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Research Links Social Support to Improved Contraceptive Decision-Making for Women

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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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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). Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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 Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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 Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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. Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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). Makerere University School of Public Health (MakSPH) Innovations for Choice and Autonomy (ICAN) project study I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023, Dissemination on July 31, 2024 at Golden Tulip Hotel, Kampala Uganda, East Africa.
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.

NB: The PMA surveys are spearheaded by Associate Professor Fredrick Makumbi and Dr. Simon Kibira of MakSPH, with support from the Uganda Bureau of Statistics and the Ministry of Health. The initiative also receives funding from the Bill & Melinda Gates Foundation, The Children’s Investment Fund Foundation (CIFF), and is supported by the Bill & Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins University and Jhpiego.

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Call for Applications: Short-term Positions under the STOP-AMDR Project

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The Makerere University School of Public Health (MakSPH) Building, Mulago Hospital Complex. Kampala Uganda, East Africa.

Makerere University School of Public Health, in collaboration with Jhpiego, invites applications for 49 short-term positions under the Scaling the Optimal Use of Multiple ACTs to Prevent Antimalarial Drug Resistance (STOP-AMDR) Project.

The available positions are:

Qualitative Research Assistants (8): https://sph.mak.ac.ug/careers/?view_job=20784

Enumerators (35): https://sph.mak.ac.ug/careers/?view_job=20783

Field Supervisors (4): https://sph.mak.ac.ug/careers/?view_job=20780

Costing Research Assistants (2): https://sph.mak.ac.ug/careers/?view_job=20786

The short-term assignments will support data collection in Buikwe and Busia districts, with some national-level activities. Applicants are encouraged to review the requirements for their preferred position before applying.

Application link: https://shorturl.at/IYFv1

Application deadline: Wednesday, 2 September 2026 at 4:00 PM EAT.

Mak Editor

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MakSPH Takes Mpox Response Lessons to Districts for Stronger Outbreak Preparedness

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Participants at the Mpox response study dissemination meeting in Amuru District on 10 August 2026. Makerere University School of Public Health (MakSPH), through the Africa-Europe Cluster of Research Excellence (CoRE) for Preparedness and Response to Pandemics and Shocks, research dissemination of Uganda’s Mpox response with stakeholders in Kasese, Amuru, Nakasongola and Mayuge Districts Uganda, East Africa, 10th-14th August 2026.

By Muhammad Jjumba

Makerere University School of Public Health (MakSPH), through the Africa-Europe Cluster of Research Excellence (CoRE) for Preparedness and Response to Pandemics and Shocks, has shared findings from its study of Uganda’s Mpox response with stakeholders in Kasese, Amuru, Nakasongola and Mayuge districts to strengthen district preparedness for future outbreaks.

The Africa-Europe CoRE is a partnership co-led by MakSPH and the Centre for Research on the Epidemiology of Disasters at UCLouvain, Belgium. It brings together universities in Africa and Europe to strengthen research, training and preparedness for pandemics and other public health shocks.

The district-level dissemination meetings, held from 10 to 14 August 2026, brought together more than 100 local government, health and security officials, Village Health Teams, implementing partners and community representatives. The meetings enabled stakeholders to validate the district-level findings, identify practical actions and provide feedback for the study’s final analysis and national dissemination.

Mr. Philliam Jabim shares the Mpox response study findings with participants during the dissemination meeting in Nakasongola District on 12 August 2026. Makerere University School of Public Health (MakSPH), through the Africa-Europe Cluster of Research Excellence (CoRE) for Preparedness and Response to Pandemics and Shocks, research dissemination of Uganda’s Mpox response with stakeholders in Kasese, Amuru, Nakasongola and Mayuge Districts Uganda, East Africa, 10th-14th August 2026.
Mr. Philliam Jabim shares the Mpox response study findings with participants during the dissemination meeting in Nakasongola District on 12 August 2026.

Uganda confirmed its first two Mpox cases on 24 July 2024 at Bwera Hospital in Kasese District. The Ministry of Health declared an outbreak on 2 August 2024. As documented in the study, the response involved health workers, communities, local governments, security agencies, political leaders, and implementing partners.

In response to the outbreak, a MakSPH research team led by Prof. Rhoda Wanyenze, Dr. Rawlance Ndejjo, Dr. Steven Kabwama and Mr. Douglas Bulafu conducted a study in May 2025 to assess Uganda’s Mpox response, including its policies, interventions, strategies and challenges, and generate lessons to inform recovery and strengthen preparedness for future public health emergencies.

Using purposive sampling, the research team conducted 20 key informant interviews and five focus group discussions in each of the four districts, drawing perspectives from western Uganda in Kasese, northern Uganda in Amuru, central Uganda in Nakasongola and eastern Uganda in Mayuge.

Participants and the MakSPH research team at the Mpox response study dissemination meeting in Nakasongola District on 12 August 2026. Makerere University School of Public Health (MakSPH), through the Africa-Europe Cluster of Research Excellence (CoRE) for Preparedness and Response to Pandemics and Shocks, research dissemination of Uganda’s Mpox response with stakeholders in Kasese, Amuru, Nakasongola and Mayuge Districts Uganda, East Africa, 10th-14th August 2026.
Participants and the MakSPH research team at the Mpox response study dissemination meeting in Nakasongola District on 12 August 2026.

The study, titled Assessment of the Mpox Response in Uganda: Documenting Challenges, Lessons and Innovations to Strengthen Emergency Preparedness and Response Capacities, was funded by the Government of Uganda through the Makerere University Research and Innovation Fund (Mak-RIF).

“This study is helping us move beyond recounting the Mpox response to identifying the actions that districts and national partners can take before the next outbreak. By validating the findings with stakeholders who led and experienced the response, we are ensuring that the evidence reflects local realities and can inform stronger surveillance, risk communication, coordination and community engagement,” said Mr. Bulafu, who led the MakSPH team during the dissemination meeting in Amuru.

Mr. Douglas Bulafu engages participants during the Mpox response study dissemination meeting in Amuru District on 10 August 2026. Makerere University School of Public Health (MakSPH), through the Africa-Europe Cluster of Research Excellence (CoRE) for Preparedness and Response to Pandemics and Shocks, research dissemination of Uganda’s Mpox response with stakeholders in Kasese, Amuru, Nakasongola and Mayuge Districts Uganda, East Africa, 10th-14th August 2026.
Mr. Douglas Bulafu engages participants during the Mpox response study dissemination meeting in Amuru District on 10 August 2026.

In Amuru, the 10 August meeting brought together over 25 stakeholders from the district health team, political leadership, security agencies, Village Health Teams, implementing partners and the community. On the same day, a second MakSPH team, led by Mr. Keneth Sebukeera and Mr. Filimin Niyongabo, convened stakeholders in Kasese for a parallel validation meeting. The consultations then continued in Nakasongola on 12 August and concluded in Mayuge on 14 August, extending the study’s engagement across all four districts.

Across the districts, stakeholders said the results reflected their experience during the outbreak. They pointed to strengths in leadership, coordination, community engagement and partner support, while also describing gaps in documentation, logistics, diagnostic access, staffing, risk communication, public trust and continuity of essential health services.

They also noted inconsistent implementation of the World Health Organization (WHO) 7-1-7 target, which calls for detecting a suspected outbreak within seven days, notifying public health authorities within one day and completing early response actions within seven days.

The MakSPH research team, led by Mr. Keneth Sebukeera and Mr. Filimin Niyongabo, with participants during the Mpox response study dissemination meeting in Kasese District on 10 August 2026. Makerere University School of Public Health (MakSPH), through the Africa-Europe Cluster of Research Excellence (CoRE) for Preparedness and Response to Pandemics and Shocks, research dissemination of Uganda’s Mpox response with stakeholders in Kasese, Amuru, Nakasongola and Mayuge Districts Uganda, East Africa, 10th-14th August 2026.
The MakSPH research team, led by Mr. Keneth Sebukeera and Mr. Filimin Niyongabo, with participants during the Mpox response study dissemination meeting in Kasese District on 10 August 2026.

In Kasese, stakeholders highlighted gaps in documentation, financial and logistical resources, and human resources. They identified Village Health Teams and grassroots, religious and cultural leaders as important resources for community surveillance and risk communication. They called for stronger collaboration between technical and non-technical leaders, engagement with traditional healers, greater use of local radio for public sensitisation, and better facilitation of district epidemic response teams to reach distant communities.

Amuru participants called for proactive preparedness in the border district, citing misinformation and rumours as barriers to risk communication. They urged timely, accurate information from health workers and other authorities; training in disease surveillance and grant writing to strengthen capacity and resource mobilisation; and compassionate care, psychosocial support and community awareness to reduce stigma and support survivor reintegration.

During the meeting in Nakasongola, stakeholders identified Community Health Workers and Community Health Extension Workers as potential resources for strengthening community surveillance and addressing workforce shortages. Given the district’s position around Lake Kyoga and along the Kampala-South Sudan transit corridor, they also called for stronger documentation, note-taking and reporting, accurate real-time information, closer communication with the Ministry of Health, and collaboration among technical, political, religious and community leaders.

Ms. Eunice Vivian Asingo, Senior Nursing Officer at Nakasongola Health Centre IV, contributes to the discussion during the Mpox response study dissemination meeting in Nakasongola District on 12 August 2026. Makerere University School of Public Health (MakSPH), through the Africa-Europe Cluster of Research Excellence (CoRE) for Preparedness and Response to Pandemics and Shocks, research dissemination of Uganda’s Mpox response with stakeholders in Kasese, Amuru, Nakasongola and Mayuge Districts Uganda, East Africa, 10th-14th August 2026.
Ms. Eunice Vivian Asingo, Senior Nursing Officer at Nakasongola Health Centre IV, contributes to the discussion during the Mpox response study dissemination meeting in Nakasongola District on 12 August 2026.

Ms. Eunice Vivian Asingo, Senior Nursing Officer at Nakasongola Health Centre IV, called for a permanent, adequately resourced outbreak-management centre to help protect routine services during future epidemics. “We appeal for better facilities to manage epidemics and outbreaks. At Nakasongola Health Centre IV, spaces previously used for outbreak management have been repurposed for other services, and we have limited staff. During the Mpox response, colleagues assigned to manage patients later returned to the general team, creating fear among staff already under pressure,” she said.

In Mayuge, Dr. Basembeza highlighted leadership, coordination and surveillance structures operating from district to community level as important factors in the response. He said the structures enabled the district to receive and respond quickly to community alerts. “Whenever there is a rumour or an alert, we are able to respond. Within 20 minutes, we had a response because of the structure we have,” Dr. Basembeza said.

Based on the findings, the research team recommends increased preparedness financing, stronger community engagement, decentralised diagnostic services through stronger district laboratory capacity, and improved health information and research systems.

Across the four districts, stakeholders reaffirmed that trusted community structures and coordinated action across sectors are essential to strengthening outbreak preparedness.

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A New Cohort Joins MakSPH’s Public Health Community

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Newly-admitted students pose with MakSPH Dean Prof. Rhoda Wanyenze during orientation for the 2026/2027 academic year at the MakSPH Auditorium. Orientation for newly admitted students-75 students in the Bachelor of Environmental Health Science, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research for the 2026/2027 academic, 7th August 2026, Makerere University School of Public Health (MakSPH) Auditorium, Main Campus, Kampala Uganda, East Africa.

Every academic year, a new group of students enters Makerere University School of Public Health (MakSPH) with different professional backgrounds, questions and ambitions. For the School, each cohort adds to a growing community of professionals and researchers shaping public health practice, policy and research in Uganda and beyond.

On Friday, 7 August 2026, MakSPH held its orientation for newly admitted students for the 2026/2027 academic year at the MakSPH Auditorium. The orientation introduced students to the School’s academic programmes, leadership, departments, academic administration, student support services and expectations for university life.

For this academic year, ending July 2027, Makerere University admitted more than 370 students to academic programmes hosted at MakSPH. The intake comprised 75 students in the Bachelor of Environmental Health Science, the School’s only bachelor’s programme, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research.

Dean Prof. Rhoda Wanyenze (centre) with MakSPH staff, student leaders and new students during orientation for the 2026/2027 academic year. Orientation for newly admitted students-75 students in the Bachelor of Environmental Health Science, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research for the 2026/2027 academic, 7th August 2026, Makerere University School of Public Health (MakSPH) Auditorium, Main Campus, Kampala Uganda, East Africa.
Dean Prof. Rhoda Wanyenze (centre) with MakSPH staff, student leaders and new students during orientation for the 2026/2027 academic year.

The master’s intake includes 103 students in the Master of Public Health by Distance Education, the highest enrolment for the year, followed by 59 in the Master of Public Health Full-Time. The remaining students joined programmes in Biostatistics, Environmental and Occupational Health, Health Informatics, Health Services Research, Monitoring and Evaluation, Nutrition, and Public Health Disaster Management. Together, the programmes reflect the breadth of knowledge and skills needed to address public health challenges and bring together students pursuing further training from diverse professional backgrounds.

Welcoming the new cohort, MakSPH Dean Prof. Rhoda Wanyenze urged students to approach their studies with purpose, discipline, and resilience, and focus on what they would be able to do with the knowledge and skills they acquire.

“Please find time to enjoy your journey. I know you’re looking ahead to exams and so many other pressures, but let this journey also be one that you enjoy in terms of what you learn and how you grow, so that you leave here better, not because of the paper that you took but because of the capability that you pick up during your time with us.”

MakSPH Dean Prof. Rhoda Wanyenze addresses new students at orientation for the 2026/2027 academic year, 7 August 2026, MakSPH Auditorium, urging them to value capability over paper. Orientation for newly admitted students-75 students in the Bachelor of Environmental Health Science, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research for the 2026/2027 academic, 7th August 2026, Makerere University School of Public Health (MakSPH) Auditorium, Main Campus, Kampala Uganda, East Africa.
MakSPH Dean Prof. Rhoda Wanyenze addresses new students at orientation for the 2026/2027 academic year, 7 August 2026, MakSPH Auditorium, urging them to value capability over paper.

The Dean’s message speaks to the different reasons students are beginning their journeys at MakSPH. For some, the opportunity is to build on professional experience and strengthen their capacity in roles they already hold. Among them is Dr. Judith Nalukwago, a dental surgeon, former 85th Vice Guild President of Makerere University, and Makindye Division III Lord Councillor, who serves as Executive Secretary for Education, Gender and Public Health at City Hall and the Office of the Lord Mayor.

“I am back here to study a Master’s in Public Health. I am very excited. I have a clinical background and have been practising as a clinician, and it has been a joyful experience. But when I joined the journey of leadership, there were challenges because, as Executive Secretary for Public Health in Kampala, we deal with everyday people’s health challenges,” said Dr. Nalukwago, adding:

“Now I am in management and leadership, and that posed a challenge to me as an individual. I asked myself, what course can I do to add to my skills? Where can I gain skills that can help me overcome this challenge while I am dealing with people? And I remembered that we have the School of Public Health at Makerere University.”

Watch: Dr. Judith Nalukwago on why she returned to MakSPH for a Master’s in Public Health:


Her experience during the Ebola response, when she served on the task force, further highlighted the need for broader public health knowledge. She said the training would strengthen her ability to contribute to policy and public health management, particularly in her role at City Hall, where councillors develop policies, bylaws, and ordinances.

For Mr. John Othieno, the motivation is similarly grounded in applying his training to practical problems. A Software Engineering graduate who previously completed a Master’s in Health Informatics at MakSPH, he has returned to pursue a PhD under the Department of Health Policy, Planning and Management. His research focuses on using technology and health informatics to address health-system challenges, including the adoption of picture archiving and communication systems for managing healthcare imaging and data. He said he wants his research to produce solutions that can be applied beyond academia.

“I purposed that, in my academic journey, I would not do research for the sake of having it gather dust on the shelves, but that it would actually be actionable research that can be translated into action, into solutions for our population,” he said.

Watch: Mr. John Othieno on why he returned to MakSPH to pursue a PhD in Public Health:


Nalukwago and Othieno reflect the diverse professional backgrounds that come together at MakSPH, where training, research, and community engagement have been central to the School’s work for over seven decades. Their journeys point to a sustained impact on public health education, seen not only in enrolment and graduate numbers but in the skills and expertise those graduates carry into policy, research, and health systems across Uganda and the region. At the close of the 2024/2025 academic year, MakSPH enrolled 1,140 students across 12 degree programmes, more than 90 percent of them in postgraduate training.

At Makerere University’s 76th Graduation Ceremony on 25 February 2026, MakSPH presented 231 graduates, comprising seven doctoral, 195 master’s and 29 bachelor’s graduates, adding to the health workforce within the region. Among the graduates was Dr. Harriet Aber, who completed her PhD on child substance use in Uganda’s health system and shared her experience with the new cohort during the orientation. She spoke candidly about the demands of postgraduate study and the need to remain positive through its challenges.

Dr. Harriet Aber, a MakSPH PhD graduate, shares her postgraduate journey with new students at orientation, 7 August 2026, MakSPH Auditorium, urging them to maintain a positive attitude through the challenges ahead. Orientation for newly admitted students-75 students in the Bachelor of Environmental Health Science, 277 across the nine master’s programmes, and 21 across the two doctoral programmes, PhD by Research and PhD by Coursework and Research for the 2026/2027 academic, 7th August 2026, Makerere University School of Public Health (MakSPH) Auditorium, Main Campus, Kampala Uganda, East Africa.
Dr. Harriet Aber, a MakSPH PhD graduate, shares her postgraduate journey with new students at orientation, 7 August 2026, MakSPH Auditorium, urging them to maintain a positive attitude through the challenges ahead.

“It’s not a rosy journey. You’re going to have so many moments where you celebrate, where you’re happy about something, but there are also several moments when maybe you’re stuck with the paper, you have to respond to comments, the proposal is not moving, the concept is not clear. Throughout all those processes, one of the things that you just have to maintain is having a positive attitude,” Aber affirmed.

Her experience offered the new cohort a glimpse of the journey ahead, while Prof. Wanyenze’s message focused on how they could make the most of it. The Dean urged students to plan ahead, pursue research opportunities, think independently, and use artificial intelligence responsibly, while seeking mentorship and making full use of the support and opportunities available at the School.

“Our students are our colleagues, and they are our future workmates. Many of them have ended up staying with us. And I know many of you are going to stay with us in the School,” the Dean said, urging students to take seriously the relationships they build with their classmates and faculty, because “we are a network that’s bound together in the same profession.”

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