An illustration of students from Nabisunsa Girls’ School during a memorable tour of the School of Public Health at Makerere University on June 12, 2025.
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.”
Max Bobholz, a PhD candidate in Public and Community Health at the Medical College of Wisconsin.
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.
Dr. Catherine Abbo, an Adolescent Psychiatrist and Associate Professor at Makerere University.
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.
Dr. Ronald Anguzu, an Assistant Professor in the Institute for Health and Humanity at the Medical College of Wisconsin.
“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.
An illustration of students from Nabisunsa Girls’ School reconnect with their proud alumna during a memorable tour of the School of Public Health at Makerere University on June 12, 2025. A day of inspiration, mentorship, and shared dreams.
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.”
Dr. Simon Kasasa, a senior lecturer and biostatistician at Makerere University School of Public Health.
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
The post holder will be required to provide nursing care to patients attending IDC, provide health education and advise to patients and their family members, provide translation whenever necessary, guide in clinical practice and duties of other nurses. Participate in clinical research studies.
Key Responsibilities
Provides nursing care to patients attending the IDC
To provide clinical care including triaging, clinical assessment of patients of patient’s problems, investigations to HIV/AIDS patients attending IDI-supported health facilities in line with standard treatment guidelines.
Assist in management of very sick patients brought in Urgent care with knowledge, skills and Support appropriate referral of complex patients’ through liaison with immediate team members, senior clinicians and other specialized facilities.
Lead education and facility sensitization efforts to continuously build knowledge among clients and the attendants at Urgent care and the general clinic.
Participate in identification, implementation and documentation of continuous quality improvement activities along client care and treatment.
Assists medical doctors in carrying out clinical procedures.
Provides translation services to visiting medical doctors as required
Ensures patient flow in the clinic ( IDC)
Performs quality assurance and quality control (QA/AC) to ensure completeness of source documents.
Participates in giving Medicines when required.
Checks medical supply stock and ensures procedure charts are fully equipped
Guides the clinical practice and duties of other nursing staff
Participates as a full member of the IDC health care team
Attends clinic staff meetings on a daily basis as available
Participate whenever requested to do so in clinic research studies.
Participate in compilation and submission of accurate activity reports according to the set guidelines.
This job description is not exhaustive and the post holder will need to be flexible and to undertake such other duties as may become necessary with the development of the Infectious Diseases Institute.
Academic Qualifications
Diploma or Bachelors Degree in Nursing
Full and active registration with the Uganda Nurses and Midwives council (Valid general practice license).
Person Specification
Completion of Nurses Training in a recognized educational institution with Diploma/ Bachelors
Minimum of 3 years work experience in a clinical setting
Full and active registration with the Uganda Nurses and Midwives council (Valid general practice license).
Self- motivated and capable of meeting deadlines.
Excellent communication skills.
Good interpersonal skills and able to interact productively with other team members.
More details
Job Code: NPCT001 No of Positions: 1 Station: IDI-Mulago Classification: Full-time Duration: 1 Months Reports to: NURSE TEAM LEAD Posted Date: 2026-07-06 09:06:27.000 Closing Date: 2026-07-19 17:00:00.000
Across Kampala, families use saucepans, cooking pots, frying pans, kettles, and pressure cookers every day. Makerere University School of Public Health is now investigating whether some of these items may expose households to lead, a toxic heavy metal that can enter food during cooking if contaminated materials are used to make them.
The year-long study, titled “Assessment of Lead Contamination in Domestic Cookware, Supply Chains, and Exposure Pathways in Informal Settlements of Kampala,” was launched on 11 June 2026 at MakSPH’s ResilientAfrica Network (RAN) in Kololo. Supported through the Lead Exposure Elimination Project (LEEP), with funding from Bloomberg Philanthropies, and led by Mr. Douglas Bulafu, Mr. Tom Okade, and Dr. Rawlance Ndejjo, the study will assess total and leachable lead levels in commonly used cookware, map how the products are sourced, distributed, and sold, and identify feasible interventions to reduce household exposure to lead.
Ms. Prossy Nabaggala, Senior Standards Officer at the Uganda National Bureau of Standards, pictured centre, consults with study co-investigators Mr. Tom Okade and Mr. Douglas Bulafu during the launch of MakSPH’s study on possible lead exposure from domestic cookware in Kampala.
Today, lead remains a major and preventable public health concern globally. WHO reports that no level of exposure is known to be without harmful effects and estimates that lead exposure contributes to more than 3.5 million deaths worldwide, mainly through cardiovascular effects. Children and women of child-bearing age are said to be especially vulnerable, with exposure linked to impaired brain development, reduced learning ability, harm to unborn children, high blood pressure, cardiovascular disease and kidney damage.
In Uganda, lead exposure concerns also extend to household products and informal markets. Aluminium pots and saucepans, particularly low-cost locally fabricated items, may be made from recycled scrap metal. If contaminated materials are used, lead may leach into food during cooking or other food-contact use, creating a possible route of exposure in homes.
During the launch, Assoc. Prof. David Musoke, Head of MakSPH’s Department of Disease Control and Environmental Health, underscored the importance of involving stakeholders throughout the research process. He said engaging stakeholders from the generation of research ideas to implementation and dissemination helps ensure findings do not remain within the University but are translated into evidence that can inform policy, practice, and community action.
“We engage with stakeholders throughout the research process, from developing ideas and designing projects to implementation and dissemination,” Dr. Musoke noted. “I am pleased that this workshop brings together policymakers, the Ministry of Health, non-governmental organisations, Kampala Capital City Authority, academia, staff and students. This helps ensure that research findings do not remain at the University but are beneficial to our stakeholders.”
Assoc. Prof. David Musoke delivers remarks during the study launch, emphasising sustained stakeholder engagement to ensure research findings inform policy, practice and community action.
He observed that the study was timely, as it addresses an important yet under-examined public health concern, arguing that while lead exposure from paint, pipes and drinking water has received considerable attention, exposure through cookware remains less understood despite its widespread use in many households. He added that the new research builds on MakSPH’s broader work in disease control and environmental health and will generate critical evidence to inform action on lead exposure risks in Uganda. Dr. Musoke also commended the study team for initiating this work.
Previously, MakSPH researchers Mr. Abdullah Ali Halage, Mr. Tom Okade, Dr. James Muleme and Dr. Juliet Kiguli, together with Mr. Ahmada Zziwa and Mr. Robert Mugabi, assessed knowledge, perceptions and practices related to heavy metal contamination and health risks among residents living near Kiteezi in Kampala, Katikolo in Mukono and Nkumba in Entebbe. The study, done in 2024, reached 505 residents and captured community and frontline perspectives from people living and working around the dumpsites. It showed how daily contact with dumpsite environments may expose communities to toxic heavy metals such as lead, arsenic, cadmium, and mercury through soil, water, air, food crops, animal products and waste-handling practices.
Evidence from the study, funded by the Government of Uganda through the Makerere University Research and Innovation Fund (MakRIF) and disseminated on 26 June 2025, showed that heavy metal exposure risks around the three municipal dumpsites within the Kampala Metropolitan Area were shaped by both environmental conditions and community behaviour.
Dr. Sabrina Kitaka, Member of the MakRIF Grant Management Committee, pictured centre, with research team members including Mr. Abdullah Ali Halage, Mr. Tom Okade and Dr. Juliet Kiguli, following the dissemination of findings on heavy metal exposure risks around Kampala Metropolitan dumpsites on 26 June 2025.
Although residents lived near dumpsites where waste can release heavy metals into soil, water and food chains, 76.4 per cent could not define heavy metals, and only 45.9 per cent had adequate knowledge of contamination and related health risks. Gaps extended to daily exposure pathways, with 38.4 per cent unaware that vegetables grown near dumpsites may contain high heavy metal levels and 39.8 per cent unaware that milk or meat from animals grazed near dumpsites may also be contaminated. More than half viewed dumpsite soils as fertile, 50.7 per cent considered such milk safe, and 51.3 per cent believed dumpsite waste could be used as manure.
The study recommended stronger risk communication, environmental monitoring, safer land-use enforcement and community education. The work on lead in domestic cookware now extends this focus from dumpsite-related heavy metal exposure to a possible household pathway. Mr. Douglas Bulafu, an early-career researcher and Principal Investigator of the study, said the team will examine whether commonly used cooking pots, saucepans and related utensils contribute to exposure, and generate evidence to guide safer cookware use, standards and market oversight.
“Lead contamination has been documented from sources such as paint, fuel and air pollution, but less attention has been given to cookware as a potential pathway of exposure. That is the gap this study seeks to address,” Mr. Bulafu said. “We focused on Kampala because it has many informal settlements, small-scale cookware workshops and a large consumer market where low-cost cookware is widely produced, sold and used. When people buy these products, they often do not know where they were made, what materials were used, or whether they contain lead. The supply chains are also poorly understood, meaning households could be exposed without knowing.”
Mr. Douglas Bulafu, Principal Investigator, speaks during the launch of the MakSPH study on possible lead exposure from domestic cookware in Kampala, highlighting the need for evidence to guide safer cookware use, standards and market oversight.
The study will use a cross-sectional, mixed-methods design to connect laboratory evidence with supply-chain realities in Kampala’s informal settlements. The team will purchase about 100 cookware samples from open-air markets, roadside vendors, retail shops and supermarkets in Kisenyi, Katanga, Bwaise, Namuwongo, Banda and Kasubi, test them for total and leachable lead, and conduct about 30 key informant interviews across the supply chain to understand how cookware is sourced, produced, distributed and used.
Findings will be validated with stakeholders and used to identify feasible interventions, including stronger regulation and enforcement, raw-material control, better manufacturing practices, market surveillance and consumer awareness. The evidence is expected to support standards development, product testing, policy uptake, safer manufacturing practices and public guidance on cookware choices, helping reduce household exposure to lead and associated health risks.
Speaking on behalf of the Ministry of Health, Dr. Didacus Namanya, a health geographer and environmental health expert, welcomed the study, saying scientific evidence on lead exposure is critical because public health decisions can have lasting consequences for life and wellbeing.
Dr. Namanya implored the research team to ensure the evidence from the study informs decisions beyond academia, shaping policy, strengthening public health practice and guiding practical measures to reduce lead exposure in communities. He emphasised that research should not remain in the “ivory tower” but reach decision-makers and the public, so that evidence from the study translates into policy, practice and stronger protection for communities.
Dr. Didacus Namanya, speaking on behalf of the Ministry of Health, delivers remarks during the study launch on 11 June 2026, urging the research team to ensure evidence on lead exposure informs policy, practice and practical community protection measures.
Kampala — On Saturday, a car park on the campus of Makerere University in Kampala became the stage for a continental emergency response. Delegates, dignitaries and diplomats gathered in the tent outside the Infectious Diseases Institute (IDI), a research institute owned by the university, for the formal launch of the Continental Incident Management Support Team (IMST), a joint Africa Centres for Disease Control and Prevention (Africa CDC) and World Health Organization (WHO) operation racing to contain the Bundibugyo strain of Ebola sweeping through the Democratic Republic of the Congo and, increasingly, Uganda. After the ribbon-cutting, guests were led inside to tour the team’s new home at IDI’s McKinnell Knowledge Centre, where the command offices have now been set up.
Dr Chris Baryomunsi joins delegates for a group photograph at the IMST launch, Infectious Diseases Institute, Makerere University.
The numbers explain the urgency. As of 21 June, more than 1,000 confirmed cases and 269 deaths had been recorded across the two countries, the vast majority in Ituri Province in eastern DRC. Uganda’s tally stood at 20 cases and two deaths, almost all traced to cross-border movement from the DRC. Eighty-two health workers have been infected, 18 fatally, a toll that helped push the WHO to declare a Public Health Emergency of International Concern in May, mirrored days later by Africa CDC’s own continental emergency declaration.
Prof Henry Mwanaki Alinaitwe, Deputy Vice Chancellor for Finance and Administration at Makerere University, with the acting US Ambassador to Uganda and Prof Samuel Luboga, IDI board chair, at the IMST launch.
Until now, the international response has been coordinated remotely, a patchwork of video calls and scattered logistics that officials admit slowed decision-making. The Kampala launch marks a shift from that fragmented model to a single, physically co-located command centre housed at IDI’s McKinnell Knowledge Centre, bringing case management, surveillance, logistics and risk communication specialists under one roof. From there, the convoy of delegates moved on to Kajjansi, on the outskirts of Entebbe, for the formal activation of the IMST’s regional logistics hub, the facility tasked with staging and rapidly deploying protective equipment and medical supplies across the outbreak zone.
Dr Chris Baryomunsi inspects the newly activated IMST logistics hub at Kajjansi, near Entebbe.
For Uganda’s health minister, Dr Chris Baryomunsi, the symbolism was as important as the logistics. Speaking at the launch, he argued that no nation can consider itself protected until its neighbours are equally prepared, framing cross-border solidarity as an operational necessity rather than an aspiration. He also announced a new memorandum of understanding with the DRC establishing joint Ebola treatment centres and laboratory services in the border towns of Aru and Kasenyi, warning that outbreak response cannot succeed while transmission continues unchecked on one side of a shared frontier.
Dr Chris Baryomunsi speaks as the guest of honour at the launch of the Continental Incident Management Support Team, Infectious Diseases Institute, Makerere University.
The WHO’s regional emergency director, Dr Marie-Roseline Belizaire, described the unified command structure as transformative, saying it would pool resources across agencies, cut duplication and keep field decisions anchored to scientific evidence. Africa CDC’s Dr Tolbert Nyenswah confirmed the team, specialists in case management, infection prevention, logistics and contact tracing, has now relocated physically to Kampala to work closer to the epicentre. Eleven epidemic-prone African nations, including Rwanda, Burundi, Angola and the Central African Republic, are participating in the preparedness effort even though most have not registered a single case.
Dr Marie-Roseline Belizaire, WHO AFRO’s regional emergency director, speaks at the launch of the Continental Incident Management Support Team in Kampala.
For IDI and Makerere University, hosting the command centre carries weight beyond the immediate crisis. IDI’s executive director, Dr Andrew Kambugu, said the institute had provided a fully equipped space, now installed at the McKinnell Knowledge Centre, enabling real-time communication between field teams, regional governments and international partners in Geneva, and framed the moment as proof that academic institutions can engage directly with pressing societal problems rather than observe from the sidelines.
Dr Andrew Kambugu delivers welcome remarks at the launch of the Continental Incident Management Support Team, Infectious Diseases Institute, Makerere University.
That framing matters for a continent whose research infrastructure has often been treated as peripheral to its own health emergencies. By anchoring the IMST’s command function within a Ugandan public university rather than in a foreign capital, the launch signals a modest but symbolic rebalancing: an African-led institution taking custody of an African-led response. The day’s itinerary made the point physically as well as symbolically: from the ribbon-cutting in Makerere’s car park, to the tour of the new command offices, to the drive out to Kajjansi to switch on the logistics hub, delegates traced the full chain of the response they had just committed to running.
Dr Chris Baryomunsi poses with the IMST logistics hub team at Kajjansi, following the hub’s formal activation.
Fred Ouma is the Corporate Communications Specialist, Infectious Diseases Institute (IDI).
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