Moroto Regional Referral Hospital, commonly known as Moroto Hospital is a hospital in the town of Moroto, in Northeastern Uganda. It is the referral hospital for the districts of Abim, Kaabong, Kotido, Moroto and Nakapiripirit and Napak.
Health professional mobility has become a defining feature of 21st-century health systems, highlighting deep structural inequalities within global health labour markets. International movement of health workers can unfairly disadvantage source countries by losing publicly funded training investments, although it offers benefits at both individual and system levels. This narrative review compiles evidence on current patterns, drivers, and impacts of health worker migration, and explores the emerging idea of proportionate co-investment as a framework for fairer global health workforce management. Literature was gathered through database searches of PubMed, Scopus, Google Scholar, and major organisational and government websites. Evidence was presented following SANRA guidelines. The review emphasises dominant South–North migration flows. Widening wage gaps, poor working conditions, and power imbalances allow high-income countries to benefit from “implicit subsidies” in health workforce development. For source countries, this results in service gaps, poor distribution, higher health system costs, and slower progress toward universal health coverage. Current ethical recruitment codes and bilateral agreements are mostly voluntary, fragmented, and inadequate to fix labour-market imbalances. Proportionate co-investment redefines health worker migration as a shared global duty. Destination countries should systematically support health workforce education, retention, and working conditions in source countries. This review advocates a proactive framework grounded in proportionality, predictability, system alignment, and shared governance, drawing on emerging models such as skills partnerships and destination-country financing. Embedding proportionate co-investment could shift global policy from managing health worker losses to sharing responsibilities, promoting ethical mobility, and strengthening health systems worldwide.
Clinical students face hazards, such as needlestick injuries and blood spills. While healthcare workers’ exposure to such hazards is well-documented, there is limited data on medical students, particularly in Uganda. We explored the prevalence and factors associated with biological occupational hazards among clinical university students. This cross-sectional study examined biological occupational hazards among 384 randomly selected undergraduate clinical medical students at a university in Southwestern Uganda. Data were collected using a structured self-administered questionnaire. Categorical and numerical data were summarised descriptively using frequencies and means. Multivariable logistic regression identified factors independently associated with hazard exposure. Adjusted odds ratios with 95
Two rapid assessments of avoidable blindness (RAAB) surveys were conducted in the Karamoja subregion, Uganda, in 2015 and 2023. This paper reports the observed changes in prevalence, causes of visual impairment and coverage of cataract services and examines how the trends differ for males and females. Standard RAAB methodology was used in both studies. Two-stage cluster sampling was used to generate random samples of adults aged over 50 years. Participants underwent a simplified visual acuity (VA) exam, a lens exam, and a posterior segment exam using a direct ophthalmoscope for all participants with presenting VA < 6/18. Data was analyzed using an inbuilt command prtesti, and the regression models were developed using Stata v15 statistical software. In 2015, 3,833 participants were enrolled, and 96.8% (3,727) examined. In 2023, 3,450 were enrolled and 91.6% (3,159) examined. The prevalence of all-cause blindness was 6.0% in 2015 and 4.9% in 2023 (p-value = 0.05). The Cataract Surgical Coverage (CSC) for persons with visual acuity threshold of <3/60, < 6/60, and <6/18 was 41.6%, 34.2% and 20.5% in 2015 and 71.6%, 56.6% and 41.5% respectively, in 2023. The effective Cataract Surgical Coverage (eCSC) for the same vision category was 20.0%, 16.2%, and 9.2% in 2015 and 22.5%, 17.1% and 12.4% in 2023 The eCSC was consistently lower among females than males with the gap widening over the years: 15.9%, 12.1%, and 9.1% in females vs 28.4%, 21.6%, and 15.7% in males respectively. The CSC levels differed across assessments while eCSC values remained low. Targeted interventions are needed to improve post-surgical visual outcomes and ensure equity in access for women and individuals with moderate visual impairment.
Malaria remains a major public health problem in Uganda, with marked spatial and temporal variation in incidence. A clearer understanding of these patterns is essential for targeting control efforts. This study quantified spatial heterogeneity, spatiotemporal clustering, and temporal dynamics of malaria incidence in Uganda (2014–2023), and generated probabilistic forecasts intended to support targeted malaria control and surveillance planning. This ecological study used district-level malaria surveillance data from Uganda’s District Health Information System 2 (DHIS2) from 2014 to 2023. Spatial heterogeneity was described using choropleth mapping with Jenks natural breaks classification. Emerging Hot Spot Analysis (EHSA) was used as the primary method to identify statistically significant spatiotemporal hotspot and cold spot dynamics. Exploratory secondary analyses included district-level Mann-Kendall trend testing and time series clustering. National monthly malaria counts were modelled using an ARIMA(2,1,1) framework, and forecasts with prediction intervals were generated to describe near-term trajectories under continuation of historical patterns. Malaria burden showed marked spatial heterogeneity across Uganda. Higher burden was concentrated in West Nile, Acholi, and Lango, with additional elevated burden in parts of Karamoja, Teso, Busoga, Bukedi and northern Buganda, while lower burden was observed across much of Tooro, Bunyoro, southern Buganda, Bugisu, Sebei, Kigezi, and Ankole. EHSA identified distinct spatiotemporal hotspot dynamics: sporadic hotspots were concentrated in West Nile, oscillating hotspots predominated in Karamoja and extended into parts of Teso and Sebei, and consecutive hotspots formed a narrower corridor through parts of Lango, Bunyoro, Busoga, southern Buganda. New hotspots were few and localized, occurring mainly in Teso and northern Buganda, whereas sporadic cold spots were largely confined to Kigezi in the south-west. Exploratory secondary analyses were broadly consistent with these patterns: time-series clustering separated districts into lower- and higher-burden trajectory groups, and Mann-Kendall trend testing showed upward trends concentrated mainly in Karamoja, with localized increases in Busoga, Teso, Buganda, Acholi, and West Nile, while downward trends were restricted to Kigezi. At the national level, the ARIMA(2,1,1) model reproduced the main level and seasonal oscillations in the series and suggested a gradually increasing underlying trend, with monthly malaria cases projected to remain approximately 1.0 to 1.2 million through 2030. Exploratory decomposition indicated a recurring seasonal pattern, with incidence generally rising from March to a primary peak in April to June. Malaria transmission in Uganda remains highly heterogeneous, with consecutive, sporadic and oscillating hot spots in eastern and north eastern regions and sustained declines in parts of the southwest. National forecasts indicate continued high incidence with a modestly increasing baseline and sharply defined seasonal peaks. These findings support intensified, geographically targeted control in high burden districts, sustained investment in areas with declining trends, and the use of routine forecasting and temporal decomposition to guide adaptive planning toward national malaria control targets for 2030.
Malaria remains a leading cause of morbidity and mortality among children under five years in Nigeria, a country accounting for over a quarter of global malaria cases. Despite the availability of interventions, Nigeria continues to face persistent challenges in controlling malaria, especially in the under-five population, thus, the need for this review. This narrative review synthesizes peer-reviewed literature, national reports, and policy documents published since 2010. A structured search was conducted across PubMed, Google Scholar, Scopus, and relevant grey literature from the WHO, UNICEF, and the Nigerian Ministry of Health. The review adhered to SANRA guidelines to ensure methodological rigour and focused on studies reporting malaria epidemiology, interventions, and control efforts targeting children under five in Nigeria. Findings revealed a high malaria burden among children in Nigeria, with notable regional disparities. Northern states report the highest prevalence, with rural areas disproportionately affected. Contributing factors include socioeconomic deprivation, climate variability, and suboptimal coverage of interventions. Key challenges include diagnostic limitations, drug resistance, and inconsistent use of preventive measures. While interventions such as long-lasting insecticidal nets (LLINs), intermittent preventive therapy, and indoor residual spraying have shown effectiveness, gaps remain in coverage and implementation. Innovations in diagnostics, vaccines, and surveillance systems are promising but underutilized. Despite progress, Nigeria faces multifaceted challenges in malaria control among under-fives. A coordinated, multisectoral response involving innovative strategies, stronger health systems, and policy reforms is essential. Attention must also be directed to enhancing the acceptability, fidelity, and longevity of these interventions.
