Health
Ugandan Study Flags Girls and Senior Students as a Mental Health High-Risk Group
Based on research led by Max Bobholz and colleagues from Makerere University in Uganda, Essentia Institute of Rural Health, and the Medical College of Wisconsin in the United States.
Adolescence is meant to be a time of holistic growth and self-discovery, but for many Ugandan teenagers, this period is becoming a season of silent mental health struggles. A new study published in PLOS Global Public Health has uncovered a silent but growing crisis: nearly one in five Ugandan secondary school students in the study areas have signs of an emotional disorder. These conditions included anxiety, depression, post-traumatic stress disorder (PTSD), and adjustment disorders often involving excessive worry, sadness, fear, or mood instability. Also, one in 20 adolescents exhibited behavioral issues ranging from attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder to substance use and other risky behaviors like alcohol use.
The study, led by Max Bobholz, a PhD candidate in Public and Community Health at the Medical College of Wisconsin, surveyed a sample of 1,953 students aged 10 to 18 years enrolled in eight secondary schools in Iganga district in Eastern Uganda and Mukono district in Central Uganda. This was one of the most comprehensive efforts yet to understand the prevalence and drivers of mental health challenges among school-going Ugandan adolescents.
“We are looking at a generation facing a complex blend of stressors, namely, academic, social, and emotional,” says Bobholz. “Our findings show that certain groups are especially vulnerable, and schools need to be equipped to respond.”
This study results, published on June 12, 2025 was funded by the Swedish International Development Cooperation Agency (SIDA), a government agency of the Swedish Ministry for Foreign Affairs, through the Makerere University Postdoctoral Fellowship to one of the investigators, Dr. Catherine Abbo. Other researchers included Julia Dickson-Gomez, Arthur Kiconco, Abdul R. Shour, Simon Kasasa, Laura D. Cassidy, and Ronald Anguzu.
According to the study, girls bear a higher emotional burden. Researchers found that female students had nearly two times higher odds of suffering from emotional disorders such as anxiety or depression than their male peers.
Dr. Catherine Abbo, an Adolescent Psychiatrist and Associate Professor at Makerere University, attributes this to both biological and socio-cultural factors. “Puberty brings hormonal shifts that can heighten emotional sensitivity,” she explains. “But just as importantly, Ugandan girls often face intense pressure to conform to gender roles while also navigating issues like body image, harassment, and future uncertainty.” The researchers are calling for gender-sensitive mental health interventions, particularly in schools, where early support could help mitigate long-term mental health issues.
Higher associations in older teens?
Age also emerged as a key associated factor, with each additional year increasing the odds of behavioral disorders by 20%. “As adolescents grow older, they are more prone to risk-taking, impulsivity, and resistance to authority,” explains Dr. Simon Kasasa, a senior lecturer and biostatistician at Makerere University School of Public Health.
“Combine that with academic pressure and identity-related stress, and it’s no surprise we’re seeing more conduct issues in late adolescence,” Dr. Ronald Anguzu, an Assistant Professor in the Institute for Health and Humanity at the Medical College of Wisconsin, added. This study raises critical questions about whether and how Ugandan secondary schools support older students as they transition toward adulthood.
The unseen influence of family mental health
The study also found that adolescents with a family history of mental illness had twice the odds of exhibiting behavioral problems compared to those without such a history.
“This speaks to the intersection of genetics and environment,” says Bobholz. “Living in a household with people affected by mental illness can mean instability, stigma, and lack of emotional support, all of which weigh heavily on a developing mind.”
The authors recommend that school mental health screening include family mental health history and advocate for greater collaboration between education and health sectors to support at-risk households.
Private schools: High marks, higher stress?
Interestingly, students in private schools had 1.4 times the odds of experiencing emotional disorders compared to those in public schools. Private schools, often seen as academic havens, may inadvertently be cultivating high-pressure environments. “There’s an assumption that better facilities mean better well-being,” says Dr. Abbo. “But intense academic competition, social isolation, and a lack of trained counselors can create emotional pressure cookers.”
Previous research in 47 secondary schools across five districts (Rakai, Kyotera, Masaka, Lwengo, and Kalungu) in southwestern Uganda found that economic and family support helped reduce absenteeism among adolescent girls in secondary schools. However, this support did not significantly improve behavior or reduce grade repetition. The region, which includes districts like Rakai and Masaka, also faces a higher burden of HIV, adding to the challenges young people experience.
Meanwhile, a review of data from 42 primary schools in Luwero District identified school-based mental health interventions such as cognitive behavioral therapy and mindset-building approaches as being particularly effective. Researchers now suggest that integrating these strategies, along with efforts to reduce school violence, could go a long way in improving the mental health of Ugandan adolescents.
A-Level pressure: Academic ambition meets mental health strain
The study also found a correlation between advanced (A’level) education and increased risk of emotional disorders. “We selected one school district from each region based on population and past academic performance. As these students prepare for university or the job market, the pressure to succeed becomes enormous,” says Kasasa. “They’re facing a future full of uncertainty, with very little structured mental health support to help them cope.”
A wake-up call for Uganda’s education and health systems
The authors of this study assert the urgent need for school-based mental health programs, especially in private and A-level institutions. These programs should offer routine screening, emotional support, and training for teachers to recognize warning signs of mental health disorders.
Importantly, this study adds weight to calls for a national adolescent mental health policy, tailored to Uganda’s context, with interventions that bridge health, education, and social services.
“Our data shows that mental health challenges are not a fringe issue,” says Bobholz. “They are widespread, significant, and deeply tied to school, home, and society.”
The COVID-19 school closures between 2020 and 2022 deepened feelings of isolation and financial strain, with out-of-school adolescents reporting depression rates as high as 21.5% to 50% higher than their peers who remained in class, according to research published in February 2025. Yet Uganda invests less than 1% of its health budget in mental health, with just one psychiatrist per million people, leaving many teens to cope through cheap alcohol used by 28% of urban youth or untrained healers, as reported by the government paper The New Vision in April 2025. With only 26% of students completing lower secondary school and 35% of the population under age 24, these mental health challenges now pose a serious threat to the country’s future.
Mercy Akankunda of Proven Foundation, a Ugandan NGO supporting vulnerable groups, warns that mental health struggles are quietly eroding the well-being of the country’s youth, over 12 million strong and making up 35% of the population. “These teens are not just statistics. They are the future of Uganda, she asserts. If Uganda hopes to reap the dividends of its young population, addressing adolescent mental health must become and remain a national priority, not just for treatment, but for prevention, resilience, and hope.
Reference:
Bobholz, M., Dickson-Gomez, J., Abbo, C., Kiconco, A., Shour, A.R., Kasasa, S., Cassidy, L.D., & Anguzu, R. (2025). Correlates of behavioral and emotional disorders among school-going adolescents in Uganda. PLOS Global Public Health. Read the study here
Health
Mak and UNICEF Uganda Sign MoU to Strengthen Child Rights through Research, Training, and Innovation
Makerere University (Mak) and United Nations Children’s Fund (UNICEF) Uganda have signed a Memorandum of Understanding that launches a two-year, renewable partnership aimed at advancing child rights and well-being through rigorous research, capacity building, and policy-driven innovation.
The agreement was signed on Thursday, 14 August 2025, by Makerere Vice Chancellor Professor Barnabas Nawangwe and UNICEF Uganda Representative Dr. Robin Nandy in the Vice Chancellor’s Boardroom at Makerere’s Main Building.
The MoU enlists a focused collaboration on generating child-focused data and research to inform policy and program design, analyzing how health, nutrition, education, and protection initiatives affect children, and strengthening the social sector workforce through targeted training, curricula, and performance standards.
It also emphasizes knowledge management, wide dissemination of findings to stakeholders, policy and legislative advocacy for child rights, and active student engagement through internships, skilling opportunities, and communities of practice. The renewed partnership is designed to bolster evidence-based policy-making and drive program improvements that contribute to Uganda’s progress toward the Sustainable Development Goals by 2030.
“The signing of this MoU deepens Makerere’s long-standing commitment to the well-being of Uganda’s children and Africa’s future,” said Vice Chancellor Nawangwe. “I thank Dr. Nandy for his leadership and for the continued collaboration that will expand our capacity to deliver research with immediate, practical benefits for communities.”
UNICEF’s Dr. Nandy stressed that the partnership reflects UNICEF’s global mission to protect and promote every child’s rights while translating research into policy and action. He highlighted Makerere’s proven strength in research leadership as a critical asset in the effort to generate robust evidence for government decision-making and resource allocation.
“This partnership shows our commitment to combine academic knowledge with practical results,” said Dr. Nandy. “Using Makerere’s research skills to create important information about child welfare issues and solutions, making sure that every project we start is based on solid data and aims to safeguard and support children’s basic rights.”
The partnership builds on Makerere University’s established research strengths and UNICEF’s global mandate to protect children. It complements longstanding collaborative work through Mak’s School of Public Health (MakSPH) and other faculties, reinforcing a broader university-wide commitment to evidence-based policy and community impact.
Since 2016, Makerere has participated in more than 30 UNICEF-supported research projects, which emphasize a deep mutual trust and shared mission. The Vice Chancellor noted that this history laid a robust foundation for the new MoU while also underlining opportunities to broaden collaboration beyond the health sector.
Among the notable prior initiatives is MakSPH’s joint work with UBOS and UNICEF, supported by EU funding, on the first comprehensive Food Security and Nutrition Assessment in ten districts of Northern Uganda and the West Nile region (2019). The findings of this work informed targeted nutrition programs and strategies to combat malnutrition among vulnerable populations, shaping policy directions at local and national levels.
In 2023, MakSPH, in collaboration with the National Planning Authority (NPA) and UNICEF, along with FHI360 and the Ministry of Health, produced an updated Situation Analysis of Newborn Health in Uganda. The document has guided the ministry’s national strategy development, including costed investments to improve newborn health across the country.
Professor Rhoda Wanyenze, Dean of MakSPH, hailed the partnership as a continuation of a long-standing relationship, noting that UNICEF’s support was instrumental in establishing the Makerere University Centre of Excellence for Maternal Newborn & Child Health (MNCH) in 2013.
“It’s such a delight, a great honor to finally get to this event where we can formalize our partnership with UNICEF. The partnership between UNICEF and Makerere has been a long-standing one, and we have worked together for decades, which has driven critical research and informed national policies,” she said. She emphasized that both institutions share a passion for tackling adolescent health challenges, particularly early pregnancies and marriages, which remain persistent barriers to progress.
The MoU extends collaboration beyond the School of Public Health. The Vice Chancellor noted productive partnerships across other departments, including the Department of Journalism and Communication and the College of Humanities and Social Sciences, emphasizing how diverse disciplines can contribute to evidence-based policy and community well-being.
Another important example is the Caring for the Caregiver (CFC) intervention led by the Makerere Institute of Teacher Education and Research (MITER) in the College of Education and External Studies (CEES). This was implemented in partnership with the Ministry of Health, UNICEF Uganda, and international partners. The evaluation examined caregiver emotional wellbeing, social support, and parenting stress in rural Uganda, contributing to the growing evidence base for nurturing care in resource-constrained settings.
Also, the School of Statistics and Planning in the College of Business and Management Sciences (CoBAMS) has partnered with UNICEF to tackle urgent socio-economic and public health challenges. A key example is the Socio-economic Impact Assessment of the 2022 Ebola Virus Disease outbreak in Mubende and Kassanda districts, which examined household-level shocks, community coping strategies, and the wider disruption of livelihoods. The study’s findings have informed national policy dialogue and action planning, emphasizing that there must be stronger preparedness measures.
According to the Vice Chancellor, the university’s broader engagement with UNICEF as a driver of research, innovation, and community outreach benefits children and families throughout Uganda.
For Dr. Nandy the partnership will support student involvement in real-world operational and programmatic work, creating pipelines for young scholars to contribute to child welfare initiatives.
Both parties expressed a shared vision of translating research findings into concrete actions that strengthen child protection and opportunities for learning and development. The collaboration is expected to yield new efforts for effective interventions, sharpen the policy dialogue, and catalyze scalable innovations that improve the daily lives of Uganda’s children.
Health
Makerere University College of Health Sciences marks Centenary with expansion of Super-Specialized healthcare Training
On 30th July 2025, Makerere University hit a milestone in specialized healthcare training as it proudly graduated 16 fellows from their Paediatric Hematology and Oncology (PHO) Fellowship Programme. These dedicated physicians who successfully completed a two-year rigorous fellowship program will serve as elite experts in treating life-threatening blood disorders and cancers in children.
The pioneering fellowship program of Makerere University College of Health Sciences (MakCHS) commenced in 2016. This cohort included fellows from Uganda, Kenya, South Sudan, Tanzania, Malawi, Nigeria, and Congo which enhances Africa’s capacity to deliver highly specialized care, promising improved survival rates and quality of life for countless young patients.
In his address to the congregation, Professor Barnabas Nawangwe, Vice Chancellor – Makerere University emphasized the university’s guiding vision of research-led, noting that the institution remains committed to producing highly skilled professionals who address Uganda’s and Africa’s evolving health challenges while acknowledging the resilient hard work of fellows during training and the vital sacrifice as well as support from family and friends.
Prof. Nawangwe recounted Makerere’s significant historical contributions to public health and medical research recalling the College of Health Sciences’ past achievements, including it’s 1964 recognition for lymphoma research leading to nomination for a Nobel Prize for the discovery of the cells that cause the cancer of the lymphoma. He cited the university’s instrumental efforts and contribution in combatting disease on the continent like the Ebola, Marburg, Nodding Disease and the recent COVID-19 pandemic.
He outlined Uganda’s demographic realities and the resultant increase in health challenges with exponential growth of a young population alongside the alarming statistics of childhood cancer and sickle cell disease. With an estimated “7,000 children and adolescents cancer with less than 50% access in treatment,” and over “20,000 babies are born with sickle cell every year,” the need for specialized care is critical, he said. Professor Nawangwe also stressed the urgency of the situation, “It is reported that many of the deaths from cancer and blood disorders are preventable,” stating, “We must produce enough doctors to manage the disease burden we have.”
Prof. Nawangwe recognized the instrumental role of partners such as Texas Children’s Global and Baylor College of Medicine, among others, who supported MakCHS in setting up the PHO fellowship that began in 2016. He underlined the success of the program, which has since trained 24 paediatricians serving as healthcare leaders across Africa.
In his remarks, Professor Bruce Kirenga, Principal – MakCHS highlighted the institution’s century of medical training excellence and its forward-looking vision as the College holds its third graduation ceremony of the PHO Fellowship Program. He emphasized MakCHS’ commitment to advancing healthcare in the region, adding that this future is geared towards more scientific research, innovation and cutting-edge medical care.
Professor Kirenga proudly announced that the fellowship program is the first of their sub-specialized training programs. He revealed the expansion of these crucial programs, noting that the college currently offers three additional sub-specialized training pathways: Neonatology, Interventional Radiology, and Fetal and Maternal Medicine, with two more programs under review; in this regard, Professor Kirenga extended gratitude to partners and collaborators, affirming the college’s unwavering dedication to its mission.
Representing the Director General Health of Services and Permanent Secretary of the Ministry of Health, Dr. Richard Mugahi – Commissioner for Child and New-born Health highlighted the vital role of the new specialists in transforming Uganda’s healthcare landscape. Dr. Mugahi emphasized the graduation as not only fellows’ dedication, but also an important step forward for Uganda’s healthcare system citing the critical need for their expertise.
He detailed the alarming burden of childhood cancer in Uganda, with 1,500 to 3,000 new cases reported annually, yet only 30% access specialized treatment, resulting in tragically low survival rates of 20-30% beyond three years. In response, the Ministry of Health is strengthening its partnership with Makerere University, recognizing that “the role of research, the role of academia is well highlighted and emphasized,” and crucial for producing skilled professionals.
Dr. Mugahi announced the government’s strategic plans to absorb these new specialists, actively developing human resource structures and mobilizing resources to utilize their skills nationwide. He also revealed ongoing efforts to decentralize cancer care through regional centres, citing the operational facility in Gulu and planned sites in Arua, Mbarara, and Mbale, all of which will strongly need the fellows’ expertise to serve our population. He concluded by reiterating the core mission: “Our mission is clear. We now have the inputs, you’re one of the inputs of providing Uganda with the best possible quality of care.” He stated.
Encouragingly, Dr. Rosemary Byanyima Mulago National Referral Hospital (MNRH) revealed that the Hospital is charting a new course towards offering highly specialized medical services, emphasizing that they can only offer that when they have people who have trained as super-specialists.
“This strategic move is predicated to building a robust local human resource, specifically super-specialists, whose rigorous training pathway extends beyond a first degree and master’s to include a specialized fellowship. The traditional approach of training abroad is very expensive” Dr. Byanyima noted. To overcome this, Mulago is actively working with collaborators to build the capacity to train locally. This innovative model involves sponsoring a select few for training abroad, who then return to establish and lead local programs, significantly enhancing the hospital’s self-sufficiency.
“Mulago is uniquely positioned as an ideal training ground due to its infrastructure. We have the equipment. And of course, there are many patients who require the service.” Dr. Byanyima said. She noted that while Mulago provides the environment, it collaborates with accredited training institutions like Makerere University for academic awards.
The benefits of local training are multifaceted; it not only builds internal capacity but also allows the hospital to continuously identify and address service delivery gaps in infrastructure, equipment, medicines, and sundries, Dr. Byanyima added. Local training is also cheaper and eases the very strenuous emotional burden on advanced-age trainees with families, who would otherwise have to relocate abroad for years. Crucially, as these experts train, they simultaneously offer services, with patients directly benefiting from their evolving skills. In addition, she noted, Mulago leverages collaborations to acquire essential resources, while simultaneously lobbying the government for sustained funding to ensure the long-term continuity of the services.
Addressing the escalating challenge of non-communicable diseases (NCDs) like cancer and diabetes, Dr. Byanyima acknowledged the continuously increasing number of patients, necessitating a proportional increase in human resource infrastructure, medicines and surgeries to be able to meet the demand. She also stated Mulago’s role in health education at the tertiary level, empowering patients to disseminate crucial health information within their families and communities, complementing primary healthcare prevention efforts by the Ministry.
In his speech, Dr. Joseph Lubega, a Children’s Cancer and Blood disease Specialist and Assistant Professor at Baylor College of Medicine, Texas Children’s Hospital, USA, recognized the significant advancements in child healthcare across Africa with specialists trained in children’s cancer and sickle cell disease.
Dr. Lubega emphasized the profound impact of PHO Fellowship Program on patient outcomes stating that ‘whereas when we started this work, most children with cancer anywhere in Africa would die within a month of a diagnosis, now most of them are cured.’ Despite this progress, he stressed the imperative to expand reach beyond major cities like Nairobi, Kampala, and Dar es Salaam, aiming for comprehensive coverage across all countries, especially given the much bigger challenge posed by sickle cell disease. The ultimate goal, he explained, is for the specialists to train lower health workers in their countries, ensuring every child is reached.
Challenging the conventional focus on infectious diseases in Africa, Dr. Lubega advocated for greater attention to non-communicable diseases (NCDs), saying, “Sickle cell disease is one of the most common non-communicable diseases. It is part of African DNA, 2% of new-borns get this diseases.” He noted that unlike acute infections, NCDs demand lifelong follow-up and community-based care, necessitating a re-evaluation of health system training.
One of the fellows, Dr. Ankunda Siyadora who works with Mbarara Regional Referral Hospital, noted that the fellowship will revolutionize the landscape of childhood cancer and blood disorder care in Western Uganda. In her words, “my passion was ignited during internship at St. Mary’s Hospital in Gulu, Uganda. I witnessed numerous children suffering from advanced Burkitt’s lymphoma, often receiving only palliative comfort. That made me a bit sad, but also built the passion I have for paediatric haematology.” she recounted.
Motivated by the stark contrast between 80% survival rates in Western countries and the grim reality she encountered, Dr. Ankunda’s desire is to change the narrative that every child with cancer or blood disorder should die or be in pain. Her fellowship, she believes, will lessen the burden by ensuring every child who has a cancer or a blood disorder, gets an early diagnosis and then get the right treatment for their disease.
Addressing the common misconception that childhood cancers stem from environmental or lifestyle factors, she clarified that “in children, it’s more about the genetics, it’s just a mistake, something went wrong in the genetics, it’s nothing to do with the family or the environment, majority, close to 99% of childhood cancers, are a result of spontaneous mutation.” While a small percentage (1-3%) can be inherited, like retinoblastoma, most cases are simply “bad luck, nothing to do with the environment, nothing to do with your parents.” This understanding is crucial for families, alleviating guilt and redirecting focus to early intervention.
The experts will be pivotal in improving care for children with blood disorders and cancers, addressing the country’s high childhood cancer burden and with the Ministry of Health planning will integrate these specialists into the healthcare system and establish regional cancer centres. This in turn will increase access to specialized care, improve treatment outcomes, and enhance the quality of life for children with cancer and blood disorders in Uganda and beyond.
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