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 women’s lives.
A new study titled “Is choosing self-injectable contraception associated with enhanced contraceptive agency? Findings from a 12-month cohort study in Uganda” 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 woman’s 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 0–3), 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. “With predictable national financing and reliable commodity supply chains, DMPA-SC can reach more women and be fully integrated into Uganda’s health system, strengthening both access and community-level service delivery’’ 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 women’s 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 “how to inject” 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.
Community-led innovations across Uganda are improving access to healthcare, reducing financial barriers and responding to needs that conventional services do not always reach. The Uganda Case Compendium 2026, published by the Social Innovation in Health Initiative (SIHI) Uganda Hub at Makerere University School of Public Health, documents these solutions, their results and opportunities for scale.
Established in 2017, SIHI Uganda identifies, studies and supports locally developed health innovations. By 2026, the Hub had documented 42 projects through research examining their impact, enabling factors and scalability. It has also convened seven national stakeholder workshops and established a fellowship programme that equips innovators with skills in project management, research, entrepreneurship, communication, fundraising and environmental impact assessment.
The compendium presents evidence of reach and impact. The Ishaka Health Plan has enrolled more than 5,000 people in community-based health insurance, enabling over 4,000 members to access healthcare annually. In Kiryandongo, the Opit Kic Widows Group trained 402 volunteers who have provided health information to more than 6,030 refugee and host-community households. Among people living with HIV who received group support psychotherapy, 98% were depression-free after six months. In Mayuge, two sickle cell clinics have been established, 12,500 children screened and 282 enrolled in continuing care, contributing to a reported 53% increase in enrolment.
Spanning maternal and child health, HIV, mental health, disability, gender-based violence, health financing, diagnostics and palliative care, the compendium provides evidence to inform investment, policy uptake and the responsible scale-up of locally grounded solutions.
Makerere University School of Public Health invites applications for two postdoctoral research fellowships under the ACT-PREP Project, a five-year, Africa-led initiative funded by the Global Health EDCTP3 Joint Undertaking. The project seeks to strengthen sustainable, context-responsive research capacity for epidemic preparedness and response across sub-Saharan Africa.
Responsibilities
Each fellowship is a full-time, 18-month appointment based at MakSPH in Kampala. Applicants must apply for one position only. Eligible candidates should be early-career researchers who are nationals of, or based in, sub-Saharan Africa and hold a PhD in a relevant discipline or have completed a post-Master’s Field Epidemiology Training Programme. Applicants should demonstrate a record of peer-reviewed publication and research dissemination. Experience in policy review, qualitative or mixed-methods research and stakeholder engagement is an advantage. Successful fellows will receive mentorship from senior researchers, collaborate with an international consortium of African and European institutions, and contribute to policy-relevant research on epidemic preparedness. A stipend commensurate with qualifications and experience will be provided. Applications should include a motivation letter of up to two pages, a two-page research concept, a detailed curriculum vitae with a publication list and contacts for at least two referees, and at least one recommendation letter.
Qualifications and Desirable Qualities
Eligible candidates should be early-career researchers who are nationals of, or based in, sub-Saharan Africa and hold a PhD in a relevant discipline or have completed a post-Master’s Field Epidemiology Training Programme.
How to Apply
Submit applications to recruitment@musph.ac.ug by 7 August 2026, quoting “ACT-PREP Postdoc – Position 1 or 2” in the email subject line. Interviews are expected around 14 August 2026 in Kampala.
Qualified women and applicants from under-represented groups are strongly encouraged to apply.
Download the full call for detailed requirements and application guidance.
The Makerere University College of Health Sciences (MakCHS) on July 10, 2026, welcomed senior six science students from Ngora High School and Wiggins Secondary School to an inspiring Career Fair aimed at guiding them on careers in health sciences and introducing them to the wide range of academic programmes offered by the College.
The event brought together students pursuing Physics, Chemistry, Biology (PCB) and Biology, Chemistry, Mathematics (BCM), providing them with a unique opportunity to interact with the College leadership, tour laboratories and teaching facilities, and learn first-hand about careers in medicine and other health science disciplines.
Welcoming the students, the College Principal, Prof. Bruce Kirenga, described the College of Health Sciences as one of Africa’s oldest and most distinguished medical schools, with a legacy spanning more than a century.
“We started in 1924, making us one of the oldest medical schools on the continent. You have made the right decision to visit Makerere, and we are delighted to welcome you,” he said.
Prof. Kirenga commended the school administrators and teachers for organizing the visit, noting that exposing learners to university environments early helps them make informed career choices. He explained that the College introduced the Open Day concept after receiving numerous requests from schools seeking career guidance visits.
Prof. Bruce Kirenga.
He congratulated the students for choosing science subjects, describing science as the foundation for solving society’s most pressing challenges.
“You have already made one of the most important decisions by choosing to become scientists. Even more importantly, you have chosen life sciences—a field dedicated to preserving and improving life,” he remarked.
The Principal emphasized that careers in life sciences extend far beyond medicine, encouraging students to remain open-minded as they consider their future.
“Everything that has life requires professionals to keep it healthy—from human beings and animals to crops and the environment. The opportunities are immense, including agriculture, veterinary medicine, biomedical sciences, public health and many other emerging fields.”
A section of senior six students and their students at the career fair.
He also advised students not to limit themselves to only one academic programme during university applications, recalling instances where highly qualified students narrowly missed admission because they selected only one course.
“Remain open to the opportunities available. Medicine is an excellent profession, but there are many other programmes that are equally rewarding and are shaping the future of healthcare and scientific innovation,” he said.
Prof. Kirenga further encouraged the students to embrace lifelong learning, reminding them that scientific knowledge remains valuable regardless of the career path they eventually pursue.
Addressing the students, the Dean of the School of Medicine, Prof. Annette Nakimuli, acknowledged the growing competition for admission into medical programmes and urged learners to work hard while keeping an open mind about the diverse opportunities available within health sciences.
Prof. Annettee Nakimuli.
She explained that admission into the Bachelor of Medicine and Bachelor of Surgery (MBChB) programme has become increasingly competitive due to the rising number of high-performing applicants.
“This year we witnessed unprecedented competition for government sponsorship, with many applicants scoring triple A at Advanced Level and outstanding grades at Ordinary Level. That tells you that you must prepare yourselves to excel academically,” she said.
Prof. Nakimuli noted that while many students aspire to become medical doctors, the health sector today offers numerous innovative programmes that are equally important.
“There are many programmes that parents, teachers and students are still not familiar with. Biomedical Engineering, for example, is one of the exciting fields driving the future of healthcare, yet many students overlook it because they focus only on medicine.”
Students and Teachers pose for a group photo with CHS staff.
She encouraged students to explore emerging disciplines that combine medicine, engineering, technology and research, noting that the future of healthcare increasingly depends on multidisciplinary professionals.
The Dean also introduced students to the structure of the School of Medicine, explaining that it comprises twelve academic departments and two specialised units covering a broad spectrum of clinical disciplines, including Internal Medicine, Surgery, Obstetrics and Gynaecology, Orthopaedics, Ophthalmology, Ear, Nose and Throat (ENT), Family Medicine, Anaesthesia and Critical Care, among others.
She explained that students are trained by specialists across these disciplines to become competent general practitioners before pursuing further specialization.
Prof. Erisa Mwaka, the Chair of the Department of Human Anatomy, shared with the students about the School of Biomedical Sciences (SBS). He said the school is one of the four schools that make up the Makerere University College of Health Sciences (MakCHS). As the foundation of medical education, the School provides students with a comprehensive understanding of the biological and molecular sciences that underpin modern healthcare, disease prevention, diagnosis and treatment.
Prof. Erisa Mwaka with students in one of the teaching spaces.
The School comprises several departments, including:
Human Anatomy
Biochemistry
Physiology
Pharmacology and Therapeutics
Pathology
Microbiology
Medical Illustration
The School offers undergraduate programmes such as the Bachelor of Science in Biomedical Sciences, which equips students with strong laboratory, research and analytical skills, and the Bachelor of Science in Biomedical Engineering, an interdisciplinary programme that integrates engineering, medicine and technology to develop innovative healthcare solutions.
At postgraduate level, the School offers a wide range of master’s and doctoral programmes, including Human Anatomy, Physiology, Pharmacology, Bioinformatics, Immunology and Clinical Microbiology, Health Bioethics, Medical Illustration, Pathology and other biomedical specializations that prepare graduates for careers in research, academia, diagnostics, biotechnology and the pharmaceutical industry. The school also offers a wide range of diploma courses.
Dr. Isaac Magulu Kimbowa from the Department of Pharmacology and Therapeutics (Right) and colleagues interact with the students.
Throughout the Career Fair, students interacted with faculty members, toured laboratories and learning facilities, and received guidance on university admission, academic programmes and career prospects within the health sciences.
The Career Fair forms part of the College’s broader outreach programme aimed at nurturing the next generation of healthcare professionals by exposing learners to university life and equipping them with the information needed to make informed academic and career decisions.