Health
Infrastructure Expansion for MakSPH, Vital for Uganda’s Public Health System – Prof. David Peters
Kampala— Professor David Peters, Dean of the Faculty of Health at York University, Canada, has hailed Makerere University School of Public Health (MakSPH) as a global leader and a cornerstone of Uganda’s public health system. He emphasized the school’s vital role during the launch of its new state-of-the-art auditorium on March 15, 2024, part of its ambitious expansion plans to bolster Public Health capacity, training, research, and service across Africa.
Drawing from extensive experience in global health systems, Professor Peters emphasized the critical role of Makerere University in driving forward public health initiatives in the region.
The ambitious MakSPH new home building construction broke ground on 28th February, 2020. The project that seeks to address the increasing demand for public health education and research, with an estimated cost of $10 million USD.
While making a case for the building, the Netherlands Ambassador to Uganda then, Henk Jan Bakker, announced the Dutch contribution to a tune of $420,000 through the Hague based Dutch organisation for internationalisation in education Nuffic and through the SET-SRHR project at Makerere University. This contribution was channeled to towards the construction of a state-of-the-art Auditorium, which is part of building design. Infrastructure forms the foundation of a healthy community and indeed as noted by Ambassador Henk, “Public Health is not only Uganda’s concern but also a global epidemic thus worth investing in.”
“I want to say how grateful I am to have been able to work with colleagues at Makerere University for now over two decades,” said Professor Peters.
Adding that; “The School of Public Health is responsible for educating and training critically needed public health workers for conducting critical science-based research that really addresses the origins of public health problems as well as for the prevention and intervention for diseases and disabilities and because it strengthens the practice of public health through knowledge translation.”
Professor Peters highlights the School of Public Health’s critical role in addressing historical and current public health challenges, including population growth, urbanization, inequity, justice, commercial influence, climate effects, and technological changes.
“And this is huge cost to the population, whether it be a maternal child, chronic diseases or aging, but also on epidemics and the costs, literally the catastrophic costs of health spending,” he said.
For Prof. Peter, while ideas on medicine and disease have really spread across countries and regions for millennia, efforts at public health and global level are really relatively recent from the last few centuries.
In the 19th century, historical concerns revolved around epidemics, famine, and conflict, closely linked to trade and environmental disruptions impacting industry and agriculture. This prompted nations to collaborate in safeguarding trade and preventing disease spread, laying the groundwork for international health regulations and the establishment of the World Health Organization (WHO).
Global public health education emerged from these efforts, rooted in scientific advancements like the germ theory and influenced by colonialism. Global health initiatives aimed to address health issues in other populations, with the Rockefeller Foundation playing a significant role in supporting and establishing schools of public health. The first, Johns Hopkins, founded in 1916, paved the way for numerous others worldwide, totaling around 35 new schools of public health, alongside several medical schools.
In modern global health, scientific advancements applied in resource-limited settings have saved countless lives. However, Professor Peters contends that this focus on biomedicine and technology, while successful in tackling specific health issues, often neglects broader local health system challenges.
He further notes that vertical and horizontal approaches, though effective at times, fail to address the comprehensive needs of communities and systems. Additionally, the dominance of Western institutions in global health perpetuates a crisis-driven mentality, prioritizing quick wins over sustainable, community-centered strategies.
This approach, exemplified during crises like the Ebola outbreak in West Africa, sidelines long-term planning and neglects social determinants of health.
Dr. Peters, also the former senior public health specialist with the World Bank argues that while science drives progress, it comes at the expense of sustainability, coherence, and holistic health approaches, favoring curative care over prevention, a perception he believes needs to change.
Looking ahead in global public health education, Professor Peters acknowledges Makerere University‘s leadership in this field and its ongoing commitment. He highlights the university’s efforts to tailor institutional design and curriculum to local needs, particularly evident in the Master of Public Health program at Makerere School of Public Health, including distance learning options.
Emphasizing the need for innovative teaching methods, such as active learning and interdisciplinary approaches, Professor Peters stresses the importance of practical experience and IT integration.
Renowned for his collaborative efforts in advancing health policy and systems research, implementation science, and enhancing institutional capacity in health systems, Professor Peters advocates for professionalism grounded in competencies. He champions collaboration among health and education stakeholders, policymakers, communities, professional organizations, and academia to drive the evolution of global public health education.
“You need to be socially relevant, coherent and accountable. This does mean that physical infrastructure is needed. Our twinning operation between Makerere and Uganda. We need the buildings for teaching, community convening and group work, but also for research wet labs, specimen storage, computing, for use of big data and for the IT infrastructure,” said Prof. Peters.
Learning between collaboration across institutions and linking global to local is really critical. He contends that Makerere School of Public Health is an essential to the public health system and a leader in this as well.
Taking inspiration from a program at the College of Health Sciences, funded by the Bill and Melinda Gates Foundation, which aimed to enhance all health schools at Johns Hopkins and Makerere University, Professor Peters emphasizes the broader scope of the initiative beyond mere technological advancements.
Dubbed the “grander challenge,” the project focused on institution-building, innovation, and human resource development for sustainable healthcare delivery. Makerere University seeks to be a transformative institution, fostering academic excellence and innovation while driving positive health outcomes in Uganda and the broader East Africa region.
“See the Makerere School of Public Health as transformational and being able to develop and generate knowledge, develop capabilities at individual levels as well as the leadership and organizational levels to model best practices and to support organizations and to develop partnerships to stimulate change,” he says.
He notes that there is a strong investment case for infrastructure at Makerere University. “It provides education training, it conducts research, it strengthens practice. If you see it as an essential part of infrastructure, here’s something that colleagues in North America put together around, this is around the National Academy of Sciences saying that ‘investment in schools of public health should be seen as analogous to government support for public goods like national defense and transportation infrastructure. It is that important.’”
According to Professor Peters, a global review found similar things how what they do in terms of education and research but also towards sustainable development goals and what it does globally. And that you need funding, human resources, agency, collaborations, and infrastructure in being able to do that.
“We need your time, your talent and your treasure to be able to contribute to Makerere School of Public Health. I want to thank you and to finally say that Makerere School of Public Health needs you, but we all need Makerere School of Public Health,” Professor David Peters.
In 2021, the USAID ASHA Program awarded $1.1 million to create an augmented reality solution for Makerere University‘s new School of Public Health. Partnering with Johns Hopkins University under the leadership of Prof. David Peters, this funding aims to launch the Makerere University Centre of Excellence for Global Health.
Since 2000, Johns Hopkins has engaged in 48 collaborative research and training projects valued at over $6 million, spanning various fields such as doctoral training, medical education, laboratory training, and health systems development, including projects like the Asha Grant.
Caitlin Kennedy, a Professor of International Health, Social, and Behavioral Interventions at Johns Hopkins, expressed excitement about the university’s involvement in the building collaboration and eagerly anticipates exploring the new space and further nurturing partnerships cultivated over the years.
“I would like to send a sincere thanks to the Asha Grant and USAID for the amazing financial support. I hope others will see projects like this, and be inspired to provide more funding for public health infrastructure,” said Prof. Caitlin.
Caitlin Kennedy extends gratitude to everyone involved in bringing the building to shape, from the visionaries to the diligent planners and builders. She also thanks the faculty, staff, and students who will transform it into a vibrant learning environment.
“We at Johns Hopkins are really looking forward to continuing to do great public health collaborations with you in that space for many years to come. Thank you so much. Everyone and congratulations enjoy the space.”
Funds raised so far
Currently, we’ve raised a total of $4,804,314, but we still face a deficit of $5,195,686 for the construction. We’re grateful for contributions from various sources: MakSPH Staff Community ($46,043), MakSPH Departments ($144,972), Private Institutions/Companies ($52,528), Other Individuals ($131,949), and a generous donation of $675,000 from Makerere University. Additionally, MakSPH has committed $2,133,822 from internally generated funds, while the Rockefeller Foundation contributed $100,000 towards furnishing the auditorium. Your support is crucial in making a meaningful impact and driving transformation. Join us on this journey by contributing through https://sph.mak.ac.ug/givedonate.
Health
Mak Researchers Partner with Safe Bangle Technologies to Roll out a Real-Time Domestic Violence Reporting Bracelet
By Joseph Odoi
A Consortium of Researchers from Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda together with Safe Bangle Technologies have rolled out a real time domestic violence reporting bracelet.
This roll out was made possible with support from the United States Agency for International Development (USAID) under the PARTNERSHIPS FOR ENHANCED ENGAGEMENT IN RESEARCH (PEER) program and the National Academies of Sciences.
Dr. Juliet Kiguli, the Principal Investigator from Makerere University, along with Dr. Roy Mayega, Deputy Chief of Party at RAN, and Dr. Agnes Nyabigambo, the study coordinator, initiated the PEER program to identify entry points for testing SafeBangle Technologies (a social enterprise based at Resilient Africa Network (RAN) with a mission to create a safer and more secure environment for women and children through innovative, affordable, and creative technology solutions to curb GBV in Africa.) wearable safety bracelet in the informal settlements. This decision stemmed from findings of increased intimate partner violence (IPV) and gender-based violence (GBV) in three informal settlements in Kampala, Uganda, following a longitudinal study, geospatial mapping, and interviews. The project, titled ‘The Impact of the COVID-19 Pandemic on Gender-Based Violence among Women and Girls in Informal Settlements in Kampala,’ highlighted the urgent need for affordable and immediate reporting mechanisms for violence.”
‘’While carrying out a study after the Covid-19 Pandemic, we identified gaps when it comes to reporting and response to Gender Based Violence (GBV) among women in informal settlements. Therefore, we used incorporated the SafeBangle intervention to solve the problem of lack of affordable and immediate reporting mechanisms for violence using a bracelet that reports violence in real time’’ explained Dr. Kiguli.
Innovation details
According to Saul Kabali and Messach Luminsa, the innovators behind SafeBangle from SafeBangle Technologies, hosted at the Resilient African Network Lab. ‘’The inspiration behind SafeBangle came from a deeply personal place. ‘’We heard countless stories of women who couldn’t call for help during moments of danger. We were deeply affected by the story of Aisha, a young woman in a rural village who was attacked while walking home alone at night. With no way to call for help, she felt helpless and vulnerable. This incident made us realize the critical need for immediate reporting alert tools, accessible to women like Aisha. We knew technology could play a crucial role and this incident awakened a strong desire in us to create a solution’’
“While developing SafeBangle, we tested with the users in both rural and urban contexts. We piloted the innovation around Kampala with support from Digital Human Righs Lab and Naguru Youth Health Network as well as it in five districts of Karamoja region with support from Save the Children and Response Innovation Lab. Right now it has become handy in Kamapala‘s informal settlements. We envision a future where SafeBangle becomes a standard tool in the fight against GBV, ensuring every woman feels safe and secure as it has the potential to transform how we respond to GBV in Africa” added Kabali.
HOW THE SAFEBANGLE TECHNOLOGY WORKS
The SafeBangle is wearable technology similar to a smartwatch that sends an alarm by SMS to people chosen by a woman herself if she feels threatened.
In terms of the acceptability of the SafeBangle innovation as a solution to GBV among at-risk women in informal settlements Of the 72 adolescent girls and women who received the SafeBangle, 22 activated the reporting button, resulting in 19 receiving immediate and appropriate support, including counseling, police intervention, and health services.
All adolescent girls and women who experienced GBV received a phone call from Somero Uganda to discuss the most appropriate intervention, including counseling, police cases being handled by the probation office, referral for health services, and post-exposure prophylaxis. All the GBV survivors received support and are still receiving continuous follow-up.
Researchers conducted a survey among 644 girls and women in Kinawataka (Nakawa Division) and Bwaise (Kawempe Division) to gain insights into awareness and understanding of sexual and gender-based violence among adolescent girls and women in informal settlements. The survey measured socioeconomic factors, mental health symptoms, and exposure to GBV. Focus group interviews were conducted with a separate sample of women over 18 in the settlements to explore responses to GBV.
A tabular representation of the key findings and lessons learned from your study on gender-based violence (GBV)
| Key Findings | Lessons learned |
| Prevalence of GBV. – Overall prevalence: 34.1% of women and girls reported experiencing GBV. – Among adolescents (15-19 years): Over 50% reported experiencing GBV. | – The pandemic highlighted the need for accessible and comprehensive support services for GBV survivors. – Schools emerged as crucial safe spaces for girls, emphasizing their well-being during crises. – Economic independence proved crucial, enabling women to leave abusive environments. – Involving men and boys as allies in GBV prevention efforts is essential. |
| Age-related trends | – GBV prevalence tends to decrease with increasing age. |
| Physical and health consequences. | – Women and girls suffered physical violence, injuries, and deaths, primarily from domestic violence and unsafe abortions due to limited healthcare access. – GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS. |
| Social and economic impact. . | – GBV contributed to family breakups, strained marriages due to financial stress. – Economic hardships forced some women and girls into transactional sex, exposing them to further health risks and exploitation. – Pandemic-related job losses and economic constraints increased financial dependence on abusers, trapping women in violent situations. – School closures and increased household responsibilities limited women’s job opportunities and subjected them to sexual harassment. |
| Psychological effects | – Survivors experienced guilt, shame, anxiety, fear, and suicidal thoughts due to ongoing abuse. |
| Long-term effects | – Post-COVID-19, survivors faced disrupted education, early marriages, pregnancies, social stigma, and persistent mental health issues. |
Reproductive Health Consequences: GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS.
Family Breakdown: The rise in GBV led to family breakups as women fled abusive relationships. Marriages were strained due to increased financial stress.
Transactional Sex for Survival: Desperate for basic needs due to job losses and economic hardship, some women and girls resorted to transactional sex, exposing them to further health risks and exploitation.
One study participant stated, “The time of COVID-19 was so terrible for some of us. We in fact got a lot of diseases from it because you would want to get food and didn’t have money. That way you would be forced to get a man who would use you and pay.” – (FGD_Girls_19–24years_Kinawataka).
Economic Effects: COVID-19 restrictions caused job losses and limited economic opportunities, particularly for women in the informal sector. This increased financial dependence on abusers and trapped women in violent situations.
Limited Access to Employment: School closures and increased household chores limited women’s ability to seek employment, perpetuating gender inequality in the workforce. Some faced sexual harassment from potential employers.
Psychological Effects: Survivors of GBV experienced guilt, shame, anxiety, fear, and even suicidal thoughts due to the constant threat and unpredictability of abuse.
Post-COVID Effects: GBV survivors faced long-term consequences, including disrupted education, early marriage, early pregnancy, social stigma, and persistent mental health issues.
Lessons learned
The pandemic highlighted the need for accessible and comprehensive support services for survivors of GBV, the significance of schools as safe spaces for girls, and the need to prioritize their well-being during crises. Economic empowerment emerged as a significant protective factor for women and girls. Those with greater economic independence were better equipped to leave abusive environments and secure their safety and well-being, while dependent ones suffered abuses. Engaging men and boys as allies in the fight against GBV and involving them in prevention efforts can help promote positive behavior change and foster more equitable relationships.
Recommendations
To address GBV against women and girls, the researchers recommend the following moving forward;
- There is need to integrate technology-driven solutions like SafeBangle into national GBV prevention and response strategies. SafeBangle can be a valuable tool for policymakers as cases of violence that would have gone unreported will be brought to light and the would-be victims will be able to get immediate help from trusted relatives and friends.
- Provide economic opportunities and vocational training for women and girls to enhance their financial independence and reduce vulnerability to violence. There is therefore a need to introduce education and training programs that empower women and girls, by providing them with skills, resources, and opportunities to start their own ventures and to participate fully in community affairs.
- Strengthen and enforce existing laws and policies related to GBV, including laws against domestic violence, child marriage, and sexual assault without discrimination be it for law enforcers, leaders, and employers where such cases were suffocated. Ensure that perpetrators are held accountable through swift and fair legal processes that have no room for corruption.
- Establish and promote effective, accessible, and confidential reporting mechanisms for GBV incidents that provide confidence and can be trusted by survivors to enhance reporting of such incidences of GBV. Community Engagement and Involvement: Involve community leaders, religious leaders, and elders in discussions about GBV to promote gender equality, change social norms, and reinforce the message that violence against women and girls is unacceptable.
- Launch extensive public awareness campaigns to challenge harmful gender norms, report cases of GBV, raise awareness about the consequences of GBV, and promote positive behaviors and attitudes towards women and girls.
- Implement comprehensive sexuality education in schools and communities, educating young people about healthy relationships, consent, and reproductive rights to be able to make informed decisions about their own lives and well-being.
- Engage men and boys as allies in the fight against GBV, encouraging them to challenge harmful masculinity norms and behaviors. This will help minimize GBV because mostly they are the perpetrators. Strengthening Support for Survivors: Provide ongoing support and follow-up services for survivors of GBV mostly counselling services to aid their recovery and facilitate their reintegration into society.
- Provide ongoing support and follow-up services for survivors of GBV, mostly counseling services to aid their recovery and facilitate their reintegration into society.
- Provide avenues to seek free or subsidized services by survivors of GBV medical services and legal processes by survivors of GBV to enhance reporting of GBV cases, access to medical care, counseling, legal support, and other essential services.
- Encourage and support more research and innovations like SafeBangle to curb incidents of GBV.
- A comprehensive and inclusive approach is required. The efforts should involve government institutions, civil society organizations, community leaders, and individuals working together to address the root causes and provide support to survivors.
- Involve media in GBV prevention activities and for enhancing campaigns against GBV mostly on radio and TV.
MORE ABOUT THE STUDY
The core project team, included researchers at Makerere University School of Public Health (MakSPH), Medical College of Wisconsin (MCW) led by Prof. Julia Dickson-Gomez, SafeBangle Technologies, and Somero Uganda, a community-focused NGO, began the project by designing their research protocol and taking a CITI Program course on human subjects social/behavioral research. Team members also met with the Ministry of Gender, Labour, and Social Development (MGLSG) in support of the gender-based violence policy process, Ministry of Health and local government. They also established relationships with the Kampala Capital City Authority (KCCA) and Nakawa and Kawempe probation offices to support legal processes for the GBV survivors. SafeBangle Team also received an award from Defenders Protection Initiative.
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