been my colleagues. I was charging 10,000 to 30,000 Ushs for gel nails. People perceive it as a “low-key job”, and I am sure it’s hard for most campusers to do this kind of work especially on their classmates. I know some people come from advantaged families, but for those of us who have been disadvantaged, please don’t look down on any opportunities or jobs that will help you raise some money to sustain you,” he says.

“I think I have worked on almost all my female classmates. The business boomed, I started getting recommendations but it was a challenge on my side to attend lectures and also attend to clients. My course is a full day course, and being a course representative, I had to be around. I managed to schedule my clients in the evenings and over the weekends when I worked all day.
Ssembuusi has throughout his school life struggled with self-doubt and imposter syndrome, but along the way found ways to overcome it through self-improvement and taking advantage of opportunities. He was active in the school community, serving as a class representative and holding leadership positions in Makerere University Environmental Health Students Association (MUEHSA).
He found success in extracurricular activities, such as participating in medical camps and running events. After finishing his course, Ssembuusi sought guidance from his mentors and ultimately landed a volunteer position under the mentorship of Dr. David Musoke, a Senior Lecturer in the Department of Disease Control and Environmental Health at Makerere University School of Public Health (MakSPH). His future goal is to pursue a Masters and eventually a PHD in academia and research. He encourages others to take advantage of opportunities in order to be successful.

To achieve a first class, one must put in hard work and strive to do their best. “I didn’t set out to achieve a first class, but I now understand its value. A lecturer once told us, ‘Don’t listen to those who say a first class isn’t worth it – if you can earn one, go for it.’ That’s my advice to my peers – aim for the best and don’t be discouraged. I didn’t actively pursue a first class, but my efforts paid off in the form of this distinction,” says Ssembuusi.
He adds; “Mr. Frederick Oporia, who taught me inspection, court etiquettes, and environmental health legislation, is my standout lecturer and role model. Currently the Head of Trauma, Injury, & Disability (TRIAD) unit, he continues to inspire me. Additionally, Dr. David Musoke, who is my mentor, is someone I look up to and strive to emulate in my work.”

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Health
WHO Report Highlights Global Drowning Burden as MakSPH Contributes to Evidence and Action
Published
5 days agoon
May 6, 2026
Makerere University School of Public Health, through its Centre for the Prevention of Trauma, Injury and Disability, contributed to the Global Status Report on Drowning Prevention 2024, the first comprehensive global assessment of drowning burden, risk factors, and country-level responses.
Published by the World Health Organisation, the report estimates that approximately 300,000 people died from drowning in 2021, with the highest burden in low- and middle-income countries, which account for 92% of deaths. The African Region records the highest mortality rate, underscoring the urgency of targeted interventions. Children and young people remain the most affected, with drowning ranking among the leading causes of death for those under 15 years.
While global drowning rates have declined by 38% since 2000, progress remains uneven and insufficient to meet broader development targets. The report highlights critical gaps in national responses, including limited multisectoral coordination, weak policy and legislative frameworks, and inadequate integration of key preventive measures such as swimming and water safety education.
It further identifies persistent data limitations, with many countries lacking detailed information on where and how drowning occurs, constraining the design of targeted interventions. At the same time, the report notes progress in selected areas, including early warning systems and community-based disaster risk management.
MakSPH’s contribution to this global evidence base reflects its role in advancing research, strengthening data systems, and supporting context-specific approaches to injury prevention. Through its Centre, the School continues to inform policy and practice, contributing to efforts to reduce drowning risks and improve population health outcomes in Uganda and similar settings.
The full report can be accessed below:
Health
Makerere University’s role in empowering Uganda’s Vital Statistics for CRVS Reform
Published
2 weeks agoon
April 27, 2026By
Mak Editor
By Dan Kajungu
In many low- and middle-income countries, mortality data remains a critical gap in public health planning, often leaving a significant portion of the population “invisible” in official records. In Uganda, where national death registration completeness has historically hovered around a mere 20%, Makerere University Centre for Health and Population Research (MUCHAP) is leading a transformative initiative. By leveraging the infrastructure of the Health and Demographic Surveillance System (HDSS), MUCHAP has demonstrated how academic research frameworks can be integrated into national systems to strengthen Civil Registration and Vital Statistics (CRVS).
A Bridge between research and governance
The core of this success lies in the collaboration between Makerere University’s infrastructure and government agencies, specifically the National Identification and Registration Authority (NIRA). This partnership, supported by the Uganda National Public Health Institute (UNPHI) and international partners like the Bloomberg Philanthropies Data for Health Initiative at the CDC Foundation, aimed at aligning local death recording practices with the legal requirements of the Registration of Persons Act (ROPA) 2015.
By utilizing the existing MUCHAP Iganga Mayuge HDSS platform, which has monitored births and deaths in the Iganga and Mayuge districts since 2005, the project demonstrated the use of a decentralized notification process. This model utilises Village Health Teams (VHTs) who already serve as HDSS scouts and part of the Ministry of Health systems as official death notifiers. These VHTs assist households in completing official NIRA notification forms at the household/community level, which are then verified by local leaders and submitted to District Registration Offices.
Impact: From 20% to over 70% completeness
The results of this collaboration have been profound. In the pilot sub counties in the districts of Iganga and Mayuge, death registration completeness reached 73–79%, a dramatic improvement over the prevailing national estimates. During the study period, 2,992 deaths were officially registered within the national CRVS system.
Key drivers of this success included:
- Reduced barriers: Decentralization brought the registration process closer to home, with an average travel distance of only 4–5 km for notification, compared to the significant distances previously required to reach district offices.
- Cost savings: Families reported that the community-based process eliminated unofficial fees and high transportation costs, facilitating essential cultural and legal tasks like property inheritance and appointing heirs.
- Advanced surveillance: The project proved that local health personnel could successfully conduct verbal autopsies (VA) in non-HDSS settings, providing critical data on causes of death that were previously unavailable for home-based deaths.
Sustainability and future potential
The MUCHAP-IMHDSS model is designed for long-term sustainability and national scalability. By embedding these tasks within the routine activities of VHTs and local leaders, the process becomes streamlined and cost-effective over time. The project also highlights that community sensitization is vital to maintaining trust and ensuring high participation rates, particularly in rural areas.
Looking forward, this initiative serves as a scalable blueprint for the rest of Uganda and other low-resource settings. Future engagements are expected to focus on:
- National scale-up: Applying the lessons learned from Iganga and Mayuge to the entire country to close the mortality surveillance data gap.
- Integration with health systems: Linking the CRVS data with broader health information systems to enhance pandemic preparedness and routine public health actions.
- Regional leadership: Aligning with the Africa CDC’s initiative to strengthen mortality surveillance across the continent, positioning Uganda’s university-led model as a regional gold standard.
The HDSS-CRVS integration Project Leader Dr. Dan Kajungu who is the Executive Director of MUCHAP emphasised that “through this work, Makerere University has again proved that academic infrastructure is not just for research, but a vital engine for building resilient national governance and health systems”. This work was disseminated at the 2026 CRVS Research Forum in Bangkok, Thailand and can be accessed at https://shorturl.at/8JLTd
Dan Kajungu Msc PhD is the Executive Director MUCHAP
Health
World Malaria Day 2026: Makerere scientists have found the countdown clock for when Ugandan children will die from malaria: The question is whether anyone is listening
Published
2 weeks agoon
April 25, 2026By
Mak Editor
On a day when the world declares it can and must end malaria, new research from Eastern Uganda shows climate change is working against us and that the evidence to fight back exists right here at home
Special Feature | World Malaria Day, 25 April 2026
By Health and Science Correspondent
Today, 25 April 2026, Uganda joins the rest of the world in marking World Malaria Day under the global theme: “Driven to End Malaria: Now We Can. Now We Must.” It is a rallying cry rooted in genuine optimism. Since 2000, 2.3 billion malaria cases and 14 million deaths have been averted globally. Forty-seven countries have been certified malaria-free, and between 2000 and 2024, the number of malaria-endemic countries fell sharply from 108 to 80.
Uganda is not one of those success stories, not yet. Malaria is endemic in 96% of Uganda, accounting for 29.1% of outpatient visits and 39.5% of hospital admissions, with over 17,556 estimated malaria deaths annually, the highest burden falling on children under five years of age. And on this World Malaria Day, a new alarm has been sounded from the heart of one of Uganda’s most malaria-burdened communities, not by foreign researchers, not by a distant global health organisation, but by scientists at Makerere University, drawing on two decades of data they have collected in the villages of Iganga and Mayuge in Eastern Uganda.
Their message is urgent: climate change is silently and measurably worsening Uganda’s malaria crisis. But this is the equally important half of the story. They have now identified the precise conditions under which children die, and exactly how long in advance those deaths can be predicted. Uganda has, for the first time, a scientifically validated early warning system for climate-driven malaria mortality. Whether the country chooses to use it is now a question of political will, not scientific capacity.
The study and the platform that made it possible
Published in BMC Public Health in August 2025, the study — “Climate-driven malaria mortality among children in malaria-endemic areas of Uganda” — was led by Dan Kajungu of Makerere University‘s Centre for Health and Population Research (MUCHAP). It analysed 14 years of weekly malaria death data from January 2008 to December 2022 matched against climate variables, using a sophisticated time-series statistical approach called the Distributed Lag Non-linear Model.
The data came from the Iganga Mayuge Health and Demographic Surveillance Site (IMHDSS), the population research platform that Makerere University has operated continuously since 2005. The IMHDSS population cohort collects data from 65 villages located within an area of 155 square kilometres, monitoring a population of close to 100,000 people. The site has 23 health facilities, including two general hospitals, and a bimodal tropical climate with rainfall seasons from March to May and September to November.
What makes the IMHDSS extraordinary and what made this study possible is its method of capturing deaths. Rather than relying on hospital registers that miss the majority of rural deaths, malaria deaths were identified using verbal autopsies and the InterVA algorithm, a probabilistic tool that uses verbal autopsy questionnaires and Bayesian statistical techniques to estimate the probabilities of various causes of death based on signs and symptoms reported by bereaved families. Three different WHO verbal autopsy tools are used, tailored for neonates, children, and adults respectively.
In other words, when a child dies in a village in Iganga, the IMHDSS knows about it. It interviews the family. It determines why the child died. And it has been doing this, without interruption, for twenty years. The result is a dataset that is both scientifically rare and profoundly Ugandan, generated here, about us, by our own researchers.
A total of 858 malaria-related deaths were recorded in the Iganga-Mayuge districts between 2008 and 2022. Of these, 53% were among males and 47% females. The vast majority, about 73% occurred among children under five years of age, while the fewest deaths occurred among those aged 15 to 49 years. Males exhibited higher mortality proportions across all age groups, except among the elderly.
Eight hundred and fifty-eight deaths. Each one a child or adult with a name, a family, a community. Each one counted.
The finding that changes everything: Uganda now has a malaria early warning system
The scientific heart of this study, the finding that every health planner, every district malaria coordinator, and every Minister of Health in Uganda should understand is this: the researchers have identified the exact temperature and rainfall thresholds at which malaria deaths among children rise, and how many weeks in advance those deaths can be predicted.
The study found an increased mortality risk across all ages at a lag of 11 to 12 weeks following exposure to rainfall above 646 mm. Higher risks of malaria mortality were also observed at a lag of 5 to 11 weeks when temperatures ranged between 25.2°C and 29.9°C. Critically, the relative risk of malaria mortality in children under five years and children aged between 5 and 14 years was more sensitive to temperature than to rainfall.
Read that again, slowly. When temperatures in Eastern Uganda climb into the range of 25.2°C to 29.9°C, children begin dying of malaria five to eleven weeks later. When extreme rainfall events exceed 646 mm, deaths rise eleven to twelve weeks after that exposure. Uganda’s meteorological service measures temperature and rainfall continuously. Uganda’s health system manages malaria interventions. These two systems have never been formally connected, but the science to connect them now exists.
This is what a malaria early warning system looks like. Not a foreign technology imported at great expense. Not a satellite system requiring international expertise to interpret. A Ugandan scientific finding, produced from Ugandan data, that tells Ugandan health authorities: when you see these weather conditions, stock your health centres, distribute your bed nets, deploy your community health workers, and prepare, because the deaths are coming in six to twelve weeks if you do not act.
On this World Malaria Day, when the global community declares that ending malaria is now possible, Uganda has precisely this tool in its hands. The only question is whether it will use it.
Climate change is not a future threat, it is already killing children
The global theme for World Malaria Day 2026 carries urgency partly because climate change, conflict, and humanitarian crises continue to drive malaria resurgence and disrupt essential services. The Makerere study puts specific, local flesh on that global warning.
Malaria is climate-sensitive, changes in temperature, rainfall patterns, and relative humidity affect the dynamics and intensity of malaria transmission by influencing the habitats of mosquitoes and parasites and their biological growth cycle. Climate remains an indirect cause of malaria mortality by affecting parasite development during periods of high rainfall and temperatures, leading to increased transmission, morbidity, and severe malaria outcomes.
The malaria parasite Plasmodium falciparum, the species responsible for almost all malaria deaths in Uganda requires specific temperature ranges to complete its development inside the Anopheles mosquito. Too cold, and development slows or stops. Too hot, and it also stops. But within the range that Eastern Uganda increasingly inhabits, and will inhabit more frequently as global temperatures rise, the parasite thrives, multiplies, and kills.
The World Malaria Report 2025 warns that drug resistance is now confirmed in four African countries including Uganda, where artemisinin partial resistance has been detected. Insecticide resistance to pyrethroids – the main chemical on bed nets is now confirmed in 48 out of 53 reporting countries. As the tools Uganda currently relies on including bed nets, indoor spraying, artemisinin-based drugs face mounting biological resistance, the importance of climate-informed prevention strategies grows exponentially. Deploying interventions at exactly the right time, guided by weather data, becomes not just efficient but essential.
The children most at risk: a finding that demands a policy response
Among the study’s most striking findings is the specific vulnerability of school-age boys. A group almost entirely absent from Uganda’s current malaria prevention architecture.
Male children aged between 5 and 14 years were found to be more vulnerable to temperature-related malaria mortality compared to females in that age group and compared to children under five years. Rainfall did not have a significant association with malaria mortality in children.
Uganda’s National Malaria Control Programme, like most in sub-Saharan Africa, has historically concentrated resources on two priority groups: children under five and pregnant women. These groups are undeniably vulnerable and deserve protection. But this study shows that school-age boys are dying from temperature-driven malaria at rates that demand their inclusion in prevention strategies.
School-aged children between 5 and 14 years have higher malaria prevalence, with 70% carrying the malaria parasite asymptomatically in high transmission settings. They carry the parasite silently, sustaining transmission in their communities, and they die when temperatures rise, particularly the boys, who in rural Uganda spend more time outdoors, sleep less consistently under nets, and receive less parental health supervision than their sisters as they grow older.
The study’s area is itself among the most heavily burdened in Uganda. The Iganga-Mayuge area has a malaria prevalence rate of 39.4% in children under five years old, making it one of the areas in Uganda most severely impacted by malaria, and the disease is the leading cause of mortality in children there. In such a high-transmission setting, the combination of asymptomatic carriage, temperature-driven transmission spikes, and inadequate prevention coverage for school-age children is a formula for preventable death.
On World Malaria Day 2026, as Uganda declares its commitment to ending malaria, the national malaria strategy must be updated to reflect this evidence. School-based distribution of insecticide-treated nets, school health programmes that include malaria education and early symptom recognition, and targeted community outreach for families with boys aged 5 to 14 are not optional additions, they are evidence-based necessities.
The platform: Makerere‘s IMHDSS as a national asset for malaria elimination
None of the findings in this study would have been possible without the IMHDSS and on World Malaria Day, it is worth being explicit about what that platform represents for Uganda’s future.
The IMHDSS platform has measured various indicators about coverage and uptake of national interventions including the coverage and utilisation of immunisation and vaccines, mosquito nets for malaria vector control, household income improvement, and family planning, and other behaviour change interventions at community level, strengthening the evaluation of burden of disease at the subnational level.
For malaria specifically, the IMHDSS has now produced the most granular mortality data in Uganda’s history capturing not just how many children die, but exactly which weather conditions preceded those deaths, which sex and age group is most vulnerable, and what the biological and epidemiological mechanisms are that connect climate to the grave. This is the kind of intelligence that a National Malaria Control Programme needs to move from reactive crisis management to proactive, evidence-driven prevention.
Scarcity of quality data remains a key development bottleneck in low and middle-income countries, and the Iganga-Mayuge HDSS represents a Makerere University platform for research and research training with a population-based cohort that longitudinally generates data for evidence-based decisions and policy.
Uganda’s malaria elimination goal, to bring mortality to zero will not be achieved by effort and goodwill alone. It requires data. It requires the kind of longitudinal, community-level, cause-of-death data that only a platform like the IMHDSS can generate. And it requires the institutional will to connect that data to the decisions that determine whether children live or die.
What must happen now
The global call on World Malaria Day 2026 is clear: “Now We Can. Now We Must.” For Uganda, the Makerere climate-malaria study translates that call into three specific and achievable actions.
First, the Ministry of Health and Uganda National Meteorological Authority must establish a formal, operational malaria early warning system. One that uses real-time weather monitoring to trigger predetermined health system responses when temperature and rainfall thresholds identified by this research are breached. The science is ready. The infrastructure for meteorological monitoring exists. What is needed is the institutional bridge between them.
Second, Uganda’s National Malaria Control Programme must extend its prevention focus to include school-age children, particularly boys aged 5 to 14, in all high-transmission areas. Bed net campaigns must reach schools, not just health centres and antenatal clinics. Community health workers must be equipped to identify and treat malaria in this age group as a priority.
Third, and most fundamentally, the Government of Uganda must formally recognise and domestically resource the IMHDSS as national public health infrastructure. The 2024 global malaria funding of US$3.9 billion was less than half of the US$9.3 billion target, leaving a projected shortfall of US$5.4 billion that leaves the response dangerously under-resourced. In a world where international health financing is under historic pressure, Uganda cannot afford to have its most powerful evidence-generation platform dependent entirely on foreign philanthropy. The IMHDSS is a Ugandan asset. It must be funded as one.
Today, children in Iganga and Mayuge are alive who might not be, because the research generated by the IMHDSS informed the malaria interventions that reached their communities. Today, Makerere scientists have given Uganda a tool, a climate-based early warning system for malaria deaths that no other country in East Africa currently possesses.
Now we can. Now we must.
The evidence is there. The science is done. The only thing Uganda needs now is the will to act on it.
“Climate-driven malaria mortality among children in malaria-endemic areas of Uganda” is published open-access in BMC Public Health, Volume 25, Article 2825, August 2025. Full text available at: https://link.springer.com/article/10.1186/s12889-025-23678-0
The Iganga Mayuge Health and Demographic Surveillance Site (IMHDSS) is operated by MUCHAP, Makerere University. Contact: info@muchap.mak.ac.ug or dkajungu@muchap.mak.ac.ug| Tel: +256 772 207127 (Dr. Dan Kajungu)
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