Faculty of Health Sciences

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A day in the life of a Ugandan doctor
(Daily Monitor, 2018-05-06) Kaggwa, Andrew
Dr. Joel says he has several challenges ranging from little pay to long working hours.
A model to strengthen utility of quality pharmaceutical health systems data in resource-limited settings
(SAGE Publications, 2020) Kagoya, Harriet Rachel; Kibuule, Dan; Rennie, Timothy William; Mitonga, Honoré Kabwebwe
Background: Limited utility of quality health data undermines efforts to strengthen healthcare delivery, particularly in resource-limited settings. Few studies model the effective utility of quality pharmaceutical information system (PIS) data in sub-Saharan Africa, typified with weak health systems. Aim: To develop a model and guidelines for strengthening utility of quality PIS data in public healthcare in Namibia, a resource-limited setting. Methods: A qualitative model based on Dickoff et al. practice-oriented theory, Chinn and Jacobs’ systematic approach to theory, and applied consensus techniques. Data from nationwide studies on quality and utility of PIS data in public healthcare conducted between 2018 and March 2020 informed the development of the model concepts. Pharmaceutical and public health systems experts validated the final model. Results: Overall, four preliminary national studies that recruited 58 PIS focal persons at 38 public health facilities and national level informed the development of four model concepts. The model describes concepts on access, management, dissemination, and utility of quality PIS data. Activities to implement the model in practice include grass-root integration of real-time automated pharmaceutical intelligence systems to collect, consolidate, monitor, and report PIS data. Strengthening coordination, human resources, and technical capacity through support supervisory systems at grass-root facilities are key activities. PIS focal persons at health facility and national level are agents to implement these activities among recipients, that is, healthcare professionals at points of care. Guidelines for implementation of the model at point of care are included. Experts described the model as clear, simple, comprehensive, and integration of pharmaceutical intelligence systems at point of care as novel and of importance to enhance utility of quality PIS data in resource-limited settings. Conclusion: While utility of quality PIS data is limited in Namibia, advantages of the model are encouraging, toward building resilient pharmaceutical intelligence systems at grass roots in resource-limited countries, where there are not only weak health systems, but high burden of misuse of medicines. Keywords: Data, health, information systems, pharmaceutical, quality, utility
Abortion adverts have an impact on maternal health
(Daily Monitor, 2018-02-10) Jjuuko, Dennis
The city is awash with adverts for legal abortion without a clear indication of what is legal and what is not. This may have harmful impact on girls and women that need this service in unregulated environment, thereby ruining Uganda's maternal health, sexual and reproductive health record, together with the gender agenda.
Acceptability of immediate CPAP for preterm infants in the delivery room to mothers, caregivers and healthcare workers in a low-resource setting: a qualitative study
(BMC Pediatrics, 2025) Napyo, Agnes; Nakiyemba, Alice; Muduwa, Martha; Ssenkusu, M. John; Okello, Francis; Hagmann, Cornelia; Namuyonga, Judith; Hewitt-Smith, Adam; Loe, Kate; Abongo, Grace; Amorut, Denis; Wandabwa, Julius; Olupot-Olupot, Peter; Burgoine, Kathy
Background: Preterm birth is the leading cause of childhood mortality, with respiratory distress syndrome as the predominant aetiology. Initiating continuous positive airways pressure (CPAP) immediately after birth may reduce CPAP failure, the need for ventilation, and surfactant use. In low-resource settings, without ventilation or surfactant, immediate CPAP could significantly reduce preterm mortality. We explored the experiences, perceptions, and acceptability of immediate CPAP among parents, caregivers, and healthcare workers in a Ugandan hospital. Methods: This qualitative study (April 2023–April 2024) was nested in a pilot randomised controlled trial of immediate delivery room CPAP for very low birthweight infants (VLBW, <1500 g) at a government hospital in Uganda. Data were collected through 12 key informant interviews and focus group discussions with 36 healthcare workers, and 37 parents and caregivers of enrolled infants. We applied deductive framework analysis using the Theoretical Framework of Acceptability (TFA) and coded transcripts using Nvivo 12. Results: Regarding affective attitude, healthcare workers, mothers and caregivers expressed positive feelings towards immediate CPAP. For perceived effectiveness, healthcare workers described immediate CPAP as a prophylactic intervention that reduces the severity of complications and shortens hospital stays, while mothers and caregivers believed it expands the infant’s lungs and increases chances of survival. Concerning burden, healthcare workers highlighted that successful implementation depends on a committed neonatal team, multidisciplinary team collaboration, adequate staffing, active maternal involvement, and the availability of sufficient CPAP machines. Opportunity costs were evident where limited staffing forced healthcare workers to choose between prioritising the mother or the infant. Under ethicality, cultural beliefs, religious views, and fear were identified as influential factors in decision making around immediate CPAP. Regarding intervention coherence, healthcare workers, mothers, and caregivers demonstrated a good understanding of the purpose and process of immediate CPAP. Finally, self-efficacy was linked to the availability of adequate staff, training, and necessary equipment to confidently engage in the intervention. Conclusions Immediate CPAP was found to be acceptable among healthcare workers and mothers/caregivers. Successful implementation requires adequate staff training, comprehensive health education, adequate human resources, and sufficient availability of CPAP machines. Trial registration Study is registered on Pan African Clinical Trials Registry (PACTR) PACTR202208462613789. Keywords Preterm, Very low birthweight, VLBW, Africa, Neonatal, CPAP, Respiratory distress syndrome, Low-resource setting, Acceptability, Barriers, Facilitators, Attitude
Acceptability of minimal invasive tissue sampling (MITS) for stillbirths in Eastern Uganda
(PLOS One, 2025) Chebet, Martin; Burgoine, Kathy; Rujumba, Joseph; Okalany, Regina Akwi Noela; Olupot-Olupot, Peter; Tylleskär, Thorkild; Weeks, D. Andrew; Napyo, Agnes; Mukunya, David; Engebretsen, Marie S. Ingunn
Background In sub-Saharan Africa, stillbirth rates remain high. To design effective interventions to reduce stillbirths, accurate determination of their aetiology is important. Conventional autopsy for accurate confirmation of cause is not acceptable or feasible in several societies in sub-Saharan Africa; minimal invasive tissue sampling (MITS), is a recently developed, less invasive alternative. In this study, we explored the acceptability of MITS in the community and among healthcare workers in Uganda to guide the future implementation. Methods A qualitative study was done among community members and healthcare workers in Mbale in Eastern Uganda. We undertook in-depth interviews and focus group discussions in English or local languages. Interviews were audio-recorded, transcribed as necessary prior to formal content analysis. The themes were organised using NVivo software and presented according to Sekhon’s theoretical framework. Results Overall, participants preferred the idea of MITS to conventional autopsy because of the perception that it was fast, maintained the facial appearance and kept the body intact. It was thought that the procedure would improve the detection of the cause of stillbirths, which in turn would help to prevent future stillbirths. It would also resolve conflicts in the community between community members or the women and the healthcare workers about the cause of a stillbirth. It was suggested that some community members may not approve of MITS because of their religious beliefs; the fear that the body parts may be extracted and stolen for witchcraft or organ donation; and a lack of trust in the healthcare system. To implement the procedure, it was suggested that extensive community sensitization should be done, space limitations in healthcare facilities overcome, healthcare workers should be trained and limited human resource should be addressed. Conclusion The implementation of MITS in Mbale, Eastern Uganda, is likely to be acceptable given sufficient training and sensitisation.
Access to safe surgery and anesthesia still rare in Africa.
(Daily monitor, 2018-05-23) Varghese, Asha
Africa is rising according to various economic analysts. the rise brings with it an increase in urbanization and a population influx in the continents big cities. the streets of Abidjan , Conakary Kinshasa and Nairobi are bustling with all sorts of activity.
Activities in Namibia to limit the impact of COVID-19 versus Europe and Iran and the implications for the future
(2020) Kibuule, Dan; Nambahu, Lahya; Sefah, Israel Abebrese; Kurdi, Amanj; Thi Phuong, Thuy Nguyen; Kwon, Hye-Young; Godman, Brian
Introduction and aims: Considerable differences in prevalence and mortality rates from COVID-19, with higher rates among European countries and Iran versus African and Asian countries in part due to early and extensive prevention measures. There has been considerable controversy surrounding hydroxychloroquine, with resultant misinformation increasing prices and suicides. Growing concerns also with unintended consequences of lockdown and other measures. Consequently, a need to investigate changes in utilisation and prices of relevant medicines during the pandemic in Namibia with its proactive approach to guide future decision making. Community pharmacists play a key role in this respect. Methods: Questionnaire survey among 55 pharmacists from March to end June 2020. Results: Proactivity among some pharmacists to plan for the pandemic with increased stocks. Limited increases in utilisation of antimalarials and antibiotics in Namibia versus other countries enhanced by restrictions on self-purchasing in Namibia, reflected in limited price rises and shortages. Higher use of Vitamin C/ immune boosters in Ghana and Nigeria versus Namibia reflected in higher price rises, with increased utilisation and prices of PPE across all countries. Encouragingly lower increases in herbal medicines in Namibia versus Ghana. Concerns though with unintended consequences. Conclusion: Encouraging to see continued low prevalence and mortality rates from COVID-19 in Namibia and limited increase in utilisation of antimalarials and antibiotics with prescribing restrictions. Concerns with rising rates of malaria and other infectious diseases following lockdown need addressing. Pharmacists can help plan for the future, educate the public during pandemics, help with vaccinations and general medicines management.
Airtel Uganda conducts free health camp in Arua.
(Daily Monitor, 2018-03-06) Airtel Uganda
Last month, Airtel Uganda continued its efforts to boost socio-economic development in North west Uganda by holding a health camp attracted residents of Arua district and surrounding communities who move long distances to receive free health care services.
Alignment of standard treatment guidelines with medicine use indicators in a limited-resource setting:
(JPHSR, 2020) Kagoya, Harriet Rachel; Rennie, Timothy William; Kibuule, Dan; Mitonga, Honore Kabwebwe
Background Standard treatment guidelines (STGs) are a critical public health tool for promoting rational use of medicines. No studies have evaluated alignment of STGs with medicine use indicators especially in low and-middle-income countries (LMICs) with disproportionate burden of disease and irrational medicine use. Objective To determine the level of alignment of Namibia’s STGs with WHO medicine use indicators. Methods A descriptive policy analysis of alignment of Namibia’s STGs and WHO medicine use indicators. Thirty-two conditions/diseases prevalent and managed at primary healthcare level were included in the study of alignment of the STGs with two WHO medicine use indicators in terms of average number of medicines/condition (polypharmacy, WHO target <2) and antibiotic prescribing (WHO target <30%) after adjusting for estimated encounters per condition. Data were analyzed using (SPSSv24 software, IBM Corporation, NY) to determine frequencies, percentages and means. Key findings Of the 32 conditions/diseases studied, 41% had three or more medicines per condition indicated in the STGs. The weighted minimum and maximum average number of medicines/condition/encounter in the STGs were 2.62 and 2.78 respectively. Antibiotics were indicated for 72% (weighted per encounter = 75%) of the 32 conditions. Conditions/diseases of the urogenital system had the highest antibiotics indicated in the STGs (100%); respiratory (80%); ENT (80%); gastrointestinal (33%) before weighting conditions for estimated patient encounters, while ENT conditions had the highest antibiotics (32%) after weighting. Conclusions Alignment of Namibia STGs and medicine use targets is sub-optimal. The STGs have a high indication of antibiotics and polypharmacy. Misalignment is the main contributor to sub-optimal medicine use indicators with respect to average number of medicines and antibiotics. Countries should review their STGs and align with medicine use indicators to enhance rational medicine use and fight antimicrobial resistance. This article provides guidance for aligning STGs with medicine use indicators. Keywords antimicrobial resistance; indicators; low-and-middle income countries; medicine use; standard treatment guidelines (STGs)
An analysis of hospital pharmacy practice in Namibia, based on FIP’s Basel Statements
(Oxford, 2021) Bare, Andrea; Ivey, Marianne; Kibuule, Dan; Stevenson, James G.
Background Sub-Saharan Africa, a region faced with a double challenge of infectious and noncommunicable diseases requires strengthening of hospital pharmacy practice to improve treatment outcomes and patient safety. Objectives The objectives of this study were to assess the current state of pharmacy practice in hospitals in Namibia and to identify opportunities for expanding pharmacists’ role in addressing public health challenges and improving medicines use outcomes. Methods A survey utilized FIP’s self-assessment tool to evaluate current hospital pharmacy practice in Namibia against best practices articulated in the Basel Statements. The study was conducted among hospital pharmacists across Namibia. Quantitative and qualitative data were analysed using descriptive statistics and thematic analysis. Key findings: The study was conducted in 24 hospital pharmacies across Namibia, the majority of which were public facilities (67%). Overall, current hospital pharmacy practice activities are focused on medicine procurement, preparation and distribution. The main barriers to optimal hospital pharmacy services are associated with limited human resources and collaboration across healthcare providers, as well as policy gaps. Conclusions There is a strong desire among hospital pharmacists to expand their contributions to improving medicines outcomes and solving public health problems. Namibia’s pharmacy educational system is a strength and should be utilized to continue advancing hospital pharmacy practice and medicines use. Therapeutics committees are usually part of each hospital’s structure and can be very effective for hospital-based policy change. The opportunity exists to optimize pharmacists’ contributions by utilizing the local therapeutics committees in combination with the educational system to advance hospital pharmacy practice in Namibia. Keywords: Namibia; hospital pharmacy; Basel Statements
Annona muricata silver nanoparticles exhibit strong anticancer activities against cervical and prostate adenocarcinomas through regulation of CASP9 and the CXCL1/CXCR2 genes axis
(IOS Press, 2021) Gavamukulya, Yahaya; Mainab, Esther N.; El-Shemy, Hany A.; Merokac, Amos M.; Kangogo, Geoffrey K.; Magomab, Gabriel; Wamunyokoli, Fred
BACKGROUND: Green synthesized nanoparticles have been earmarked for use in nanomedicine including for the development of better anticancer drugs. OBJECTIVE: The aim of this study was to undertake biochemical evaluation of anticancer activities of green synthesized silver nanoparticles (AgNPs) from ethanolic extracts of fruits (AgNPs-F) and leaves (AgNPs-L) of Annona muricata. METHODS: Previously synthesized silver nanoparticles were used for the study. The effects of the AgNPs and 5-Fluorouracil were studied on PC3, HeLa and PNT1A cells. The resazurin, migration and colonogenic assays as well as qRT-PCR were employed. RESULTS: The AgNPs-F displayed significant antiproliferative effects against HeLa cells with an IC50 of 38.58 g/ml and PC3 cells with an IC50 of 48.17 g/ml but selectively spared normal PNT1A cells (selectivity index of 7.8), in comparison with first line drug 5FU and AgNPs-L whose selectivity index were 3.56 and 2.26 respectively. The migration assay revealed potential inhibition of the metastatic activity of the cells by the AgNPs-F while the colonogenic assay indicated the permanent effect of the AgNPs-F on the cancer cells yet being reversible on the normal cells in contrast with 5FU and AgNPs-L. CASP9 was significantly over expressed in all HeLa cells treated with the AgNPs-F (1.53-fold), AgNPs-L (1.52-fold) and 5FU (4.30-fold). CXCL1 was under expressed in HeLa cells treated with AgNPs-F (0.69-fold) and AgNPs-L (0.58-fold) and over expressed in cells treated with 5FU (4.95-fold), but the difference was not statistically significant. CXCR2 was significantly over expressed in HeLa cells treated with 5FU (8.66-fold) and AgNPs-F (1.12-fold) but under expressed in cells treated with AgNPs-L (0.76-fold). CONCLUSIONS: Here we show that biosynthesized AgNPs especially AgNPs-F can be used in the development of novel and better anticancer drugs. The mechanism of action of the AgNPs involves activation of the intrinsic apoptosis pathway through upregulation of CASP9 and concerted down regulation of the CXCL1/ CXCR2 gene axis. Keywords: Silver nanoparticles, HeLa, PC3, PNT1A, CASP9, CXCL1/CXCR2
Awareness of, responsiveness to and practice of patients’ rights at Uganda’s national referral hospital
(Sabinet, 2013) Kagoya, Harriet Rachel; Kibuule, Dan; Mitonga-Kabwebwe, Honoré; Ekirapa-Kiracho, Elizabeth; Ssempebwa, John C.
Background: The realisation of patients’ rights in resource-constrained and patient-burdened public health care settings in Uganda remains an obstacle towards quality health care delivery, health careseeking behaviour and health outcomes. Although the Uganda Patients’ Charter of 2009 empowers patients to demand quality care, inequitable access and abuse remain common. Aim: The study aimed to assess level of awareness of, responsiveness to and practice of patients’ rights amongst patients and health workers (HWs) at Uganda’s national referral hospital, Mulago Hospital in Kampala. Methods: A three-phase cross-sectional questionnaire-based descriptive survey was conducted amongst 211 patients, 98 HWs and 16 key informants using qualitative and quantitative data collection methods. The study was conducted in May–June 2012, 2.5 years after the launch of the Uganda Patients’ Charter. Results: At least 36.5% of patients faced a challenge regarding their rights whilst seeking health care. Most of the patients (79%) who met a challenge never attempted to demand their rights. Most patients (81.5%) and HWs (69.4%) had never heard of the Uganda Patients’ Charter. Awareness of patients’ rights was significantly higher amongst HWs (70%) than patients (40%) (p < 0.01). Patients’ awareness was associated with education level (c2 = 42.4, p < 0.001), employment status (c2 = 33.6, p < 0.001) and hospital visits (c2 = 3.9, p = 0.048). For HWs it was associated with education level (c2 = 155.6, p < 0.001) and length of service (c2 = 154.5, p <0.001). Patients feel powerless to negotiate for their rights and fear being discriminated against based on their ability to bribe HWs with money to access care, and political, socio-economic and tribal status. Conclusion and recommendations: Awareness of, responsiveness to and practice of patients’ rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel, multichannel, patient-centred approach that incorporates social services and addresses intrinsic patient, HW and health system factors to strengthen patients’ rights issues at the hospital.
Be aware of UTIs
(Daily monitor, 2018-05-27) Nakibuuka, Beatrice
While at campus, RITAH KYOMPIIRE suffered recurrent UTIs almost three times a year. She would get treatment, and the infection would clear in a week, but because she was using a dirty toilet seat, she kept picking up the bacteria from the toilet seat.
Best feeding for diabetics.
(Daily monitor, 2018-05-26) Nakibuuka, Beatrice
Healthy eating is the most important tool you have in managing diabetes. healthy eating will help loose weight or maintain healthy weight that can improve your blood glucose and reduce the complication of diabetes such as heart, kidney and eye disease.
Busolwe General Hospital operating in dire condition
(Daily Monitor, 2018-02-06) Kitunzi, Yahudu
The facility has not got any major repair since it's establishment in 1970. What welcomes you upon arrival at the facility are rotten beds, dilapidated buildings and poor hygiene.
Butaleja's main hospital run without matresses, water
(Daily Monitor, 2018-05-04) Kitunzi, Yahudu
For the past 10 years Busolwe Hospital in Butaleja District has suffered neglect and is grappling with numerous challenges, including lack of water and beds.
Capacity building in field epidemiology in Sub Saharan Africa : findings from Infectious Disease Field Epidemiology and Biostatistics in Africa (IDEA) Fellowship Program
(Taylor & Francis Group, 2025) Alunyo, Patrick Jimmy; Paasi, George; Ario, Riolexus Alex; Olupot-Olupot, Peter
Background: Emerging and re-emerging infectious diseases (EREIDs) remain a major public health threat globally, particularly in sub-Saharan Africa (SSA), where fragile health systems, inadequate infrastructure, and limited workforce training exacerbate vulnerabilities. Uganda, a recognised hotspot for outbreaks, faces increasing risk due to anthropogenic and environmental drivers. To address critical capacity gaps, the Infectious Disease Epidemiology and Biostatistics in Africa (IDEA) Fellowship was launched as Uganda’s first master’s-level programme in infectious disease field epidemiology. Led by Busitema University, in collaboration with national and international partners, the programme was funded through EDCTP-II (CSA2020E). Methods: The IDEA Fellowship combined theoretical instruction with fieldwork and research tailored to national health priorities. Activities included outbreak investigations, disease modelling, and surveillance, supported by Africa CDC, Uganda’s Ministry of Health, and UK institutions. A REDCap-based survey was administered to 202 public health professionals across SSA to assess training needs, skill gaps, and barriers. Data were analysed using descriptive statistics and thematic analysis. Results: The programme trained 15 master‘s-level fellows, strengthening Uganda’s capacity in surveillance, early detection, and outbreak response. Survey results showed that 55.4% of professionals required further training, with skill gaps in zoonotic disease management (64.4%), outbreak preparedness (64.9%), and data management (59.4%). Key barriers included limited diagnostic capacity (73.8%) and weak collaboration (49.5%). Qualitative findings highlighted inconsistent mentorship, restricted data access, and limited funding for fieldwork. Respondents advocated for structured mentorship, longer training durations (≥3–6 months), and hybrid delivery models (42.3%). Conclusion: The IDEA Fellowship demonstrates a scalable model for infectious disease capacity building in SSA. Training African scientists in local contexts promotes relevance, retention, and cost-effectiveness. Regional expansion, cross-sector collaboration, and systemic investment are essential for sustainable epidemic preparedness and global health security. Keywords: field epidemiology, capacity building, infectious disease training, Sub-Saharan Africa
Cholera outbreak: boost community health teams
(Daily Monitor, 2018-05-07) Editorial
It is common knowledge that poor sanitation, often worsened by flooding caused by heavy rainfall, is the leading cause of diseases such as cholera - primarily transmitted through contaminated food or water.
Commentary on the Antidiabetic Activity of Kigelia Africana
(JPRM, 2021) Muyenga-Akapelwa, Tumelo; Ezaela, Christian E.; Mushabati, Festus; KayondeBamitale, Samuel Dominion; Kibuule, Dan
Kigelia Africana Lam (Benth) a plant of the Bignoniaceae family, is a medicinal plant with many medicinal properties [1]. Of interest to this paper are the highlighted blood-glucose-lowering activities of the plant, which have led to its use among traditional healers in Zambia [2] and other parts of Africa [3,4,5] Traditional healers in Zambia macerate the fruit using water as a solvent which is drunk as prescribed [6] Anecdotal evidence suggests that the patient takes the fruit maceration twice daily after meals.
Compliance to guidelines for the prescribing of antibiotics in acute infections at Namibia’s national referral hospital:
(Taylor & Francis, 2017) Nakwatumbah, S.; Kibuule, D.; Godman, B.; Haakuria, V.; Kalemeera, F.; Baker, A.; Mwangana, M.
Background: Sub-optimal antibiotic prescribing remains a public health concern in Namibia. The objective is to determine the level and predictors of compliance to guidelines in the prescribing of antibiotics in acute infections at a national referral hospital in Namibia to improve future prescribing. Methods: Descriptive observational cross-sectional study. The clinical records of patients receiving care were reviewed. Prescribing practices were assessed using a self- administered questionnaire with reference to Namibia Standard Treatment Guidelines (NSTG). Results: The majority of prescriptions (62%) complied with the NSTGs; however, lower than national targets (95%). Most prescriptions were empiric and prescribers typically made reference to the NSTG (58%). Diagnosed infections were principally respiratory infections (58%) and penicillins were the most used antibiotics. Good concurrence between signs and symptoms with the diagnosis; diagnosis of upper respiratory tract, oral-dental and urogenital infections with prescribing of penicillins. Combination antibiotics and amphenicols were independent predictors of compliance to the NSTGs. The main behaviours associated with antibiotic prescribing were patient influences, clinical state, and access to guidelines. Conclusions: Compliance to NSTGs is suboptimal. Prescribing of combination antibiotics, penicillins and diagnosis of oral dental, genitourinary and ear, nose and throat infections were important predictors for NSTG compliance. There is a need to implement antibiotic indicators and stewardship programmes, and ensure access to NSTGs, to improve future antibiotic prescribing in Namibia.

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