The SCHEMA-Uganda project officially started on 1st February this year. Moving on quickly from the joy of being awarded the grant, the hard work began on the project’s set up and the early ground work that will enable us to deliver on our aims. A key activity in these early months was the project’s official launch and stakeholder meeting – hosted by Makerere University at the Golden Tulip Hotel from 31st March to 2nd April 2026.
SCHEMA-Uganda aims to strengthen Uganda’s community health system, ensuring it can better meet both routine and emergency health needs – work which is particularly timely, given the current Ebola outbreak in the region. The project focuses on creating actionable policy tools through modelling, knowledge mobilisation, and stakeholder engagement.
The three-year research project is led by Makerere University School of Public Health, in partnership with the Ministry of Health, Uganda, and the Centre for Health Economics, University of York. It is supported by a grant from the National Institute for Health and Care Research (NIHR).
Why SCHEMA-Uganda Matters Now
Uganda continues to face the dual challenge of managing everyday healthcare needs alongside repeated disease outbreaks. Recurring emergencies, including Ebola and COVID-19, have exposed the fragility of community-level systems, especially in rural and underserved areas.
While community health workers (CHWs), village health teams (VHTs), and local leaders serve as the critical first point of contact for households, they frequently struggle with fragmented governance, uneven funding, limited supervision, and a lack of operational evidence on how to deliver resources effectively. SCHEMA-Uganda responds to this gap by generating evidence to optimise resource allocation, strengthen community response, and embed outbreak preparedness within the community health system.
The Three Core Workstreams
To address both systems and governance challenges, the project is structured around three interconnected workstreams:
- Workstream 1: Governance and Stakeholder Mapping: Uses political economy and social network analyses to map the complex landscape of government bodies, UN agencies, NGOs, faith-based institutions, and community groups. It aims to clarify how authority, funding, and responsibilities are distributed, identifying coordination bottlenecks and opportunities for stronger policy alignment.
- Workstream 2: Knowledge Mobilisation and Capacity Building: Synthesises existing evidence and gathers primary data on the real-world workloads, activity logs, and logistical constraints of CHWs. Crucially, it also builds local capacity by training district and national stakeholders in outbreak modelling and decision analysis to promote long-term sustainability.
- Workstream 3: Modelling and Decision Support: Uses epidemiological and economic modelling to simulate disease transmission scenarios to assess the cost-effectiveness of various CHW-led interventions. The team will develop a decision-support tool to help planners and district health managers explore resource allocation scenarios under budget and staffing constraints.
Key Takeaways and Stakeholder Feedback
The launch event signalled how we will produce research that can go on to generate real and lasting impact: with co-production from start to finish. Government officials, researchers, civil society actors, NGOs and implementing partners gathered to provide feedback and refine the project’s direction. Five central themes emerged from the discussions:
- Integrating Routine Care and Emergency Response: Emergency responses are most effective when leveraging existing, trusted community networks rather than operating in parallel. The research team were encouraged to look at real-world practice and not only policy statements.
- Centering Frontline and Community Voices: Participants valued the project’s recognition that community health workers are central to Uganda’s health system. Research must reflect the lived realities of households and CHWs, recognising that local trust and legitimacy drive policy adoption during outbreaks.
- Understanding the Flow of Coordination and Finance: Given the complex web of actors in Uganda’s health sector, stakeholders expressed strong interest in mapping where coordination succeeds or fails in practice, given issues with duplication, fragmented accountability and varied geographic coverage. Discussions highlighted the need to analyse the role of funding in shaping outbreak actions across different administrative levels.
- Producing Actionable, Policy-Relevant Evidence: Rather than creating abstract academic theories, SCHEMA-Uganda is committed to delivering concise, highly practical recommendations – where complex data and insights are effectively presented into clear actions for policy and implementation.
- Securing Sustainability and Scale-Up: To ensure lasting impact, participants stressed that the project’s findings must be directly embedded into existing government frameworks and partner programmes – rather than running in parallel – laying the groundwork for more resilient, equitable health services in Uganda.
We wish to express our thanks to all participants of the stakeholder meeting. We are grateful for the positive feedback and support given to the project, and the valuable insights provided that will guide the team as they set out to deliver practical, evidence-informed solutions tailored to Uganda’s health system.
Looking Ahead
In early July, we held the first SCHEMA-Uganda Advisory Group meeting where our valued members expressed their enthusiasm for the work, noting its relevance and potential for impact. Led by Principal Investigator Prof. Freddie Ssengooba (Makerere University School of Public Health), the SCHEMA-Uganda team will now proceed with field-level data collection, stakeholder interviews, and initial model designs. As the project progresses, we look forward to sharing further updates and emerging insights.
Keep an eye on thanzi.org and LinkedIn for research, events, and opportunities from across the Thanzi Programme.
This research was funded by the NIHR (NIHR169017) using UK international development funding from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Government.
By: Kath Devlin – with thanks to colleagues at Makerere University | August 2026
