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Makerere & Johns Hopkins Universities Release Report on Speed and Helmet Use in Kampala

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Makerere University School of Public Health (MakSPH) and the Johns Hopkins International Injury Research Unit (JH-IIRU) have launched the status summary report 2023; Road Risk Factors for Kampala, Uganda, in partnership with Kampala Capital City Authority (KCCA) and Vital Strategies.

The report was launched at Hotel Africana in Kampala on January 16, 2024. It delineates key findings, including the average speed of speeding vehicles at a high average of 57km/hr, higher speeds on roads partially accessible to pedestrians compared to roads freely accessible to pedestrians.  Also, helmet usage remains low among motorcyclists and is almost non-existent among passengers, contributing to a rise in accidents and fatalities since 2020.

There has been a variable trend in the reported numbers of deaths and serious injuries since 2018. Specifically, in 2022, there was a 1% increase in reported deaths compared to 2021, while serious injuries witnessed a 4% decrease during the same period.

In 2018, a total of 294 death were recorded, 315 recorded in 2019 while 236 were recorded in 2020. In 2021, there were 419 road traffic death and 425 recorded in 2022. Motorcyclists accounted for nearly half (49%) of the reported deaths followed by pedestrians made up 44% of deaths. In a bid to improve road safety by providing quality data, the research the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS) made roadside observations on speed and helmet use in Kampala City.

The researchers made six observation rounds citing 500,000 for speed and 600,000 cyclists to determine helmet use. The results, based on data collected between February 2021 and October 2023 indicate that the mean speed among speeding vehicles was high mostly among sport utility vehicles (SUVs) at 10%, sedans/saloons at 9%, minibuses/minivans at 8), and pickup/light trucks at 7%. Five percent of the observed vehicles were exceeding the posted speed limit.

A cyclist lying on the ground following an accident in Kampala. Photo by Katumba Badru Sultan
A cyclist lying on the ground following an accident in Kampala. Photo by Katumba Badru Sultan

Speeding in Kampala

Presenting findings, Mr. Bonny Balugaba, a Researcher based at the Trauma, Injuries and Trauma Unit of MakSPH noted that the international best practices for speed management recommend a safe speed of 30 km/h on roads where conflicts between cars and unprotected users are possible. Also, 50 km/h speed is recommended at intersections where side-on conflicts between cars may occur. This is particularly applicable in urban areas.

Mr. Bonny Balugaba, a Researcher based at the Trauma, Injuries and Trauma Unit of MakSPH speaks to the media shortly after the dissemination of the report at Hotel African, Kampala. Photo by Davidson Ndyabahika. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Mr. Bonny Balugaba, a Researcher based at the Trauma, Injuries and Trauma Unit of MakSPH speaks to the media shortly after the dissemination of the report at Hotel African, Kampala. Photo by Davidson Ndyabahika

“If in Kampala we are seeing 57km/h speed, it means that we are way above the recommended speed limits and we know that beyond 40km/h, the chances of survival of someone that has been knocked are very minimal,” says Balugaba.

The researchers recommend enforcing a 50 km/h speed limit in metropolitan areas and a 30 km/h limit in places where motorized traffic interacts with bikes and pedestrians. In order to safeguard vulnerable road users, particularly the Ministry of Works and Transport and the Kampala Capital City Authority, it suggests implementing speed-calming techniques including bumps and signage as well as designating low-speed areas.

Investigators further advise the Kampala Metropolitan Traffic Police to increase enforcement, especially on local roads and on vehicles such as SUVs, sedans, pickup trucks, minibuses on routes with limited pedestrian access. It is recommended that public awareness campaigns and enforcement measures regarding the dangers of speeding be regularly monitored and evaluated to ensure continued efficacy.

Balugaba noted; “Mass media is good but if you are telling me the dangers of speed but am not apprehended on speed then it tends to entertainment. You come, entertain me with your campaign and adverts and go away but you are not enforcing.”

Some of the participants follow proceedings during the launch. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Some of the participants follow proceedings during the launch.

Helmet Use in Kampala

Helmet use compliance among motorcyclists was notably low at 39%, and even lower for passengers at 2%. This trend persisted on both local and collector roads (39%) and arterial roads (40%). During weekends, helmet use dropped by 20%. Ride-share motorcycle drivers, particularly Safe Boda, exhibited the highest compliance at 84%, surpassing commercial motorcycle drivers (50%), taxi drivers (55%), and private/government motorcycle users (55%).

From 2020 to 2022, 210 motorcycle occupants and 185 pedestrians lost their lives. Notably, 40% of pedestrian fatalities resulted from collisions with cars, SUVs, or pickups, whereas 36% of motorcycle deaths were attributed to accidents involving other motorcycles.

“We saw that only 2% of the motorcycles are using helmets. This really means that the situation is still bad. We need to put in place measures knowing that helmets save those that are wearing them,” says Balugaba.

Mr. Bonny Balugaba, a Researcher based at the Trauma, Injuries and Trauma Unit of MakSPH speaks to the media shortly after the dissemination of the report at Hotel African, Kampala. Photo by Davidson Ndyabahika. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Mr. Bonny Balugaba, a Researcher based at the Trauma, Injuries and Trauma Unit of MakSPH speaks to the media shortly after the dissemination of the report at Hotel African, Kampala. Photo by Davidson Ndyabahika

Adding that while four of every 10 riders are wearing a helmet but less than one in every 10 passengers has a helmet. “is it that passengers have harder heads than riders? That in case they are involved in a crash, they don’t get affected? These are issues we need to work on.”

While sharing the data outcomes, Dr Raphael Awuah, the African Regional Advisor on Data and Surveillance for Vital Strategies notes that while many of the cities in Africa, pedestrians constitute the majority fatalities, this is different for Kampala. “For most parts of Africa, we see that pedestrians account for most fatalities. However, in Kampala, this is not the case. We see that majority of the deaths are among the motorcyclists and this trend has been observed since 2018. So clearly this emphasizes the need to prioritize the vulnerable road users in Kampala particularly motorcyclists and pedestrians.”

Dr. Raphael Awuah, the African Regional Advisor on Data and Surveillance for Vital Strategies speaking at the dissemination. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Dr. Raphael Awuah, the African Regional Advisor on Data and Surveillance for Vital Strategies speaking at the dissemination.

The top five locations for pedestrian fatalities and serious injuries from 2019 to 2022 are high-capacity roads: Kampala Road, Jinja Road, Bombo Road, Entebbe Road, and Masaka Road.

The distribution of motorcycle fatal crash locations does not exhibit any clear pattern, but there is a noticeable concentration on high-capacity highways. Kampala Road, Masaka Road, Bombo Road, Kisaasi Road, and the Northern Bypass are the top five places.

“While it is true that these are high capacity roads, speeding is probably one of the causes of fatalities. I hope we will use this data to inform the discussions, actions, plans, strategies to reduce the outcomes that I have just shared,” observed Dr Raphael Awuah. 

The Kampala Metropolitan Traffic Police has been urged to increase the enforcement of proper helmet use, with a focus on passengers, taxis, and commercial motorbikes on arterial, local, and collector roads all week round. Also, KCCA and the Ministry of Works and Transport may want to start public awareness programs promoting the appropriate use of helmets and advocate for sanctions and fines for improper helmet wear in conjunction with coordinated increased enforcement.

Becky Bavinger, from the public health area of Bloomberg Philanthropies hands a copy of the Kampala Summary Status Report on Road Safety Risk Factors to CSO representatives. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Becky Bavinger, from the public health area of Bloomberg Philanthropies hands a copy of the Kampala Summary Status Report on Road Safety Risk Factors to CSO representatives.

“This is about behavioral change. It is extremely difficult. We are all humans. All of us know that speeding is bad for us but when we get behind the wheel, we will still try to speed. All of us know that wearing a helmet will protect our heads, but only 2% of us wear helmets when we are riding on a motorcycle. So what else is needed? Yes, knowledge is important, it is important to tell people why they should be putting on these helmets and the consequences they will face if they don’t wear them but it is also important to have reinforcing mechanism. Yes, mass media campaigns are important but equally important is visible and widespread enforcement,” explained Dr. Abdulgafoor Bachani, Director of JH-IIRU.

Dr. Abdulgafoor Bachani, Director of JH-IIRU hands over the Kampala Summary Status Report to SP. Michael Kananura, spokesperson, Traffic and Road Safety Directorate, Uganda Police Force during the launch at Hotel Africana on Tuesday, January 16, 2024. Photo by Davidson Ndyabahika. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Dr. Abdulgafoor Bachani, Director of JH-IIRU hands over the Kampala Summary Status Report to SP. Michael Kananura, spokesperson, Traffic and Road Safety Directorate, Uganda Police Force during the launch at Hotel Africana on Tuesday, January 16, 2024. Photo by Davidson Ndyabahika

On his part, Dr. Fredrick Oporia said “Road safety is an issue of concern to everyone. To improve this safety, we must have high-quality data on the risk factors and share it with our stakeholders. Most importantly, we need local stakeholders who are charged with making laws and policies for the country because this is a systems issue that calls for systems thinking. We must involve the local to get the attention of the international.”

SP. Michael Kananura, spokesperson, Traffic and Road Safety Directorate, Uganda Police Force says there is a regulation on helmet use targeting not only riders but also passengers, although he acknowledges challenges with enforcement. He calls on the public support these public health and road safety measures.  

SP. Michael Kananura, spokesperson, Traffic and Road Safety Directorate, Uganda Police Force speaks to journalists at the launch of the status report. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
SP. Michael Kananura, spokesperson, Traffic and Road Safety Directorate, Uganda Police Force speaks to journalists at the launch of the status report.

“We really appreciate our colleagues from MakSPH and the rest for this work and the academia generally for the work you are doing in as far as research is concerned and also being able to share with us this data. We also use this data to improve in our enforcements. It guides us on areas of improvement and prioritization. The data really is so helpful to us and we also continue to work to see how we can improve in that area. We have a unit in traffic directorate that is for enforcement basically,” SP Kananura.  

Comments from KCCA leadership

Hon. Kizza Hakim Sawula, the lord councilor from Lubaga and Executive Secretary and a Minister for Works and Physical Planning –KCCA noted that one of the causes of this these accidents in the capital city is the poor-quality roads that wear out easily with numerous potholes and the meagre maintenance budget appropriated by parliament to the city authority.

Hon. Kizza Hakim Sawula, the lord councilor from Lubaga and a Minister for Works and Physical Planning -KCCA speaking at the launch. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Hon. Kizza Hakim Sawula, the lord councilor from Lubaga and a Minister for Works and Physical Planning -KCCA speaking at the launch.

“Can you imagine that each kilometer of the road within Kampala is constructed at an average cost of 14 billion shillings. For the last three budgets, we were getting 78bn but but in the current budget, we received only 43 billion shillings for the entire capital, for the entire financial year for roads, drainages and traffic lights. How many kilometers are we looking at? 3 kilometers for a financial year, 43 billion shillings?

We used to get Shs26 billion from the national road fund, for road maintenance every financial year. You can confirm from the mayors and load counselors here. This time around, we received only 11 billion for all the maintenance. Now, what do we expect out of that money? So, the task is upon the members of the Parliament to improve on the budget. We have 2,110 kilometers of roads within Kampala. Only 654 kilometers are paved, when shall we complete the entire balance? So, we need a budget, enough budget from the members of parliament. When we talk to MPs they only talk about loans we get from development partners which is usually for new roads,” explained Hon. Sawula.

Concerned, Nakawa Division Mayor, Paul Mugambe said it was disheartening that many people continue to lose their lives prematurely. He cited that not every death is predetermined by the Lord. “Driving at excessively high speeds, and resulting in a crash is not the Lord’s decision. Many individuals lose their lives prematurely due to reckless behavior, and it’s truly regrettable.”

Nakawa Division Mayor, Paul Mugambe speaks to the media at the launch. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Nakawa Division Mayor, Paul Mugambe speaks to the media at the launch.

Mr. Mugambe urged Police to use the evidence provided to improve on the enforcement of road traffic laws and regulations.

Prof. Elizeus Rutebemberwa, the Deputy Dean, MakSPH thanked the Bloomberg Philanthilopies “for supporting us to help ourselves” and the JH-IIRU for the technical support to the TRIAD unit, the university and many partners. He also noted that the urban population in Uganda is steadily increasing and called for proactive and inclusive urban planning.

Prof. Elizeus Rutebemberwa, the Deputy Dean, MakSPH speaks at the launch. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Prof. Elizeus Rutebemberwa, the Deputy Dean, MakSPH speaks at the launch.

“From 2012, the urban population was 20%. In 2022, which is one year and a half ago, it was 26%. So, one in four people in Uganda were in urban areas. Now in 2040 it is estimated that 33 million would be living in urban areas and that would be 46%. So, it’s not getting better, it’s getting worse. So, we need to manage our urban areas so that people don’t shift from the rural areas to come to die in urban areas,” said Prof. Rutebemberwa.

He called on government and the city authority to fast-track mass transport systems to reduce congestion on the roads. “Look at the traffic that come to Kampala. They are in private cars and each one is carrying one person. In very few cases, two people. Now, if you have all those cars for one kilometre stretch, you could actually park all those people in one bus. And you have all space and you reduce the pollution, why should this be difficult for people to know that. For you to have an organized urban area, you need mass transport. You don’t need to research to know that. So why don’t we have them? Some of these things, some of them we talked about in the national drive, dedicated walk lanes.

According to Becky Bavinger, from the public health area of Bloomberg Philanthropies, road traffic injuries are the leading cause of death for people aged 5 to 29. She mentioned that the fatalities from road traffic are at a crisis level in Uganda.

Becky Bavinger, from the public health area of Bloomberg Philanthropies urged stakeholders to utilise the data for proper decision making. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Becky Bavinger, from the public health area of Bloomberg Philanthropies urged stakeholders to utilise the data for proper decision making. 

“I want to say this again. This is the leading cause of death. It’s not HIV. It’s not tuberculosis. It’s real traffic injuries for people aged 5 to 29. Those are the young people. We had the mayor talking about the economic impact as well. These are young people going to school, getting trained, coming back into your workforce, starting out in the workforce, and you’re losing their lives. There’s a forthcoming research from the Road Safety Coalition Uganda looking at the loss of GDP from road traffic injuries. In 2017, your government reported 3,500 deaths. The WHO estimated it was double that at about 6,000. It has gone up. In 2021, your government reported 4,159 deaths. Again, the WHO estimated it was about double that at 7,300. This is not good. This is a crisis and we need everyone working together on it,” Ms. Bavinger said.

She noted that Bloomberg Philanthropies will be working over these next two years with KCCA and with the government of Uganda to institutionalize data collection and the surveillance of road traffic injuries and deaths to improve its accuracy.

Becky Bavinger, from the public health area of Bloomberg Philanthropies hands a copy of the Kampala Summary Status Report on Road Safety Risk Factors to KCCA to MPs. Makerere University School of Public Health, Johns Hopkins International Injury Research Unit, KCCA, Vital Strategies launch of Status Summary Report 2023; Road Risk Factors for Kampala, Uganda, 16th January 2024, Hotel Africana, Kampala Uganda, East Africa.
Becky Bavinger, from the public health area of Bloomberg Philanthropies hands a copy of the Kampala Summary Status Report on Road Safety Risk Factors to KCCA to MPs.

“These data are critical to forming your decision making. I just want to conclude by saying congratulations to Makerere University, to Johns Hopkins University, but ultimately to KCCA for launching this report, for conducting this research and this is not easy research to conduct. To the stakeholders, use these data. Please, please do not go home and put this report on your shelf. Look through it. Talk to the journalist. Get the media to write stories about this, let everyone know what is happening,” said Bavinger. 

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Davidson Ndyabahika

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Call for Applications: Short Course in Molecular Diagnostics March 2026

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Some of the equipment used to store samples at the Makerere University Biomedical Research Centre (MakBRC), College of Health Sciences (CHS). Kampala Uganda, East Africa.

Makerere University College of Health Sciences, Department of Immunology and Molecular Biology, in collaboration with the Makerere University Biomedical Research Centre (MakBRC), is pleased to invite applications for a Short Course in Molecular Diagnostics scheduled for 23rd–27th March 2026.

This hands-on course will introduce participants to core principles and practical skills in molecular diagnostics, including nucleic acid structure and function, laboratory design and workflow, PCR setup, gel electrophoresis and DNA band interpretation, contamination control and quality assurance, and clinical applications of PCR in disease diagnosis.

The training will take place at the Genomics, Molecular, and Immunology Laboratories and will accommodate 30 trainees. The course fee is UGX 500,000.

Target participants include:

  • Graduate students with basic exposure to molecular biology (e.g., MICM, MSBT)
  • Final year undergraduate students (e.g., BBLT, BMLS)
  • Medical and veterinary clinicians
  • Agricultural professionals interested in practical molecular biology

To apply, please send your signed application via email to nalwaddageraldine@gmail.com (copy Dr. Eric Kataginy at kataginyeric@gmail.com). Indicate your current qualification, physical address, and phone contact (WhatsApp preferred), and attach a copy of your National ID or passport data page, your current transcript or testimonial, and your degree certificate (if applicable).

The application deadline is 13th March 2026. Successful applicants will be notified by email. Admitted participants are required to pay the course fee within five days to confirm their slot.

For further inquiries, don’t hesitate to get in touch with Ms. Geraldine Nalwadda on +256 701 361449.

See download below for detailed call.

Mak Editor

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When Birth Becomes the Most Dangerous Moment, Wanduru & the Work of Making Labour Safer

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Makerere University School of Public Health Communications Office, Graduation Profiles Series, 76th Graduation Ceremony, Phillip Wanduru, “Intrapartum-Related Adverse Perinatal Outcomes: Burden, Consequences, and Models of Care from Studies in Eastern Uganda,” Kampala Uganda, East Africa.

The ward is never quiet during labour. Even at night, there are cries, some sharp with pain, others muted by exhaustion. Monitors beep. Midwives move quickly between beds. In the moments just before birth, everything narrows to breath, pressure, and time.

It was in places like this, years ago, that Phillip Wanduru first learned how fragile that moment can be.

Working as a clinical nurse at Nakaseke Hospital in central Uganda, he watched babies who should have survived struggle for breath. Some were born still. Others cried briefly, then went silent. Many were not premature or unusually small; they were full-term babies whose lives unraveled during labour.

“What troubled me most,” Wanduru recalls, “was that these were complications we have known how to manage for more than a hundred years, prolonged labour, obstructed labour, and hypertension. And yet babies were still dying or surviving with brain injuries.”

Those early encounters never left him. They became the questions that followed him into public health, into research, and eventually into a doctoral thesis that would confront one of Uganda’s most persistent and preventable tragedies.

A mother lovingly cradles her newborn baby hospital room.
A mother lovingly cradles her newborn baby hospital room.

A Public Defense, Years in the Making

On Friday, June 13, 2025, Wanduru stood before colleagues, mentors, and examiners in a hybrid doctoral defense held at the David Widerström Building in Solna, Sweden, and online from Kampala. The room was formal, but the subject matter was anything but abstract.

His PhD thesis, “Intrapartum-Related Adverse Perinatal Outcomes: Burden, Consequences, and Models of Care from Studies in Eastern Uganda, was the culmination of years spent listening to mothers, following newborns long after delivery, and documenting what happens when birth goes wrong.

He completed the PhD through a collaborative programme between Makerere University and Karolinska Institutet, under the supervision of Prof. Claudia Hanson, Assoc. Prof. Peter Waiswa, Assoc. Prof. Helle Mölsted Alvesson, and Assoc. Prof. Angelina Kakooza-Mwesige, a team that bridged global expertise and local reality. His doctoral training unfolded as the two institutions marked 25 years of collaboration, a partnership that has shaped generations of public health researchers and strengthened research capacity across Uganda and beyond.

By the time he defended, the findings were already unsettlingly clear.

Phillip Wanduru holds a bound copy of his Thesis shortly after his Defense at the David Widerström Building in Solna, Sweden. Makerere University School of Public Health Communications Office, Graduation Profiles Series, 76th Graduation Ceremony, Phillip Wanduru, “Intrapartum-Related Adverse Perinatal Outcomes: Burden, Consequences, and Models of Care from Studies in Eastern Uganda,” Kampala Uganda, East Africa.
Phillip Wanduru holds a bound copy of his Thesis shortly after his Defense at the David Widerström Building in Solna, Sweden.

One in Ten Births

In hospitals in Eastern Uganda, Wanduru’s research found that more than one in ten babies experiences an intrapartum-related adverse outcome. This medical term refers to babies who are born still, die shortly after birth, or survive with brain injury caused by oxygen deprivation during labour.

Among those outcomes, stillbirths accounted for four in ten cases. Five in ten babies survived with brain injury.

“These are not rare events,” Wanduru explains. “They are happening every day, often in facilities where care should be available.”

But survival was only part of the story.

Following infants diagnosed with intrapartum-related neonatal encephalopathy for a year, his research revealed that about seven in ten babies with severe brain injury died before their first birthday. Among survivors, many faced lifelong challenges, difficulty walking, talking, and learning.

“What happens in labour,” he says, “does not end in the delivery room. It follows families for years.”

He describes the findings of his PhD research as appalling, evidence of an urgent failure in how labour and delivery are managed, and a call for immediate action to prevent avoidable complications. “Babies with severe brain injuries,” he notes, “faced the greatest odds. Even when they survived birth, nearly seven in ten died before their first birthday. Of those who lived beyond infancy, about half were left with long-term challenges, including difficulties with walking, talking, or learning.”

Wanduru with some of his supervisors including Prof. Peter Waiswa at the David Widerström Building in Solna, Sweden. Makerere University School of Public Health Communications Office, Graduation Profiles Series, 76th Graduation Ceremony, Phillip Wanduru, “Intrapartum-Related Adverse Perinatal Outcomes: Burden, Consequences, and Models of Care from Studies in Eastern Uganda,” Kampala Uganda, East Africa.
Wanduru with some of his supervisors including Prof. Peter Waiswa at the David Widerström Building in Solna, Sweden.

Mothers at the Centre—Yet Often Invisible

Wanduru’s work did not stop at numbers. Through in-depth interviews with mothers and health workers, he uncovered a quieter truth that parents, especially mothers, were desperate to help their babies survive, but often felt unsupported themselves.

Mothers followed instructions closely. They learned to feed fragile babies, keep them warm, and monitor breathing. They complied with every rule, driven by fear and hope in equal measure.

“The survival of the baby became the only focus,” Wanduru says. “But the mothers were exhausted, emotionally drained, and often ignored once the baby became the patient.”

Even as mothers remained central to care, their own physical and mental well-being received little attention. For the poorest families, the burden was heavier still: long hospital stays, transport costs, and uncertainty about the future.

These insights shaped one of the thesis’s most powerful conclusions: saving newborn lives requires caring for families, not just treating conditions.

Why Care Fails—Even When Knowledge Exists

One of the most uncomfortable findings in Wanduru’s research was that emergency referrals and caesarean sections did not consistently reduce the risk of brain injury, except in cases of prolonged or obstructed labour.

The problem, he found, was not the intervention, but the delay.

In many facilities, hours passed between identifying a complication and acting on it. Ambulances were unavailable. Referral systems were weak. Operating theatres lacked supplies or staff.

“These are not failures of science,” Wanduru says. “They are failures of systems.”

His work reinforces a sobering reality for policymakers that most intrapartum-related deaths and disabilities are preventable, but only if care is timely, coordinated, and adequately resourced.

From Bedside to Systems Thinking

Wanduru’s path into public health began at the bedside. After earning a Bachelor of Science in Nursing from Mbarara University of Science and Technology in 2011, he trained as a clinician, caring for patients during some of their most vulnerable moments. He later completed a Master of Public Health at Makerere University in 2015, a transition that gradually widened his focus from individual patients to the health systems responsible for their care.

His work gradually drew him deeper into the systems shaping maternal and newborn care. As a field coordinator for the MANeSCALE project, he worked within public and private not-for-profit hospitals, helping to improve clinical outcomes for mothers and babies. Under the Preterm Birth Initiative, he served as an analyst, contributing to efforts to reduce preterm births and improve survival among vulnerable infants through quality-improvement and discovery research across Uganda, Kenya, and Rwanda.

In the Busoga region, he coordinated prospective preterm birth phenotyping, following mothers and babies over time to better understand the causes and consequences of early birth. Since 2016, this work has been anchored at Makerere University School of Public Health, where he serves as a Research Associate in the Department of Health Policy, Planning, and Management.

Across these roles, he found himself returning to the same question: why babies continue to die during a moment medicine has long learned to handle.

Models of Care That Could Change Outcomes

Wanduru’s thesis does more than document failure; it points toward solutions.

He highlights family-centred care models, including Kangaroo Mother Care, which keep babies and parents together and improve recovery, bonding, and brain development. He emphasizes early detection of labour complications, functional referral systems, and rapid access to emergency obstetric care.

“These are not new ideas,” he says. “The challenge is doing them consistently.”

He also calls for recognizing stillbirths, not as inevitable losses, but as preventable events deserving data, policy attention, and bereavement support.

“Stillbirths are often invisible,” he notes. “But they matter to mothers, to families, and to the health system.”

Research That Changes Practice

For Wanduru, the most meaningful part of the PhD journey is that the evidence is already being used. Findings from his work have informed hospital practices, advocacy reports, and quality-improvement discussions.

“Yes, the PhD was demanding,” he admits. “But knowing that the work is already contributing to change makes it worthwhile.”

His mentors see him as part of a broader lineage, researchers committed not only to generating evidence but to ensuring it improves care.

With a PhD in his bag, Wanduru sees his work as a continuation rather than a conclusion.

L-R: Irene Wanyana, Nina Viberg, Kseniya Hartvigsson, Faith Hungwe and Monika Berge-Thelander members of the CESH working group, a collaboration between Makerere University and Karolinska Institutet congratulate Wanduru Phillip on his PhD. Makerere University School of Public Health Communications Office, Graduation Profiles Series, 76th Graduation Ceremony, Phillip Wanduru, “Intrapartum-Related Adverse Perinatal Outcomes: Burden, Consequences, and Models of Care from Studies in Eastern Uganda,” Kampala Uganda, East Africa.
L-R: Irene Wanyana, Nina Viberg, Kseniya Hartvigsson, Faith Hungwe and Monika Berge-Thelander members of the CESH working group, a collaboration between Makerere University and Karolinska Institutet congratulate Wanduru Phillip on his PhD.

“The fight to make birth safe for every mother and baby continues,” he says. “I want to contribute to improving care and to building the capacity of others to do the same.”

That means mentoring young researchers, strengthening hospital systems, and keeping the focus on families whose lives are shaped in the delivery room.

Dr. Wanduru joins fellows in the MakSPH PhD forum who concluded their doctoral journeys in 2025, and his work speaks for babies who never cried, for mothers who waited too long for help, and for health workers doing their best within strained systems. It insists that birth, while always risky, does not have to be deadly.

Makerere University School of Public Health Communications Office, Graduation Profiles Series, 76th Graduation Ceremony

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Davidson Ndyabahika

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Study Alert: Power in Her Hands; Why Self-Injectable Contraception May Be a Game Changer for Women’s Agency in Uganda

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The Self-injectable contraception, known as DMPA-SC, disrupts the provider-client model by shifting care from the clinic to the individual woman.

By Joseph Odoi

In the remote villages of Eastern and Northern Uganda, a small medical device is doing far more than preventing unintended pregnancies, it appears to be quietly shifting the balance of power in women’s lives.

A new study titled “Is choosing self-injectable contraception associated with enhanced contraceptive agency? Findings from a 12-month cohort study in Uganda” has revealed that self-injection gives women more than just a health service, it can boost their confidence, control, and agency over their reproductive health.

The research was conducted by Makerere University namely; Professor Peter Waiswa, Catherine Birabwa, Ronald Wasswa, Dinah Amongin and Sharon Alum in collaboration with colleagues from the University of California, San Francisco

Why this Study matters for Uganda

For decades, family planning in Uganda has followed a provider-client model. Women travel long distances to clinics, wait in queues, and rely on health workers to administer contraception. This system creates barriers transport costs, clinic stock-outs, long waiting times, and limited privacy.

Self-injectable contraception, known as DMPA-SC, disrupts this model by shifting care from the clinic to the individual woman.

DMPA-SC is a discreet, easy-to-use injectable that women can administer themselves after receiving basic training and counselling.

What the Data Tells Us

To see if self-care technology actually shifts the needle on women’s power, researchers tracked 1,828 women across Eastern (Iganga and Mayuge Districts) and Northern Uganda (Kole, Lira, and Oyam Districts) for a full year. They compared women who chose to self-inject their birth control (216 women) against a control group, most of whom chose methods requiring dependency on clinics (1,612 women).   

The Six-Month “Agency Spike”

The study used a Contraceptive Agency scale (scored from 0 to 3) to measure a woman’s internal confidence and her ability to act on her health choices.

The Self-Injectors

For the Self Injectors, their agency scores rose significantly, from 2.65 to 2.74 by the six-month mark.

The Clinic-Dependent Group

Scores for the group using mostly provider-led methods (like clinic shots or implants) remained nearly flat, moving from 2.61 to only 2.63.

Within just six months, women who took control of their own injections noted that they felt a measurable boost in their Consciousness of reproductive Rights (0.08 points) since they transitioned from being passive recipients of care to active decision-makers.

Using the Agency in Contraceptive Decisions Scale (scored 0–3), the study found a clear empowerment advantage for women who chose self-injection.

The findings come at a time when Uganda has reaffirmed its commitments under FP2030, aiming to expand access to voluntary, rights-based family planning. The study also aligns with the National Family Planning Costed Implementation Plan, which prioritises method choice, equity, and continuation, as well as national gender and youth empowerment strategies.

Can Uganda Sustain and Scale DMPA-SC?

Self-injectable contraception does not require continuous high-cost investment. Training and rollout costs are largely one-time, and the main recurring expense is the contraceptive commodity itself. Compared with the cumulative costs of repeated clinic visits for both the health system and women self-injection is more cost-effective over time.

Advancing primary health care with DMPA-SC

Beyond cost savings, self-injection eases pressure on health facilities and allows health workers to focus on more complex care. It also extends health services into communities, supporting continuity of care in areas where facilities are few and far between. In this way, family planning is no longer confined to the clinic.

While donor support has helped introduce the method, it can be sustained locally without relying on external funding. “With predictable national financing and reliable commodity supply chains, DMPA-SC can reach more women and be fully integrated into Uganda’s health system, strengthening both access and community-level service delivery’’ according to the researchers.

Implications for Policy and Practice

As Uganda continues to reform its primary health care system, the findings add evidence to ongoing discussions about how family planning services are delivered, financed, and prioritised.

The research also positions self-injectable contraception not as a temporary innovation, but as a scalable method with the potential to be embedded within national systems provided that commodity availability and financing are safeguarded.

To ensure these gains are lasting, researchers recommend moving beyond the technology and addressing the structural and social barriers that can limit women’s agency.

Key recommendations from the researchers include the following

1. Reliable Supply Chains

Empowerment collapses when products are unavailable. DMPA-SC must be consistently stocked at the community level.

2. Creating a Supportive Social Environment

Privacy concerns, stigma, and partner resistance must be tackled through community engagement and sensitisation.

3. Prioritizing Informed Choice

Self-injection should be offered as a top-tier option in every facility, framed as a fundamental right to autonomy rather than just a medical convenience.

4. Integrated Counseling

Providers must be trained to support women not only in the “how to inject” but also in navigating the social challenges of self-care.

On the next step, the researchers call for a clear integration of DMPA-SC into national health financing, protection of family planning commodity budgets, and deliberate scaling of self-injectable contraception within Primary Health Care reforms. These actions will ensure sustainability, reliable access, and greater control for women over their reproductive choices according to the researchers.

Read the full study here: https://www.contraceptionjournal.org/article/S0010-7824(26)00003-X/fulltext

Mak Editor

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