Children participate in a drawing and colouring activity at Kamuli General Hospital. The activity gave children an opportunity to express themselves while demonstrating how play can support participation and emotional well-being in healthcare settings. Photo: Busoga Health Forum.

By Tatumwa Desmond Benjamin| Busoga Health Forum  |  August 2026

A hospital can be an intimidating place for a child. The unfamiliar rooms, illness, medical procedures and long waiting times can create fear at the very moment when a child most needs comfort and reassurance. Busoga Health Forum is working with hospitals across the Busoga Region to change that experience by placing play, communication and children’s rights within the delivery of paediatric care.

In the latest phase of the initiative, BHF supported six hospitals with child play and learning materials: Kamuli General Hospital, Kamuli Mission Hospital, Buwenge General Hospital, St Francis Hospital–Buluba, Iganga General Hospital and Bugiri General Hospital. The materials are intended to strengthen child-friendly corners and give children opportunities to read, draw, play and receive health information while waiting for care or during admission.

The intervention is part of a broader child-rights programme that also promotes community dialogue, awareness, children’s participation, health-worker orientation, caregiver education and the establishment of supportive spaces within paediatric departments. The approach recognises that quality care is not measured only by medicines and procedures, but also by whether children feel safe, respected, heard and included.

Starting with dialogue and children’s participation in Kamuli

Community Health Extension Workers and Village Health Team members participate in a child-rights engagement at Kamuli General Hospital. Photo: Busoga Health Forum.

The regional activity began at Kamuli General Hospital with a meeting involving Community Health Extension Workers and Village Health Team members. The discussion explored children’s rights and responsibilities, prevention of violence against children, inclusion of children living with disabilities and the importance of involving children in decisions that affect their health and well-being.

Community-level workers are often the first link between families and formal health services. By strengthening their understanding of child protection and participation, the initiative extends child-friendly care beyond hospital walls and into the communities where children live. The engagement also reinforced the principle that a community that understands children’s rights is better positioned to protect children, recognise risk and connect families to appropriate services.

The meeting was followed by a practical painting and colouring activity with children. Rather than speaking about participation only in theory, the activity created a safe space in which children could choose colours, draw, interact and communicate through creative expression. It demonstrated that children can contribute meaningfully to activities within healthcare environments when adults provide the time, materials and encouragement.

Dorothy Akongo, the Project Coordinator at Busoga Health Forum, explained that the initiative is intended to help hospitals move beyond an illness-centred approach and create care environments that respond to children’s developmental, emotional and communication needs. She emphasised that the value of the materials will depend on how consistently health workers and hospital leaders use them to support participation, reduce fear and improve the experience of children and caregivers.

Taking play and learning materials to hospitals across Busoga

Handover of play and learning materials at Kamuli Mission Hospital.

Hospital staff and BHF representatives during the handover at St Francis Hospital–Buluba.

Following the Kamuli General Hospital activities, BHF continued the handover of materials to Kamuli Mission Hospital, Buwenge General Hospital, St Francis Hospital–Buluba, Iganga General Hospital and Bugiri General Hospital. Each facility received a selection of resources suited to children’s play, learning and communication needs.

The materials included children’s storybooks and picture books, educational posters and visual aids, drawing books and crayons, toys, child-sized plastic chairs and storage materials. Within a paediatric unit, these simple resources can serve several purposes: they can occupy children during long waiting periods, support early learning and stimulation, make communication easier and create opportunities for health workers to observe and engage children in a less threatening way.

Hospital staff and BHF representatives review play, drawing and learning materials during the handover at Bugiri General Hospital. Photo: Busoga Health Forum.

The handovers were therefore not presented as stand-alone donations. They were linked to a wider responsibility for hospital teams to organise, protect and actively use the materials. The aim is to ensure that the resources become part of routine paediatric care rather than items that are stored away after a ceremonial handover.

Hospitals are turning training and materials into lasting child-friendly spaces

Dr Rolland Mutumba, Consultant Paediatrician at Iganga General Hospital, with colleagues during the BHF visit. Photo: Busoga Health Forum.

Iganga General Hospital At Iganga General Hospital, Dr Rolland Mutumba, a Consultant Paediatrician, highlighted the importance of play in the care of children. He explained that play supports comfort, communication, development and emotional recovery, particularly for children who may be frightened or remain in hospital for extended periods. Following child-rights training supported by BHF, the hospital established a children’s play room within the paediatric ward. The room provides a dedicated place where children can interact with age-appropriate materials while receiving care. The development shows how training can lead to a practical change in the hospital environment when local clinical leadership takes ownership.

Bugiri commits to a permanent play centre

The leadership of Bugiri General Hospital also demonstrated a commitment to sustaining the initiative. The hospital has identified a dedicated space within its grounds for a children’s play centre, which it plans to establish by the end of 2026. In the meantime, the hospital is repainting walls in areas where children receive care, using more attractive and child-friendly designs that can stimulate learning and make the environment feel less clinical.

This commitment is significant because lasting child-friendly healthcare depends on more than donated materials. It requires hospitals to allocate space, assign responsibility, maintain resources and incorporate play and child participation into routine service delivery. Bugiri’s planned play centre and Iganga’s established play room demonstrate different ways in which hospitals can translate the same principles into locally appropriate action.

A child uses toys in an emerging play area at Kamuli Mission Hospital, showing how donated resources can be integrated into paediatric care. Photo: Busoga Health Forum.

Play is part of quality care The impact of the initiative is beginning to appear in both visible and less visible ways. The visible changes include colourful chairs, books, toys, drawing materials, painted walls and dedicated play areas. The deeper change is in how hospital teams understand children: not as passive recipients of treatment, but as people who communicate, learn, feel fear, need reassurance and have a right to participate in matters affecting them. For Busoga Health Forum, the next priority is to continue supporting hospital teams to use the materials responsibly, strengthen child-friendly communication and involve caregivers and communities. The broader programme covers Jinja Regional Referral Hospital, Buwenge General Hospital, Kamuli Mission Hospital, St Francis Hospital–Buluba, Bugiri General Hospital, Iganga General Hospital and Kamuli General Hospital.

On 10 July 2026, Uganda woke up to news headlines celebrating the promotion of Prof. Peter Kyobe Waiswa to Full Professor of Health Policy, Planning and Management at the Makerere University School of Public Health a milestone that marked another chapter in the journey of one of the country’s leading voices in health systems research and transformation.

But beyond the academic title and the celebration that followed, lies a story that began far away from the university corridors, a story rooted in Naigobya Village, Bukooma Sub-county, Luuka District. It is the story of a boy whose humble beginnings did not define the limits of his dreams, but instead became the foundation for a lifelong commitment to serving communities, the nation, Africa, the world at large

By: Tatumwa Desmond Benjamin | Busoga Health Forum | desmondbenja@gmail.com

A promotion that formalised a long record of impact

On 10 July 2026, during its 811th meeting, the Makerere University Appointments Board promoted Prof. Peter Kyobe Waiswa from Associate Professor to Full Professor of Health Policy, Planning and Management at the Makerere University School of Public Health. The University described the decision as recognition of his sustained contributions to teaching, research and innovation, mentorship, institutional development, leadership and service to society.[1]

The title matters, but the story behind it matters more. Prof. Waiswa’s career has never been confined to lecture rooms, journal articles or conference platforms. It has consistently moved between the village, the health centre, the district, the university, the national policy table and the international stage. His promotion therefore recognised not only academic seniority, but a model of scholarship in which knowledge is expected to serve people.

“Professional expertise becomes transformative when it is deliberately placed at the service of people.”

A principle reflected throughout Prof. Waiswa’s community and academic journey

The First Blackboard: Naigobya as the Beginning of Purpose

Every journey has a beginning. For Prof. Peter Kyobe Waiswa, that beginning was Naigobya Village in Bukooma Sub-county, Luuka District, Eastern Uganda, a rural community in the Busoga region that shaped his understanding of life.

It was in Naigobya that he first encountered a classroom and saw a blackboard. To many, it may have been an ordinary moment. But for the young Peter Waiswa, it represented something much bigger, a doorway to learning, possibility and a future beyond the boundaries of his village.

Growing up in a rural community exposed him to the realities faced by many families; the challenges of accessing quality health services, the consequences of preventable illnesses and the inequalities that often determine who receives opportunities and who is left behind.

This left him with more questions than answers …Why do mothers and newborns continue to die from preventable causes? Why do proven health solutions sometimes fail to reach the families who need them most? How can health systems become stronger, more equitable and more responsive to communities? He often wondered

Those early experiences would later influence the questions that shaped his career to become a medical doctor.

Community dialogue in Naigobya, Luuka District. International practicum engagement continues the cross-cultural learning model that grew through UDHA’s partnerships. Photo: One Village at a Time.

From medicine to health systems

Prof. Waiswa trained as a medical doctor at Mbarara University of Science and Technology. He later completed a Master of Public Health at the Hebrew University of Jerusalem and a joint doctoral programme through Makerere University and Karolinska Institutet in Sweden, followed by postdoctoral training in health systems and policy.[2]

He also served in Uganda’s public health system, including work in the Iganga district health services. This experience helped him understand that better outcomes depend on more than clinical skill. They depend on financing, leadership, staffing, referral pathways, information systems, community trust and the ability to translate policy into reliable care.

The UDHA days: starting local and building trust

Long before his promotion to Full Professor, Prof. Waiswa helped create Uganda Development and Health Associates (UDHA), a grassroots organisation founded in Iganga in 2003 and formally registered as a non-governmental organisation in 2005. UDHA was built around a simple conviction: local problems require locally owned solutions, strengthened by professional expertise and carefully chosen partnerships.[3][4][5]

UDHA’s early work addressed the priorities communities were living with every day. Its programmes included youth-friendly health services, sexual and reproductive health, maternal and child health, immunisation, nutrition, food security, HIV prevention, community counselling and referral. By 2015, its activities reached communities in Iganga, Mayuge, Luuka, Kaliro and Namutumba.[5]

The importance of UDHA was not only the services it delivered. It built local structures: community health workers, peer educators, youth platforms, referral networks, monitoring systems and relationships with district health teams. It demonstrated that a small regional organisation could grow into a credible delivery platform without losing community ownership.

Naigobya Health Centre III: service close to home

One of the most visible expressions of this commitment was Naigobya UDHA Health Centre III. The facility brought primary health services closer to a rural community that had long faced barriers to care. UDHA reports describe maternal and child-health activities linked to Naigobya, including antenatal engagement, nutrition education, immunisation, deworming, Vitamin A supplementation and community outreach.[6]

The health centre represented a practical form of institution-building. It was not an isolated charity activity, but part of a wider effort to connect households, community health workers, local government and formal health services. It also gave Naigobya a place within a wider network of learning and partnership.

USA volunteers in the field: global partnership under local leadership

UDHA’s partnership with GlobeMed at Washington University in St. Louis brought American students and other international volunteers into field-based learning and service in Eastern Uganda. The volunteers participated in internships, community engagement, youth initiatives and shared learning with local staff and residents. The partnership widened the circle of expertise and resources, but the programmes remained grounded in UDHA’s local leadership and community priorities.[7]

That distinction is important. International partnership is most useful when it strengthens local institutions rather than replacing them. The UDHA – Washington University relationship became an early example of how cross-cultural collaboration can support community action, mentorship and mutual learning while keeping decision-making close to the people affected.

Local participation and transparent community decision-making in Naigobya. Photo: One Village at a Time.

From projects to systems: expansion through Global Fund and TASO support

UDHA’s growth accelerated when it became part of larger HIV and health-systems partnerships, including implementation linked to The AIDS Support Organisation (TASO) and Global Fund financing. This support enabled the organisation to move beyond isolated activities and invest in repeatable systems: mapping community-based organisations, training distributors and peer educators, expanding home-based counselling and testing, strengthening linkage to care and improving accountability across districts.[6][8]

The expansion changed the nature of the organisation. UDHA was no longer only delivering projects; it was helping to construct networks, standards, reporting systems and community structures that made quality services more consistent. The lesson was clear: scale is not simply doing more of the same. It is building systems that allow good work to be repeated, monitored and sustained.

What the UDHA period revealed about Prof. Waiswa’s leadership

The UDHA years revealed four qualities that would later define Prof. Waiswa’s academic and public leadership. First, he began with problems communities could recognise. Second, he built coalitions instead of personal empires. Third, he used evidence to attract resources and improve accountability. Fourth, he invested in institutions capable of continuing beyond a single project or individual.

These qualities later appeared at a much larger scale in his university leadership, research collaborations, regional health advocacy and international advisory work. UDHA was therefore not separate from his academic journey; it was one of the places where his approach to implementation science and health-systems strengthening was tested in practice.

Community engagement has remained central to Prof. Waiswa’s work from the early UDHA years to later regional and research initiatives. Photo: peterwaiswa.com.

COMONETH: evidence translated into maternal and newborn survival

Between 2017 and 2020, the Communities in which Mothers and Newborns Thrive project-COMONETH – was implemented across Luuka District. Led through the Makerere University maternal and newborn health platform, the project linked households, community health workers, health facilities and district leadership in a single demand-and-supply strategy.[9][10]

At community level, health workers conducted home visits, identified high-risk mothers and newborns, provided health education and supported referral. Pregnant women viewed locally adapted videos in Lusoga on danger signs and timely care-seeking. At facility level, health workers received mentorship and simulation-based training, while referral and obstetric surgical capacity were strengthened.[9]

COMONETH study setting in Luuka District. Source: Wafula et al., BMC Pregnancy and Childbirth, 2024.

8,283 pregnant mothers reached 6,494 newborns reached 5% → 61% preterm and low-birth-weight babies receiving kangaroo mother care 19.4% → 99.7% mothers knowing at least two newborn danger signs

The evaluation reported meaningful improvements in the use of maternal and newborn services and in appropriate care practices. The project showed the value of joining community demand with facility readiness. Educating families without improving services is insufficient; strengthening facilities without building community trust and referral is equally incomplete. COMONETH treated the health system as a connected whole.[9]

For Prof. Waiswa, COMONETH also demonstrated how locally generated evidence can travel. The project began with the realities of Luuka, but its findings contribute to international understanding of how community–facility linked interventions can improve maternal and newborn care in rural, low-resource settings.

From UDHA to One Village at a Time

One Village at a Time (OVAAT) extended the village-centred philosophy into a broader model of rural transformation. Naigobya became the pioneer village for an approach that brings together education, health, livelihoods, environment and community governance. The initiative reflects a belief that health cannot be separated from the social and economic conditions in which families live.[11]

OVAAT has also continued international practicum engagement, including links with the Brown School at Washington University in St. Louis. This creates a bridge between local knowledge and international learning while preserving community participation and ownership as the foundation of change.[11]

International practicum and community dialogue in Naigobya. Photo: OVAAT.

Residents participate in local planning and decision-making. Photo: OVAAT.

Busoga Health Forum: from individual projects to a regional movement

In 2020, at the height of the COVID-19 pandemic, Busoga Health Forum emerged as a platform to convene professionals, institutions and communities around the health priorities of the Busoga sub-region. Prof. Waiswa became its founding Board Chair, bringing into the Forum the same principles visible throughout his earlier work: local ownership, evidence, partnership and systems that can outlive individuals.[3][12]

Busoga Health Forum has grown beyond a professional network. It now provides a regional platform for continuing professional development, community programmes, research, advocacy, partnerships and accountability. Its work links government, academia, health workers, cultural and religious leadership, civil society, the diaspora and local communities.

Busoga Health Forum leaders, members and partners at the 2025 Annual General Meeting. Photo: Busoga Health Forum.

BHF in action: malaria elimination led from the community

The Busoga Malaria Eradication Programme became one of the clearest expressions of Prof. Waiswa’s belief that communities can organise around large public-health challenges. The programme combines community mobilisation, indoor and outdoor vector control, testing and treatment, surveillance, research and local accountability.[13]

In the Nawanyingi pilot area, the programme covered 6,955 households and 25,533 people. Monitoring recorded a major reduction in mosquito density and high household acceptance of indoor residual spraying. The model mobilised local leaders, health workers, researchers and residents around a shared objective: a malaria-free Busoga.[13]

HE. Dr. Speciosa Wandira Kazibwe and Hon. Justine Kasule Lumumba with young people champion community-led malaria elimination in Busoga. Photo: Busoga Health Forum.

At the 2026 national World Malaria Day commemoration in Iganga, Prof. Waiswa used the platform not only to celebrate community action, but to advocate for government financing, stronger health infrastructure for Busoga and formal collaboration with the Ministry of Health. This is characteristic of his leadership: field implementation is used to generate evidence, and evidence is carried into policy dialogue.

Strengthening specialised care at Jinja Regional Referral Hospital

Busoga Health Forum has also translated professional networks into direct support for specialised services at Jinja Regional Referral Hospital. In March 2026, members of the Forum and public servants from Busoga handed over neurosurgical equipment valued at approximately UGX 20 million. The equipment included a craniotomy set for brain surgery and a cervical instrumentation set for spinal procedures.[14]

The donation was the first phase of a wider UGX 200 million mobilisation campaign to strengthen neurosurgery services. For families in Eastern Uganda, this work has practical meaning. It can reduce dangerous referral delays, bring life-saving surgery closer to home and strengthen Jinja Regional Referral Hospital as a centre for specialised care, training and research.

Prof. Peter Waiswa and Busoga Health Forum partners hand over neurosurgical equipment to Jinja Regional Referral Hospital in March 2026. Photo: Busoga Health Forum.

“When we learned that Jinja Hospital urgently needed neurosurgical equipment, we mobilised ourselves.”

Prof. Peter Kyobe Waiswa, Board Chair, Busoga Health Forum

The equipment handover illustrates a broader lesson in Prof. Waiswa’s service: regional problems do not have to wait for distant solutions. Professionals, public servants, institutions and citizens can pool resources, build public pressure and create the first step toward stronger systems. Community mobilisation may begin with a donation, but its larger goal is to change what the regional health system is capable of providing.

Building a learning health region

Under Prof. Waiswa’s Board leadership, Busoga Health Forum has also invested heavily in professional learning. Its continuing medical education programme connects frontline health workers with specialists, researchers and policy experts. Through regular webinars, hybrid training, mentorship and a growing digital learning platform, the Forum is helping health workers remain current while reducing the geographic barriers that often limit access to continuing professional development.

This work connects directly to his academic philosophy. Better health systems require capable people, and capable people require continuous learning. A professor’s influence is therefore not limited to students formally enrolled at a university. It can extend to nurses, midwives, clinical officers, doctors, allied health professionals and community workers serving across an entire region.

A scholar whose research travels internationally

Alongside his community and institutional work, Prof. Waiswa has become one of Africa’s most visible health-systems and maternal-newborn health researchers. He leads the Makerere University Centre of Excellence for Maternal, Newborn and Child Health and has contributed to major research collaborations, implementation programmes and advisory platforms involving African institutions, the World Health Organization, UNICEF and other global partners.[15][16]

His scholarship covers maternal and newborn survival, stillbirths, vulnerable newborns, community health workers, quality improvement, measurement, implementation science and health policy. His publications have appeared in leading international journals, and The Lancet profiled him as a researcher “building better health systems in Africa and beyond.”[17]

Prof. Waiswa contributing to an international health-policy and research forum. Photo: peterwaiswa.com.

The international reach of his work is significant because it is not detached from place. Questions generated in Naigobya, Iganga, Luuka and the wider Busoga region have informed research with global relevance. At the same time, international networks have brought knowledge, partnerships and visibility back to Uganda. His career demonstrates that local relevance and global excellence are not opposites; each can strengthen the other.

A Mentor Who Creates a Multiplier Effect

The true measure of a leader is not only found in the milestones they achieve, the titles they earn or the institutions they lead. It is found in the people whose lives are transformed because of their influence. In this regard, Prof. Peter Kyobe Waiswa’s legacy extends far beyond his own accomplishments; it lives through the many people he has inspired, mentored and empowered to serve others.

Throughout his remarkable journey as a physician, researcher, academic and community leader, Prof. Waiswa has invested deeply in developing people. He has mentored more than 100 individuals across different stages of their professional journeys from students taking their first steps into academia, to early-career researchers, health professionals, programme leaders and emerging public health practitioners.

But his mentorship has never been limited to supervision or instruction. It has been a deliberate act of building confidence, opening pathways, sharing knowledge and nurturing the next generation of thinkers and problem-solvers. He has challenged those around him not only to pursue excellence, but to use their skills in service of communities and society.

The impact of this mentorship can be seen in the lives and careers of those he has guided. Many have gone on to become mentors themselves, lead innovations, strengthen health programmes, generate influential research and contribute to healthier communities. Through them, Prof. Waiswa’s influence continues to expand creating a multiplier effect that extends far beyond his immediate reach.

This is perhaps one of the most enduring dimensions of his legacy; he has not only built programmes and institutions; he has invested in people, nurturing individuals who have gone on to lead, innovate and empower others.

To put it in his words

“The greatest impact we can make is not only in what we accomplish ourselves, but in the people we empower to continue the work, solve problems and create change beyond us.”

Prof. Waiswa’s journey reminds us that, regardless of where we come from, our humble beginnings do not define the limits of what we can achieve.

We also learn that lasting change is never the work of one individual alone. It begins with commitment, is anchored in service, strengthened through partnership and sustained through the lives transformed and the people empowered to carry the mission forward.

In the end, the greatest measure of a life’s work is not only the milestones achieved, but the people inspired, the institutions strengthened and the hope created for generations to come.

Why the promotion was due

The promotion was due because the record was already professorial in every major dimension. His research demonstrated sustained productivity and international influence. His implementation work showed an ability to move from evidence to programme design and scale. His teaching and mentorship developed others. His leadership built institutions. His public service ensured that scholarship remained accountable to society.

It was also due because Prof. Waiswa has helped elevate implementation science and health-systems research. In many low-resource settings, the central problem is not that solutions are unknown; it is that proven solutions are not delivered consistently, equitably or at sufficient scale. His career has focused on that gap—on the difficult work of making systems function for mothers, newborns, children and communities.

The title of Full Professor therefore did not create his influence. It formally recognised an influence already evident in villages, health facilities, district systems, academic institutions, African research networks and global policy spaces.

What this milestone means

For Naigobya and Luuka District, the promotion is proof that a rural beginning does not determine the limits of a child’s future. The first blackboard can become the beginning of a journey into medicine, public health, research and global leadership.

For Busoga, it is a source of pride and responsibility. The region has produced a scholar whose work is internationally respected, but whose service remains visible at home—in community health programmes, malaria elimination, professional education, advocacy and support to regional hospitals.

For Makerere University and Uganda, the promotion affirms the value of scholarship that combines academic excellence with public purpose. It shows why universities must support researchers who build institutions, mentor others and respond to national priorities.

For Africa, Prof. Waiswa’s journey represents African-led global health. African researchers must not participate only as data collectors or local partners in questions defined elsewhere. They must lead the framing of problems, the design of interventions, the interpretation of evidence and the institutions that carry the work forward.

For young professionals, his life offers a demanding but hopeful lesson: growth is cumulative. It is built through disciplined education, consistent service, courage to begin small, willingness to collaborate and patience to build systems that may take years to mature.

The true measure of professional success is not only what we achieve at work, but what changes in society because we chose to serve.

A fitting summary of Prof. Waiswa’s journey beyond the workspace

The journey continues

Prof. Peter Kyobe Waiswa’s promotion to Full Professor is a moment for celebration, but it is not the end of the work. Maternal and newborn deaths remain unacceptably high. Malaria continues to burden families and economies. Regional hospitals require stronger specialised services. Health workers need continuous learning. Young researchers need mentorship. Communities need institutions they can trust.

From UDHA’s early community programmes to COMONETH, OVAAT and Busoga Health Forum, his growth has followed a consistent direction: begin with the problem people live with, build coalitions, use evidence to move resources and policy, and create systems that can endure.

The boy who first encountered a blackboard in Naigobya now helps shape health-systems thinking across the world. His promotion honours how far he has travelled. More importantly, it enlarges the platform from which he and the many people and institutions built around this work can continue to serve.

Sources and further reading

1. Makerere University News. “Makerere University Promotes Prof. Peter Waiswa to Full Professor.” 13 July 2026. Open source

2. Peter Waiswa official website. “Education & Training.” Open source

3. Peter Waiswa official website. “Community Service.” Open source

4. Uganda Development and Health Associates. Annual Report 2014. BHF/UDHA archive.

5. Uganda Development and Health Associates. Annual Report 2015. BHF/UDHA archive.

6. Uganda Development and Health Associates. Annual Report 2016. BHF/UDHA archive.

7. GlobeMed at Washington University in St. Louis. “Our Partner: Uganda Development and Health Associates.” Open source

8. PATH. Global Fund Prospective Country Evaluation, Uganda; documentation of TASO partnership with UDHA. Open source

9. Wafula ST et al. “Effect of community–facility linked interventions on maternal health service utilization and newborn care in rural low-resource settings in Eastern Uganda.” BMC Pregnancy and Childbirth. 2024;24:692. Open source

10. Makerere University School of Public Health. “COMONETH: Communities in which Mothers and Newborns Thrive.” Open source

11. One Village at a Time Uganda. Official website. Open source

12. Busoga Health Forum. Annual Report 2025 and AGM records. BHF archive. Open source

13. Busoga Health Forum. Busoga Malaria Eradication Programme pilot and World Malaria Day reports, 2025–2026. BHF archive. Open source

14. Busoga Health Forum. “Busoga Health Forum Hands Over Specialized Neurosurgical Equipment to Strengthen Specialized Care in Eastern Uganda.” 16 March 2026. Open source

15. Makerere University News. “Prof. Waiswa elected Fellow of the African Academy of Sciences.” 21 November 2025. Open source

16. Peter Waiswa official website. “Leadership & Advisory” and “Scientific Activity.” Open source

17. Dawson Q. “Peter Waiswa: building better health systems in Africa and beyond.” The Lancet. 2022;400(10357):989. Open source

Under the Child Thrive Project, local radio stations are being used to bring conversations about children’s rights closer to communities. Through interactive talk shows, listeners are learning what children’s rights mean, why they matter and how individuals and institutions can protect and fulfil them.

One of these engagements was held on BABA FM Radio, where Sam Sabagereka, a Psychiatric Clinical Officer, and Allen Nabisere, a Medical Clinical Officer at Jinja Regional Referral Hospital, discussed children’s rights with listeners. The programme provided an opportunity to move the conversation beyond healthcare facilities and directly into homes and communities across Busoga.

Children have rights in every area of life

During the talk show, the presenters explained that children’s rights cover the whole life of a child. They include the rights to education, healthcare, protection, dignity, equality, development, play and participation in decisions affecting them.

Children’s rights are legally protected entitlements and freedoms mainly established through the United Nations Convention on the Rights of the Child. They are intended to promote the survival, development, protection and participation of every person below the age of 18. Children are not simply future adults; they are individuals with their own needs, experiences, views and voices in the present.

The discussion placed particular emphasis on a child’s right to participate and express an opinion. Children should be allowed to give their views on matters affecting their lives, and those views should be considered according to their age and maturity.

This also applies in healthcare settings. Health workers should not communicate only with parents or caregivers while ignoring the child receiving care. Children should be given information in language they can understand, allowed to ask questions and encouraged to express their fears, concerns and preferences.

When a healthcare worker recommends an examination, treatment, admission, referral or medical procedure, the child should receive an age-appropriate explanation of what is happening and why the decision is being made. Listening to children does not remove the responsibility of parents and health professionals. Instead, it helps ensure that decisions are made respectfully and with the child’s best interests at the centre.

The Child Rights Ambassador Toolbox highlights non-discrimination, the best interests of the child, life and development, participation, protection from harmful work and abuse, access to healthcare, inclusion of children with disabilities, and the right to play and rest as important children’s rights.

The callers brought real community concerns to the discussion

The strength of local radio is that communication does not move in only one direction. Listeners can call, ask questions, share experiences and draw attention to situations affecting children in their communities.

During the BABA FM talk show, one caller from Iganga raised concern about children in villages who are involved in labour, including cutting sugar cane. The caller explained that some of the affected children are orphans who have dropped out of school. He wanted to know whether there was an office or organisation that could support them to leave harmful labour and return to school.

His concern demonstrated that awareness about children’s rights must be connected to clear reporting and referral pathways. It is not enough for communities to recognise that a child is being exploited. They must also know where to report the case and how the child can be linked to protection, education and social support.

Children involved in harmful work, children who have dropped out of school and children without adequate parental care may require support from several actors. These include local council leaders, community development officers, the District Probation and Social Welfare Office, and the Child and Family Protection Unit of the Uganda Police Force. Uganda’s child-protection structures also include the government-operated Sauti 116 Uganda Child Helpline, through which children and adults can report abuse and other violations of children’s rights. (Uganda Police Force)

The Child Thrive Project therefore seeks to work through existing government and community structures rather than establish parallel systems. Trained Child Rights Ambassadors can raise awareness, identify concerns and help guide families towards the appropriate authorities and services.

Addressing pregnancy and childbirth among children

Another important contribution came from David Jumba of Nakilulwe in Iganga District, who asked what could be done to reduce the number of children becoming pregnant and giving birth before the age of 18 in Busoga.

His question highlighted a serious child-rights concern that requires action from families, schools, healthcare providers, communities and government institutions. Preventing pregnancy among children requires more than telling young people to avoid sexual activity. Communities must address the conditions that place children at risk, including sexual violence, exploitation, school dropout, harmful social norms, inadequate parental guidance and limited access to reliable, age-appropriate health information.

Parents and caregivers should create environments in which children can speak openly about concerns without fear of punishment or shame. Schools should provide safe learning environments and identify children who may be at risk of dropping out. Health facilities should provide respectful and adolescent-responsive services, while police, probation officers and local leaders must respond appropriately when abuse, exploitation or other violations are reported.

Most importantly, the child must not be blamed. Children facing pregnancy, violence or exploitation need protection, appropriate healthcare, counselling, education support and access to justice.

Why local radios matter

Local radio stations remain among the most accessible communication platforms in Uganda. They reach listeners in towns, trading centres and villages, including people who may not have regular access to smartphones, social media or formal training opportunities.

Radio programmes can reach parents while they are at home, farmers working in the fields, drivers on the road, health workers travelling from duty and community leaders in remote areas. Discussions can also be delivered in languages that communities understand best, making complex legal and health information more practical and relatable.

Radio also gives communities an opportunity to shape the discussion. The calls received during the BABA FM programme showed that listeners were not only interested in definitions of children’s rights. They wanted practical answers about child labour, school dropout, orphaned children, pregnancy among children and the institutions responsible for helping affected families.

This interaction helps transform children’s rights from an abstract concept into an everyday community responsibility.

Building a network of Child Rights Ambassadors

The radio engagements are supported by the wider work of the Child Rights Ambassadors Programme. So far, the project has trained 112 Child Rights Ambassadors through four cohorts.

The ambassadors are equipped with knowledge and practical skills to promote children’s rights within healthcare facilities and communities. Their responsibilities include educating and supporting colleagues, promoting children’s participation, identifying practices that may violate children’s rights and encouraging institutions to improve how they communicate and interact with children.

The programme is intended to produce visible changes in attitudes and practice—not merely certificates. The Child Rights Ambassador Toolbox emphasises that trained ambassadors should drive child-rights work within their workplaces, monitor whether children’s rights are respected, support institutional leaders and collect children’s views to inform improvements.

The impact of the programme will therefore be seen when a health worker speaks directly to a child, when an examination is explained before it is conducted, when a child’s privacy is respected, when children with disabilities receive inclusive services and when children’s opinions influence decisions about the services intended for them.

The Child Thrive partnership

The Child Thrive Project is built around a partnership between Ugandan and Swedish local governments, healthcare institutions and civil society organisations. It uses Sustainable Development Goal 3—Good Health and Well-being as its point of departure and aims to improve children’s ability to survive, thrive and reach their full potential.

Its four interconnected areas are neonatal care, paediatric emergency and critical care, care for children with developmental or neurological conditions, and the strengthening of children’s rights in healthcare. (ICLD)

The partners have complementary roles:

The Swedish International Centre for Local Democracy funds the partnership and provides a local-democracy framework centred on equity and inclusion, transparency, accountability and citizen participation. Through this approach, children and their caregivers are recognised not only as service users but also as citizens whose experiences and opinions should influence local services.

Region Stockholm, through Astrid Lindgren Children’s Hospital, is the Swedish local-government and healthcare partner. It contributes paediatric expertise, professional exchange, training, mentorship and joint learning in the project’s clinical and child-rights areas.

Jinja City provides local-government leadership and helps connect the project to local planning, public services, accountability structures and community priorities.

Jinja Regional Referral Hospital, including Nalufenya Children’s Hospital, serves as a major clinical implementation and learning site. Its health workers and leaders participate in training, mentorship and practical improvements aimed at making healthcare safer, more responsive and more respectful of children.

Busoga Health Forum supports local coordination, communication, health-worker engagement, documentation and community awareness. Its role includes taking children’s rights information beyond health facilities through platforms such as local radio talk shows.

Pediatric Health Initiative supports the collaboration between the Ugandan and Swedish partners, including technical exchange, coordination, training and the implementation of improvements in paediatric healthcare.

The Child Rights Ambassador Programme was developed within this partnership by teams from Astrid Lindgren Children’s Hospital and Jinja Regional Referral Hospital/Nalufenya Children’s Hospital, working with Pediatric Health Initiative and Busoga Health Forum.

From awareness to collective action

A radio talk show cannot solve every challenge affecting children. However, it can begin conversations, correct misunderstandings, help communities recognise violations and direct vulnerable children towards support.

The voices from Iganga showed why these conversations must continue. Communities are seeing children involved in harmful labour, children out of school, orphans needing support and children becoming parents before reaching adulthood. They need accessible information and confidence that existing institutions will listen and respond.

By combining the reach of local radio stations, the knowledge of 112 trained Child Rights Ambassadors, and established government structures such as probation offices, community development departments and the police’s Child and Family Protection Unit, the Child Thrive Project is helping move children’s rights from awareness to action.

Protecting children is not the responsibility of one organisation, one health worker or one parent. It requires families, communities, healthcare institutions, schools, government departments, civil society and children themselves to work together.

Every child has the right to be protected, educated, respected and heard. Every child deserves the opportunity to survive, thrive and reach their full potential.

A life‑saving procedure marks a new chapter for women’s health in Busoga

On 30 March 2026, a surgical team at HHC, led by Dr. Musana Othiniel (gyne‑oncologist) and Dr. Isaac Mubezi (general surgeon), performed the hospital’s first radical hysterectomy, a landmark achievement for the Busoga region. The patient had early‑stage cervical cancer (FIGO stage 1B). Radical hysterectomy is a complex operation that removes the uterus, cervix, upper vagina and nearby lymph nodes to eliminate cancerous tissue and provide the best chance of cure. By carrying out this procedure locally, HHC has shown that life‑saving oncology surgery can be delivered in the region with the right trained personel and resources rather than having women to travel to distant centres.

Why it matters

Cervical cancer is a major health burden in Uganda. According to the Uganda National Cervical Cancer Prevention and Control Strategic Plan (2018 – 2023), cervical cancer has the highest incidence among Ugandan women; the age‑standardised incidence and mortality rates are 44.4 and 27.4 per 100,000 women, respectively. The same report notes that approximately 3,915 women are diagnosed each year and about 2,275 die, and that over 80 % of patients present at an advanced stage, when survival is minimal. Globally, cervical cancer remains the fourth most frequently diagnosed cancer and fourth leading cause of cancer death among women, with about 604,000 new cases and 342,000 deaths worldwide in 2020. Almost all of the top 20 countries with the highest burden are in sub‑Saharan Africa, and limited access to prevention, screening and treatment contributes to 90 % of deaths.

Early detection dramatically improves outcomes. For invasive cervical cancer caught at an early stage, the 5‑year relative survival rate is about 92 %. A Tanzanian study of women with early‑stage cervical cancer treated with radical hysterectomy reported a 3‑year overall survival rate of 96.5 % and disease‑free survival of 79.1 %. These figures show that radical hysterectomy, when performed for well‑selected stage 1 patients, can be curative and offer excellent prospects for long‑term survival.

The Busoga breakthrough

Until now, women in Busoga who required a radical hysterectomy have to be referred to national centres, often facing long delays and prohibitive costs. HHC’s first successful radical hysterectomy demonstrates that the necessary skills and infrastructure are now available locally. Dr. Musana and Dr Mubezi’s collaboration brings together specialist oncologic and general surgical expertise, ensuring that the operation adheres to international standards of care. Their team’s achievement represents not only a surgical milestone but also an important message: with commitment and training, high‑quality cancer care can be decentralised to regional hospitals.

The surgery was performed on a woman with stage 1B cervical cancer, for which radical hysterectomy is an established treatment. As the procedure removes the uterus and cervix entirely, patients lose fertility, but the operation can provide a cure and prevent the need for chemoradiation. To reduce such difficult choices in the future, HHC will collaborate with Busoga Health Forum to launch community outreach for early cervical cancer screening and HPV vaccination. Screening allows detection of pre‑cancerous lesions that can be treated before invasive cancer develops, and vaccination prevents infection with high‑risk human papillomavirus, the virus that causes most cervical cancers.

Looking ahead

HHC’s inaugural radical hysterectomy sends a powerful message across Busoga:

• Early diagnosis saves lives. Most Ugandan women still present with advanced disease. By promoting screen‑and‑treat strategies and encouraging women to attend routine screening, HHC hopes to catch cervical cancer at pre‑cancerous or early stages when treatment is most effective.
• Investing in local surgical capacity pays off. HHC’s success shows that regional hospitals can develop the expertise to perform complex oncologic surgeries. This reduces travel burdens and brings care closer to patients.
• Collaboration is key. The partnership between gyne‑oncology and general surgery at HHC illustrates how pooling skills can overcome resource limitations. Continued training, mentorship and investment will be needed to sustain and expand this programme.

Cervical cancer need not be a death sentence. With early screening, HPV vaccination and access to curative surgery, thousands of women’s lives can be saved. The Busoga community should celebrate this milestone and support initiatives that ensure no woman is denied timely care. HHC’s first radical hysterectomy is more than a surgical achievement – it is a commitment to a future where cervical cancer is detected early, treated effectively and ultimately eliminated.

The equipment, valued at approximately UGX 20 million, was mobilized through contributions from members of the Busoga Health Forum and public servants from the region. The initiative is part of a broader campaign to raise UGX 200 million to fully equip the hospital’s neurosurgery services.

Strengthening a Regional Referral Hospital

Speaking during the handover ceremony, Dr. Alfred Yayi, Senior Executive Consultant at Jinja Regional Referral Hospital, said the hospital envisions becoming a center of excellence providing both general and specialized services, while also functioning as a training and research hub supporting lower-level health facilities across Eastern Uganda.

Currently, many specialized medical services remain concentrated in Kampala, forcing patients to travel long distances for treatment.

Neurosurgical Burden in Eastern Uganda

According to Dr. Ronald Mabubi, a neurosurgeon and volunteer neurosurgeon at the hospital, Jinja Regional Referral Hospital serves a catchment population of about 4.5 million people across Eastern Uganda.

He explained that neurosurgical emergencies often face dangerous delays due to limited specialists, inadequate equipment, and referral challenges.

“Most neurosurgical conditions require immediate intervention to prevent permanent disability or death,” Dr. Mabubi said.

Road traffic crashes are among the leading causes of traumatic brain and spinal injuries in Uganda. The World Health Organization estimates that road traffic injuries cause about 1.19 million deaths globally every year, with many survivors suffering severe head injuries that require neurosurgical care.

Many of these patients are breadwinners injured on the roads, and delayed treatment often results in death or lifelong disability.

Equipment That Enables Life-Saving Surgery

The newly acquired equipment includes a craniotomy set used in brain surgery and a cervical instrumentation set for spinal surgery, enabling surgeons to treat conditions such as traumatic brain injuries, brain tumors, intracranial bleeding, and spinal trauma locally.

Previously, patients requiring these procedures had to be referred to national referral hospitals such as Mulago National Referral Hospital, leading to treatment delays and increased mortality.

With these tools now available, the hospital can begin performing critical neurosurgical procedures within the region.

Community Mobilization for Better Health

Prof. Peter Waiswa, Board Chair of Busoga Health Forum, thanked members for their contributions and emphasized the importance of collective action in improving healthcare.

“When we learned that Jinja Hospital urgently needed neurosurgical equipment, we mobilized ourselves and raised UGX 20 million to purchase the first priority equipment needed to start services,” he said.

He called on leaders, professionals, and citizens across Busoga to unite in improving health outcomes in the region.

A Government Call to Action

The chief guest, Dr. Agrey Kibenge, Permanent Secretary at the Ministry of Gender, Labour and Social Development, praised the initiative and urged more citizens to support efforts to strengthen regional health facilities.

He shared a recent experience where a patient died after delays in accessing CT and MRI services in nearby districts.

“How many people lose their lives simply because services are too far away?” he asked. “Millions of Ugandans face these challenges.”

Dr. Kibenge emphasized that those who are privileged have a responsibility to contribute to strengthening public services.

The Next Step: Raising UGX 200 Million

While the UGX 20 million raised so far has enabled the purchase of initial equipment, stakeholders say more support is needed to fully establish neurosurgery services in Busoga.

Health leaders explained that anyone can become a victim of neurosurgical emergencies, including:

• Road traffic crashes, which frequently cause head and spinal injuries
• Falls, especially among children and the elderly
• Brain tumors or infections requiring surgical treatment
• Stroke and bleeding in the brain
• Spinal injuries from workplace or domestic accidents

These conditions can affect any person, regardless of age, profession, or social status.

“Today it may be someone else, tomorrow it may be a member of our own family,” Mr. Moses Kyangwa, Executive Director Busoga Health Forum noted.

Stakeholders therefore called on individuals, businesses, professionals, diaspora communities, and public servants from Busoga to contribute toward the remaining UGX 180 million needed to fully equip the neurosurgery unit.

Health leaders believe that with collective effort, Jinja Regional Referral Hospital can become a fully functional neurosurgery center serving millions of people across Eastern Uganda, reducing preventable deaths and strengthening the region’s healthcare system.

Executive Summary: The Luuka Model of Co-Creation

The initial feasibility study, supported by Grand Challenges Canada (GCC), successfully developed and validated an integrated model designed to prevent childhood malnutrition in Luuka District, Eastern Uganda. This innovation yielded a culturally acceptable, nutrient-dense complementary food prototype, Sample 520, alongside a functional, community-embedded service delivery framework. The findings confirmed that achieving sustained nutritional improvement in a region where 25% of children under five years (U5) suffer from stunting requires addressing malnutrition as a complex, multi-sectoral, or “systems problem,” rather than simply a matter of food scarcity.

The project’s co-creation approach successfully engaged local expertise and generated critical data. This initial phase involved 545 direct beneficiaries and mobilized 656 key intermediaries, including Village Health Team (VHT) members and district leaders, establishing a powerful social and institutional network. Key outcomes include the scientific validation and selection of Sample 520 based on superior sensory qualities (flavour, texture, and aroma) preferred by the community, and the identification of intersectional vulnerabilities—such as pervasive food taboos and deficiencies in hygiene—that necessitate integrated, non-food interventions. The established forward path prioritizes rigorous field and clinical trials, optimization of localized manufacturing capabilities, and extensive policy advocacy to translate this proven feasibility into scalable, national-level impact.

1. Contextual Imperative: Addressing Chronic Malnutrition in Eastern Uganda

1.1. The Critical Window: Malnutrition Rates and the 1,000-Day Opportunity

The foundation of the Luuka project is rooted in addressing Uganda’s persistent public health crisis of chronic malnutrition, specifically targeting the internationally recognized “1,000 days” window—from conception up to a child’s second birthday—where interventions yield irreversible positive impacts on growth and cognitive development. Interventions during this crucial period are paramount because virtually all stunting occurs within this time frame.

The quantitative burden of malnutrition in Uganda remains unacceptable. Nationally, 33% of children under five years of age are stunted,14% are underweight, and 5% are wasted. The project’s operational area, the East Central sub-region encompassing Luuka District, suffers from particularly acute rates of chronic malnutrition. Local statistics reveal that 33% of U5 children are underweight, 17% are stunted, and 5% are wasted. Furthermore, data collected during the proposal phase showed alarming prevalence of micronutrient deficiencies in Eastern Uganda, with 58% of U5s and 28% of women of reproductive age suffering from anaemia.

Research Assistants during during field pretest.

The elevated anaemia rate in the target region highlights the necessity of developing an intervention that rigorously addresses micronutrient density, specifically iron and zinc, in addition to protein and energy content. Anaemia significantly compromises immunity, increases susceptibility to infectious diseases like malaria, and limits cognitive development. Any supplementary food intended for this population must inherently address these high prevalence micronutrient gaps to demonstrate substantial health efficacy in future efficacy trials. This aligns the project directly with national policy goals, particularly the Uganda Nutrition Action Plan (UNAP) and the broader objectives of the Health Sector Strategic Plan (HSSP III). These policies recognize that malnutrition represents a severe economic drag, costing the nation approximately 5.6% of its Gross Domestic Product (GDP) in 2009 alone, thereby reinforcing the urgent need for impactful and scalable solutions.

1.2. The Socio-Economic and Agricultural Landscape of Luuka District

Luuka District, situated in the Busoga sub-region, presented a complex environment characterized by reliance on traditional agriculture and a fragile economic structure. The area is primarily agricultural, cultivating staples such as maize, sweet potatoes, cassava, rice, millet, beans, groundnuts, and various green vegetables. This local availability is fundamental to the project’s design, ensuring that the nutrient-dense product could be produced affordably and sustainably without reliance on external supply chains.

Pre-existing traditional food preparation methods were noted, including nutrient-combining practices like Mixed beans + Silver fish (Mukene) and Ground Nuts + Silver fish + Posho/Sweet Potatoes. The identification of these indigenous premixes and food pairings validated the cultural acceptability of blending local protein sources with staple carbohydrates, confirming a pre-existing social foundation for the product development strategy. The successful innovation trajectory inherently depended on anchoring the scientific formulation within these local, traditional techniques.

The existing local health infrastructure, comprising five local health units, depends critically on the Village Health Team (VHT) network for community outreach. This network of community workers was identified early in the project as the only feasible and reliable conduit for delivering long-term behavior change communication (BCC) and for distributing the product, thereby shaping the integrated delivery model developed under the grant.

2. The Integrated Design: Scientific Rigour and Community Systems

2.1. Pillars of the Integrated Model: Food Innovation, Delivery, and Participation

The project intentionally adopted an integrated, multi-sectoral approach after acknowledging that singular food product interventions rarely succeed in tackling deeply embedded malnutrition. This paradigm defined malnutrition as a complex issue rooted in political, social, and economic deficits, necessitating solutions combining different scientific fields.

The integrated model rested on three core pillars:

1. Product Development: Scientifically formulated, nutrient-dense food made entirely from locally sourced ingredients.
2. Service Delivery: A community-anchored distribution and behavioural change model utilizing VHTs, district officials, women’s groups, and caregivers.
3. Participatory Process: A collaborative development structure ensuring the final product was deemed acceptable, affordable, and feasible for rapid adoption in rural households.

The implementation was a joint effort between the Makerere University School of Public Health (focusing on public health and behaviour change) and the School of Food Technology, Nutrition and Bio-engineering (MakSFTNB), responsible for the scientific food development. This necessary collaboration ensured that technical development was constantly filtered through the lens of social and public health reality.

A section of the participants attentively observe cooking demonstration

2.2. Foundational Objectives and Collaborative Structure

The project’s feasibility phase involved rigorous initial objectives, including conducting participatory assessments (PRRA) to capture existing practices, establishing baseline nutritional status measurements, and undertaking the critical product development and sensory testing process.

The food science team initiated the process using NutriSurvey software to create six preliminary flour formulations based on local ingredients, carefully balancing energy, protein, and micro-nutrient content to meet the high demands of pregnant women, lactating mothers, and children aged 6 to 24 months.

3. Achievement I: Developing a Culturally Resonant Food Prototype

3.1. Formulation Science: Leveraging Local Staples and Traditional Processing

The selection of ingredients utilized locally available foods in Luuka, including staples (maize, rice, cassava), legumes (beans, soy, groundnuts), protein sources (small fish/Mukene), and supplementary nutrients (sugar, micronutrient premix). All raw materials were purchased directly from local markets to promote local economic activity, linking the health intervention to socio-economic development through a model of social entrepreneurship.

A critical technical component involved adapting and enhancing traditional food processing techniques to maximize nutritional value. Specifically, major ingredients like maize and beans underwent germination (malting). This step is vital because germination increases the digestibility and nutrient bioavailability, reduces anti-nutrients (such as phytates), and makes the food richer in vitamins, minerals, and amino acids. Beans and cowpeas were also roasted to improve flavor, while all ingredients were meticulously sun-dried to ensure a low moisture content before milling. Reducing moisture content is a fundamental strategy for increasing product shelf life and preventing the proliferation of toxic contaminants, such as aflatoxins and fumonisins, which are commonly associated with moldy kernels in stored crops like peanuts. This emphasis on safety engineering prolonged the overall Phase I timeline to one year, rather than the anticipated six months, as the principal investigator deemed it essential to conduct rigorous product safety tests before initiating community piloting—an important ethical and scientific decision to prevent unforeseen health risks.

3.2. Two-Tier Sensory Testing and Selection of Sample 520

The sensory evaluation phase was intentionally structured as a two-stage process to guarantee the innovation’s broad appeal, moving beyond laboratory preference to confirm community acceptance.

The first stage involved Laboratory Testing, where a semi-trained panel of food technologists and evaluators used a 7-point hedonic scale to systematically score the formulations based on key sensory attributes: Taste, Aroma, Colour, Texture, and Overall acceptability. The second and more decisive stage involved Community Testing in Luuka, engaging pregnant women, breastfeeding mothers, and caregivers. These participants were trained to record feedback using a simpler 5-point hedonic scale to maximize participation and ensure user-friendliness.

Of the initial formulations, Sample 520 and Sample 344 emerged as strong contenders. Sample 962 was consistently rejected in both settings and was dropped immediately. The final decision favoured Sample 520, which consistently received the highest scores, especially from the community panel, on the basis of its good flavour, smooth texture, and mild aroma. This deliberate selection based on overwhelming community preference validated the core project tenet: that successful nutrition innovation requires deep community engagement, reinforcing the belief that scientific formulation plus community validation equals a product that people will actually use. The cultural acceptability of the final prototype is viewed as paramount for long-term uptake and scalability.

Laboratory Testing of recipes by trained panel

4. Achievement II: Building the Community-Anchored Delivery System

A cornerstone of the project’s success was the establishment of a robust local infrastructure designed not just for intervention delivery but for co-governance and sustainability.

4.1. Quantifying Engagement and Network Establishment

The RMAF (Results-Based Management and Accountability Framework) reported significant engagement figures for the feasibility phase. The project directly accessed 545 direct beneficiaries (mothers, infants, and children below 24 months), including 36 pregnant mothers and 36 lactating mothers involved in the sensitive sensory evaluation exercises.

Critically, the project mobilized a wide network of 656 intermediaries. This extensive network included 72 Village Health Team (VHT) Members, 9 sub-county level local leaders, 20 District Health Team members, and 5 District Technical staff. The high number of engaged intermediaries relative to the initial target population indicates a successful front-loaded investment in social and political infrastructure. This broad institutional and political buy-in is considered vital for overcoming systemic barriers to large-scale intervention adoption, particularly those related to a “lack of harmonization” and “low capacity of implementing agencies” cited in Uganda’s national nutrition strategy. By embedding the innovation within local governance structures, the project minimized the perception of being an “external initiative” and fostered lasting community ownership.

The process developed two key outputs: one nutrient-rich food prototype (Sample 520) and one service delivery model.

4.2. Operationalizing Co-Creation: VHT Capacity Building and Local Realities

The VHT members were designated as the essential frontline workers, necessitating specialized training and validation. The training for 27 Research Assistants (RAs) and VHTs encompassed the ethics of human research, anthropometric measurement procedures, and hands-on preparation of the food product through cooking demonstrations.

This training exposed critical challenges rooted in local social norms. RAs reported that women were reluctant to disclose pregnancies early or show newborns until the umbilical cord had dropped off, reflecting deep-seated cultural caution. Furthermore, the RAs expressed fear regarding high community expectations for material offers, a pervasive issue where external projects are often viewed solely as sources of immediate aid.

The project addressed these operational constraints by clearly communicating that their role was research and feasibility assessment, not clinical treatment or immediate material provision, thereby managing expectations and relying on the VHTs’ local credibility to maintain trust. This confirmation that caregivers desire and require repeated counselling and peer support validates the design of the service delivery model, which must integrate sustained community engagement rather than relying on episodic visits to drive complex behaviour changes related to feeding, hygiene, and product adoption.

5. Nuanced Analysis: Defining Malnutrition as a Systems Problem

The empirical data and the qualitative findings from the Luuka project strongly reinforce the fundamental conclusion that chronic childhood malnutrition is not merely a “food problem” but a “systems problem” characterized by intersecting social, economic, and cultural vulnerabilities.

5.1. Economic Stressors and Detrimental Modernization

The stability of household income and local food production directly dictates dietary adequacy. Limited income forces families to pursue cash crops, often replacing diversified food gardens or necessitating the sale of nutritious home-grown food. This economic pressure exacerbates seasonal hunger and limits the resources available to sustain diverse diets throughout the year.

Furthermore, modern conveniences sometimes inadvertently undermine traditional nutritional practices. Local VHTs pointed out that the traditional practice of fermenting maize (which enhances nutrient absorption) has been abandoned, and current commercial maize mills often remove nutritious husks during processing, resulting in less nutritious staple foods. This deterioration in quality, driven by a poorly managed transition to modernization, contributes significantly to nutritional deficiencies despite overall food availability.

5.2. Pervasive Cultural Barriers and Food Taboos

Cultural beliefs impose direct, localized constraints on optimal feeding practices, particularly affecting the most vulnerable groups: pregnant/lactating women and young children.

Specific food taboos identified in Luuka included:

1. Fish (Mukene) Restriction: Households associated with traditional healers (herbalists) deny all family members, including vulnerable children and mothers, this affordable source of protein, calcium, and zinc.
2. Egg Restriction: Eggs, a vital source of protein, are restricted from babies because of the local belief that they “hinder teeth development”.
3. Postpartum Diet: Women who have recently given birth are discouraged from consuming nutritious staples like Kalo (millet) and sweet potatoes due to the belief they cause diarrhea.

These cultural barriers translate directly into nutrient deficits during the critical ,000-day window, often leading to monotonous diets, pre-lacteal feeding, and delayed introduction of complementary foods. Interventions must therefore combine scientific knowledge with tailored behaviour change strategies designed to overcome these long-standing, community-specific beliefs.

5.3. Intersecting Health and Hygiene Deficits

Malnutrition is intrinsically linked to concurrent poor health conditions and inadequate public health environments. Caregivers universally report facing the burden of infectious diseases such as malaria, anaemia, and recurrent childhood illness. These illnesses increase nutrient requirements, impair appetite, and compromise nutrient absorption, trapping children in a cycle of illness and malnutrition.

Moreover, deficiencies in Water, Sanitation, and Hygiene (WASH) practices, such as the use of un-boiled water and poor hygiene habits, drive diarrheal episodes. Diarrhea is a leading cause of stunting and wasting, directly undermining the goals of nutritional supplementation. Therefore, any future solution must consciously integrate nutrition interventions with the provision of health, WASH, and maternal care services, confirming that the solution must combine nutrition + health + community systems.

6. Strategic Road Map: Scaling the Integrated Innovation

The successful feasibility phase in Luuka provides essential guidance for the next innovation pathway, demanding a shift from local prototype validation to national efficacy proof and scale-up planning.

6.1. From Feasibility to Efficacy: The Need for Rigorous Trials

The established success of Sample 520 in terms of acceptability must now be backed by rigorous evidence of clinical impact. The pathway requires significant forward investment and continued methodical research.

The definitive next step is to conduct rigorous field trials focusing on three outcome measures: adoption rates, nutritional impact (measured through anthropometrics), and the cost-effectiveness of the delivery strategy. This process will confirm that the prototype is not only used but actively prevents malnutrition. Furthermore, the strategic plan calls for testing the developed product in a clinical setting among a purely malnourished target population to understand its therapeutic effectiveness. This two-pronged approach—testing prevention at the community level and treatment efficacy clinically—is critical for securing the evidence needed for policy adoption and long-term funding.

6.2. Product and Production Pathway Optimization

The long-term sustainability and scalability of the innovation require finalizing the Sample 520 prototype and exploring commercial manufacturing avenues.

The product must be enhanced to maximize its public health impact. To address the pervasive issue of anaemia, the project plans to explore the possibility of adding a fortificant to comply with Uganda’s National Food Fortification guidelines, making the food richer in essential micronutrients.

Crucially, the production model must be refined for low-income settings. Recognizing that large-scale production using local technology requires accurate forecasting, the team intends to undertake further research into the product development process and conduct a detailed cost-benefit analysis of different production options. This analysis will determine the most appropriate local manufacturing and commercialization pathways, aiming for the eventual goal of marketing the product at a national level to save lives. This proactive approach ensures the innovation remains affordable and locally viable when scaled.

GCC food product.

6.3. Strengthening the Continuum of Care through VHT Systems

The delivery model must leverage the established VHT network and evolve into a sustained, high-intensity support system to counter the complexity of behaviour change.

The operational strategy mandates strengthening community-based nutrition counselling and VHT systems. Based on the observation that behaviour change requires ongoing support, the new approach will shift toward intensive (monthly) group nutrition education programs. These intensive sessions will integrate data collection on nutritional status with essential product re-filling, achieving three major objectives within a single community interaction. VHTs will also lead focused individual counselling for mothers of children borderline or severely malnourished, ensuring timely referral to health facilities.

This sustained, localized effort, built on the successful engagement of 72 VHT members in the feasibility stage, is non-negotiable for ensuring that the intervention reaches the poorest and most vulnerable children, thereby countering the limitations of traditional top-down interventions.

6.4. Advocacy and Multi-Sectoral Partnership for Policy Integration

Successful scaling depends heavily on securing high-level political commitment and integrating the intervention into existing health and agricultural frameworks.

The project demonstrated early political savvy by involving Ministry of Health officials in the initial stages to secure necessary policy buy-in and advise on the timeline for policy adoption of the study’s findings. This proactive engagement resulted in Makerere University School of Public Health being invited to participate in programming for large-scale collaborations, where the innovation is appreciated and positioned to lead the nutrition objective across five districts in Eastern Uganda. Future advocacy efforts will involve the local political wing to mobilize neighbouring leaders in the region, promoting the eradication of malnutrition through coordinated action.

To ensure multi-sectoral resilience, the planned pathway includes explicitly addressing multi-sectoral gaps faced by rural families, requiring the integration of services spanning malaria control, sanitation, maternal health, and early childhood development. The project continues to cultivate strategic partnerships with the World Health Organisation (WHO), UNICEF, the Ministry of Health, and the Resilient Africa Network (RAN), which is actively seeking to sponsor students with innovative ideas in health and nutrition to support the target community further. This comprehensive web of collaborations ensures the innovation is systemically aligned with broader child-health and development needs.

Conclusion: Guiding a New Generation of Nutrition Solutions

The Grand Challenges Canada-supported feasibility study in Luuka District has yielded powerful and enduring lessons for nutrition innovation in low- and middle-income countries. The project successfully demonstrated that it is possible to produce a high-quality, scientifically sound, and culturally acceptable complementary food prototype (Sample 520) using entirely local resources and processing methods. The central finding confirms that community ownership, driven by local preference for taste and texture, is the single most critical factor for sustainable product uptake.

The integrated model revealed that translating product feasibility into national nutritional impact mandates a systemic response to intersecting vulnerabilities. This requires overcoming deep-seated cultural barriers (such as food taboos against fish and eggs), countering the detrimental effects of rapid economic modernization (e.g., loss of fermenting practices), and aggressively tackling co-morbidities like malaria and poor hygiene through enhanced public health systems. The next phase is strategically designed to generate the clinical and cost-effectiveness data required for national policy integration and scale, building on a foundation of scientific rigor, community trust, and unprecedented multi-sectoral collaboration with both political leadership and development partners. These achievements prove that rural communities are not passive beneficiaries, but essential co-creators of sustainable, life-saving solutions.

Today, Iganga General Hospital joined the rest of the world to commemorate World Prematurity Day, marked every year on 17 November. The event was graced by the Rt. Rev. Patrick Wakula, Bishop of the Diocese of Central Busoga, who served as the Chief Guest and delivered deeply moving remarks.

Bishop Wakula shared his own remarkable journey of survival as a premature baby born at Nsinze Health Centre IV in Namutumba six decades ago. At a time when health facilities had no incubators and resources were limited, his parents relied on resilience and faith. His father, a cotton farmer, provided cotton that his mother used to keep him warm, ensuring he survived those fragile early days.

Bishop Wakula blesses a couple and their thriving twins, once premature babies at Iganga Hospital

He recalled that he was so weak that he rarely cried. One day, when he finally let out a soft cry, his mother said in Lusiki:

“Mwana wange olaba okungile mu bwoti, wakula,” meaning “My son, that you have managed a cry, you will grow.”

From that moment, he was named Wakula — meaning “you will grow” — a name that has carried a story of hope, love, and God’s grace for over 60 years.

Bishop Wakula’s testimony is a powerful reminder that every premature baby deserves a chance to survive and thrive, and that with proper care, community support, and strong health systems, many more lives can be saved.

Moments from the World Prematurity Day procession in Iganga, a community stepping forward for stronger newborn care

Earlier today, the commemoration activities began with a march around Iganga town, where health workers, partners, and community members made several strategic stops to deliver health talks on:

• Causes and risk factors of prematurity
• Importance of early antenatal care
• Recognizing danger signs during pregnancy
• The need for warmth, nutrition, and timely care for newborns
• Community responsibility in supporting mothers and babies

Busoga Health Forum applauds Iganga General Hospital, its dedicated health workers, and all partners who continue to champion newborn health in the region.

As we reflect on this day, may Bishop Wakula’s story inspire us to continue strengthening maternal and newborn care so that every baby born too soon has a fighting chance — and every mother feels supported.

The Busoga sub‑region in Eastern Uganda has a population of more than 3.3 million people and includes 11 districts plus Jinja city. Despite fertile soils and fishing along Lake Victoria, families in Busoga struggle with food insecurity; 14 % of the population is in a food‑crisis phase and only 47 % are food secure (April–July 2025). By late 2025 the situation is projected to improve slightly (53 % food secure), yet 8 % of families will remain in crisis and nearly 39 % “stressed”. Sugar‑cane monoculture has displaced food crops, incomes are volatile and access to safe water is limited, leading many households to adopt crisis coping strategies (e.g., reducing meal portions or selling assets) ipcinfo.org.

Burden of malnutrition and anemia

Recent research paints a stark picture:

• Anemia epidemic. A 2025 community‑based study in the Busoga region found that 67.4 % of children aged 6‑59 months are anemic; 38.2 % have mild anemia, 54.4 % moderate and 7.4 % severe. Anemia risk was 20 % higher among children who had malaria within the previous two weeks and 50 % higher when caregivers were aged 45–59 years Researchers noted that Busoga’s anemia prevalence far exceeds Uganda’s national estimate (~51.7 %) and is associated with economic deprivation and the expansion of sugar‑cane at the expense of food crops, which fuels household food insecurity.
• Insufficient diets. In the IPC Acute Malnutrition analysis (March–August 2025), only 17 % of children in Busoga met the Minimum Acceptable Diet, and only 34.8 % met Minimum Dietary Diversity. Diets are dominated by starchy staples, while intake of animal‑source foods, fruits and vegetables is low Merely 7.2 % of women of reproductive age achieved minimum dietary diversity.
• Acute malnutrition. Although Global Acute Malnutrition (GAM) prevalence in Busoga was relatively low (2.3 %), an estimated 60,860 children and 15,181 pregnant/breast‑feeding women were expected to suffer or require treatment for acute malnutrition between March 2025 and February 2026ipcinfo.org. Only eight districts were classified as IPC Phase 1 (acceptable); but poor feeding practices and recurrent illnesses (malaria, diarrhoea, respiratory infections) jeopardise children’s recovery.
• Stunting and wasting. Nationally, 26 % of Ugandan children under five are stunted. Eastern Uganda (where Busoga is located) has significant stunting (23.8 %), and anemia rates (57.5 %) are the highest nationally.

These figures underscore that child nutrition in Busoga is a severe public‑health emergency. Without decisive action, children risk irreversible cognitive delays, diminished school performance and lifelong economic disadvantages.

Our Strategy – Integrating Community and Hospital Care

Busoga Health Forum (BHF) is spearheading a comprehensive nutrition program anchored on community engagement and hospital partnerships. Our approach is evidence‑based and borrows from successful models of community‑based management of acute malnutrition (CMAM), which have demonstrated high recovery rates and low mortality when integrated with health systems.

Community‑level action

1. Early screening & referral. BHF trains community health volunteers and mothers’ support groups to use simple tools like mid‑upper arm circumference (MUAC) tapes to detect malnutrition early. In Mali, integrating acute malnutrition treatment into community case management increased treatment coverage from 20–29 % to 57–61 % within one yearand improved recovery rates (66.9–86.2 %) when supervision and support were strong. We aim to replicate this success in Busoga by decentralizing screening and ensuring swift referral to health facilities.
2. Nutrition education & counselling. Community health workers conduct home visits and group sessions on exclusive breastfeeding, appropriate complementary feeding, balanced diets and hygiene. They help caregivers diversify diets using locally available foods and promote iron‑rich foods (beans, leafy greens, fortified porridge) to combat anemia.
3. Food security & livelihoods. BHF supports household and school gardens, introducing bio‑fortified crops (orange‑fleshed sweet potatoes, iron‑rich beans) and drought‑tolerant vegetables. We partner with farmer groups to integrate nutrition education with sustainable agriculture and provide training on improved food storage—an issue highlighted in Mayuge District, where 23.5 % of households lacked permanent food storage.
4. Health promotion. We collaborate with local leaders and schools to encourage timely immunization, dewormingand malaria prevention (use of insecticide‑treated nets and indoor residual spraying) to reduce infection‑related anemia. Water‑sanitation‑hygiene (WASH) campaigns address diarrhoeal disease and parasite infections that exacerbate malnutrition.

Hospital‑level and clinical care

1. Stabilization centres and outpatient therapeutic programs. Children with severe acute malnutrition (SAM) and medical complications are treated at hospital‑based stabilization centres. After stabilization, they graduate to outpatient therapeutic programs (OTPs), receiving ready‑to‑use therapeutic foods (RUTF) and regular follow‑up. A meta‑analysis of integrated management of acute malnutrition programs in Somalia reported recovery rates of 95.4 % in OTPs and 80.8 % in stabilization centres, with death rates under 2 %, far surpassing Sphere standards. These results show that hospital‑community integration saves lives when adequate supplies and trained staff are available.
2. Capacity building for health workers. BHF equips clinicians and nurses with up‑to‑date protocols on Integrated Management of Acute Malnutrition (IMAM), including danger‑sign recognition, antibiotic use and counselling on feeding. Regular mentorship ensures adherence to treatment guidelines. Evidence from Mali indicates that recovery rates improved substantially (up to 86 %) when health centres and community health worker (CHW) sites received intensive technical and financial support and supervision.
3. Supply chain and logistics. We work with district health offices to ensure consistent availability of RUTFs, micronutrient powders, iron‑folate supplements and deworming tablets. A GiveWell review found that although CMAM programs can cost around US$ 70 per child in some contexts, they target children at a high mortality risk (~6 % annually) and reduce the risk of death by roughly 45 %, making them highly cost‑effective.
4. Data systems and follow‑up. Health facilities are supported to maintain nutrition registers and track children from admission through discharge and into post‑discharge follow‑up. Community volunteers follow up at home to monitor weight gain, detect relapse early and support feeding practices. Better data allow us to evaluate impact and adapt strategies.

Anticipated Impact and Key Goals

BHF’s programme aims to achieve measurable improvements over five years:

• Reduce anemia prevalence among children under five from 67 % to below 40 %. This includes mass deworming, malaria control and iron supplementation.
• Increase the proportion of children meeting the Minimum Acceptable Diet from 17 % to 50 %, through nutrition education, diversified food production and social protection measures.
• Treat at least 15,000 children with acute malnutrition through integrated hospital and community services, ensuring recovery rates above 85 % and mortality below 2 %.
• Empower women: train 5,000 women in nutrition, breastfeeding counselling and income‑generating activities to improve household food security.
• Strengthen surveillance: implement digital nutrition data systems in all district hospitals and regularly share findings with local governments and partners.

Budgetary Needs and How Donors Can Help

To realise these goals, BHF seeks support for:

1. Training and mentorship: equipping community health workers and hospital staff with skills in nutrition assessment, counselling and IMAM protocols.
2. Nutrition supplies: procuring RUTFs, micronutrient powders, iron/folate tablets, deworming drugs and MUAC tapes.
3. Demonstration gardens and seed distribution: establishing community/school gardens and supplying bio‑fortified seeds and planting materials.
4. Monitoring and evaluation: developing digital data systems, conducting periodic surveys and evaluations to track progress and impact.
5. Community outreach and education: producing communication materials (posters, radio spots, mobile messages) promoting diversified diets, breastfeeding and hygiene.

Investing in child nutrition yields lifelong dividends. Adequately nourished children are more likely to survive, achieve better educational outcomes and become productive adults. By partnering with the Busoga Health Forum, donors can contribute to a scalable, evidence‑based program that combines community empowerment and hospital care to break the cycle of malnutrition. Together, we can ensure that every child in Busoga has the opportunity to thrive.

Key Indicators Summary

BHF’s programme draws on these proven approaches to deliver a scalable, integrated nutrition intervention tailored to the Busoga context. We invite donors to partner with us to nurture a healthier, more prosperous future for Busoga’s children.

The Child Thrive Partnership is a unique four-in-one project and involves the partnership of two municipal councils, The Region Stockholm and Jinja city, two civil society organizations; Busoga Health Forum and Pediatric Health Initiative and the two hospitals Jinja Regional Referral Hospital and Astrid Lindgren Children’s Hospital. The four projects included in this partnership are: Emergency pediatric care, Pediatric Neurology, Neonatology and Child rights project. Below is a summary of major achievements;

Equity

Trained health workforce that strengthens the inclusive health care provided to the children in the region. Health workers from both participating countries have participated in exchanges which have exposed them to increased understanding of health systems in other countries and the impact of global inequities.

The emergency project has trained 196 health workers in emergency pediatric care that provide timely and life-saving interventions at health facilities in the region. The training has been developed in collaboration with Uganda Ministry of Health as part of a nationwide attempt to implement updated emergency care guidelines. Health workers from one regional referral hospital, six district hospitals and 13 health center IVs have been trained. Out of 196, 18 health care providers have done the trainers of trainees’ program in Sweden and have been recognized by the Ministry of Health as regional and national ETAT trainers.

Prof. Helena Hildenwall demonstrates the proper technique for inserting an intraosseous (IO) line during a paediatric emergency care training session for health workers in Jinja.

Eighty health care providers trained in epilepsy management now better assess and manage children with seizures, developmental delays, and neurological conditions. Five (5) in school Epilepsy information sessions have been conducted plus three (3) radio talk shows in Baba and Busoga one to increase the awareness of Epilepsy in the region and reduce stigma.

70 neonatology-trained staff are improving survival outcomes for newborns, especially premature and low birthweight babies. Infection prevention control has been improved at the NICU with bedside sanitizers and min pharmacy available at the unit. Baby nests have also been introduced to support the neonates with posture.

80 Child Rights Ambassadors have been trained and are actively sensitizing communities on children’s rights and reporting abuse or neglect, strengthening child protection at grassroots level. We developed a child rights training tool box and planning to share with a wider group

Participation
Children’s voices in health care is improved with the involvement of hospital administration and policy makers.

Through the child rights project, children have had an engagement in a formal to express their voices, share concerns, and make recommendations to local leaders, leading to increased visibility and inclusion in decisions. Two child rights awareness weeks have been conducted and it attracted the children, care givers, community and the hospital administrators who pledged support. During the child rights awareness week, the first ever children’s parliament was conducted and children were able to raise their voices on the kind of facility they need.

The neurology project has engaged in radio talks and school visits to enhance epilepsy awareness and reduce stigma in the public. The project has also developed information material for the health facilities to be shared with affected children and their families.

The neonatology project actively works with increased involvement of mothers in the care of their newborns.

Transparency
In all projects, Swedish and fifty (50) Ugandan health professionals have participated in exchange visits, learning from each other’s systems, improving skills, and building lasting collaborations. The Ugandan team were involved from the project inception and they have taken ownership of the project. Post-training follow-ups show increased confidence and competence among trained staff, with reported improved clinical practices and decision-making.

Accountability
Policy Engagement and Political Will Strengthened: The project successfully engaged local politicians and policymakers, leading to greater prioritization of child health and rights in district development agendas. The leadership of Jinja City involved in the project include the City Mayor, the City Clerk, the City Health Officer, the City Deputy Clerk and the ADHO Maternal and Child.

We performed a Citizen Report Card assessment which highlighted issues within Jinja City in relation to the consideration of child rights and equity within the health system.

The ED, Busoga Health Forum, City Health Officer, Area Member of Parliament, Jinja Regional Referral Hospital Director and City Mayor, join the Child Thrive Partnership exchange visit in Sweden. The engagement strengthened collaboration between Jinja’s political, administrative, and health leaders, fostering greater commitment to advancing child health, equity, and rights within the city’s development agenda.

Research

The project has conducted several research activities with baseline surveys that informed the intervention. The research conducted include, baseline emergency care research, baseline quality of care research, infection prevention and citizen report card surveys. We have so far published one paper to share knowledge; Capacity for delivery of paediatric emergency care and the current use of emergency triage, assessment and treatment in health facilities in the Busoga region, Uganda—A mixed methods study

Summary of Achievements