Health
An Indigenous Community-Led Model to Address Type 2 Diabetes: Through Evidence Informed Cross-Cultural Learning and Adaptation in Uganda
By Joseph Odoi
Globally, an estimated 462 million individuals are affected by type 2 diabetes, corresponding to 6.28% of the world’s population. In high-income regions like Europe, of all persons with Type 2 Diabetes Mellitus (T2DM), 39.3% are undiagnosed. Low-income countries in Africa have the highest prevalence of undiagnosed diabetes, estimated at 66.7%. In Uganda alone, a steady increase in the number of diabetes cases has been observed in various regions
Despite the increasing burden of Type 2 diabetes in the country, there is hardly any Community-led Behavioral Science oriented change model to address the risky factors that increase chances of developing Non-Communicable Diseases including Type 2 diabetes among Rural Population in Uganda.
To counter this implementation science – practice gap, researchers from Makerere University led by Dr Juliet Kiguli have embarked on a journey to develop and pilot-test a community-led Behavioral Change Model in Teso, Lango, Busoga and among the Samia cultural groups in Uganda. This Development follows a study by Makerere University researchers with funding from Government of Uganda and Makerere University Research and Innovations Fund (Mak-RIF) who sought to understand the patterns of socio-cultural norms in two high incidence districts namely, Busia and Bugiri, in Eastern Uganda.
While facilitating at the cross-cultural learning event in late July 2023, Ramadhan Kirunda one of the Co-Principal Investigators noted that addressing Type 2 Diabetes requires a cross-cultural approach where communities take lead in identifying drivers of T2D and also share what works in context to their areas.
Ramadhan noted that the team is developing a behavioral change approach for type 2 diabetes risky factors because this condition is a behavioral and lifestyle disease. We are planning to engage religious leaders, cultural leaders, local leaders (LC1s), health workers, para-social workers, VHTs, husbands, wives, and in-laws in co-designing and co-implementing this change behavioral change approach. This intervention is designed to look at the community and the affected people as implementers as opposed to looking at them as beneficiaries of the intervention – hence the potential for sustainable change is high. In addition, it targets some duty bearers and thus social accountability for healthy behaviours can be enhanced. This study started as an “exploratory to co-design to pilot testing to implementation” study, making it one of the few that directly link research and practice.
At this event, Dr. Gerald Mutungi, Assistant Commissioner of Non-Communicable Diseases (NCDs) at the Ministry of Health, emphasized the seriousness of Type 2 Diabetes and its significant consequences. He highlighted the urgent need to address this issue effectively.
Dr. Mutungi further noted that ‘’While there are established interventions recommended by the World Health Organization (WHO) and other advising agencies, it is encouraging to see efforts being made to find local solutions for Type 2 Diabetes’’. He added that this study is of great importance as it will provide us with valuable insights into the factors contributing to the increase of Type 2 Diabetes in our local communities. Furthermore, it will enable us to understand the perspectives of local stakeholders and leaders, informing us about effective strategies specific to our context, rather than simply adopting approaches from countries like Switzerland or the USA.
Regarding the factors contributing to the rise of Type 2 Diabetes, Dr. Mutungi said, “Ugandans are continuously eating poorly. They say they are eating well but eating badly by consuming processed foods, fried foods, and fast foods.” He also highlighted the issue of physical inactivity, stating, “Ugandans are becoming physically inactive because they are using motorized transport even where they could have walked. They spend a lot of time in offices and go to sleep.”
On the significance of the study, Dr. Gerald noted, report from the study will inform programming and action around Type 2 Diabetes in Uganda.
Andrew Ochole, the Deputy Prime Minister of the TESO Cultural Union, expressed his sincere appreciation to Makerere University and the Fidelitas Scientific Execution Facility for their pioneering efforts in conducting the first-ever Type 2 Diabetes Study in the Teso Region.
’Despite Type TWO Diabetes being a killer, No Type TWO Diabetes Research has never been done in TESO and no one has been coming up to find local ways of lowering even when we have peculiar and shared norms that facilitate Type 2 Diabetes, I’m happy that Makerere University has taken up this initiative and we are ready to take it up as a community’’ explained Ochole.
He further reaffirmed TESO’s commitment to collaborate with researchers and development partners, such as Fedelitas, who are working alongside Makerere University in this study adding that Teso Cultural Union is prepared to actively disseminate the study’s innovations to educate and raise awareness among its community members in an effort to address Type 2 Diabetes.
In his remarks, the District Health Officer (DHO) of Busia District, Dr. Fredrick Ouma, emphasized the importance of recognizing that the world is a global village, with norms that cut across boundaries adding that there is an alarming prevalence of non-communicable diseases (NCDs) in Uganda which can’t be ignored.
To address these health challenges, the DHO stressed the need to develop and disseminate messages that can effectively raise awareness and educate the community about Type 2 Diabetes.
Additionally, Dr. Ouma emphasized the importance of sharing original and accurate information as reliable data is crucial for making informed decisions and designing effective interventions to address the health needs in the community.
In terms of Lifestyle, He urged participants to be role models by engaging in continuous exercise and adopting healthy lifestyles. By embodying these behaviors, health workers can inspire others in the community to follow suit and become agents of change according to him
According to Dr Juliet Kiguli – the Principal investigator, notes that this study is intended to change the implementation landscape for NCD programs. She underlined the importance of connecting research with indigenous local organizations like Fidelitas Scientific Execution Facility (Fidelitas), who can support research uptake, further resource mobilization and support scale-up of the innovations developed by researchers.
In his closing remarks at the Workshop, Mr John King Odolon, the CEO Fidelitas Scientific Execution Facility, emphasized the importance of active participation from all participants to drive change in addressing Type 2 Diabetes – noting that the participation and zeal should continue upto field level. He urged them to play their respective roles effectively, recognizing that collective efforts are needed to make a significant impact.
Looking ahead, Odolon mentioned that the valuable lessons learned from the Workshop would be disseminated across the four regions. This dissemination aims to ensure that the insights gained from the study reach a wider audience and contribute to addressing Type 2 Diabetes on a broader scale.
As part of the study, researchers actively engaged with various health stakeholders. These stakeholders shared their experiences and insights regarding the behavioral factors influencing Type 2 Diabetes. Their input and expertise added valuable perspectives to the study, enhancing its comprehensiveness and applicability.
More about the study
In the next phase, the team working with Fidelitas is going to pilot test the intervention, through piloting and spreading the type 2 diabetes desired future state messages for social norms change. This will be done through a quasi-experimental implementation research intervention in the four regions of Busoga, Teso, Lango and the Samia cultural groups. Stay tuned for the results, learning brief and a publication!
The 92nd Guild Ministry of Health is set to host the Annual Makerere Guild Medical Camp, a two-day outreach that will bring free and essential medical services to students, staff, and the surrounding community. The camp will run from 17th to 18th September 2026, from 8:00am to 5:00pm each day, at the Freedom Square.
Themed around promoting student wellness for academic excellence, the medical camp is organised under the leadership of Hon. Wamezaya Ebenezer, the Minister of Health in the 92nd Guild Government, in alliance with several partner organisations supporting the university’s health and wellness agenda. The initiative reflects a growing recognition within student leadership circles that academic performance is closely tied to the physical and mental wellbeing of the university community.
Comprehensive Range of Services
The medical camp will offer a wide range of services designed to address both routine and specialised health needs. On the general health side, attendees will have access to general and specialist medical consultations, allowing students, staff, and community members to seek professional advice on a variety of health concerns without the usual costs associated with private or even public healthcare.
Screening services will also be a central feature of the camp. Organisers have confirmed that sickle cell testing, malaria rapid diagnostic testing, and HIV screening will be available on site, giving participants the opportunity to know their status and receive guidance on appropriate next steps. Eye care services and laboratory diagnostics will round up this category, addressing common but often neglected areas of student health.
Beyond diagnostics and consultations, the camp will provide free essential medicines to those who need them, easing the financial burden that often accompanies treatment even after a diagnosis has been made. Reproductive health counseling will also be offered, giving students a confidential space to discuss matters that are frequently overlooked in general campus health conversations. Mental health counseling completes the list of available services, an inclusion that speaks to the increasing attention being paid to psychological wellbeing within the university community.
A Camp Open to the Wider Community
While the camp is organised by the Guild Ministry of Health and centred on student welfare, its reach extends beyond the student body. Organisers have made it clear that the free medical services will be available to students, staff, and members of the whole Makerere community, positioning the event as a broader public health contribution rather than a strictly internal university affair. This inclusive approach mirrors similar outreach efforts previously undertaken by student leadership and university departments, which have sought to position Makerere University not just as a centre of learning but as an active contributor to community welfare in the areas surrounding its campuses.
Freedom Square, long regarded as the symbolic heart of student activity and expression at Makerere University, was selected as the venue for the two-day event. Its central location and historic significance make it an accessible and fitting site for an initiative of this scale, expected to draw considerable numbers of participants over the course of the camp.
Health as a Pillar of Academic Success
The organisers have anchored the medical camp around the message of promoting student wellness for academic excellence, a theme that underscores the connection between health and academic performance. University life often places significant demands on students, both physically and mentally, and untreated health concerns can quietly undermine academic progress long before they become visible crises. By bringing screening, treatment, and counseling services directly to students at no cost, the Guild Ministry of Health is addressing barriers that might otherwise prevent students from seeking care, whether due to cost, distance, or stigma, particularly around mental health and reproductive health matters.
The inclusion of mental health counseling alongside more traditional physical health services is particularly notable. It signals an evolving understanding among student leaders that wellness cannot be addressed through physical checkups alone, and that psychological support deserves equal standing within campus health initiatives. Similarly, the presence of reproductive health counseling reflects an effort to normalise conversations that many young people find difficult to initiate on their own.
What to Expect
Over the two days, participants can expect a structured environment at Freedom Square, with separate service points catering to the different categories of care on offer. Medical professionals will be on hand to conduct consultations and screenings, while counselors will provide guidance on reproductive and mental health matters in a setting designed to protect privacy and encourage openness.
Given the scale of services on offer and the open invitation extended to staff and community members in addition to students, organisers anticipate strong turnout throughout the two-day period. Those interested in attending are encouraged to plan their visits within the stated hours of 8:00am to 5:00pm to take full advantage of the services available.
For any inquiries regarding the medical camp, members of the university community and the public have been directed to reach out to Hon. Wamezaya Ebenezer, the Minister of Health, through the contact provided by the Guild Ministry of Health.
Building on a Guild Tradition
The Annual Makerere Guild Medical Camp is not a new concept within student governance at the university. Successive Guild Ministries of Health have used the medical camp as a recurring platform through which they translate campaign promises around student welfare into visible action. Each edition tends to build on the lessons of the one before it, with organisers typically expanding the range of services offered as new partnerships are secured and as feedback from previous camps is incorporated into planning.
This year’s edition, organised under the 92nd Guild Ministry of Health, appears to place particular emphasis on breadth of service, combining preventive screening, curative consultation, and psychosocial support within a single two-day window. The decision to bundle sickle cell testing, malaria and HIV screening alongside eye care and laboratory diagnostics suggests an intention to make the camp a one stop point for health assessment, reducing the need for participants to seek out multiple providers across the city for basic checks they might otherwise postpone indefinitely.
Why Timing Matters
The scheduling of the camp in September places it at a point in the academic calendar when many students are settling back into campus life after recess, a period during which health concerns accumulated over the break, whether physical ailments left unattended or emerging mental health pressures tied to academic anxiety, tend to surface. Offering free consultations and counseling at this juncture allow students to address these concerns early, before they compound into more serious complications that could interfere with coursework, examinations, or general campus participation.
For staff members and residents of the areas surrounding the university, the timing also offers a convenient opportunity to access services that might otherwise require travel to distant health facilities or extended waiting periods within an already strained public health system. In this sense, the camp functions as a modest but meaningful supplement to existing healthcare provision in the vicinity of the university.
As the 17th of September approaches, the Annual Makerere Guild Medical Camp stands as another example of the Guild Ministry of Health stepping beyond the boundaries of policy and advocacy into direct, hands-on service delivery, a model that continues to shape the character of guild ministries at Makerere University. Students, staff, and members of the surrounding community are encouraged to take advantage of the free services on offer and to look out for further communication from the Guild Ministry of Health as the event draws closer.
For more info, reach Hon. Wamezaya on +256 784 541248
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