Mackuline has worked as a research assistant in a health economics survey in Maseno Division, and an antiretroviral adherence intervention study in Chulaimbo Health Centre, both in western Kenya. She has been involved in volunteer palliative care both at the community and health facility level. She also has vast experience in teaching, translating and clinical nursing. Mackuline is a registered nurse holding a Bachelor degree from the School of Medicine at Moi University.