Group discussion on Continuation of Treatment, Prevention & Sub-Groups and Health Systems Strengthening at the
PEPFAR stakeholders meeting, February 22-23, 2023, Mestil Hotel, Kampala Uganda. Photo: METS.
The Monitoring and Evaluation Technical Support (METS) Program is a 5-year CDC-supported collaboration of Makerere UniversitySchool of Public Health (MakSPH), the University of California San Francisco (UCSF) and Health Information Systems Program (HISP Uganda).
Highlights of the METS February 2023 Newsletter
Roll-out of ‘UgandaEMR Mobile’ Application to TASO-Supported Facilities
UgandaEMR is currently operational at over 1900 ART facilities countrywide and facilitates HIV /AIDS data capture at various service delivery points at the health facility either in real-time or retrospectively.
Between 16th and 20th January 2023, METS embarked on supporting the rollout of the UgandaEMR Mobile App to several TASO-supported health facilities in the districts of Gulu, Mbarara, and Masaka.
Supporting Electronic Medical Records (EMR) Functionality at Regional Referral Hospitals (RRHs)
In January 2023, two Regional Referral Hospitals – Mubende and Soroti experienced challenges in management of their electronic data. As a result, the hospitals were unable to prepare routine program reports. The Ministry of Health established that the problem was due to non-functional servers and requested METS to intervene.
With funding from PEPFAR, METS was able to procure new servers to support the functionality of UgandaEMR in the ART clinics at the two hospitals. The METS support team spent three days providing technical assistance in installing Operations Systems (Windows Server OS), UgandaEMR System, and migrating data from the old servers.
Improving Services to Orphans and other Vulnerable Children
In November 2022, the METS team working together with Ministry of Gender, Labor and Social Development, USAID’s Strategic Information Technical Support (SITES) and other stakeholders conducted a follow-on Orphans and other Vulnerable Children (OVC) program service quality assessment to assess satisfaction among the beneficiaries of the program services provided between October 2021 and March 2022.
Overall, the assessment revealed that the quality of OVC service offered in the Rwenzori region was adequate and met expectations at 86% on average under the sections of Economic Strengthening & Stability, Education & Development, Care & Protection and Survival and Health.
Site-readiness Assessment for Safe Male Circumcision (SMC)
METS in collaboration with the three new Implementing Partners (Uganda Catholic Medical Bureau, Uganda Protestant Medical Bureau and Kampala Capital City Authority) conducted an inter-agency service quality assessment for SMC site readiness at 13 supported sites.
Four sites obtained low scores (below 60%) mainly due to suboptimal availability of key items for the SMC services indicating a low level of readiness. Four sites had a high score (at least 90%) indicating a high level of readiness. The remaining 5 sites had acceptable level of readiness (60-89%) for SMC service provision with minimal need for improvement. Only 46% of the sites had the required information, education and communication materials.
Distribution of HIS Hardware equipment
Over the last 3 years PEPFAR, through the METS program, has procured computer and networking equipment for distribution to health facilities. This equipment is intended to support the Ministry of Health digitization project, improve electronic medical (EMR) coverage, and accelerate the implementation of Point of Care (PoC).
This has been a phased process that began in January 2022 with distribution to over 600 health facilities. The current distribution phase is data capture devices which include mini servers, desktops, laptops, tablets, and fingerprint scanners to 26 implementing partners across the country.
Pictorial: PEPFAR Partners and Stakeholders Strategy Meeting
METS was part of a meeting held on 22-23 February 2023 at Mestil Hotel to review partners’ progress and discuss the strategy of 95% of all people living with HIV knowing their status, 95% of all people with diagnosed HIV infection receiving antiretroviral treatment, and 95% of all people receiving treatment having viral suppression by 2030.
PEPFAR Science Summit
METS was part of the annual PEPFAR Science Summit, a U.S. Uganda Mission-led platform that brings together U.S. government researchers and scholars and partners (IPs) in Uganda to share new scientific research to inform the implementation of HIV and TB programs and related policies.
METS made two presentations on Measurement of Regional Referral Hospitals Health Systems Capacity: Application of Progression Model by Dr. Simon Muhumuza and Improving the Quality of Cervical Cancer Services in Uganda: Onsite Mentorship and Coaching Approach by Connie Ninisiima
METS provided technical assistance to the Ministry of Health (MoH) during a Joint Technical Supportive Supervision and Performance Review exercise for 9 Regional Referral Hospitals (RRH) across the country from February 20-24, 2023.
The exercise was an opportunity to assess how far along the facilities were implementing their work plans, review their performance targets as well as identifying implementation challenges of the RRH mechanism that was introduced by MoH.
Key Population and Pre-Exposure Prophylaxis (KP/PrEP) Tracker training
The Peace Corps requested METS to support its partners to conduct KP tracker training and an orientation on data collecting tools for community outreaches. Key populations are defined groups who, due to specific higher-risk behaviors, are at increased risk of HIV.
Makerere University’s Professor Peter Waiswa has been appointed to the World Health Organization (WHO) Technical Working Group of Experts tasked with developing the Essential Child Health Services (ECHS) framework.
The appointment, communicated in an official letter dated October 21, 2026, and signed by Dr. Pascale Allotey, Director of WHO’s Department of Sexual, Reproductive, Maternal, Child, Adolescent and Ageing Health, runs until December 31, 2027.
The technical working group will support WHO in defining a core package of essential health services for newborns, older children and adolescents, alongside practical approaches for delivering these services effectively and equitably to improve their health and well-being.
As a member of the working group, Prof. Waiswa will contribute scientific and technical expertise to the development of the framework. His responsibilities will include participating in technical consultations, reviewing draft documents, providing written feedback and contributing to consensus-building on key technical issues.
The group is expected to hold approximately five online meetings between November 2026 and mid-2027. Members will serve in their individual capacities as independent experts rather than as representatives of their respective governments or institutions.
The appointment builds on Prof. Waiswa’s longstanding service and contributions to WHO. He previously served for seven years on WHO’s Strategic and Technical Advisory Group of Experts (STAGE) on Maternal, Newborn, Child and Adolescent Health and Nutrition, with his tenure concluding in June 2026.
Makerere University proudly celebrates the recognition of Mr. Mordecai Tayebwa, Senior Grants Manager, Makerere University Lung Institute and Ms. Bonny Tusiime, Grants and Contracts Officer, Makerere University College of Health of Sciences (MakCHS) as recipients of the prestigious Future of the Field Award of Society of Research Administrators International (SRAI), an international recognition that Honors emerging leaders making outstanding contributions to the advancement of research administration. This year’s ‘Future of the Field’ honorees were formally recognized at SRAI’s Annual Meeting held in Honolulu, Hawaii, USA in October, 2026.
The Future of the Field Award recognizes professionals who demonstrate exceptional leadership, innovation, and commitment to strengthening research management and administration. The award celebrates individuals whose work is shaping the future of the profession by improving research support systems, fostering collaboration, and advancing excellence in research administration.
At Makerere University, Mr. Tayebwa and Ms. Tusiime have played key roles in strengthening grants and contracts management, supporting researchers throughout the grant lifecycle, promoting compliance with sponsor requirements, and contributing to the development of sustainable research management systems. Their efforts have enhanced institutional capacity to attract, manage, and administer competitive research funding while ensuring accountability and excellence. Commenting on the recognition, the award recipients expressed their gratitude for the opportunity to contribute to the growth of research administration. “This recognition reflects not only our individual efforts but also the collaborative environment at MakCHS and Makerere University. It inspires us to continue strengthening research administration and supporting researchers in generating impactful scientific discoveries that improve lives.” They said.
The achievement highlights the growing international recognition of research administration professionals in Africa and underscores Makerere University and MakCHS’s general commitment to building strong research support systems that enable world-class research. This also reflects the institution’s investment in professional development and its dedication to advancing research excellence through effective grants management.
Commenting on the award, Dara C. Little, President, (SRAI) said “In a field as dynamic and rapidly evolving as research administration, the need for visionary,adaptable leaders have never been greater,” . “SRAI’s Future of the Field recipients represent the next generation of changemakers – those who will not only navigate complexity but shape the future of our profession. To embrace change, is to lead your innovation, resilience, and leadership are exactly what this moment demands. Rise to the opportunity and you will do great things!”
Makerere University congratulates Mr. Mordecai Tayebwa and Ms. Bonny Tusiime on this significant achievement and wishes them continued success as they contribute to shaping the future of research administration both regionally and globally
Prof. David Guwatudde, Principal Investigator (centre), and Dr. Justine Bukenya with researchers and stakeholders at the ARISE-NUTRINT dissemination meeting in Iganga, 1 October 2026.
Adolescence is a consequential period for health, when diets, behaviours and other risks can form and persist into adulthood. In Mayuge District, new evidence from Makerere University School of Public Health is showing how some of these early vulnerabilities could contribute to the later risk of non-communicable diseases (NCDs), and what can change when interventions begin early.
The evidence comes from the ARISE-NUTRINT project, a three-year EU-funded study led by Prof. David Guwatudde and Dr. Justine Bukenya. The project examines health and behavioural risks among adolescents and young adults, with a particular focus on nutrition-related NCD risks, and tests interventions designed to improve nutrition fluency and diet quality.
The work comes against a substantial NCD burden in a country where 73.2% of the population is below 30. WHO estimates that NCDs accounted for 42.2% of deaths in Uganda in 2023, while the country’s latest national NCD risk-factor survey found significant risk factors persisting in the population, with little overall change from the previous survey in 2014. Together, the evidence strengthens the case for prevention much earlier in life.
“There is strong evidence from literature demonstrating that most behavioral NCD risk factors, including nutrition-related, are established during childhood, persisting into adulthood. This may lead to development of actual NCDs if such risks are not reversed early,” Prof. Guwatudde said.
The study, he explained, linked assessment of young people’s health risks with developing responses suited to their circumstances. Since enrolling 1,206 participants aged 10–24 in Mayuge District in March 2024, the team has conducted three annual rounds of data collection, with young people and local stakeholders also helping evaluate interventions to reduce the risks identified.
Prof. David Guwatudde (right) addresses stakeholders alongside the ARISE-NUTRINT study team in Iganga on 1 October 2026.
A problem that starts early
The findings, shared with community and district stakeholders in Iganga on October 1, 2026, show that some vulnerabilities were already evident at baseline. Nearly one in three participants had anaemia, 49% had low nutrition literacy, while about one in ten reported symptoms of anxiety and a similar proportion reported depressive symptoms.
Anaemia, a condition in which the blood does not have enough healthy red blood cells or haemoglobin to carry adequate oxygen around the body, was highest among the youngest participants. Overall, 375, or 31%, had anaemia, rising to 35.7 per cent among 10–14-year-olds, compared with 18.9% among those aged 15–19 and 10.6 per cent among young adults aged 20–24.
Nutrition presented another challenge. At baseline, 49% of participants had low nutrition literacy and 13% had poor overall diet quality. Low nutrition literacy was associated with more than four times the odds of poor diet quality.
Gaps also emerged in sexual and reproductive health knowledge and behaviour. About 14 per cent of participants did not know that HIV cannot be transmitted by sharing food with a person living with HIV, 10% believed a condom could be used more than once, and 13 per cent did not know pregnancy could occur during first sexual intercourse. Among 168 participants who reported having had sex, more than half reported using no method to prevent pregnancy during their first or most recent sexual intercourse.
Mental health findings added another dimension. Anxiety symptoms were reported by 10 per cent of participants, depressive symptoms by 9.5% and loneliness by 6.3 per cent. Among 534 participants aged 13–24 assessed for suicidal ideation, 1.9% reported suicidal thoughts.
Together, the baseline findings show that vulnerabilities extended beyond any single health issue. For nutrition, the study went further to examine what shaped everyday food choices and whether those influences could be changed.
Nutrition literacy goes beyond knowing which foods are healthy. It includes understanding nutrition information and applying it to everyday choices. The study found those choices were also shaped by parents, peers, food vendors, culture, prices, seasons, and what was available locally. Improving diets, therefore, required reaching beyond individual knowledge to the households and communities where food choices are made.
What early action changed
The baseline evidence informed the Adolescent Nutrition Fluency Intervention. Working with adolescents and young adults, caregivers, Community Health Workers (CHWs), district teams and other stakeholders, the project adapted nutrition messages to local foods, language and household realities. Ten trained CHWs delivered nine monthly household sessions covering balanced diets, physical activity, vitamins and minerals, meal planning and anaemia prevention.
The household approach reached young people in and out of school. The nutrition literacy, diet-quality and intervention analyses form part of the PhD research of Mr. Thomas Buyinza, supported through ARISE-NUTRINT. At endline, participants who received the sessions recorded higher nutrition literacy and overall diet-quality scores.
“The improvement in nutrition literacy and diet quality suggests that practical education, grounded in local foods and household realities, can support healthier choices among adolescents and young adults. In addition, involving parents and caregivers is important because they influence what families buy, prepare, and eat,” Dr. Bukenya said.
She stressed that nutrition education needed to be complemented by better access to affordable, nutritious foods. Dr. Bukenya also called for continued follow-up, including the use of nutrition and dietary data from DHIS2, to assess whether improvements were maintained and guide district planning.
Dr. Justine Bukenya emphasises family involvement in nutrition education and access to affordable, nutritious foods during the ARISE-NUTRINT dissemination meeting in Iganga on 1 October 2026.
Changes in other outcomes were mixed. Participants reporting no physical activity fell from 22.6% to 7.4%, while those active on four to seven days a week increased from 46% to 54.8%. But activity duration did not improve: those reporting more than 60 minutes a day declined from 28.2% to 21.1%. Underweight fell modestly from 6.2% to 5%, while overweight and obesity did not change significantly.
Anaemia recorded the largest change, falling from 31.1% before the intervention to 9.9% afterwards. During the intervention period, participants received weekly iron and folic acid supplementation and deworming alongside nutrition education on iron-rich foods, dietary diversity and practices that improve iron absorption.
Illustration of the ARISE-NUTRINT household approach: ten trained community health workers delivered nine monthly nutrition education sessions to adolescents and young adults, involving parents and caregivers. AI-generated illustration.
Mayuge District’s Assistant District Health Officer, Ms. Elizabeth Kawaala, said the findings reflected problems recognised locally and highlighted the need for a response involving families and other stakeholders.
“There is a serious challenge that needs to be tackled with many stakeholders, with parents at the centre because these are children. We also learnt that many parents, I think, lack the skills to communicate with their adolescents,” she said.
Mayuge District’s Assistant District Health Officer, Ms. Elizabeth Kawaala, speaks during the dissemination of ARISE-NUTRINT study findings in Iganga on 1 October 2026.
She said the findings had been shared with colleagues and described integrating health education and sensitisation into services. She also called for departments to use the evidence when planning activities in their workplans.
Beyond Mayuge
Seen alongside Uganda’s 2023 STEPS survey, the Mayuge findings add an earlier-life dimension to the national evidence. Makerere University School of Public Health contributed to both studies, with Prof. Guwatudde contributing to the national STEPS survey and now leading ARISE-NUTRINT. While STEPS found significant NCD risk factors persisting among adults, ARISE-NUTRINT shows that some behaviours and vulnerabilities relevant to later NCD risk are already evident during adolescence and young adulthood. The Mayuge research goes further by testing what can change when interventions begin during this period.
The findings leave Mayuge with more than a measure of the problem. They show where vulnerabilities are emerging, what changed when interventions were introduced and where challenges remain. For ARISE-NUTRINT, the evidence now turns attention to which approaches can be sustained and how lessons from Mayuge can inform efforts to support healthier transitions from adolescence into adulthood.