Seated: Commissioner NCDs MoH-Dr. Oyoo Charles Akiya (2nd R), Executive Director of Butabika National Referral Mental Hospital-Dr. Juliet Nakku (2nd L) and Assistant Commissioner NCDs MoH-Dr. Hafsa Lukwata with researchers and officials from MoH and the World Bank at the Inception Meeting on 13th April 2023 at the Ministry of Health (MoH), Kampala.
As mental health gains recognition as a critical aspect of overall well-being, a pioneering study is set to delve into its integration in schools, communities and healthcare units across Uganda.
With funding from the World Bank, this landmark study titled; “Assessing the Extent of Integration of Mental Health Services into Primary Healthcare, Community and Schools” will focus on four purposively selected districts in Uganda – Adjumani in the Northern region, Bushenyi in Western Uganda, Kapchorwa in Eastern Uganda, and Butambala in Central Uganda.
With the potential to revolutionize mental health practices in schools, this study will through rigorous research and analysis shed light on the implementation and impact of mental health integration initiatives in schools, uncovering new insights that could shape policies and practices for generations to come.
A team of stakeholders at the Inception Meeting.
Latest data from the international Burden of Disease Study indicates that mental illness and substance use disorders account for 3.35% of the total disease burden in Uganda. According to the latest WHO data, at least 7.4% of Ugandans are affected by common mental disorders particularly depression, anxiety and alcohol use disorders.
Comparable to high-income countries, depression and generalized anxiety disorders in Uganda, are prevalent at 5.3% and 4.1% respectively. Uganda ranks among the top five countries globally with the highest depression prevalence. Poverty, HIV infection, disasters, and adverse environmental conditions are factors that increase the risk and consequence of mental health conditions in Uganda.
It is against this background that the World Bank Group solicited for consultancy services for a nation-wide study to assess the extent of integration of mental health services into primary healthcare, schools and communities.
Dr. Juliet Nakku, Senior Consultant Psychiatrist and Executive Director of Butabika National Referral Mental Hospital, during an inception meeting of mental health stakeholders on April 13, stated that the study will reveal the prevalence and types of mental health issues in these settings and their impact on community well-being.
This study that will be conducted by a team of mental health experts from the Ministry of Health and Makerere University School of Public Health. This study will assess the availability, access, and quality of mental health services in PHC, communities, and schools.
The study’s Principal Investigator Dr. Nakku further emphasized that the research will assess existing services, identify gaps/barriers, and explore opportunities/challenges in integrating mental health into primary healthcare and schools. This will involve examining policies, resources, support systems, and obstacles to integration.
Dr. Juliet Nakku, Senior Consultant Psychiatrist and Executive Director of Butabika National Referral Mental Hospital, during an inception meeting of mental health stakeholders on April 13, 2023.
Over the last 20 years, Uganda has taken measures to enhance its healthcare system and promote better health outcomes for its population. In 1996, the government-initiated efforts to integrate mental health into primary healthcare, providing training for general healthcare workers to identify and address common mental health disorders.
Dr. Hafsa Lukwata, Assistant Commissioner for NCDs and Mental Health at the Ministry of Health, emphasizes that there is increased risk of mental health problems among specific sub-populations, including children, the elderly, refugees, and individuals in uniform.
Dr. Lukwata asserts that the government is addressing mental health through policies that highlight its importance as a fundamental component of health at all care levels. These policies promote decentralization, integration of evidence-based services, and partnerships to increase mental health knowledge and service provision.
Dr. Hafsa Lukwata, Assistant Commissioner for NCDs and Mental Health at the Ministry of Health speaks during the inception at MoH.
She further stresses that mental health conditions impact individuals throughout their lifespan, affecting quality of life. This includes early childhood, adolescence, pregnancy, adulthood, as well as specific groups such as men in uniform, workplace populations, and the elderly who are at an increased risk for mental illnesses.
Uganda, according to Dr. Hafsa invested USD 25m in 2009 to improve mental health facilities and provide training for health workers, with support from the African Development Bank.
“We have set up several health facilities and trained numerous health workers with the support of the African Development Bank,” says Dr. Hafsa. “However, there have been no studies to assess the impact of these investments. Routine data from the Ministry of Health Management Information Systems (HMIS) indicates an increase in new patients treated for mental health conditions.”
She adds that improvements have been made to the structure of mental health care at all levels to increase the number and mix of mental health professionals.
Despite progress, as noted in the 2018 report of the Sectoral Committee on Health, Uganda still grapples with a significant mental health treatment gap of 85%, leaving only 15% of those in need with access to care. Primary healthcare facilities often refer individuals to higher-level tertiary care, and mental health stigma persists, with limited awareness among the general population, as highlighted by the World Bank.
To bridge the gap, WHO suggests integrating mental health services into PHC systems in countries like Uganda. However, challenges such as prioritization, poverty, cultural differences, health system issues, medication supply, workforce shortages, and inflexibility pose barriers to this integration.
A team of researchers, stakeholders including MoH, World Bank, at the Inception Meeting.
Dr. Nakku acknowledges that mental health has received policy priority in Uganda, but gaps remain in delivering services at primary care, community, and school levels, leaving some populations underserved.
“Mental health problems are risk factors for various public health concerns, such as road traffic accidents and injuries. The role of alcohol and substance use in these issues is significant. Integrating mental health into primary health care may be a cost-effective solution with desirable treatment outcomes. There have been efforts to integration. We now want to assess the extent of integration into PHC, communities and schools in Uganda,” explained Dr. Nakku.
The study aims to evaluate the Knowledge, Attitudes, and Practices (KAP) related to mental health care/services among a total of 1380 individuals, including 45 students/pupils from each of the 33 schools. The assessment will focus on both teachers, learners’ senior women teachers, school nurses and matrons.
Dr. Fredrick E. Makumbi, an Associate Professor of Biostatistics at MakSPH outlined how the study will use qualitative and quantitative data to comprehensively understand mental health integration in Uganda. He provided specifics on the quantitative component, including the study population, sample size, sampling procedure, and data analysis plans. He stressed that the collected data will yield indicators for developing a composite measure of integration, stratified by primary healthcare, communities, and schools.
Dr. Fredrick E. Makumbi, an Associate Professor of Biostatistics at MakSPH speaks during the inception meeting.
“This study is quite interesting because we have primary health care units as a study population. We shall randomly pick study participants from the villages and schools served by the health care units. We also have plans to construct an Integration of Mental Health Services/Care Composite (IMHC) based on scores from the items/indicators of integration at each of the 3 levels. Each indicator present will be scored ‘1’ else ‘0’, and a total score will be obtained as the sum of all individual indicator scores. The proportion of schools/communities/PHC facilities generated will be based on an agreed cut-off,” explained Dr. Fred Makumbi, a Co-Principal Investigator of the MHISU study.
Professor Rhoda Wanyenze, the Dean and study Advisory team member expressed her enthusiasm for hosting a study highlighting that mental health was “an integral part of our lives.” Accordingly, she stressed MakSPH’s commitment to increasing mental health knowledge through research and expressed her delight in partnering with Butabika Hospital, citing their history of effective teamwork. “The School of Public Health will document the learnings from this study and this study is not a one-off.”
Professor Rhoda Wanyenze, the Dean and study Advisory team member expressed her enthusiasm for hosting a study.
Dr. Wilson Winstons Muhwezi, an Associate Professor in the Department of Psychiatry at Makerere University College of Health Sciences, provided insights on the qualitative component of the study during the discussion. He emphasized the purpose of describing and providing context for integration, and how the study team aims to explain trends, relationships, consistencies, and inconsistencies through the numerous question items they have put together.
“We think if we are able to go to very many sub-populations that we have marked out for purposes of collecting this qualitative data, we shall be able to provide context and meaning according to the data sources themselves so that we have better appreciation of what is going on,” says Dr. Muhwezi.
Dr. Wilson Winstons Muhwezi, an Associate Professor in the Department of Psychiatry at Makerere University College of Health Sciences.
Dr. Muhwezi expressed excitement to be part of a study that recognizes the value of qualitative data in increasing the wealth of knowledge. “As far as I am concerned, I am very excited about this study because rarely do we get to do studies where the qualitative approach is given prominence like the quantitative approach. I think we will get good information when we come from the field.”
Dr. Oyoo Charles Akiya, the Commissioner NCDs-Ministry of Health, expressed the Ministry’s keen interest in the upcoming study on Ugandan mental health during an inception meeting chaired on their behalf. He emphasized that understanding the mental health needs of Uganda will lead to better interventions and contribute to achieving Sustainable Development Goal 3 – Good Health and Well-being.
Dr. Oyoo Charles Akiya, the Commissioner NCDs-Ministry of Health.
According to Dr. Oyoo, Ministry of Health will support the study team and that it was eager to learn more about the study and how they can be of service. He expressed gratitude to the World Bank, MakSPH, and Butabika Hospital for their contribution to improving mental health care in Uganda.
Dr. Hafsa Lukwata speaks during the inception at MoH.
The Makerere University School of Public Health 2025 Annual Report documents a defining year in the School’s institutional journey. Effective January 2025, MakSPH attained stand-alone status within Makerere University, recognising seven decades of growth in public health training, research, policy engagement and community service. The transition gives the School greater focus and institutional agility to respond to Uganda’s and Africa’s evolving health priorities.
During the 2024/2025 academic year, MakSPH had more than 1,000 students across 12 degree programmes and different years of study. It presented 269 graduands at Makerere University’s 75th Graduation Ceremony, more than 80 per cent at graduate level, while 12 doctoral candidates successfully defended their studies. Training remained closely connected to practice through eight district field-training sites and student participation in outbreak response, disease surveillance and community-based public health action.
The School produced more than 350 peer-reviewed publications. Its evidence informed national and global action across HIV, tuberculosis, maternal and newborn health, antimicrobial resistance, health systems, climate change, urban health, injuries and noncommunicable diseases. MakSPH’s contribution to the PURPOSE 1 trial supported evidence showing more than 99 per cent protection from twice-yearly injectable lenacapavir, while locally led programmes expanded HIV screening, prevention and referral services for underserved populations.
This work was sustained through partnerships with government, communities, funders, universities and implementation agencies. MakSPH’s research and training network extended across more than 35 African countries, while longstanding collaborations were renewed and new institutional relationships established. Strong research governance, unqualified audits and positive due-diligence assessments continued to reinforce partner confidence in the School’s ability to manage complex national and multi-country programmes with accountability.
Construction of the new MakSPH building on Makerere University Main Campus advanced during 2025, with completion targeted for 2026. Designed as a modern public health hub, the facility will expand teaching and specialised laboratory space, strengthen digital learning and research, and provide improved environments for students, faculty, innovation and collaboration.
These achievements reflect the shared contribution of faculty, staff, students and partners. Guided by its 2025–2030 Strategic Plan, MakSPH remains committed to training public health leaders, generating evidence that informs policy and practice, strengthening health systems and improving health in Uganda, across Africa and beyond.
The post holder will be required to provide nursing care to patients attending IDC, provide health education and advise to patients and their family members, provide translation whenever necessary, guide in clinical practice and duties of other nurses. Participate in clinical research studies.
Key Responsibilities
Provides nursing care to patients attending the IDC
To provide clinical care including triaging, clinical assessment of patients of patient’s problems, investigations to HIV/AIDS patients attending IDI-supported health facilities in line with standard treatment guidelines.
Assist in management of very sick patients brought in Urgent care with knowledge, skills and Support appropriate referral of complex patients’ through liaison with immediate team members, senior clinicians and other specialized facilities.
Lead education and facility sensitization efforts to continuously build knowledge among clients and the attendants at Urgent care and the general clinic.
Participate in identification, implementation and documentation of continuous quality improvement activities along client care and treatment.
Assists medical doctors in carrying out clinical procedures.
Provides translation services to visiting medical doctors as required
Ensures patient flow in the clinic ( IDC)
Performs quality assurance and quality control (QA/AC) to ensure completeness of source documents.
Participates in giving Medicines when required.
Checks medical supply stock and ensures procedure charts are fully equipped
Guides the clinical practice and duties of other nursing staff
Participates as a full member of the IDC health care team
Attends clinic staff meetings on a daily basis as available
Participate whenever requested to do so in clinic research studies.
Participate in compilation and submission of accurate activity reports according to the set guidelines.
This job description is not exhaustive and the post holder will need to be flexible and to undertake such other duties as may become necessary with the development of the Infectious Diseases Institute.
Academic Qualifications
Diploma or Bachelors Degree in Nursing
Full and active registration with the Uganda Nurses and Midwives council (Valid general practice license).
Person Specification
Completion of Nurses Training in a recognized educational institution with Diploma/ Bachelors
Minimum of 3 years work experience in a clinical setting
Full and active registration with the Uganda Nurses and Midwives council (Valid general practice license).
Self- motivated and capable of meeting deadlines.
Excellent communication skills.
Good interpersonal skills and able to interact productively with other team members.
More details
Job Code: NPCT001 No of Positions: 1 Station: IDI-Mulago Classification: Full-time Duration: 1 Months Reports to: NURSE TEAM LEAD Posted Date: 2026-07-06 09:06:27.000 Closing Date: 2026-07-19 17:00:00.000
Across Kampala, families use saucepans, cooking pots, frying pans, kettles, and pressure cookers every day. Makerere University School of Public Health is now investigating whether some of these items may expose households to lead, a toxic heavy metal that can enter food during cooking if contaminated materials are used to make them.
The year-long study, titled “Assessment of Lead Contamination in Domestic Cookware, Supply Chains, and Exposure Pathways in Informal Settlements of Kampala,” was launched on 11 June 2026 at MakSPH’s ResilientAfrica Network (RAN) in Kololo. Supported through the Lead Exposure Elimination Project (LEEP), with funding from Bloomberg Philanthropies, and led by Mr. Douglas Bulafu, Mr. Tom Okade, and Dr. Rawlance Ndejjo, the study will assess total and leachable lead levels in commonly used cookware, map how the products are sourced, distributed, and sold, and identify feasible interventions to reduce household exposure to lead.
Ms. Prossy Nabaggala, Senior Standards Officer at the Uganda National Bureau of Standards, pictured centre, consults with study co-investigators Mr. Tom Okade and Mr. Douglas Bulafu during the launch of MakSPH’s study on possible lead exposure from domestic cookware in Kampala.
Today, lead remains a major and preventable public health concern globally. WHO reports that no level of exposure is known to be without harmful effects and estimates that lead exposure contributes to more than 3.5 million deaths worldwide, mainly through cardiovascular effects. Children and women of child-bearing age are said to be especially vulnerable, with exposure linked to impaired brain development, reduced learning ability, harm to unborn children, high blood pressure, cardiovascular disease and kidney damage.
In Uganda, lead exposure concerns also extend to household products and informal markets. Aluminium pots and saucepans, particularly low-cost locally fabricated items, may be made from recycled scrap metal. If contaminated materials are used, lead may leach into food during cooking or other food-contact use, creating a possible route of exposure in homes.
During the launch, Assoc. Prof. David Musoke, Head of MakSPH’s Department of Disease Control and Environmental Health, underscored the importance of involving stakeholders throughout the research process. He said engaging stakeholders from the generation of research ideas to implementation and dissemination helps ensure findings do not remain within the University but are translated into evidence that can inform policy, practice, and community action.
“We engage with stakeholders throughout the research process, from developing ideas and designing projects to implementation and dissemination,” Dr. Musoke noted. “I am pleased that this workshop brings together policymakers, the Ministry of Health, non-governmental organisations, Kampala Capital City Authority, academia, staff and students. This helps ensure that research findings do not remain at the University but are beneficial to our stakeholders.”
Assoc. Prof. David Musoke delivers remarks during the study launch, emphasising sustained stakeholder engagement to ensure research findings inform policy, practice and community action.
He observed that the study was timely, as it addresses an important yet under-examined public health concern, arguing that while lead exposure from paint, pipes and drinking water has received considerable attention, exposure through cookware remains less understood despite its widespread use in many households. He added that the new research builds on MakSPH’s broader work in disease control and environmental health and will generate critical evidence to inform action on lead exposure risks in Uganda. Dr. Musoke also commended the study team for initiating this work.
Previously, MakSPH researchers Mr. Abdullah Ali Halage, Mr. Tom Okade, Dr. James Muleme and Dr. Juliet Kiguli, together with Mr. Ahmada Zziwa and Mr. Robert Mugabi, assessed knowledge, perceptions and practices related to heavy metal contamination and health risks among residents living near Kiteezi in Kampala, Katikolo in Mukono and Nkumba in Entebbe. The study, done in 2024, reached 505 residents and captured community and frontline perspectives from people living and working around the dumpsites. It showed how daily contact with dumpsite environments may expose communities to toxic heavy metals such as lead, arsenic, cadmium, and mercury through soil, water, air, food crops, animal products and waste-handling practices.
Evidence from the study, funded by the Government of Uganda through the Makerere University Research and Innovation Fund (MakRIF) and disseminated on 26 June 2025, showed that heavy metal exposure risks around the three municipal dumpsites within the Kampala Metropolitan Area were shaped by both environmental conditions and community behaviour.
Dr. Sabrina Kitaka, Member of the MakRIF Grant Management Committee, pictured centre, with research team members including Mr. Abdullah Ali Halage, Mr. Tom Okade and Dr. Juliet Kiguli, following the dissemination of findings on heavy metal exposure risks around Kampala Metropolitan dumpsites on 26 June 2025.
Although residents lived near dumpsites where waste can release heavy metals into soil, water and food chains, 76.4 per cent could not define heavy metals, and only 45.9 per cent had adequate knowledge of contamination and related health risks. Gaps extended to daily exposure pathways, with 38.4 per cent unaware that vegetables grown near dumpsites may contain high heavy metal levels and 39.8 per cent unaware that milk or meat from animals grazed near dumpsites may also be contaminated. More than half viewed dumpsite soils as fertile, 50.7 per cent considered such milk safe, and 51.3 per cent believed dumpsite waste could be used as manure.
The study recommended stronger risk communication, environmental monitoring, safer land-use enforcement and community education. The work on lead in domestic cookware now extends this focus from dumpsite-related heavy metal exposure to a possible household pathway. Mr. Douglas Bulafu, an early-career researcher and Principal Investigator of the study, said the team will examine whether commonly used cooking pots, saucepans and related utensils contribute to exposure, and generate evidence to guide safer cookware use, standards and market oversight.
“Lead contamination has been documented from sources such as paint, fuel and air pollution, but less attention has been given to cookware as a potential pathway of exposure. That is the gap this study seeks to address,” Mr. Bulafu said. “We focused on Kampala because it has many informal settlements, small-scale cookware workshops and a large consumer market where low-cost cookware is widely produced, sold and used. When people buy these products, they often do not know where they were made, what materials were used, or whether they contain lead. The supply chains are also poorly understood, meaning households could be exposed without knowing.”
Mr. Douglas Bulafu, Principal Investigator, speaks during the launch of the MakSPH study on possible lead exposure from domestic cookware in Kampala, highlighting the need for evidence to guide safer cookware use, standards and market oversight.
The study will use a cross-sectional, mixed-methods design to connect laboratory evidence with supply-chain realities in Kampala’s informal settlements. The team will purchase about 100 cookware samples from open-air markets, roadside vendors, retail shops and supermarkets in Kisenyi, Katanga, Bwaise, Namuwongo, Banda and Kasubi, test them for total and leachable lead, and conduct about 30 key informant interviews across the supply chain to understand how cookware is sourced, produced, distributed and used.
Findings will be validated with stakeholders and used to identify feasible interventions, including stronger regulation and enforcement, raw-material control, better manufacturing practices, market surveillance and consumer awareness. The evidence is expected to support standards development, product testing, policy uptake, safer manufacturing practices and public guidance on cookware choices, helping reduce household exposure to lead and associated health risks.
Speaking on behalf of the Ministry of Health, Dr. Didacus Namanya, a health geographer and environmental health expert, welcomed the study, saying scientific evidence on lead exposure is critical because public health decisions can have lasting consequences for life and wellbeing.
Dr. Namanya implored the research team to ensure the evidence from the study informs decisions beyond academia, shaping policy, strengthening public health practice and guiding practical measures to reduce lead exposure in communities. He emphasised that research should not remain in the “ivory tower” but reach decision-makers and the public, so that evidence from the study translates into policy, practice and stronger protection for communities.
Dr. Didacus Namanya, speaking on behalf of the Ministry of Health, delivers remarks during the study launch on 11 June 2026, urging the research team to ensure evidence on lead exposure informs policy, practice and practical community protection measures.
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