Health
Rising to the Top: Carol Nabbanja’s Journey to Becoming the Best Graduating Student from MakSPH
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.
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.”
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.”
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.”
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, 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.
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
Health
What works, what doesn’t work? Researchers uncover the effect of supporting districts to operationalise digital payments for vaccination campaign workers
KAMPALA, Uganda —Supporting districts to adopt digital payments can significantly improve the efficiency of mass vaccination campaigns in Uganda, even if the gains do not directly translate into higher worker motivation, a new study by Makerere University School of Public Health (MakSPH) researchers has found.
Published on September 10, 2025, in BMJ Global Health, the study examined how helping districts in Uganda transition from cash-based to electronic payments affected vaccination campaign workers. Conducted in early 2023, some four months after the nationwide oral poliovirus vaccination campaign of November 2022, the research assessed the impact of digitised payments on efficiency, timeliness, and worker satisfaction.
With generous support from the Bill & Melinda Gates Foundation, the study was led by MakSPH researchers Peter Waiswa, Juliet Aweko, Maggie Ssekitto Ashaba, Elizabeth Ekirapa-Kiracho, and Charles Opio, in collaboration with Margaret McConnell of the Harvard T.H. Chan School of Public Health, Daniel Donald Mukuye from Uganda’s Ministry of Health, and Andrew Bakainaga from the World Health Organisation (WHO)–Uganda Country Office.
The study’s Principal Investigator and lead author, Assoc. Prof. Peter Waiswa, a health systems researcher at Makerere University School of Public Health, said while the research was conducted in Uganda, its implications are global. He pointed out that some African countries, such as Côte d’Ivoire, Zambia, Tanzania, and Kenya, are already ahead in adopting digital payment systems, while others still lag behind. The study’s findings, he said, are relevant across these contexts and have already informed the work of global actors such as Gavi, WHO, and the Global Fund, who are now integrating digital payments into their own processes.
“This paper is part of several studies we are conducting, but perhaps the most significant,” said Dr. Waiswa, clearly enthusiastic about the findings. “Another outlines the research agenda for digital payments, emphasising the need for more evidence on whether they improve the quality of immunisation campaigns, ensure timeliness and efficiency, and identify which groups face barriers to their use.”
The study was coordinated by MakSPH in collaboration with a network of partners. In Uganda, these included the Ministry of Finance, the Ministry of Health, the World Health Organisation, several implementing organisations, district authorities, as well as telecommunication companies. Importantly, the involvement of Airtel as a non-traditional actor in the study demonstrated the critical role of private sector engagement, often absent in such collaborations, in generating evidence and advancing digital health solutions, particularly in addressing challenges such as timely payments for health campaign workers.
The November 2022 polio campaign, led by the government of Uganda with support from the U.S. CDC and WHO, targeted 8.7 million children under five with the novel oral polio vaccine (nOPV2). Nearly 72,000 teams, including health workers, Village Health Teams, and Local Council representatives, were mobilised nationwide, administering about 10 million doses despite the temporary exclusion of five districts due to the Ebola outbreak at the time.
Building on the campaign, the researchers conducted an exploratory cluster-randomised trial using a mixed-methods approach across 54 districts in Uganda, where they enrolled 2,665 healthcare workers. Intervention districts were trained to use Uganda’s e-cash platform, a government innovation managed by the Ministry of Finance. Introduced in 2017 and formalised in 2019, the cashless system was designed to digitise urgent government payments, enhance efficiency, and improve transparency. It now complements the Integrated Financial Management System, which, though effective for routine payments, was seen as too slow for time-sensitive transactions, including paying campaign health workers, where timely remuneration is critical for maintaining workforce readiness, sustaining campaign momentum, and promptly addressing public health challenges in the communities served.
Intervention studies usually introduce a treatment or program to a group to observe its effects, and the results are compared with a group that does not receive it. The training during the study addressed the delays, leakages, and administrative bottlenecks common in cash-based systems. Intervention districts received instruction on navigating the government e-cash platform, managing user roles, uploading beneficiary data, and generating payment reports, while control districts maintained standard cash payment procedures, serving as a baseline.
Dr. Juliet Aweko, co-author and Research Associate at MakSPH, said the study was timely, observing that health workers are central to successful vaccination campaigns and delayed payments can demotivate them and compromise campaign effectiveness.
“To make digital payments truly work, campaigns must be planned with the workforce in mind. Government and partners need to ensure funds are disbursed on time, streamline and automate registration and verification, and keep accurate records of health workers and their performance. Making mobile money systems compatible and giving workers real-time updates on their payments would not only build trust but also keep them motivated, ultimately improving turnout and ensuring smoother service delivery,” Dr. Aweko stated.
The study found that electronic cash adoption was significantly higher in intervention districts, where 57.5% of workers were paid digitally compared to 44.1% in control districts. What’s more, digital payments did not delay disbursement, as 97.6% of all workers received payment after campaign completion, regardless of method. Still, workers paid via e-cash consistently described the cashless system as convenient, transparent, and cost-effective, citing reduced travel time, lower personal costs, and fewer security risks.
Today, Uganda’s rapidly expanding digital ecosystem provides ground for scaling up cashless payment systems. The Uganda Communications Commission reports that the country has over 43 million active mobile subscriptions, nearly 88% of the estimated 49 million population. Its latest market report shows 26.1 million active internet users, while mobile money continues to dominate financial transactions with more than 33 million accounts and transaction values growing by over 25% annually, according to reports by the Bank of Uganda as of March 2025. This trend reflects a population increasingly reliant on digital platforms, creating a strong opportunity to embed e-payment systems in health service delivery.
For MakSPH researchers Dr. Waiswa and Dr. Aweko, the study evidence confirms that digital payments are both feasible and practical for strengthening the delivery of mass campaigns in low- and middle-income countries like Uganda. With relatively modest support, districts can adopt e-cash systems, providing a scalable model for the health sector. This approach, they suggest, would streamline compensation, reduce administrative delays, and provide a stronger basis for integrating digital payments into future immunisation drives and other public health interventions in the country, thereby strengthening our health systems.
The researchers further emphasised that digitising campaign payments reduces transaction costs and minimises leakages, enabling more funds to reach frontline workers quickly. E-cash also simplifies logistics, strengthens accountability, and enhances financial tracking in health campaigns. These advantages, they found, directly align with the global effort to advance digital transformation in health systems and ensure reliable, transparent worker compensation. The implications also extend beyond just polio, as Uganda continues to rely on mass campaigns for routine immunisation and other outbreak responses, such as measles and yellow fever, where digital payments could improve the efficiency of scarce health resources.
Still, the study acknowledged barriers that could hinder full adoption of a cashless system. Some districts lacked the technical capacity to operate the government’s e-cash platform, upload beneficiary data, and manage user roles. Connectivity issues, limited digital literacy among staff, and occasional system downtimes further disrupted implementation. Additionally, many campaign workers lacked national identity cards or mobile money accounts, making them ineligible for digital payments. To address these challenges, the researchers, among others, recommend targeted capacity building for district finance and health teams, expanded identity and mobile registration for campaign workers, improved internet connectivity, and integration of e-payment systems into routine health planning.
Health
Ekyaalo Diagnostics; Johns Hopkins University Partners with Makerere and MUST to Advance AI Innovation for Breast Cancer Diagnosis
By Joseph Odoi
Globally, Breast cancer remains a serious health challenge, with the World Health Organization (2022) reporting over 2.3 million new cases annually and nearly 670,000 deaths. In Uganda, breast cancer is one of the leading cancers among women, yet the majority of patients are diagnosed at late stages due to delays in accessing diagnostic services, most of which are centralized at the Uganda Cancer Institute (UCI) in Kampala. Since 72% of Uganda’s population lives in rural areas, women often face late diagnosis due to long travel distances. Even after accessing care, results can take 1–6 months due to the slow process of transporting samples to central laboratories. This delay directly impacts the timely start of treatment.
To address this gap, Johns Hopkins University in collaboration with Makerere University and Mbarara University of Science and Technology (MUST), is spearheading innovative solutions that leverage artificial intelligence (AI) and low-cost technologies to improve early diagnosis and treatment.
As part of this collaboration, the Centre for Maternal, Newborn, and Child Health Research at Makerere University School of Public Health led by Associate Professor Peter Waiswa in July hosted a team of graduate biomedical engineers from the Center for Bioengineering Innovation and Design (CBID) at John Hopkins University.
The team is developing a low-cost, AI-powered technology called Ekyaalo Diagnostics, aimed at reducing the turnaround time for breast cancer diagnosis, especially in hard-to-reach areas. As part of their work, they undertook a learning tour at the Ministry of Health, Uganda Cancer Institute, and regional cancer referral centres. The purpose was to map stakeholders in the breast cancer space, gather Ekyaalo diagnostic technology usability feedback, and understand the local innovation ecosystem in breast cancer care.
Ekyaalo Diagnostics and Bringing Pathology Closer to Communities
The flagship innovation, Ekyaalo Diagnostics, is a portable AI-powered whole-slide scanner (WSS) designed to digitize cytology samples at Health Centre IVs and General Hospitals. These digitized images are securely transmitted to pathologists at higher-level facilities for timely review, eliminating the need for physically transporting samples to Kampala.
This technology has the potential to reduce diagnosis delays from several months to just a few days, thereby improving survival outcomes for breast cancer patients.
Building Local Solutions to Global Challenges
In addition to Ekyaalo Diagnostics, Makerere researchers at the Department of Biomedical Engineering are also advancing other innovations such as development of artificial breast prototypes to be used in educating women on breast cancer symptoms while Research at Mbarara University led by Dr. William Waswa, are developing PapsAI, a low-cost automated tool that support whole slide scanning of slides for cervical cancer screening.
These initiatives are aligned with the National Cancer Control Plan (NCCP) of the Ministry of Health, which emphasizes prevention, early detection, timely diagnosis.
Design Challenges and Considerations
Despite the progress being made, challenges persist, according to the team’s findings from the tour,these technologies hold great promise however their success in Uganda will depend on addressing some critical barriers.
One of the biggest challenges is limited staffing. Many lower-level health facilities lack trained laboratory personnel to prepare slides. For this reason, new technologies must be designed to be simple, user-friendly, and capable of being adopted after short training sessions.
Another major barrier is equipment maintenance. Past medical innovations in Uganda have often struggled with frequent breakdowns and software failures. The team emphasized that new diagnostic tools must be affordable, durable, and resistant to common system crashes if they are to serve rural health facilities effectively.
Finally, high operational costs continue to undermine sustainability. Some innovations fail because their maintenance costs are too high or because they are incompatible with existing health systems. Ensuring cost-effectiveness and system integration will therefore be vital for the long-term success of breast cancer diagnostic technologies in Uganda.
MORE ABOUT THE PROJECT
The project is led by the Johns Hopkins Center for Bioengineering Innovation and Design (CBID) in collaboration with Makerere’s Department of Biomedical Engineering and MUST researchers. Field learning tours have already been conducted at Mulago National Referral Hospital, Jinja, Mbarara, and Fort Portal Regional Referral Hospitals, with input from clinicians, technologists, and innovators in Uganda’s health ecosystem.
The Johns Hopkins team has conducted usability interviews with clinicians, laboratory technologists, and surgeons at multiple hospitals including Mulago, Jinja, Mbarara, and Fort Portal. They have also engaged with Uganda’s innovation ecosystem, including makerspaces and industry partners. It has been noted that the Ministry of Health together with Partners working on treatment of cancer has drafted the National Cancer Control Plan (NCCP) that is aimed at reducing incidence, morbidity and mortality through prevention and early treatment and palliative care. The Plan will give guide on health education, early detection, and diagnosis among others Special thanks go to the Center for Bioengineering Innovation and Design (CIBID) Johns Hopkins University for funding this field learning tour, Centre for Maternal Newborn and Child Health Research at School of Public health (Makerere University) for hosting the team, Departments of Bioengineering at Makerere University and Mbarara University of Science and Technology, Mulago pathology department and the Uganda cancer institute, Regional Referral hospitals of Jinja, Mbarara and Fort Portal among other General hospitals and Health center IVs visited for technical input.
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