To access treatment and care services at the Uganda Cancer Institute (UCI), patients spend on average 300,000 Uganda shillings on a single visit although some spend to as high as 800,000 (Figure 1). This was revealed by a study done by Makerere University in collaboration with the Strengthening Institutional Capacity for Research Administration (SICRA) and Uganda Cancer Institute (UCI) with funding from the Government of the Republic of Uganda through Makerere UniversityResearch and Innovation fund (Mak-RiF).
Conducted in 2021 during the Covid-19 pandemic lockdown, this study titled “Impoverishing and Catastrophic Health Expenditure on Cancer Care among Persons affected by Cancer in Uganda” is among the first few in the country to estimate the catastrophic health expenditure among cancer patients receiving care in Uganda.
The study revealed that patients suffering from Prostate and Colorectal Cancers were the most affected, with their out-of-pocket expenditure greater than 600,000 per visit. Out of pocket expenditure refers to all direct payments for healthcare or services from household income or savings that patients incur at the point they receive health services.
The study also highlighted that a considerable proportion of cancer patients experience catastrophic health expenditure. “Overall, at least half of all cancer patients experienced catastrophic health expenditure on Cancer Care and treatment. 5 out of 10 patients spent at least 40% of their household income on Cancer health care,” the study findings reveal in part. Further, “Cancer patients or households with patients are unable to solely meet costs associated with cancer care. Often they depend on family, relatives, and friends’ support. However, the continuity of support coming through is not guaranteed throughout the patient’s time of sickness.” Speaking during the Dissemination and Stakeholders Engagement at UCI, Dr. Allen Kabagenyi, the Principal Investigator, noted that unemployed patients, who constituted 86% in the study, were among those who spend at least 300,000 Uganda shillings whenever they visit UCI. “This money is spent on buying missing drugs, imaging services, and tests among others,” she added.
Besides digging deep into their pockets to meet the cancer treatment costs, the findings reveal that families often sell their household property like land, animals, homes among others, in order to raise money for treatment and any related care. “The Shs300,000 is for only one visit but remember a cancer patient who is on stage one and two has to visit regularly, translating to almost Shs. 3.6 million in a year,” Dr. Francis Kiweewa, the Director Strengthening Institutional Capacity for Research Administration (SICRA) said.
The Assistant Commissioner – Non communicable diseases (NCDs) prevention and control Department at Ministry of Health, Uganda, Dr. Gerald Mutungi said; “At the ministry, we have adopted the approach of evidence-based policy decision making. Therefore, the policy recommendations of this study are well received.” He further said that as the Ministry waits for the passing and implementation of the National Health Insurance Scheme, researchers need to investigate and come up with measures aimed at cancer prevention and control.”
Dr. Jackson Orem, the Executive Director of Uganda Cancer Institute, while responding to the study findings admitted to the growing cancer burden, which he said could only be managed through establishing regional Cancer management centers. He said “currently when you look at the statistics of the number of cancer patients we receive at UCI, 15% are from central region while 85% come from up country. What I can say is that we need to decentralize our services so that these people are able to access them with ease in their respective areas.”
Dr. Nixon Niyonzima, the Head of Research at UCI, said government should have focused interventions of increasing household income so that the patients are able meet the cancer care and treatment related expenses.
Speaking to journalists, Prof. Bruno Yawe, the Ag. Principal College of Business and Management Sciences (CoBAMS) noted that the study speaks to the objectives of Makerere University’s strategic planning framework for the 2020–2030 period, which seeks to enhance a research-led university. He commended the multidisciplinary study team led by Dr. Allen Kabagenyi, saying that the findings were timely especially when Uganda is registering rising cancer related morbidity and mortality. He thanked the Mak-RIF Grants Management Committee representative Dr. Mercy Amiyo, for insights and continued support to researchers at Makerere University.
In Uganda, over 56,238 are living with cancer and more than 21,000 deaths were registered in 2020, according to the Globocan Cancer Statistics report. Further the report shows the top seven cancers in Uganda including; cervical cancer, Kaposis Sarcoma, breast, prostate, Non-Hodgikin Lymphoma, cancer of the liver and esophageal – account for 70% of new cancer cases. Knowing the catastrophic health expenditure on cancer care is crucially important to design strategies of providing financial protection against the rising medical expenditure by households with cancer patients.
Meet the study team
Acknowledgements
This study was funded by the Government of the Republic of Uganda through Makerere UniversityResearch and Innovation Fund (MAK-RiF). Special thanks to all the patients, Care Givers and Key informants who participated in this study. Graduate Assistants Mr. Ronald Wasswa and Mr. Kayemba, Makerere University.
Over 30 Stakeholders from Uganda’s transport and energy sectors convened at the Kolping Hotel, Kampala, for a workshop aimed at accelerating the adoption of electric mobility (e-mobility) as a strategy for reducing emissions and improving energy efficiency. Organized by the Environment for Development (EfD)-Mak Centre, the workshop brought together researchers, policymakers, transport operators and users, as well as  private sector players to address challenges and opportunities in Uganda’s e-mobility transition.
Promoting Energy Efficiency and Reduced Emissions
The workshop, led by Dr. Peter Babyenda, Policy Engagement Specialist  at EfD-Mak, centered on the theme “Energy Efficiency and Reduced Emissions in Uganda’s Transport Sector.” Dr. Babyenda highlighted the environmental and economic importance of transitioning to e-mobility, stating, “Transforming Uganda into a modern society as envisioned under Vision 2040 demands that we address the environmental challenges in the transport sector, a major carbon emitter.”
The agenda included discussions on the status of energy efficiency, the role of women in e-mobility, and strategies to promote the adoption of electric motorcycles and buses.
Rising Numbers and the E-Mobility Transition
According to survey findings by the EfD researchers, Uganda’s transport sector has seen an unprecedented rise in vehicle and motorcycle usage. The number of vehicles in the country has more than doubled, increasing from 739,036 in 2012 to 1,355,090 in 2018. Motorcycles have seen an even sharper increase, growing from 354,000 in 2010 to over one million by 2018. This growth has intensified emissions and air pollution, particularly in urban areas like Kampala, which was ranked the world’s fifth most polluted city in 2020.
Electric mobility is emerging as a viable solution. Over 400 electric motorcycles, introduced by private sector players such as Zembo, GOGO, and Spiro, are already on Uganda’s roads. These e-motorbikes offer cost savings on fuel and maintenance, zero emissions, and enhanced security. Dr. Babyenda described them as a step forward in reducing the sector’s environmental footprint, though he acknowledged the challenges of limited charging stations, counterfeit batteries, and insufficient awareness.
Government Policy and Infrastructure Development
Eng. David Birimumaso, Principal Energy Officer at the Ministry of Energy, detailed the government’s efforts to support e-mobility. These include developing charging infrastructure, establishing policies for electric vehicle adoption, and training technicians and operators.
“Transport contributes 16% of energy-related emissions,” said Eng. Birimumaso. “Through partnerships with private players like Zembo and Kiira Motors, we are promoting e-mobility by building charging stations and offering capacity-building programs for stakeholders. By 2030, we aim to ensure 100% electricity access, making e-mobility viable for all Ugandans.”
So far, the Ministry has piloted electric vehicle charging at Amber House in Kampala and supported the establishment of four charging stations along the Masaka Road corridor. These efforts are part of the broader energy policy, which emphasizes the transition to cleaner, more efficient energy sources.
Economic and Gender Inclusion in E-Mobility
The workshop also highlighted the importance of economic and gender inclusion in e-mobility. Dr. Babyenda noted that while women are increasingly involved, barriers such as cultural stigmas, inappropriate vehicle designs, and limited training opportunities persist.
“Encouraging women to take up roles as drivers and technicians in the e-mobility sector is essential for a holistic transition,” Dr. Babyenda remarked. Participants recommended vehicle redesigns to accommodate women and initiatives to encourage female participation in the sector.
Key Challenges and Recommendations
Despite the promise of e-mobility, several barriers hinder its widespread adoption in Uganda. One major challenge is the limited availability of charging stations and battery-swapping points, which restricts the operational range and convenience of electric vehicles. The prevalence of counterfeit batteries further undermines reliability, discouraging potential users. Additionally, the high upfront costs of electric vehicles and motorcycles present a significant financial barrier for many Ugandans. Insufficient public awareness and persistent misconceptions about e-mobility also contribute to slow adoption, highlighting the need for targeted education and sensitization campaigns.
To address these challenges, participants recommended expanding charging networks, introducing subsidies for electric vehicles, enforcing quality standards for batteries, and conducting nationwide sensitization campaigns. Hybrid vehicles were also suggested as a transitional solution to address range anxiety.
Workshop’s Relevance to National Goals
This workshop was part of the Inclusive Green Economy (IGE) program, a regional initiative funded by Sida through the University of Gothenburg, Sweden. Since its inception in 2020, the program has trained over 25 fellows across East Africa, focusing on green transitions and evidence-based policymaking.
The 2024 workshop theme aligns with Uganda’s Vision 2040 and the National Development Plan IV, which prioritize energy efficiency and emission reductions in the transport sector.
As the workshop concluded, stakeholders expressed optimism about Uganda’s e-mobility potential. Dr. Babyenda emphasized the importance of inclusivity, stating, “Achieving energy efficiency requires collective effort. We must involve everyone, from boda boda riders to policymakers, to ensure a successful transition to clean, efficient transport.”
With over 400 electric motorcycles on Uganda’s roads and a growing network of charging stations, the country is making strides in its journey toward sustainable mobility. However, much work remains to achieve widespread adoption and integration of e-mobility solutions. The workshop served as a vital platform for collaboration and innovation in this critical sector.
Jane Anyango is the Communication Officer at EfD Uganda
The Public Investment Management Centre of Excellence (PIMCoE), hosted by the College of Business and Management Sciences at Makerere University, successfully concluded the training of its 4th cohort of public officers on November 15, 2024. This capacity-building program focused on the User Acceptance Training on Guidelines for Clearance of Financial Implications, a critical process mandated by Section 76 of the Public Finance Management Act (PFMA), 2015.
Under the PFMA, every bill presented to Parliament must include a Certificate of Financial Implications (CFI) issued by the Ministry of Finance, Planning and Economic Development (MoFPED). The preparation of the Statement of Financial Implications (SFI), which forms the basis for the CFI, is the responsibility of Ministries, Departments, and Agencies (MDAs). This statement provides detailed revenue and expenditure estimates and projected savings over a minimum of two years’ post-enactment.
Empowering MDAs with Essential Skills
The training sessions, which began last week and will continue into the following week, aim to equip MDAs with the skills required to prepare robust SFIs. These competencies are essential for MoFPED Budget Analysts to review and draft CFIs or Letters of Financial Clearance effectively.
The 4th cohort comprised officers from key institutions, including the Ministry of Lands, Ministry of Agriculture, National Environmental Management Authority (NEMA), Uganda Land Commission, Ministry of Local Government, National Agricultural Research Organization (NARO), and the Ministry of Kampala, among others.
A Step Toward Transparent and Accountable Governance
Speaking at the closing ceremony, Mr. Moses Sonko, Principal Economist at MoFPED, commended the initiative and acknowledged the value it brings to Uganda’s public policy and legislative processes. Representing the Permanent Secretary of MoFPED, Mr. Sonko highlighted the importance of the training in strengthening governance frameworks.
“This training was developed to equip us with tools and knowledge essential for our roles in ensuring that Uganda’s policy and legislative proposals are financially sound, transparent, and align with national priorities,” Mr. Sonko remarked. He encouraged participants to apply their newly acquired skills to enhance policy preparation and implementation.
He also emphasized the multi-dimensional nature of the training, which enables officers to identify the financial, social, environmental, and economic impacts of proposed bills and policies.
Participant Feedback
Participants expressed their enthusiasm and gratitude for the training. Mr. Davis Kwizera from the National Animal Genetic Resources Centre and Data Bank (NAGRC&DB) shared his positive experience, stating: “This training has offered a wealth of knowledge and an in-depth understanding of policy processes. It will significantly enhance our ability to prepare relevant policy documents. If you’ve taken the courses on Financial and Risk Analysis as well as Investment Appraisal and Risk Analysis, this program completes the package.”
The new guidelines for the clearance of financial implications will officially take effect in July 2025. PIMCoE remains committed to building the capacity of public officers to ensure that Uganda’s legislative and policy frameworks are underpinned by sound financial and risk analyses, fostering a culture of accountability and sustainable development.
In a pivotal workshop held at Makerere University on November 12, stakeholders, researchers, and policymakers gathered to discuss the progress and emerging issues in the implementation of Uganda’s Parish Development Model (PDM). This transformative model, conceptualized by Prof. Ezra Suruma, aims to tackle some of Uganda’s most pressing socio-economic challenges: poverty, unemployment, and limited access to essential services, particularly in healthcare and agriculture.
Prof. Suruma, the architect of PDM, underscored the crucial role of researchers in creating wealth-empowering strategies for Ugandans. “The PDM is designed to eradicate poverty, promote economic inclusion, improve service delivery, and modernize agriculture,” Prof. Suruma stated. He highlighted that the model not only provides a pathway for Uganda’s rural households to participate in the economy but also aims to address the underlying issues that leave many citizens unable to afford basic needs.
The Vice Chancellor of Makerere University, Prof. Barnabas Nawangwe, commended Prof. Suruma’s visionary leadership and the significant impact PDM is expected to have on communities across Uganda. “The PDM stands as one of the largest government interventions aimed at eradicating poverty and uplifting communities,” he remarked. Prof. Nawangwe also emphasized Makerere University’s commitment to supporting PDM through the PDM Lab hosted by the College of Business and Management Sciences (CoBAMS), which serves as a hub for real-time data analysis to guide the implementation of PDM activities across the country.
The PDM Lab at CoBAMS, led by Prof. Eria Hisali and funded by the United Nations Development Programme (UNDP), is instrumental in collecting, analyzing, and interpreting data that can shape PDM policies at the grassroots level. During the workshop, Dr. Suruma extended his appreciation to UNDP for their support and acknowledged the researchers for their efforts in generating valuable insights into the effectiveness of PDM.
Despite Uganda’s notable economic growth in recent years, poverty remains a persistent challenge, with a significant portion of the population struggling to meet basic needs. Unemployment rates, especially among youth, are high, limiting economic opportunities for the country’s largest demographic. Access to healthcare, particularly in rural areas, is another critical issue, with many Ugandans unable to afford or reach essential medical services. These challenges underscore the need for initiatives like the PDM that are designed to create sustainable economic opportunities, improve household incomes, and ensure equitable access to services.
“PDM seeks to empower households to create wealth, ultimately reducing dependence on subsistence farming and encouraging local economic development,” Prof. Suruma emphasized. He believes that the model’s holistic approach will foster greater self-sufficiency among Uganda’s communities by addressing poverty from multiple angles, including agricultural modernization, financial literacy, and service accessibility.
As the workshop concluded, participants expressed optimism about PDM’s potential to drive sustainable change. Prof. Nawangwe reiterated Makerere University’s dedication to supporting this national initiative, affirming that the PDM Lab will continue to play a key role in assessing and enhancing the model’s effectiveness.
The Parish Development Model offers a beacon of hope for millions of Ugandans striving for a better quality of life, aligning with Uganda’s broader aspirations for economic growth, social equity, and sustainable development.