Health
Inside Uganda’s National Health Adaptation Plan to Combat Climate Change
By John Okeya
On August 22, 2024, Uganda made history as the first African nation to launch a National Health Adaptation Plan (H-NAP), fulfilling the country’s global commitments at the UN Conference of Parties (COP) 26 and 28 summits in Glasgow (2021), and Dubai (2023), respectively, in response to the growing global climate change risks and challenges.
The National Health Adaptation Plan 2025-2030, dubbed H-NAP, which was launched by the health ministry yesterday in Kampala, seeks to fortify the country’s healthcare system against the current mounting health challenges driven by climate fluctuations, to safeguard public well-being amid the rising temperatures, erratic weather patterns, and associated health risks.
Officiating the H-NAP launch, Uganda’s Prime Minister, Rt. Hon. Robinah Nabbanja, represented by the third Deputy Prime Minister and Minister without Portfolio, Rt. Hon. Lukia Isanga Nakadama, commended the fruitful collaborative initiative of the government, development, and civil society partners in delivering the Health National Adaptation Plan.
“The government of Uganda has created an enabling policy and legal environment to tackle the climate change challenges,” she noted emphatically, revealing that: “In the Parish Development Model (PDM), we need to integrate climate change interventions. I was recently talking to my people (constituents in Mayuge district) about the PDM programme, I told them; ‘we gave you money and we know you are doing well. They said no, all our crops were washed away by the heavy rains, we did not get anything.’ So, it’s not all that easy.”
She said the current five-year term National Development Plan (NDP) III which is bound to expire and the new NDP IV underscore climate change as a cross-cutting issue requiring mainstreaming across all sectors, assuring that the Office of the Prime Minister (OPM) will coordinate multisectoral engagements for Ministries, Departments, and Agencies (MDAs) and support awareness raising for the new Health National Adaptation Plan.
“I congratulate the Ministry of Health and all sectoral partners for developing the Health National Adaptation Plan that we are launching today. This Plan is based on evidence from the Climate Change Health Vulnerability and Adaptation Assessment and should provide a systematic guide to building a resilient health system for Uganda,” the Prime Minister observed, urging the different multi-stakeholders to support the implementation of the Plan to harness its full potential in guiding the country’s climate change adaptation action.
Climate change adaptation, commonly used, means the steps taken to help both natural and human environmental systems adjust to the impacts of climate change, whether those changes are happening now or expected in the future. Such interventions may include actions, policies, and strategies designed to specifically reduce the negative effects of climate change while making the most of any potential benefits that may arise.
On the other hand, climate change refers to the long-term shifts in temperatures and weather patterns, mostly caused by human activities like burning fossil fuels, which release greenhouse gases (also known as GHGs) into the atmosphere. These changes lead to more extreme weather events, rising sea levels, and ecosystem disruptions, impacting everything, from agriculture to human health.
One of the key successes arising out of the two weeks deliberation between 120 world leaders and over 40,000 registered participants, including 22,274 party delegates, 14,124 observers, and 3,886 media representatives at COP26 summit in Glasgow, from Sun, Oct 31, 2021 – Fri, Nov 12, 2021, was the compromise to step up support for climate change adaptation, reflected in the Glasgow Pact calling for the doubling of finance to support developing countries like Uganda in adapting to the adverse weather impacts and build resilient health systems.
A key highlight during the Glasgow negotiations, was the realisation by the global actors of the critical linkage between climate change and health, as the discussions culminated in the consensus that the worsening climate crisis directly threatens global health through increased extreme weather events, the spread of diseases, and the increased strain on healthcare systems, thus necessitating urgent integrated action to protect public health.
Subsequently, nation states committed to developing national climate change health vulnerability and adaptation assessments and the health national adaptation plans, both documents that Uganda has now concluded, to emerge as a regional and global leader in the charge towards adaptation to combat climate change effects and build resilience.
The November 2023 Climate Change Health Vulnerability and Adaptation Assessment (VAA) for Sound Management of Climate Change-related Health Risks in Uganda and the Health – National Adaptation Plan (H-NAP) 2025- 2030, were conducted through a collaboration led by Uganda’s Ministry of Health, with partners including Rockefeller Foundation, Makerere University, World Health Organization, Ministry of Water and Environment, Amref Health Africa, Reproductive Health Uganda, Pathfinder Uganda, Tree Adoption Uganda, Seed Global Health Uganda, Clinton Health Access Initiative and Regenerate Africa.
Makerere University School of Public Health’s Dr. John Bosco Isunju, who led the teams in the development of both the VAA and H-NAP, was honoured by the Ministry of Health with the 2024 Climate and Health Champions Award during the Health National Adaptation Plan Launch, for his significant contributions to building a climate-resilient health system in Uganda.
The Rockefeller Foundation’s investment played a pivotal role in funding the development of these two strategic documents. Mr. William Asiko, Vice President and head of The Rockefeller Foundation’s Africa Regional Office, emphasised, “Climate change is now the gravest threat to the health and well-being of billions of African people. Initiatives like Uganda’s Health National Adaptation Plan demonstrate how African countries are rising to the challenge by scaling the necessary climate solutions and setting an example for the world.”
Makerere University Vice Chancellor, Prof. Barnabas Nawangwe, in his remarks delivered by the University Secretary, Mr. Yusuf Kiranda commended the role played by the partners in the development of the Plan, noting that: “Our academics from the Makerere University School of Public Health played a vital role in leading the Climate Change Vulnerability and Adaptation Assessment (VAA), which has been instrumental in shaping the development of the H-NAP.”
“This is just one example of Makerere University’s strategic commitment to research, innovation, and capacity-building. We are dedicated to generating evidence and human resources capabilities that guide decision-making and contribute to the development and implementation of climate-resilient strategies in health, agriculture, and other sectors,” the Makerere University Vice Chancellor observed.
He stated that the success of the National Adaptation Plan depends on the strength of our collaborations, which requires concerted efforts of government ministries, health agencies, civil society organisations, the private sector, development partners, and the academic community, as he reiterated University’s commitment to being a key partner in the endeavour.
Today, Uganda, like the rest of the region and the globe, continues to grapple with the adverse effects of climate change. Subsequently, the Health National Adaptation Plan’s overarching goal is to enhance the resilience of Uganda’s health sector against climate-related impacts by incorporating climate adaptation into health strategies and planning, ensuring sustainable and continuous healthcare services during climatic challenges;
“Uganda is already experiencing severe climate change effects, such as floods, droughts, and temperature changes, which contribute to health issues like waterborne diseases, vector-borne diseases, malnutrition, and mental health problems.” The H-NAP report reads in part.
Its precursor, the 2023 Climate Change Health Vulnerability and Adaptation Assessment (VAA) survey, conducted across 716 selected health facilities in Uganda, highlighted the significant risks and challenges that climate change poses to public health.
The Vulnerability Assessment revealed that many healthcare facilities in Uganda are highly vulnerable to climate change-related hazards, due to unpreparedness across several critical components. In terms of energy, healthcare facilities were found to lack secure locations to protect emergency energy sources from hazards, had inadequate coverage for critical service areas, and failed to consistently check alternative energy sources.
The health workforce was also underprepared, with gaps in participation in climate adaptation plans, insufficient readiness for outdoor work during extreme conditions, and limited capacity to identify and manage health conditions, worsened by climate impacts.
Significant weaknesses were apparent in water, sanitation and hygiene, and healthcare waste management, including inadequate strategies to monitor and reduce water contamination, limited preparedness to prevent vector breeding in facility water systems, and a lack of comprehensive water safety and contingency plans. Post-hazard recovery plans were insufficient, with no safe locations for critical equipment during emergencies, inadequate safety measures for vital supplies, and inconsistent evacuation mechanisms for health workers and patients.
“These findings highlight a need for implementation of climate change adaptation plans and policies, building capacity of the health workers, and strengthening WASH management systems and water safety plans. There’s also a need for improvement of the reliability of energy infrastructure, development of contingency plans and enhancement of infrastructure resilience, evacuation plans, and post-disaster recovery,” the VAA report reads in part.
Today, Uganda has established a robust policy and legal framework to address climate change, including the National Climate Change Policy of 2015, the Climate Change Act of 2021, and the updated Nationally Determined Contribution of 2022. These frameworks aim to transform Uganda into a climate-resilient, low-carbon society by 2050.
The Uganda National Health Adaptation Plan (H-NAP) aligns with these policies, emphasising the integration of climate change adaptation into health sector plans and policies.
“A key recommendation to tackle climate change issues in Uganda is the integration of climate services for health. These services involve the provision of climate data, tools, and information tailored to the health sector’s needs, enabling health professionals to better anticipate, prepare for, and respond to climate-related health risks. Climate services for health include forecasting climate variables, monitoring and predicting the spread of climate-sensitive diseases and issuing early warnings for heatwaves and air pollution episodes,” The H-NAP reads in part.
According to the Plan, by integrating these services into health planning and operations, Uganda can enhance its public health resilience against the impacts of climate change. Furthermore, the H-NAP proposes a range of short-term and long-term interventions across ten components that include climate-transformative leadership, climate-smart health workforce, integrated risk monitoring, and sustainable financing.
From the H-NAP, specific actions identified include developing guidelines for mainstreaming climate and health, training health workers, enhancing disease surveillance systems, and revising infrastructure standards for climate-proofing. Also, the plan presents a financing framework to mobilise resources for implementing the identified interventions. This includes developing a comprehensive resource mobilisation plan, increasing national budgets for health and climate change policies, and advocating for health issues in climate funding streams.
Uganda is all too familiar with the harsh realities of climate change, having continuously experienced rising temperatures, prolonged droughts, and increasingly severe rainy seasons—each intensifying public health challenges. This National Health Adaptation Plan marks a critical step in the country’s climate action efforts, standing as the first of its kind. It serves as a crucial component of Uganda’s broader strategy to mitigate climate impacts and safeguard public health in the face of growing environmental threats.
Health
Professor Nakimuli awarded at FIGO Congress for outstanding contribution to Women and Child Health
Kampala, Uganda – Makerere University School of Public Health (MakSPH) and Estonia’s Tallinn University of Technology (TalTech) have launched a two-year collaborative project to transform health informatics education and practice in Uganda, positioning the country as a regional leader in digital health. Unveiled earlier this month at MakSPH and supported by the Estonian Centre for International Development (ESTDEV), the initiative aims to build a skilled digital health workforce and accelerate Uganda’s transition to a data-driven health system, while aligning the country’s digital agenda with global best practices through partnership.
This strategic collaboration builds on the success of MakSPH’s Master of Health Informatics (MHI) programme. The MHI is one of the eight master’s degrees hosted at the School and was first introduced in 2016, jointly delivered with Makerere University College of Computing and Information Sciences (Mak-CoCIS). The two-year graduate training equips students with skills in health information systems design, data analytics, and digital health leadership through a hybrid model of face-to-face, online, and self-paced learning. So far, since its inception, nearly 50 graduates have completed the programme, many of whom have now gone on to lead national and regional health data initiatives. In August last month, the School received 26 new entrants for the MHI 2025/2026 cohort, reflecting its rising demand.
Now, the new project, launched on September 9, 2025, links TalTech’s MSc in Digital Health, one of Europe’s pioneering programmes introduced in 2009, with MakSPH’s Master of Health Informatics to strengthen curricula, mentor faculty, and give students exposure to global best practices. The goal is to create a skilled workforce capable of leading Uganda’s digital health transformation. The initiative is co-led by Prof. Peeter Ross, Professor of e-Health at TalTech, and Prof. Nazarius M. Tumwesigye, Professor of Epidemiology and Biostatistics at MakSPH. They are joined by Doris Kaljuste, Programme Director of the MSc in Digital Health, and Mr. Michael Anywar, Doctoral Student at TalTech and the initiator of the collaboration, as well as Ms. Irene Wanyana, MHI Programme Coordinator and PhD Candidate at Karolinska Institute, Sweden, and Mr. Chris A. Balwanaki, the Coordinator for the project at MakSPH.
Prof. Ross, a leading global authority on e-health and head of the Digital Health Research Unit at Tallinn University of Technology, commenting on the project and the link between health and technology, stressed that while health itself is not technology, the intelligent integration of digital tools is indispensable for making healthcare more efficient, affordable, and accessible. He underscored that this collaboration marks a key step in that direction, with capacity development and academic exchange key to sustainable digital transformation.
“Capacity building is critical. In Estonia, when the nationwide health information system was being launched, about a third of the budget went into training healthcare professionals. This required training trainers first, underscoring the strategic role of academia. Estonia has a master’s programme in digital health, while Makerere University offers a blended Master of Health Informatics. Together, these programmes can expand training across Uganda and beyond,” Prof. Ross explained, adding that the collaboration also gives Estonia the chance to test digital health solutions in a large, English-speaking population, while Uganda benefits from Estonia’s decades of experience and avoids common pitfalls.
Estonia, a Northern European country currently with about 1.37 million people and covering a total area of 45,339 km², is seen as one of Europe’s leaders in digital innovation. About 99 per cent of its public services are reportedly delivered online, and its health information system records nearly every citizen’s medical history from birth to death. The X-Road platform in the country enables secure, encrypted data exchange, while e-prescriptions cover almost all prescriptions nationwide. Meanwhile, the Digilugu.ee patient portal allows citizens to access their health records, track activity logs, and even generate certificates, a system widely trusted by users. The Estonian team revealed that the integrated digital health ecosystem shows how technology, governance, and policy work together to provide efficient, patient-centred care.
Conversely, Uganda’s growing digital ecosystem makes the timing of the collaboration strategic. The country currently has more than 43 million mobile subscriptions, over 26 million internet users, and more than 33 million mobile money accounts, creating fertile ground for scaling digital health solutions. With this, strengthening health informatics will build a skilled workforce needed to design, implement, and manage these solutions effectively.
The MakSPH Project Co-lead, Prof. Tumwesigye, hailed the partnership as a turning point for the MHI programme, noting that modules such as Health Analytics are being upgraded to give students hands-on experience in developing tools to digitise public and private health systems. He said Estonia’s model, where digital innovations are widely adopted and lead to measurable improvements, offers a blueprint Uganda can adapt to move beyond paper-based systems, improve data quality, and train graduates to design solutions that strengthen health outcomes.
“Uganda is still behind in digital health use. We rely heavily on paper-based systems, experience long delays in transmitting data from primary health facilities to the national level, and face issues with data quality, including missing or inaccurate figures. Strengthening our programme will help address these challenges and produce graduates who can design solutions that lead to better health outcomes. Learning from TalTech University and Estonia’s digital health success will help us put Uganda on a better footing for the future,” Prof. Tumwesigye observed, noting that Estonia’s model stands out for ensuring digital innovations are widely adopted and deliver measurable improvements in health system performance.
The Programme Coordinator, Ms. Irene Wanyana, noted that since its launch in 2016, the Health Informatics training at Makerere University has made a strong impact, earning a reputation as one of the leading graduate programmes of its kind in the region. She observed that faculty members and students have been instrumental in designing, developing, and supporting national health information systems critical to Uganda’s health sector. These include UgandaEMR, an advanced electronic medical record system now deployed in more than 1,700 health facilities; the Weekly Stock Status System, which enables real-time tracking of essential medical commodities; and the Early Infant Diagnosis Laboratory Information Management System (LIMS), which improves the management of HIV testing data for infants.
Still, the programme has contributed to the development of PrEP and DREAMS/OVC tracking systems, supporting HIV prevention and care for vulnerable populations such as adolescent girls, young women, and children. The graduate training has also strengthened national HIV surveillance through the Centralised Blood Screening (CBS) dashboard, advanced the Uganda Health Information Exchange Platform to improve interoperability, and facilitated the migration of critical health data systems into the Ministry of Health’s national data centres, continuing to ensure that health information is secure, reliable, and accessible nationwide.
Ms. Wanyana is optimistic that with the new collaboration with TalTech University in Estonia, MakSPH’s Health Informatics programme is poised to deliver even greater innovations and impact to transform Uganda’s digital health system. In September 2024, four of our MHI students, Mr. Edwin Ayebare, Mr. Brian Twesigye, Mr. Enock Mwesigwa, and Mr. Iving Mumbere, won a global Award of Distinction at the Open Group India Awards for Innovation & Excellence in New Delhi. Competing against 22 university teams worldwide, they were recognised for their innovative application of enterprise architecture to address real-world health system challenges, attesting to Makerere University’s global competitiveness.
Speaking at the launch event, H.E. Girisch M. Nair, Honorary Consul of Estonia to Uganda, emphasised that Estonia’s experience offers Uganda a practical blueprint for building interoperable systems, standardising health data, and strengthening national health information infrastructure. “This collaboration is a platform for us to aspire more. Imagine a patient in Bundibugyo with a secure digital ID linked to their electronic health record. Wherever they go, authorised health workers can access their records, prescriptions are issued electronically, and medicines are dispensed at registered pharmacies. This generates rich, actionable data that helps plan better, reduce waste, and improve health outcomes.”
There is evidence of the Estonian Consul’s remarks. A new study conducted in 2023 by a team from Makerere University School of Public Health, led by Assoc. Prof. Peter Waiswa, published this September in BMJ Global Health, confirmed that supporting Ugandan districts to adopt digital payments significantly improved the efficiency of mass vaccination campaigns in the country, reducing delays, cutting administrative bottlenecks, and enhancing transparency. The findings from this and similar multi-country studies by the same team show that with targeted support, cashless systems are both feasible and practical for strengthening public health.
For Mr. Jamiru Mpiima, an alumnus of MakSPH and graduate of the Health Informatics programme, these developments underscore the critical need for a skilled workforce to design, implement, and manage digital health systems effectively. Speaking on behalf of Mr. Paul Mbaka, Head of the Division of Health Information at Uganda’s Ministry of Health, Mr. Mpiima shared the Ministry’s progress in digitising health information systems, from electronic medical records to the electronic community health information system, and the lessons learned along the way. He urged stronger collaboration between MakSPH and the Ministry, particularly in training future health informatics professionals and building institutional capacity to manage change in Uganda’s digital health sector transformation.
During the launch, MakSPH Dean, Prof. Rhoda Wanyenze, commended the remarkable speed of the Estonia–Makerere collaboration, noting that within a year, early conversations had already matured into a funded joint project. She emphasised that this milestone marks not just the start of a promising partnership, but also a unique opportunity to embed it more firmly within Uganda’s health system. Prof. Wanyenze called on all partners, the Ministry of Health, Makerere University, and the Estonian counterparts, to pursue a strategic tripartite arrangement, stressing that such collaboration could greatly strengthen Uganda’s digital health systems, accelerate technological innovation, and deliver measurable improvements in national health outcomes.
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