Connect with us

Health

Former Grade III Teacher graduates with a PhD: NCDC approves her Study Intervention for Adolescent Care

Published

on

Sixty four-year-old Sarah Bunoti Nantono is a retired teacher and Lecturer of Psychology. She enrolled for a Ph.D. program at Makerere University School of Public Health (MakSPH) in 2013 with the goal of studying early adolescent reproductive health. 

Having taught for more than thirty years, Dr. Sarah Bunoti Nantono had moved up the academic ladder from being a primary school teacher to a lecturer at Kyambogo University. She believed that earning a PhD would be her ultimate goal in life. While at Kyambogo University, the second largest of the now 13 public universities in Uganda, Dr. Sarah Bunoti devoted her professional life to training social scientists, teachers and teacher educators.

Eleven years later, Dr. Bunoti Sarah Nantono is one of the 46 females of the 132 PhD graduands in the #Mak74thGrad, which begins on Monday, January 29, 2024. 

She successfully earns a Doctor of Philosophy ( PhD) in Public Health from Makerere University following her in-depth research titled; “Pubertal and Child Rights Awareness, Communication, and Child Protection against Sexual Abuse and Exploitation among 10–14-year-olds in Jinja Primary Schools: Opportunities, Challenges, and the Effectiveness of a School-Based Intervention.”

Dr. Sarah Bunoti is a seasoned lecturer with a proven track record in teacher training, social sciences, and psychology. Holding an MSc in Environment from Makerere University Institute of Environment, she also earned a Bachelor of Science in Zoology and Psychology from Makerere University in 1999, a Diploma in Teacher Education from ITEK in 1995, and a Grade III Primary School Teachers’ Certificate from the National Institute of Education. Beginning her career in 1981 as a primary school teacher,  and later  as a Teacher Trainer in the Ministry of Education in 1995, Sarah transitioned to Kyambogo University in 2000, where she currently serves as a part-time Lecturer, following her retirement. Sarah Bunoti Nantono is not only an educator but also an accomplished author, contributing to the development of the Child Rights Curriculum (CRED-PRO).

Dr. Sarah Bunoti’s PhD research examined how Jinja primary school children, aged 10 to 14, understood puberty and their rights related to sexual and reproductive health (SRH). The study looked at their knowledge sources, difficulties, and prospects for managing pubertal health effectively. 

The 10-14 age group comprises 10% of the global population, with Uganda having a higher percentage at 16%. This period marks the onset of significant changes, known as the storm in Psychology, involving body transformations and social shifts.

According to Dr. Sarah Bunoti, timely support during these changes fosters a sense of achievement, but delays can lead to anxiety and unpreparedness. Uganda, aligning with international agreements, including the UN Convention on the Rights of the Child, works to uphold children’s sexual well-being through policies and partnerships. 

Dr. Sarah Bunoti further notes in her research that the 10-14 age group in Uganda encounters puberty during primary school without appropriate information, support, protection, or preparation for the changes, leading to psychological challenges, sexual abuse, early marriages, unplanned pregnancies, and a rise in school dropouts.

Dr. Sarah Bunoti's PhD Defense Panel [Professor Stella Neema, Associate Professor Joseph Ssenyonga, Dr. Siu E. Godfrey, Dr. Beyeza-Kashesya Jolly and supervisors Associate Professor Lynn Atuyambe, Prof. Nazarius Mbona Tumwesigye alongside the session chairperson Prof. Garimoi Orach] determining the verdict before she was declared to have passed her defense. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Sarah Bunoti’s PhD Defense Panel [Professor Stella Neema, Associate Professor Joseph Ssenyonga, Dr. Siu E. Godfrey, Dr. Beyeza-Kashesya Jolly and supervisors Associate Professor Lynn Atuyambe, Prof. Nazarius Mbona Tumwesigye alongside the session chairperson Prof. Garimoi Orach] determining the verdict before she was declared to have passed her defense.

Busoga region, where the study was conducted faces particularly high rates of teenage pregnancies (7%) and school dropouts (91%). Children hold misconceptions driven by myths about puberty, emphasizing the lack of systematic guidance. Current Adolescent Sexual Reproductive Health programs focus on older children in secondary schools, neglecting the needs of those under 15.

Traditional sources, like family discussions, have diminished, placing the responsibility on schools, which often lack the necessary resources and teacher training. As a result, many 10-14-year olds are ill-prepared for changes and lack protection against sexual abuse, highlighting the necessity for evidence-based school interventions to address this information gap.

“Previously in our African traditional setting, the Aunties, Uncles and grandparents talked about puberty and prepared children for adulthood however with the breakdown of African traditional settings, schools are expected to do the role of talking to children about puberty.

Unfortunately, schools often look at puberty as an issue that is concerned with the family and expect the family to do that but also one possible problem is that the teachers themselves don’t know what to do when they are preparing these children for that,” observes Dr. Sarah Bunoti. 

Unfortunately, some stakeholders use threatening language, warnings, and punishments, contributing to risk behaviors, including sexual abuse, mood swings, and trauma among children.

“We wanted to find out what these children know about puberty, challenges they face and the support they get. We also wanted to find out from key duty bearers, these are parents and teachers, what kind of support do they give to the children and to what extent do they fulfill their obligations to protect the children against sexual abuse,” said Dr. Sarah Bunoti.

The study covered 16 primary schools purposefully selected for their diverse characteristics, including boarding status, religious affiliations, gender specifications, and geographical locations. The investigators also engaged with government officials to understand their stance on current sexual and reproductive health issues among young adolescents. 
The study exposed deficiencies in children’s understanding of puberty and child rights, along with teachers’ inadequate knowledge and skills in teaching puberty. 

Findings for instance revealed that kids—particularly boys—don’t often get the chance to talk candidly about puberty with adults. In all focus group conversations, the study gave boys and girls a forum to openly address their experiences, difficulties, and rights related to sexual and reproductive health. This emphasizes how important it is for all people to become widely sensitive to the issues that face kids.  Stepmothers were found not to communicate about puberty because of generalization and others.

Sarah Bunoti Nantono on the day of her PhD Defence. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Sarah Bunoti Nantono on the day of her PhD Defence.

“Surprisingly, discussions on pubertal challenges elicited more extensive responses from both boys and girls compared to other topics. Boys, although engaging in perceived anti-social behavior, demonstrated a level of conscience. It became evident that children, despite being sexually and biologically mature, require guidance on navigating the impact of hormones on their sexual feelings. The blame for communication gaps often falls on parents, who may be absent due to work, divorce, or being orphaned,” says Dr. Bunoti. 

Subsequently, she developed, applied, and assessed two intervention books; A children’s Resource book and a Teachers’ guide. The Randomized Control Trial demonstrated improved pubertal knowledge among children and enhanced teaching capabilities in teachers, affirming the intervention’s effectiveness. These intervention books were approved by the National Curriculum Development Centre (NCDC) and approved for teaching pubertal health and safety in primary schools nationwide. 

Dr. Bunoti has recommended empowering and involving young communicators to convey Sexual and Reproductive Health and Rights (SRHR) information to 10-14-year-olds, working collaboratively with parents and teachers, a strategy she believes will narrow the generation gap and enhance effective communication. Additionally, she calls for increased awareness and participation of male parents and teachers in SRH communication and child protection.

“Parents and adults should supplement school-based SRHR education by instilling age-appropriate individual, family, and community values and skills rooted in social, cultural, and religious contexts. Provide specialized training for Senior Women Teachers and Male Teachers, and reduce their teaching load to ensure dedicated attention to this critical aspect of education,” Dr. Bunoti expertly says. 

Her study, funded by Sida and supervised by Dr. Lynn Atuyambe and Prof. Nazarius Mbona Tumwesigye, successfully attained this recognition.

During her PhD defense, Associate Professor Lynn Atuyambe remarked, “It was a very enjoyable defense. You truly and successfully defended your PhD—now, you own your PhD.”

“I want to thank most especially your family, they’ve been part of this journey I am not guessing, I know they’ve been and am excited to see them and I like the support they have offered to mum. The highest level of education in the world is a PhD, you can do no more than that. You have reached at the saddle of your life in academia, congratulations and I wish you good luck,” said Dr. Lynn Atuyambe

Associate Professor Lynn Atuyambe, Dr. Sarah Bunoti's supervisor speaking during her defense. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Associate Professor Lynn Atuyambe, Dr. Sarah Bunoti’s supervisor speaking during her defense.

How her PhD Journey started

About a decade ago, SIDA had been consistently supporting Makerere University. However, they decided to extend their support to other public universities. When the opportunity arose, she seized it. 

“I have a habit of greeting, and my children often question why I greet so much. Sometimes, it turns out to be quite beneficial. One day, I walked into my Dean Dr. J Katigo – Kaheeru’s office and greeted, asking how he was. He said, ‘Sarah, I am glad you’ve come, read this but I said Doctor I am not ready for this,  but he said, ‘Sarah, you can’t give any more excuses, this is a God given opportunity, they want a concept for the SIDA Scholarships, go ahead and write a concept.’ I later met Professor Mary N Okwakol, my undergraduate Lecturer of Zoology, and Professor Albert Lutalo Bbosa, the former Vice Chancellor of Kyambogo University, who too reassured me of my potential to attain a PhD.    Out of 26 submissions from Kyambogo University, only three concepts were selected, and fortunately, mine was one of them,” Dr. Sarah Bunoti recalls. 

Once her concept was ready, Dr. Bunoti came to Makerere University, but her research topic was broad. Unfortunately, her background did not align with the faculties that typically received sponsorship from SIDA. Zoology, Psychology, Education, and Environmental Studies were her strengths, but none fell within the supported areas. 
Feeling disconsolate, she sought guidance from the then Director of Research and Graduate Studies at Makerere University, Professor Elly Katunguka. “He said, ‘why should you really struggle looking for a home, go and try School of Public Health. With your background, you’ll find a home,” she recalls.

Acting on his advice, Dr. Sarah Bunoti visited the School of Public Health one morning. However, the Dean, Prof. William Bazeyo, then, was away on leave; “I spoke with Assoc. Prof. Fred Wabwire-Mangen, the Acting Dean at the time. I explained my situation, highlighting my expertise in teaching, psychology, and environmental studies. He encouraged me to submit my concept, assuring me that these areas were valued in public health. This led to provisional admission, and I began refining my proposal with their guidance.”

As she exited Dr. Mangeni’s office, he promptly contacted Professor Anne Katahoire, who was by then the Director of Makerere University Child Health and Development Centre  and  Prof. Atuyambe, who was in Nairobi for a conference and told them; “We have a prospective student here, are you willing to take her up and without hesitation, Prof. Anne said yes and Prof. Lynn said, ‘I am in Nairobi but when I come back, I want to see that student,” Sarah recollects.

Subsequently, Prof. Mangeni reached out to Prof. Nazarius Mbona Tumwesigye upon recognizing the importance of the statistics component, he promptly invited her to discuss further details at the school. “In a short span, I found myself with a dedicated team of supervisors, a supportive Doctoral Committee chaired by Prof. Christopher Garimoi Orach with Prof Joseph Oonyu (RIP) and Dr. Christine K. Nalwadda, and a scholarly home in the Department of Community and Behavioral Sciences at the Makerere University School of Public Health,” Sarah Bunoti says.

Dr. Sarah Bunoti expresses gratitude to the MakSPH PhD Forum, the MakSPH family, the funder and her mother institution -Kyambogo University for the immeasurable support.

Dr. Sarah Bunoti (holding flowers) in a group photo with her PhD supervisors, examiners and family after her PhD defense. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Sarah Bunoti (holding flowers) in a group photo with her PhD supervisors, examiners and family after her PhD defense.

Dr. Sarah Bunoti expresses gratitude to the MakSPH PhD Forum, the MakSPH family, the funder and her mother institution -Kyambogo University for the inestimable support. She is also grateful to head teachers, teachers, children, and parents from her 16 project schools; Jinja City and District Education, Health and  Community Development officers as well as the Family and Child Protection Unit of the Uganda Police Force and others for the information and support rendered to her.

“I can’t quantify the support I received from MakSPH, from PhD forum, from my supervisors you all did a good job to support me in this. In addition, SIDA did a good job because with our teaching salary, paying for my PhD would have been a problem but they paid all my tuition even when the scholarship was ending they said Sarah, we are paying for two years at ago and paid for the field’s activities,” she recalls. 

She is equally grateful to everyone who provided her and her research team with useful information; Kyambogo University for assigning a teaching assistant to help her focus and her husband, Dr. Bunoti, who has promised to support her dream.  
“I want to thank my family, my sister Mrs. Rebecca Lucy and her husband Eng. Dr  James Muwuluke, my children. They have been there for me, my husband, Dr. Bunoti met me when I was a primary school teacher and he was a Doctor teach and told me, Sarah, I will support you until you are tired of reading and has kept his word, there are few empowered men who will want a woman to come up and get the title they hold,” she said. 

Dr. Sarah Bunoti with her family. Davies Lecture Theatre, College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Sarah Bunoti with her family.

“Given what I have gone through, am so excited about this achievement. My family is so excited about this. My husband is extremely excited. They have written short paragraphs about me about my resilience. I had decided not to hold any celebration but my sister and her husband says this could not pass since it is no mean achievement,” she says.

Dr. Godfrey Siu Etyang, her Ph.D. overseer, has invited her to collaborate on a parenting project at the Child Health and Development CenterCollege of Health Sciences, Makerere University. Over the past month, she has been actively contributing to the development of a comprehensive parenting curriculum for the unit.

Dr. Bunoti anticipates scaling up the approved intervention, particularly to additional primary schools in the Busoga region and beyond and has already began talks with Ministry of Education and Sports to support children’s understanding of puberty, a sine qua non for education and parenting.

Unexpected difficulties affected Dr. Sarah Bunoti Nantono’s journey to earning her Ph.D., resulting in longer than the expected four to six years. Midway through her studies, she developed insomnia, which was an unexpected health problem. In 2020 when it appeared that she would soon graduate, the Doctoral Committee insisted that she must publish her work, and was reluctant to accept a monograph, one of the options for one to graduate with a PhD at Makerere University. Further delays were due to lengthy processes to have her manuscripts published and clearances through the Institutional Review Board (IRB). Other than these challenges, Dr. Nantono also had to repeat the entire data collection process and deal with the untimely death of Assoc. Prof. Joseph Oonyu, a key member of her doctorate committee, in October 2020. Despite these challenges, Dr. Nantono feels proud to have completed her doctorate, demonstrating her incredible endurance in the face of adversity.


Congratulations Sarah!

View on MakSPH

Davidson Ndyabahika

Health

NIH/Fogarty Director Visits MakCHS, Underscores Impact of Research Training and Health Partnerships

Published

on

Officials pose for a group photo with Dr. Steven Schiff during his visit to CHS on 5th August 2026. Makerere University College of Health Sciences (MakCHS) hosts Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, 5th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.

On 5th August 2026, Makerere University College of Health Sciences (MakCHS) hosted the Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, for a visit highlighting the College’s research, training and institutional partnerships supported through the National Institutes of Health (NIH)/Fogarty International Center.

The visit included engagements at MakCHS and Mulago National Referral Hospital, bringing together College leadership, Directors of teaching hospitals affiliated with MakCHS, research investigators and trainees. In attendance were Dr. Joseph Kagaayi who represented the Dean of the Makerere University School of Public Health, Dr. Elias Kumbakumba, Dean of the School of Health Sciences at Mbarara University of Science and Technology (MUST) and Dr. Cissy Kityo Mutuluuza, Executive Director, Joint Clinical Research Centre (JCRC).

A key focus of the visit was the impact of D43 research training programmes supported by NIH/FIC. Principal Investigators presented examples of how the programmes have strengthened research capacity, developed new scientific expertise, supported postgraduate training and contributed to health research and policy in Uganda.

Welcoming Dr. Schiff, Professor Bruce Kirenga, Principal-MakCHS provided an overview of the College, its history, academic programmes, research priorities and extensive network of teaching and research sites. The College, Uganda’s premier centres for health professional education, currently brings together four schools: the School of Medicine, School of Biomedical Sciences, School of Health Sciences, School of Dentistry, alongside a range of research centres and specialised programmes.

Professor Kirenga highlighted the growing breadth of research at MakCHS, including infectious diseases, non-communicable diseases, translational medicine, population health, mental health, digital health, implementation science, biomedical sciences, genomics, bioinformatics and data science.

Prof. Bruce Kirenga (Standing) makes his remarks. Makerere University College of Health Sciences (MakCHS) hosts Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, 5th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Prof. Bruce Kirenga (Standing) makes his remarks.
CURRENT D43 PROJECTS AT MAKCHS
No.Award TitlePrincipal Investigator
1Reducing the Impact of Rheumatic Heart Disease across the Life Span: The Impact ProgramProf. Nelson Sewankambo
2Enhancing Research capacity for Sickle Cell Disease and related NCDs across the Lifespan in Uganda. “Enrich Project”Prof. Sarah Kiguli
3Scaling Up advanced genomics and bioinformatics Research training in paediatric HIV/AIDS in Uganda – SURGEDr. Kyobe, Samuel
4Training in Malaria Epidemiology, Translational Research, and Implementation Science to Strengthen Malaria Policy and Control in UgandaProf. Moses Robert Kamya
5Strengthening behavioral and social science research capacity to address overlapping stigma, social and psychological challenges among people with HIV in UgandaProf. Moses Robert Kamya
6Training in non-communicable diseases epidemiological, data science and Implementation Science research to strengthen evidence-based interventions, policy and control in UgandaAssoc. Prof. Bruce James Kirenga
7Building Implementation Science Capacity at Makerere University to Strengthen the Response to the HIV/AIDS Epidemic in UgandaProf. Moses Robert Kamya
8Training in Malaria Epidemiology, Translational Research, and Implementation Science to Strengthen Malaria Policy and Control in UgandaProf. Moses Robert Kamya
9Harnessing Health Data Science capacity to strengthen evidence-based interventions, policy and response to the HIV/AIDS Epidemic in Uganda (H-DATA)Prof. David Patrick Kateete

From research training to real-world impact

Presentations from D43 Principal Investigators demonstrated how sustained NIH/FIC investment has supported researchers at different stages of their careers while contributing to evidence that can inform health programmes and policy.

In malaria research, trainees have been involved in studies examining the effectiveness of interventions such as insecticide-treated bed nets and the immunological consequences of reduced malaria transmission. Researchers are also investigating how malaria risk and immunity change when transmission is interrupted, generating evidence that can help inform strategies for sustaining the gains made through malaria control.

The implementation science portfolio provided another example of research translating into measurable health outcomes. One study examining enhanced counselling and peer support among young people living with HIV in south-western Uganda reported improvements in HIV-related outcomes, demonstrating the potential of locally-led research to strengthen service delivery.

Researchers in behavioural and social sciences have also been supported to investigate mental health and other health outcomes, illustrating the multidisciplinary nature of MakCHS research and the importance of combining biomedical, clinical and social science approaches.

Building capacity in specialised and emerging fields

The presentations also showcased the role of NIH/FIC-supported programmes in creating expertise in areas that were previously limited or unavailable within Uganda.

A programme focused on HIV research among pregnant women, children and adolescents has supported postgraduate and short-course training in areas including clinical trial design, pharmacokinetics, biostatistics, behavioural science, regulatory and ethical considerations, and implementation science.

Other programmes have contributed to the development of expertise in bioinformatics, genomics and data science, including the establishment and strengthening of postgraduate programmes. Researchers are increasingly applying artificial intelligence and machine learning to complex biomedical and HIV datasets, with the goal of generating evidence that can be translated into policy and practice.

Dr. Cissy Kityo Mutuluuza, Executive Director of the JCRC highlighted emerging work in gene and cell therapy under the NIH/FIC supported project Building Gene Therapy Capacity in Uganda implemented at JCRC. She explained that the programme includes efforts to establish sustainable research and training capacity for HIV cure research in Uganda. The programme brings together institutions in Uganda and international partners, with an emphasis on developing locally relevant expertise, infrastructure and research capability.

Dr. Cissy Kityo Mutuluuza (Standing) highlights JCRC's work. Makerere University College of Health Sciences (MakCHS) hosts Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, 5th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Dr. Cissy Kityo Mutuluuza (Standing) highlights JCRC’s work.

Strengthening institutions and developing future leaders

Beyond individual research projects, speakers emphasised the broader institutional impact of Fogarty-supported training.

Over the years, NIH/FIC-supported collaborations have contributed to the development of postgraduate programmes, research laboratories, specialised scientific disciplines and networks of researchers across Uganda. Trainees have progressed into academic and research leadership positions, with some becoming professors, programme leaders and advisors contributing to national health initiatives.

The programmes have also supported short courses, mentorship, international research placements and collaborations designed to enable Ugandan scientists to develop advanced skills and return to strengthen research and training at home.

Presenters stressed the importance of moving beyond individual training to building institutions capable of sustaining research programmes, mentoring future scientists, managing complex studies and translating findings into health interventions.

Research serving Uganda’s health system

The visit also underscored the close relationship between MakCHS research and Uganda’s health system. Researchers and faculty contribute to national programmes in areas including HIV, tuberculosis, malaria, vaccines, maternal and child health and other public health priorities.

Evidence generated through research has helped inform national guidelines, programmes and policy discussions, while College researchers and teaching hospitals continue to provide expertise during public health emergencies and disease outbreaks.

The speakers noted that partnerships such as those supported by NIH/FIC are most valuable when they create lasting local capacity — enabling Ugandan institutions and scientists to generate and use evidence to address the country’s health priorities.

A partnership built on shared learning

Dr. Steven Schiff makes his presentation. Makerere University College of Health Sciences (MakCHS) hosts Director of the NIH Fogarty International Center (FIC), Dr. Steven Schiff, 5th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Dr. Steven Schiff makes his presentation.

In his engagement with the College, Dr. Schiff reflected on the longstanding relationship between NIH/Fogarty-supported programmes and Ugandan researchers. He acknowledged the depth of expertise and experience that has developed through years of collaboration and emphasised the value of partnerships that support scientific exchange and capacity building in both directions.

Dr. Schiff noted that the presentations demonstrated impact of the partnerships which extends well beyond the number of people trained. Investments in researchers have helped establish new academic programmes, strengthen laboratories and research infrastructure, expand multidisciplinary collaborations and create a growing generation of scientists able to lead research in Uganda and internationally.

The visit therefore provided an opportunity not only to showcase ongoing work, but also to reflect on the evolution of research capacity at MakCHS and its contribution to Uganda’s health priorities.

As MakCHS continues to expand its research portfolio into emerging areas such as artificial intelligence, genomics, precision medicine, translational science and advanced therapeutics, the College reaffirmed the importance of strategic partnerships in developing the people, systems and infrastructure needed to turn scientific discoveries into improved health outcomes.

Zaam Ssali
Zaam Ssali

Continue Reading

Health

AFRHiCARE Shares Evidence and Co-Creates Solutions to Strengthen Uganda’s First-Referral Hospitals

Published

on

Stakeholders pose for a group photo during the AFRHiCARE Meeting held on 13th August 2026. Makerere University School of Public Health (MakSPH) Wellcome Trust through a 2023–2029 Discovery Award-funded Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative stakeholders from five first-referral hospitals in Uganda meeting to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care, 13th August 2026, Kabira Country Club, Kampala Uganda, East Africa.

The Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative on August 13, 2026 brought together stakeholders from five first-referral hospitals in Uganda to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care.

Funded by the Wellcome Trust through a 2023–2029 Discovery Award, AFRHiCARE is a partnership between Makerere University, the University of the Witwatersrand, the KEMRI-Wellcome Trust Research Programme and the University of Oxford. The initiative seeks to generate evidence to inform the future development of first-referral hospitals, with a focus on service delivery, health workforce dynamics, leadership, management, governance and technology.

In Uganda, the study is being implemented at Kawolo Hospital, St. Joseph’s Hospital Naggalama, Adjumani Hospital, Kiryandongo Hospital and Masindi Hospital. The hospitals play a critical role within the Primary Health Care (PHC) system, linking lower-level health facilities to higher-level referral services.

The stakeholder meeting provided an opportunity for the participating hospitals and other stakeholders to move beyond receiving research findings to interrogating the evidence, sharing experiences and identifying actions that can be implemented at hospital, district and national levels. This approach is central to AFRHiCARE, which uses stakeholder engagement to promote cross-learning and support hospitals to develop quality improvement actions.

Evidence from the health workforce

One of the key areas presented was the status of the health workforce across the five hospitals. The first-round assessment surveyed 609 frontline health workers. It examined staffing, job satisfaction and professional quality of life.

Some of the AFRHiCARE Stakeholders in a group discussion. Makerere University School of Public Health (MakSPH) Wellcome Trust through a 2023–2029 Discovery Award-funded Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative stakeholders from five first-referral hospitals in Uganda meeting to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care, 13th August 2026, Kabira Country Club, Kampala Uganda, East Africa.
Some of the AFRHiCARE Stakeholders in a group discussion.

The findings show a significant staffing gap. Against the 2023 staffing norm of 343 staff, all five hospitals were operating at less than half of the recommended level. Masindi Hospital had the largest gap, operating at 37.6% of the norm, while Adjumani, Kiryandongo, Kawolo and Naggalama were at 48.1%, 48.7%, 44.9% and 44.6%, respectively.

However, the findings suggest that staff retention is relatively good in the public hospitals. The main challenge appears to be recruitment and filling vacant positions rather than widespread staff turnover.

Health workers identified promotion, workload and salary as the lowest-rated aspects of their jobs across the five hospitals. Overall job satisfaction ranged from 59% in Masindi to 71% in Naggalama.

Despite these challenges, the findings reveal strong commitment among health workers. Compassion satisfaction was high, with many reporting pride in their work. At the same time, workload emerged as a major concern.

Strong relationships among colleagues were also identified as a key strength, suggesting that teamwork and peer support remain important sources of resilience within the hospitals.

Strengthening hospitals within the health system

Speaking during the dissemination, Dr. Raymond Tweheyo, Co-Principal Investigator and Research Manager for AFRHiCARE Uganda, noted that first-referral hospitals have often been neglected in critical areas, including staffing, financing, infrastructure, leadership, management and governance.

Dr. Raymond Tweheyo. Makerere University School of Public Health (MakSPH) Wellcome Trust through a 2023–2029 Discovery Award-funded Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative stakeholders from five first-referral hospitals in Uganda meeting to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care, 13th August 2026, Kabira Country Club, Kampala Uganda, East Africa.
Dr. Raymond Tweheyo.

He said these gaps affect hospitals’ ability to deliver services effectively and respond to the needs of the communities they serve.

Dr. Tweheyo re-echoed a message from the Principal Investigator, Professor Frederick Ssengooba, on the importance of situating the district hospital at the apex of the PHC network. This perspective recognises that challenges experienced at district hospitals may be linked to weaknesses elsewhere in the health system.

For example, weak referral systems, shortages of health workers and capacity challenges at lower-level facilities can increase pressure on first-referral hospitals. Addressing these problems therefore requires system-level solutions involving multiple actors.

The AFRHiCARE protocol similarly identifies persistent challenges around resource constraints, service delivery, workforce wellbeing, leadership and management, governance, technology and the ability of hospitals to meet changing community needs.

Dr. Raymond Tweheyo makes his presentation. Makerere University School of Public Health (MakSPH) Wellcome Trust through a 2023–2029 Discovery Award-funded Future of Africa’s First Referral Hospitals: Innovation and Care (AFRHiCARE) research initiative stakeholders from five first-referral hospitals in Uganda meeting to review research findings, reflect on persistent challenges and identify practical solutions to strengthen hospital performance and quality of care, 13th August 2026, Kabira Country Club, Kampala Uganda, East Africa.
Dr. Raymond Tweheyo makes his presentation.

From research to action

Participants discussed priorities including filling critical staffing gaps, improving transparency and equity around promotion, addressing excessive workloads, strengthening referral systems and reducing the pressure created when patients bypass lower-level facilities. The meeting also considered which challenges can be addressed by hospitals and which require action from district authorities and the Ministry of Health.

Betty Kyakuwa
Betty Kyakuwa

Continue Reading

Health

Dr. Musoke Takes Over as Head of Disease Control & Environmental Health

Published

on

Officials witness as Dr. David Musoke and Dr. Esther Buregyeya shake hands at the handover ceremony on 11th August 2026. Makerere University School of Public Health (MakSPH) leadership transition, Department of Disease Control and Environmental Health, Dr. David Musoke takes over from Dr. Esther Buregyeya, 11th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.

The Makerere University School of Public Health (MakSPH) has formally transitioned leadership of the Department of Disease Control and Environmental Health, with Dr. David Musoke taking over from Dr. Esther Buregyeya, who served as Head of Department for more than nine years.

The handover marked both an appreciation of Dr. Buregyeya’s tenure and a renewed call for the Department to strengthen its position as a leading centre for Environmental Health, Occupational Health, Disease Control and Prevention.

Dr. Buregyeya, who took over the leadership of the Department in January 2017 and served until May 2026, described her tenure as a period of significant growth in teaching, research, community engagement and staff development. She emphasised that the achievements were a result of shared leadership and the collective efforts of Department members, School leadership and partners.

Dr. David Musoke (L) and Dr. Esther Buregyeya (R). Makerere University School of Public Health (MakSPH) leadership transition, Department of Disease Control and Environmental Health, Dr. David Musoke takes over from Dr. Esther Buregyeya, 11th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Dr. David Musoke (L) and Dr. Esther Buregyeya (R).

Among the key milestones during her tenure was the strengthening of the Department’s academic portfolio. The Department completed the review of the Bachelor of Environmental Health Science curriculum and supported the development of the Master’s programme in Environmental and Occupational Health. It also contributed to the development of the PhD by coursework and expanded online learning materials and short-course offerings, including training in Water, Sanitation and Hygiene and Occupational Health and Safety.

The Department also made progress in strengthening its laboratory capacity. With support from the School leadership, equipment was procured for the Environmental Health laboratory, which is currently based at Kasangati. The Department has also benefited from equipment donated through partnerships.

Another significant achievement highlighted during the handover was the development of human capacity. Several staff and research associates have pursued doctoral training, strengthening the Department’s pool of researchers and future academic leaders. Dr. Buregyeya noted that building this capacity was essential to ensuring continuity and preparing the next generation of faculty.

Dean commends leadership and mentorship

The Dean of MakSPH, Prof. Rhoda Wanyenze, commended Dr. Buregyeya for her leadership and credited the Department with developing a strong culture of mentorship and nurturing young professionals.

Prof. Wanyenze noted that although Disease Control is one of the School’s original departments, its membership has remained relatively young, with many emerging professionals being mentored and supported to grow within the School. She particularly applauded the Department for attracting and retaining talented Environmental Health graduates and for creating opportunities for research associates to contribute to the School’s work.

Prof. Rhoda Wanyenze (Left) and Mr. Amos Dembe (Rear) witness as Dr. David Musoke presents an appreciation plaque to Dr. Esther Buregyeya. Makerere University School of Public Health (MakSPH) leadership transition, Department of Disease Control and Environmental Health, Dr. David Musoke takes over from Dr. Esther Buregyeya, 11th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Prof. Rhoda Wanyenze (Left) and Mr. Amos Dembe (Rear) witness as Dr. David Musoke presents an appreciation plaque to Dr. Esther Buregyeya.

She also welcomed the establishment of the Master’s programme in Environmental Health, describing Environmental Health as an important frontier for public health. She challenged the Department to consider developing a PhD pathway in Environmental Health and to build a coordinated research agenda examining the links between the environment, infectious diseases, non-communicable diseases and broader health systems.

Prof. Wanyenze further called for greater investment in Occupational Health, noting the importance of workplace health, mental health, physical health and occupational safety, particularly as Uganda’s informal sector continues to grow. She also urged the Department to strengthen entomology and related research in vector-borne diseases.

A new chapter under Associate Professor David Musoke

Receiving the responsibility, Associate Professor David Musoke described his appointment as both an honour and a homecoming. He completed his Bachelor’s degree in Environmental Health at Makerere and later worked in the Department of Health Policy, Planning and Management before returning to Disease Control, where he has spent much of his professional career.

Assoc. Prof. Musoke paid tribute to Dr. Buregyeya, whom he described as a mentor and an example of shared leadership. He noted that during her tenure, the Department had grown from having a single undergraduate programme to developing a Master’s programme, contributing to PhD training and expanding its research portfolio into new and emerging areas. He also recognised the growth of early-career researchers, many of whom have progressed through doctoral training and into academic roles.

He pledged to build on these achievements while working closely with Department members, the Dean and other School departments. He also acknowledged the confidence placed in him by colleagues during the selection process and committed to working collectively to advance the Department.

A call to define the Department’s future

While celebrating the Department’s achievements, Prof. Wanyenze challenged the new leadership to develop a clear strategic agenda that distinguishes and strengthens the Department’s areas of expertise.

Dr. David Musoke and Dr. Esther Buregyeya cut cake at the handover ceremony. Makerere University School of Public Health (MakSPH) leadership transition, Department of Disease Control and Environmental Health, Dr. David Musoke takes over from Dr. Esther Buregyeya, 11th August 2026, Mulago Hospital Complex, Kampala Uganda, East Africa.
Dr. David Musoke and Dr. Esther Buregyeya cut cake at the handover ceremony.

Prof. Wanyenze urged the Department to take forward the urban health agenda, particularly in light of Uganda’s rapid urbanisation and the emerging challenges associated with waste management, environmental health and the delivery of preventive health services in urban settings.

She further called for deliberate investment in people, infrastructure, research and partnerships. In particular, she encouraged the Department to use the new School infrastructure to develop a laboratory and to strategically support PhD training in areas where expertise is currently limited.

“You don’t have to carry this burden alone. There are people who can support the growth of the department,” Prof. Wanyenze said in encouraging the new leadership to build on the expertise already within the Department.

The handover concluded with the formal transfer of responsibility, followed by a presentation to Dr. Buregyeya in appreciation of her service and a cake-cutting ceremony bringing together the outgoing and incoming Heads of Department and members of the Department.

Betty Kyakuwa
Betty Kyakuwa

Continue Reading

Trending