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Hearing Clinic Launched at Makerere University Hospital

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A Hearing Clinic and Temporal Bone Laboratory were launched on 15th August 2023 at the Makerere University Hospital (MakHosp). The clinic and laboratory are operated by the Department of Ear, Nose, Throat (ENT), Head and Neck Surgery, School of Medicine, Makerere University College of Health Sciences (MakCHS). The clinic which is the first to be established in a Public Hospital will manage persons with hearing impairments as well as support research in Uganda.

The Principal Investigator for the project Dr. Christopher Ndoleriire who also heads the Department of ENT at MakCHS thanked the partners who have supported the project since inception. These included Makerere Research and Innovation Fund (MakRIF), Austrian Development Agency, MED-EL, Professor Tom Roland Jr (NYU), Rotary Club of Kololo; and Hear His Voice Uganda.

The Project Principal Investigator also Head of the Department of Ear, Nose, Throat (ENT), Dr. Christopher Ndoleriire with some of the partners at the Audiology Clinic. Makerere University Hospital, Kampala Uganda, East Africa.
The Project Principal Investigator also Head of the Department of Ear, Nose, Throat (ENT), Dr. Christopher Ndoleriire with some of the partners at the Audiology Clinic.

He said, ‘all age groups can have hearing impairment (HI) however Children with HI face many challenges such as barriers in communication, discrimination, child labour, violence, etc. The challenges of HI do not enable these children to grow to their full potential.  Thus their rights to education, health, interaction and play are hindered. This is due to the lack of knowledge and skills on how to screen and manage HI in these children. Therefore, there is a great need to screen, manage and empower children with HI so as to thrive through life.

The cost of not identifying and managing hearing impairment in children at an early age is very high both to the parents and to the government. It`s against this background that a research project linking four main hospitals to asses hearing impairment among children (0-59months) in Uganda was conceived and started.

The Plaque at the Audiology Clinic. "Project Name-Uganda Hearing Centre. In Memory of Dr. Irwin Stewart. PROJECT NO. GG1866567. This Audiology Clinic was donated by Rotary International in collaboration with The Rotary Clubs of Kololo-Kampala D9213, New Westminster District 5040, Makerere University Hospital, The Department of ENT, College of Health Sciences Makerere & Hear His Voice Uganda."
The Plaque at the Audiology Clinic. “Project Name-Uganda Hearing Centre. In Memory of Dr. Irwin Stewart. PROJECT NO. GG1866567. This Audiology Clinic was donated by Rotary International in collaboration with The Rotary Clubs of Kololo-Kampala D9213, New Westminster District 5040, Makerere University Hospital, The Department of ENT, College of Health Sciences Makerere & Hear His Voice Uganda.”

The clinic which opened in October 2022 provides hearing screening and hearing diagnostic services to the University and community at large. It also conducts and coordinates hearing impairment research in a bid to create a database for hearing loss burden in Uganda. The clinic oversees hearing screening services in other 4 main hospitals namely; Kawempe National Referral Hospital, Masaka Regional Referral Hospital, Mbarara Regional Referral Hospital, Gulu Regional Referral Hospital.

The Partners tour the Audiology Clinic. Makerere University Hospital, Kampala Uganda, East Africa.
The Partners tour the Audiology Clinic.

To-date, over 1,000 children have been screened since April 2023 at the collaborating hospitals, 16 have visited Makerere University Hospital; 795 at Kawempe Hospital; 780 Masaka Regional Referral Hospital; 180 at Gulu Regional Referral Hospital; and 240 at Mbarara Regional Referral Hospital. All the patient data at the hospitals is interlinked and stored in a central system at MakHosp for tracking and follow-up of referred cases.

Dr. Christopher Ndoleriire gives the partners a guided tour of the Temporal Bone Laboratory. Makerere University Hospital, Kampala Uganda, East Africa.
Dr. Christopher Ndoleriire gives the partners a guided tour of the Temporal Bone Laboratory.

In addition, a temporal bone dissection laboratory has been set up to help train graduate ENT students in surgical management of ear disease and hearing impairment. This facility at MakHosp is open to other ENT professionals to continually improve their skills at a reasonable fee.

Some of the Partners that attended the launch follow proceedings. They included Dr. Sam Zaramba, Former Director General of Health Services (Right). Makerere University Hospital, Kampala Uganda, East Africa.
Some of the Partners that attended the launch follow proceedings. They included Dr. Sam Zaramba, Former Director General of Health Services (Right).

Professor Josaphat Byamugisha, Director-MakHosp explained that the clinic was opened in memory of Dr. Irwin Stewart from Canada who spearheaded improvement of hearing health in Africa, particularly Uganda. He recommended that babies` hearing should be checked within the first month of life to treat any defects early.

Professor Josaphat Byamugisha addresses participants at the launch. Makerere University Hospital, Kampala Uganda, East Africa.
Professor Josaphat Byamugisha addresses participants at the launch.

Professor Byamugisha thanked Makerere University management and the Ministry of Health for the support. He requested government to employ Audiologists, more speech and language therapists. Professor also added, ‘it is good to celebrate our successes; MakHosp is expanding and the addition of the hearing clinic is one of the new developments’. He advised that feedback from members that visit the hospital is welcome to inform future developments.

Alex Muhwezi, President, Rotary Club-Kololo delivers his remarks. Makerere University Hospital, Kampala Uganda, East Africa.
Alex Muhwezi, President, Rotary Club-Kololo delivers his remarks.

Alex Muhwezi, the president, Rotary Club-Kololo congratulated Makerere University, MakHosp and MakCHS on the launch of the hearing clinic. He thanked the partners for the contributions made to realise the milestone. He added, ‘I am proud of the contribution by Rotary to launch the facility. The clinic has opportunity to be a regional centre of excellence. Rotary contributed $150,000 towards renovation of the hearing clinic, installation of equipment in the temporal bone laboratory, training of specialists as well as outreach services.

Professor Annettee Nakimuli congratulated the Hospital on the new development. Makerere University Hospital, Kampala Uganda, East Africa.
Professor Annettee Nakimuli congratulated the Hospital on the new development.

Professor Annettee Nakimuli, Dean – School of Medicine, MakCHS represented the Principal, Professor Damalie Nakanjako and Vice Chancellor, Professor Barnabas Nawangwe. In her remarks, the Dean said ‘the Vice Chancellor and Principal send congratulations to MakHosp and partners on the new development’

The Hearing Clinic and Temporal Bone Laboratory Project signage at the Makerere University Hospital. Kampala Uganda.
The Hearing Clinic and Temporal Bone Laboratory Project signage at the Makerere University Hospital. Kampala Uganda.

Professor Nakimuli noted, ‘many partnerships don’t bear fruit and opening the hearing clinic is an opportunity for all partners here to pat yourselves on the back for the achievement, expressing that as a school we are proud of the ENT department for this milestone’. Teaching, learning, research and community service are a mandate of the university and following celebration of 100years of Makerere University, partnerships are a key feature as we embark on the next 100, she added.

One of the buildings at the Makerere University Hospital that houses the Temporal Bone Laboratory. Kampala Uganda.
One of the buildings at the Makerere University Hospital that houses the Temporal Bone Laboratory.

‘For a long time, universities were ivory towers, but we must go to the communities to help solve challenges. Communities don’t only want a healthy life but also achieve their full potential’. The dean also commended the ENT department for getting good friends, noting that Uganda has about 60 specialists in this area and more are needed.

Dr. Daniel Kyabainze speaks on behalf of the Director General, Ministry of Health. Makerere University Hospital, Kampala Uganda, East Africa.
Dr. Daniel Kyabainze speaks on behalf of the Director General, Ministry of Health.

The Director-Public Health at MoH, Dr. Dan Kyabainze, represented the Director General, MoH. He emphasised that government appreciates support from the various partners. He congratulated Makerere University, MakHosp on the developments and pledged government support to the hearing clinic.

Zaam Ssali

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MakSPH 2024 Annual Report

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Partners from the Ministry of Health, WHO, and Makerere University leadership, including Council Chairperson Ms. Lorna Magara, Vice Chancellor Prof. Barnabas Nawangwe, and Dean Prof. Rhoda Wanyenze, join the Minister of Health in cutting the MakSPH@70 anniversary cake. 13th December 2024, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.

It is with great pride and gratitude that I present the 2024 Annual Report of the Makerere University School of Public Health (MakSPH). The past twelve months have been a time of remarkable achievements, significant progress, and renewed commitment to shaping the future of public health.

This report captures some of the highlights that reflect the resilience, innovation, and impact that define our community. 2024 was both an extraordinary and transformative year. We successfully concluded our strategic plan and launched a bold new five-year roadmap (2025–2030), positioning us to respond swiftly to the evolving public health landscape.

The year was especially productive—marked by impactful research, evidence generation, and strengthened partnerships across Uganda, the African region, and globally. Our work continued to demonstrate that we do not simply publish findings—we produce evidence that shapes national policy, informs practice, and addresses real-world public health challenges.

I am deeply privileged to lead this vibrant community of educators, researchers, students, and partners. I extend my sincere appreciation to my colleagues for their exceptional commitment—whether delivering outstanding education, driving research and innovation, or creating an inclusive and welcoming environment. I also thank Makerere University Council, the University Management, , our students, alumni, and partners for their unwavering support; each plays a vital role in advancing our mission.

Despite a challenging global context, we look ahead with great optimism. We have equipped our staff and students with the skills and resilience to thrive amidst uncertainty. In 2024, we celebrated 70 years of impact—seven decades of transformative contributions to public health in Uganda, the region, and beyond. Our legacy in HIV/AIDS research, family planning, maternal and child health, infectious disease control (including COVID-19, TB, and malaria), and health systems strengthening is profound.

MakSPH remains a powerhouse of research at Makerere University, consistently attracting nearly half of the University’s research grants. In the past five years, we have worked in collaboration with universities and research institutions across 25 countries in Arfrica and established strong global partnerships, reinforcing our role as a leader in public health innovation and capacity building.

A landmark achievement was our transition into a standalone School in January 2025, following approval by the Makerere University Council. This new status heralds a transformative phase—enabling us to expand our reach, deepen our impact, and respond with agility to contemporary public health challenges.

In line with this growth, we launched our taught PhD program—designed for early-career and mid-career professionals, as well as strategic level leaders, seeking to strengthen their skills in public health research and leadership.

The School is undertaking a major infrastructure project, the construction of our new home at Makerere Main Campus—which is steadily taking shape into a premier centre for public health training, research, and community engagement. This investment will strengthen our capacity to deliver impact in Uganda, and beyond. We hope that the building will ease the critical space needs for our staff, students, and partners. We are grateful to all individuals, agencies, government bodies, and partners who have supported this transformative endeavor. We warmly welcome further support to help us complete this important project and advance public health for generations to come.

As we move forward, our resolve remains steadfast: to shape health outcomes, empower future generations, and strengthen the resilience of communities across Africa and beyond. We thank you for your continued support to Makerere University and the School of Public Health in particular. Together, we are shaping health, empowering the future, and building a brighter tomorrow.

Dr. Rhoda Wanyenze
Professor and Dean, School of Public Health, Makerere University

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TB in Prisons Eight Times Higher Risk than General Population in Uganda, Study

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L-R: Mr. Samuel Akena, Deputy Commissioner General of Prisons; Dr. Simon Kasasa, the Principal Investigator; Dr. Charles Olaro, Director General of Health Services, MoH; and Professor Rhoda Wanyenze, the Dean, School of Public Health, at the launch of the survey. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.

Nearly half of Uganda’s prison population has latent tuberculosis (TB), according to the latest Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19. The survey, released on May 15, 2025, found that active TB cases in prisons stand at 1,900 per 100,000—eight times higher than in the general population.

The survey was conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC)—and purposed to have a more profound understanding of TB to help inform public health programs for this high-risk population.

Dr. Simon Kasasa, a Senior Lecturer at MakSPH and Principal Investigator of this study, stressed that “staying for a longer duration, three years and above, posed a greater risk to TB infection in prison.” He also noted TB infection was much higher among male prisoners (48%) compared to female prisoners (38%) and among those of older age, 65 years and above. Meanwhile, the report noted concerns about excessive numbers in prisons as a key risk factor for TB transmission.

Dr. Simon Kasasa, a Senior Lecturer at MakSPH and Principal Investigator of this study presenting the findings. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Dr. Simon Kasasa, a Senior Lecturer at MakSPH and Principal Investigator of this study presenting the findings.

UPS consists of 257 prisons spread over 16 administrative regions with an average prisoner population of 56,400 (95% male), accommodation capacity of 16,612 (340%), and 9,904 staff (29% female).

HIV prevalence among prisoners was also alarmingly high at 11%, twice that of the general population. Notably, female persons in prison (PIP) had the highest HIV rates at 21%, compared to 11% for male PIP and just 2% among prison staff. However, the data also showed a significant drop in overall HIV prevalence within prisons, falling from 15% in 2013 to 11% in 2023, with the most dramatic decline among staff, from 12% to 2%.

A section of officers keenly follows proceedings. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
A section of officers keenly follows proceedings.

Dr. George Tumusinze, a Program Manager and Research Associate, pointed out that although 92% of people with HIV in prisons know their status and 99% are receiving antiretroviral therapy (ART), only 70% have successfully reduced the virus in their bodies, highlighting important issues with how well the treatment is working.

Dr. George Tumusinze, a Program Manager and Research Associate presenting results of HIV prevalence and burden in Uganda Prisons. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Dr. George Tumusinze, a Program Manager and Research Associate presenting results of HIV prevalence and burden in Uganda Prisons.

Mr. Samuel Akena, the Deputy Commissioner General of Prisons, echoed these concerns by stating that the survey represents a significant milestone for the Prisons, not only in terms of data collection but also in Uganda’s journey towards achieving equity, justice, and the right to health for all. “This survey is historic. It represents one of the most comprehensive efforts to understand the health status of people in prisons in Uganda.” He emphasized the necessity of a collective and bold response, urging that “the time for piecemeal responses is over.”

Dr. Charles Olaro, Director General of Health Services at the Ministry of Health, emphasized the urgency of the situation, stating, “As we gather today to reflect on the findings of this important survey, we must recognize the urgent need for action in our fight against tuberculosis (TB) in Uganda. Despite our efforts, we are still grappling with the burden of this disease, and our progress toward eliminating it by 2030 has not been as swift as we had hoped.” He pointed out that the survey serves as a critical baseline that will shape future responses and guide resource allocation.

Dr. Charles Olaro, Director General of Health Services at the Ministry of Health interacts with officers of the Uganda Prisons Service, at the MakSPH Auditorium on Thursday. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Dr. Charles Olaro, Director General of Health Services at the Ministry of Health interacts with officers of the Uganda Prisons Service, at the MakSPH Auditorium on Thursday.

HIV prevalence among prison staff members was the lowest, at just 2%, reflecting a significant achievement in workplace health. Dr. Daniel Byamukama, Head of HIV Prevention at the Uganda AIDS Commission, praised prison authorities for their efforts, noting the remarkable progress over the past decade. In the first survey in 2013, only 34% of HIV-positive staff on treatment had achieved viral load suppression. Today, that figure has reached an impressive 100%, underscoring the impact of sustained prevention and care efforts.

While the prison HIV program has shown effectiveness—evidenced by a drop in prevalence from 15% to 11% among the prisoners over the past decade—Mr. Akena stressed the importance of prioritizing gender-responsive strategies in health interventions.

“Diseases do not recognize bars or borders. They thrive in environments where conditions are poor and resources are scarce. Women in prison face disproportionately higher risks, yet often remain invisible in program planning. This is not acceptable. If we are serious about health equity, we must prioritize gender-responsive strategies — within prison health systems and beyond,” Mr. Akena.

Mr. Samuel Akena, the Deputy Commissioner General of Prisons speaking at the release of results of the survey. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Mr. Samuel Akena, the Deputy Commissioner General of Prisons speaking at the release of results of the survey.

CDC Uganda Director Dr. Adetinuke (Mary) Boyd reinforced the significance of the survey in addressing public health risks. “In Uganda, CDC partners are helping to ensure inmates stay healthy during custody. This work facilitates safe reintegration into their communities, mitigates disease transmission to the general population, and reduces public health risks like untreated TB,” she stated. Dr. Boyd highlighted the role of PEPFAR in tackling critical global health threats, asserting that the survey offers helpful data for enhancing health collaboration within this vulnerable population.

The U.S. CDC has been supporting Uganda Prisons Services to provide comprehensive HIV/AIDS, STI, and TB prevention, care, and treatment services for the last 15 years (2010–2025), totaling over $18,046,263 in investment—including $550,000 to this study alone, through the Makerere University School of Public Health. The program supports capacity building, scale-up, and health system strengthening efforts in HIV/TB testing, care, and support for prisoners and prison staff, plus surrounding communities.

Part of the audience follows proceedings during dissemination. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Part of the audience follows proceedings during dissemination.

With 80% of prison wards overcrowded and 95% lacking adequate natural ventilation, the conditions in which these individuals live exacerbate the spread of infectious diseases, public health specialists have warned. This survey underlines the urgent need for systemic changes within the prison health system, as well as a commitment to uphold the rights and health of all individuals, regardless of their circumstances.

As Uganda grapples with these alarming statistics, the call to action is clear. Stakeholders must come together to implement effective health interventions, improve screening and treatment protocols, and ensure that the rights of incarcerated individuals are respected. The health of the general population is inextricably linked to the health of those within prison walls, and addressing these challenges is not just a moral imperative but a public health necessity.

Professor Rhoda Wanyenze compares notes with Mr. Samuel Akena during the event. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Professor Rhoda Wanyenze compares notes with Mr. Samuel Akena during the event.

Professor Rhoda Wanyenze, one of the investigators and Dean of the School of Public Health, asserts that the Survey findings are a wake-up call for stakeholders to prioritize health equity and justice for society’s most vulnerable members.

Prof. Wanyenze advocated for improved TB screening methods and institutionalization of regular mass TB screening using the WHO-recommended advanced diagnostic tools like digital chest X-rays with Computer-Aided Detection (CAD), as well as molecular diagnostics like GeneXpert and TB LAM, noting that traditional symptom-based screening missed nearly half of TB cases. “The use of molecular diagnostics like GeneXpert significantly improved case detection in our study,” she added, emphasizing the importance of timely diagnosis and treatment.

Professor Rhoda Wanyenze, one of the investigators and Dean of the School of Public Health delivering her remarks. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Professor Rhoda Wanyenze, one of the investigators and Dean of the School of Public Health delivering her remarks.

Uganda Prisons Service, in partnership with the Ministry of Health, has so far installed 14 GeneXpert machines in medium- to high-volume prison health facilities.

While some, including Members of Parliament, have raised concerns about the potential infringement on individual rights through mandatory TB testing in prisons, Dr. James Kisambu, the Commissioner for Prison Health Services, noted that it is now apparent, with these findings, for everyone to appreciate that in such confined settings, the risk of transmission is extraordinarily high. TB testing in these settings is not just a medical practice but also a crucial public health precaution that protects both prisoners and the wider community.

“Prisons are high-risk, high-transmission environments where one undetected case can rapidly escalate into an outbreak. In such settings, the right to refuse testing must be weighed against the right of others to be protected from infection. Mandatory TB screening, when done with dignity and linked to prompt treatment, is not a violation of rights — it is an essential public health measure to protect both people in prison and the communities they return to,” said Dr. James Kisambu.

Dr. James Kisambu, the Commissioner for Prison Health Services speaking during a panel discussion at the dissemination and data utility meeting at the MakSPH Auditorium. Release of findings of Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 conducted by Makerere University School of Public Health (MakSPH) in conjunction with the Uganda Prisons Services (UPS) and the Ministry of Health—with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and technical support from the U.S. Centers for Disease Control and prevention (CDC), 15th May 2025, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Dr. James Kisambu, the Commissioner for Prison Health Services speaking during a panel discussion at the dissemination and data utility meeting at the MakSPH Auditorium.

The researchers from MakSPH were; Dr. Simon Kasasa, Associate Professor Esther Buregyeya, Dr. George Tumusinze, Dr. Simon Walusimbi, Dr. Dick Kasozi, Dr. Ronald Senyonga, John Baptist Bwanika, Prossy Nabaterega and Professor Rhoda Wanyenze.

Additionally, the study team from the Uganda Prisons Service comprised of Dr. Leonard Marungu, Charles Butagasa, Dr. James Kisambu and Dr. Johnson Byabashaiza, the Commissioner General of Prisons.

Finally, Dr. Deus Lukoye, Dr. Julius Ssempiira, Charles Kavuma, Rise Nakityo, Samuel Sendagala, Grace Nantege, Lisa Mills, Dr. Lisa Nelson, Kenneth Mwambi from U.S. CDC Uganda/Atlanta and PEPFAR USG agencies, and George William Kasule, Didas Tugumisirize, Dr. Simon Muchuro, Professor Moses Joloba, Dr. Turyahabwe Stavia from the Uganda Ministry of Health National TB and Leprosy Program (NTLP) completed the team.

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MakSPH Champions Leadership Boost for Wakiso Health Managers

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A group photo of delegates during the Leadership and Management dissemination workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating 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 implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.

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.

Dr. David Musoke speaking during the dissemination workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating 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 implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
Dr. David Musoke speaking during the dissemination workshop on April 23, 2025.

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.

A group photo with the Wakiso district health managers during the dissemination workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating 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 implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
A group photo with the Wakiso district health managers during the dissemination workshop on April 23, 2025.

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.

Dr. Sarah Byakika awarding a certificate to the Cohort President, Mr. Mathias Sserwanga, the In-charge of Namulonge Health Centre III in Nansana Municipality during the workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating 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 implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
Dr. Sarah Byakika awarding a certificate to the Cohort President, Mr. Mathias Sserwanga, the In-charge of Namulonge Health Centre III in Nansana Municipality during the workshop on April 23, 2025.

“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.

Mr. Kakande speaking during the dissemination event at Makerere University School of Public Health on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating 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 implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
Mr. Kakande speaking during the dissemination event at Makerere University School of Public Health on April 23, 2025.

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.

Dr. Sheba Gitta (right) sharing with Prof. Linda Gibson during the dissemination workshop on April 23, 2025. Makerere University School of Public Health (MakSPH) disseminating 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 implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Uganda’s Ministry of Health, 23rd April 2025, MakSPH Auditorium, Kampala, East Africa.
Dr. Sheba Gitta (right) sharing with Prof. Linda Gibson during the dissemination workshop on April 23, 2025.

“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.

John Okeya

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