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Poorly implemented COVID-19 incentives eroded health workers’ motivation in Africa – Study

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By Okeya John & Davidson Ndyabahika

As the COVID-19 pandemic swept across Africa, it brought with it a wave of unprecedented challenges, impacting economies, social dynamics, and political structures. National healthcare systems were particularly strained, prompting governments to implement various strategies to combat the virus and its repercussions. Among these measures were the introduction of incentives, both financial and non-financial, aimed at boosting the morale of health workers and bolstering the capacity of healthcare systems to respond to health emergencies.

Due to COVID-19’s increased risks and demand on healthcare workers working in already overburdened health systems, incentive packages must be strengthened. Researchers conducted a multi-country qualitative study in DRC, Nigeria, Senegal, and Uganda with funding from the Bill and Melinda Gates Foundation and Gates Ventures/Exemplars in Global Health. The study examined pandemic-related workplace incentives. In 60 virtual interviews via phone and Zoom, ministry officials, policymakers, and health care providers provided important viewpoints.

Entitled “Health Workforce Incentives and Dis-Incentives During the COVID-19 Pandemic: Experiences from Democratic Republic of Congo, Nigeria, Senegal, and Uganda,” the research conducted by healthcare experts delved into the realm of incentive mechanisms, their allocation, and the inadvertent dis-incentives experienced by the health workforce amidst the pandemic response efforts.

The researchers were from Makerere University School of Public Health (Uganda), University of Kinshasa (DRC), University of Ibadan (Nigeria) and University of Dakar (Senegal). The research team comprised Suzanne Kiwanuka, Ziyada Babirye, Steven Kabwama, Andrew Tusubira, Susan Kizito, Rawlance Ndejjo, Marc Bosonkie, Landry Egbende, Berthold Bondo, Mala Ali Mapatano, Ibrahima Seck, Oumar Bassoum, Mamadou Leye, Issakha Diallo, Olufunmilayo Fawole, Segun Bello, Mobolaji Salawu, Eniola Bamgboye, Magbagbeola David Dairo, Ayo Steven Adebowale, Rotimi Afolabi, and Rhoda Wanyenze,

In their work, the scientists authoritatively note that: “Health worker incentives during the COVID-19 response were mostly unplanned, predominantly non-financial, and invariably implemented. Across these countries, there were neither guiding frameworks nor standard pre-determined packages of financial and non-financial incentives for health workers during emergencies.”  

Before the outbreak of the COVID-19 pandemic in December 2019, “Africa already had weak health systems,” they note, citing that the pandemic exposed this challenge, increasing work overload for health workers, mental stress, infections and deaths, who in turn, needed incentives to adequately work to respond and deliver good health outcomes during the emergency.

However, due to the dire working conditions, the Word Health Organization (WHO) had warned that frontline healthcare workers were most at risk of acquiring the deadly COVID-19 virus. In their report, WHO highlighted that between January 2020 and May 2021 alone, over 80,000 to 180,000 health and care workers respectively, had died of COVID-19 globally, calling for urgent need to reverse the tide.

From this study, Senegal faces a doctor and nurse shortage with only 0.38 healthcare workers per 1,000 people, well below the WHO recommendation. By December 2021, Senegal had recorded 75,055 COVID-19 cases and 1,890 deaths, including five health workers. Similarly, Uganda, with approximately 2.58 healthcare workers per 1,000 people, reported 146,030 COVID-19 cases and 3,306 deaths, including 37 health workers.

The researchers also noted that the DRC had 1.05 healthcare workers per 1,000 people, with 79,632 cases and 1,225 deaths, including 35 health workers. Nigeria faced a similar challenge, with 2.0 healthcare workers per 1,000 people, 243,450 cases, and 3,031 deaths by December 2021, including seven health workers. These findings stressed the strain on Africa’s fragile healthcare systems in responding to the COVID-19 pandemic.

“These challenges and consequences resulted in health workers either absconding from duty or in extreme circumstances, resigning from the health profession and opting for alternative professions,” the researchers note in their review of the COVID-19 response in Africa. They state that elsewhere by this time, measures had already been mounted to motivate health workers, necessitating a similar response in the continent.

In the countries where the study was conducted, the strategies adopted by governments and development partners to counter declining health worker motivation included offering financial rewards like allowances and salary increments, and non-financial incentives like adequate provision of medicines and supplies, on the job trainings, medical care for health workers, social welfare including meals, transportation and housing, recognition, health insurance, psychosocial support and increased supervision.

The researchers found that the financial rewards were a big motivating factor for the health workers in these countries in sustaining the health systems and COVID-19 efforts, while the non-financial incentives also contributed to improved health worker determination.

The incentives, although a success, however in their strength lied the weaknesses. The multi-country study reveals that the incentives had the double effect of creating disincentives and demotivating healthcare workers. This was occasioned by the lack of personal protective equipment, transportation to health facilities during lockdown, long working hours, harassment by security forces and perceived unfairness in access and adequacy of the rewards.

The study got its findings from virtual key informant interviews with the staff at ministries of health, policy makers, and health workers. In the study report, health managers and workers in DRC, Nigeria, Senegal, and Uganda confirmed that health workers received monetary benefits as a means of motivation for their effort towards the continuity of health services.

In Senegal, incentives were reported to mostly be financial. However, in DRC, although the salaries of the health workers involved in COVID-19 testing were reported to be similar to all other staff in response committees like epidemiological surveillance, case management, and communication, the government moved to temporarily waiver taxes to bait the COVID-19 health workers during the pandemic.

“Since financial incentives were mostly administered in an ad-hoc manner, some health workers felt they were unfairly distributed and complained about the lack of transparency in the allocation of these incentives. In Nigeria, it was reported that payments did not meet the health worker expectations, while in Uganda, it was reported that allowances were given selectively to some health workers such as those involved in contact tracing, COVID 19 testing, and COVID 19 isolation units but not to others.” The study report reads in part.

Respondents also revealed that although allowances were availed, there was dissatisfaction caused by delays and non-payment. In Uganda for example, the recruitment of additional 700 staff on contract although initially perceived positively, their irregular dismissal following budget shortfalls created discontentment and immense pressure for the government.

Accordingly, the authors observe that the incentive packages in the four African countries were inconsistent, lacked transparency, adequacy, and equity. “Therefore, there is a need to develop guiding frameworks within which governments and partners can deliver incentives and reduce dis-incentives for the health workforce during emergencies.”

The study suggests that during health emergencies like COVID-19, increased risks and workloads should mandate the provision of safety gear and adequate supplies. However, the researchers caution that both financial and non-financial incentives can have unintended consequences if perceived as unfair in their implementation.

They also call for incentives to be pre-determined, equitable and transparently provided during health emergencies ‘because arbitrarily applied financial and non-financial incentives become dis-incentives’, while still holding that the financial incentives are only useful in as far as they are administered together with non-financial incentives such as supportive and well-resourced work environments.

“Governments need to develop guidelines on incentives during health emergencies with careful consideration of mitigating potential dis-incentives. The harmonization of roles across state and non-state sector players in incentivizing the health personnel during health emergencies is paramount.” The study affirms.

Find the detailed scientific study here.

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Davidson Ndyabahika

Health

Mak and UNICEF Uganda Sign MoU to Strengthen Child Rights through Research, Training, and Innovation

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The Vice Chancellor Professor Barnabas Nawangwe (Right) and UNICEF Uganda Representative Dr. Robin Nandy (Left) show off the signed MoU on 14th August 2025. Makerere University (Mak) and United Nations Children’s Fund (UNICEF) Uganda sign MoU that launches a two-year, renewable partnership aimed at advancing child rights and well-being through rigorous research, capacity building, and policy-driven innovation, CFC, MITER, CEES, MakSPH, 14th August 2025, Main Building, Kampala Uganda, East Africa.

Makerere University (Mak) and United Nations Children’s Fund (UNICEF) Uganda have signed a Memorandum of Understanding that launches a two-year, renewable partnership aimed at advancing child rights and well-being through rigorous research, capacity building, and policy-driven innovation.

The agreement was signed on Thursday, 14 August 2025, by Makerere Vice Chancellor Professor Barnabas Nawangwe and UNICEF Uganda Representative Dr. Robin Nandy in the Vice Chancellor’s Boardroom at Makerere’s Main Building.

The MoU enlists a focused collaboration on generating child-focused data and research to inform policy and program design, analyzing how health, nutrition, education, and protection initiatives affect children, and strengthening the social sector workforce through targeted training, curricula, and performance standards.

It also emphasizes knowledge management, wide dissemination of findings to stakeholders, policy and legislative advocacy for child rights, and active student engagement through internships, skilling opportunities, and communities of practice. The renewed partnership is designed to bolster evidence-based policy-making and drive program improvements that contribute to Uganda’s progress toward the Sustainable Development Goals by 2030.

Makerere Vice Chancellor Professor Barnabas Nawangwe expresses delight after signing the MoU. Photo by John Okeya Makerere University (Mak) and United Nations Children’s Fund (UNICEF) Uganda sign MoU that launches a two-year, renewable partnership aimed at advancing child rights and well-being through rigorous research, capacity building, and policy-driven innovation, CFC, MITER, CEES, MakSPH, 14th August 2025, Main Building, Kampala Uganda, East Africa.
Makerere Vice Chancellor Professor Barnabas Nawangwe expresses delight after signing the MoU. Photo by John Okeya

“The signing of this MoU deepens Makerere’s long-standing commitment to the well-being of Uganda’s children and Africa’s future,” said Vice Chancellor Nawangwe. “I thank Dr. Nandy for his leadership and for the continued collaboration that will expand our capacity to deliver research with immediate, practical benefits for communities.”

UNICEF’s Dr. Nandy stressed that the partnership reflects UNICEF’s global mission to protect and promote every child’s rights while translating research into policy and action. He highlighted Makerere’s proven strength in research leadership as a critical asset in the effort to generate robust evidence for government decision-making and resource allocation.

UNICEF Uganda Representative Dr. Robin Nandy speaks to the press shortly after the signing of the MoU at Makerere University. Photo by John Okeya Makerere University (Mak) and United Nations Children’s Fund (UNICEF) Uganda sign MoU that launches a two-year, renewable partnership aimed at advancing child rights and well-being through rigorous research, capacity building, and policy-driven innovation, CFC, MITER, CEES, MakSPH, 14th August 2025, Main Building, Kampala Uganda, East Africa.
UNICEF Uganda Representative Dr. Robin Nandy speaks to the press shortly after the signing of the MoU at Makerere University. Photo by John Okeya

“This partnership shows our commitment to combine academic knowledge with practical results,” said Dr. Nandy. “Using Makerere’s research skills to create important information about child welfare issues and solutions, making sure that every project we start is based on solid data and aims to safeguard and support children’s basic rights.”

The partnership builds on Makerere University’s established research strengths and UNICEF’s global mandate to protect children. It complements longstanding collaborative work through Mak’s School of Public Health (MakSPH) and other faculties, reinforcing a broader university-wide commitment to evidence-based policy and community impact.

Since 2016, Makerere has participated in more than 30 UNICEF-supported research projects, which emphasize a deep mutual trust and shared mission. The Vice Chancellor noted that this history laid a robust foundation for the new MoU while also underlining opportunities to broaden collaboration beyond the health sector.

Vice Chancellor Prof. Barnabas Nawangwe and UNICEF Uganda Representative Dr. Robin Nandy with Makerere University faculty at the signing of the MoU. Makerere University (Mak) and United Nations Children’s Fund (UNICEF) Uganda sign MoU that launches a two-year, renewable partnership aimed at advancing child rights and well-being through rigorous research, capacity building, and policy-driven innovation, CFC, MITER, CEES, MakSPH, 14th August 2025, Main Building, Kampala Uganda, East Africa.
Vice Chancellor Prof. Barnabas Nawangwe and UNICEF Uganda Representative Dr. Robin Nandy with Makerere University faculty at the signing of the MoU.

Among the notable prior initiatives is MakSPH’s joint work with UBOS and UNICEF, supported by EU funding, on the first comprehensive Food Security and Nutrition Assessment in ten districts of Northern Uganda and the West Nile region (2019). The findings of this work informed targeted nutrition programs and strategies to combat malnutrition among vulnerable populations, shaping policy directions at local and national levels.

In 2023, MakSPH, in collaboration with the National Planning Authority (NPA) and UNICEF, along with FHI360 and the Ministry of Health, produced an updated Situation Analysis of Newborn Health in Uganda. The document has guided the ministry’s national strategy development, including costed investments to improve newborn health across the country.

Professor Rhoda Wanyenze, Dean of MakSPH, hailed the partnership as a continuation of a long-standing relationship, noting that UNICEF’s support was instrumental in establishing the Makerere University Centre of Excellence for Maternal Newborn & Child Health (MNCH) in 2013.

“It’s such a delight, a great honor to finally get to this event where we can formalize our partnership with UNICEF. The partnership between UNICEF and Makerere has been a long-standing one, and we have worked together for decades, which has driven critical research and informed national policies,” she said. She emphasized that both institutions share a passion for tackling adolescent health challenges, particularly early pregnancies and marriages, which remain persistent barriers to progress.

Professor Rhoda Wanyenze, Dean of MakSPH speaks to the press during the MoU Signing ceremony at Makerere University on Thursday. Makerere University (Mak) and United Nations Children’s Fund (UNICEF) Uganda sign MoU that launches a two-year, renewable partnership aimed at advancing child rights and well-being through rigorous research, capacity building, and policy-driven innovation, CFC, MITER, CEES, MakSPH, 14th August 2025, Main Building, Kampala Uganda, East Africa.
Professor Rhoda Wanyenze, Dean of MakSPH speaks to the press during the MoU Signing ceremony at Makerere University on Thursday.

The MoU extends collaboration beyond the School of Public Health. The Vice Chancellor noted productive partnerships across other departments, including the Department of Journalism and Communication and the College of Humanities and Social Sciences, emphasizing how diverse disciplines can contribute to evidence-based policy and community well-being.

Another important example is the Caring for the Caregiver (CFC) intervention led by the Makerere Institute of Teacher Education and Research (MITER) in the College of Education and External Studies (CEES). This was implemented in partnership with the Ministry of Health, UNICEF Uganda, and international partners. The evaluation examined caregiver emotional wellbeing, social support, and parenting stress in rural Uganda, contributing to the growing evidence base for nurturing care in resource-constrained settings.

Partnering for child rights and well-being through rigorous research, capacity building, and policy-driven innovation. Makerere University (Mak) and United Nations Children’s Fund (UNICEF) Uganda sign MoU that launches a two-year, renewable partnership aimed at advancing child rights and well-being through rigorous research, capacity building, and policy-driven innovation, CFC, MITER, CEES, MakSPH, 14th August 2025, Main Building, Kampala Uganda, East Africa.
Partnering for child rights and well-being through rigorous research, capacity building, and policy-driven innovation.

Also, the School of Statistics and Planning in the College of Business and Management Sciences (CoBAMS) has partnered with UNICEF to tackle urgent socio-economic and public health challenges. A key example is the Socio-economic Impact Assessment of the 2022 Ebola Virus Disease outbreak in Mubende and Kassanda districts, which examined household-level shocks, community coping strategies, and the wider disruption of livelihoods. The study’s findings have informed national policy dialogue and action planning, emphasizing that there must be stronger preparedness measures.

According to the Vice Chancellor, the university’s broader engagement with UNICEF as a driver of research, innovation, and community outreach benefits children and families throughout Uganda.

For Dr. Nandy the partnership will support student involvement in real-world operational and programmatic work, creating pipelines for young scholars to contribute to child welfare initiatives.

Both parties expressed a shared vision of translating research findings into concrete actions that strengthen child protection and opportunities for learning and development. The collaboration is expected to yield new efforts for effective interventions, sharpen the policy dialogue, and catalyze scalable innovations that improve the daily lives of Uganda’s children.

Professor Barnabas Nawangwe (Right) and Dr. Robin Nandy (Left) shake hands after signing the MoU. Makerere University (Mak) and United Nations Children’s Fund (UNICEF) Uganda sign MoU that launches a two-year, renewable partnership aimed at advancing child rights and well-being through rigorous research, capacity building, and policy-driven innovation, CFC, MITER, CEES, MakSPH, 14th August 2025, Main Building, Kampala Uganda, East Africa.
Professor Barnabas Nawangwe (Right) and Dr. Robin Nandy (Left) shake hands after signing the MoU.

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Davidson Ndyabahika

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Call for Abstracts: 2nd AI in Health Africa Conference

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Call for Abstracts: 2nd AI in Health Africa Conference. Deadline: 15th September 2025 11:59pm (EAT). Hosted by: Health AI for All Network, Makerere University AI Health Lab & Infectious Disease Institute, Kampala Uganda, East Africa.

The  2nd AI in Health Africa Conference set to be held 6th – 7th November invites researchers, policymakers, healthcare practitioners, and innovators to submit abstracts for our 2025 event! We’re excited to explore the incredible, transformative potential of AI in healthcare across Africa, with a keen focus on developing ethical, scalable, and context-specific solutions that truly make a difference.

Deadline15th September 2025 11:59pm (EAT)

Format: Structured abstract (max 300 words) – Background, Methods, Results & Conclusion.

Submissions should emphasize African contexts & solutions

Thematic Areas

  • AI Policy, Governance & Ethics in Healthcare
  • Localization & Contextualization of AI Solutions
  • AI Capacity Building for Health Practitioners
  • AI Integration in Healthcare Systems
  • Generative AI in Healthcare
  • Sustainable AI Business Models

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Makerere University College of Health Sciences marks Centenary with expansion of Super-Specialized healthcare Training

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Prof. Barnabas Nawangwe addresses the congregation on 30th July 2025 in the Main Hall. Makerere University College of Health Sciences (MakCHS) in collaboration with Texas Children’s Global Hospital, Baylor College of Medicine Children’s Foundation–Uganda, the Ministry of Health (MOH) of Uganda, and Mulago National Referral Hospital (MNRH) Paediatric Haematology and Oncology Fellowship (PHO) Program 16 Fellows Award ceremony 30th July 2025, Kampala Uganda, East Africa.

On 30th July 2025, Makerere University hit a milestone in specialized healthcare training as it proudly graduated 16 fellows from their Paediatric Hematology and Oncology (PHO) Fellowship Programme. These dedicated physicians who successfully completed a two-year rigorous fellowship program will serve as elite experts in treating life-threatening blood disorders and cancers in children.

The pioneering fellowship program of Makerere University College of Health Sciences (MakCHS) commenced in 2016. This cohort included fellows from Uganda, Kenya, South Sudan, Tanzania, Malawi, Nigeria, and Congo which enhances Africa’s capacity to deliver highly specialized care, promising improved survival rates and quality of life for countless young patients.

In his address to the congregation, Professor Barnabas Nawangwe, Vice Chancellor – Makerere University emphasized the university’s guiding vision of research-led, noting that the institution remains committed to producing highly skilled professionals who address Uganda’s and Africa’s evolving health challenges while acknowledging the resilient hard work of fellows during training and the vital sacrifice as well as support from family and friends.

Makerere University College of Health Sciences (MakCHS) in collaboration with Texas Children’s Global Hospital, Baylor College of Medicine Children’s Foundation–Uganda, the Ministry of Health (MOH) of Uganda, and Mulago National Referral Hospital (MNRH) Paediatric Haematology and Oncology Fellowship (PHO) Program 16 Fellows Award ceremony 30th July 2025, Kampala Uganda, East Africa.
Prof. Barnabas Nawangwe.

Prof. Nawangwe recounted Makerere’s significant historical contributions to public health and medical research recalling the College of Health Sciences’ past achievements, including it’s 1964 recognition for lymphoma research leading to nomination for a Nobel Prize for the discovery of the cells that cause the cancer of the lymphoma. He cited the university’s instrumental efforts and contribution in combatting disease on the continent like the Ebola, Marburg, Nodding Disease and the recent COVID-19 pandemic.

He outlined Uganda’s demographic realities and the resultant increase in health challenges with exponential growth of a young population alongside the alarming statistics of childhood cancer and sickle cell disease. With an estimated “7,000 children and adolescents cancer with less than 50% access in treatment,” and over “20,000 babies are born with sickle cell every year,” the need for specialized care is critical, he said. Professor Nawangwe also stressed the urgency of the situation, “It is reported that many of the deaths from cancer and blood disorders are preventable,” stating, “We must produce enough doctors to manage the disease burden we have.”

Prof. Nawangwe recognized the instrumental role of partners such as Texas Children’s Global and Baylor College of Medicine, among others, who supported MakCHS in setting up the PHO fellowship that began in 2016. He underlined the success of the program, which has since trained 24 paediatricians serving as healthcare leaders across Africa.

In his remarks, Professor Bruce Kirenga, Principal – MakCHS highlighted the institution’s century of medical training excellence and its forward-looking vision as the College holds its third graduation ceremony of the PHO Fellowship Program. He emphasized MakCHS’ commitment to advancing healthcare in the region, adding that this future is geared towards more scientific research, innovation and cutting-edge medical care.

Professor Kirenga proudly announced that the fellowship program is the first of their sub-specialized training programs. He revealed the expansion of these crucial programs, noting that the college currently offers three additional sub-specialized training pathways: Neonatology, Interventional Radiology, and Fetal and Maternal Medicine, with two more programs under review; in this regard, Professor Kirenga extended gratitude to partners and collaborators, affirming the college’s unwavering dedication to its mission.

Prof. Bruce Kirenga. Makerere University College of Health Sciences (MakCHS) in collaboration with Texas Children’s Global Hospital, Baylor College of Medicine Children’s Foundation–Uganda, the Ministry of Health (MOH) of Uganda, and Mulago National Referral Hospital (MNRH) Paediatric Haematology and Oncology Fellowship (PHO) Program 16 Fellows Award ceremony 30th July 2025, Kampala Uganda, East Africa.
Prof. Bruce Kirenga.

Representing the Director General Health of Services and Permanent Secretary of the Ministry of Health, Dr. Richard Mugahi – Commissioner for Child and New-born Health highlighted the vital role of the new specialists in transforming Uganda’s healthcare landscape. Dr. Mugahi emphasized the graduation as not only fellows’ dedication, but also an important step forward for Uganda’s healthcare system citing the critical need for their expertise.

He detailed the alarming burden of childhood cancer in Uganda, with 1,500 to 3,000 new cases reported annually, yet only 30% access specialized treatment, resulting in tragically low survival rates of 20-30% beyond three years. In response, the Ministry of Health is strengthening its partnership with Makerere University, recognizing that “the role of research, the role of academia is well highlighted and emphasized,” and crucial for producing skilled professionals.

Dr. Mugahi announced the government’s strategic plans to absorb these new specialists, actively developing human resource structures and mobilizing resources to utilize their skills nationwide. He also revealed ongoing efforts to decentralize cancer care through regional centres, citing the operational facility in Gulu and planned sites in Arua, Mbarara, and Mbale, all of which will strongly need the fellows’ expertise to serve our population. He concluded by reiterating the core mission: “Our mission is clear. We now have the inputs, you’re one of the inputs of providing Uganda with the best possible quality of care.” He stated.

Encouragingly, Dr. Rosemary Byanyima Mulago National Referral Hospital (MNRH) revealed that the Hospital is charting a new course towards offering highly specialized medical services, emphasizing that they can only offer that when they have people who have trained as super-specialists.

“This strategic move is predicated to building a robust local human resource, specifically super-specialists, whose rigorous training pathway extends beyond a first degree and master’s to include a specialized fellowship. The traditional approach of training abroad is very expensive” Dr. Byanyima noted. To overcome this, Mulago is actively working with collaborators to build the capacity to train locally. This innovative model involves sponsoring a select few for training abroad, who then return to establish and lead local programs, significantly enhancing the hospital’s self-sufficiency.

Makerere University College of Health Sciences (MakCHS) in collaboration with Texas Children’s Global Hospital, Baylor College of Medicine Children’s Foundation–Uganda, the Ministry of Health (MOH) of Uganda, and Mulago National Referral Hospital (MNRH) Paediatric Haematology and Oncology Fellowship (PHO) Program 16 Fellows Award ceremony 30th July 2025, Kampala Uganda, East Africa.
The Vice Chancellor-Prof. Barnabas Nawangwe (Centre) and Principal CHS-Prof. Bruce Kirenga (Green Cap) with some of the 16 PHO Fellows at the Award Ceremony on 30th July 2025.

“Mulago is uniquely positioned as an ideal training ground due to its infrastructure. We have the equipment. And of course, there are many patients who require the service.” Dr. Byanyima said. She noted that while Mulago provides the environment, it collaborates with accredited training institutions like Makerere University for academic awards.

The benefits of local training are multifaceted; it not only builds internal capacity but also allows the hospital to continuously identify and address service delivery gaps in infrastructure, equipment, medicines, and sundries, Dr. Byanyima added. Local training is also cheaper and eases the very strenuous emotional burden on advanced-age trainees with families, who would otherwise have to relocate abroad for years. Crucially, as these experts train, they simultaneously offer services, with patients directly benefiting from their evolving skills. In addition, she noted, Mulago leverages collaborations to acquire essential resources, while simultaneously lobbying the government for sustained funding to ensure the long-term continuity of the services.

Addressing the escalating challenge of non-communicable diseases (NCDs) like cancer and diabetes, Dr. Byanyima acknowledged the continuously increasing number of patients, necessitating a proportional increase in human resource infrastructure, medicines and surgeries to be able to meet the demand. She also stated Mulago’s role in health education at the tertiary level, empowering patients to disseminate crucial health information within their families and communities, complementing primary healthcare prevention efforts by the Ministry.

In his speech, Dr. Joseph Lubega, a Children’s Cancer and Blood disease Specialist and Assistant Professor at Baylor College of Medicine, Texas Children’s Hospital, USA, recognized the significant advancements in child healthcare across Africa with specialists trained in children’s cancer and sickle cell disease.

Dr. Lubega emphasized the profound impact of PHO Fellowship Program on patient outcomes stating that ‘whereas when we started this work, most children with cancer anywhere in Africa would die within a month of a diagnosis, now most of them are cured.’ Despite this progress, he stressed the imperative to expand reach beyond major cities like Nairobi, Kampala, and Dar es Salaam, aiming for comprehensive coverage across all countries, especially given the much bigger challenge posed by sickle cell disease. The ultimate goal, he explained, is for the specialists to train lower health workers in their countries, ensuring every child is reached.

Challenging the conventional focus on infectious diseases in Africa, Dr. Lubega advocated for greater attention to non-communicable diseases (NCDs), saying, “Sickle cell disease is one of the most common non-communicable diseases. It is part of African DNA, 2% of new-borns get this diseases.” He noted that unlike acute infections, NCDs demand lifelong follow-up and community-based care, necessitating a re-evaluation of health system training.

One of the fellows, Dr. Ankunda Siyadora who works with Mbarara Regional Referral Hospital, noted that the fellowship will revolutionize the landscape of childhood cancer and blood disorder care in Western Uganda. In her words, “my passion was ignited during internship at St. Mary’s Hospital in Gulu, Uganda. I witnessed numerous children suffering from advanced Burkitt’s lymphoma, often receiving only palliative comfort. That made me a bit sad, but also built the passion I have for paediatric haematology.” she recounted.

Dr. Ankunda. Makerere University College of Health Sciences (MakCHS) in collaboration with Texas Children’s Global Hospital, Baylor College of Medicine Children’s Foundation–Uganda, the Ministry of Health (MOH) of Uganda, and Mulago National Referral Hospital (MNRH) Paediatric Haematology and Oncology Fellowship (PHO) Program 16 Fellows Award ceremony 30th July 2025, Kampala Uganda, East Africa.
Dr. Ankunda.

Motivated by the stark contrast between 80% survival rates in Western countries and the grim reality she encountered, Dr. Ankunda’s desire is to change the narrative that every child with cancer or blood disorder should die or be in pain. Her fellowship, she believes, will lessen the burden by ensuring every child who has a cancer or a blood disorder, gets an early diagnosis and then get the right treatment for their disease.

Addressing the common misconception that childhood cancers stem from environmental or lifestyle factors, she clarified that “in children, it’s more about the genetics, it’s just a mistake, something went wrong in the genetics, it’s nothing to do with the family or the environment, majority, close to 99% of childhood cancers, are a result of spontaneous mutation.” While a small percentage (1-3%) can be inherited, like retinoblastoma, most cases are simply “bad luck, nothing to do with the environment, nothing to do with your parents.” This understanding is crucial for families, alleviating guilt and redirecting focus to early intervention.

The experts will be pivotal in improving care for children with blood disorders and cancers, addressing the country’s high childhood cancer burden and with the Ministry of Health planning will integrate these specialists into the healthcare system and establish regional cancer centres. This in turn will increase access to specialized care, improve treatment outcomes, and enhance the quality of life for children with cancer and blood disorders in Uganda and beyond.

Zaam Ssali

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