Health

Study Alert: Power in Her Hands; Why Self-Injectable Contraception May Be a Game Changer for Women’s Agency in Uganda

Published

8 months ago

February 10, 2026

Mak Editor

The Self-injectable contraception, known as DMPA-SC, disrupts the provider-client model by shifting care from the clinic to the individual woman.

_{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 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.

Read the full study here: https://www.contraceptionjournal.org/article/S0010-7824(26)00003-X/fulltext

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Health

PhD Fellowship Opportunity: NETOMA Study

Published

1 week ago

October 12, 2026

Mak Editor

Dr. Henry Komakech (centre) stands with fellow MakSPH PhD graduands at Makerere University’s 76th Graduation Ceremony (L–R): Dr. Olivia Nakisita, Dr. Aber Harriet Odonga, Dr. David Lubogo, Dr. Samalie Namukose, Dr. Moses Ntaro and Dr. Jimmy Osuret. February 25, 2026, Freedom Square, Makerere University. Makerere University School of Public Health Communications Office, Graduation Profiles Series, 76th Graduation Ceremony, Dr. Henry Komakech, “Effects of the Repatriation of Refugees on the Health Services of the Host Populations in the West Nile Districts of Arua, Moyo, and Adjumani,” Kampala Uganda, East Africa.

Makerere University School of Public Health invites applications for a PhD fellowship under the Wellcome Trust-supported NETOMA study, which examines the coexistence of health worker shortages and unemployment among qualified health professionals in Africa.

The successful candidate will undertake doctoral research involving ethnographic fieldwork and qualitative analysis of health workers’ professional identities, employment experiences and livelihoods. Applicants should hold a Master’s degree in Anthropology, Sociology, Development Studies, Political Economy or a closely related discipline, with training in qualitative research methods.

Application deadline: 21 October 2026

Full details and application instructions: https://sph.mak.ac.ug/careers/?view_job=21462

Health

Makerere-Mulago Host Oncology Specialist – Professor Dr. Thiha AUNG

Published

1 week ago

October 12, 2026

Elvis Lubanga

Professor Dr. Thiha AUNG during his interview with the Public Relations Office on 7th October 2026. Public Relations Office interview with Professor Dr. Thiha AUNG, German oncology reconstruction specialist, surgeon, trainer at the Deggendorf Institute of Technology (THD), and researcher on cancer from the Deggendorf Institute of Technology (DIT), Germany. 7th October 2026, Main Building, Makerere University, Kampala Uganda, East Africa.

Through a European Union (EU) funded initiative, Makerere University and Mulago Hospital are hosting a German oncology reconstruction specialist Professor Dr. Thiha AUNG. AUNG is a surgeon, trainer at the Deggendorf Institute of Technology (THD), and researcher on cancer from the Deggendorf Institute of Technology (DIT), Germany.

With his international expertise in oncology and medical management roles at his home institution, his visit is a valuable addition to Uganda’s capacity building efforts in medical advancement.

Prof. Aung who arrived in Uganda in late September 2026 and has since then conducted free identified patient specialised surgeries and training for locals. These are expected to span two weeks. For the period, his service intersects medical expertise and humanitarian efforts.

This is not Prof. Aung’s first time in the country; his first major visit was in 2023, when he performed life-changing free surgeries on early patients. He then made medical history in June 2024 when he arrived to perform Africa’s first-ever lymph node transplant at Mulago Hospital.

It was against this background that the Makerere Public Relations Office engaged him in an exclusive interview to share his philosophy on medical service, his experiences in oncology reconstruction, and his unwavering belief that passion and dedication rather than just resources are the true drivers of sustainable medical progress.

Transforming Lives Through Oncology Reconstruction

At the heart of his mission through the ERASMUS – Oncology/Lymphedema project, is the treatment of lymphedema, a condition often referred to as elephantiasis.

In Europe, such surgeries can cost between 80,000 and 100,000 euros, making them inaccessible to many.

Thankfully, Professor and his team, including some of his post graduate students like Anna Friedrich (B.Sc) and Sophia Waser (B.Sc., PA) from the Institute of Medical Science and Engineering, have once again brought this specialised care to Uganda pro bono.

Professor AUNG with the article author. Public Relations Office interview with Professor Dr. Thiha AUNG, German oncology reconstruction specialist, surgeon, trainer at the Deggendorf Institute of Technology (THD), and researcher on cancer from the Deggendorf Institute of Technology (DIT), Germany. 7th October 2026, Main Building, Makerere University, Kampala Uganda, East Africa. — ***Professor AUNG with the article author.***

He highlights the story of a teacher who, after receiving surgery, regained her quality of life and returned to the classroom. For him, the impact is exponential. “You change one life, but this person changes a lot in the community.”

This shift from individual surgery to the long-term wellbeing of the community, reinforces the local impact of these services.

Professor AUNG’s Personal Conviction

The professor confessed that inherently, he commands himself that beyond knowledge, true progress is driven by passion and will rather than resources.

He does not agree with those that think money and resources are the sole prerequisite for change in the medical world, stating, “you cannot change with money only.” Rather, he upholds the importance of personal decision and commitment.

When discussing the challenges of working in resource-limited settings, he maintains a simple, direct explanation “it’s always beyond the money.”

Ultimately, the Professor believes that if he can provide the spark, his students and patients can carry through with the same flame for significant change.

Motivation to Serve in Uganda

When asked about his inspiration for entering the field and now volunteering to work in Uganda, he explained that his primary goal was always to serve others. “That’s why I finished my medical school to help as many people as possible with my skills.”

Professor AUNG gestures during the interview. Public Relations Office interview with Professor Dr. Thiha AUNG, German oncology reconstruction specialist, surgeon, trainer at the Deggendorf Institute of Technology (THD), and researcher on cancer from the Deggendorf Institute of Technology (DIT), Germany. 7th October 2026, Main Building, Makerere University, Kampala Uganda, East Africa. — ***Professor AUNG gestures during the interview.***

He views his medical expertise not as a tool for the privileged, but as a universal resource., “People are all the same, their anatomy is the same. So, I can help all these people pretty well,” Prof AUNG remarked.

His approach is motivated by a pay it forward dogma where treating a single patient creates a broader societal benefit. He illustrates this through his work with patients who, after surgery, are able to return to their professions like the teacher earlier mentioned.

Tips for Medical Professionals working in Uganda

As a foundation for professional growth, the Professor advised medical professionals working in Uganda to prioritise genuine interest in their work because he believes it is “the most important…” for “if you are interested, you will go far in the profession.”

He further reinforced the human capacity point, noting, “no matter what kind of equipment you have… it all depends on the people operating them and the patient.”

Professor AUNG concluded by encouraging doctors to overcome resource fears through action, stating, “If you want to create impact or change, you do.”

Dr. AUNG is part of the Lymphoedema Warriors Association (LWAU) in Uganda. He describes it as a grassroots organisation and commends them for “leveling the grond”. He reiterated his commitment to work with the organisation in reviewing patient reports to determine the best course of treatment.

Health

Makerere Public Health Showcases EU Funded Research

Published

2 weeks ago

October 8, 2026

Allan Ainematsiko

Makerere University’s School of Public Health (MakSPH) showcased research, training and international partnerships supported through European Union funding during the EU Uganda Research and Study Fair 2026 held at Makerere University.

The fair brought together students, researchers, academics, government representatives and development partners to explore opportunities in education, research, innovation and international collaboration, while celebrating 50 years of partnership between Uganda and the European Union.

Through its exhibition, MakSPH highlighted research and capacity building initiatives addressing public health challenges including infectious diseases, non communicable diseases, health systems, climate change and pandemic preparedness.

18 EU funded projects supported at MakSPH

Prof. Rhoda Wanyenze, Dean of Students, School of Public Health, said the School has benefited from 18 EU funded projects over the past five years, supporting research and training across several areas of public health.

Prof. Rhoda Wanyenze explains MakSPH research projects to Acting Minister of Education and Sports Dr John Chrysostom Muyingo during a tour of exhibition stands at the EU Uganda Research and Study Fair.

She said the projects have contributed to the training of PhD researchers and the development of research addressing infectious diseases and prevention, non communicable diseases, health systems, climate change and health.

Prof. Wanyenze also highlighted a new five year programme which started in 2021 that is aiming at strengthening capacity for research on pandemic preparedness and response, including outbreaks such as Ebola.

***Stella Kakeeto interacts with students during the EU Uganda Research and Study Fair***

Another programme being undertaken with the Ministry of Health and Karolinska Institute focuses on improving maternal health while also addressing adolescent pregnancy and the health of mothers and children.

She described partnerships as critical to advancing science and innovation, noting that collaboration allows researchers in Africa and Europe to share knowledge and strengthen the impact of research on communities.

Research partnerships strengthen innovation

Prof. Robert Wamala, Director of the Directorate of Research, Innovation and Partnerships at Makerere University, said the exhibition provided an opportunity to showcase EU funded projects across the University.

He noted that the School of Public Health alone has more than 18 such projects, while other colleges also have several EU supported initiatives.

One of the projects showcased was PREPARE TID, a partnership aimed at developing rapid diagnostic technologies for emerging and re emerging infectious diseases.

Prof. Julius Okuni, Associate Professor of Veterinary Pathobiology and Molecular Diagnostics at Makerere University, said the project brings together universities, industries and other organisations from Africa and Europe.

The project is working to develop technologies that can quickly identify pathogens responsible for outbreaks such as Ebola, Rift Valley fever and Crimean Congo haemorrhagic fever.

According to Prof. Okuni, Makerere is involved in field and laboratory work to test and refine the technologies before they can be delivered to end users.

Fair provides platform for research visibility

For researchers at MakSPH, the fair also provided an opportunity to increase the visibility of ongoing research and create new connections with researchers, policymakers and potential funders.

Dr. Raymond Tweheyo, Honorary Lecturer and Senior Research Fellow in the Department of Health Policy, Planning and Management, said such exhibitions allow researchers to share their work and identify others working on related challenges.

***Dr. Raymond Tweheyo and Assoc. Prof. Angelina Kakooza Mwesigye at the exhibition***

He cited the CONNECT for Health project, which focuses on transforming non-communicable disease care in Uganda through collaboration with partners across several countries.

Dr. Tweheyo said exhibitions can help researchers connect with policymakers, civil society organisations and other partners who can contribute to translating research into practical solutions.

Assoc. Prof. Angelina Kakooza Mwesigye, Associate Professor and Child Neurologist at Makerere University College of Health Sciences, also emphasised the importance of exposing young people to international research opportunities.

She said the long standing Uganda Europe partnership provides opportunities for the next generation of researchers to learn, build networks and prepare for future research collaborations.

The School of Public Health’s participation highlighted the role of international partnerships in strengthening research capacity, supporting innovation and developing evidence based responses to Uganda’s public health challenges.