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Dr. Achola’s PhD Study Uncovers Family Planning Barriers in Adjumani refugee hosting district

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At precisely 10:53 AM, on 14th January 2025, the air in Freedom Square buzzed with anticipation as Dr. Crispus Kiyonga, Chancellor of Makerere University, delivered the life-changing words: “By virtue of the authority entrusted to me, I confer upon you a degree of Doctor of Philosophy of Makerere University.” In that moment, Miss Achola became Dr. Achola, a title that resonated deeply with her sister and father, Ms. Evelyn Nyafwono and Mr. Owino Vincent Olele, who stood nearby joyfully with open arms to receive her.

As Achola bagged her doctoral award, she walked majestically toward her excited lecturers and mentors, who eagerly queued to congratulate her. Her sister, Evelyne Nyafwono, and father, Mzee Owino, could hardly contain their excitement. The rhythmic beats of the cultural ensemble filled the air with celebration, while the vibrant melodies of ethnic music and dance, expertly crafted by Dr. Milton Wabyona and his talented team, wove around her. Each step she took was a heartfelt tribute to her journey, a celebration of hard work and achievement that enveloped her in warmth and joy.

Ms. Roselline Achola walking majestically to receive her PhD award from the Chancellor on Graduation day. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Ms. Roselline Achola walking majestically to receive her PhD award from the Chancellor on Graduation day.

Yet, as Dr. Achola reveled in her triumph, a bittersweet shadow hung over her heart. Her beloved mother, Veronica Abbo Owino (RIP), who had always been her greatest supporter, was not there to share in the joy, having passed away midway through her PhD journey.

In the beginning…

Back in time, 2015 was the year. Ms. Roselline Achola, while working with the United Nations Populations Fund as a Technical Specialist for Maternal Health and Reproductive Health Commodity Security/family planning, was charged with the responsibility of ensuring that there is increased access to voluntary information and services to both men and women who need family planning in Uganda and beyond. She was in charge of the Global Program for RHCS.

At the time, as a team leader, she was supervising an assignment that the UN had contracted an expert – Dr. Christopher Garimoi Orach, a Professor of Community Health, to undertake in developing the first family planning costed Implementation Plan for Uganda.

Dr. Roselline Achola on Graduation day being welcomed by her teachers following her PhD award. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Dr. Roselline Achola on Graduation day being welcomed by her teachers following her PhD award.

Achola found her motivation for pursuing a PhD, particularly in family planning, due to its cost-effectiveness in improving maternal and child health in resource-limited countries like Uganda.

“We began with the ambitious idea of evaluating the entire family planning program in Uganda, but that proved impossible at the time. I then went silent for two years, not mentioning anything. One day, Prof [Garimoi Orach] called to ask why I was quiet. I explained that I was overwhelmed with UN work and may not manage to juggle with academics. He fell silent too but continued to check on me and offered encouragement,” Achola recalls.

“Why family planning? It was my mandate to ensure the effective implementation of the family planning program in Uganda by supporting the Ministry of Health and implementing partners. I always felt a deep sadness reading about women dying in childbirth while having their 12th or 13th child, knowing that contraception could help them regulate their births and reduce the risk of dying from pregnancy-related complications associated with too many pregnancies,” recalls Achola.

Stefan Swartling Peterson, a Professor of Global Transformations for Health Karolinska Institutet & Makerere Universities also the XChief of Health UNICEF congratulates Dr. Roselline Achola on Graduation day. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Stefan Swartling Peterson, a Professor of Global Transformations for Health Karolinska Institutet & Makerere Universities also the XChief of Health UNICEF congratulates Dr. Roselline Achola on Graduation day.

In 2019, she officially enrolled in the PhD program at Makerere University hosted by the Department of Community Health and Behavioural Sciences at the School of Public Health (MakSPH). This was after submitting a concept that was quickly approved, granting her provisional admission. “It wasn’t an easy path though; I remember going nearly a year without progress until my lead supervisor encouraged me to continue working on my proposal. I had almost lost hope due to the demands of my job at the United Nations and had set aside my academic aspirations. This burden weighed heavily on me until I resumed my efforts, ultimately leading to the acceptance of my proposal.”

Inspired by the challenging conditions in Adjumani district in the West Nile region with several refugee settlements—where low family planning uptake and domestic violence related to its use were prevalent—Achola chose to study decision-making around the issue especially in Nyumanzi, Pagirinya and Mirieyi settlements including the surrounding host communities. Her goal was to develop recommendations to address the barriers faced by women and girls in these refugee-affected areas.

Uganda is a leading Africa’s largest refugee-hosting country with more than 1.6 million refugees residing in various settlements established in 12 districts within its borders, as per the latest National Population and Housing Census data from 2024. Adjumani is home to over 250,000 refugees, with more than half of them being female. Here, 1,310 respondents comprising both men and women were involved in the quantitative study.

Ochola is welcomed by her father, Mzee Owino Vincent Olele on graduation day. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Ochola is welcomed by her father, Mzee Owino Vincent Olele on graduation day.

The major highlight of her research was the low uptake of family planning methods in Adjumani, where only about one-third of the population utilizes modern contraceptives. She explored decision-making processes at individual, family, community, and institutional levels, identifying key factors influencing family planning use.

Her findings show that fear of harassment from family members and concerns about side effects deter many from using contraceptives, while motivations include limiting family size and financial constraints. To enhance family planning uptake, Dr. Achola recommends community outreach strategies to raise awareness about its benefits and promote couple counseling.

“I want to take this opportunity to once again thank SET SRHR for the scholarship that saw progress this far, the Tuition and initial research was supported by SET SRHR. The Mak-RIF support was equally timely because it supported the intervention and evaluation components of my PhD study. Both funds played a big role in enabling me to complete this study and have the achievement today,” says Achola.

While decision-making is a key part of everyday life, Dr. Achola found that it involves complex processes with four dynamic pathways: starting ideas, thinking them through, consulting others, and finally making a decision. Gender dynamics too play a definitive role in contraceptive use, as women often have less power and men typically dominate health decisions.

Dr. Achola together with her sister and father, Ms. Evelyn Nyafwono and Mr. Owino Vincent Olele. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Dr. Achola together with her sister and father, Ms. Evelyn Nyafwono and Mr. Owino Vincent Olele.

“I am so excited that my work has resulted in the development of a model for decision-making pathways. These include the idea inception, cognitive process, consultation, and making a decision I sincerely hope that this contribution will enhance the improvement of maternal and child health in humanitarian settings across Uganda and Sub-Saharan Africa, ultimately reducing pregnancy-related deaths associated with the non-use of family planning among both refugee and host populations,” says Achola.

At first, the language barrier stood in her way during her investigation with interpreters often sharing only what refugees wanted to hear instead of her intended messages. “Cultural norms favoring large families made it hard to communicate contraception information. Limited funding also slowed our progress in Adjumani. Although delays in getting my papers published affected my PhD requirements, I’m relieved that it’s finally complete and here we are,” she says.

How her PhD will impact family planning programs in Uganda

Dr. Achola’s research uncovered several key factors influencing contraception use, highlighting a pressing need for targeted solutions. To make a meaningful impact on family planning programs in Uganda, she advocates for community-based strategies that connect people with essential information and services to help them make informed decisions. She views community dialogues and outreach events as vital tools to spark conversations about the benefits of family planning and encourage couples to seek counseling together. “This approach will be instrumental in creating a supportive environment where families can make informed decisions about their health and future.”

With her background as a public health specialist and technical advisor to the Ministry of Health on family planning, she is eager to integrate the four decision-making pathways into all family planning efforts. She recognizes how influential significant others can be in shaping contraceptive choices, whether through encouragement or hesitation. By involving them in the planning process, she aims to develop more effective strategies and hopes her recommendations will be included in the Ministry of Health’s plans, thereby strengthening support for family planning initiatives at every level.

Dr. Christine K. Nalwadda, a Senior Lecturer and Head, Department of Community Health and Behavioural Sciences of the School of Public Health hands a plaque to Dr. Roselline Achola to congratulate her on her PhD. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Dr. Christine K. Nalwadda, a Senior Lecturer and Head, Department of Community Health and Behavioural Sciences of the School of Public Health hands a plaque to Dr. Roselline Achola to congratulate her on her PhD.

Achola firmly believes that family planning is a cost-effective way for the government of Uganda to reduce maternal and child mortality rates. And that by choosing to space births, mothers bond with their babies and allow themselves time to heal before the next pregnancy, thus allowing their bodies to heal and rejuvenate for the next pregnancy.

“When mothers space their childbirth for at least two years, their health improves, which reduces the risks of pregnancy-related challenges. Babies born with at least a two-year gap have a higher chance of survival than those born less than two years apart,” she stresses.

The next steps…

Achola resonates with the sentiment that “Research never ends.” She recognizes there’s still much to explore in her field and believes her work paves the way for others to examine how culture influences family planning perceptions and practices. This broader perspective can lead to more comprehensive results, with an emphasis on the role of family in decision-making. Achola also imagines future research that will dig deeper into these processes through longitudinal studies with key stakeholders. She also sees the importance of exploring decision-making pathways before applying her findings to larger populations, especially since her study focused on a refugee community in Adjumani, which may differ from other groups in Uganda. For her, the possibilities for further exploration are enormous and stresses that the journey of research is a shared and ongoing adventure. She is, therefore, set to continue with research in this area as a post-doctoral undertaking.

Upon achieving her PhD, Achola feels a renewed sense of determination and purpose in her field. “I will not look back,” she declares with conviction. “I will continue my work in sexual and reproductive health and rights (SRHR) and family planning, where I have developed passion, skills and expertise, positioning me as a leader in this area.”

She is committed to advising government bodies and engaging with the international community and development partners to advance this important field. Additionally, Achola plans to continue teaching in Public Health, nurturing the next generation of specialists and mentoring aspiring doctoral candidates. With her steadfast commitment, she is ready to make a lasting impact, inspiring others to embark on this important journey alongside her.

Davidson Ndyabahika

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TWAS recognises Dr. Angelina Mwesige Kakooza for her research

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Dr. Angelina Mwesige Kakooza, Associate Professor of Paediatrics in the Department of Paediatrics and Child Health receives her award.

Dr. Angelina Mwesige Kakooza, Associate Professor of Paediatrics in the Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences (MakCHS) received the 2025 TWAS-Fayzah M. Al-Kharafi Award in Medical Sciences. She was recognised for her research on neurodevelopmental disorders – particularly epilepsy, cerebral palsy, and nodding syndrome – and for advancing policy and research, mentorship, as well as local community interventions to enhance children’s health.

The award was given at the recent 17th General Conference of The World Academy of Sciences (TWAS) held in Rio de Janeiro, Brazil under the theme ‘Building a Sustainable Future: The Role of Science, Technology, and Innovation for Global Development.’ Organized in partnership with the Brazilian Academy of Sciences (BAS) and TWAS, the conference brought together leading scientists, policymakers, and institutional leaders from across the global South and beyond.

In her remarks after receiving the award, Dr. Kakooza said, “This award highlights the importance of neurodevelopmental disorders which are a great health problem worldwide, often diagnosed late and treated poorly,” said Kakooza. “It affirms my contribution to science in Africa, strengthens advocacy for gender equity in science and education and makes me a role model for others, increasing my influence in the scientific community.”

Associate Professor Angelina Mwesige Kakooza.
Associate Professor Angelina Mwesige Kakooza.

Dr. Angelina Kakooza Mwesige is a Ugandan scholar with over 25years teaching experience whose research focuses on neurodevelopmental disorders in children centred on their epidemiology, early screening, identification and community based interventions in Uganda. Her current areas of research cover studies on early detection and interventions for young infants at high risk of neurodevelopmental delay and disability in Nepal and Uganda; development of community engagement projects to empower adolescents living with epilepsy in Uganda reduce stigma in their communities; as well as development and testing of an interactive epilepsy smart phone application to improve resilience among them.

TWAS is a global merit-based science academy based in Trieste, Italy, and administered as a UNESCO Programme Unit. Read more here: https://twas.org/

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Zaam Ssali

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Refugee Health Journalism as Empowerment: Why Accuracy, Dignity & Context Matter

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Participants in the Media Training Workshop on Refugee Health and Migration Reporting that brought together twenty journalists from Kampala, Kyaka II, Adjumani, and other refugee-hosting districts at MakSPH on 3rd October 2025. Media Training Workshop on Refugee Health and Migration Reporting that brought together twenty journalists from Kampala, Kyaka II, Adjumani, and other refugee-hosting districts, Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa on 3rd October 2025.

In July this year, I joined a study tour to Imvepi Refugee Settlement in Uganda’s West Nile region under the RISK-WASH Project, led by Dr. Richard Mugambe. Established in 2017 in what is now Terego District, Imvepi is one of several settlements created to host people fleeing conflict in neighbouring South Sudan. Now home to more than 60,000 refugees, it reflects Uganda’s progressive refugee policy, anchored in the 2006 Refugee Act, which promotes the integration of displaced families within host communities, allocates land for livelihoods, and ensures access to national services. It remains a model both commendable and instructive for the region.

With nearly two million refugees and asylum seekers, most of whom are women and children, Uganda stands among the world’s leading examples of inclusive, community-based refugee protection. The RISK-WASH Project, implemented by the Makerere University School of Public Health (MakSPH) in collaboration with IHE-Delft, BRAC, and icddr,b, with support from the Dutch Ministry of Foreign Affairs, organised the three-day visit. The project builds evidence for better Water, Sanitation, and Hygiene (WASH) decision-making in humanitarian settings, developing practical tools to assess how exposure to unsafe water, poor sanitation, and environmental hazards affects the health of both displaced and host populations.

The RISK-WASH Project team, together with officials from the Uganda Red Cross Society, meet the Imvepi Refugee Settlement Commandant during a field visit in July 2025. Media Training Workshop on Refugee Health and Migration Reporting that brought together twenty journalists from Kampala, Kyaka II, Adjumani, and other refugee-hosting districts, Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa on 3rd October 2025.
The RISK-WASH Project team, together with officials from the Uganda Red Cross Society, meet the Imvepi Refugee Settlement Commandant during a field visit in July 2025.

In Imvepi, that evidence takes human form. Water points run dry under intense demand or drought; latrines overflow during rains; fragile health systems strain to contain preventable diseases that flourish in such conditions. One nurse may attend to hundreds of patients in a single day, treating malaria, respiratory infections, and diarrhoeal diseases directly linked to inadequate WASH infrastructure. The images linger long after one leaves, especially when reflecting on the media’s role in shaping refugee narratives. What struck me most was how such realities are often reduced to statistics or fleeting headlines that reveal little about the lives behind them. I left Imvepi convinced that we, in the media, must not only report but listen differently.

When we cover refugees, we often begin with numbers. Yet behind every statistic is a heartbeat and a history the news cycle rarely pauses to hear. Refugee health, perhaps the most human measure of displacement, is still too often framed as a crisis rather than a continuum of resilience, policy, and rights. The World Health Organisation’s World Reports on the Health of Refugees and Migrants reminds us that refugees frequently experience poorer health outcomes than host populations, not because they are inherently vulnerable, but because access to care is often obstructed by law, language, and logistics. Health, like truth, then, becomes interestingly dependent on who is allowed to speak and who is heard.

Floods in Adjumani refugee settlement left shelters destroyed and water sources contaminated, heightening the risk of disease outbreaks and exposing the fragile health conditions faced by displaced families. Photo taken in 2024 during a MakSPH study on refugee health and climate change. Media Training Workshop on Refugee Health and Migration Reporting that brought together twenty journalists from Kampala, Kyaka II, Adjumani, and other refugee-hosting districts, Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa on 3rd October 2025.
Floods in Adjumani refugee settlement left shelters destroyed and water sources contaminated, heightening the risk of disease outbreaks and exposing the fragile health conditions faced by displaced families. Photo taken in 2024 during a MakSPH study on refugee health and climate change.

It was in this spirit that, on October 3, 2025, we convened the Media Training Workshop on Refugee Health and Migration Reporting at MakSPH. The one-day seminar brought together twenty journalists from Kampala, Kyaka II, Adjumani, and other refugee-hosting districts. Our goal was not to add another humanitarian angle to the news but to rethink how the media can report with depth, ethics, and empathy. Working with partners such as Africa Humanitarian Action, Emesco Development Foundation, and Farmamundi, we explored the subtle power the media wields to either dignify or diminish, to clarify or distort, the lived realities of refugees, particularly in the realm of health.

During my session, Refugee Health Reporting as Empowerment: Negotiating Accuracy, Dignity, and Context,” I invited participants to view journalism through the lens of Paulo Freire, the celebrated Brazilian transformative educator who wrote the Pedagogy of the Oppressed while in exile in 1970. Through his influential work, Freire argued that oppression persists when those in power control language and narrative, when others are spoken for rather than heard. Liberation begins, he said, when people “name their world.” That principle remains profoundly relevant to our craft as journalism and communications practitioners. Refugees must not remain objects of our storytelling; they are its subjects. Journalism, in its truest public function, becomes liberating only when it is dialogic, when we report with people, not merely about them.

I led a session titled “Refugee Health Reporting as Empowerment: Negotiating Accuracy, Dignity, and Context” on October 3, 2025, framing it around Paulo Freire’s pedagogical philosophy of liberation through dialogue and critical reflection. Media Training Workshop on Refugee Health and Migration Reporting that brought together twenty journalists from Kampala, Kyaka II, Adjumani, and other refugee-hosting districts, Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa on 3rd October 2025.
I led a session titled “Refugee Health Reporting as Empowerment: Negotiating Accuracy, Dignity, and Context” on October 3, 2025, framing it around Paulo Freire’s pedagogical philosophy of liberation through dialogue and critical reflection.

This transformation begins with accuracy. In Uganda, refugees share the same health system as host communities, one already strained by staff shortages, drug stock-outs, and donor fatigue. Yet many stories stop at official statements or NGO press releases. Limited access, shrinking newsroom budgets, and bureaucratic gatekeeping tempt journalists to rely on polished humanitarian narratives. But when we do, we risk becoming megaphones for the powerful. Accuracy demands courage, the willingness to verify, to cross-check, and to step beyond curated camp tours. In refugee reporting, truth is not just a professional standard; it is an act of respect.

Still, truth without dignity can harm. Too often, images of refugees serve as shorthand for despair—dust, hunger, tents. Such imagery may evoke sympathy, but it often strips away humanity. From practice, I have seen journalists lower their lenses before asking names. I have also seen how a small shift in approach, say seeking consent, giving space, and listening before photographing, can restore dignity to both subject and story. Words matter too. Calling someone an “illegal immigrant” or describing an “influx” of refugees turns people into problems. Language should humanise, not flatten. To describe refugees as mothers, health workers, or students is to reassert their agency and affirm our shared humanity, something Freire would have deeply valued today.

Media trainer Mr. Wilson Akiiki Kaija facilitates a session on “Centring Humanity” during the Refugee Health and Migration Reporting Workshop at MakSPH, underscoring the media’s role in advancing accuracy, dignity, and context in refugee reporting. October 3, 2025. Media Training Workshop on Refugee Health and Migration Reporting that brought together twenty journalists from Kampala, Kyaka II, Adjumani, and other refugee-hosting districts, Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa on 3rd October 2025.
Media trainer Mr. Wilson Akiiki Kaija facilitates a session on “Centring Humanity” during the Refugee Health and Migration Reporting Workshop at MakSPH, underscoring the media’s role in advancing accuracy, dignity, and context in refugee reporting. October 3, 2025.

And no story exists in isolation. Every health headline in a settlement echoes across systems of policy, climate, economics, and gender. A cholera outbreak in Kyangwali is not merely a medical event or isolated incident; it may be showing broken sanitation infrastructure and the politics of aid, which may result in a national disease outbreak. Context is the soul of credibility. Without it, even accurate stories can mislead. In Imvepi, I saw first-hand that refugees’ health challenges are inseparable from Uganda’s own development journey, from how budgets are made to how global partners value African hospitality. The more connections we draw, the closer we come to the truth.

By the close of the workshop, it was evident that empowerment in journalism is not a slogan but a discipline. It demands patience, humility, and persistence. It calls for the co-production of stories, revisiting them, verifying them, and allowing refugees to narrate their realities. It also calls on institutions to invest and fund field reporting, train correspondents in trauma-sensitive and peace journalism, and protect journalists pursuing uncomfortable truths. Without such support, even good intentions dissolve into soundbites.

I often return to Freire’s words of wisdom: To speak a true word is to transform the world. This means that words are not just passive descriptions but powerful tools for action and social change, especially when they are paired with critical reflection and a commitment to praxis (work and action). Refugee health journalism, at its best, is precisely that kind of speech: accurate, dignified, and deeply contextual. It is not merely charity reporting; it is solidarity reporting. For anyone, given the wrong circumstances, can become a refugee. And solidarity, unlike sympathy, does not look down; it stands beside. When we write from that conviction, our stories do more than inform. They humanise, connect, and remind us that telling the truth well is, in itself, an act of justice.

From right: Africa Humanitarian Action’s Mr. Yakobo Kaheesi and Emesco Development Foundation’s Mr. Patrick Ssentalo join facilitators and organisers Mr. Wilson Akiiki Kaija and Mr. Davidson Ndyabahika in awarding certificates to media participants after the successful training on Refugee Health and Migration Reporting on October 3, 2025. Media Training Workshop on Refugee Health and Migration Reporting that brought together twenty journalists from Kampala, Kyaka II, Adjumani, and other refugee-hosting districts, Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa on 3rd October 2025.
From right: Africa Humanitarian Action’s Mr. Yakobo Kaheesi and Emesco Development Foundation’s Mr. Patrick Ssentalo join facilitators and organisers Mr. Wilson Akiiki Kaija and Mr. Davidson Ndyabahika in awarding certificates to media participants after the successful training on Refugee Health and Migration Reporting on October 3, 2025.

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John Okeya

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Professor Nakimuli awarded at FIGO Congress for outstanding contribution to Women and Child Health

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Dr. Annettee Nakimuli, Associate Professor of Obstetrics and Gynaecology and Dean, School of Medicine, Makerere University College of Health Sciences. Kampala Uganda, East Africa.

Dr. Annettee Nakimuli, an Associate Professor of Obstetrics & Gynaecology and Dean – School of Medicine at Makerere University College of Health Sciences was awarded by the International Federation of Gynaecology and Obstetrics (FIGO) for her outstanding contribution to improving the health of Women and children as a researcher and practitioner.

She received the award on the 6th Oct 2025 at the FIGO General Assembly/FIGO Congress that is ongoing in Cape Town, South Africa.

Professor Nakimuli is a leading maternal health researcher focused primarily on investigating the aetiology, treatment, prevention and long term outcomes of pregnancy complications among women in Sub-Saharan Africa. She is committed to building maternal and new-born research capacity in Africa and her aim is, with East African and International colleagues, to establish a multidisciplinary centre for African maternal and neonatal health research located at Makerere University in Uganda.

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Zaam Ssali

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