Health

The African Critical Illness Outcomes Study (ACIOS): a point prevalence study of critical illness in 22 nations in Africa

Published

1 year ago

April 7, 2025

Mak Editor

The African Critical Illness Outcome Study (ACIOS) is the largest study to date on critical illness in Africa, highlighting a significant burden of life-threatening conditions in hospitals across the continent. The study aimed to assess the prevalence, management, and outcomes of critically ill patients while identifying gaps in essential emergency and critical care (EECC).

Associate Professor Arthur Kwizera (College of Health Sciences, Makerere University) was a Co-Investigator and National Lead for Uganda in partnership with researchers from Europe and Africa.

A Research publication detailing the study was published in the Lancet and can be downloaded here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02846-0/fulltext

Key Findings

High Prevalence of Critical Illness: One in eight hospital inpatients (12.5%) in Africa are critically ill.
High Mortality Rate: Critically ill patients face a 21% seven-day mortality rate, significantly higher than the 2.7% mortality for non-critically ill patients.
Limited Access to Intensive Care: Nearly 70% of critically ill patients receive care in general hospital wards rather than intensive care units (ICUs) or high-dependency units.
Insufficient Emergency Care: Over 56% of critically ill patients do not receive essential emergency and critical care (EECC), including oxygen therapy, intravenous fluids, and airway management.

Significance
The study provides first-of-its-kind epidemiological data on critical illness across multiple African countries. The findings highlight severe gaps in emergency care infrastructure and resources, emphasizing the need for investment in low-cost, lifesaving interventions to reduce mortality. Addressing these gaps through EECC can save many lives without requiring high-cost ICU infrastructure.

Study Methodology
ACIOS was a multi-country prospective study, involving 20,000 patients from 180 hospitals in 22 African countries. Investigators assessed all adult inpatients (≥18 years) across different hospitals, identifying those with severely deranged vital signs. Patients were then followed up over seven days to determine their health outcomes. Additionally, the study collected hospital resource availability data to assess the readiness of facilities to provide critical care.

Funding and Collaboration
The study was funded by the National Institute for Health and Care Research (NIHR) Global Health Group in Perioperative and Critical Care (NIHR133850) with Professors Rupert Pearse and Bruce Biccard as PIs, and conducted in partnership with Makerere University (Uganda) led by Associate Professor Arthur Kwizera (as Co-PI and national lead), Busitema University (Uganda) led by Dr Adam Hewitt Smith, University of Cape Town (South Africa) led by Bruce Biccard, Muhimbili University of Health and Allied Sciences (Tanzania) Led by Dr Tim Baker, Queen Mary University of London (UK), the African Perioperative Research Group, and the EECC Network.

Policy Implications
The findings call for urgent action by health policymakers and hospital administrators to:

Strengthen emergency and critical care services in general hospital wards.
Improve the availability of essential life-saving interventions such as oxygen therapy and IV fluids.
Train healthcare workers in essential emergency and critical care (EECC) protocols to enhance patient outcomes.

Relevance to Uganda
Uganda, like many African countries, faces a severe shortage of ICU beds and critical care services. The study underscores the urgent need for investment in critical care infrastructure and workforce training to improve survival rates among critically ill patients.

Conclusion
The ACIOS study is a wake-up call for Africa’s healthcare systems, urging greater focus on low-cost, high-impact interventions that can significantly reduce mortality among critically ill patients. By prioritizing essential emergency and critical care, health systems can improve survival rates without requiring large investments in ICU infrastructure.

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Health

Announcement: 2026 Intake – Certificate in Applied Health Systems Research

Published

1 week ago

May 6, 2026

Mak Editor

Announcement: 2026 Intake – Certificate in Applied Health Systems Research. Photo: Nano Banana 2

Makerere University School of Public Health invites applications for the 2026 intake of the Certificate in Applied Health Systems Research, a short, intensive virtual programme designed for professionals working at the intersection of research, policy, and health system practice.

Why this course matters

Health system challenges are rarely linear. They are shaped by institutional complexity, political realities, and competing stakeholder interests. In many cases, the issue is not the absence of evidence, but the difficulty of producing research that is relevant, timely, and usable within real decision-making environments. This course is designed to address that gap, equipping participants to generate and apply evidence that responds to actual system constraints.

Apply via: https://docs.google.com/forms/d/1SjPWK37nZGuLb25S2X6d9NPtME2AKlEW_kJjCimivhY/viewform?ts=6821a62d&edit_requested=true

What you will gain

Participants will develop the ability to:

frame research problems grounded in real system conditions
analyse complex interactions within health systems
design policy-relevant and methodologically sound studies
translate findings into actionable insights for decision-making

Course format and key details

The programme runs virtually from 6^th to 17^th July 2026 (2:00–5:45 PM EAT) and combines interactive sessions, applied learning, and expert-led discussions across:

systems thinking and problem framing
research design and mixed methods
evidence use in policy and practice

For full course details:https://sph.mak.ac.ug/program-post/certificate-in-health-systems-research/

Who should apply

This course is suited for:

Researchers and graduate students
Policy analysts and programme managers
Health practitioners involved in planning, implementation, or evaluation

Fees

Ugandan participants: UGX 740,000
International participants: USD 250

Application Deadline: 14 June 2026

Please find the course details below:

2026-Intake-–-Certificate-in-Applied-Health-Systems-Research Download

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Health

WHO Report Highlights Global Drowning Burden as MakSPH Contributes to Evidence and Action

Published

1 week ago

May 6, 2026

John Okeya

Demonstration of emergency medical procedures performed by the Uganda Red Cross Society at the first-ever National Water Safety Swimming Gala organised by the Ministry of Water and Environment at Greenhill Academy in Kibuli on March 21, 2026. Photo: Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.

Makerere University School of Public Health, through its Centre for the Prevention of Trauma, Injury and Disability, contributed to the Global Status Report on Drowning Prevention 2024, the first comprehensive global assessment of drowning burden, risk factors, and country-level responses.

Published by the World Health Organisation, the report estimates that approximately 300,000 people died from drowning in 2021, with the highest burden in low- and middle-income countries, which account for 92% of deaths. The African Region records the highest mortality rate, underscoring the urgency of targeted interventions. Children and young people remain the most affected, with drowning ranking among the leading causes of death for those under 15 years.

While global drowning rates have declined by 38% since 2000, progress remains uneven and insufficient to meet broader development targets. The report highlights critical gaps in national responses, including limited multisectoral coordination, weak policy and legislative frameworks, and inadequate integration of key preventive measures such as swimming and water safety education.

It further identifies persistent data limitations, with many countries lacking detailed information on where and how drowning occurs, constraining the design of targeted interventions. At the same time, the report notes progress in selected areas, including early warning systems and community-based disaster risk management.

MakSPH’s contribution to this global evidence base reflects its role in advancing research, strengthening data systems, and supporting context-specific approaches to injury prevention. Through its Centre, the School continues to inform policy and practice, contributing to efforts to reduce drowning risks and improve population health outcomes in Uganda and similar settings.

The full report can be accessed below:

Global-status-report-drowning-1 Download

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Health

MakSPH Contributes to Global Strategy to Reduce Drowning Deaths

Published

1 week ago

May 5, 2026

John Okeya

Illustrative photo of a man splashing in a water body. Photo: MakSPH

Makerere University School of Public Health, through its Center for the Prevention of Trauma, Injury and Disability, contributed to the Global Strategy for Drowning Prevention (2025–2035): Turning the Tide on a Leading Killer, a landmark framework guiding coordinated global action to reduce drowning.

Developed through the Global Alliance for Drowning Prevention, a multi-agency platform hosted by the World Health Organization, the strategy identifies drowning as a leading yet preventable cause of death, responsible for over 300,000 deaths annually. The burden falls disproportionately on low- and middle-income countries, particularly among children and young people.

The strategy sets a global target of reducing drowning deaths by 35% by 2035 and outlines six strategic pillars, including governance, multisectoral coordination, data systems, advocacy, financing, and research. It also prioritises ten evidence-based interventions such as strengthening supervision, improving water safety and swimming skills, enhancing rescue capacity, and enforcing safety regulations.

MakSPH’s inclusion in the Global Alliance for Drowning Prevention reflects its contribution to advancing research, policy engagement, and capacity strengthening in injury prevention. Through its Centre, the School supports the generation and application of context-specific evidence, positioning itself as a key contributor to global efforts to reduce drowning and strengthen community resilience.

The full document can be accessed below:

Global-strategy-for-drowning-prevention-1 Download

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