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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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Davidson Ndyabahika

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Call for Applications: Responsible Conduct of Research (RCR) Training Course

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An elevated shot of the School of Biomedical Sciences Building, College of Health Sciences (CHS), Makerere University. Kampala Uganda, East Africa

The Responsible Conduct of Research (RCR) Training Course, scheduled to take place from July 30th to August 1st, 2025, at the Makerere University College of Health Sciences’ Conference Room.

Background

The SUSTAIN: Advancing Makerere University Masters of Health Sciences in Bioethics program at Makerere University College of Health Sciences aims at developing and institutionalizing a mentorship program in research ethics that facilitates development of bioethics professionals and health researchers who are committed to the growth and application of research ethics in Uganda’s academic and research institutions to the highest possible degree. The Responsible Conduct of Research (RCR) course is one of the short courses that introduces trainees to a framework that involves application of established scientific, professional norms and ethical principles in the performance of all activities related to scientific research.

Course objectives

At the end of this course, trainees should be able to identify, manage and prevent research misconduct.

Course outline

Introduction to RCR; Introduction to Professionalism and Ethics; Human subject’s protection and regulatory framework in Uganda; Humane handling of animal research subjects; Conflict of interest;

Responsible laboratory practices; Mentor-mentee relationships; Collaborative research international, industry); Peer review; Research misconduct (including policies for handling misconduct); Community involvement during research in a low resource setting; Responsibility to society and environment; Responsible financial management; Data acquisition, management, sharing and ownership; Responsible authorship, publication and communication.

Target group

The Responsible Conduct of Research course is targeted at Researchers, Research administrators, Research assistants, Study coordinators, Graduate students and Student supervisors. Certificates will only be awarded to participants with 80% attendance.

Course fee: 205,000/=, or 56USD is payable.

The course fee will cater for meals and refreshments during the training period.

Payment & Registration procedure:

9030026194023, Stanbic Bank, Mulago, Makerere University Biomedical Research Center Limited

Dollar Currency:

9030026194147, Stanbic Bank, Mulago, Makerere University Biomedical Research Center Limited

Please Note: Share payment details on email/whatsup and a hardcopy deposit slip delivered on the first day of the training to Miriam Musazi, Department of anatomy, Bioethics Centre, Room C4,

Mob: +256 782 363 996/ +256 701 363 996, Email: mmusazi@gmail.com.

NB. Only those who will have paid by this date will be considered for the course

Venue: The training will take place at Makerere University College of Health Sciences’ Conference room

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Call For Applications: PhD Fellowship Training Position

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A newborn baby in an incubator in Neonatal Care Unit. Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies national health systems strengthening initiative the Uganda Newborn Programme (UNP) launched 2022. Program uses regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions. Achievements 2025. Kampala, East Africa.

Background:

Makerere University College of Health Sciences (MakCHS), Kampala, Uganda and Global Health Uganda (GHU); in collaboration with other research consortium partner institutions, including, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya; Training and Research Unit of Excellence (TRUE), Blantyre, Malawi; University of Bergen, Bergen, Norway; University of Amsterdam, The Netherlands; and Liverpool School of Tropical Medicine (LSTM), UK have been conducting clinical research on Malaria Chemoprevention. This research has focused on Malaria Chemoprevention in vulnerable patient populations, including children with severe anaemia, children with sickle cell anaemia and pregnant women. As an example, two of our recently completed studies are “The post-discharge malaria chemoprevention in children with severe anaemia [https://pubmed.ncbi.nlm.nih.gov/33264546/] and Malaria chemoprevention in children with sickle cell anaemia [https://pubmed.ncbi.nlm.nih.gov/39718172/]”.

With support from the UK Research and Innovation (UKRI) body, the consortium is expanding these studies to children with severe acute malnutrition, by conducting a large multi-centre randomized controlled trial entitled “Chemoprevention of malaria in the postdischarge management of children with severe acute malnutrition in Malawi and Uganda”.

In Uganda, the study will be conducted at one or two of their study sites in Jinja Regional Referral Hospital, Hoima Regional Referral Hospital or Kitgum General Hospital. Makerere University College of Health Sciences (MakCHS) and Uganda and Global Health Uganda (GHU) seek to appoint a full-time PhD Fellow, on this study. This will be a 4-year post, tenured at Makerere University and hosted at MakCHS.

Expectations of the PhD fellowship:

The PhD fellow will:

  • Be a part of the main trial team, and participate fully in its implementation. However, he/she will be expected to design and develop his/her PhD research project, nested in the main trial.
  • The area of study will be around “interactions between anaemia and severe acute malnutrition (SAM) in children or the interactions between malaria and severe acute malnutrition in children”.
  • Conduct rigorous research, leading to high quality scientific publications.
  • Submit a full research concept and obtain registration in the University by end of year-one. As such, there be an initial appointment for one year, renewable upon satisfactory performance.
  • Academic mentorship and supervision will be provided by the research consortium (see above – composed of national and international researchers).
  • Doctoral scholarly support and training environment, as well as didactic training in research methods and scientific writing skills will be provided by Makerere University.
  • The funding support will cover tuition and a competitive monthly stipend for 4 years, scientific conferences fees/travel and other research-related costs.

Prospective candidates must:

  • Hold Master’s of Medicine in Paediatrics and Child Health from a recognized university, and licensed to practice medicine in Uganda by the UMDPC.
  • Possess undergraduate training in Medicine and Surgery (MBChB/MBBS/MD).
  • Willingness to fully commit time and effort to their PhD studies, expected to start immediately
  • Candidate should not hold other/concurrent fellowships
  • Having publication experience will be an added advantage.
  • Be highly motivated and willing to commit to a career in research and academia.

Application procedure:

Interested applicants should submit their application and supportive documents – listed here below, in one PDF document, in an email titled “PDMC-SAM–PhD Fellowship Application” to hr@globalhealthuganda.org [and cc – chdc.desk@mak.ac.ug] by 25th July 2025. The documents should include the following:

  • An application letter (Max. 1 page)
  • Motivation statement (Max. 500 words)
  • CV (Max. 2 pages), including a list of publications
  • Two (2) recommendation letters
  • Academic transcripts and certificates for all university qualifications
  • A synopsis focusing on the proposed PhD research work, describing briefly what is already known/burden, challenges, the gaps and potential interventions (include references) [Max. 800 words].

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Makerere Hailed for Its Leadership in Health Policy and Knowledge Systems

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Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.

KAMPALA, July 9, 2025Makerere University has been hailed as a continental and global leader in health policy and systems research. This recognition came during the Partnerships for Stronger Knowledge Systems in Africa (KNOSA) Learning Forum, held July 8–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research.

Delegates from Uganda, Kenya, Ethiopia, and Somalia applauded Makerere’s role in advancing evidence-informed policymaking and strengthening national knowledge systems. The forum highlighted the institution’s trusted leadership, practical research, and commitment to driving real change.

Dr. Kumanan Rasanathan, Executive Director of the WHO Alliance, praised Makerere’s long-standing role in bridging research and policy:

“You are a shining beacon on the continent and for the world,” he said. “In this moment of crisis, where every health investment must be efficient and equitable, Makerere’s leadership matters more than ever.”

He emphasized the Alliance’s 25-year partnership with Makerere: “We know Makerere University very well. My predecessors have worked with the Alliance since its inception in the 1990s. Makerere has been especially instrumental in advancing the field of health policy and systems.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Dr. Kumanan Rasanathan, Executive Director of the WHO Alliance speaking at the KNOSA East Africa Learning Forum hosted by Makerere University in Kampala, Uganda.

Dr. Rasanathan called for a move away from siloed approaches toward more adaptive, coherent systems. He reaffirmed WHO’s commitment to supporting regional initiatives like KNOSA that are driving this shift across Africa.

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
The Vice Chancellor, Makerere University Professor Barnabas Nawangwe chats with H.E Rt. Hon. Kenneth M. Lusaka, EGH Governor Bungoma County, Kenya during the KNOSA East Africa Learning Forum at Makerere University in Kampala, Uganda on Wednesday, July 10, 2025.

In the face of current funding cuts, Dr. Christine Musanhu of the WHO Uganda Country Office echoed these sentiments with a stern call to action: “In times of uncertainty, we need national systems that not only generate evidence but also understand and communicate it in ways that drive real change.”

She warned of tightening budgets, citing an 11% cut (roughly $67 million) in global funding for Uganda’s public health programs. “We are being asked to do more with less,” she said, urging countries to reprogram resources towards high-impact, evidence-based interventions.
Adding that, “Evidence must go beyond routine data—it is a measure of transformation.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Dr. Christine Musanhu of the WHO Uganda Country Office encouraged participants attending the KNOSA East Africa Learning Forum at Makerere University in Kampala, Uganda to leave with shared purpose and concrete steps to advance the use of evidence for healthier communities.

This year’s KNOSA forum focused on sharing country-level progress, refining evaluation approaches, enhancing communication products, including scientific publications, and engaging more deliberately with Uganda’s wider policy and research ecosystem.

Makerere University Vice Chancellor Prof. Barnabas Nawangwe, while sharing the institutional vision, called for African universities to lead from the front in addressing health and development challenges: “We can do all the research in the world, but unless it moves beyond our laptops and lecture rooms into real decision-making spaces, it won’t change lives.”

He noted that Makerere contributes over 80% of Uganda’s academic output and praised MakSPH and the College of Health Sciences (MakCHS) for innovations that have shaped responses to HIV, Ebola, and COVID-19. “Our work, backed by partnerships with government and global collaborators, is proof that African universities must lead from the front.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Makerere University Vice Chancellor, Prof. Barnabas Nawangwe, applauds country teams and university partners during the KNOSA Learning Forum for their dedication to building a stronger, more resilient Africa. He emphasized the vital role of universities in low-income countries in driving socio-economic development.

Professor Nawangwe urged deeper collaboration within KNOSA: “Our continent is interconnected. We cannot afford to work in silos. We are stronger together.”

Dr. Aku Kwamie, the unit head at the WHO-Alliance, noted that there is a need for partners to shift their thinking regarding policy. She particularly shared three critical transitions to institutionalize evidence use: embedding knowledge within institutions, not just individuals; linking research directly to decision-making; and advancing from isolated academic work to system-level thinking. These shifts, she noted, are essential for embedding evidence into routine governance.

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Dr. Aku Kwamie, the unit head at the WHO-Alliance, during the the KNOSA East Africa Learning Forum hosted by Makerere University in Kampala, Uganda.

Professor Freddie Ssengooba, a Health Policy and Knowledge Systems expert at MakSPH, reaffirmed Makerere University’s regional leadership in the field and stressed the urgency for African countries to take full ownership of their health systems considering the shifting funding landscape:

“Health policy and knowledge systems research may not be as prominent as epidemiology or disease control,” he said, “but it’s central to how we harvest and connect knowledge with policy and resources. When the vaccine is here and the evidence is clear, that’s when they come to us, asking, “How do we achieve over 80% coverage?”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Professor Freddie Ssengooba, a Health Policy and Knowledge Systems expert at MakSPH speaking during the on-going KNOSA East Africa Learning Forum at Makerere University in Kampala, Uganda.

He praised KNOSA for helping elevate the field’s relevance: “There’s real appreciation for the work we do—not just with Uganda’s Ministry of Health, but across the region.”

Recalling the early collaboration with WHO, he said, “Back in 1997–98, a few of us, myself included, responded to an initial call and began what has now become a long-standing relationship with the WHO Alliance.”

“The Alliance is building capacity across Africa to ensure that research doesn’t stop at findings but goes on to shape decision-making and society,” he disclosed.

Professor Rhoda Wanyenze, the Dean of MakSPH, is currently ambitiously driving her colleagues, staff, and partners to embrace the culture of evidence use. She reiterated the School’s commitment to leading in evidence translation: “I’ve often told the Vice Chancellor—we at the School of Public Health are not in an ivory tower. We are deeply connected to real-world problems.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Professor Rhoda Wanyenze, Dean of Makerere University School of Public Health, delivers her remarks at the KNOSA East Africa Learning Forum in Kampala, Uganda. She highlighted the School’s deep engagement with policy and practice, noting that over 80% of staff serve on national, regional, or global technical committees—underscoring MakSPH’s commitment to producing grounded research that informs real-world solutions.

To her, the need for a clear framework to improve engagement with decision-makers and address uneven success in research translation has never been greater than now: “Yes, we publish in high-impact journals. But the question is, what change happened because of your evidence?”
“I would love to see the School lead in developing a framework that showcases what we’ve done well and identifies where we can grow.”

She also acknowledged Prof. Ssengooba’s influence in broadening the lens on knowledge management: “You’ve challenged us to think beyond institutions, to consider networks and systems. That’s a gap we must fill.”

Partnerships for Stronger Knowledge Systems in Africa (KNOSA) East Africa Learning Forum, held July 9–10, 2025, hosted by Makerere University School of Public Health (MakSPH) with support from the WHO Alliance for Health Policy and Systems Research, Kampala Uganda, East Africa.
Participants of the KNOSA East Africa Learning Forum alongside members of the WHO Alliance for Health Policy and Systems Research in a group photo with Makerere University leadership at the Forum meeting in Kampala, Uganda.

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Davidson Ndyabahika

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