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Mak and Karolinska to Continue Prioritising Sustainable Health

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Makerere University and Karolinska Institutet Sweden have embarked on undertaking strategies aimed at ensuring that sustainable health becomes a priority on the global agenda. This was revealed during a high level meeting involving Makerere University Management and a delegation from the Karolinska Institutet Sweden, held on Tuesday 6th February 2024 at the Rotary Peace Centre Board Room, Frank Kalimuzo Central Teaching Facility.

The Vice Chancellor, Prof. Barnabas Nawangwe welcomed the Vice President of Karolinska Institutet Prof. Martin Bergö and his delegation to Makerere University. Reflecting on Makerere University’s 100 year journey (1922-2022), the Vice Chancellor pointed out that the institution has been at the forefront of training human resources who have been key in the identification and finding solutions to various development challenges.

Makerere is a very collaborative university. We have collaborations within Africa of course, most of our external collaborations are in Europe and the United States. Times Higher Education (THE) considers Makerere the most collaborative university on their database,” said Professor Barnabas Nawangwe.

Adding that; “We publish jointly with a professor at another university, more than any other university in the world, 167 MOUs signed in one year and quite a number of them are very active and particularly in the College of Health Sciences.”

Professor Nawangwe also expressed the government of Uganda’s support to the Makerere University’s research agenda through its funding commitments under the Research and Innovation Fund.“When the SIDA support was due to end, I accompanied the Swedish Ambassador to go and see our Minister of Education and Sports, who is our First Lady as well, and he told her, ‘Swedish support is going to end in two years. Is the government going to take over?’ And she said, ‘yes we shall.’ For the first time, the government committed an equivalent of about $8 million dollars every year for research at Makerere University. A lot of projects have been funded. There are more than 1,250 since the project started four years that have been funded. 39% of all the grants are going to health,” shared Prof. Nawangwe.

Prof. Barnabas Nawangwe (Right) and Prof. Martin Bergö (Left) during the courtesy call prior to the meeting. Frank Kalimuzo Central Teaching Facility, Makerere University, Kampala Uganda, East Africa.
Prof. Barnabas Nawangwe (Right) and Prof. Martin Bergö (Left) during the courtesy call prior to the meeting.

As Makerere University embraces the next century, Prof. Nawangwe said that partnerships with Karolinska Institutet will be leveraged to ensure that research in sustainable health takes centre stage.  “Global Health is a major issue. The Centre for Excellence for Sustainable Health, which is a collaboration between Makerere University in Uganda and Karolinska Institutet in Sweden will be central in addressing global issues.”

In this regard, the Vice Chancellor implored the researchers at Makerere and Karolinska to explore bringing more academic disciplines on board including those in agriculture, food security, gender, architecture, to mention but a few, for a holistic approach.  In the same vein, the Director of Research and Graduate Training, Prof. Edward Bbaale proposed the need to include smart energy options, climate change, nutrition as well as the environment into sustainable health. For instance, how do nutritionists contribute to sustainable health?

Prof. Tobias Alfvén, a Pediatrician and Researcher at Karolinska Institutet, and Co-Chair of the CESH Working Group, underscored the fundamental role of the longstanding 20-year relationship between the two institutions and the dedicated teams involved in facilitating this work. Reflecting on the genesis of their collaboration, he explains, “We met just a month before the pandemic hit Sweden and Uganda, and we started collaboration; everything went online, and we started developing what became the Centre of Excellence for Sustainable Health (CESH). Without that long-term thinking and the good team already there, we would not have achieved that.”

Prof. Rhoda Wanyenze, the Dean, Makerere University School of Public Health (MakSPH) and Co-Chair of the Centre’s Working Group informed the University Management and the visiting delegation that sustainable health involves humans, animals, and the environment. In this regard, the CESH has embraced a multi-disciplinary approach towards research by involving students from different disciplines. She pointed out that CESH has identified students from the College of Agricultural and Environmental Sciences (studying climate change) and those from MakSPH (Environmental Health Sciences) to form research teams that will provide solutions to global health issues.

Left to Right: Prof. Umar Kakumba, Prof. Martin Bergö, Prof. Rhoda Wanyenze and Ms. Monika Berge-Thelander during a courtesy call on the DVCAA in his office. Senate Building, Makerere University, Kampala Uganda, East Africa.
Left to Right: Prof. Umar Kakumba, Prof. Martin Bergö, Prof. Rhoda Wanyenze and Ms. Monika Berge-Thelander during a courtesy call on the DVCAA in his office.

The CESH Working Group’s three-year commitment to promoting sustainable health practices was emphasized by Prof. Wanyenze who also reported a notable shift in focus toward sustainable health during sessions of the World Health Summit held last year.

“We can work together and learn from each other and we can bridge those gaps and the challenges that are leaving some of these vulnerable groups behind. It might be refugees’ issues in Uganda, it might be other disadvantaged groups within Sweden, but we can learn from one another and be able to reach out to them,” Professor Rhoda Wanyenze.

She added that; “When we are thinking about our health and wellbeing today, we should not have the health and well-being of future populations because there are many things we do today to keep ourselves happy and healthy that will affect those that are coming after us.”

Dr. Roy Mayega, an alumnus of Karolinska Institutet and a Senior Lecturer in the Department of Epidemiology and Biostatistics at MakSPH acknowledged Makerere University for valuing the partnership through funding research in sustainable health.  He also pointed out that the research teams were discovering new issues such as gender and climate change in the realization of sustainable health.

Left to Right: Prof. Roy Mayega, Prof. Stefan Peterson Swartling and Prof. Tobias Alfvén during the courtesy call on the DVCAA in his office. Senate Building, Makerere University, Kampala Uganda, East Africa.
Left to Right: Prof. Roy Mayega, Prof. Stefan Peterson Swartling and Prof. Tobias Alfvén during the courtesy call on the DVCAA in his office.

On behalf of Karolinska Institutet, Prof. Martin Bergö thanked the Makerere University Management for the warm reception and the commitment to sustainable health. He mentioned that this was his first visit to Uganda and Makerere University. Acknowledging the partnership between both institutions for the last 22 years, Prof. Bergö who is the current Chairman of the Centre of Excellence for Sustainable Health expressed delight at being part of this collaboration.

He noted that all crises, whether caused by pandemics, poverty, conflicts, or climate change, have an impact on both physical and mental health. He further noted that the link between human, animal, and plant health, known as “One health” increases the importance of collaborating and working together across borders and between different sectors of society.

Prof. Bergö nevertheless acknowledged that people are at the heart of collaborations. “However, partnerships are foremost between people”, he noted, before adding “Building equitable personal relationships and learning from one another. This is perhaps the most important objective of this visit!”

He commended CESH, whose evaluation of the first three years of operation 2021-2023 revealed that the Centre was well on its way to achieving the set objectives. CESH has to date developed four out of planned five tools for working with sustainable health, while the last one is being finalized. “The tools are being used in education and research and I am happy to learn that we are making an impact.”

Prof. Martin Bergö (Left) and Prof. Rhoda Wanyenze (Right) during the courtesy call on the DVCAA in his office. Senate Building, Makerere University, Kampala Uganda, East Africa.
Prof. Martin Bergö (Left) and Prof. Rhoda Wanyenze (Right) during the courtesy call on the DVCAA in his office.

Prof. Bergö equally commended Prof. Barnabas Nawangwe and the former President of Karolinska Institutet, Prof. Ole Petter Ottersen on co-authoring a publication defining sustainable health. Other co-authors included Rhoda Wanyenze, Tobias Alfvén, Rawlance Njejjo, Nina Viberg, Roy William Mayega, and Stefan Swartling Peterson.

“I have read it with much interest and see myself as an ambassador for spreading the concept in different contexts. I am pleased to understand that this definition is the point of departure for all activities devised and carried out by the Centre of Excellence for Sustainable Health” he said, adding that the Karolinska Institutet President, Annika Östman Wernerson is looking forward to visiting Makerere University this November.

During this interactive meeting, both institutions underscored the role of the library in advancing research and preservation of knowledge. The Vice Chancellor, Prof. Barnabas Nawangwe pointed that the Makerere University Library serves as a national reference library as well as a legal and United Nations repository. He therefore acknowledged the support received from NORAD and Sida in the professionalization of library services and making it a model library in Africa.  Prof. Bergö mentioned that libraries are the guardians of knowledge and thanked the Vice Chancellor for inviting the University Librarian to the discussion.

Makerere University Management Members who attended the meeting included: Deputy Vice Chancellor (Academic Affairs)-Assoc. Prof. Umar Kakumba, Director Research and Graduate Training-Prof. Edward Bbaale, Director of Quality Assurance-Dr. Cyprian Misinde, Academic Registrar-Prof. Buyinza Mukadasi, University Librarian-Assoc. Prof. Ruth Nalumaga, Deputy University Secretary-Mr. Simon Kizito, Head of Advancement Office- Mr. Awel Uwihanganye, and Principal Public Relations Officer-Ms Ritah Namisango

Prof. Barnabas Nawangwe (Left) and Prof. Martin Bergö (right) interact with staff from Makerere and Karolinska during the meeting. Rotary Peace Centre Board Room, Frank Kalimuzo Central Teaching Facility, Makerere University, Kampala Uganda, East Africa.
Prof. Barnabas Nawangwe (Left) and Prof. Martin Bergö (right) interact with staff from Makerere and Karolinska during the meeting.

The Karolinska Institutet delegation included; Head of the International Office-Erika Dabhilkar, Co-chair of CESH-Tobias Alfvén, International Coordinator-Monika Berge-Thelander, Project Coordinator-Nina Viberg, Member of CESH Steering Committee-Stefan Peterson Swartling, and Communications Officer-Kseniya Hartvigsson.

Teams Visit the Swedish Ambassador’s residence

While hosting the two institutions, H.E. Maria Håkansson, the Ambassador of Sweden to Uganda, emphasized the significant ties between the two nations and their respective peoples as key drivers for this 22 year-old partnership.

“Collaboration between Karolinska and Makerere is still one of the most important international flagships. Which I think says a lot of what has been built and what the relations that have been creating between institutions but of course also between people. Also, we all know individually what role the university researchers play in the country’s policy development,” said Amb. Håkansson

Adam Kahsai-Rudebeck, First Secretary – Deputy Head of Cooperation Health and Social Protection at the Swedish Embassy added “We look forward to just building upon the already established relationships and initiatives that are ongoing.”

A Video Highlighting the Visit

Highlights of KI- Mak #CESH Working group Engagements in Kampala, February 2024

Photography and Video by Davidson Ndyabahika

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Holistic Retirement Planning includes Psychological, Emotional & Social well-being across all Career Stages

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The Chairperson MURBS Board of Trustees-Dr. Michael Kizito (8th Right) with Professor Seggane Musisi (7th Right) and Members after the session on 8th January 2026. Makerere University Retirement Benefits Scheme (MURBS) Member Sensitisation Session on "Understanding Identity Shifts; Developing Routines; Sustaining Motivation and Purpose", 8th January 2026, Yusuf Lule Central Teaching Facility Auditorium, Kampala Uganda, East Africa.

The Makerere University Retirement Benefits Scheme (MURBS) on Thursday, 8 January 2026 organised a Member Sensitisation Session on “Understanding Identity Shifts; Developing Routines; Sustaining Motivation and Purpose”. The session focused on holistic retirement planning, emphasising that readiness for life after work goes beyond finances to include psychological, emotional, and social well-being across all career stages—from early career to post-retirement.

The session featured a keynote presentation by Professor Seggane Musisi, who highlighted how work-related titles and roles often shape personal identity, and how retirement can trigger a sense of loss if individuals are unprepared to redefine themselves. Members were encouraged to consciously design a post-work identity grounded in values, purpose, and community contribution.

Participants learned practical strategies for:

  1. Preparing early for retirement at different career stages;
  2. Developing healthy, meaningful routines that support mental stability and productivity;
  3. Sustaining motivation and purpose beyond formal employment;
  4. Managing stress, maintaining physical and mental health, and nurturing social connections; and
  5. Balancing family responsibilities with personal well-being.

The discussion also addressed cultural realities of retirement in Uganda, including family expectations, social obligations, and financial pressures. Special attention was given to age-related challenges such as dementia, depression, and chronic illness, underscoring the importance of preventive health care, emotional resilience, and timely professional support.

Overall, the session reinforced the message that retirement is a lifelong transition, not a one-time event. Members were encouraged to plan early, adapt continuously, and intentionally design a fulfilling, purposeful life beyond work—psychologically, socially, and financially.

To view the session, please click the embedded video below. Further below is the presentation.


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Kampala at a Crossroads: What New Research Reveals About Mobility, Governance, and the City’s Public Health Risks

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Motorists navigate the Clock Tower Flyover intersection in Kampala. Uganda, East Africa

Every day in Kampala, millions of people inch through gridlock, dodge swarming boda-bodas threading through narrow gaps in traffic, inhale dangerously polluted air, and walk along streets rarely designed for pedestrians. These conditions, and more, are often dismissed as ordinary transport frustrations. Yet researchers at Makerere University School of Public Health (MakSPH) are examining how such everyday realities translate into public health outcomes, shaped not simply by congestion, but by governance, policy, and power. Their work forms part of a multi-country project investigating the political economy of urban mobility in three African cities.

A boda-boda rider navigates floodwaters alongside a car on a waterlogged road in Kampala’s Industrial Area in 2024, highlighting how rapid urban development, inadequate drainage, and car-oriented road design combine to heighten daily mobility risks for vulnerable road users. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
A boda-boda rider navigates floodwaters alongside a car on a waterlogged road in Kampala’s Industrial Area in 2024, highlighting how rapid urban development, inadequate drainage, and car-oriented road design combine to heighten daily mobility risks for vulnerable road users.

Co-led by Dr. Aloysius Ssennyonjo, the Principal Investigator and health systems and governance researcher at MakSPH, together with Uganda’s Country Principal Investigator, Dr. Esther Bayiga-Zziwa, a road safety and injury epidemiologist, and Co-Principal Investigator Dr. Jimmy Osuret, an injury prevention researcher, the project titled The Political Economy of Urban Mobility Policies and Their Health Implications in African Cities (PUMA) applies a political economy lens to understand how political interests, institutional arrangements, and power dynamics shape mobility systems and their consequences for public health in Kampala, Kigali, and Lilongwe.

To note, political economy analysis examines how public decisions are shaped by the interplay of politics, interests, institutions, and resources, in short, who has influence, who controls what, and how money and power circulate within a system. In Kampala, a capital of nearly two million residents whose daytime population swells with commuters, this lens helps explain why some transport options attract funding and enforcement while others are tolerated, neglected, or contested. These choices are not just technical, but reflect competing interests and priorities, with consequences for safety, equity, and the everyday well-being of those moving through the city.

Illustration of the Index of Sustainable Urban Mobility (I_SUM) in a planned city, highlighting how transport, accessibility, environmental, social, infrastructure, and political factors jointly shape mobility outcomes. Source: Internet.
Illustration of the Index of Sustainable Urban Mobility (I_SUM) in a planned city, highlighting how transport, accessibility, environmental, social, infrastructure, and political factors jointly shape mobility outcomes. Source: Internet.

Now, through the NIHR-funded project, the Ugandan team is currently working with colleagues from the University of Rwanda, led by Professor David Tumusiime, and Kamuzu University of Health Sciences in Malawi, led by Dr. Dominic Nkhoma. The research partnership aims to generate evidence that can strengthen mobility governance and improve public health outcomes across the three African cities above, with advisory support for the research consortium from the University of Antwerp in Belgium and Canterbury Christ Church University in the UK.

Explaining the project’s rationale for the Politics of Urban Mobility, or PUMA, during the 2025 Universal Health Coverage Day webinar held on December 12 under the theme “Mobility, Costs, and Politics: How Urban Systems Shape Access and Progress Towards Universal Health Coverage in African Cities,” Principal Investigator Dr. Ssennyonjo said Africa is urbanising at an unprecedented pace. Projections show that by 2050, nearly 60% of the continent’s population will live in cities, a shift that is intensifying transport pressures and increasingly turning everyday mobility into a public health risk.

Participants at the PUMA Stakeholder Analysis Workshop held on November 21, 2025, where policymakers, practitioners, and researchers examined how political and governance dynamics shape urban mobility and public health outcomes in Kampala. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Participants at the PUMA Stakeholder Analysis Workshop held on November 21, 2025, where policymakers, practitioners, and researchers examined how political and governance dynamics shape urban mobility and public health outcomes in Kampala.

“Rapid urbanisation has created multiple challenges: transport systems are under strain, risks and vulnerabilities are rising, and opportunities for healthy behaviours such as walking are often limited. Access to livelihoods is also affected, with broad implications for health,” Ssennyonjo noted, adding: “Crucially, these issues are shaped by political and governance dynamics, yet few initiatives explicitly address them. This gap motivated our focus on the politics and governance of urban mobility.”

Dr. Aloysius Ssennyonjo, Principal Investigator of the PUMA project, speaks during the Stakeholder Analysis Workshop on November 21, 2025, highlighting the role of politics and governance in shaping urban mobility and public health outcomes in Kampala. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Dr. Aloysius Ssennyonjo, Principal Investigator of the PUMA project, speaks during the Stakeholder Analysis Workshop on November 21, 2025, highlighting the role of politics and governance in shaping urban mobility and public health outcomes in Kampala.

He mentioned that health outcomes are shaped by social, economic, and environmental factors, with transport costs, risks, and stress often posing greater barriers than medical fees alone to achieving affordable health for all. He noted that the PUMA project brings together multidisciplinary teams to study how governance and political dynamics shape urban mobility, public health, and development, a perspective reflected in Prof. Julius Kiiza’s observation that effective urban development relies on coordinated action by diverse stakeholders across sectors to improve health outcomes, though emphasising the primacy of politics.


“Uganda and Singapore had comparable levels of underdevelopment in the 1960s. Under Lee Kuan Yew, Singapore embarked on a deliberate nation-building project. Today, it is among the smartest cities globally, outperforming many Western cities in clean government, mobility, and liveability. Why are we lagging behind? The answer, I argue, lies largely in the nature of our politics,” Prof. Julius Kiiza cogently argued.


He intimated that the result has been cities that are “unreliable, unsafe, unsmart, and chaotic,” noting that claims of inclusive urban development often ring hollow. “I have argued, and repeat here, that boda bodas as a symbol of inclusivity represent a false model of inclusion. We must interrogate this and invest in better urban transport systems and wider, well-planned highways,” he affirmed.


Prof. Julius Kiiza, Professor of Political Science, speaking during a PUMA team–organised Universal Health Coverage Day webinar, highlighted how politics and governance shape urban mobility and public health outcomes. December 12, 2025. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Prof. Julius Kiiza, Professor of Political Science, speaking during a PUMA team–organised Universal Health Coverage Day webinar, highlighted how politics and governance shape urban mobility and public health outcomes. December 12, 2025.

Prof. Kiiza urged policymakers and practitioners to move beyond piecemeal technical fixes and instead treat urban mobility as a governance challenge requiring coordinated, cross-sector action. He stressed the importance of aligning transport planning with public health, housing, employment, and skills development, arguing that safer, more liveable cities depend on institutions that work together and are accountable to the public. Such reforms, he noted, demand sustained political commitment and inclusive dialogue across government, academia, civil society, and the private sector, precisely the terrain the PUMA project is engaging, by convening stakeholders and shaping a shared research agenda around Uganda and the continent’s urban mobility challenge.

Students cross a busy road in Kampala, Uganda, navigating traffic dominated by cars and motorcycles—an everyday reality that highlights the public health and safety risks shaping urban mobility in the city. 2024. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Students cross a busy road in Kampala, Uganda, navigating traffic dominated by cars and motorcycles—an everyday reality that highlights the public health and safety risks shaping urban mobility in the city. 2024.

Indeed, on November 21, 2025, the Ugandan team convened a national stakeholder workshop in Kampala, bringing together a wide range of stakeholders. Opening the workshop, Assoc. Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management (HPPM) at MakSPH, commended the team for highlighting what she described as a long-underexplored dimension of Uganda’s urban health landscape: mobility and its governance.

Reflecting on her own experience, she noted how boda-bodas have become increasingly indispensable for millions seeking quick, flexible transport, but also carry complex health, safety, and economic implications that demand multisectoral attention, calling for a balanced, evidence-driven dialogue that recognises their value while also addressing the infrastructural and policy gaps that shape mobility systems in Uganda’s rapidly growing cities.


“I sometimes use boda-bodas,” Assoc. Prof. Suzanne Kiwanuka said. “They are necessary when you need to move quickly during heavy traffic. Yet we all know how unsafe they can be. This PUMA initiative is timely to generate evidence not only on the politics of urban mobility and its health implications, but also its economic consequences.”


Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa. Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management, addresses participants during a PUMA stakeholder workshop, emphasising the need for evidence-informed, multisectoral approaches to urban mobility and public health governance in Kampala.
Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management, addresses participants during a PUMA stakeholder workshop, emphasising the need for evidence-informed, multisectoral approaches to urban mobility and public health governance in Kampala.

Notably, road traffic crashes remain one of Uganda’s most urgent public health threats today. The recent Uganda Police Force Annual Crime Report 2024 recorded 5,144 road deaths, a seven per cent rise from 2023, with motorcyclists accounting for nearly half of all fatalities. In Kampala, pedestrians, cyclists, and motorcycle riders constitute 94 per cent of all fatal crashes, according to the Kampala Capital City Authority. Thousands more suffer life-altering injuries each year.

Still, evidence from MakSPH, through its Centre for Trauma, Injury and Disability Prevention (C-TRIAD) and the Johns Hopkins International Injury Research Unit (JH-IIRU) under the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS), shows that the design and use of city roads are worsening the risk environment. Between 2021 and 2023, the team conducted more than one million roadside observations across Kampala, finding that while only five per cent of vehicles are officially recorded as speeding, those that do travel at an average of 57 km/h, well above safe limits for dense urban corridors, making city roads increasingly unsafe.

Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa. The motorcycle rider at the centre of the image is travelling against the flow of traffic in Kampala, highlighting everyday road-use practices that increase safety risks in the city. 2024.
The motorcycle rider at the centre of the image is travelling against the flow of traffic in Kampala, highlighting everyday road-use practices that increase safety risks in the city. 2024.

The World Health Organization (WHO) guidelines, cited in the report, recommend speed limits of 30 km/h on community roads and in urban areas where pedestrians, cyclists, and other vulnerable road users share space with motorised traffic, and 50 km/h on major urban roads. Yet the findings show that six in ten vehicles on community roads exceed these limits, heightening risks for those least protected and underscoring the need for lower-speed zones, traffic-calming measures such as speed humps and raised crossings, and consistent enforcement of traffic regulations.

For the PUMA team in Uganda, the writing on the wall shows that these rising injuries coincide with worsening congestion and rapid urbanisation, yet city mobility policies within Kampala remain heavily oriented toward road expansion and vehicular flow, with limited attention to safety, health protection, or non-motorised transport. This policy imbalance, then, explains why daily commuting remains hazardous and why progress on safer streets has been slow.

Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa. A designated non-motorised transport corridor on Namirembe Road, Kampala, intended for pedestrians, is partially occupied by parked motorcycles and roadside trading. The scene highlights how everyday encroachment weakens urban mobility interventions aimed at improving safety and walkability. November 2025.
A designated non-motorised transport corridor on Namirembe Road, Kampala, intended for pedestrians, is partially occupied by parked motorcycles and roadside trading. The scene highlights how everyday encroachment weakens urban mobility interventions aimed at improving safety and walkability. November 2025.

The study uses a three-tiered approach that combines policy analysis, regional evidence, and local experiences to examine how mobility decisions are made in Kampala, Kigali, and Lilongwe, who holds authority, and how these processes affect public health and equity. This is strengthened by structured co-creation workshops with practitioners, policymakers, and community actors, which reveal how governance functions in practice, often diverging from what is written on paper.

In parallel, the research team is conducting a continent-wide review of academic and grey literature to map regional trends, gaps, and the broader forces shaping African mobility systems. Together, these streams enable the researchers to compare cities, identify shared challenges, and build a grounded analytical framework for improving mobility governance across Africa.

In Kampala, preliminary findings by the MakSPH PUMA research team show a city governed by many mobility policies but marked by weak mobility governance. The team shared that Kampala operates under a dense mix of frameworks, from the National Integrated Transport Master Plan and National Urban Policy to road safety, climate, and KCCA development plans. While these documents acknowledge congestion, urbanisation, and road injury risks, they also reveal overlapping mandates, blurred institutional roles, and limited coordination authority.

Minibuses crowd a busy transport hub in Kampala, reflecting the scale and intensity of the city’s paratransit-based transport system and the planning challenges shaping everyday mobility. 2024. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Minibuses crowd a busy transport hub in Kampala, reflecting the scale and intensity of the city’s paratransit-based transport system and the planning challenges shaping everyday mobility. 2024.

Key government Ministries, Departments, and Agencies (MDAs) actors include the Ministry of Works and Transport, KCCA, the Ministry of Lands, the Office of the Prime Minister, and the Ministry of Finance, with the Ministry of Health conspicuously absent despite clear health implications. Policy attention, according to the early findings, remains heavily skewed toward road transport, leaving non-motorised mobility and major health pathways, noise exposure, psychosocial stress, community severance, heat, and mobility independence largely unaddressed.

Governance realities are further shaped by political processes, including electoral cycles, informal negotiations with transport unions, selective regulation of boda-bodas, and heavy reliance on development partners that often influence what is prioritised and implemented. Together, these dynamics help explain stalled master plans, inconsistent enforcement, and resistance to progressive interventions. While the PUMA research remains at a preliminary stage currently, the emerging findings underscore the need for an integrated, multisectoral mobility agenda that places health at the centre of Kampala’s transport policy and practice.

Motorcycle riders travel alongside a heavy truck emitting exhaust fumes on a road in Kampala, illustrating how daily urban transport exposes road users to air pollution and related public health risks. 2024. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.
Motorcycle riders travel alongside a heavy truck emitting exhaust fumes on a road in Kampala, illustrating how daily urban transport exposes road users to air pollution and related public health risks. 2024.

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How People Earn a Living is Contributing to Malaria Risk in Uganda, Study Finds

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How People Earn a Living is Contributing to Malaria Risk in Uganda, Study Finds. Photo: ImageFX

Livelihood activities such as farming, livestock keeping, construction, and night-time work significantly increase malaria risk in Uganda, according to new research by Dr Kevin Deane, a development economist at The Open University, UK, and Dr Edwinah Atusingwize and Dr David Musoke, a Research Associate and Associate Professor of Environmental Health at Makerere University School of Public Health, respectively.

The study, Livelihoods as a key social determinant of malaria: Qualitative evidence from Uganda, published on December 2, 2025, in the journal Global Public Health, examines how everyday economic activities shape exposure to malaria, often undermining conventional prevention measures such as insecticide-treated nets and indoor residual spraying. The findings are based on qualitative fieldwork conducted in June 2024 in Busiro County, Wakiso District, a peri-urban area with persistently high malaria transmission in Uganda.

Using a qualitative design, the researchers conducted 14 key informant interviews, 10 focus group discussions, and 11 in-depth interviews with households recently affected by malaria, engaging 100 participants from communities, health services, local government, and civil society across Kajjansi, Kasanje, and Katabi Town Councils, as well as Bussi Sub-County, in Busiro South. Their analysis, guided by the Dahlgren–Whitehead social determinants of health model, enabled the researchers to situate malaria risk within the broader social, economic, and environmental conditions shaping how people live and work.

Dahlgren and Whitehead model of the social determinants of health. Source: internet.
Dahlgren and Whitehead model of the social determinants of health. Source: internet.

In their findings, participants linked malaria exposure to agricultural practices, among which is maize cultivation near homes, which was associated with increased mosquito density during the rainy season. “One of the most common crops cultivated in Uganda, which many rely on as staple foods, creates environments in which mosquitoes are attracted to and thrive, often in settings where maize is grown near homes in rural areas and urban areas. This increases mosquito density around homes and contributes to increased outdoor biting and the number of mosquitoes entering houses,” the study argues.

Its authors say this poses a difficult policy challenge because maize is central to household food security, leaving few practical options for reducing exposure. They argue that proposals to keep maize away from homes are often unrealistic for families with limited land or those farming in urban areas, while targeted control during flowering periods may have limited impact given mosquitoes’ ability to travel beyond cultivation sites.

Screenshot of the open-access research article “Livelihoods as a key social determinant of malaria: Qualitative evidence from Uganda,” published in Global Public Health on December 2, 2025.
Screenshot of the open-access research article “Livelihoods as a key social determinant of malaria: Qualitative evidence from Uganda,” published in Global Public Health on December 2, 2025.

Beyond crop farming, the study reports that livestock rearing, especially zero-grazing cattle kept close to houses, attracts mosquitoes into household compounds. Other livelihood activities, including construction and brick-making, created stagnant water-filled pits that served as breeding sites, while night-time livelihoods, such as street vending, guarding, fishing, bar work, and brick burning, among others, prolonged outdoor exposure during peak mosquito biting hours. Gender further shaped risk, with women’s livelihoods and caregiving responsibilities frequently exposing young children alongside them.

“The evidence we present illustrates the unintended health consequences of development strategies intended to promote key livelihood activities, food security, and poverty reduction. There are no straightforward solutions given the complexity of these relationships and the importance of these livelihoods for many households,” the authors assert.

They conclude that malaria elimination efforts will fall short unless livelihoods and development activities are explicitly integrated into malaria prevention strategies, calling for stronger alignment between public health, agriculture, urban development, and economic policy.

Please see below for the study:

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