Health
NCDs Symposium 2023: Stakeholders Pledge to Work together to Address growing burden in Uganda & Beyond
Stakeholders pledged to work together to address the growing burden of Non-Communicable Diseases (NCDs) in Uganda and beyond. The pledge was made at the NCDs Symposium held on Saturday 4th March 2023 and hosted by Makerere University College of Health Sciences (MakCHS), as a member of the Alliance of Research Universities in Africa (ARUA) NCD Centre of Excellence. The theme of the symposium was ‘Advances in NCD Training, Research and Community Impact’.
Research shows that, globally, non-communicable diseases (NCDs) are responsible for a significant proportion of deaths, with 41 million people dying from these chronic diseases each year. NCDs, also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors. The main types of NCD are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.
NCDs disproportionately affect people in low- and middle-income countries, where more than three-quarters of global NCD deaths (31.4 million) occur. In Uganda, the number of people living with NCDs has been increasing dramatically, making NCDs a major public health threat. For instance, 74,354 new cases of diabetes were seen at health facilities in Uganda in 2009-10 compared to 58,523 five years earlier showing an increase of 27% (HMIS data 2009/10). In 2013, the Uganda Diabetes Association revealed that over 200,000 children had diabetes and expressed fears the number could be higher because many of the children do not report to the hospital for diagnosis.
In her remarks as host, Professor Damalie Nakanjako, The Principal College of Health Sciences, Makerere University, in a special way welcomed participants to the Symposium and noted that the purpose of the event was to showcase the latest advances in NCD training, research, and community impact, and to provide a platform for stakeholders to engage and collaborate on issues related to NCDs.
Citing WHO data, Professor Nakanjako noted that NCDs represent the largest cause of mortality in adults with 86% of these premature deaths occurring in middle-income countries such as Uganda. She further pointed out that the incidence of NCDs among children, particularly diabetes, is increasing, indicating the urgent need for attention.
Professor Nakanjako stressed the importance of data-driven interventions, knowledge translation, and a multi-sectoral approach in addressing NCDs, and called for more investment in NCD research, collaborations, and regular exercise among children. She also reiterated Makerere University’s commitment to addressing NCDs through continuous advances in NCD training, research, and community engagement.
WHO Key Facts On Non-Communicable Diseases (NCDs)
- Non-communicable diseases (NCDs) kill 41 million people each year, equivalent to 74% of all deaths globally.
- Each year, 17 million people die from a NCD before age 70; 86% of these premature deaths occur in low- and middle-income countries.
- Of all NCD deaths, 77% are in low- and middle-income countries.
- Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), chronic respiratory diseases (4.1 million), and diabetes (2.0 million including kidney disease deaths caused by diabetes).
- These four groups of diseases account for over 80% of all premature NCD deaths.
- Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from an NCD.
- Detection, screening and treatment of NCDs, as well as palliative care, are key components of the response to NCDs.
During his speech, Dr. Fred Bukachi, the Director of ARUA Centre of Excellence for NCDs, highlighted the urgent need to address the rising prevalence of non-communicable diseases (NCDs) in the region and beyond through research, capacity building, and dissemination of findings. The Centre’s main objective is to develop scientific evidence for NCD policies, prevention, management, and control, while engaging with communities. To achieve this, Dr. Bukachi presented several strategies, including the creation of multi-disciplinary research programs, a training research and mobility program, an NCD research and data repository for Africa, and an annual international NCD symposium.
In addition, Dr. Bukachi emphasized the Centre’s commitment to improving the health and well-being of people in sub-Saharan Africa and beyond by addressing the NCD epidemic through research and capacity building. The audience responded positively to his presentation, with many impressed by the Centre’s ambitious goals and plans for tackling NCDs in Africa.
In his remarks, read by Dr. Frank Mugabe, Dr. Oyoo Charles Akiya, the Commissioner of Health Services-NCD Ministry of Health, stated that non-communicable diseases and injuries (NCDIs) are on the rise in Uganda. He revealed that the burden of NCDs has more than doubled in the last 20 years, with 22% of adults at risk of premature death (30-70 years) as of 2016. NCDs account for 41% of all deaths in the country.
Dr. Akiya cited the NCD risk factor survey and other studies, highlighting heavy alcohol consumption in men and women, consumption of unhealthy diets, tobacco use, physical inactivity, and obesity as some of the problems that need urgent attention. Data on high burden NCD conditions reveal that 24% of adults in Uganda suffer from hypertension requiring treatment, with only 24.3% accessing treatment. The prevalence of diabetes is estimated at 1.4%, and there is a high prevalence of sickle cell disease in the central, eastern, and northern parts of the country, with 1.3% of the population having the trait.
Mental health disorders, especially depression, are also prevalent, with over one million Ugandans experiencing depression.
On government efforts towards NCDS, Akiya revealed that Uganda is conducting the 2nd risk factor survey thanks to the World Health Organization and the School of Public Health.
Moving forward, Dr. Akiya proposed priority areas for research and training ; including the need to quantify the level of misinformation around diabetes treatment, implement preventive programs for known carrier communities of sickle cell disease, determine the cause and risk factors for increased cases of gastrointestinal cancer in Southwestern Uganda, understand the biomass gap and its correlation to chronic respiratory diseases, determine the gap in mental health service provision among general health workers, reduce the cost of kidney chronic disease transplant services, increase awareness of cardiovascular disease screening, and determine and document the cost of road traffic-associated injuries to the health sector and the country to halt these conditions.
In his remarks as Chief Guest, Professor Umar Kakumba, on behalf of Makerere University’s Vice Chancellor Professor Barnabas Nawangwe, commended academia for their role in addressing emerging health threats, adding that Makerere University, as a research-led institution, is committed to supporting NCD activities through training, research, and community engagement. He emphasized that beyond training and research, there is a need to go to communities and share knowledge, as there is a gap in knowledge uptake around NCDs.
Professor Kakumba also highlighted the role of the private sector in supporting these causes, as a healthy population is key to their business success. He thanked Arua partners for taking the lead in addressing NCDs, which are responsible for 71% of global deaths and 85% of premature deaths in low and middle-income countries, including Uganda.
Moving forward, Professor Kakumba proposed a collaborative effort among stakeholders to address NCDs comprehensively. He emphasized the need for a holistic approach that involves the government, private sector, civil society organizations, and academia to address the growing burden of NCDs in Uganda.
He reiterated the commitment of Makerere University in supporting NCD activities through research, training, and community engagement, and he called on other institutions to join in this effort to achieve a healthier population and a more prosperous country.
In her remarks, Dr. Kasule Hasifa discussed the priority areas for research and training in non-communicable diseases (NCDs) identified by the World Health Organization (WHO), including the need to prevent and control NCDs through public health interventions and policies, address the social determinants of NCDs such as poverty and education, improve healthcare accessibility and quality particularly in low- and middle-income countries, strengthen health systems to better respond to the growing burden of NCDs, and promote research on the causes, prevention, and treatment of NCDs.
The event featured presentations from several NCD groups at MakCHS, including Cardiovascular Diseases, Renal Diseases, Diabetes Mellitus & Other Endocrine Disorders, Cancers, Mental Health Disorders, Respiratory Diseases and Lung Health, Sickle Cell Disease, and Other Haematological Conditions, as well as Interactions between NCDS and Infectious Diseases.
The symposium was attended by researchers, students, academicians, policymakers, practitioners, and health advocates with a special interest in NCDs. The day was crowned off with cake-cutting and all participants pledging to work together in addressing NCDs.
At the symposium, stakeholders agreed that it is crucial to work collaboratively to comprehensively address the growing burden of NCDs in Uganda. They recognized the need to implement preventive programs, increase awareness of cardiovascular disease screening, improve healthcare accessibility and quality, particularly in low- and middle-income countries, and promote research on the causes, prevention, and treatment of NCDs. It was emphasized that a holistic approach involving the government, private sector, civil society organizations, and academia is necessary to achieve a healthier population and a more prosperous country.
On April 23, 2025, Makerere University School of Public Health (MakSPH) convened district leaders, health managers, and project partners to disseminate the outcomes of a major leadership and management strengthening initiative in Wakiso District, Central Uganda. The one-year project, part of the Global Health Partnerships programme funded by NHS England, was implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health.
Launched in 2024, the project titled Strengthening Leadership and Management Among Local Government Health Managers in Wakiso District, aimed to co-design and pilot a leadership and management training tailored to the realities of Uganda’s decentralised health system. The intervention, led by Makerere University’s Dr. David Musoke and Nottingham Trent University’s Prof. Linda Gibson, through the over 15-year-old NTU-Mak Partnership impacting lives in Wakiso, began with a field visit to over 60 public health facilities in the district, a needs assessment within these facilities to identify key priority gaps, and a baseline survey with the health in-charges to establish the initial status of key indicators.
“We have been very fortunate to work with a supportive local government in Wakiso, from the top leadership down. While many projects struggle to engage district teams, our longstanding relationship with Wakiso made collaboration seamless. Although this was our first initiative specifically focused on leadership and management, we hope it will serve as a stepping stone for even more impactful work in the future,” Dr. David Musoke, a Senior Lecturer at Makerere University and the Uganda Project Lead, said during the dissemination workshop, highlighting the key success factors for the leadership and management project.
Initial results from the needs assessment and baseline on leadership and management competencies conducted among Wakiso District health facility supervisors early last year by the project team and shared during the three-day workshop in June 2024, held in Kampala, which kickstarted the six-month structured fellowship programme for 53 health managers in Wakiso, had found critical capacity gaps. Using a tool evaluating 17 leadership and 33 management competencies, only 40% of the managers met the 80% benchmark for leadership, scoring highest in cognitive skills, while just 33% met the required management standard, performing best in self-management and lowest in quality management.
Then, the health facility managers with postgraduate training, longer service, and strong team dynamics, showed overall better performance. While working relationships with subordinates and the district leadership were largely positive, performance was hampered by systemic challenges such as limited resources, low motivation, and weak teamwork. Overall, the study also pointed to a misalignment of expectations between the District Local Government and the Health Ministry, underscoring the need to strengthen coordination to improve services.
The result of this mismatch was to the effect that, as of this time last year, Wakiso District ranked among the bottom 10 on the national health league table, which is an annual Ministry of Health assessment of district performance across key service delivery and patient satisfaction indicators. This was despite Wakiso being Uganda’s most populous district, with over 3.4 million residents today, as it continued to struggle to deliver essential health services to the public. The 2022/2023 Annual Health Sector Performance Report also flagged persistent challenges, including frequent transfers of facility in-charges, overstretched management structures, and weak internal communication and coordination.
It was this stark reality that informed the leadership and management intervention in Wakiso. Officiating the dissemination of the project outcomes, Dr. Sarah Byakika, Commissioner for Planning, Financing, and Policy at the Ministry of Health and a member of the National Oversight Mechanism for the programme, commended the remarkable progress made in just six months, citing visible improvements across the district as a direct result of the intervention.
“I have been involved with this programme right from its inception, and I’m proud that Uganda became one of its major beneficiaries,” Dr. Byakika said with gratitude, commending the strong collaboration between the Ministry of Health, Makerere University, Nottingham Trent University, Nottingham University Hospitals, Wakiso District and the development partners for supporting the initiative. She emphasised the value of this partnership in strengthening leadership and management competencies among Wakiso District health managers to address critical performance gaps in health service delivery.
“Wakiso is Uganda’s largest and most populous district, yet it has long underperformed on key health indices. Despite its semi-urban nature, it faces enormous health service delivery challenges, partly due to the overwhelming burden on its District Health Officer, who oversees more than 60 public and over 340 private health facilities. Many of these private facilities open and close frequently, complicating service oversight,” Dr. Byakika observed with concern.
Her sentiments were echoed by the District Health Officer, Dr. Emmanuel Mukisa, in a message delivered by Wakiso District Biostatistician, Mr. Frank Kakande. He noted that the project had contributed to a noticeable shift in the district’s health system performance, with visible improvements in leadership, communication, and accountability among facility in-charges beginning to translate into better overall health service delivery outcomes.
“You cannot talk about management without addressing performance: they go hand in hand. As someone who sits at the centre of district health data, I can confidently say that performance has improved. During the most recent national local government performance assessment, where I participated in the evaluation, Wakiso District’s health department ranked 18th out of 146 districts. That health ranking is a major achievement. We have consistently performed poorly in the past, but this time, we made significant progress,” Mr. Kakande told the attentive audience, speaking with an air of relief and satisfaction.
The Wakiso District Biostatistician credited part of this progress within the district, from the poor performance last year, to the leadership training and mentorship delivered through the project, citing visible improvements across key health indicators. He stressed the need to sustain this momentum through continued mentorship, internal capacity strengthening, and consistent application of the skills acquired by health managers, particularly in tackling persistent management challenges such as absenteeism, delegation, and accountability.
“Last week, I held a performance review at Kakiri Health Centre III, and the improvements were clear. These management skills are making a difference. You can see the change across indicators. But what matters now is sustainability. The support provided through supervision and mentorship was essential. But it’s up to us to keep the fire burning. We have learned a lot: communication skills, problem-solving, time management, and decision-making. Managers are now communicating better. Even issues like absenteeism are being addressed through proper reporting and action,” Mr. Kakande said.
Earlier, Dr. Musoke, presenting the overall project overview and success, explained that based on initial findings from the baseline and needs assessment, the team co-designed and delivered a structured six-month capacity-building programme targeting 60 health facility in-charges in Wakiso District. The programme blended in-person and virtual sessions, combining practical training with one-on-one mentorship, and included an exchange component between Uganda and the UK to promote international exposure and peer learning. This allowed the health managers to apply new skills to strengthen health outcomes in Wakiso.
“This project rightly focused on addressing gaps in leadership and management. I advocated for including this component in the programme, because our national health review missions consistently show that poor performance often stems from weak leadership and management,” Dr. Byakika affirmed, adding that: “I am pleased to see that nearly all public facilities in Wakiso participated. While the project had a short implementation window, the evaluation already shows encouraging results. Health managers feel more empowered, motivated, and aware of their roles. That’s a significant step.”
For her part, Dr. Sheba Gitta, Uganda Country Director for Global Health Partnerships, formerly Tropical Health and Education Trust, applauded the leadership and management capacity-building initiative in Wakiso as a timely, locally driven intervention. She underscored the value of two-way learning between Uganda and the UK health systems through the programme, noting that Global Health Partnerships works closely with the Ministry of Health to ensure all funded initiatives align with Uganda’s national development priorities.
“What excites me most is that this was not a pre-packaged programme imported from the UK. The training was co-created by partners, based on local realities and needs. That approach reflects strong collaboration between Makerere University School of Public Health and Nottingham Trent University. I thank Prof. Linda Gibson for her continued commitment and Dr. David Musoke for his proactive leadership in bringing this programme to life. Your consistency and quality of work continue to stand out,” Dr. Gitta shared.
While commending the progress made, she cautioned against “pilotism”, as a tendency for promising projects to end prematurely, calling for the model to be scaled up nationally. To support sustainability, she stressed the importance of documenting the training process, outcomes, and costs to inform ministry-level decision-making and long-term adoption.
Dr. Gitta joined Prof. Linda Gibson, the UK Lead for the Project, to encourage the trained managers to become champions of leadership within their facilities and districts, ensuring that the impact of the programme endures beyond its current cycle. She also thanked NHS England and the UK Government for their trust and investment in Uganda’s health system.
Health
Makerere-Incubated Safe Bangle Technologies Wins Prestigious World Summit Award for Innovation Against GBV
By Joseph Odoi
In a groundbreaking achievement, SafeBangle Technologies, an innovation incubated at Makerere University, has won the prestigious World Summit Award 2025 for its groundbreaking contribution to the fight against gender-based violence (GBV) in Africa. This remarkable honor comes in recognition of the development and implementation of a real-time domestic violence reporting bracelet.
The award was presented to the SafeBangle team that was represented by Saul Kabali, Messach Luminsa, and Janet Christine Nabaloga from SafeBangle Technologies at the WSA Global Congress in Hyderabad, India, where Uganda’s innovation potential was proudly showcased on a global stage.
The award was conferred in the Inclusion & Empowerment category for Safe Bangle’s cutting-edge solution; a wearable safety bracelet designed to address the pressing challenge of gender-based violence (GBV) across Africa.
The SafeBangle is a smartwatch-like, real-time domestic violence reporting bracelet that allows users to send SMS alerts via a single button press. Its core mission is to create a safer, more secure environment for women and children in Africa through innovative, affordable tech solutions.
According to Saul Kabali and Messach Luminsa, the innovators behind SafeBangle from SafeBangle Technologies, hosted at the Resilient African Network Lab. This award is very timely and a recognition that cements the importance of community rooted technology.
The team further stated that ‘’This award is a powerful affirmation of our mission and refuels our commitment to empowering Ugandan women and girls through innovation and technology. It influences our next steps by opening doors to new partnerships, increasing our credibility, and accelerating efforts to scale the SafeBangle nationally. We’re now more equipped to positively impact the daily lives of Ugandan women and girls through our SafeBangle bracelet.
To further the innovation, the team has called upon government to support the Safe Bangle Innovation
‘’Governments can support us by providing funding, facilitating policy support, and creating collaborative platforms for innovation. NGOs can help with grassroots outreach, and connect us to potential donors and funders interested in solving Sexual and Gender Based Violence amongst vulnerable communities; and tech partners can enhance scalability through infrastructure, data insights, and capacity building.
Moving forward, the team emphasized the importance of uniting innovation, partnership, and purpose to scale impact. “As we empower communities, invest in local solutions, and promote collaboration, we can transform how technology protects and uplifts women and girls across Uganda,” added the award-winning team.
The Story Behind the Safe Bangle Bracelet Innovation
According to the Safe Bangle innovators Saul Kabali and Messach Luminsa , ‘’The inspiration behind SafeBangle came from a deeply personal place. ‘’We heard countless stories of women who couldn’t call for help during moments of danger. We were deeply affected by the story of Aisha, a young woman in a rural village who was attacked while walking home alone at night. With no way to call for help, she felt helpless and vulnerable. This incident made us realize the critical need for immediate reporting alert tools, accessible to women like Aisha. We knew technology could play a crucial role and this incident awakened a strong desire in us to create a solution’’
To Makerere University School of Public Health’s Dr. Juliet Kiguli, who collaborated closely with the team during the rollout of the bracelet, this award is a vote of confidence in the work of Makerere University, whose core function focuses on teaching, learning, community engagement, research, and innovation, all contributing to the university’s efforts in addressing domestic violence.
‘’The award-winning innovation stems from the findings of a longitudinal study led by the Makerere University School of Public Health.
While carrying out a study after the Covid-19 Pandemic, we identified gaps when it comes to reporting and response to Gender Based Violence (GBV) among women in informal settlements. Therefore, we used to incorporate the SafeBangle intervention to solve the problem of lack of affordable and immediate reporting mechanisms for violence using a bracelet that reports violence in real time
We’re excited about the progress so far, and with this recognition, we hope that more like-minded partners will join us to scale this initiative and ultimately help make the world a safer place for all.” Added Dr Kiguli of the Safe Bangle innovation potential
The research team, comprising Dr. Juliet Kiguli (Principal Investigator), Dr. Roy Mayega (Deputy Chief of Party, RAN), and Dr. Agnes Nyabigambo (Study Coordinator), piloted the bracelet under the PEER (Partnerships for Enhanced Engagement in Research) program with support from USAID and the National Academies of Sciences.
A consortium of partners, including SafeBangle Technologies, Makerere School of Public Health/RAN , the Medical College of Wisconsin, and Somero Uganda, implemented the rollout of the Domestic Violence Real-Time Reporting Bracelet. The initiative was supported by USAID and the National Academy of Sciences in Washington, DC. Key contributors to the project included Dr Juliet Kiguli Roy Mayega from Makerere University School of Public Health, Dr. Kelly Robbins, Dr. Lina Stankute-Alexander, Dr. Brent Wells, Dr. Melissa Trimble, and Uganda’s Dr. Gloria Kasozi at USAID. Wisconsin Madison Medical University’s Prof. Julia Dickson-Gomez was also a collaborator.
In terms of the acceptability of the SafeBangle innovation as a solution to GBV, the team has piloted the technology with more than 1,000 users, resulting in a 63% reduction in response times
During the event, SafeBangle Team participated in the “Equity by Design” panel, sharing insights on inclusive technology development with global experts including Dorothy Gordon, Abhishek Singh from India’s Ministry of Electronics and IT, Baroness Beeban Kidron, and representatives from UNESCO and WE Hub.
About SafeBangle Technologies
SafeBangle Technologies is a Ugandan social enterprise hosted at Resilient African Network Lab focused on addressing gender-based violence through innovative safety solutions. The company combines wearable technology with an interactive web platform to provide real-time reporting of violence and physical assaults, even in areas without internet connectivity. Founded in 2018, SafeBangle operates with a mission to make safety accessible and affordable for vulnerable populations, especially women and children.
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