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First-Ever Harmonized Health Facility Assessment by MakSPH and MoH Reveals Improvements in Uganda’s Overall Health Services

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By Julius Tukacungurwa & Davidson Ndyabahika

The first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by MakSPH and the Ministry of Health (MoH) has illuminated significant advancements in Uganda’s healthcare landscape. This ground-breaking survey, which serves as a robust benchmark for evaluating health services across the country, offers a comprehensive overview of service availability and readiness within Ugandan health facilities. 

The HHFA, a successor to the esteemed Service Availability and Readiness Assessment (SARA) tool endorsed by the WHO, probes into four critical modules: service availability, service readiness, quality of care and safety, and management and finance. 

Focusing initially on service availability and readiness, the HHFA embarked on a cross-sectional analysis of 642 facilities in April 2022, spanning National Referral Hospitals (NRHs), Regional Referral Hospitals (RRHs), General Hospitals (GHs), primary healthcare facilities at levels II, III, and IV.

The findings, while highlighting disparities in service availability and facility capacity across different healthcare sectors, underscore a promising trajectory towards enhancing overall health services nationwide.

Dr. Christopher Garimoi Orach, a Professor of Community Health at Makerere University School of Public Health (MakSPH), led the team that conducted the survey. He presented the report which was subsequently launched by Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero on Tuesday 12th.March.2024 during the 10th Annual National Health Care Quality Improvement Conference at Imperial Resort Beach Hotel, Entebbe.

Dr. Christopher Garimoi Orach, a Professor of Community Health at Makerere University School of Public Health (MakSPH) speaks to the press during the launch of the report in Entebbe. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Dr. Christopher Garimoi Orach, a Professor of Community Health at Makerere University School of Public Health (MakSPH) speaks to the press during the launch of the report in Entebbe.

The findings of the HHFA report indicate that Reproductive Maternal Newborn Care and Adolescent Health (RMNACH) services were available in most health care facilities across the country. In Uganda, healthcare facilities offer a wide range of essential services, including pediatric care, antenatal and postnatal care, malaria prevention during pregnancy, and newborn care, with over 95% providing these services according to the report. Findings also show that continuous antenatal care is available in about 79% of facilities, while skilled delivery services are offered in 89%. Additionally, family planning, emergency obstetric care, immunization, and adolescent health services are widely accessible, with percentages ranging from 77% to 91%.

During the launch event, Dr. Aceng underscored the significant steps made by the health sector in meeting crucial performance benchmarks. These include a notable 47% reduction in Maternal Mortality between 2016 and 2022, a commendable 12% decrease in Under 5 Mortality over the same period, and a promising 7% decline in Infant Mortality rates as highlighted in the Uganda Demographic Survey (UDHS) Report 2022.

“As you might know, overall, the health sector has made good progress towards achieving the key performance indicator targets. I wish to appreciate each one of you for the job well done,” said Dr. Aceng. 

Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero speaks at the launch on March 12, 2024. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero speaks at the launch on March 12, 2024.

Adding that; “The Ministry of Health continues to make big investments in the national health system. Mulago National Referral Hospital, Mulago Specialised Women and Neonatal Hospital, and several Regional Referral Hospitals have received infrastructure development including installation of modern medical equipment.

There is also deliberate effort to improve access to health service, delivery to the community through purposeful upgrade of some HC IIs to corresponding equipping and general review of the human resource requirements in the health sector. There is also deliberate effort to improve access to health services, delivery to the community through purposeful upgrade of some HC lIs to HC Ills with corresponding equipping and general review of the human resource requirements in the health sector.”

Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero signs off the launch of the Harmonized Health Facility Assessment in Uganda Report, 2023. Looking on is Professor Garimoi Orach Christopher. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero signs off the launch of the Harmonized Health Facility Assessment in Uganda Report, 2023. Looking on is Professor Garimoi Orach Christopher.

The also study highlights a significant increase in Uganda’s general service index, rising from 48% in 2018 to 59% presently. Utilizing a similar survey methodology, researchers observed notable improvements in the availability of health interventions across various domains. Particularly in Reproductive Maternal Adolescent Health services, higher provision rates were evident, especially at higher-level health facilities. Moreover, delivery assistance at Health Centres IIIs and above by skilled attendants has become standard practice, with nine out of ten cases receiving skilled care. 

Immunization services have also witnessed widespread availability, notably in hospital settings. However, while all surveyed facilities now offer malaria treatment services, access to non-communicable disease management, such as cancer diagnosis and treatment, remains limited, and readiness to provide transportation services for community members in need is inadequate.

According to Professor Orach, the Ministry of Health should strengthen and improve diagnosis and treatment of cancers generally across the country, especially at the National and Regional Referral Hospitals so that many more people at community levels can access the services. He also notes that the Ministry needs to quickly do everything possible to strengthen the transportation systems for patients from communities to reach and access health services.

Professor Orach presenting findings of the Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero signs off the launch of the Harmonized Health Facility Assessment in Uganda Report, 2023. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Professor Orach presenting findings of the Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero signs off the launch of the Harmonized Health Facility Assessment in Uganda Report, 2023.

The research noted that salary enhancement is a step in the right direction for improving how health workers perform. “We need to enhance that by ensuring that, ‘the health system, which is a complex system’, when we enhance salaries, we still need to continue to monitoring the health workers, we still need to continue to provide other requirements for the performance of health services, like drugs should be available,” noted Professor Orach. 

Adding that; “Transport should be available, other ways of ensuring that their performance can be up to the expected standard. So, in other words, that’s an important step and we must thank the government for what they’ve done here for we should still support them in other ways and monitor them closely to ensure, guidelines are available for services, that drugs are available, so that they can continue to provide good services.” 

“Our findings also show that for instance, the private health practitioners are not carrying out a lot of immunization, but government health facilities and private not for profit facilities are providing immunization services. This means that the private health practitioners don’t focus on immunization since it may not be bringing them money, they sought the ministry to engage with them to ensure that they’re brought on board so that they can provide their services in an integrated manner,” he noted. 

During the event, Associate Professor Peter Waiswa from the Health Policy, Planning and Management Department at MakSPH delivered a keynote address on ‘Understanding Health Systems Strengthening in a resource limited set-up.’  Professor Waiswa has had research work in maternal, new-born and child health in low and middle-income countries.

Stakeholders during the launch of the report in a group photo. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Stakeholders during the launch of the report in a group photo. 

According to Dr. Diana Atwiine, the Permanent Secretary of the Ministry of Health, this health facility assessment and report will significantly enhance MoH’s institutional capacity for strategic planning and policy development in Uganda’s health sector.

“The Makerere University School of Public Health (MakSPH) Team led by Prof. Christopher Garimoi Orach is appreciated for spearheading the entire process of undertaking the HHFA and developing the report. The MoH is very grateful for the diligent work well-done by the various actors that included the technical officers, research assistants and the administration staff to have the final report meticulously developed,” said Dr. Atwiine. 

Dr. Henry G. Mwebesa, Director General of Health Services, emphasizes the pivotal role of robust health systems in achieving lasting health advancements. He underscores that the findings will facilitate the country’s ability to track health service progress, advancing towards Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs). This data supports evidence-based decision-making, fortifying national health system planning and policy-making.

“This HHFA report is recommended for use by the various key stakeholders including health service managers, district leaders, ministry of health officials, both government, private sector, civil society organizations and development partners at different levels to inform and improve planning and implementation of effective health services delivery in Uganda,” says Dr. Mwebesa. 

Photos by Julius Tukacungurwa.

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Davidson Ndyabahika

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Call For Applications: Mak-BSSR Postdoc, PhD, Master’s Fellowship-level Training 2026

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Mak-BSSR PhD-Level beneficiary Khamisi Musanje presents his research during a meeting at the College of Health Sciences (CHS). Makerere University, Kampala Uganda, East Africa.

The Makerere University-Behavioral and Social Science Research (Mak-BSSR) in HIV Training Program, in partnership with the University of California, San Francisco (UCSF), invites applications for Post-doctoral, PhD, Master’s and Fellowship-level training opportunities in Behavioral and Social Sciences Research (BSSR) with a focus on HIV.

This is a five-year research training program on the HIV cascade, funded by the Fogarty International Center (FIC) of the National Institutes of Health (NIH).

Research priority areas for the training opportunities are; 1) Intersectional stigma, 2) Alcohol/substance use; 3) Mental health (psychosocial health), 4) Limited social support, social isolation and loneliness and impact on HIV outcomes, and 5) Ageism and HIV.

Please see downloads for detailed information.

Apply Before: Monday, 31st August, 2026 at 6:00PM EAT.

Mak Editor

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MakCHS 2026 Orientation begins: Freshers Urged to Prioritise Responsibility, Integrity and Academic Excellence

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The MakCHS Orientation Opening Ceremony in the Davies Lecture Theatre on 4th August 2026. Opening session of the Makerere University College of Health Sciences (MakCHS) Freshers' Orientation Ceremony, 4th August 2026, Davies Lecture Theatre, Mulago Hospital Complex, Kampala Uganda, East Africa.

New students joining Makerere University College of Health Sciences (MakCHS) have been urged to embrace responsibility, discipline, integrity and hard work as they embark on their journey towards becoming healthcare professionals. 

The call was made during the opening session of the college’s orientation programme that began on the 4th August and will conclude on 7th August 2026. During the session, College leaders including the Principal and Deans welcomed students admitted to study various programmes at MakCHS. The speakers outlined expectations for academic and professional conduct. 

The session was moderated by Professor Mark Kaddu, Deputy Dean-School of Medicine. Welcoming the freshers, he stressed the importance of hard work highlighting that ‘your academic documents will speak for you and excellence will open doors’.

Professor Mark Kaddu. Opening session of the Makerere University College of Health Sciences (MakCHS) Freshers' Orientation Ceremony, 4th August 2026, Davies Lecture Theatre, Mulago Hospital Complex, Kampala Uganda, East Africa.
Professor Mark Kaddu.

The college leaders congratulated the students on securing admission to Makerere University, noting that many qualified applicants were unable to secure places. They encouraged the new entrants to make the most of the opportunity by committing themselves to excellence from the first day. The students were reminded that programmes offered by the college are rigorous full-time courses that demand commitment, discipline and consistency.

In his remarks, Professor Bruce Kirenga – Principal, MakCHS welcomed the new entrants and provided an overview of the College’s rich history, highlighting its growth and commitment to excellence in health professionals’ education. The Principal reaffirmed the college’s mission of impacting the national health agenda through transformational teaching, research and innovation for societal development. Students were encouraged to embrace the wide range of career pathways and professional opportunities available upon qualification, emphasizing that their training would equip them to make a meaningful contribution to society.

Professor Bruce Kirenga. Opening session of the Makerere University College of Health Sciences (MakCHS) Freshers' Orientation Ceremony, 4th August 2026, Davies Lecture Theatre, Mulago Hospital Complex, Kampala Uganda, East Africa.
Professor Bruce Kirenga.

Stressing the importance of mind-set change which has also been introduced as a crosscutting course, the Principal urged the students to cultivate discipline, resilience, professionalism, and a passion for lifelong learning. “The journey you have embarked on is challenging, but it is achievable,” the Principal noted, reminding the students that many graduates before them successfully completed the programme through dedication and hard work. The address concluded with a call for the new students to remain focused, work diligently, and strive for academic excellence as they prepare to become the next generation of healthcare professionals who will transform their communities.

Professor Annettee Nakimuli, Dean – School of Medicine encouraged students to work collaboratively rather than viewing learning as a competition. She urged them to form productive study groups, support one another and take advantage of opportunities for mentorship, research and international exchange programmes available through the college. “We are here to support you throughout your journey,” she told the students, adding that strong academic performance could open doors to international exchanges, postgraduate training and research collaborations with universities around the world.

Professor Annettee Nakimuli. Opening session of the Makerere University College of Health Sciences (MakCHS) Freshers' Orientation Ceremony, 4th August 2026, Davies Lecture Theatre, Mulago Hospital Complex, Kampala Uganda, East Africa.
Professor Annettee Nakimuli.

Professor Nakimuli warned students against academic dishonesty, including examination malpractice, falsification of academic records and illegal programme changes. She cautioned that such misconduct could lead to dismissal from the university, even after several years of study. Students were further advised to be vigilant against fraudsters who promise to alter admission records or transfer students into different academic programmes through unofficial channels.

In his remarks, Dr. Richard Muhindo, Dean-School of Health Sciences highlighted the importance of personal responsibility and wellbeing beyond academics. He encouraged students to manage their time wisely, avoid drug and alcohol abuse, stay away from gambling and maintain healthy lifestyles throughout their studies. Dr. Muhindo emphasized the importance of professionalism, reminding students that healthcare careers are built on compassion, teamwork and service to humanity. He encouraged students from different programmes to learn together, respect one another’s professions and build networks that will benefit them throughout their careers.

Dr. Richard Muhindo. Opening session of the Makerere University College of Health Sciences (MakCHS) Freshers' Orientation Ceremony, 4th August 2026, Davies Lecture Theatre, Mulago Hospital Complex, Kampala Uganda, East Africa.
Dr. Richard Muhindo.

In his address to the freshers, Dr. David Nono who represented Dr. Annet Kutesa, Dean – School of Dentistry, encouraged students to embrace the opportunities before them by working hard, maintaining discipline, and striving for academic excellence. He emphasised the importance of achieving a strong academic record, noting that outstanding performance opens doors to competitive opportunities and future specialisation. The Dean also urged students to pursue postgraduate studies, reminding them that the dental profession requires highly qualified specialists. Reflecting on his own academic journey, he shared how dedication and continuous learning enabled him to study and work internationally before returning to serve the University. He concluded by encouraging students to remain focused, respect University rules, support one another, and make the most of their time at the institution as they prepare for successful professional careers.

Representing the Dean of the School of Biomedical Sciences, Professor Elisa Mwaka welcomed the freshers and congratulated them on earning admission to the College, urging them to embrace responsibility and discipline as they begin university life.  Introducing the School of Biomedical Sciences to students, he explained that it handles core foundational courses like Physiology, Biochemistry, Pathology, Medical Microbiology, Immunology, Molecular Biology, among others that support their academic journey. Professor Mwaka reminded students that success at university depends on personal responsibility, regular class attendance, effective time management, and organised study habits, emphasizing that attendance of at least 80 percent of lectures and practical sessions is required to qualify for examinations. He also encouraged students facing academic or personal challenges to seek guidance from their lecturers early rather than waiting until examination time, and urged them to be punctual, prepare adequately for classes.

Mental health featured prominently during the orientation. Leaders acknowledged that health sciences programmes can be stressful encouraging students experiencing emotional or psychological challenges to seek support early rather than suffering in silence. They also called on students to avoid stigmatizing colleagues facing mental health difficulties.

Students were also cautioned to safeguard their personal belongings, particularly phones and laptops, as they settle into campus life. Officials warned that new students are often targeted by thieves during the first weeks of the academic year.

The opening session for the 2026 orientation concluded with a message of encouragement, with MakCHS leaders expressing confidence that the students would develop into competent, ethical and compassionate healthcare professionals capable of contributing to Uganda’s health sector and beyond.

The Orientation Programme continues until Friday, 7th August, and all students were strongly encouraged to attend every session to give themselves the best possible start to their academic journey. Important topics to be covered include IT services, registration procedures, university policies, mental health and well-being, and awareness and prevention of sexual harassment. These sessions are designed to equip students with the knowledge and support they need to thrive both academically and personally.

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Zaam Ssali
Zaam Ssali

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SIHI Uganda Turning Community-Led Solutions into Better Health

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Providing Opportunities for Women in Entrepreneurship and Reproductive Health (POWER) is a Young Women Social Entrepreneurship Accelerator Program that nurtures and empowers women to lead, innovate, and build sustainable startups in SRHR/FP. SIHI, Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.

Community-led innovations across Uganda are improving access to healthcare, reducing financial barriers and responding to needs that conventional services do not always reach. The Uganda Case Compendium 2026, published by the Social Innovation in Health Initiative (SIHI) Uganda Hub at Makerere University School of Public Health, documents these solutions, their results and opportunities for scale.

Established in 2017, SIHI Uganda identifies, studies and supports locally developed health innovations. By 2026, the Hub had documented 42 projects through research examining their impact, enabling factors and scalability. It has also convened seven national stakeholder workshops and established a fellowship programme that equips innovators with skills in project management, research, entrepreneurship, communication, fundraising and environmental impact assessment.

The compendium presents evidence of reach and impact. The Ishaka Health Plan has enrolled more than 5,000 people in community-based health insurance, enabling over 4,000 members to access healthcare annually. In Kiryandongo, the Opit Kic Widows Group trained 402 volunteers who have provided health information to more than 6,030 refugee and host-community households. Among people living with HIV who received group support psychotherapy, 98% were depression-free after six months. In Mayuge, two sickle cell clinics have been established, 12,500 children screened and 282 enrolled in continuing care, contributing to a reported 53% increase in enrolment.

Spanning maternal and child health, HIV, mental health, disability, gender-based violence, health financing, diagnostics and palliative care, the compendium provides evidence to inform investment, policy uptake and the responsible scale-up of locally grounded solutions.

Read the full report:

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John Okeya

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