Health
MakSPH Champions Leadership Boost for Wakiso Health Managers
Published
9 months agoon

On April 23, 2025, Makerere University School of Public Health (MakSPH) convened district leaders, health managers, and project partners to disseminate the outcomes of a major leadership and management strengthening initiative in Wakiso District, Central Uganda. The one-year project, part of the Global Health Partnerships programme funded by NHS England, was implemented in collaboration with Nottingham Trent University, Nottingham University Hospitals NHS Trust, Wakiso District Local Government, and Ugandaās Ministry of Health.
Launched in 2024, the project titled Strengthening Leadership and Management Among Local Government Health Managers in Wakiso District, aimed to co-design and pilot a leadership and management training tailored to the realities of Ugandaās decentralised health system. The intervention, led by Makerere Universityās Dr. David Musoke and Nottingham Trent Universityās Prof. Linda Gibson, through the over 15-year-old NTU-Mak Partnership impacting lives in Wakiso, began with a field visit to over 60 public health facilities in the district, a needs assessment within these facilities to identify key priority gaps, and a baseline survey with the health in-charges to establish the initial status of key indicators.
āWe have been very fortunate to work with a supportive local government in Wakiso, from the top leadership down. While many projects struggle to engage district teams, our longstanding relationship with Wakiso made collaboration seamless. Although this was our first initiative specifically focused on leadership and management, we hope it will serve as a stepping stone for even more impactful work in the future,ā Dr. David Musoke, a Senior Lecturer at Makerere University and the Uganda Project Lead, said during the dissemination workshop, highlighting the key success factors for the leadership and management project.

Initial results from the needs assessment and baseline on leadership and management competencies conducted among Wakiso District health facility supervisors early last year by the project team and shared during the three-day workshop in June 2024, held in Kampala, which kickstarted the six-month structured fellowship programme for 53 health managers in Wakiso, had found critical capacity gaps. Using a tool evaluating 17 leadership and 33 management competencies, only 40% of the managers met the 80% benchmark for leadership, scoring highest in cognitive skills, while just 33% met the required management standard, performing best in self-management and lowest in quality management.
Then, the health facility managers with postgraduate training, longer service, and strong team dynamics, showed overall better performance. While working relationships with subordinates and the district leadership were largely positive, performance was hampered by systemic challenges such as limited resources, low motivation, and weak teamwork. Overall, the study also pointed to a misalignment of expectations between the District Local Government and the Health Ministry, underscoring the need to strengthen coordination to improve services.
The result of this mismatch was to the effect that, as of this time last year, Wakiso District ranked among the bottom 10 on the national health league table, which is an annual Ministry of Health assessment of district performance across key service delivery and patient satisfaction indicators. This was despite Wakiso being Ugandaās most populous district, with over 3.4 million residents today, as it continued to struggle to deliver essential health services to the public. The 2022/2023 Annual Health Sector Performance Report also flagged persistent challenges, including frequent transfers of facility in-charges, overstretched management structures, and weak internal communication and coordination.

It was this stark reality that informed the leadership and management intervention in Wakiso. Officiating the dissemination of the project outcomes, Dr. Sarah Byakika, Commissioner for Planning, Financing, and Policy at the Ministry of Health and a member of the National Oversight Mechanism for the programme, commended the remarkable progress made in just six months, citing visible improvements across the district as a direct result of the intervention.
āI have been involved with this programme right from its inception, and Iām proud that Uganda became one of its major beneficiaries,ā Dr. Byakika said with gratitude, commending the strong collaboration between the Ministry of Health, Makerere University, Nottingham Trent University, Nottingham University Hospitals, Wakiso District and the development partners for supporting the initiative. She emphasised the value of this partnership in strengthening leadership and management competencies among Wakiso District health managers to address critical performance gaps in health service delivery.

āWakiso is Ugandaās largest and most populous district, yet it has long underperformed on key health indices. Despite its semi-urban nature, it faces enormous health service delivery challenges, partly due to the overwhelming burden on its District Health Officer, who oversees more than 60 public and over 340 private health facilities. Many of these private facilities open and close frequently, complicating service oversight,ā Dr. Byakika observed with concern.
Her sentiments were echoed by the District Health Officer, Dr. Emmanuel Mukisa, in a message delivered by Wakiso District Biostatistician, Mr. Frank Kakande. He noted that the project had contributed to a noticeable shift in the districtās health system performance, with visible improvements in leadership, communication, and accountability among facility in-charges beginning to translate into better overall health service delivery outcomes.
āYou cannot talk about management without addressing performance: they go hand in hand. As someone who sits at the centre of district health data, I can confidently say that performance has improved. During the most recent national local government performance assessment, where I participated in the evaluation, Wakiso Districtās health department ranked 18th out of 146 districts. That health ranking is a major achievement. We have consistently performed poorly in the past, but this time, we made significant progress,ā Mr. Kakande told the attentive audience, speaking with an air of relief and satisfaction.

The Wakiso District Biostatistician credited part of this progress within the district, from the poor performance last year, to the leadership training and mentorship delivered through the project, citing visible improvements across key health indicators. He stressed the need to sustain this momentum through continued mentorship, internal capacity strengthening, and consistent application of the skills acquired by health managers, particularly in tackling persistent management challenges such as absenteeism, delegation, and accountability.
āLast week, I held a performance review at Kakiri Health Centre III, and the improvements were clear. These management skills are making a difference. You can see the change across indicators. But what matters now is sustainability. The support provided through supervision and mentorship was essential. But itās up to us to keep the fire burning. We have learned a lot: communication skills, problem-solving, time management, and decision-making. Managers are now communicating better. Even issues like absenteeism are being addressed through proper reporting and action,ā Mr. Kakande said.
Earlier, Dr. Musoke, presenting the overall project overview and success, explained that based on initial findings from the baseline and needs assessment, the team co-designed and delivered a structured six-month capacity-building programme targeting 60 health facility in-charges in Wakiso District. The programme blended in-person and virtual sessions, combining practical training with one-on-one mentorship, and included an exchange component between Uganda and the UK to promote international exposure and peer learning. This allowed the health managers to apply new skills to strengthen health outcomes in Wakiso.
āThis project rightly focused on addressing gaps in leadership and management. I advocated for including this component in the programme, because our national health review missions consistently show that poor performance often stems from weak leadership and management,ā Dr. Byakika affirmed, adding that: āI am pleased to see that nearly all public facilities in Wakiso participated. While the project had a short implementation window, the evaluation already shows encouraging results. Health managers feel more empowered, motivated, and aware of their roles. Thatās a significant step.ā
For her part, Dr. Sheba Gitta, Uganda Country Director for Global Health Partnerships, formerly Tropical Health and Education Trust, applauded the leadership and management capacity-building initiative in Wakiso as a timely, locally driven intervention. She underscored the value of two-way learning between Uganda and the UK health systems through the programme, noting that Global Health Partnerships works closely with the Ministry of Health to ensure all funded initiatives align with Ugandaās national development priorities.

āWhat excites me most is that this was not a pre-packaged programme imported from the UK. The training was co-created by partners, based on local realities and needs. That approach reflects strong collaboration between Makerere University School of Public Health and Nottingham Trent University. I thank Prof. Linda Gibson for her continued commitment and Dr. David Musoke for his proactive leadership in bringing this programme to life. Your consistency and quality of work continue to stand out,ā Dr. Gitta shared.
While commending the progress made, she cautioned against “pilotism”, as a tendency for promising projects to end prematurely, calling for the model to be scaled up nationally. To support sustainability, she stressed the importance of documenting the training process, outcomes, and costs to inform ministry-level decision-making and long-term adoption.
Dr. Gitta joined Prof. Linda Gibson, the UK Lead for the Project, to encourage the trained managers to become champions of leadership within their facilities and districts, ensuring that the impact of the programme endures beyond its current cycle. She also thanked NHS England and the UK Government for their trust and investment in Ugandaās health system.
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Health
Call for Applications: Short Course in Molecular Diagnostics March 2026
Published
5 days agoon
February 12, 2026By
Mak Editor
Makerere University College of Health Sciences, Department of Immunology and Molecular Biology, in collaboration with the Makerere University Biomedical Research Centre (MakBRC), is pleased to invite applications for a Short Course in Molecular Diagnostics scheduled for 23rdā27th March 2026.
This hands-on course will introduce participants to core principles and practical skills in molecular diagnostics, including nucleic acid structure and function, laboratory design and workflow, PCR setup, gel electrophoresis and DNA band interpretation, contamination control and quality assurance, and clinical applications of PCR in disease diagnosis.
The training will take place at the Genomics, Molecular, and Immunology Laboratories and will accommodate 30 trainees. The course fee is UGX 500,000.
Target participants include:
- Graduate students with basic exposure to molecular biology (e.g., MICM, MSBT)
- Final year undergraduate students (e.g., BBLT, BMLS)
- Medical and veterinary clinicians
- Agricultural professionals interested in practical molecular biology
To apply, please send your signed application via email to nalwaddageraldine@gmail.com (copy Dr. Eric Kataginy at kataginyeric@gmail.com). Indicate your current qualification, physical address, and phone contact (WhatsApp preferred), and attach a copy of your National ID or passport data page, your current transcript or testimonial, and your degree certificate (if applicable).
The application deadline is 13th March 2026. Successful applicants will be notified by email. Admitted participants are required to pay the course fee within five days to confirm their slot.
For further inquiries, don’t hesitate to get in touch with Ms. Geraldine Nalwadda on +256 701 361449.
See download below for detailed call.
Health
When Birth Becomes the Most Dangerous Moment, Wanduru & the Work of Making Labour Safer
Published
6 days agoon
February 11, 2026
The ward is never quiet during labour. Even at night, there are cries, some sharp with pain, others muted by exhaustion. Monitors beep. Midwives move quickly between beds. In the moments just before birth, everything narrows to breath, pressure, and time.
It was in places like this, years ago, that Phillip Wanduru first learned how fragile that moment can be.
Working as a clinical nurse at Nakaseke Hospital in central Uganda, he watched babies who should have survived struggle for breath. Some were born still. Others cried briefly, then went silent. Many were not premature or unusually small; they were full-term babies whose lives unraveled during labour.
āWhat troubled me most,ā Wanduru recalls, āwas that these were complications we have known how to manage for more than a hundred years, prolonged labour, obstructed labour, and hypertension. And yet babies were still dying or surviving with brain injuries.ā
Those early encounters never left him. They became the questions that followed him into public health, into research, and eventually into a doctoral thesis that would confront one of Ugandaās most persistent and preventable tragedies.

A Public Defense, Years in the Making
On Friday, June 13, 2025, Wanduru stood before colleagues, mentors, and examiners in a hybrid doctoral defense held at the David Widerstrƶm Building in Solna, Sweden, and online from Kampala. The room was formal, but the subject matter was anything but abstract.
His PhD thesis, āIntrapartum-Related Adverse Perinatal Outcomes: Burden, Consequences, and Models of Care from Studies in Eastern Uganda,ā was the culmination of years spent listening to mothers, following newborns long after delivery, and documenting what happens when birth goes wrong.
He completed the PhD through a collaborative programme between Makerere University and Karolinska Institutet, under the supervision of Prof. Claudia Hanson, Assoc. Prof. Peter Waiswa, Assoc. Prof. Helle Mƶlsted Alvesson, and Assoc. Prof. Angelina Kakooza-Mwesige, a team that bridged global expertise and local reality. His doctoral training unfolded as the two institutions marked 25 years of collaboration, a partnership that has shaped generations of public health researchers and strengthened research capacity across Uganda and beyond.
By the time he defended, the findings were already unsettlingly clear.

One in Ten Births
In hospitals in Eastern Uganda, Wanduruās research found that more than one in ten babies experiences an intrapartum-related adverse outcome. This medical term refers to babies who are born still, die shortly after birth, or survive with brain injury caused by oxygen deprivation during labour.
Among those outcomes, stillbirths accounted for four in ten cases. Five in ten babies survived with brain injury.
āThese are not rare events,ā Wanduru explains. āThey are happening every day, often in facilities where care should be available.ā
But survival was only part of the story.
Following infants diagnosed with intrapartum-related neonatal encephalopathy for a year, his research revealed that about seven in ten babies with severe brain injury died before their first birthday. Among survivors, many faced lifelong challenges, difficulty walking, talking, and learning.
āWhat happens in labour,ā he says, ādoes not end in the delivery room. It follows families for years.ā
He describes the findings of his PhD research as appalling, evidence of an urgent failure in how labour and delivery are managed, and a call for immediate action to prevent avoidable complications. āBabies with severe brain injuries,ā he notes, āfaced the greatest odds. Even when they survived birth, nearly seven in ten died before their first birthday. Of those who lived beyond infancy, about half were left with long-term challenges, including difficulties with walking, talking, or learning.ā

Mothers at the CentreāYet Often Invisible
Wanduruās work did not stop at numbers. Through in-depth interviews with mothers and health workers, he uncovered a quieter truth that parents, especially mothers, were desperate to help their babies survive, but often felt unsupported themselves.
Mothers followed instructions closely. They learned to feed fragile babies, keep them warm, and monitor breathing. They complied with every rule, driven by fear and hope in equal measure.
āThe survival of the baby became the only focus,ā Wanduru says. āBut the mothers were exhausted, emotionally drained, and often ignored once the baby became the patient.ā
Even as mothers remained central to care, their own physical and mental well-being received little attention. For the poorest families, the burden was heavier still: long hospital stays, transport costs, and uncertainty about the future.
These insights shaped one of the thesisās most powerful conclusions: saving newborn lives requires caring for families, not just treating conditions.
Why Care FailsāEven When Knowledge Exists
One of the most uncomfortable findings in Wanduruās research was that emergency referrals and caesarean sections did not consistently reduce the risk of brain injury, except in cases of prolonged or obstructed labour.
The problem, he found, was not the intervention, but the delay.
In many facilities, hours passed between identifying a complication and acting on it. Ambulances were unavailable. Referral systems were weak. Operating theatres lacked supplies or staff.
āThese are not failures of science,ā Wanduru says. āThey are failures of systems.ā
His work reinforces a sobering reality for policymakers that most intrapartum-related deaths and disabilities are preventable, but only if care is timely, coordinated, and adequately resourced.
From Bedside to Systems Thinking
Wanduruās path into public health began at the bedside. After earning a Bachelor of Science in Nursing from Mbarara University of Science and Technology in 2011, he trained as a clinician, caring for patients during some of their most vulnerable moments. He later completed a Master of Public Health at Makerere University in 2015, a transition that gradually widened his focus from individual patients to the health systems responsible for their care.
His work gradually drew him deeper into the systems shaping maternal and newborn care. As a field coordinator for the MANeSCALE project, he worked within public and private not-for-profit hospitals, helping to improve clinical outcomes for mothers and babies. Under the Preterm Birth Initiative, he served as an analyst, contributing to efforts to reduce preterm births and improve survival among vulnerable infants through quality-improvement and discovery research across Uganda, Kenya, and Rwanda.
In the Busoga region, he coordinated prospective preterm birth phenotyping, following mothers and babies over time to better understand the causes and consequences of early birth. Since 2016, this work has been anchored at Makerere University School of Public Health, where he serves as a Research Associate in the Department of Health Policy, Planning, and Management.
Across these roles, he found himself returning to the same question: why babies continue to die during a moment medicine has long learned to handle.
Models of Care That Could Change Outcomes
Wanduruās thesis does more than document failure; it points toward solutions.
He highlights family-centred care models, including Kangaroo Mother Care, which keep babies and parents together and improve recovery, bonding, and brain development. He emphasizes early detection of labour complications, functional referral systems, and rapid access to emergency obstetric care.
āThese are not new ideas,ā he says. āThe challenge is doing them consistently.ā
He also calls for recognizing stillbirths, not as inevitable losses, but as preventable events deserving data, policy attention, and bereavement support.
āStillbirths are often invisible,ā he notes. āBut they matter to mothers, to families, and to the health system.ā
Research That Changes Practice
For Wanduru, the most meaningful part of the PhD journey is that the evidence is already being used. Findings from his work have informed hospital practices, advocacy reports, and quality-improvement discussions.
āYes, the PhD was demanding,ā he admits. āBut knowing that the work is already contributing to change makes it worthwhile.ā
His mentors see him as part of a broader lineage, researchers committed not only to generating evidence but to ensuring it improves care.
With a PhD in his bag, Wanduru sees his work as a continuation rather than a conclusion.

āThe fight to make birth safe for every mother and baby continues,ā he says. āI want to contribute to improving care and to building the capacity of others to do the same.ā
That means mentoring young researchers, strengthening hospital systems, and keeping the focus on families whose lives are shaped in the delivery room.
Dr. Wanduru joins fellows in the MakSPH PhD forum who concluded their doctoral journeys in 2025, and his work speaks for babies who never cried, for mothers who waited too long for help, and for health workers doing their best within strained systems. It insists that birth, while always risky, does not have to be deadly.
ā Makerere University School of Public Health Communications Office, Graduation Profiles Series, 76th Graduation Ceremony
Health
Study Alert: Power in Her Hands; Why Self-Injectable Contraception May Be a Game Changer for Womenās Agency in Uganda
Published
7 days agoon
February 10, 2026By
Mak Editor
By Joseph Odoi
In the remote villages of Eastern and Northern Uganda, a small medical device is doing far more than preventing unintended pregnancies, it appears to be quietly shifting the balance of power in womenās lives.
A new study titled āIs choosing self-injectable contraception associated with enhanced contraceptive agency? Findings from a 12-month cohort study in Ugandaā has revealed that self-injection gives women more than just a health service, it can boost their confidence, control, and agency over their reproductive health.
The research was conducted by Makerere University namely; Professor Peter Waiswa, Catherine Birabwa, Ronald Wasswa, Dinah Amongin and Sharon Alum in collaboration with colleagues from the University of California, San Francisco
Why this Study matters for Uganda
For decades, family planning in Uganda has followed a provider-client model. Women travel long distances to clinics, wait in queues, and rely on health workers to administer contraception. This system creates barriers transport costs, clinic stock-outs, long waiting times, and limited privacy.
Self-injectable contraception, known as DMPA-SC, disrupts this model by shifting care from the clinic to the individual woman.
DMPA-SC is a discreet, easy-to-use injectable that women can administer themselves after receiving basic training and counselling.
What the Data Tells Us
To see if self-care technology actually shifts the needle on women’s power, researchers tracked 1,828 women across Eastern (Iganga and Mayuge Districts) and Northern Uganda (Kole, Lira, and Oyam Districts) for a full year. They compared women who chose to self-inject their birth control (216 women) against a control group, most of whom chose methods requiring dependency on clinics (1,612 women).
The Six-Month “Agency Spike”
The study used a Contraceptive Agency scale (scored from 0 to 3) to measure a womanās internal confidence and her ability to act on her health choices.
The Self-Injectors
For the Self Injectors, their agency scores rose significantly, from 2.65 to 2.74 by the six-month mark.
The Clinic-Dependent Group
Scores for the group using mostly provider-led methods (like clinic shots or implants) remained nearly flat, moving from 2.61 to only 2.63.
Within just six months, women who took control of their own injections noted that they felt a measurable boost in their Consciousness of reproductive Rights (0.08 points) since they transitioned from being passive recipients of care to active decision-makers.
Using the Agency in Contraceptive Decisions Scale (scored 0ā3), the study found a clear empowerment advantage for women who chose self-injection.
The findings come at a time when Uganda has reaffirmed its commitments under FP2030, aiming to expand access to voluntary, rights-based family planning. The study also aligns with the National Family Planning Costed Implementation Plan, which prioritises method choice, equity, and continuation, as well as national gender and youth empowerment strategies.
Can Uganda Sustain and Scale DMPA-SC?
Self-injectable contraception does not require continuous high-cost investment. Training and rollout costs are largely one-time, and the main recurring expense is the contraceptive commodity itself. Compared with the cumulative costs of repeated clinic visits for both the health system and women self-injection is more cost-effective over time.
Advancing primary health care with DMPA-SC
Beyond cost savings, self-injection eases pressure on health facilities and allows health workers to focus on more complex care. It also extends health services into communities, supporting continuity of care in areas where facilities are few and far between. In this way, family planning is no longer confined to the clinic.
While donor support has helped introduce the method, it can be sustained locally without relying on external funding. āWith predictable national financing and reliable commodity supply chains, DMPA-SC can reach more women and be fully integrated into Ugandaās health system, strengthening both access and community-level service deliveryāā according to the researchers.
Implications for Policy and Practice
As Uganda continues to reform its primary health care system, the findings add evidence to ongoing discussions about how family planning services are delivered, financed, and prioritised.
The research also positions self-injectable contraception not as a temporary innovation, but as a scalable method with the potential to be embedded within national systems provided that commodity availability and financing are safeguarded.
To ensure these gains are lasting, researchers recommend moving beyond the technology and addressing the structural and social barriers that can limit womenās agency.
Key recommendations from the researchers include the following
1. Reliable Supply Chains
Empowerment collapses when products are unavailable. DMPA-SC must be consistently stocked at the community level.
2. Creating a Supportive Social Environment
Privacy concerns, stigma, and partner resistance must be tackled through community engagement and sensitisation.
3. Prioritizing Informed Choice
Self-injection should be offered as a top-tier option in every facility, framed as a fundamental right to autonomy rather than just a medical convenience.
4. Integrated Counseling
Providers must be trained to support women not only in the āhow to injectā but also in navigating the social challenges of self-care.
On the next step, the researchers call for a clear integration of DMPA-SC into national health financing, protection of family planning commodity budgets, and deliberate scaling of self-injectable contraception within Primary Health Care reforms. These actions will ensure sustainability, reliable access, and greater control for women over their reproductive choices according to the researchers.
Read the full study here: https://www.contraceptionjournal.org/article/S0010-7824(26)00003-X/fulltext
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