Health
Dr. Samalie Namukose and the Quiet Work of Making Nutrition Count
Between Tuesday, February 24 and Friday, February 27, 2026, Freedom Square at Makerere University will fill with a familiar choreography of anticipation. The air will fill with the rustle of academic gowns, the nervous laughter of graduands, and the careful positioning of proud families searching for familiar faces in a sea of crimson, green, and black. It is a moment of ceremony, yes, but also of reckoning.
Up close, the doctoral gowns feel heavier than they look. The deep crimson fabric, warm and deliberate, settles on the shoulders. Green panels edged in gold are gently pressed against the chest. Wide sleeves gently brush against clasped hands, soft bonnets rest low on foreheads, and tassels remain motionless. Beneath the regalia are steady breaths, quickened heartbeats, and bodies carrying the quiet fatigue of years spent balancing work, study, and life. These are garments worn not only for display but also for endurance, stitched to nights without sleep, to questions carried long before they were answered.
At this four-day Makerere University’s 76th Graduation Ceremony, 185 doctoral degrees will be conferred. Each PhD will represent years of unanswered questions, interrupted sleep, financial strain, and relentless intellectual persistence. Among them will be Dr. Samalie Namukose, a woman whose academic journey was never separate from the health system she serves, only threaded through it.
For more than two decades, Samalie Namukose has worked inside Uganda’s Ministry of Health, rising steadily from Nutritionist to Assistant Commissioner for Health Services/Nutrition. She has helped write policy, coordinate national programs, supervise districts, respond to emergencies, and advocate for mothers and infants whose voices rarely travel beyond clinic walls. Her PhD did not pull her away from that world but plunged her deeper into it.
The Question That Would Not Let Go
Dr. Namukose’s doctoral journey began not in a library, but in a pattern she kept seeing and could no longer ignore.
Uganda’s nutrition policies are robust. They speak clearly about the importance of maternal and infant nutrition, especially in the first 1,000 days of life. Yet in health facilities across the country, nutrition services often appeared fragmented, present in principle, and inconsistent in practice. Mothers attending antenatal or postnatal care were weighed, yes, but not always counselled. Infants were measured, but follow-up was irregular. Nutrition existed, but it was not always integrated.
“I kept asking myself,” she recalls, “not whether nutrition interventions exist, but how well they are embedded in routine care, and what prevents health workers from delivering them consistently.”
That question shaped her PhD research at Makerere University’s School of Public Health, where she examined the integration of Nutrition Assessment, Counselling, and Support (NACS) into routine health services in the Tororo and Butaleja districts in Eastern Uganda.
At its core, NACS integration is deceptively simple: assess nutritional status at every health point, provide tailored counseling, and link clients to support within the same system and beyond. But in practice, it tests the very backbone of health systems: workforce capacity, financing, governance, supervision, and community linkages.
“When NACS is well integrated, health facilities can identify nutrition risks early, prevent deterioration, and provide timely support rather than responding only when malnutrition becomes severe,” she says.
Inside Resource-Constrained Health Facilities
What Dr. Namukose found was not a clear story of failure or success, but something in between. Many health facilities were offering basic nutrition education and assessments, and health workers were clearly trying their best. However, long patient queues, limited time, and a shortage of basic tools and job aids often hindered counseling and follow-up. Food demonstrations were rare. Growth monitoring was inconsistent. Efforts to improve quality occurred only sporadically.
In facilities without trained nutritionists, nurses, and midwives, already stretched thin, took on nutrition work alongside many other duties, leaving little room to support mothers and children in a steady, continuous way.
And yet, her findings revealed something deeply hopeful: “facilities with knowledgeable, motivated, and supported health workers delivered better nutrition services, even within the same constraints.” To Dr. Namukose, this showed that leadership, mentorship, and attitude mattered. Where nutrition was treated not as an extra task but as essential care, outcomes began to improve.
One of the strongest findings from Dr. Namukose’s research was that even when nutrition services were only partly integrated, they still made a visible difference. Mothers gained weight more steadily during pregnancy and in the early months of breastfeeding. Babies were born heavier and grew better in their first months of life. Across health facilities with more fully integrated nutrition services, children consistently showed healthier growth patterns.
These were not just numbers on a page; babies started life stronger, and mothers were better supported to care for them.
“To me,” she explains, “the improvements in maternal weight gain reflected the value of regular assessment and context-specific counseling. For infants, the better growth outcomes showed that a package of nutrition interventions, delivered consistently, can make a real difference during the most critical window of life.”
It was clear evidence that nutrition integration works effectively, though gradually and significantly.
The Fragility of Progress
Dr. Namukose’s research also exposed how fragile these gains remain. Weaknesses in financing and governance emerged as the greatest threats to sustainability. Nutrition services often depended on unpredictable partner funding rather than routine government budgets. Essential supplies, anthropometric tools, job aids, and therapeutic foods were frequently unavailable or externally dependent.
Her study captured glaring governance gaps that compounded the problem. For instance, nutrition was not always clearly positioned within accountability structures, and this, according to Dr. Namukose, often led to limited supervision and weak performance monitoring. Many districts lacked dedicated nutritionists altogether.
She notes that community follow-up was essential for sustaining behaviour change after clinic visits, especially for those who suffered most. Village Health Teams and care groups struggled without supervision, feedback mechanisms, or resources.
“Most nutrition-related behaviours, such as maternal diet, infant and young child feeding, and care practices, are shaped and sustained within households and communities,” says Dr. Namukose.
She contends that nutrition integration cannot rely on projects but must be embedded in systems.
A PhD Written in the Margins of Life
Conducting this research while holding a senior national leadership role in the Ministry of Health was, by her own admission, one of the hardest things she has ever done.
Dr. Namukose did not request study leave. Partly self-sponsored, she worked full days at the Ministry of Health, then wrote at night, often between midnight and 4:00 am, and again in the early mornings, on Saturdays, and on borrowed hours of Sunday.
“There were days when I sacrificed sleep completely,” she says quietly.
National emergencies such as COVID-19, Ebola, and MPOX repeatedly interrupted her doctoral journey, drawing her back into crisis response. To her, returning to her PhD after each interruption felt like re-entering a conversation mid-sentence, struggling to find the thread.
At one point, she simultaneously prepared for a Top Management Committee presentation, attended a doctoral committee meeting, and sat for Health Service Commission promotional interviews.
“The pressure from the supervisors kept me on my toes. The PhD forum was another motivating factor, consistently sharing updates, books, courses, encouragement, and invitations to PhD defenses. Peer support was tremendous. Without a supportive family, you can’t make it,” she remarks.
A Career That Prepared the Ground
Dr. Namukose’s PhD sits atop a formidable professional foundation. She holds Bachelor’s and Master’s degrees in Agriculture from Makerere University, a Postgraduate Diploma in Food and Nutrition Security from Wageningen University in the Netherlands, and a Postgraduate Diploma in Business Administration from Makerere University Business School. She has undergone extensive training in nutrition leadership, research methods, health systems, and quality improvement across Africa, Europe, and Asia.
Within the Ministry of Health, she has served as a Public Health Nutritionist, Senior Nutritionist, Principal Nutritionist, and now Assistant Commissioner, coordinating national nutrition interventions, designing training modules, mobilising resources, and overseeing district implementation.
She has played key roles in multi-million-dollar initiatives, from HIV-Free Survival programmes to Integrated Child Health Days, public food procurement policy, and the scale-up of Multiple Micronutrient Supplements (MMS) for pregnant women.
Her research has been published in leading peer-reviewed journals, including PLOS ONE and BMC Health, Population and Nutrition, ensuring that her findings speak both to policy and global evidence.
On a mission to keep research from gathering dust
Now a Doctor of Philosophy, Dr. Namukose has determined that her work will not sit quietly on a shelf. Her findings have already informed Uganda’s Health Sector Nutrition Strategic Plan, strengthening the case for financing, governance reform, and recruitment of skilled nutrition cadres. She continues to champion platforms, such as national nutrition symposia, that bring student research into policy dialogue and implementation spaces.
“Very often, excellent student research is left on the shelves. I plan to allocate some days during these symposia to nutrition students to showcase best practices and innovations,” she says.
Adding that, “I urge mothers and their infants to actively engage in self-care, growth-promotion, and monitoring activities to improve their own health and that of their children.”
Central to her recommendations is a call to embed nutrition services within routine health and community systems, with sustained government leadership, financing, and competent human resources.
Integration, she insists, is not achieved by guidelines alone, but through continuous engagement with frontline health workers and communities.
As graduation day approaches, Dr. Namukose’s thoughts turn outward. To frontline health workers delivering nutrition services under pressure, her message is one of respect and reassurance. Even with limited resources, the assessments they conduct, the counselling they provide, and the care they offer can change outcomes.
“Endeavor to participate in training programmes whenever available to bridge gaps in nutrition knowledge and skills, including on-the-job and rotational training to support cost-effective and efficient nutrition service delivery,” she asks.
To mothers and caregivers, she urges active engagement in self-care, growth monitoring, and nutrition programmes, especially those strengthened through digital innovation.
And to policymakers, her research offers both evidence and urgency that nutrition integration is no longer optional but foundational to maternal and child health.
When Dr. Samalie Namukose walks across the stage at Freedom Square, followed by applause, the true weight of that moment lies in health facilities where nutrition is no longer an afterthought. In mothers whose pregnancies are better supported. In infants whose growth curves bend upward, quietly, decisively.
Among the 185 PhDs conferred at Makerere University’s 76th graduation, the School of Public Health Communications Office shares her story, which is a reminder that the most transformative scholarship is not always loud. It builds patiently, between policy meetings and midnight writing, between emergencies and examiners’ comments, until it transforms systems and lives from within.
Health
Makerere Researchers Find Psychological Therapy Effective in Improving Diabetes Care in Uganda
By Nelson Bahati
Researchers from Makerere University‘s School of Psychology have found that psychotherapy intervention can improve the well-being of adults living with Type II diabetes mellitus, opening the door for integrating psychosocial support into diabetes care in Uganda.
The findings were disseminated on 16 June 2026 during a research dissemination workshop held at the Physiology Lecture Theatre at the College of Health Sciences, Mulago Hospital.
Led by Professor Peter Baguma, the study titled “The Effectiveness of Cognitive Behavioural Therapy for Diabetes Distress, Depression, Health Anxiety, Quality of Life and Treatment Adherence among Adult Patients with Type II Diabetes Mellitus” investigated whether Cognitive Behavioural Therapy (CBT), a psychological treatment that has proven effective in Western countries, could also work in the Ugandan context.
Presenting the findings, Professor Baguma said the study was motivated by the growing burden of diabetes and the psychological challenges that often accompany the disease but are rarely addressed in routine healthcare.
“Diabetes affects many people in Uganda and across the world. It kills, and those who live with it face many challenges. While psychological interventions have been developed and applied in the Western world, we did not know whether these approaches could work in Uganda. That is why we decided to undertake this study,” he said.
He explained that Cognitive Behavioural Therapy focuses on changing negative thoughts and behaviours that affect people’s wellbeing and ability to manage chronic illnesses.
The researchers sought to determine whether CBT could reduce psychological distress among diabetes patients and improve treatment outcomes.
The controlled study involved 200 adult participants with Type II diabetes mellitus. One hundred participants received the CBT intervention while another 100 formed the control group. Participants in the intervention arm attended eight counselling sessions over four months, with each session lasting between one and one-and-a-half hours.
The therapy covered several modules, including psychoeducation on diabetes, cognitive restructuring, medication adherence, problem-solving, coping strategies, physical exercise, relaxation techniques and strategies for maintaining treatment.
According to Professor Baguma, the findings showed that psychotherapy significantly improved participants’ wellbeing.
“The group that received the intervention experienced reduced stress levels and lower blood sugar levels compared to those who did not receive the therapy. We conclude that CBT is effective and should be adopted as part of diabetes care,” he said.
The study also yielded another important discovery.
“We have discovered that CBT as practised in the Western world is somewhat narrow. Their manual contains only eight elements. In Africa, we found that three additional components are necessary: effective communication between patients and health workers, goal setting, and instilling hope among patients. We call this African CBT,” Professor Baguma explained.
He added that the findings had also revealed the need to incorporate psychosocial care into the management of chronic illnesses and to train healthcare workers to address the psychological dimensions of disease.
Professor Andrew Marcel Otim, one of the co-investigators and founder of the Uganda Diabetes Association, said the study had brought to the fore an aspect of diabetes care that has long been neglected.
“There have been many efforts to address the physiological effects of diabetes, but we have largely ignored the psychological part of the disease. Yet the psychological aspect is huge,” he said.
He added that, diabetes management should go beyond medication but rather intergrate other components of care.
“Education, nutrition, exercise and self-monitoring are extremely important. Even simply knowing what to do is a very powerful intervention. Psychological distress and depression can increase blood sugar levels, so we need to help patients remain calm and hopeful,” he said.
Drawing from his experience as a clinician and educator, Professor Otim encouraged people living with diabetes to embrace physical activity.
“I tell my students and my patients to put on some music, dance, sweat and enjoy themselves. Nutrition, education and exercise remain central to managing diabetes.”
Dr. Wilber Karugahe, a counselling psychologist at Makerere University‘s School of Psychology and one of the co-investigators, said the findings demonstrate the need to integrate psychological care into the management of chronic diseases.
“A lot of studies focus on physical illness and not the psychological conditions that accompany these illnesses. This study confirms that diabetes has a significant psychological aspect and that patients need psychological interventions as part of their care,” he said.
Explaining the essence of Cognitive Behavioural Therapy, Dr. Karugahe noted that the approach helps people restructure their thoughts and behaviours.
“Imagine putting a sticker on your fridge that reminds you that some foods are not good for you and that healthier options are better. That is CBT. It helps people change the way they think and behave, and it can be used to address many behavioural challenges.”
The dissemination workshop was also attended by officials from the Ministry of Health, including Mrs. Christine Ninsiima Ahimbisibwe, Senior Programme Officer for Mental Health and Substance Abuse Control, and Mrs. Patience Butesi from the Department of Mental Health and Drug and Substance Abuse.
Mrs. Ahimbisibwe welcomed the findings and emphasised the need to integrate the study’s recommendations into Uganda’s clinical guidelines to enable healthcare workers to provide psychosocial support to patients living with chronic illnesses such as diabetes.
The human impact of the intervention was perhaps best illustrated by testimonies from participants who underwent the psychosocial training.
Tebugulwa Josephine, a retired teacher and employee at Mulago National Referral Hospital, said the intervention restored hope in her life.
“When we first joined the programme, we thought we were moving dead people. But now we have hope. I have hope of reaching 90 years. We were taught how to exercise and take care of ourselves. Even our families no longer treat us as sick people because we can now walk and participate in daily activities.”
Another participant, Bunje Joice, described the intervention as life-changing.
“People had already given up on me and were waiting for me to die. I could hardly walk, but now I can walk long distances and my diabetes levels have improved. Physical exercise has become my first medicine.”
Kyomuhendo Kate said the programme helped her manage stress and improve her health.
“I was so stressed and my legs were swelling, but after attending the treatment sessions, I am now much better.”
Sebuliba Bernard said the training transformed how he manages his condition.
“They taught us how to exercise, how to live and how to eat. If we follow what we were taught, we can change our lives.”
Based on the findings, the researchers recommended scaling up the intervention to district, regional and national referral hospitals, integrating psychosocial interventions into the training of health workers, and undertaking policy reforms to strengthen mental health support for people living with chronic illnesses.
The study was funded by the Makerere University Research and Innovations Fund (Mak-RIF) and brought together researchers from psychology and medicine, including co-investigators: Dr. Fredrick Nakwagala, Dr. Wilber Karugahe and Dr. Anne Ampaire.
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