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Rising to the Top: Carol Nabbanja’s Journey to Becoming the Best Graduating Student from MakSPH

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Carol Esther Nabbanja, 22, is set to graduate with First Class Honours in Bachelor of Environmental Health Science (BEHS) from the Makerere School of Public Health as the best-graduating student in the school this year. She graduates in Makerere University‘s 73rd Graduation ceremony today. 

With a CGPA of 4.61, she has emerged as the best-graduating student in the MakSPH this year. She graduates alongside her other 43 classmates who made it to the graduation list this year.

Born in Kitemu village, Nsangi Parish, Wakiso District, to Samuel Mawejje, and Alice Naggawa, Nabbanja is the third born of four siblings and first to come to Makerere University, the very first to be on a government scholarship, and the very first to go through Kings College Budo.

Right from her childhood, Nabbanja has always been passionate about health and clean environments, which started from her early years as a head monitor at a government-aided St. Charles Primary School, where she did her nursery to primary five and the sanitation prefect at Clevers Origin Junior School.

Carol Esther Nabbanja at the MakSPH gardens.
Carol Esther Nabbanja at the MakSPH gardens.

While at St. Charles, Naggawa, Nabbanja’s mother was not convinced that she would make a foundation for a great future. She wanted better for her daughter. Nestled in the bustling streets of Kitintale, lies Clevers Origin Junior School, a beacon of hope for many students in the area. For Naggawa, her daughter’s joining the school would mark the beginning of a new chapter in her life.

She approached the owner of the school, Christopher Mugwanya, who happened to be her brother. Despite being a private school, Mugwanya, a kind-hearted and supportive uncle, offered the Nabbanja a half-bursary based on academic merit and family relationship. “I was overjoyed and couldn’t wait to start his new journey at Clevers Origin,” says Nabbanja.

Settling into her new school, Nabbanja encountered some challenges in mathematics, but her uncle was there to help. “I had some challenges in math, but he ably supported me, he gave me food, visited me when my mother couldn’t make it, and sometimes I would stay at his place over the holidays. He was really supportive. I was able to overcome my difficulties in math and excel in my studies. In fact, my grades improved and I found a newfound passion for learning. I am grateful for the support from my uncle and I feel proud of my academic achievements so far.”

Nabbanja receives a leadership certificate from Dr. Damalie Nakanjako, Professor of Medicine, and Principal of the College of Health Sciences.
Nabbanja receives a leadership certificate from Dr. Damalie Nakanjako, Professor of Medicine, and Principal of the College of Health Sciences.

Because of her unwavering determination and hard work, the School was convinced that she would sit her Primary Leaving Examinations (PLE) in Primary Six.

“I did PLE in P.6. The centre I registered at was in Nateete and I was the only first grade there but I didn’t want those results. I decided to wait for my actual time, and when it came, I excelled. I got aggregate 5,” says Nabbanja.

She was the best-performing female academician in her cohort. This was a significant achievement, as her cohort had the best grades since the school was founded. “I was also awarded the best female academician during my time at the school. I, in fact still have the certificate. I have also always been pertinent about health, and so I took up positions like the Sanitation Prefect,” says Nabbanja.

Nabbanja also had a passion for cleanliness and health. As the Sanitation Prefect, she made sure that the school environment was clean and hygienic at all times, something that was important to her from a young age. “I always loved a clean environment and to have everything in its place, so my interest developed that early.”

Carol Esther Nabbanja making a submission during her class interaction with the Dean, Prof. Rhoda Wanyenze in August ‎2022.
Carol Esther Nabbanja making a submission during her class interaction with the Dean, Prof. Rhoda Wanyenze in August ‎2022.

Joining Kings College Budo

Given her outstanding performance, Nabbanja was offered several scholarships to join Secondary School. “I was the very first from that Clevers Origin Junior School to ever go to Kings College Budo—we were two students that performed well, a boy who got 4 and me who got 5 and joined Budo on merit. My parents were offered other offers of schools giving me scholarships but Budo was exceptional. We had to make a decision that would set for me a good standard.”

Her journey to Makerere School of Public Health was paved at Budo. She was initially worried about School fees and how her father, a taxi driver would raise money to support her education.

“On joining my S.1, my parents were worried about the high fees, and the fact that I had studied on bursaries up to this point, they were not financially ready. We were paying about Shs1.4M. My mother talked to the Deputy Head Teacher, Rebecca Kiwanuka, who told her to let me join and that things would work out in the long run. Fortunately, my parents paid fees for S. 1,” says Nabbanja.

Unsure of how the second term would go, by sheer luck, Ligomarc Advocates, a financial and corporate law firm located at Social Security House in Kampala was celebrating 10 years and the partners decided to go back to their high schools and support students who were having financial issues

“By God’s grace, after the meeting between the School administration and the law firm, Mrs. Kiwanuka, our deputy head teacher informed me that I had gotten a sponsor,” Nabbanja says.

Ligomarc Advocates did not only sponsor her education but also provided opportunities for her to work with them during school breaks.

“Ligomarc took me for the 6 years I was at Budo. They were not just sponsors but also supporters, they supported me financially, came for V.Ds [Visitation Days], and also gave me an opportunity to work with them as an office attendant during my vacations. I also assisted the administration, delivering letters here and there. They supported me beyond just academics,” she says.

Budo was a turning point in Nabbanja’s life. It exposed her to new experiences and taught her valuable life lessons that have stayed with her to this day. She thrived in her studies, maintaining an average of 94 and earning 10 out of 8 aggregates in S.4 and 16 out of 20 in S.6.

Nabbanja never lost sight of her goals and was motivated by quotes from her late headmaster, Mr. Patrick Bakamale, such as “In this era of information and technology, we need to have the power of selection,” and “Focus on roots not fruits.”

Carol Esther Nabbanja, third left with her classmates during the times at MakSPH.
Carol Esther Nabbanja, third left with her classmates during the times at MakSPH.

Shaping her dream

Growing up, Nabbanja had always been fascinated by journalists, with the thrill of being on TV. “I used to hear that they earn 1 million, so that excited me.” However, it was her frequent trips to the dentist that truly sparked her interest in the field of dentistry. As she watched the dentists work their magic, Nabbanja was drawn to their ability to improve people’s dental health and change their lives for the better. “As a child I had so many dental issues, even at home. When I would visit the dentist, I would see a guy in a coat, doing some good work so I realized he doesn’t even work the night shift and it made me want to become a dentist,” she added.

Despite being tempted to pursue a career in law due to the time she spent at Ligomarc Advocates, Nabbanja held firm to her dream of attending medical school and becoming a dentist. She was determined to help her siblings, and others, achieve the confident smile they deserved.

However, her dream course, Dental Surgery, eluded her by just one point. Instead, she was given the opportunity to study Environmental Health Science, a subject that would soon become her passion.

“I didn’t know much about MakSPH, actually my first few days were not that pleasant. I kept thinking about my friends who were doing my dream course even though they were on private not government sponsorship, but my mother didn’t have the money,” she says.

Ruth Mubeezi Neebye, an Assistant Lecturer in the Department of Disease Control and Environmental Health would later become Nabbanja’s mentor. According to Nabbanja, she has equally been inspired by Dr. Esther Buregyeya and Dr. David Musoke.

Throughout her time at MakSPH, Nabbanja has consistently stood out as a top performer, earning high grades and impressing her professors and peers alike. Despite her impressive academic record, she remains humble and grateful for the support she has received from her family, friends, and sponsors along the way.

Nabbanja (Right) with her classmates at MakSPH.
Nabbanja (Right) with her classmates at MakSPH.

Nabbanja, a sports personality

As a student at Makerere School of Public Health, Nabbanja was a standout in both academics and sports. She fell in love with swimming. As a member of the Makerere University swim team, Nabbanja excelled in competitions and brought home medals for the university. She found solace in the sport, using it as a way to relax after long days of lectures and studying. Swimming also provided her with the opportunity to travel and make new friends, as well as to work on her physical and mental health.

“Swimming gives you a lot of opportunities, so that inspired me as well. Very many people travel on University tickets, and since I love outdoor life and traveling, I looked at this as an opportunity. Swimming teaches you to read, and do other things like jogging before joining the pool. It is also an individual sport because when you don’t swim for a month, your time is cut,” says Nabbanja.

Carol Esther Nabbanja, with her classmates in a group photo during the times at MakSPH.
Carol Esther Nabbanja, with her classmates in a group photo during the times at MakSPH.

Journeying to First Class

For some students, University education is just a three-four-year period of attending lectures and socializing with peers. But for others, it’s a stepping stone to a brighter future. And that’s exactly what happened to Nabbanja, the best-graduating student from Makerere School of Public Health (MakSPH). She has not only excelled in academics but was also a talented swimmer who represented the University in various competitions.

Nabbanja’s success journey started with a clear plan and a strong determination to succeed. She believed that becoming a first-class student was not only about attending lectures but also about being self-aware and taking control of one’s own learning process. Nabbanja made a habit of reflecting on what was learned each day and relating it to real-life situations.

When asked about her experience at MakSPH, Nabbanja had nothing but praise for the staff and their professionalism. She says she never encountered any corrupt practices and appreciated the well-defined structure that made it easy to know where to go for assistance. Marks were received on time and she never felt lost or unsure of what to do next.

“The staff is also supportive, right from the reception, everyone is helpful—when inquiring about offices, or office protocol. We also get our marks on time, usually a week into the new semester. The service delivery is good and we are not tossed around.”

Nabbanja’s journey serves as a testament to the power of hard work, determination, and support from family and sponsors.

By Davidson Ndyabahika and Samantha Agasha

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Davidson Ndyabahika

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Holistic Retirement Planning includes Psychological, Emotional & Social well-being across all Career Stages

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The Chairperson MURBS Board of Trustees-Dr. Michael Kizito (8th Right) with Professor Seggane Musisi (7th Right) and Members after the session on 8th January 2026. Makerere University Retirement Benefits Scheme (MURBS) Member Sensitisation Session on "Understanding Identity Shifts; Developing Routines; Sustaining Motivation and Purpose", 8th January 2026, Yusuf Lule Central Teaching Facility Auditorium, Kampala Uganda, East Africa.

The Makerere University Retirement Benefits Scheme (MURBS) on Thursday, 8 January 2026 organised a Member Sensitisation Session on “Understanding Identity Shifts; Developing Routines; Sustaining Motivation and Purpose”. The session focused on holistic retirement planning, emphasising that readiness for life after work goes beyond finances to include psychological, emotional, and social well-being across all career stages—from early career to post-retirement.

The session featured a keynote presentation by Professor Seggane Musisi, who highlighted how work-related titles and roles often shape personal identity, and how retirement can trigger a sense of loss if individuals are unprepared to redefine themselves. Members were encouraged to consciously design a post-work identity grounded in values, purpose, and community contribution.

Participants learned practical strategies for:

  1. Preparing early for retirement at different career stages;
  2. Developing healthy, meaningful routines that support mental stability and productivity;
  3. Sustaining motivation and purpose beyond formal employment;
  4. Managing stress, maintaining physical and mental health, and nurturing social connections; and
  5. Balancing family responsibilities with personal well-being.

The discussion also addressed cultural realities of retirement in Uganda, including family expectations, social obligations, and financial pressures. Special attention was given to age-related challenges such as dementia, depression, and chronic illness, underscoring the importance of preventive health care, emotional resilience, and timely professional support.

Overall, the session reinforced the message that retirement is a lifelong transition, not a one-time event. Members were encouraged to plan early, adapt continuously, and intentionally design a fulfilling, purposeful life beyond work—psychologically, socially, and financially.

To view the session, please click the embedded video below. Further below is the presentation.


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Kampala at a Crossroads: What New Research Reveals About Mobility, Governance, and the City’s Public Health Risks

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Motorists navigate the Clock Tower Flyover intersection in Kampala. Uganda, East Africa

Every day in Kampala, millions of people inch through gridlock, dodge swarming boda-bodas threading through narrow gaps in traffic, inhale dangerously polluted air, and walk along streets rarely designed for pedestrians. These conditions, and more, are often dismissed as ordinary transport frustrations. Yet researchers at Makerere University School of Public Health (MakSPH) are examining how such everyday realities translate into public health outcomes, shaped not simply by congestion, but by governance, policy, and power. Their work forms part of a multi-country project investigating the political economy of urban mobility in three African cities.

A boda-boda rider navigates floodwaters alongside a car on a waterlogged road in Kampala’s Industrial Area in 2024, highlighting how rapid urban development, inadequate drainage, and car-oriented road design combine to heighten daily mobility risks for vulnerable road users. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
A boda-boda rider navigates floodwaters alongside a car on a waterlogged road in Kampala’s Industrial Area in 2024, highlighting how rapid urban development, inadequate drainage, and car-oriented road design combine to heighten daily mobility risks for vulnerable road users.

Co-led by Dr. Aloysius Ssennyonjo, the Principal Investigator and health systems and governance researcher at MakSPH, together with Uganda’s Country Principal Investigator, Dr. Esther Bayiga-Zziwa, a road safety and injury epidemiologist, and Co-Principal Investigator Dr. Jimmy Osuret, an injury prevention researcher, the project titled The Political Economy of Urban Mobility Policies and Their Health Implications in African Cities (PUMA) applies a political economy lens to understand how political interests, institutional arrangements, and power dynamics shape mobility systems and their consequences for public health in Kampala, Kigali, and Lilongwe.

To note, political economy analysis examines how public decisions are shaped by the interplay of politics, interests, institutions, and resources, in short, who has influence, who controls what, and how money and power circulate within a system. In Kampala, a capital of nearly two million residents whose daytime population swells with commuters, this lens helps explain why some transport options attract funding and enforcement while others are tolerated, neglected, or contested. These choices are not just technical, but reflect competing interests and priorities, with consequences for safety, equity, and the everyday well-being of those moving through the city.

Illustration of the Index of Sustainable Urban Mobility (I_SUM) in a planned city, highlighting how transport, accessibility, environmental, social, infrastructure, and political factors jointly shape mobility outcomes. Source: Internet.
Illustration of the Index of Sustainable Urban Mobility (I_SUM) in a planned city, highlighting how transport, accessibility, environmental, social, infrastructure, and political factors jointly shape mobility outcomes. Source: Internet.

Now, through the NIHR-funded project, the Ugandan team is currently working with colleagues from the University of Rwanda, led by Professor David Tumusiime, and Kamuzu University of Health Sciences in Malawi, led by Dr. Dominic Nkhoma. The research partnership aims to generate evidence that can strengthen mobility governance and improve public health outcomes across the three African cities above, with advisory support for the research consortium from the University of Antwerp in Belgium and Canterbury Christ Church University in the UK.

Explaining the project’s rationale for the Politics of Urban Mobility, or PUMA, during the 2025 Universal Health Coverage Day webinar held on December 12 under the theme “Mobility, Costs, and Politics: How Urban Systems Shape Access and Progress Towards Universal Health Coverage in African Cities,” Principal Investigator Dr. Ssennyonjo said Africa is urbanising at an unprecedented pace. Projections show that by 2050, nearly 60% of the continent’s population will live in cities, a shift that is intensifying transport pressures and increasingly turning everyday mobility into a public health risk.

Participants at the PUMA Stakeholder Analysis Workshop held on November 21, 2025, where policymakers, practitioners, and researchers examined how political and governance dynamics shape urban mobility and public health outcomes in Kampala. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Participants at the PUMA Stakeholder Analysis Workshop held on November 21, 2025, where policymakers, practitioners, and researchers examined how political and governance dynamics shape urban mobility and public health outcomes in Kampala.

“Rapid urbanisation has created multiple challenges: transport systems are under strain, risks and vulnerabilities are rising, and opportunities for healthy behaviours such as walking are often limited. Access to livelihoods is also affected, with broad implications for health,” Ssennyonjo noted, adding: “Crucially, these issues are shaped by political and governance dynamics, yet few initiatives explicitly address them. This gap motivated our focus on the politics and governance of urban mobility.”

Dr. Aloysius Ssennyonjo, Principal Investigator of the PUMA project, speaks during the Stakeholder Analysis Workshop on November 21, 2025, highlighting the role of politics and governance in shaping urban mobility and public health outcomes in Kampala. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Dr. Aloysius Ssennyonjo, Principal Investigator of the PUMA project, speaks during the Stakeholder Analysis Workshop on November 21, 2025, highlighting the role of politics and governance in shaping urban mobility and public health outcomes in Kampala.

He mentioned that health outcomes are shaped by social, economic, and environmental factors, with transport costs, risks, and stress often posing greater barriers than medical fees alone to achieving affordable health for all. He noted that the PUMA project brings together multidisciplinary teams to study how governance and political dynamics shape urban mobility, public health, and development, a perspective reflected in Prof. Julius Kiiza’s observation that effective urban development relies on coordinated action by diverse stakeholders across sectors to improve health outcomes, though emphasising the primacy of politics.


“Uganda and Singapore had comparable levels of underdevelopment in the 1960s. Under Lee Kuan Yew, Singapore embarked on a deliberate nation-building project. Today, it is among the smartest cities globally, outperforming many Western cities in clean government, mobility, and liveability. Why are we lagging behind? The answer, I argue, lies largely in the nature of our politics,” Prof. Julius Kiiza cogently argued.


He intimated that the result has been cities that are “unreliable, unsafe, unsmart, and chaotic,” noting that claims of inclusive urban development often ring hollow. “I have argued, and repeat here, that boda bodas as a symbol of inclusivity represent a false model of inclusion. We must interrogate this and invest in better urban transport systems and wider, well-planned highways,” he affirmed.


Prof. Julius Kiiza, Professor of Political Science, speaking during a PUMA team–organised Universal Health Coverage Day webinar, highlighted how politics and governance shape urban mobility and public health outcomes. December 12, 2025. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Prof. Julius Kiiza, Professor of Political Science, speaking during a PUMA team–organised Universal Health Coverage Day webinar, highlighted how politics and governance shape urban mobility and public health outcomes. December 12, 2025.

Prof. Kiiza urged policymakers and practitioners to move beyond piecemeal technical fixes and instead treat urban mobility as a governance challenge requiring coordinated, cross-sector action. He stressed the importance of aligning transport planning with public health, housing, employment, and skills development, arguing that safer, more liveable cities depend on institutions that work together and are accountable to the public. Such reforms, he noted, demand sustained political commitment and inclusive dialogue across government, academia, civil society, and the private sector, precisely the terrain the PUMA project is engaging, by convening stakeholders and shaping a shared research agenda around Uganda and the continent’s urban mobility challenge.

Students cross a busy road in Kampala, Uganda, navigating traffic dominated by cars and motorcycles—an everyday reality that highlights the public health and safety risks shaping urban mobility in the city. 2024. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Students cross a busy road in Kampala, Uganda, navigating traffic dominated by cars and motorcycles—an everyday reality that highlights the public health and safety risks shaping urban mobility in the city. 2024.

Indeed, on November 21, 2025, the Ugandan team convened a national stakeholder workshop in Kampala, bringing together a wide range of stakeholders. Opening the workshop, Assoc. Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management (HPPM) at MakSPH, commended the team for highlighting what she described as a long-underexplored dimension of Uganda’s urban health landscape: mobility and its governance.

Reflecting on her own experience, she noted how boda-bodas have become increasingly indispensable for millions seeking quick, flexible transport, but also carry complex health, safety, and economic implications that demand multisectoral attention, calling for a balanced, evidence-driven dialogue that recognises their value while also addressing the infrastructural and policy gaps that shape mobility systems in Uganda’s rapidly growing cities.


“I sometimes use boda-bodas,” Assoc. Prof. Suzanne Kiwanuka said. “They are necessary when you need to move quickly during heavy traffic. Yet we all know how unsafe they can be. This PUMA initiative is timely to generate evidence not only on the politics of urban mobility and its health implications, but also its economic consequences.”


Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa. Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management, addresses participants during a PUMA stakeholder workshop, emphasising the need for evidence-informed, multisectoral approaches to urban mobility and public health governance in Kampala.
Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management, addresses participants during a PUMA stakeholder workshop, emphasising the need for evidence-informed, multisectoral approaches to urban mobility and public health governance in Kampala.

Notably, road traffic crashes remain one of Uganda’s most urgent public health threats today. The recent Uganda Police Force Annual Crime Report 2024 recorded 5,144 road deaths, a seven per cent rise from 2023, with motorcyclists accounting for nearly half of all fatalities. In Kampala, pedestrians, cyclists, and motorcycle riders constitute 94 per cent of all fatal crashes, according to the Kampala Capital City Authority. Thousands more suffer life-altering injuries each year.

Still, evidence from MakSPH, through its Centre for Trauma, Injury and Disability Prevention (C-TRIAD) and the Johns Hopkins International Injury Research Unit (JH-IIRU) under the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS), shows that the design and use of city roads are worsening the risk environment. Between 2021 and 2023, the team conducted more than one million roadside observations across Kampala, finding that while only five per cent of vehicles are officially recorded as speeding, those that do travel at an average of 57 km/h, well above safe limits for dense urban corridors, making city roads increasingly unsafe.

Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa. The motorcycle rider at the centre of the image is travelling against the flow of traffic in Kampala, highlighting everyday road-use practices that increase safety risks in the city. 2024.
The motorcycle rider at the centre of the image is travelling against the flow of traffic in Kampala, highlighting everyday road-use practices that increase safety risks in the city. 2024.

The World Health Organization (WHO) guidelines, cited in the report, recommend speed limits of 30 km/h on community roads and in urban areas where pedestrians, cyclists, and other vulnerable road users share space with motorised traffic, and 50 km/h on major urban roads. Yet the findings show that six in ten vehicles on community roads exceed these limits, heightening risks for those least protected and underscoring the need for lower-speed zones, traffic-calming measures such as speed humps and raised crossings, and consistent enforcement of traffic regulations.

For the PUMA team in Uganda, the writing on the wall shows that these rising injuries coincide with worsening congestion and rapid urbanisation, yet city mobility policies within Kampala remain heavily oriented toward road expansion and vehicular flow, with limited attention to safety, health protection, or non-motorised transport. This policy imbalance, then, explains why daily commuting remains hazardous and why progress on safer streets has been slow.

Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa. A designated non-motorised transport corridor on Namirembe Road, Kampala, intended for pedestrians, is partially occupied by parked motorcycles and roadside trading. The scene highlights how everyday encroachment weakens urban mobility interventions aimed at improving safety and walkability. November 2025.
A designated non-motorised transport corridor on Namirembe Road, Kampala, intended for pedestrians, is partially occupied by parked motorcycles and roadside trading. The scene highlights how everyday encroachment weakens urban mobility interventions aimed at improving safety and walkability. November 2025.

The study uses a three-tiered approach that combines policy analysis, regional evidence, and local experiences to examine how mobility decisions are made in Kampala, Kigali, and Lilongwe, who holds authority, and how these processes affect public health and equity. This is strengthened by structured co-creation workshops with practitioners, policymakers, and community actors, which reveal how governance functions in practice, often diverging from what is written on paper.

In parallel, the research team is conducting a continent-wide review of academic and grey literature to map regional trends, gaps, and the broader forces shaping African mobility systems. Together, these streams enable the researchers to compare cities, identify shared challenges, and build a grounded analytical framework for improving mobility governance across Africa.

In Kampala, preliminary findings by the MakSPH PUMA research team show a city governed by many mobility policies but marked by weak mobility governance. The team shared that Kampala operates under a dense mix of frameworks, from the National Integrated Transport Master Plan and National Urban Policy to road safety, climate, and KCCA development plans. While these documents acknowledge congestion, urbanisation, and road injury risks, they also reveal overlapping mandates, blurred institutional roles, and limited coordination authority.

Minibuses crowd a busy transport hub in Kampala, reflecting the scale and intensity of the city’s paratransit-based transport system and the planning challenges shaping everyday mobility. 2024. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Minibuses crowd a busy transport hub in Kampala, reflecting the scale and intensity of the city’s paratransit-based transport system and the planning challenges shaping everyday mobility. 2024.

Key government Ministries, Departments, and Agencies (MDAs) actors include the Ministry of Works and Transport, KCCA, the Ministry of Lands, the Office of the Prime Minister, and the Ministry of Finance, with the Ministry of Health conspicuously absent despite clear health implications. Policy attention, according to the early findings, remains heavily skewed toward road transport, leaving non-motorised mobility and major health pathways, noise exposure, psychosocial stress, community severance, heat, and mobility independence largely unaddressed.

Governance realities are further shaped by political processes, including electoral cycles, informal negotiations with transport unions, selective regulation of boda-bodas, and heavy reliance on development partners that often influence what is prioritised and implemented. Together, these dynamics help explain stalled master plans, inconsistent enforcement, and resistance to progressive interventions. While the PUMA research remains at a preliminary stage currently, the emerging findings underscore the need for an integrated, multisectoral mobility agenda that places health at the centre of Kampala’s transport policy and practice.

Motorcycle riders travel alongside a heavy truck emitting exhaust fumes on a road in Kampala, illustrating how daily urban transport exposes road users to air pollution and related public health risks. 2024. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Motorcycle riders travel alongside a heavy truck emitting exhaust fumes on a road in Kampala, illustrating how daily urban transport exposes road users to air pollution and related public health risks. 2024.

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John Okeya

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How People Earn a Living is Contributing to Malaria Risk in Uganda, Study Finds

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How People Earn a Living is Contributing to Malaria Risk in Uganda, Study Finds. Photo: ImageFX

Livelihood activities such as farming, livestock keeping, construction, and night-time work significantly increase malaria risk in Uganda, according to new research by Dr Kevin Deane, a development economist at The Open University, UK, and Dr Edwinah Atusingwize and Dr David Musoke, a Research Associate and Associate Professor of Environmental Health at Makerere University School of Public Health, respectively.

The study, Livelihoods as a key social determinant of malaria: Qualitative evidence from Uganda, published on December 2, 2025, in the journal Global Public Health, examines how everyday economic activities shape exposure to malaria, often undermining conventional prevention measures such as insecticide-treated nets and indoor residual spraying. The findings are based on qualitative fieldwork conducted in June 2024 in Busiro County, Wakiso District, a peri-urban area with persistently high malaria transmission in Uganda.

Using a qualitative design, the researchers conducted 14 key informant interviews, 10 focus group discussions, and 11 in-depth interviews with households recently affected by malaria, engaging 100 participants from communities, health services, local government, and civil society across Kajjansi, Kasanje, and Katabi Town Councils, as well as Bussi Sub-County, in Busiro South. Their analysis, guided by the Dahlgren–Whitehead social determinants of health model, enabled the researchers to situate malaria risk within the broader social, economic, and environmental conditions shaping how people live and work.

Dahlgren and Whitehead model of the social determinants of health. Source: internet.
Dahlgren and Whitehead model of the social determinants of health. Source: internet.

In their findings, participants linked malaria exposure to agricultural practices, among which is maize cultivation near homes, which was associated with increased mosquito density during the rainy season. “One of the most common crops cultivated in Uganda, which many rely on as staple foods, creates environments in which mosquitoes are attracted to and thrive, often in settings where maize is grown near homes in rural areas and urban areas. This increases mosquito density around homes and contributes to increased outdoor biting and the number of mosquitoes entering houses,” the study argues.

Its authors say this poses a difficult policy challenge because maize is central to household food security, leaving few practical options for reducing exposure. They argue that proposals to keep maize away from homes are often unrealistic for families with limited land or those farming in urban areas, while targeted control during flowering periods may have limited impact given mosquitoes’ ability to travel beyond cultivation sites.

Screenshot of the open-access research article “Livelihoods as a key social determinant of malaria: Qualitative evidence from Uganda,” published in Global Public Health on December 2, 2025.
Screenshot of the open-access research article “Livelihoods as a key social determinant of malaria: Qualitative evidence from Uganda,” published in Global Public Health on December 2, 2025.

Beyond crop farming, the study reports that livestock rearing, especially zero-grazing cattle kept close to houses, attracts mosquitoes into household compounds. Other livelihood activities, including construction and brick-making, created stagnant water-filled pits that served as breeding sites, while night-time livelihoods, such as street vending, guarding, fishing, bar work, and brick burning, among others, prolonged outdoor exposure during peak mosquito biting hours. Gender further shaped risk, with women’s livelihoods and caregiving responsibilities frequently exposing young children alongside them.

“The evidence we present illustrates the unintended health consequences of development strategies intended to promote key livelihood activities, food security, and poverty reduction. There are no straightforward solutions given the complexity of these relationships and the importance of these livelihoods for many households,” the authors assert.

They conclude that malaria elimination efforts will fall short unless livelihoods and development activities are explicitly integrated into malaria prevention strategies, calling for stronger alignment between public health, agriculture, urban development, and economic policy.

Please see below for the study:

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John Okeya

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