Health
Global Conversations: Climate Change Multiplies Health Risks, A Call to Action on Extreme Weather Effects
By Davidson Ndyabahika, Johanna Blomgren and Julius T. Mugaga
Experts have urged urgent action to mitigate the health risks of climate change. The 2023 global conversation, on Climate Change and Health highlighted the need for transformational action in every sector to protect people’s health from climate change.
Held on September 5, 2023 the virtual seminar, organized by the Centre of Excellence for Sustainable Health (CESH), a collaboration between Makerere University and the Karolinska Institutet that aims to increase capacity and spur action to advance the agenda for sustainable health drew over 230 attendees from all over the world. It placed emphasis on mitigating the effects of extreme weather, such flooding.
In its 2023 report, the Intergovernmental Panel on Climate Change (IPCC) notes that global terrestrial, freshwater, and ocean ecosystems have already been affected by climate change, along with the associated losses and costs. It predicts that heavy rainfall and flooding events are expected to worsen and occur more frequently in the majority of regions of Africa, Asia, North America, and Europe by 1.5°C global warming (high confidence).
The 2023 IPCC report identifies barriers that prevent people and society from implementing climate-resilient behaviors. Financial limitations, conflicts with the SDGs, inequalities, institutional, economic, and social hurdles, as well as dispersed strategies, are a few of these. The panel equally agree that if global warming exceeds 1.5 °C and the SDGs are not adequately progressed, chances for climate-resilient development would be considerably more limited.
Now, during the seminar, the panel, by consensus agreed that climate change is critical citing that such conversations on critical factors in relation to the climate and health crisis are not only timely but necessary.
Climate change impacts the social determinants of health, which include excellent health and wellbeing, by causing decreased food output, low fishing yields, flooding, and infrastructure damage, according to Daniel Helldén, a PhD student at KI Department of Global Public Health.
“The future emission scenarios are dire. What is becoming more and more clear is that climate change is a generational issue. Children born today will continue to bear the biggest burden of climate change impact,” said Helldén.
Dr. Mugume Isaac Amooti, the Director of Weather Forecasting Services at the Uganda National Meteorological Authority (UNMA), emphasized the importance of considering both long-term averages and unprecedented weather events driven by climate change. These events are thought extreme only when they exceed past records. He noted for instance that in Uganda; “The widespread flooding brought on by heavy and frequent precipitation is what we are seeing in Uganda, particularly in the cities. However, we are witnessing heat waves and cold waves at different times of the year.”
Although there isn’t a clear pattern in Sweden’s precipitation, Dr. Johanna Sörensen of Lund University in Sweden said that forecasts suggest that rainfall may increase by the end of the century. Given the flooding problems that already present, this, she says is something to worry about. “Flooding is increasing not only because of climate change but also even more that we construct the cities more densely and we construct buildings and industries on lowly areas that we used not to do in the past which is of course not a good idea.”
Dr. Tamer Rabie, a lead health specialist at the World Bank Group, notes that risks are amplified by climate change, which therefore has an intensified negative impact. He points out, for instance, that in order to comprehend how climate change and changes in temperature and precipitation patterns will affect health, it is critical to view climate change as a risk multiplier.
Dr. Tamer, also the architect of the World Bank’s global Health-Climate and Environment Program (H-CEP), underscored three pathways through which climate change impacts health: direct effects, indirect effects, and those mediated by ecosystems. Some of the direct pathways include issues like increased temperatures likely to lead to heat waves, heat-related illnesses, worsened non-communicable diseases, and increase in the risk of events like traumatic injuries.
According to Dr. Tamer, ecosystem-mediated risks include vector-borne diseases (like Malaria and Dengue), foodborne illnesses, and waterborne diseases (like Cholera). These risks are closely tied to how health outcomes are influenced by the ecosystem. Additionally, indirect health impacts encompass mental health due to population displacements, as well as malnutrition resulting from shifts in food production and overall food systems.
“We have done estimates in the World Bank that show that extreme weather events and climate change will lead to pushing nearly 132 million people into extreme poverty by 2030. If you look at the health impacts within those figures and the main drivers, we are seeing that nearly 44 million out of those 132 will be pushed into extreme poverty by 2030 if we don’t take any action today,” Dr. Tamer.
According to Dr. Tamer, the World Bank has conducted climate and health vulnerability assessments specifically looking at the cost of inaction moving into the 2030s and 2050s using information that relates to malaria, dengue, diarrhea, stunting in children, heat related illnesses, floods, among others.
“What we are seeing is that on average, countries will be losing anywhere between 1-5% of their GDP as a result of not really addressing the climate crisis, not being able to address these impacts that we are talking about, and obviously not investing enough into the health systems to be able to be more resilient,” Dr. Tamer noted during the webinar.
According to Dr. Sara Gabrielsson, an Associate Senior Lecturer in Sustainability Science at Lund University’s Centre for Sustainability Studies (LUCSUS), addressing immediate health risks involves containing flooding, which is just one aspect of climate change-related challenges like sea level rise and drought.
She highlights the connection between various deadly diseases like dengue, typhoid, trachoma, and cholera among others to this issue. During a crisis like flooding, treatment for these diseases she notes often takes a backseat due to the overwhelming health burdens that arise.
“There is death from drowning or direct injury from debris in these very storm surges, but then we also have the issue of just water sitting, waiting in water for longer periods, leading to lots of infections, urine-tract infections, vaginal infections, skin diseases, hypothermia, lots of those kinds of things, but also vector-borne diseases, and especially malaria, which is, of course, one big thing here,” Dr. Gabrielsson opines.
She adds that flooding brings problems like contaminated drinking water, leading to chronic diarrhea and malnutrition. Additionally, damaged sanitation facilities force people into open defecation, exposing them to harmful bacteria and further risk of chronic diarrhea.
“These immediate health risks are just the beginning. Moving into long-term risks, flooding severely impacts the availability of clean water for basic hygiene. As we’ve learned from COVID, hygiene is paramount for health. Insufficient handwashing and personal hygiene can breed disease. We need proper hygiene for preparing food, tending to babies, managing menstrual health, and more. Without it, there’s increased exposure to harmful bacteria, compounded by the use of inadequate sanitation systems, resulting in outbreaks of various diseases,” observed Gabrielsson.
Way forward
Dr. Sörensen, from a Swedish standpoint, proposes proactive steps to mitigate flooding. These include slowing down water flow, discouraging construction in flood-prone zones, and avoiding building in areas prone to heavy rain. She points out that in cities like Mumbai and Gothenburg, there has been a concerning trend of construction in flood-prone regions. Dr. Sörensen emphasizes the importance of adapting solutions for creating greener, more sustainable cities. “In China, they call it a sponge city. It’s like a sponge—you fill it up with water during rainfall and then use it later for various purposes. Utilizing vegetation and water storage helps retain water and slow down its flow in urban areas. Green spaces in cities are crucial for health, well-being, and providing shade, especially during heatwaves,” she says.
In Uganda, Dr. Mugume notes that the government has invested in weather monitoring infrastructure, including the three weather radars, which are strategically spread across the country to enable UNMA to monitor weather at any part of the country.
“With this technology, we can now offer more precise and timely services, ensuring our communities respond effectively. Weather and climate forecasts range from hourly to seasonal projections. Shorter forecasts tend to be more accurate, although longer ones still fall within manageable limits. For instance, our seasonal forecast accuracy in Uganda is at 90%, aligning with National Development Plan 3. We collaborate with development partners to fine-tune these forecasts.”
For Dr. Gabrielsson, preparedness is key, especially for the 2.2 billion people worldwide relying on sanitation systems, many of whom live in rapidly urbanizing areas and unplanned settlements.
Unfortunately, these systems often lack proper management, leading to health risks. In urban settings, she says, the spread of sludge from these systems can have widespread health implications. To address this, there’s a pressing need to prioritize climate-resilient sanitation systems. Historically, the sanitation sector has been under-prioritized, resulting in insufficient funding and political attention. Without a one-size-fits-all solution due to diverse living habits, cultural considerations become paramount. A gender-responsive approach is crucial, as women are primarily responsible for WASH (Water, Sanitation, and Hygiene) practices.
“It involves recognizing the unique needs of different groups, such as refugees, the elderly, disabled individuals, children, and menstruating individuals. Climate-resilient wash infrastructure requires community responsibility, government policy, and financial support. For instance, in flood-prone areas like the Amazon Basin, sanitation facilities are designed to align with local livelihoods, incorporating features like composting latrines that produce manure for farming and collecting rainwater for handwashing. This approach ensures environmental safety and sustainable practices,” she observes.
Dr. Gabrielsson emphasizes the importance of cultural acceptance in encouraging people’s dedication to upholding basic sanitation and hygiene practices, particularly in the face of flooding. “Another example I presented is a UNICEF-supported toilet in Bangladesh. It’s elevated with precast concrete rings to prevent flooding, sealed with concrete mortar for contamination prevention, and reinforced to withstand heavy rain and wind. This design was developed in close consultation with local communities, ensuring cultural acceptance and affordability. The goal is to create facilities that people actually want to use, which is why it’s crucial to integrate natural and social sciences for effective solutions.”
The World Bank has substantially supported action on climate change, including both adaptation and mitigation initiatives. Dr. Tamer says over $2.2 billion has been set aside as of today for climate-related health interventions, especially in South Asia and sub-Saharan Africa. Significant assistance has also been given to assist tiny island states in managing the effects of climate change, particularly extreme events.
In Yemen, the World Bank has sponsored efforts to put in place electronic early warning systems for real-time health data and policy response due to outbreaks of diseases including cholera and malaria. In Madagascar, the World Bank has funded work combining climate and nutrition programming. The World Bank worked with the government of Ghana to create long-lasting vaccine delivery networks.
In March 2020, Uganda slowed to a near standstill. Roads emptied. Clinics fell quiet. Fear moved faster than information. Many perceived COVID-19 as a virus to avoid. Others saw it as a barrier that stood between a mother and antenatal care, a child and routine immunization, and a patient and life-saving HIV medication. What followed was not only a public health emergency but also a test of whether health systems could keep doing the ordinary work of care while responding to the extraordinary.
In early December 2025, a question first asked with urgency during a global crisis resurfaced in a quieter, more reflective moment. On December 2, a single bound copy of Steven Kabwama’s doctoral thesis was fastened to a wooden board dubbed ‘The Wall of Fame‘ at Karolinska Institutet. The ritual, known as spikning, is modest in appearance but weighty in meaning: a thesis is made public, opened to scrutiny, and years of private intellectual labour are released into the world. For Kabwama, it marked the moment when research forged in the pressure of a global emergency became part of the public record, no longer his alone but open to collective examination.
The tradition stretches back centuries, often traced to Martin Luther’s public posting of his theses in the 15th century. But in Stockholm, on a winter afternoon, history gave way to something more immediate. Kabwama stood briefly by the wooden board with a hammer and fixed his work in place. The moment was less about ceremony than readiness. The research was complete. The questions were now open.
Three days later, on Friday, December 5, 2025, Kabwama publicly defended the thesis in a hybrid ceremony at Wretlindsalen in Solna, joined, both in person and online, by colleagues from Uganda, Sweden, and beyond. By then, the work, which examines how health systems sustain essential services during crises, had already begun to circulate, quietly shaping conversations about preparedness, continuity, and care.
What that bound document contained, however, had been forged years earlier, inside outbreaks, lockdowns, data sets, and long nights spent asking how health systems hold together when everything else is falling apart.
Steven Ndugwa Kabwama remembers the beginning not as a single crisis, but as a series of decisions, some made urgently, others too late. As an epidemiologist by training, Kabwama, who had spent years responding to outbreaks through Uganda’s Field Epidemiology Fellowship Program, clearly understood that outbreaks had patterns; they arrived, demanded attention, and eventually receded.
COVID-19 was different.
“It became clear very early on,” he recalls, “that the urgency of the response was going to affect everything else: malaria, immunization, maternal health, HIV. And yet, very little had been written about how systems are supposed to hold both at the same time.”
That realization would shape the next chapter of his life and, eventually, his PhD.
From Outbreak Response to System Questions
Kabwama’s academic journey did not begin in epidemiology. In 2006, he enrolled for a Bachelor’s degree in Food Science and Technology at Makerere University, a programme traditionally geared toward food processing, quality assurance, and industrial production. It is a discipline that prepares graduates for careers in manufacturing plants, laboratories, and supply chains, work that often unfolds far from clinics, outbreaks, and emergency response rooms.
Yet even then, his interests leaned beyond production lines and quality controls. He was drawn to how systems affect people’s health long before illness appears and how nutrition, safety, access, and policy intersect. That early grounding in systems thinking would later resurface in unexpected ways.
He went on to earn a Master of Science in Public Health from the University of Southern Denmark in 2013, supported by a Danish State Scholarship. It was there that population-level analysis sharpened his interest in data, surveillance, and health equity. But it was the Advanced Field Epidemiology Fellowship, jointly run by Makerere University School of Public Health (MakSPH), Uganda’s Ministry of Health, and the U.S. Centers for Disease Control and Prevention, that placed him directly inside emergencies, where evidence, decisions, and lives converge.
As a Fellow, his work stood out. He later received the Outstanding Fellow Award from the Uganda Public Health Fellowship Program (Field Epidemiology Track, Cohort 2015), recognition of his contributions to outbreak response, national non-communicable disease analyses, and policy work, including Uganda’s Alcohol Control Policy. “You respond, you stabilize, you move on,” he says. “But I kept asking myself—what happens to everything else while we’re responding?”
The arrival of COVID-19 made it impossible to delay these questions.
A Crisis Within the Crisis
As countries rushed to contain the virus, restrictions came swiftly: lockdowns, curfews, and travel bans. From a disease-control perspective, the logic was familiar and defensible. In outbreak management, 21 days is a standard epidemiological window, often used to break chains of transmission in infectious diseases. But during COVID-19 in Uganda, the phrase “therefore…another 21 days of lockdown” took on a different meaning altogether: The repeated phrase in presidential addresses stretched from a technical containment tool into a lived reality that reshaped access to care, livelihoods, and movement. From a health-system perspective, the consequences were profound.
Kabwama joined a multi-country research effort spanning Uganda, Nigeria, the Democratic Republic of Congo, Senegal, and Ghana, examining how countries attempted to maintain essential health services while responding to COVID-19. This work was spearheaded by Dr. Rhoda Wanyenze, a Professor of Disease Control, Researcher, Public Health Expert, and Dean of the School of Public Health at Makerere University. She was then a member of the COVID-19 Scientific Advisory Committee to the Ministry of Health.
Kabwama volunteered to lead the objective of documenting these experiences, an area he quickly realized was underexplored.
“Criticism is always easier in hindsight,” he reflects. “But generally, the considerations about how restrictions would affect access to essential health services were made after the fact.”
His doctoral research, later defended at Karolinska Institutet, set out to answer a deceptively simple question: How can health systems minimize disruptions to essential services during public health emergencies while emerging stronger afterward?
What the Data Revealed
Kabwama examined how health service use changed before and during the pandemic by using a mix of interrupted time-series analysis, document reviews, key informant interviews, and focus group discussions.
The findings were sobering.
Facility deliveries and outpatient visits dropped sharply during lockdown periods. Routine childhood immunizations declined, and DPT3 doses fell by more than 4 percent, with similar reductions across polio vaccines. Movement restrictions, fear of infection, and overwhelmed facilities combined to keep patients away.
But the story did not end there.
Where systems were adapted by integrating services, leveraging community health workers, removing user fees, modifying logistics, and establishing coordination mechanisms for continuity of care, the declines softened. In some cases, the adaptations strengthened systems beyond their pre-pandemic state.
“These were not perfect solutions,” Kabwama notes. “But they showed us what flexibility, leadership, and trust can do under pressure.”
The Human Cost—and the Human Shield
Behind every data point were health workers navigating impossible conditions. Many worked without adequate protective gear. Others faced delayed allowances, long hours, and constant risk.
Kabwama asserts that health workers risk their lives in their work. “If we expect services to continue, then protecting their physical and mental well-being is not optional.”
His research consistently returned to one conclusion: that service continuity depends on people. Policies can guide. Infrastructure can support. But without motivated, protected health workers and trusted community intermediaries, systems falter.
Uganda’s community health workers, he observed, became a backbone of resilience. They traced contacts, delivered information, encouraged women to attend antenatal care, and helped sustain immunization demand when facilities felt distant or dangerous.
“In our context,” he says, “they were critical. That’s a lesson worth holding onto.”
Learning Across Borders
Conducting his PhD through a collaborative programme between Karolinska Institutet and Makerere University School of Public Health exposed Kabwama to how different systems responded under pressure.
At Karolinska’s Department of Global Public Health, students from around the world shared experiences shaped by culture, trust, and governance. One story stayed with him: Sri Lanka’s military, highly trusted by the public, played a key role in vaccine rollout.
“It taught me that resilience looks different everywhere,” he says. “What matters is understanding what each system already has and how trust operates within it.”
His supervision team, spanning Sweden and Uganda, including Prof. Tobias Alfvén, Prof. Rhoda K. Wanyenze, Dr. John Ssenkusu, Prof. Helena Lindgren, and Dr. Neda Razaz, reflected that same cross-system thinking.
Wanyenze describes Kabwama as “focused, committed, and remarkably productive.” She notes that he led two major workstreams across the five participating countries, helping generate critical evidence on health systems resilience and trust during infectious disease emergencies. “He made an enormous contribution to the research,” she says, “and he continues to do excellent work in this area.”
The Quiet Challenge of Doing Research in a Pandemic
Methodologically, the pandemic forced adaptation. Interviews moved to phones and Zoom. Access was negotiated carefully. Yet Kabwama sees the technology not as a limitation but as a strength.
“We captured experiences while they were still fresh,” he explains. “Before details were forgotten, before narratives were smoothed over.”
That immediacy gave his work an unusual clarity, documenting decisions as they unfolded, not as they were later remembered.
But beyond COVID-19, Kabwama’s thesis does not treat it as an anomaly. Rather, it presents COVID-19 as a stress test, exposing pre-existing weaknesses and potential strengths.
His central argument is that the ability to maintain essential health services during emergencies depends on baseline capacity.
“Now is the time,” he says, “to invest in health workers, in infrastructure, in guidelines for service continuity. This should be done now, not when the next crisis arises.
That conviction extends to learning itself. After-Action Reviews are conducted, lessons are noted, but too often, they fade.
“We need to be deliberate about learning,” he insists. “About documenting what worked and making sure those gains are not lost once the emergency ends.”
Work That Continues
Today, Kabwama is a Research Associate at Makerere University School of Public Health, a Monitoring, Evaluation and Learning Specialist with the Uganda Public Health Fellowship Program, and a member of WHO initiatives on trust and pandemic preparedness. He leads mortality surveillance in Uganda’s island districts, supports national NCD analyses, and continues to advise on emergency preparedness across Africa.
He remains, by his description, an optimist.
“There are people who think we are worse off now than before COVID-19,” he says. “In some ways, that’s true. But there are also many ways in which we are better prepared.”
Vaccines, data systems, community engagement, and global awareness have all shifted. The challenge is ensuring that momentum does not fade.
Dr. Steven Ndugwa Kabwama joins fellows in the MakSPH PhD forum who concluded their doctoral journeys in 2025. And the work of his research and scholarship does not promise certainty but offers something more useful: evidence that systems can bend without breaking—if they are prepared to learn, invest, and protect the people who hold them together.
Between Tuesday, February 24 and Friday, February 27, 2026, Freedom Square at Makerere University will fill with a familiar choreography of anticipation. The air will fill with the rustle of academic gowns, the nervous laughter of graduands, and the careful positioning of proud families searching for familiar faces in a sea of crimson, green, and black. It is a moment of ceremony, yes, but also of reckoning.
Up close, the doctoral gowns feel heavier than they look. The deep crimson fabric, warm and deliberate, settles on the shoulders. Green panels edged in gold are gently pressed against the chest. Wide sleeves gently brush against clasped hands, soft bonnets rest low on foreheads, and tassels remain motionless. Beneath the regalia are steady breaths, quickened heartbeats, and bodies carrying the quiet fatigue of years spent balancing work, study, and life. These are garments worn not only for display but also for endurance, stitched to nights without sleep, to questions carried long before they were answered.
At this four-day Makerere University’s 76th Graduation Ceremony, 185 doctoral degrees will be conferred. Each PhD will represent years of unanswered questions, interrupted sleep, financial strain, and relentless intellectual persistence. Among them will be Dr. Samalie Namukose, a woman whose academic journey was never separate from the health system she serves, only threaded through it.
For more than two decades, Samalie Namukose has worked inside Uganda’s Ministry of Health, rising steadily from Nutritionist to Assistant Commissioner for Health Services/Nutrition. She has helped write policy, coordinate national programs, supervise districts, respond to emergencies, and advocate for mothers and infants whose voices rarely travel beyond clinic walls. Her PhD did not pull her away from that world but plunged her deeper into it.
The Question That Would Not Let Go
Dr. Namukose’s doctoral journey began not in a library, but in a pattern she kept seeing and could no longer ignore.
Uganda’s nutrition policies are robust. They speak clearly about the importance of maternal and infant nutrition, especially in the first 1,000 days of life. Yet in health facilities across the country, nutrition services often appeared fragmented, present in principle, and inconsistent in practice. Mothers attending antenatal or postnatal care were weighed, yes, but not always counselled. Infants were measured, but follow-up was irregular. Nutrition existed, but it was not always integrated.
“I kept asking myself,” she recalls, “not whether nutrition interventions exist, but how well they are embedded in routine care, and what prevents health workers from delivering them consistently.”
That question shaped her PhD research at Makerere University’s School of Public Health, where she examined the integration of Nutrition Assessment, Counselling, and Support (NACS) into routine health services in the Tororo and Butaleja districts in Eastern Uganda.
At its core, NACS integration is deceptively simple: assess nutritional status at every health point, provide tailored counseling, and link clients to support within the same system and beyond. But in practice, it tests the very backbone of health systems: workforce capacity, financing, governance, supervision, and community linkages.
“When NACS is well integrated, health facilities can identify nutrition risks early, prevent deterioration, and provide timely support rather than responding only when malnutrition becomes severe,” she says.
Inside Resource-Constrained Health Facilities
What Dr. Namukose found was not a clear story of failure or success, but something in between. Many health facilities were offering basic nutrition education and assessments, and health workers were clearly trying their best. However, long patient queues, limited time, and a shortage of basic tools and job aids often hindered counseling and follow-up. Food demonstrations were rare. Growth monitoring was inconsistent. Efforts to improve quality occurred only sporadically.
In facilities without trained nutritionists, nurses, and midwives, already stretched thin, took on nutrition work alongside many other duties, leaving little room to support mothers and children in a steady, continuous way.
And yet, her findings revealed something deeply hopeful: “facilities with knowledgeable, motivated, and supported health workers delivered better nutrition services, even within the same constraints.” To Dr. Namukose, this showed that leadership, mentorship, and attitude mattered. Where nutrition was treated not as an extra task but as essential care, outcomes began to improve.
One of the strongest findings from Dr. Namukose’s research was that even when nutrition services were only partly integrated, they still made a visible difference. Mothers gained weight more steadily during pregnancy and in the early months of breastfeeding. Babies were born heavier and grew better in their first months of life. Across health facilities with more fully integrated nutrition services, children consistently showed healthier growth patterns.
These were not just numbers on a page; babies started life stronger, and mothers were better supported to care for them.
“To me,” she explains, “the improvements in maternal weight gain reflected the value of regular assessment and context-specific counseling. For infants, the better growth outcomes showed that a package of nutrition interventions, delivered consistently, can make a real difference during the most critical window of life.”
It was clear evidence that nutrition integration works effectively, though gradually and significantly.
The Fragility of Progress
Dr. Namukose’s research also exposed how fragile these gains remain. Weaknesses in financing and governance emerged as the greatest threats to sustainability. Nutrition services often depended on unpredictable partner funding rather than routine government budgets. Essential supplies, anthropometric tools, job aids, and therapeutic foods were frequently unavailable or externally dependent.
Her study captured glaring governance gaps that compounded the problem. For instance, nutrition was not always clearly positioned within accountability structures, and this, according to Dr. Namukose, often led to limited supervision and weak performance monitoring. Many districts lacked dedicated nutritionists altogether.
She notes that community follow-up was essential for sustaining behaviour change after clinic visits, especially for those who suffered most. Village Health Teams and care groups struggled without supervision, feedback mechanisms, or resources.
“Most nutrition-related behaviours, such as maternal diet, infant and young child feeding, and care practices, are shaped and sustained within households and communities,” says Dr. Namukose.
She contends that nutrition integration cannot rely on projects but must be embedded in systems.
A PhD Written in the Margins of Life
Conducting this research while holding a senior national leadership role in the Ministry of Health was, by her own admission, one of the hardest things she has ever done.
Dr. Namukose did not request study leave. Partly self-sponsored, she worked full days at the Ministry of Health, then wrote at night, often between midnight and 4:00 am, and again in the early mornings, on Saturdays, and on borrowed hours of Sunday.
“There were days when I sacrificed sleep completely,” she says quietly.
National emergencies such as COVID-19, Ebola, and MPOX repeatedly interrupted her doctoral journey, drawing her back into crisis response. To her, returning to her PhD after each interruption felt like re-entering a conversation mid-sentence, struggling to find the thread.
At one point, she simultaneously prepared for a Top Management Committee presentation, attended a doctoral committee meeting, and sat for Health Service Commission promotional interviews.
“The pressure from the supervisors kept me on my toes. The PhD forum was another motivating factor, consistently sharing updates, books, courses, encouragement, and invitations to PhD defenses. Peer support was tremendous. Without a supportive family, you can’t make it,” she remarks.
A Career That Prepared the Ground
Dr. Namukose’s PhD sits atop a formidable professional foundation. She holds Bachelor’s and Master’s degrees in Agriculture from Makerere University, a Postgraduate Diploma in Food and Nutrition Security from Wageningen University in the Netherlands, and a Postgraduate Diploma in Business Administration from Makerere University Business School. She has undergone extensive training in nutrition leadership, research methods, health systems, and quality improvement across Africa, Europe, and Asia.
Within the Ministry of Health, she has served as a Public Health Nutritionist, Senior Nutritionist, Principal Nutritionist, and now Assistant Commissioner, coordinating national nutrition interventions, designing training modules, mobilising resources, and overseeing district implementation.
She has played key roles in multi-million-dollar initiatives, from HIV-Free Survival programmes to Integrated Child Health Days, public food procurement policy, and the scale-up of Multiple Micronutrient Supplements (MMS) for pregnant women.
Her research has been published in leading peer-reviewed journals, including PLOS ONE and BMC Health, Population and Nutrition, ensuring that her findings speak both to policy and global evidence.
On a mission to keep research from gathering dust
Now a Doctor of Philosophy, Dr. Namukose has determined that her work will not sit quietly on a shelf. Her findings have already informed Uganda’s Health Sector Nutrition Strategic Plan, strengthening the case for financing, governance reform, and recruitment of skilled nutrition cadres. She continues to champion platforms, such as national nutrition symposia, that bring student research into policy dialogue and implementation spaces.
“Very often, excellent student research is left on the shelves. I plan to allocate some days during these symposia to nutrition students to showcase best practices and innovations,” she says.
Adding that, “I urge mothers and their infants to actively engage in self-care, growth-promotion, and monitoring activities to improve their own health and that of their children.”
Central to her recommendations is a call to embed nutrition services within routine health and community systems, with sustained government leadership, financing, and competent human resources.
Integration, she insists, is not achieved by guidelines alone, but through continuous engagement with frontline health workers and communities.
As graduation day approaches, Dr. Namukose’s thoughts turn outward. To frontline health workers delivering nutrition services under pressure, her message is one of respect and reassurance. Even with limited resources, the assessments they conduct, the counselling they provide, and the care they offer can change outcomes.
“Endeavor to participate in training programmes whenever available to bridge gaps in nutrition knowledge and skills, including on-the-job and rotational training to support cost-effective and efficient nutrition service delivery,” she asks.
To mothers and caregivers, she urges active engagement in self-care, growth monitoring, and nutrition programmes, especially those strengthened through digital innovation.
And to policymakers, her research offers both evidence and urgency that nutrition integration is no longer optional but foundational to maternal and child health.
When Dr. Samalie Namukose walks across the stage at Freedom Square, followed by applause, the true weight of that moment lies in health facilities where nutrition is no longer an afterthought. In mothers whose pregnancies are better supported. In infants whose growth curves bend upward, quietly, decisively.
Among the 185 PhDs conferred at Makerere University’s 76th graduation, the School of Public Health Communications Office shares her story, which is a reminder that the most transformative scholarship is not always loud. It builds patiently, between policy meetings and midnight writing, between emergencies and examiners’ comments, until it transforms systems and lives from within.
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