Researchers at Makerere University School of Public Health (MakSPH) are urging the Ugandan government to boost healthcare funding to enhance reproductive health services. Dr. Dinah Amongin, an obstetrics and gynecology expert at MakSPH, has expressed concern about the lack of access to family planning methods, which forces women to use less preferred options due to unavailability.
Dr. Amongin notes that within just six months to a year of using contraception, some women encountered issues and switched methods. This highlights the need for the Ministry of Health to improve the availability of various contraceptive options. A rights-based approach to contraception ensures that women have access to a range of methods, preventing situations where desired options are unavailable at health facilities.
Performance Monitoring for Action’s Phase 2 Survey Results by MakSPH (Sept-Nov 2021) reveals increased stockouts of injectables and erratic availability of pills at 225 public FP facilities, mainly due to supply issues.
“Stockouts are a significant issue, and this extends to parliamentary discussions on health sector budgets. As we focus on human capital development and improving maternal and newborn health outcomes, we must consider crucial components like preventing unwanted pregnancies through family planning. The budget allocation for the health sector directly impacts this issue. When women cannot access their preferred contraceptive methods due to stockouts, it reflects a failure in our legislative and budgeting processes. This situation forces women to switch to fewer desirable methods, which is not acceptable,” says Dr. Amongin.
Adding that; “These are things we need to continue discussing as a country but we must invest into family planning. We can talk about human capital development but until we step up and actually support women to prevent unwanted pregnancies, support them in their decisions of whether she wants to use a method for contraception or not. That is her choice. We must make sure access to the methods of her choice is actually addressed.”
Dr. Dinah Amongin, an obstetrics and gynecology expert at MakSPH, has expressed concern about the lack of access to family planning methods, which forces women to use less preferred options due to unavailability.
Dr. Amongin’s comments follow a recent study on the I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023. The study highlights that social support significantly improves women’s ability to make informed contraceptive choices, potentially leading to better reproductive health outcomes.
Part of the Innovations for Choice and Autonomy (ICAN) project, the study shows that self-injection with DMPA-SC (Sayana Press) could increase contraceptive use, especially among women with limited access to healthcare. Despite the rollout of this method in 2017, its use remains low in Uganda. Sayana Press as popularly known is a subcutaneous depot medroxyprogesterone acetate (DMPA-SC). It is a hormonal birth control shot, administered under the skin and is an all-in-one contraceptive that puts women in charge of their reproductive health.
Social support boosts self-efficacy, enhances privacy, and reduces access barriers, making self-management easier. Family planning helps manage the number and timing of children, lowering maternal and infant mortality rates and reducing complications from pregnancy. Conversely, unmet contraceptive needs can lead to unintended pregnancies and their associated risks.
A woman self-injecting while demonstrating to fellow women in Oyam district.
In Uganda, 52% of pregnancies are unwanted or mistimed, with over 43% due to unmet family planning needs. The country’s youthful population complicates the issue, with 50% under 17 years old, at least according to the recent National Population Census. Notably, 10% of girls, one in every 10 girls you encounter, has already had sex before she turns 15 years, and 20% of boys, two in 10 boys have engaged in sexual intercourse by the same age.
Uganda’s population pyramid showing age and sex composition of the population as of 2024. Source UBOS, Census 2024.
Methods of contraception include oral contraceptive pills, implants, injectables, patches, vaginal rings, intra uterine devices, condoms, male and female sterilization, lactational amenorrhea methods, withdrawal and fertility awareness-based methods.
Global statistics show that 77.5% of women aged 15–49 had their family planning needs met with modern methods in 2022, up from 67% in 1990. In sub-Saharan Africa, the proportion of women who have their need for family planning satisfied with modern methods (SDG indicator 3.7.1) continues to be among the lowest in the world at 56 per cent. Nevertheless, it also increased faster than in any other region of the world, having more than doubled since 1990, when this proportion was only 24 per cent.
Among 1.9 billion women of reproductive age (15-49 years), an estimated 874 million women use a modern contraceptive method and 92 million, a traditional contraceptive method. The number of modern contraceptive users has nearly doubled worldwide since 1990 (from 467 million). Yet, there are still 164 million women who want to delay or avoid pregnancy and are not using any contraceptive method, and thus are considered to have an unmet need for family planning.
Number of women of reproductive age (15-49 years) using various contraceptive methods, world, 2020 (millions and percentage)
Slow progress is due to factors like limited method choices, restricted access, fear of side effects, cultural opposition, and gender-based barriers.
Between 2015 and 2019, there were 121 million unintended pregnancies annually worldwide – 48 per cent of all pregnancies. Despite decreases in the rate of unintended pregnancy in all regions over the past three decades, nearly one in 10 women in sub-Saharan Africa, Western Asia and Northern Africa, and Oceania (excluding Australia and New Zealand) continue to experience an unintended pregnancy every year
Watercolor painted fetus illustration.
In Uganda, where healthcare services are stretched thin and women juggle numerous responsibilities, accessing contraceptives can be challenging.
Dr. Amongin emphasizes that self-injection methods like DMPA-SC, also known as Sayana Press could ease the burden on women facing long queues and logistical challenges at health facilities. “This method allows for discretion and reduces the need for frequent visits, which is crucial for women with busy lives,” she says.
Researchers argue that the health sector’s budget should include substantial funding for family planning. The high cost of inaction is evident: neglecting family planning leads to unplanned pregnancies, which ultimately burdens families and the nation. Addressing this issue early in the life cycle is crucial to prevent these long-term consequences.
“This is the gist of the matter behind all our research, that a woman’s preference needs to be respected. The health facilities must stock commodities so that when a woman is in need, she actually gets it,” noted Dr. Amongin.
PMA researchers surveyed DMPA-SC (Sayana Press) users to find out if they self-administered the injection or received it from a healthcare provider. Results show a slight increase in self-injection among users between 2020-2021.
Dr. Peter Waiswa, an Associate Professor at MakSPH, stresses the importance of informed choice in family planning. ICAN studies across Kenya, Malawi, Nigeria, and Uganda show that self-injection benefits all women, including young adolescents. “Supporting young people to make informed choices helps prevent unintended pregnancies,” says Prof. Waiswa.
“We spent four years trying to understand which women benefit from injecting themselves. And we found that all women benefit from it, including younger children. Because younger children in Uganda, whether we hide our heads in the sand or not, especially those 12 years and above are having sex and some of them using contraceptives,” Professor Waiswa says.
Dr. Peter Waiswa, an Associate Professor at MakSPH interacts with legislators Hon. Nancy Acora, the Lamwo District Woman MP and the Mbarara district woman MP Ayebare Margaret Rwebyambu.
What is factually true is that by age 18, 60% of Ugandans have reported having sexual intercourse. Despite the benefits, dropout rates from family planning methods remain high due to side effects and lack of support. Dr. Waiswa also, a Public Health specialist, critique and dreamer for better health systems for mothers, newborns and children in Africa calls for better education and support to address these issues.
“As a way of being supported in a safe space whereby people are not asking questions, they are not fearing parents, they are not fearing other people, then they can use the methods. What we did in Mayuge and Oyam, we trained women who are users of family planning. To identify people who need to use family planning but are not currently using and then they go and see whether they can use or not. And we found that when people are supported, those groups which are currently not being reached can be reached by family planning,” argues Prof. Waiswa.
Women with most recent unintended pregnancies by age and residence. 2 in 5 women had their last pregnancy unintended in Uganda. 13% wanted no more while 33% wanted later. Source, PMA
A 2021 study found that contraceptive discontinuation significantly impacts the effectiveness of family planning services, leading to higher fertility rates, unwanted pregnancies, and induced abortions.
Analysis of data from PMA 2020 show that 6.8% of women discontinued contraceptive use, with discontinuation linked to factors such as age, marital status, method type, and health concerns. The study suggests prioritizing interventions to encourage contraceptive use among young people and promoting partner involvement and awareness, as many contraceptive methods are not discreet.
Prof. Waiswa is concerned of the high dropout rate from family planning methods, where many women discontinue use due to side effects, a need for better education and support.
“We need to see how to educate women so that they are informed when they are choosing a method to use. They need to have enough information because when they discontinue, the method can be ineffective, can cause side effects, but also these methods are expensive, so they waste money. There are a lot of those who change to other methods. We are learning a lot on the use of family planning why we still have a large unmet need,” says Prof. Waiswa.
Contraceptive methods used among women of reproductive age (15-49 years), world and by region, 1995 and 2020 (percentage) -Source: UN – World Family Planning 2022 Report
Ms. Roseline Achola, Technical Specialist for Sexual and Reproductive Health and Self-Care at the Ministry of Health, hailed the MakSPH study on self-injection contraception. She noted that the findings will help her enhance support for self-care initiatives. However, she expressed that only 29% of women willing to self-inject as indicated in the study is still low, highlighting a need to address barriers to increase acceptance as well as managing sexually active adolecents. “We must discuss how to handle minors seeking contraception to prevent unintended pregnancies,” she says.
On Friday August 23, 2024, the Daily Monitor reported, an increase in young girls adopting family planning to combat teenage pregnancies and school dropouts. Quoting data from the Uganda Health Information System, statistics show that between March 2023 and March 2024, 2,476 girls under 15 had their first antenatal care visit, and 1,755 gave birth. The highest number of pregnancies among this age group was in Oyam district.
In this period, Lango subregion saw 52 pregnancies among this age group, with Oyam district recording the highest at 10 cases. The 2021 UNFPA fact sheet indicates that Busoga region, particularly Kamuli and Mayuge districts, has the highest rates of teenage pregnancies, with 6,535 and 6,205 cases respectively.
Calculations based on United Nations, Department of Economic and Social Affairs, Population Division (2022). World Contraceptive Use 2022.
“As the country, it’s clear that adolescents are limited to access to contraception because of so many reasons. For us as a Ministry, any woman between the age of 15 to 49 is a woman of reproductive age and that tells you that she is capable of getting pregnant and when such a girl of probably 15 years goes to a facility to seek for contraception, it rings a message that actually she is sexually active. So how do we handle her? So that is a matter of discussion for the country.
It is a matter that the nation needs to decide on, because we all know the girls are getting pregnant, the girls want to use contraception, but they have no access because of the fact that they are children,” wondered Achola.
Assoc. Prof. Lynn Atuyambe one of the researchers on post-abortion care shares a light moment with Ms. Roseline Achola, Technical Specialist for Sexual and Reproductive Health and Self-Care at the Ministry of Health during the ICAN Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala.
Unintended pregnancies and Uganda’s abortion paradox
Abortion in Uganda, is largely illegal except in specific circumstances. It contributes to maternal death due to unsafe practices. Between 2010 and 2014, WHO reported that 30.6million abortions conducted were safe and 25.1million were unsafe. 97% of these occurred in developing countries. In East Africa, the total number of abortions per year according to the Lancet are around 2.65million.
The Ministry of Health’s HMIS data show a rise in abortion cases, with 96,620 reported between July 2020 and June 2021in both government and private health facilities.
Another recent study on the quality of post-abortion care by MakSPH researchers Assoc. Prof. Lynn Atuyambe, Dr. Justine Bukenya, Dr. Arthur Bagonza and Mr. Sam Etajak highlights the need for accurate post-abortion care data to improve healthcare planning and policymaking.
Dr. Arthur Bagonza, a Public Health Consultant and Research fellow with specialization in health systems at MakSPH and one of the uality of post-abortion care has called for accurate abortion data to improve healthcare planning and policymaking. He notes that health workers often avoid documenting abortion data due to legal fears and calls for reforms to restrictive laws to ensure accurate reporting without legal repercussions.
“All assessed health facilities reviewed in our study achieved a 100% timeliness rate for report submissions. However, significant disparities were observed in data accuracy between different levels of health facilities, with lower-level facilities (HC IIs and HC IIIs) showing higher rates of data discrepancies,” says Dr. Bagonza.
Dr. Arthur Bagonza., a Public Health Consultant and Research fellow at MakSPH presenting results of the quality of post abortion care. He calls for accurate abortion data to improve healthcare planning and policymaking.
According to Dr. Amongin, the high incidence of early sexual activity among Uganda’s youth is a pressing public health issue.
“We know as a country many women continue to die following unsafe abortions; abortions for pregnancies that they did not want. And these abortions are highest among adolescents and also other women categories.
We would want to ensure that we actually enhance access to contraceptives, but making it easier for them to have it and putting the power in the hands of a woman to as much extent as we can. So that a woman can practice what we call self-care, but of course she also will need the support of the healthcare system. But we want this power in women’s hands because of all the challenges that the women actually can encounter in accessing these methods,” she said.
On her part, Achola insists that abortion should not be a last resort for women and urges them to abstain or use protective means in order to avoid unwanted pregnancies. She notes that as long as abortion remains illegal in Uganda, many health workers will avoid addressing it, leading people to unsafe alternatives.
“I can’t be happy because abortion means we have failed to give people a method of their choice to prevent that pregnancy. Or the people are not able to access contraception to prevent unintended pregnancies. Abortion is not the last resort, it’s not a solution because it has its own complications as well,” says Achola.
Ms. Roseline Achola, Technical Specialist for Sexual and Reproductive Health and Self-Care at the Ministry of Health listens through during one of the dissemination sessions organised by MakSPH.
Despite this, Achola, notes most of the women who walk in health facilities with post-abortion complications must be attended to. “Whereas we don’t encourage people to do abortions, as Ministry of Health we are mandated to handle all complications for anyone who walks in our facilities because our priority is to save life. We want to urge women to avoid certain things. Why should you wait for unintended pregnancy to occur and then abort?”
Dr. Charles Olaro, a Senior Consultant Surgeon and the Director Health services – Curative in the Ministry of Health highlights the financial burden on individuals seeking health services and suggests exploring private sector opportunities and community-based approaches to improve access. “We need to balance values and rights while addressing access barriers,” he notes.
According to Dr. Olaro, the autonomy and agency of women in sexual and reproductive health, particularly in African cultures remain a challenge where social norms may require women to defer decisions to their partners.
Dr. Charles Olaro, a Senior Consultant Surgeon and the Director Health services – Curative in the Ministry of Health (MoH).
He notes that there is a high burden of abortion and self-harm, with a significant portion of maternal mortality attributed to sepsis, which is often a result of unsafe abortions in Uganda.
“We still need evidence to ensure that access barriers are addressed. And this is a question I keep on asking Makerere University, yes, we have a young population but how are these people accessing contraceptives. Other issue we have to deal with is complex. I know we have to do a balance between values and rights, but we will be able to look at that when they gain the success to do it.”
Dr. Olaro points out that individuals often face a financial burden in health services, spending more on prescriptions than on the medications themselves. He suggests exploring private sector opportunities and a community-based approach to improve access to healthcare.
Kampala — On Saturday, a car park on the campus of Makerere University in Kampala became the stage for a continental emergency response. Delegates, dignitaries and diplomats gathered in the tent outside the Infectious Diseases Institute (IDI), a research institute owned by the university, for the formal launch of the Continental Incident Management Support Team (IMST), a joint Africa Centres for Disease Control and Prevention (Africa CDC) and World Health Organization (WHO) operation racing to contain the Bundibugyo strain of Ebola sweeping through the Democratic Republic of the Congo and, increasingly, Uganda. After the ribbon-cutting, guests were led inside to tour the team’s new home at IDI’s McKinnell Knowledge Centre, where the command offices have now been set up.
Dr Chris Baryomunsi joins delegates for a group photograph at the IMST launch, Infectious Diseases Institute, Makerere University.
The numbers explain the urgency. As of 21 June, more than 1,000 confirmed cases and 269 deaths had been recorded across the two countries, the vast majority in Ituri Province in eastern DRC. Uganda’s tally stood at 20 cases and two deaths, almost all traced to cross-border movement from the DRC. Eighty-two health workers have been infected, 18 fatally, a toll that helped push the WHO to declare a Public Health Emergency of International Concern in May, mirrored days later by Africa CDC’s own continental emergency declaration.
Prof Henry Mwanaki Alinaitwe, Deputy Vice Chancellor for Finance and Administration at Makerere University, with the acting US Ambassador to Uganda and Prof Samuel Luboga, IDI board chair, at the IMST launch.
Until now, the international response has been coordinated remotely, a patchwork of video calls and scattered logistics that officials admit slowed decision-making. The Kampala launch marks a shift from that fragmented model to a single, physically co-located command centre housed at IDI’s McKinnell Knowledge Centre, bringing case management, surveillance, logistics and risk communication specialists under one roof. From there, the convoy of delegates moved on to Kajjansi, on the outskirts of Entebbe, for the formal activation of the IMST’s regional logistics hub, the facility tasked with staging and rapidly deploying protective equipment and medical supplies across the outbreak zone.
Dr Chris Baryomunsi inspects the newly activated IMST logistics hub at Kajjansi, near Entebbe.
For Uganda’s health minister, Dr Chris Baryomunsi, the symbolism was as important as the logistics. Speaking at the launch, he argued that no nation can consider itself protected until its neighbours are equally prepared, framing cross-border solidarity as an operational necessity rather than an aspiration. He also announced a new memorandum of understanding with the DRC establishing joint Ebola treatment centres and laboratory services in the border towns of Aru and Kasenyi, warning that outbreak response cannot succeed while transmission continues unchecked on one side of a shared frontier.
Dr Chris Baryomunsi speaks as the guest of honour at the launch of the Continental Incident Management Support Team, Infectious Diseases Institute, Makerere University.
The WHO’s regional emergency director, Dr Marie-Roseline Belizaire, described the unified command structure as transformative, saying it would pool resources across agencies, cut duplication and keep field decisions anchored to scientific evidence. Africa CDC’s Dr Tolbert Nyenswah confirmed the team, specialists in case management, infection prevention, logistics and contact tracing, has now relocated physically to Kampala to work closer to the epicentre. Eleven epidemic-prone African nations, including Rwanda, Burundi, Angola and the Central African Republic, are participating in the preparedness effort even though most have not registered a single case.
Dr Marie-Roseline Belizaire, WHO AFRO’s regional emergency director, speaks at the launch of the Continental Incident Management Support Team in Kampala.
For IDI and Makerere University, hosting the command centre carries weight beyond the immediate crisis. IDI’s executive director, Dr Andrew Kambugu, said the institute had provided a fully equipped space, now installed at the McKinnell Knowledge Centre, enabling real-time communication between field teams, regional governments and international partners in Geneva, and framed the moment as proof that academic institutions can engage directly with pressing societal problems rather than observe from the sidelines.
Dr Andrew Kambugu delivers welcome remarks at the launch of the Continental Incident Management Support Team, Infectious Diseases Institute, Makerere University.
That framing matters for a continent whose research infrastructure has often been treated as peripheral to its own health emergencies. By anchoring the IMST’s command function within a Ugandan public university rather than in a foreign capital, the launch signals a modest but symbolic rebalancing: an African-led institution taking custody of an African-led response. The day’s itinerary made the point physically as well as symbolically: from the ribbon-cutting in Makerere’s car park, to the tour of the new command offices, to the drive out to Kajjansi to switch on the logistics hub, delegates traced the full chain of the response they had just committed to running.
Dr Chris Baryomunsi poses with the IMST logistics hub team at Kajjansi, following the hub’s formal activation.
Fred Ouma is the Corporate Communications Specialist, Infectious Diseases Institute (IDI).
Every 4 July, the United States marks its independence. This year’s commemoration carries added significance as the country celebrates 250 years, offering partners across the world a moment to reflect on relationships built through shared purpose, investment and trust.
For Makerere University School of Public Health (MakSPH), that reflection leads to a long and productive partnership with the people and Government of the United States, spanning more than 35 years. Through U.S. Government agencies and programmes, the collaboration has supported MakSPH’s growth from a national public health training institution into a regional platform for evidence, leadership, health systems strengthening and public health preparedness.
Today, MakSPH stands at a defining point in its institutional journey. Tracing its roots to the introduction of preventive medicine in Makerere University’s then Faculty of Medicine in 1954, the School has grown into a leading public health institution in Africa, training more than 1,000 students across 12-degree programmes, working through district field training sites, contributing to national technical committees, and implementing research and capacity-building work across Uganda and more than 35 African countries.
Hon. Margaret Muhanga, then State Minister for Primary Health Care and Chief Guest, joins Makerere University leaders and partners in cutting the MakSPH@70 anniversary cake during the School’s 70th anniversary celebrations in December 2024.
Its work spans infectious diseases, maternal and child health, noncommunicable diseases, climate and health, digital health, injury prevention, universal health coverage and epidemic preparedness. While grounded in close collaboration with the Government of Uganda, especially the Ministry of Health, this reach has also been shaped by long-standing U.S. Government support. Reflecting on this shared history, MakSPH Dean Prof. Rhoda Wanyenze said the partnership has made a lasting contribution to public health capacity.
“For more than three decades, MakSPH has been privileged to work in strong partnership with the people and Government of the United States. We are grateful for this collaboration, which has made a major contribution to advancing public health training, research and practice in Uganda and across Africa. From the Master of Public Health programme to fellowships, enhanced surveillance, operational research, HIV and infectious disease work, regional networks, innovation, and programmes such as METS, this partnership has helped build the people, evidence and systems that support public health action,” Prof. Wanyenze said.
MakSPH Dean Prof. Rhoda Wanyenze speaks during the UPHIA 2025 launch in Kampala, highlighting MakSPH’s contribution to Uganda’s public health response through research, evidence and technical guidance.
Training Leaders for Uganda’s Health System
In 1994, as Uganda decentralised its administration and public services, the Institute of Public Health, now Makerere University School of Public Health, established the Master of Public Health (MPH) Full-Time programme in response to a clear workforce need for public health leaders who could manage district health systems, investigate outbreaks, conduct needs assessments and respond to emerging health challenges.
Prof. David Serwadda, Professor Emeritus at Makerere University and former Dean of MakSPH, recalls the programme was designed to fill a critical district-level leadership gap. “After a very strong needs assessment by Makerere University and the Ministry of Health, it was found that we needed to train a specific cadre of public health leaders for the districts,” he said. “We needed people with good management skills, people who could investigate an epidemic, do a needs assessment and respond to health challenges.”
Prof. David Serwadda speaks during a departmental retreat in Jinja in June 2026. He served as Director of the Makerere Institute of Public Health from 2003 to 2007 and as the first Dean of MakSPH from 2007 to 2009.
Established as a two-year programme, the MPH Full-Time was based on the Public Health Schools Without Walls model and became one of the earliest community-based public health graduate programmes in Africa. Developed through joint commitment by the Institute of Public Health, the Ministry of Health and the Rockefeller Foundation, and with technical support from the U.S. CDC, the programme placed students at district field sites to learn through apprenticeship while working on real public health problems. Other partners, including WHO and UNFPA, later provided scholarship support.
Three decades later, the MPH Full-Time programme remains one of MakSPH’s flagship contributions to Uganda and the region’s public health workforce. It has trained more than 1,000 public health professionals for leadership across districts, Ministry programmes, research, teaching, implementation and technical advisory work. Many graduates have gone on to serve as District Health Officers, commissioners, programme leaders, researchers, lecturers and public health specialists, strengthening Uganda’s health system leadership.
Fellowships That Strengthened Public Health Response
In 2002, MakSPH hosted the first direct cooperative agreement between Makerere University and the U.S. CDC, formalising the workforce development arm of the partnership. Under the Leadership and Investment in Fighting Epidemics (LIFE) initiative, the agreement launched the HIV/AIDS Fellowship Programme, which trained leaders for organisations working in HIV and AIDS. By 2014, the programme had produced more than 100 long-term fellows, more than 200 medium-term fellows, and over 3,000 short-course participants.
Graduates pose with then U.S. Ambassador to Uganda H.E. William W. Popp during the 10th graduation of Advanced Field Epidemiology Fellows and the 2nd graduation of Laboratory Leadership Fellows under the Uganda Public Health Fellowship Programme in January 2026.
The fellowship platform later transitioned into the Uganda Public Health Fellowship Programme and, through subsequent cooperative agreements in 2016 and 2021, expanded into the broader Public Health Workforce Development Programme. Led by the Ministry of Health through the Uganda National Institute of Public Health, and implemented with the U.S. CDC, districts and MakSPH, the programme now supports advanced field epidemiology, Frontline and Intermediate Field Epidemiology Training, and laboratory leadership.
Fellows are embedded within the Ministry of Health, districts and public health institutions, strengthening surveillance, outbreak investigation, HIV/TB programming, quality improvement, laboratory systems and health informatics. The Field Epidemiology Track has supported an average of about 37 active fellows, including 39 in 2024/2025. That year, fellows provided technical assistance to the Ministry and conducted 84 epidemiological studies and investigations, including work linked to Uganda’s Mpox response.
HIV Evidence That Changed Policy and Practice
UPHIA 2025 laboratory technicians undergo pre-deployment training at MakSPH, delivered with Uganda National Health Laboratory Services, ahead of field data collection on HIV and related health indicators across Uganda.
Uganda’s HIV crisis in the 1980s became one of the earliest tests of MakSPH’s public health mission. The wasting illness, then known as “Slim”, was reported in Rakai in the early 1980s and later identified as HIV/AIDS. Researchers at the Institute of Public Health, now MakSPH, helped advance understanding of the epidemic, with Prof. David Serwadda among the earliest physicians in Uganda to recognise and describe the disease.
That work grew into the Rakai Health Sciences Programme, established in 1989 through collaboration involving Makerere University, Columbia University, Johns Hopkins University, the U.S. National Institutes of Health (NIH) and partners. Over the decades, Rakai became a platform for research, surveillance, service delivery and training in communities deeply affected by HIV.
One landmark contribution showed that safe medical male circumcision reduced female-to-male HIV acquisition by about 60 per cent, helping inform HIV prevention policy in Uganda and globally. PEPFAR support also helped expand treatment in Rakai, where surveillance documented reduced mortality, lower HIV incidence, reduced orphanhood and improved community productivity.
The search for stronger prevention tools continued through MakSPH researchers, including Prof. Noah Kiwanuka, whose work in rural and fishing communities highlighted the need for better options for adolescent girls and young women. From 2022 to 2024, MakSPH managed the Makerere-Kalangala study site with UVRI-IAVI for the Gilead Sciences-led PURPOSE 1 trial, with Prof. Kiwanuka as Site Principal Investigator. The study contributed evidence on lenacapavir, a twice-yearly injectable now recognised as a major advance in HIV prevention.
Surveillance and National Decisions
Then Minister of Health Dr. Jane Ruth Aceng flags off UPHIA 2025 field teams in Kampala on 29 May 2025. The Ministry of Health-led survey is implemented with technical support from MakSPH and partners.
The partnership has also strengthened Uganda’s ability to measure the HIV epidemic and use evidence for national decisions. The Uganda Population-based HIV Impact Assessment (UPHIA) 2024/2025 is the country’s third national household-based HIV impact survey, commissioned by the Ministry of Health with technical support from MakSPH in partnership with UBOS, UVRI, and the U.S. CDC. After two earlier rounds supported by ICAP at Columbia University in 2016 and 2020, the current survey marks a shift to Ugandan leadership in implementation, analysis and use of evidence for the national response.
Funded by the U.S. Government through PEPFAR, UPHIA represents a USD 10 million investment in national evidence generation. Its results, expected in 2026, will provide updated national and subnational estimates of HIV prevalence, incidence, viral load suppression, service coverage and progress toward UNAIDS 95-95-95 targets. The survey covers 6,685 households and about 15,000 people aged 15 years and above, with additional focus on adolescents, noncommunicable diseases among people living with HIV, and barriers among those not virally suppressed.
Related surveillance work through the CRANE Survey has generated evidence on populations at higher risk of HIV and often missed by routine data. Established in 2008 with U.S. Government support through PEPFAR and implemented by MakSPH with the Ministry of Health and U.S. CDC, CRANE is one of Uganda’s longest-running HIV bio-behavioural surveillance platforms. More than USD 7 million in U.S. Government investment has supported evidence used in Uganda’s HIV Investment Case, the National HIV Strategic Plan, national bio-behavioural surveillance guidelines and UNAIDS guidance.
In its third round, conducted in 2023 and disseminated in 2024, CRANE reached 7,947 female sex workers and sexually exploited minors across 12 districts. About one in three participants were living with HIV, rising to 54 per cent among those aged 35 to 49. The survey also documented syphilis, high-risk HPV infection, violence, stigma in health facilities and high levels of depression, strengthening the case for targeted HIV prevention, treatment, mental health support, violence prevention, cervical cancer prevention and access to justice.
Then U.S. Ambassador to Uganda H.E. William W. Popp tours MakSPH exhibition stands with MakSPH and U.S. CDC leadership during the 2024 dissemination of CRANE Survey results in Kampala.
Regional Leadership, One Health and Innovation
U.S. Government support extended MakSPH’s contribution from national workforce development to regional public health leadership. In 2005, USAID, through the Higher Education for Development programme, supported the Leadership Initiative for Public Health in East Africa (LIPHEA), led by MakSPH with Muhimbili University of Health and Allied Sciences, Johns Hopkins Bloomberg School of Public Health and Tulane University School of Public Health and Tropical Medicine. The initiative strengthened leadership, competency-based training, faculty development and collaborative research across East Africa.
LIPHEA’s legacy continued through the East Africa HEALTH Alliance, which evolved into the One Health Central and Eastern Africa network and later the Africa One Health University Network (AFROHUN). These platforms brought public health, veterinary, environmental and allied disciplines into shared training and practice, helping build a workforce able to predict, detect and respond to zoonotic diseases, epidemics and other complex health threats.
The regional focus expanded further in 2012, when USAID selected Makerere University, through MakSPH, to lead the ResilientAfrica Network (RAN) under the Higher Education Solutions Network (HESN). Operating in 16 African countries through a network of 20 African universities, RAN connected African universities, U.S. partners and local innovators to strengthen community resilience to disease outbreaks, climate shocks, food insecurity, conflict and natural disasters. Through research, innovation grants, policy engagement and capacity building, it expanded MakSPH’s regional contribution to resilience science, innovation and implementation research.
METS and National Stewardship
MakSPH Dean Prof. Rhoda Wanyenze signs the METS handover board during the transition of digital health systems and assets to the Ministry of Health on 31 March 2026, as then U.S. Ambassador to Uganda H.E. William W. Popp and Dr. Diana Atwine, Permanent Secretary, Ministry of Health, look on.
A recent marker of partnership maturity came through the Monitoring and Evaluation Technical Support (METS) Programme. Launched in 2010 with U.S. Government support through the U.S. CDC and PEPFAR, METS strengthened Uganda’s health information systems, case-based surveillance, monitoring, evaluation and quality improvement for HIV, TB and broader public health programming. Across three five-year grants totalling USD 103.8 million, the programme helped move Uganda from fragmented reporting toward stronger national data systems and more integrated digital health infrastructure.
During its March 2026 handover to the Ministry of Health, METS transferred 16 digital health systems, 725 servers, more than 4,700 computing devices, solar systems for nearly 800 facilities, connectivity equipment for more than 1,300 sites, and network upgrades for regional referral hospitals. The transferred ICT infrastructure was valued at USD 9.3 million. METS also helped improve District Health Information System 2 reporting from 58 per cent in 2020 to 98 per cent by 2025, while Electronic Medical Record coverage expanded to more than 86 per cent nationally, with 1,900 sites using electronic medical records.
Infrastructure and Future Capacity
MakSPH’s new home takes shape near the Eastern Gate at Makerere University Main Campus, supported in part through the USAID ASHA grant.
MakSPH’s expanding mandate has placed new demands on its infrastructure. With more than 1,000 students, wider regional work and a growing research portfolio, the new MakSPH complex on Makerere University Main Campus is designed to support training, research, policy engagement and innovation at scale. In 2021, USAID, through the American Schools and Hospitals Abroad (ASHA) programme, awarded USD 1.1 million through Johns Hopkins University to support the Makerere University Centre of Excellence for Global Health within the new building.
The infrastructure agenda also points to the next phase of the MakSPH and U.S. Government partnership. After more than three decades of investment in leadership, evidence, surveillance, digital systems, regional networks and response capacity, sustaining these gains will require stronger shared responsibility.
As the United States marks 250 years of independence, MakSPH recognises a partnership that has strengthened Uganda’s public health system and continues to build capacity for the region.
The Infectious Diseases Institute (IDI) at Makerere University has been awarded a grant from the European and Developing Countries Clinical Trials Partnership (EDCTP) to carry out a large-scale trial of secondary TB preventive therapy. The Recurrent TB Screening and Prevention Study (RECENT TB study) is a randomized controlled trial which will be carried out in Uganda and South Africa from September 1, 2026, to August 31, 2030. The study will examine the effectiveness of secondary TPT for preventing recurrent TB while also evaluating the implementation considerations for the successful implementation of secondary TPT in public health settings and the potential of biomarkers to identify patients at the highest risk of recurrence.
To support the successful implementation of this trial, IDI is seeking a highly motivated individual to serve as a study coordinator while simultaneously pursuing a PhD. This dual role offers a unique opportunity to contribute to cutting-edge clinical research while developing advanced research skills at the doctoral level.
Job Purpose:
The Project Coordinator will be responsible for the day-to-day coordination of the trial. S/he will work closely with the Scientific Lead and the broader study team to ensure high-quality, protocol-compliant study implementation. Concurrently, s/he will be enrolled in a doctoral program, using the trial data and research experience to develop and complete a PhD thesis within the contract period.
Key Responsibilities
Study Coordination and Trial Management
Oversee participant recruitment, randomization, and follow-up schedules in accordance with the approved protocol, Good Clinical Practice (GCP) guidelines, and EDCTP regulations
Ensure timely and accurate collection, entry, and verification of study data using electronic data capture systems.
Oversee training and coordination of study nurses, health facility staff, and community health workers in both Uganda and South Africa to ensure smooth trial operations. Occasional travel to South Africa may be needed for this.
Maintain up-to-date versions of all study documentation, including study protocol, informed consent forms, and data collection tools.
Assist in the preparation of study reports, safety reports, and interim analyses for the Data Safety Monitoring Board (DSMB) and EDCTP.
Liaise with the IDI Research and Ethics Committee and the Uganda National Council for Science and Technology (UNCST) to ensure ongoing compliance.
Coordinate and support monitoring visits, audits, and inspections by the IDI monitoring unit, EDCTP, and other regulatory authorities.
Participate in study team meetings, investigator meetings, and relevant scientific conferences.
PhD Research Activities
Develop a PhD concept and enroll in an approved PhD program at Makerere University and/or the University of Amsterdam by the end of Year 1.
Develop a full doctoral research proposal in consultation with the RECENT TB Scientific and Capacity Building Leads as well as academic supervisors and achieve full registration by the end of Year 2.
Prepare and submit at least 2 manuscripts for peer-reviewed publication in accordance with PhD requirements by the end of Year 4.
Present research findings at national and international scientific conferences.
Engage with the PhD supervisory committee and attend required academic modules and seminars.
Supervise at least one master’s-level student by the end of Year 4.
Submission of PhD thesis for final viva voce examination by the end of Year 4
Reporting and Supervision
For trial-related outputs, the study coordinator will report directly to the scientific lead—RECENT TB. Regular performance reviews will be conducted by the Scientific Lead in alignment with IDI’s performance management framework. For academic purposes, s/he will report to the RECENT TB Capacity Building Lead as well as her designated PhD supervisory committee in accordance with the requirements of Makerere University and/or the Graduate School of the Amsterdam University Medical Center.
Academic Qualifications
Bachelor’s degree in medicine and surgery (MBChB), plus a Master’s degree in Public Health, Epidemiology, Clinical Research or Internal Medicine
Minimum of 5 years of experience working in clinical research or public health in the Ugandan setting, preferably in TB, HIV, or other infectious diseases.
Demonstrable interest in research, scientific writing and publication with at least one first author peer reviewed publication
Person Specification
Experience with electronic data capture tools and statistical software (RedCap, STATA, R)
Training in Human Subjects Research (HSP) and Good Clinical Practice (GCP)
Strong interpersonal skills and cultural sensitivity for working with TB affected communities.
More Details
Job Code: PJC001 No of Positions: 1 Station: IDI Mulago Classification: Full-time Duration: 9 Months Reports to: co-investigator Posted Date: 2026-07-01 10:45:53.000 Closing Date: 2026-07-14 17:00:00.000
General3 days ago
General1 week ago
General2 weeks ago
General2 weeks ago
Agriculture & Environment2 weeks ago