Health
Inside Uganda’s National Health Adaptation Plan to Combat Climate Change
Published
1 year agoon
By
Mak Editor
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.
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Health
Holistic Retirement Planning includes Psychological, Emotional & Social well-being across all Career Stages
Published
7 days agoon
January 12, 2026By
Mak Editor
The Makerere University Retirement Benefits Scheme (MURBS) on Thursday, 8 January 2026 organised a Member Sensitisation Session on “Understanding Identity Shifts; Developing Routines; Sustaining Motivation and Purpose”. The session focused on holistic retirement planning, emphasising that readiness for life after work goes beyond finances to include psychological, emotional, and social well-being across all career stages—from early career to post-retirement.
The session featured a keynote presentation by Professor Seggane Musisi, who highlighted how work-related titles and roles often shape personal identity, and how retirement can trigger a sense of loss if individuals are unprepared to redefine themselves. Members were encouraged to consciously design a post-work identity grounded in values, purpose, and community contribution.
Participants learned practical strategies for:
- Preparing early for retirement at different career stages;
- Developing healthy, meaningful routines that support mental stability and productivity;
- Sustaining motivation and purpose beyond formal employment;
- Managing stress, maintaining physical and mental health, and nurturing social connections; and
- Balancing family responsibilities with personal well-being.
The discussion also addressed cultural realities of retirement in Uganda, including family expectations, social obligations, and financial pressures. Special attention was given to age-related challenges such as dementia, depression, and chronic illness, underscoring the importance of preventive health care, emotional resilience, and timely professional support.
Overall, the session reinforced the message that retirement is a lifelong transition, not a one-time event. Members were encouraged to plan early, adapt continuously, and intentionally design a fulfilling, purposeful life beyond work—psychologically, socially, and financially.
To view the session, please click the embedded video below. Further below is the presentation.
Health
Kampala at a Crossroads: What New Research Reveals About Mobility, Governance, and the City’s Public Health Risks
Published
2 weeks agoon
January 8, 2026
Every day in Kampala, millions of people inch through gridlock, dodge swarming boda-bodas threading through narrow gaps in traffic, inhale dangerously polluted air, and walk along streets rarely designed for pedestrians. These conditions, and more, are often dismissed as ordinary transport frustrations. Yet researchers at Makerere University School of Public Health (MakSPH) are examining how such everyday realities translate into public health outcomes, shaped not simply by congestion, but by governance, policy, and power. Their work forms part of a multi-country project investigating the political economy of urban mobility in three African cities.

Co-led by Dr. Aloysius Ssennyonjo, the Principal Investigator and health systems and governance researcher at MakSPH, together with Uganda’s Country Principal Investigator, Dr. Esther Bayiga-Zziwa, a road safety and injury epidemiologist, and Co-Principal Investigator Dr. Jimmy Osuret, an injury prevention researcher, the project titled The Political Economy of Urban Mobility Policies and Their Health Implications in African Cities (PUMA) applies a political economy lens to understand how political interests, institutional arrangements, and power dynamics shape mobility systems and their consequences for public health in Kampala, Kigali, and Lilongwe.
To note, political economy analysis examines how public decisions are shaped by the interplay of politics, interests, institutions, and resources, in short, who has influence, who controls what, and how money and power circulate within a system. In Kampala, a capital of nearly two million residents whose daytime population swells with commuters, this lens helps explain why some transport options attract funding and enforcement while others are tolerated, neglected, or contested. These choices are not just technical, but reflect competing interests and priorities, with consequences for safety, equity, and the everyday well-being of those moving through the city.

Now, through the NIHR-funded project, the Ugandan team is currently working with colleagues from the University of Rwanda, led by Professor David Tumusiime, and Kamuzu University of Health Sciences in Malawi, led by Dr. Dominic Nkhoma. The research partnership aims to generate evidence that can strengthen mobility governance and improve public health outcomes across the three African cities above, with advisory support for the research consortium from the University of Antwerp in Belgium and Canterbury Christ Church University in the UK.
Explaining the project’s rationale for the Politics of Urban Mobility, or PUMA, during the 2025 Universal Health Coverage Day webinar held on December 12 under the theme “Mobility, Costs, and Politics: How Urban Systems Shape Access and Progress Towards Universal Health Coverage in African Cities,” Principal Investigator Dr. Ssennyonjo said Africa is urbanising at an unprecedented pace. Projections show that by 2050, nearly 60% of the continent’s population will live in cities, a shift that is intensifying transport pressures and increasingly turning everyday mobility into a public health risk.

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

He mentioned that health outcomes are shaped by social, economic, and environmental factors, with transport costs, risks, and stress often posing greater barriers than medical fees alone to achieving affordable health for all. He noted that the PUMA project brings together multidisciplinary teams to study how governance and political dynamics shape urban mobility, public health, and development, a perspective reflected in Prof. Julius Kiiza’s observation that effective urban development relies on coordinated action by diverse stakeholders across sectors to improve health outcomes, though emphasising the primacy of politics.
“Uganda and Singapore had comparable levels of underdevelopment in the 1960s. Under Lee Kuan Yew, Singapore embarked on a deliberate nation-building project. Today, it is among the smartest cities globally, outperforming many Western cities in clean government, mobility, and liveability. Why are we lagging behind? The answer, I argue, lies largely in the nature of our politics,” Prof. Julius Kiiza cogently argued.
He intimated that the result has been cities that are “unreliable, unsafe, unsmart, and chaotic,” noting that claims of inclusive urban development often ring hollow. “I have argued, and repeat here, that boda bodas as a symbol of inclusivity represent a false model of inclusion. We must interrogate this and invest in better urban transport systems and wider, well-planned highways,” he affirmed.

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

Indeed, on November 21, 2025, the Ugandan team convened a national stakeholder workshop in Kampala, bringing together a wide range of stakeholders. Opening the workshop, Assoc. Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management (HPPM) at MakSPH, commended the team for highlighting what she described as a long-underexplored dimension of Uganda’s urban health landscape: mobility and its governance.
Reflecting on her own experience, she noted how boda-bodas have become increasingly indispensable for millions seeking quick, flexible transport, but also carry complex health, safety, and economic implications that demand multisectoral attention, calling for a balanced, evidence-driven dialogue that recognises their value while also addressing the infrastructural and policy gaps that shape mobility systems in Uganda’s rapidly growing cities.
“I sometimes use boda-bodas,” Assoc. Prof. Suzanne Kiwanuka said. “They are necessary when you need to move quickly during heavy traffic. Yet we all know how unsafe they can be. This PUMA initiative is timely to generate evidence not only on the politics of urban mobility and its health implications, but also its economic consequences.”

Notably, road traffic crashes remain one of Uganda’s most urgent public health threats today. The recent Uganda Police Force Annual Crime Report 2024 recorded 5,144 road deaths, a seven per cent rise from 2023, with motorcyclists accounting for nearly half of all fatalities. In Kampala, pedestrians, cyclists, and motorcycle riders constitute 94 per cent of all fatal crashes, according to the Kampala Capital City Authority. Thousands more suffer life-altering injuries each year.
Still, evidence from MakSPH, through its Centre for Trauma, Injury and Disability Prevention (C-TRIAD) and the Johns Hopkins International Injury Research Unit (JH-IIRU) under the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS), shows that the design and use of city roads are worsening the risk environment. Between 2021 and 2023, the team conducted more than one million roadside observations across Kampala, finding that while only five per cent of vehicles are officially recorded as speeding, those that do travel at an average of 57 km/h, well above safe limits for dense urban corridors, making city roads increasingly unsafe.

The World Health Organization (WHO) guidelines, cited in the report, recommend speed limits of 30 km/h on community roads and in urban areas where pedestrians, cyclists, and other vulnerable road users share space with motorised traffic, and 50 km/h on major urban roads. Yet the findings show that six in ten vehicles on community roads exceed these limits, heightening risks for those least protected and underscoring the need for lower-speed zones, traffic-calming measures such as speed humps and raised crossings, and consistent enforcement of traffic regulations.
For the PUMA team in Uganda, the writing on the wall shows that these rising injuries coincide with worsening congestion and rapid urbanisation, yet city mobility policies within Kampala remain heavily oriented toward road expansion and vehicular flow, with limited attention to safety, health protection, or non-motorised transport. This policy imbalance, then, explains why daily commuting remains hazardous and why progress on safer streets has been slow.

The study uses a three-tiered approach that combines policy analysis, regional evidence, and local experiences to examine how mobility decisions are made in Kampala, Kigali, and Lilongwe, who holds authority, and how these processes affect public health and equity. This is strengthened by structured co-creation workshops with practitioners, policymakers, and community actors, which reveal how governance functions in practice, often diverging from what is written on paper.
In parallel, the research team is conducting a continent-wide review of academic and grey literature to map regional trends, gaps, and the broader forces shaping African mobility systems. Together, these streams enable the researchers to compare cities, identify shared challenges, and build a grounded analytical framework for improving mobility governance across Africa.
In Kampala, preliminary findings by the MakSPH PUMA research team show a city governed by many mobility policies but marked by weak mobility governance. The team shared that Kampala operates under a dense mix of frameworks, from the National Integrated Transport Master Plan and National Urban Policy to road safety, climate, and KCCA development plans. While these documents acknowledge congestion, urbanisation, and road injury risks, they also reveal overlapping mandates, blurred institutional roles, and limited coordination authority.

Key government Ministries, Departments, and Agencies (MDAs) actors include the Ministry of Works and Transport, KCCA, the Ministry of Lands, the Office of the Prime Minister, and the Ministry of Finance, with the Ministry of Health conspicuously absent despite clear health implications. Policy attention, according to the early findings, remains heavily skewed toward road transport, leaving non-motorised mobility and major health pathways, noise exposure, psychosocial stress, community severance, heat, and mobility independence largely unaddressed.
Governance realities are further shaped by political processes, including electoral cycles, informal negotiations with transport unions, selective regulation of boda-bodas, and heavy reliance on development partners that often influence what is prioritised and implemented. Together, these dynamics help explain stalled master plans, inconsistent enforcement, and resistance to progressive interventions. While the PUMA research remains at a preliminary stage currently, the emerging findings underscore the need for an integrated, multisectoral mobility agenda that places health at the centre of Kampala’s transport policy and practice.

Health
How People Earn a Living is Contributing to Malaria Risk in Uganda, Study Finds
Published
2 weeks agoon
January 5, 2026
Livelihood activities such as farming, livestock keeping, construction, and night-time work significantly increase malaria risk in Uganda, according to new research by Dr Kevin Deane, a development economist at The Open University, UK, and Dr Edwinah Atusingwize and Dr David Musoke, a Research Associate and Associate Professor of Environmental Health at Makerere University School of Public Health, respectively.
The study, Livelihoods as a key social determinant of malaria: Qualitative evidence from Uganda, published on December 2, 2025, in the journal Global Public Health, examines how everyday economic activities shape exposure to malaria, often undermining conventional prevention measures such as insecticide-treated nets and indoor residual spraying. The findings are based on qualitative fieldwork conducted in June 2024 in Busiro County, Wakiso District, a peri-urban area with persistently high malaria transmission in Uganda.
Using a qualitative design, the researchers conducted 14 key informant interviews, 10 focus group discussions, and 11 in-depth interviews with households recently affected by malaria, engaging 100 participants from communities, health services, local government, and civil society across Kajjansi, Kasanje, and Katabi Town Councils, as well as Bussi Sub-County, in Busiro South. Their analysis, guided by the Dahlgren–Whitehead social determinants of health model, enabled the researchers to situate malaria risk within the broader social, economic, and environmental conditions shaping how people live and work.

In their findings, participants linked malaria exposure to agricultural practices, among which is maize cultivation near homes, which was associated with increased mosquito density during the rainy season. “One of the most common crops cultivated in Uganda, which many rely on as staple foods, creates environments in which mosquitoes are attracted to and thrive, often in settings where maize is grown near homes in rural areas and urban areas. This increases mosquito density around homes and contributes to increased outdoor biting and the number of mosquitoes entering houses,” the study argues.
Its authors say this poses a difficult policy challenge because maize is central to household food security, leaving few practical options for reducing exposure. They argue that proposals to keep maize away from homes are often unrealistic for families with limited land or those farming in urban areas, while targeted control during flowering periods may have limited impact given mosquitoes’ ability to travel beyond cultivation sites.

Beyond crop farming, the study reports that livestock rearing, especially zero-grazing cattle kept close to houses, attracts mosquitoes into household compounds. Other livelihood activities, including construction and brick-making, created stagnant water-filled pits that served as breeding sites, while night-time livelihoods, such as street vending, guarding, fishing, bar work, and brick burning, among others, prolonged outdoor exposure during peak mosquito biting hours. Gender further shaped risk, with women’s livelihoods and caregiving responsibilities frequently exposing young children alongside them.
“The evidence we present illustrates the unintended health consequences of development strategies intended to promote key livelihood activities, food security, and poverty reduction. There are no straightforward solutions given the complexity of these relationships and the importance of these livelihoods for many households,” the authors assert.
They conclude that malaria elimination efforts will fall short unless livelihoods and development activities are explicitly integrated into malaria prevention strategies, calling for stronger alignment between public health, agriculture, urban development, and economic policy.
Please see below for the study:
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