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Sample records for kayunga district uganda

  1. Development of a district mental healthcare plan in Uganda

    PubMed Central

    Kigozi, Fred N.; Kizza, Dorothy; Nakku, Juliet; Ssebunnya, Joshua; Ndyanabangi, Sheila; Nakiganda, Blandina; Lund, Crick; Patel, Vikram

    2016-01-01

    Background Evidence is needed for the integration of mental health into primary care advocated by the national health sector strategic investment plan in Uganda. Aims To describe the processes of developing a district mental healthcare plan (MHCP) in rural Uganda that facilitates integration of mental health into primary care. Method Mixed methods using a situational analysis, qualitative studies, theory of change workshops and partial piloting of the plan at two levels informed the MHCP. Results A MHCP was developed with packages of care to facilitate integration at the organisational, facility and community levels of the district health system, including a specified human resource mix. The partial embedding period supports its practical application. Key barriers to scaling up the plan were identified. Conclusions A real-world plan for the district was developed with involvement of stakeholders. Pilot testing demonstrated its feasibility and implications for future scaling up. PMID:26447171

  2. Ivermectin distribution using community volunteers in Kabarole district, Uganda.

    PubMed

    Kipp, W; Burnham, G; Bamuhiiga, J; Weis, P; Büttner, D W

    1998-06-01

    Ivermectin mass distribution for the control of onchocerciasis in Uganda began in 1991. This report describes a community based ivermectin distribution programme covering two foci in the Kabarole district which have an estimated 32,000 persons infected and another 110,000 at risk. Through nodule palpation in adult males, 143 villages were identified where nodule prevalence exceeded 20%. Skin snips were also taken from a sample of the population to measure changes in community microfilarial load (CMFL) with treatment. The delivery programme was integrated into the district health management structure, and used community volunteers supervised by medical assistants from adjacent health facilities for annual ivermectin distribution campaigns. After initial efforts by the community to support distributors in-kind proved inadequate, ivermectin distributors earned money retailing condoms as part of the social marketing component of district STD/AIDS programme. Reduction in the CMFL ranged from 40-62% twelve months after the second ivermectin treatment in three villages, and from 69-84% six months after the fourth round of treatment in two villages. After four years of treatment, 85% of eligible persons were receiving ivermectin from community volunteers in each treatment cycle. Drop out rates among volunteers did not exceed 20% over the four years reported here. The direct cost of treatment was US $0.29 per person. Among the reasons for low per-person treatment costs were the strong supervisory structure, the presence of health centres in the foci and a well developed and capable district Primary Health Care management team. PMID:10180405

  3. Assessment of Leadership Training of Head Teachers and Secondary School Performance in Mubende District, Uganda

    ERIC Educational Resources Information Center

    Benson, Kayiwa

    2011-01-01

    The purpose of the study was to establish the relationship between leadership training of head teachers and school performance in secondary schools in Mubende district, Uganda. Descriptive-correlational research design was used. Six schools out of 32 were selected and the sample size of head teachers, teachers and students leaders was 287 out of…

  4. Planning the Location of Schools: Ankole District, Uganda. Case Studies -- 3.

    ERIC Educational Resources Information Center

    Gould, W. T. S.

    Ankole District, Uganda, is typical of many developing areas of Africa, characterized by rapid population change (a result of both growth and redistribution), inadequate school provision, and severe financial constraints. The study relates the present patterns and organization of elementary and secondary level educational provision to the existing…

  5. Serological and molecular investigation for brucellosis in swine in selected districts of Uganda.

    PubMed

    Erume, Joseph; Roesel, Kristina; Dione, Michel M; Ejobi, Francis; Mboowa, Gerald; Kungu, Joseph M; Akol, Joyce; Pezo, Danilo; El-Adawy, Hosny; Melzer, Falk; Elschner, Mandy; Neubauer, Heinrich; Grace, Delia

    2016-08-01

    Brucellosis is a notifiable zoonotic disease affecting livestock, humans, and wildlife in Uganda. Pigs can be infected with human pathogenic Brucella suis biovars 1 and 3 and can be a significant source of brucellosis for humans. Uganda has a rapidly growing pig population, and the pork consumption per capita is the highest in East Africa. The objective of this work was to determine the seroprevalence of brucellosis in Ugandan pigs. A cross-sectional serosurvey of pigs was conducted in three of the major pig-keeping districts in Uganda (Masaka (n = 381 samples), Mukono (n = 398), and Kamuli (n = 414)). In addition, pigs originating from these districts were sampled in the major pig abattoir in Kampala (n = 472). In total, 1665 serum samples were investigated by serological and molecular tests. Only three putative brucellosis-positive samples were detected serologically using indirect ELISA. These sera were found negative for Brucella antibodies by CFT; however, two had antibodies against Yersinia enterocolitica as determined by SAT. Presence of antibodies against Yersiniae was confirmed by Y. enterocolitica antibody-specific ELISA. The two Yersiniae ELISA-positive samples were brucellosis negative using real-time PCR. We tested additional 142 sera from the 1665 samples with real-time PCR. All tested negative. Under this type of production system, we expect a maximum B. suis prevalence of less than 1 % at 95 % confidence level, and therefore, the risk of acquiring brucellosis from the pigs or their products is negligible. However, pigs may harbor the zoonotic Y. enterocolitica. This is the first study to investigate the occurrence of brucellosis in pigs in Uganda and the first study to report Y. enterocolitica antibodies in swine in Uganda. PMID:27142028

  6. Uganda.

    PubMed

    1988-03-01

    Uganda occupies 94,354 square miles in central Africa, bounded by Kenya, Tanzania, Rwanda, Zaire, and Sudan. It includes part of Lake Victoria, and the Ruwenzori mountains are on its border with Zaire. The country is largely on a plateau and thus has a pleasant climate. 12% of the land is devoted to national parks and game preserves. The northeast is semiarid; the southwest and west are rainy. The population of 15,900,896, growing at 3.7% a year, is mostly rural and is composed of 3 ethnic groups: The Bantu, including the Buganda, the Banyankole and the Basoga; the Nilo-Hamitic Iteso; and the Nilots. There are also some Asians and Arabs. The official language is English, but Luganda and Swahili are widely used. The majority of the people are Christian. Literacy is about 52%, and 57% of school-age children attend primary school. Infant mortality rate is 108/1000, and life expectancy is 49 years. The 1st Englishman to see Uganda was Captain John Speke in 1862. The Kingdom of Buganda became a British protectorate in 1894, and the protectorate was extended to the rest of the country in 1896. In the 1950s the British began an africanization of the government prior to formal independence, but the 1st general elections in 1961 were boycotted by the Bugandans, who wanted autonomy. In the 2nd election, in March, 1962, the Democratic Party, led by Benedicto Kiwanuka, defeated the Uganda People's Congress (UPC), led by Apollo Milton Obote; however, a month later, the UPC allied with the Buganda traditionalists, the Kabaka Yekka, and formed a collision government under Obote. Uganda became independent in 1962 with the King of Buganda, Sir Edward Frederick Mutesa II as president. Political rivalries continued, and in 1966 Prime Minister Obote suspended the constitution, and the Buganda government lost its semiautonomy. Obote's government was overthrown in 1971 by Idi Amin Dada, under whose 8-year reign of terror 100,000 Ugandans were murdered. Amin was ousted by an invading

  7. STUDIES ON THE SPECIES COMPOSITION AND RELATIVE ABUNDANCE OF MOSQUITOES OF MPIGI DISTRICT, CENTRAL UGANDA

    PubMed Central

    Mayanja, Martin; Mutebi, John-Paul; Crabtree, Mary B.; Ssenfuka, Fred; Muwawu, Teddy; Lutwama, Julius J.

    2015-01-01

    Prediction of arboviral disease outbreaks and planning for appropriate control interventions require knowledge of the mosquito vectors involved. Although mosquito surveys have been conducted in different regions of Uganda since the mid 30’s such studies have not been carried out in Mpigi District. In October 2011, we conducted mosquito collections in Mpigi district to determine species composition and relative abundance of the different species. The survey was conducted in four villages, Njeru, Ddela, Kiwumu and Nsumbain Kammengo sub-county, Mpigi district, Uganda. CDC light traps baited with dry ice (carbon dioxide) were used to capture adult mosquitoes. A total of 54,878 mosquitoes comprising 46 species from eight genera were collected. The dominant species at all sites was Coquilletidia (Coquilletidia) fuscopennata Theobald (n=38,059, 69%), followed by Coquillettidia (Coquillettidia) metallica Theobald (n=4,265, 7.8%). The number of species collected varied from 17 in the genus Culex to 1 in the genus Lutzia. Of the 46 species identified, arboviruses had previously been isolated from 28 (60.9%) suggesting a high potential for arboviral transmission and/or maintenance in Mpigi District. PMID:26346305

  8. Uganda.

    PubMed

    1985-07-01

    Uganda's population increased from 4.7 million in 1950 to 15.5 million in 1985, representing a present growth rate of 3.5%. The government realizes that rapid population growth has created underemployment and unemployment, but does not view the issue as critical to present development. Death rates have declined rapidly but birth rates have remained high, largely due to poverty, early marriage by females, illiteracy, and women's low educational status. The government has recently developed an official policy to decrease population growth and is now working with the Family Planning Association of Uganda to 1) lower the population growth rate from 3% to 2.6% and 2) increase the population's physical, mental, and social quality. Current life expectancy is now 52 years, and infant mortality is 94/1000. Health care has deteriorated in recent years as hospitals have closed and medical personnel have left the country. Government priorities include maternal and child health care, diarrhoeal control, and environmental sanitation. The fertility rate is projected to fall from the current 6.9 rate to 6.3 by the year 2000. Government fertility reduction plans include 1) merging family planning and maternal and child health services, 2) sex education in schools, 3) population education, 4) maternity and paternity benefits, and 5) raising the legal marriage age. Abortion for contraception purposes is illegal; sterilization is legal. 1) Refugee repatriation to Sudan, 2) Indo-Pakistani expulsion (1972), and 3) mass flight in the 1970s have affected Uganda's recent development. The government encourages skilled Ugandans living abroad to return home. Urban growth has increased from 8% in 1979 to 14% in 1985; to slow rural to urban migration, the government plans to encourage and educate people to remain on the land, encourage the development of specific areas, repair and maintain urban areas, and improve land access and resettlement opportunities. PMID:12314238

  9. The topic is the Relevance of wetland economic valuation in Uganda Acase study of Kiyanja-Kaku wetland in Lwengo District-Central Uganda.

    NASA Astrophysics Data System (ADS)

    Namulema, Mary Jude

    2016-04-01

    This study examined the relevance of economic valuation of wetlands in Uganda. A case study was done on Kiyanja-Kaku wetland in Lwengo District in Central Uganda using a semi-structured survey. Three objectives were examined i.e.: (i) To identify wetland ecosystem services in Uganda (ii) To identify the economic valuation methods appropriate for wetlands in Uganda (iii) To value clean water obtained from Kiyanja-Kaku wetland. The wetland ecosystem services were identified as provisioning, regulating, habitat, cultural and amenities services. The community had knowledge about 17 out of the 22 services as given by TEEB (2010). The economic valuation methods identified were, market price, efficiency price, travel cost, contingent valuation, hedonic pricing, and production function and benefit transfer methods. These were appropriate for valuation of wetlands in Uganda but only three methods i.e. market price, contingent valuation and productivity methods have been applied by researchers in Uganda so far. The economic value of clean water from Kiyanja-Kaku wetland to the nearby community was established by using the market price of clean water the National water and Sewerage Corporation charges for the water in Uganda to obtain the low value and the market price of water from the survey was used to obtain the high value. The estimated economic value of clean water service for a household ranges from UGX. 612174 to 4054733 (US 168.0-1095.0). The estimated economic value of clean water service from Kiyanja-Kaku wetland to the entire community ranges from UGX. 2,732,133,000.0 to 18,096,274,000.0 (US 775,228.0-4,885,994.0).

  10. Herbal medicine use in the districts of Nakapiripirit, Pallisa, Kanungu, and Mukono in Uganda

    PubMed Central

    2012-01-01

    Background Traditional medicine (TM) occupies a special place in the management of diseases in Uganda. Not with standing the many people relying on TM, indigenous knowledge (IK) related to TM is getting steadily eroded. To slow down this loss it is necessary to document and conserve as much of the knowledge as possible. This study was conducted to document the IK relevant to traditional medicine in the districts of Mukono, Nakapiripirit, Kanungu and Pallisa, in Uganda. Methods An ethnobotanical survey was conducted between October 2008 and February 2009 using techniques of key informant interviews and household interviews. Results The common diseases and conditions in the four districts include malaria, cough, headache, diarrhea, abdominal pain, flu, backache and eye diseases. Respondents stated that when they fall sick they self medicate using plant medicines or consult western-trained medicine practitioners. Self medication using herbal medicines was reported mostly by respondents of Nakapiripirit and Mukono. Respondents have knowledge to treat 78 ailments using herbal medicines. 44 species, mentioned by three or more respondents have been prioritized. The most frequently used part in herbal medicines is the leaf, followed by the stem and root. People sometime use animal parts, soil, salt and water from a grass roof, in traditional medicines. Herbal medicines are stored for short periods of time in bottles. The knowledge to treat ailments is acquired from parents and grandparents. Respondents’ age and tribe appears to have a significant influence on knowledge of herbal medicine, while gender does not. Conclusion This survey has indicated that IK associated with TM stills exists and that TM is still important in Uganda because many people use it as a first line of health care when they fall sick. Age and tribe influence the level of IK associated with herbal medicine, but gender does not. PMID:22943789

  11. Ethnopharmacological practices by livestock farmers in Uganda: Survey experiences from Mpigi and Gulu districts

    PubMed Central

    2014-01-01

    Background There is continued reliance on conventional veterinary drugs including anthelmintics, to some of which resistance has developed. Loss of indigenous technical knowledge (ITK) from societies affects the opportunities for utilization of ethnopharmacological practices unless properly documented. This study was conducted to identify common traditional practices using medicinal plants against helminthosis and other livestock diseases in Mpigi and Gulu districts of Uganda. Methods Seven focus group discussions with ten farmers per group plus 18 key informant interviews were held in each district from August to November 2011. Ranking was used to quantify disease burdens and to identify priority livestock and breeds. Samples of each plant were submitted to Makerere University herbarium for identification and documentation. The local name, relative availability and International Union for Conservation of Nature (IUCN) status were recorded. Results Seventy six farmers in Mpigi and 74 in Gulu were interviewed. Theileriosis and helminthosis were the most common disease conditions in cattle and goats, respectively. Forty plant species within 34 genera from 22 botanical families were identified, with 20 of these used against helminthosis. Other plants treated wounds and ecto-parasites, theileriosis, retained placenta and bovine ephemeral fever. Non-plant practices (7) and plants cited were used in combination depending on availability. Males older than 40 years had most ethnopharmacological knowledge. Most plants (75%, n = 40) were common, but 10 were rare. IUCN status was not evaluated for 95% of these plants. Conventional and traditional drug use in Gulu and Mpigi districts was different (χ2 = 24; p < 0.001). The scientific, English, Luganda and Acholi names of all plants and their availability within the communities are documented herein. Conclusion This is the first detailed livestock-related ethnopharmacological study in Gulu district. Farmers in

  12. Voluntary Counseling and Testing Services: Breaking Resistance to Access and Utilization among the Youths in Rakai District of Uganda

    ERIC Educational Resources Information Center

    Sebudde, Stephen; Nangendo, Florence

    2009-01-01

    Voluntary counseling and testing is important in controlling the spread of HIV, especially among adolescents. The aim is to describe the perceptions of adolescents of the best options to providing voluntary counseling and testing services to them in Rakai District Uganda. A cross-sectional descriptive study was carried out among male and female…

  13. False Teeth Still a Public Health Problem among Children in Kanungu District--South Western Uganda 2006

    ERIC Educational Resources Information Center

    Stephen, Sebudde

    2006-01-01

    False teeth among children are a Public Health problem which has not received adequate attention in Uganda. This study was therefore developed as a community-based descriptive cross-sectional carried out in Kanungu District using qualitative methods of data collection among caregivers of children, Community Owned Resource Persons and Service…

  14. An Epidemiologic Investigation of Potential Risk Factors for Nodding Syndrome in Kitgum District, Uganda

    PubMed Central

    Foltz, Jennifer L.; Makumbi, Issa; Sejvar, James J.; Malimbo, Mugagga; Ndyomugyenyi, Richard; Atai-Omoruto, Anne Deborah; Alexander, Lorraine N.; Abang, Betty; Melstrom, Paul; Kakooza, Angelina M.; Olara, Dennis; Downing, Robert G.; Nutman, Thomas B.; Dowell, Scott F.; Lwamafa, D. K. W.

    2013-01-01

    Introduction Nodding Syndrome (NS), an unexplained illness characterized by spells of head bobbing, has been reported in Sudan and Tanzania, perhaps as early as 1962. Hypothesized causes include sorghum consumption, measles, and onchocerciasis infection. In 2009, a couple thousand cases were reportedly in Northern Uganda. Methods In December 2009, we identified cases in Kitgum District. The case definition included persons who were previously developmentally normal who had nodding. Cases, further defined as 5- to 15-years-old with an additional neurological deficit, were matched to village controls to assess risk factors and test biological specimens. Logistic regression models were used to evaluate associations. Results Surveillance identified 224 cases; most (95%) were 5–15-years-old (range = 2–27). Cases were reported in Uganda since 1997. The overall prevalence was 12 cases per 1,000 (range by parish = 0·6–46). The case-control investigation (n = 49 case/village control pairs) showed no association between NS and previously reported measles; sorghum was consumed by most subjects. Positive onchocerciasis serology [age-adjusted odds ratio (AOR1) = 14·4 (2·7, 78·3)], exposure to munitions [AOR1 = 13·9 (1·4, 135·3)], and consumption of crushed roots [AOR1 = 5·4 (1·3, 22·1)] were more likely in cases. Vitamin B6 deficiency was present in the majority of cases (84%) and controls (75%). Conclusion NS appears to be increasing in Uganda since 2000 with 2009 parish prevalence as high as 46 cases per 1,000 5- to 15-year old children. Our results found no supporting evidence for many proposed NS risk factors, revealed association with onchocerciasis, which for the first time was examined with serologic testing, and raised nutritional deficiencies and toxic exposures as possible etiologies. PMID:23823012

  15. Prevalence of gastrointestinal nematodes in growing pigs in Kabale District in Uganda.

    PubMed

    Nissen, Sofie; Poulsen, Idahella H; Nejsum, Peter; Olsen, Annette; Roepstorff, Allan; Rubaire-Akiiki, C; Thamsborg, Stig M

    2011-03-01

    During the last 30 years, pig production in Uganda and neighbouring counties has increased markedly. Pigs are mainly kept as a source of income for small-scale farmers; however, the pig production is subject to several constraints, one of them being worm infections. A study was carried out in rural communities in Kabale District in the South Western part of Uganda in September and October 2007 in order to estimate the prevalence of gastrointestinal nematode parasites in pigs based on coprological examination. Fifty-six households were randomly selected and visited. Housing system and deworming history were recorded. Faeces was sampled from rectum of one to five pigs (age, 3-12 months) per household. A total of 106 pigs were examined coprologically of which 91% excreted nematode eggs. The following prevalences of nematode eggs were recorded: strongyles (89%), Ascaris suum (40%), Trichuris suis (17%) and spiruroid eggs (48%). On household level, rearing pigs on slatted floors in pens significantly reduced the faecal egg excretion of strongyle eggs with almost 80% (p=0.010) and a significant interaction between floor type and anthelmintic treatment was found for spiruroids (p=0.037). Fifteen T. suis egg positive pigs were selected for post-mortem examination of the gastrointestinal tract. The post-mortem examinations revealed that 93% pigs were infected with Oesophagostomum spp. (worm burden, min-max 10-2,180), 73% with A. suum (1-36), 67% with T. suis (6-58), and 20% with Hyostrongylus rubidus (worms not quantified). In general, nematode infections were widespread and polyparasitism common in pigs in Uganda. However, worm burdens were moderate which may be related to recent deworming or to the practice of rearing pigs on slatted floors in wooden elevated pens. PMID:21088893

  16. Challenges Faced by Village Health Teams (VHTs) in Amuru, Gulu and Pader Districts in Northern Uganda

    PubMed Central

    Kimbugwe, Geofrey; Mshilla, Maghanga; Oluka, Denis; Nalikka, Olivia; Kyangwa, Joseph; Zalwango, Stella; Kilizza, Uthuman; Turyasiima, Munanura; Ntambazi, Louis; Walugembe, Fred; Galiwango, Julius

    2015-01-01

    Primary health care provision through innovative community level interventions such as the Village Health Team (VHT) concept in Uganda can be a rational way of achieving universal access to healthcare. This cross-sectional study interviewed 150 VHT members and 16 key informants in three districts in Northern Uganda to establish the roles of VHTs, the service gaps encountered and the measures in place to address these gaps. Quantitative data were analyzed using SPSS 16.0. Direct content analysis of themes of transcribed qualitative data was conducted manually for common codes. The majority of the respondents 64.29% (n = 72) reported to have been VHT volunteers for more than 5 years. Among the roles were community mobilization reported by 99.1% (n = 111) and home visiting of individuals reported by 97.3% (n = 109). Lack of transport, motivation, adequate skills and community appreciation with nearly no measures in place to counteract the challenges was reported by almost all respondents. Although the VHT concept can be a significant means of achieving universal access to primary health care, extensive community involvement and motivation of the volunteers are highly needed for a maximum benefit. PMID:26301128

  17. Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda.

    PubMed

    Musoke, David; Ekirapa-Kiracho, Elizabeth; Ndejjo, Rawlance; George, Asha

    2015-05-01

    Uganda continues to have poor maternal health indicators including a high maternal mortality ratio. This paper explores community level barriers affecting maternal health in rural Wakiso district, Uganda. Using photovoice, a community-based participatory research approach, over a five-month period, ten young community members aged 18-29 years took photographs and analysed them, developing an understanding of the emerging issues and engaging in community dialogue on them. From the study, known health systems problems including inadequate transport, long distance to health facilities, long waiting times at facilities and poor quality of care were confirmed, but other aspects that needed to be addressed were also established. These included key gender-related determinants of maternal health, such as domestic violence, low contraceptive use and early teenage pregnancy, as well as problems of unclean water, poor sanitation and women's lack of income. Community members appreciated learning about the research findings precisely hence designing and implementing appropriate solutions to the problems identified because they could see photographs from their own local area. Photovoice's strength is in generating evidence by community members in ways that articulate their perspectives, support local action and allow direct communication with stakeholders. PMID:26278841

  18. Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

    PubMed Central

    2012-01-01

    Background Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies. Methods We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5%) of sub-counties, 21/42 (50.0%) parishes and 32/212 (15.1%) villages (clusters), were interviewed. Data were analysed using STATA version 10.0. Results Community pre-emergency support interventions available included community awareness creation (sensitization) while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies) included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54) and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14). Conclusions Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community sensitization by empowered

  19. Public knowledge and attitudes toward HIV/AIDS and antiretroviral therapy in Kabarole district, western Uganda.

    PubMed

    Kipp, Walter Eigen; Alibhai, Arif; Saunders, Duncan; Konde-Lule, Joseph; Ruhunda, Alex

    2009-01-01

    A study on knowledge about HIV/AIDS and antiretroviral therapy (ART) was conducted in the general population of a rural district in western Uganda. Three hundred seventy-two participants were selected by random cluster sampling and interviewed with an interview-administered questionnaire. Data were analyzed quantitatively with descriptive, univariate and linear multivariate statistical analysis with the knowledge score about ART as the dependent variable. The results indicate that the mean knowledge was 7.7 in a scale from 0 to 13. Predictor for better ART knowledge was a higher educational status of the participants. Older participants over 50 years were less ART knowledgeable. Only 19% of the participants have been tested for HIV. The conclusions are that the ART knowledge in this population is remarkably high which is reaffirming and important for achieving a high adherence to ART. Of concern is the low proportion of persons tested for HIV in this general population. Kabarole district seems to be receptive and capable for intensifying HIV testing which is a precondition for the ART roll-out. PMID:19085228

  20. Widows' and orphans' property disputes: the impact of AIDS in Rakai District, Uganda.

    PubMed

    Roys, C

    1995-11-01

    The 1991 census identified 44,000 orphans in the Rakai District of Uganda. The Child Social Care Project (CSCP) in the district helps ensure that orphaned children under 18 years who have lost one or both parents to AIDS receive the property rights to which they are entitled. The property rights of widows are also championed by the CSCP. The project has enjoyed considerable success in settling individual disputes. The CSCP has also had some success in enabling communities to deal appropriately with the conflicts without recourse to experts. The author notes that while it is important to promote the empowerment of women, the phrase is so overused that it is in danger of becoming meaningless. That said, a vital aspect of empowerment is economic independence. The CSCP helps women claim the right to own property, land, and housing, as well as to care for their children in the attempt to give them some degree of economic control over their destiny and that of their children. The paper discusses widows' and orphans' property disputes in sections on wills, customary law, and statutory law. The CSCP is described followed by a case study and consideration of gender and legal reform. PMID:12319864

  1. Nodding syndrome in Kitgum District, Uganda: association with conflict and internal displacement

    PubMed Central

    Landis, Jesa L; Palmer, Valerie S; Spencer, Peter S

    2014-01-01

    Objectives To test for any temporal association of Nodding syndrome with wartime conflict, casualties and household displacement in Kitgum District, northern Uganda. Methods Data were obtained from publicly available information reported by the Ugandan Ministry of Health (MOH), the Armed Conflict Location & Event Data (ACLED) Project of the University of Sussex in the UK, peer-reviewed publications in professional journals and other sources. Results Reports of Nodding syndrome began to appear in 1997, with the first recorded cases in Kitgum District in 1998. Cases rapidly increased annually beginning in 2001, with peaks in 2003–2005 and 2008, 5–6 years after peaks in the number of wartime conflicts and deaths. Additionally, peaks of Nodding syndrome cases followed peak influxes 5–7 years earlier of households into internal displacement camps. Conclusions Peaks of Nodding syndrome reported by the MOH are associated with, but temporally displaced from, peaks of wartime conflicts, deaths and household internment, where infectious disease was rampant and food insecurity rife. PMID:25371417

  2. Prevalence and spatial distribution of Theileria parva in cattle under crop-livestock farming systems in Tororo District, Eastern Uganda

    PubMed Central

    2014-01-01

    Background Tick-borne diseases (TBDs) present a major economic burden to communities across East Africa. Farmers in East Africa must use acaracides to target ticks and prevent transmission of tick-borne diseases such as anaplasmosis, babesiosis, cowdriosis and theileriosis; the major causes of cattle mortality and morbidity. The costs of controlling East Coast Fever (ECF), caused by Theileria parva, in Uganda are significant and measures taken to control ticks, to be cost-effective, should take into account the burden of disease. The aim of the present work was to estimate the burden presented by T. parva and its spatial distribution in a crop-livestock production system in Eastern Uganda. Methods A cross sectional study was carried out to determine the prevalence and spatial distribution of T. parva in Tororo District, Uganda. Blood samples were taken from all cattle (n: 2,658) in 22 randomly selected villages across Tororo District from September to December 2011. Samples were analysed by PCR and T. parva prevalence and spatial distribution determined. Results The overall prevalence of T. parva was found to be 5.3%. Herd level prevalence ranged from 0% to 21% with majority of the infections located in the North, North-Eastern and South-Eastern parts of Tororo District. No statistically significant differences in risk of infection were found between age classes, sex and cattle breed. Conclusions T. parva infection is widely distributed in Tororo District, Uganda. The prevalence and distribution of T. parva is most likely determined by spatial distribution of R. appendiculatus, restricted grazing of calves and preferential tick control targeting draft animals. PMID:24589227

  3. Prevention of spina bifida: folic acid intake during pregnancy in Gulu district, northern Uganda

    PubMed Central

    Bannink, Femke; Larok, Rita; Kirabira, Peter; Bauwens, Lieven; van Hove, Geert

    2015-01-01

    Introduction The intake of folic acid before conception and during the first trimester of pregnancy can prevent spina bifida. This paper describes folic acid intake in women in Gulu district in northern Uganda. Methods Structured interviews were held with 394 women attending antenatal care (ANC), 15 mothers of children with spina bifida, and 35 health workers in 2012 and 2013. SPSS16 was used for data analysis. Results 1/4 mothers of children with spina bifida took folic acid during late pregnancy, none preconception. None had knowledge about folic acid and spina bifida prevention. 33.5% of women attending ANC had ever heard about spina bifida, 1% knew folic acid intake can prevent spina bifida. 42.4% took folic acid supplements in late pregnancy, 8.1% during the first trimester, none preconception. All women said to have eaten food rich in folic acid. None were aware about fortified foods. 7% of health workers understood the importance of early folic acid intake. All health workers recommended folic acid intake to women attending ANC. 20% of the health workers and 25% of the women said folic acid supplements are not always available. Conclusion Folic acid intake is limited in northern Uganda. This is attributed to limited education and understanding of women and health workers about the importance of early folic acid intake, late presentation of women at ANC, poor supply chain and dilapidated health services caused by war and poverty. A combination of food fortification, sensitization of health workers, women, and improving folic acid supply is recommended. PMID:26090048

  4. Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

    PubMed Central

    Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.

    2016-01-01

    Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting

  5. User fees, health staff incentives, and service utilization in Kabarole District, Uganda.

    PubMed Central

    Kipp, W.; Kamugisha, J.; Jacobs, P.; Burnham, G.; Rubaale, T.

    2001-01-01

    OBJECTIVE: To determine the impact of user fees on the utilization of health services in a community-based cost-sharing scheme in Kabarole District, western Uganda. METHODS: Of the 38 government health units that had introduced user-fee financing schemes, 11 were included in the study. Outpatient utilization was assessed as the median number of visits per month before and after cost sharing began. FINDINGS: After the introduction of cost sharing, overall utilization of general outpatient services, assessed by combining the data from all the participating units, dropped by 21.3%. Utilization increased, however, in facilities located in remote areas, while it decreased in those located in urban or semi-urban areas. The increased utilization in remote facilities was considered to be largely attributable to health workers' incentive payments derived from cost-sharing revenues. CONCLUSIONS: Incentive payments led the health workers to offer improved services. Other factors may also have been influential, such as an improved drug supply to health facilities and increased public identification with community projects in remote areas. PMID:11731810

  6. Ambient particulate matter air pollution in Mpererwe District, Kampala, Uganda: a pilot study.

    PubMed

    Schwander, Stephan; Okello, Clement D; Freers, Juergen; Chow, Judith C; Watson, John G; Corry, Melody; Meng, Qingyu

    2014-01-01

    Air quality in Kampala, the capital of Uganda, has deteriorated significantly in the past two decades. We made spot measurements in Mpererwe district for airborne particulate matter PM2.5 (fine particles) and coarse particles. PM was collected on Teflon-membrane filters and analyzed for mass, 51 elements, 3 anions, and 5 cations. Both fine and coarse particle concentrations were above 100 µg/m(3) in all the samples collected. Markers for crustal/soil (e.g., Si and Al) were the most abundant in the PM2.5 fraction, followed by primary combustion products from biomass burning and incinerator emissions (e.g., K and Cl). Over 90% of the measured PM2.5 mass can be explained by crustal species (41% and 59%) and carbonaceous aerosol (33%-55%). Crustal elements dominated the coarse particles collected from Kampala. The results of this pilot study are indicative of unhealthy air and suggest that exposure to ambient air in Kampala may increase the burden of environmentally induced cardiovascular, metabolic, and respiratory diseases including infections. Greater awareness and more extensive research are required to confirm our findings, to identify personal exposure and pollution sources, and to develop air quality management plans and policies to protect public health. PMID:24693293

  7. Medicinal plants of Otwal and Ngai Sub Counties in Oyam District, Northern Uganda

    PubMed Central

    2011-01-01

    Background An ethnobotanical study was carried out in four parishes in the Ngai and Otwal Sub Counties in Oyam district, Northern Uganda, where insurgency has been prevalent for the past 20 years. Documenting medicinal plant species used in treating various health conditions among the local people. Methods Information was obtained from mainly the local population, the traditional healers and other experienced persons through interviews, formal and informal discussions and field excursions. Results Seventy one plant species were reported for use in the treatment of various diseases in the study area. These plant species belongs to 41 families, with Asteraceae being the most represented. Roots were ranked the commonest plant part used. Oral administration was the most frequently used route of administration. A total of 41 different health conditions were reported to be treated by use of medicinal plant species. Thirty nine percent of the recorded plant species were reported for treating stomach related ailments. Conclusion The use of medicinal plants in primary healthcare is still a common practice in Ngai and Otwal Sub Counties. The trust they have is built on the curative outcome properties claimed, poverty and armed conflict that lead to inadequate healthcare facilities. The generation gap caused by the over 20 years of insurgency in the area has brought about knowledge gap on the usage of medicinal plant species between the young and the older generation. PMID:21241484

  8. Factors influencing choice of delivery sites in Rakai district of Uganda.

    PubMed

    Amooti-Kaguna, B; Nuwaha, F

    2000-01-01

    In order to understand factors influencing choice of delivery sites in Rakai district of south-western Uganda, eight focus group discussions based on the Attitudes-Social influence-Self efficacy model were held with 32 women and 32 men. Semi-structured interviews were also held with 211 women from 21 random cluster samples who had a delivery in the previous 12 months (from 2 June 1997). Forty four percent of the sample delivered at home, 17% at traditional birth attendant's (TBA) place, 32% at public health units, and 7% at private clinics. Among the factors influencing choice of delivery site were: access to maternity services; social influence from the spouse, other relatives, TBAs and health workers; self-efficacy; habit (previous experience) and the concept of normal versus abnormal pregnancy. Attitudinal beliefs towards various delivery sites were well understood and articulated. Attendance of ante-natal care may discourage delivery in health units if the mothers are told that the pregnancy is normal. In order to make delivery safer, there is need to improve access to maternity services, train TBAs and equip them with delivery kits, change mother's self-efficacy beliefs, and involve spouses in education about safe delivery. PMID:10619690

  9. Barriers to contraception among HIV-positive women in a periurban district of Uganda.

    PubMed

    Mbonye, A K; Hansen, K S; Wamono, F; Magnussen, P

    2012-09-01

    This study explored perceptions and care-seeking practices for HIV testing and contraception in order to obtain data for designing effective interventions to increase contraception among HIV-positive women. A triangulation of methods (household survey, focus group discussions and key informant interviews) were conducted in Wakiso district, central Uganda from January to April 2009. Results show that a majority of women, 2062/2896 (71.2%) would like to have an HIV test, while access to antiretroviral therapy (ART) was low at 237/879 (27%). Of the women who were on ART, 133/266 (50.0%) could not use contraception due to negative perceptions that a combination of ART and contraceptives would weaken them, as these drugs were perceived to be 'strong'. Fear of side-effects for contraceptives and resistance from spouses were other main reasons. Constraints to HIV testing included fear of clients knowing their own HIV status and fear of their spouses' reactions to the test results. Private midwives were identified as a potential outlet for delivering contraception to HIV-positive women. PMID:23033523

  10. Delays in diagnosis and treatment of pulmonary tuberculosis in Wakiso and Mukono districts, Uganda

    PubMed Central

    2014-01-01

    Background Delay in tuberculosis (TB) diagnosis may worsen the disease and increase TB transmission. Therefore, timely diagnosis and treatment is critical in TB control. We aimed to assess the treatment delay of pulmonary TB and its determinants in two Ugandan districts where TB infection control (TBIC) guidelines were formerly implemented. Methods A facility based cross-sectional study was conducted in Mukono and Wakiso districts. Adult pulmonary TB patients within three months of initiating treatment were included in the study. Delays were categorized into unacceptable patient delay (more than 3 weeks from the onset of cough and the first consultation with a health care provider), health service (more than one week from the first consultation to the initiation of TB treatment) and total delay (more than 4 weeks since the onset of cough). The prevalences as well as predictors for the three delays were determined. Results We enrolled 158 sputum positive patients. Unacceptable patient delay was noted in 91 (58%) patients, a health service delay in 140 (88%) patients and a total delay in 140 (90%) patients. An independent predictor for patient delay was male gender (p < 0.001). First visiting a non-public health facility (p = 0.001) was an independent predictor of health service delay. Conclusion There is still a significant TB diagnosis and treatment delay in Uganda. Most of the delay was caused by health system delay in the non-public health care sector. There is need for TB advocacy in the community, training of health workers in TBIC and strengthening public-private partnerships in TB control. PMID:24916459

  11. Responding to abuse: Children's experiences of child protection in a central district, Uganda.

    PubMed

    Child, Jennifer Christine; Naker, Dipak; Horton, Jennifer; Walakira, Eddy Joshua; Devries, Karen M

    2014-10-01

    Part of a comprehensive response to violence against children involves child protection systems, but there are few data available on such systems in low-income countries. This study describes the characteristics and help seeking behavior of children referred to local child protection services and the quality of the first-line response in one district in Uganda. Participants included 3,706 children from 42 primary schools who participated in a baseline survey on violence as part of the Good Schools Study (NCT01678846, clinicaltrial.gov). Children who disclosed violence were referred according to predefined criteria based on the type, severity, and timeframe of their experiences. Children were followed up to 4 months after the study ended. First-line responses by receiving agencies were classified into 3 categories: plan for action only, some action taken, and no plan and no action taken. Appropriateness of responses was based on which agency responded, timeliness of the response, quality of the documentation, and final status of the case. From the baseline survey, 529 children (14%) were referred. Girls were more likely to be referred and to meet the criteria for a serious case (9% girls, 4% boys). In total, 104 referrals (20%) had some kind of concrete action taken, but only 20 (3.8%) cases met all criteria for having received an adequate response. Nearly half (43%) of referred children had ever sought help by disclosing their experiences of violence prior to the baseline survey. In our study areas, the first-line response to children's reports of abuse was poor even though some referral structures are in place. PMID:25035172

  12. Community Acceptance of Tsetse Control Baits: A Qualitative Study in Arua District, North West Uganda

    PubMed Central

    Kovacic, Vanja; Tirados, Inaki; Esterhuizen, Johan; Mangwiro, Clement T. N.; Torr, Stephen J.; Lehane, Michael J.; Smith, Helen

    2013-01-01

    Background There is renewed vigour in efforts to eliminate neglected tropical diseases including sleeping sickness (human African trypanosomiasis or HAT), including attempts to develop more cost-effective methods of tsetse control. In the West Nile region of Uganda, newly designed insecticide-treated targets are being deployed over an area of ∼500 km2. The operational area covers villages where tsetse control has not been conducted previously. The effectiveness of the targets will depend, in part, on their acceptance by the local community. Methodology/Principal Findings We assessed knowledge, perceptions and acceptance of tsetse baits (traps, targets) in villages where they had or had not been used previously. We conducted sixteen focus group discussions with male and female participants in eight villages across Arua District. Discussions were audio recorded, translated and transcribed. We used thematic analysis to compare the views of both groups and identify salient themes. Conclusions/Significance Despite the villages being less than 10 km apart, community members perceived deployed baits very differently. Villagers who had never seen traps before expressed fear, anxiety and panic when they first encountered them. This was related to associations with witchcraft and “ghosts from the river” which are traditionally linked with physical or mental illness, death and misfortune. By contrast, villagers living in areas where traps had been used previously had positive attitudes towards them and were fully aware of their purpose and benefits. The latter group reported that they had similar negative perceptions when tsetse control interventions first started a decade ago. Our results suggest that despite their proximity, acceptance of traps varies markedly between villages and this is related to the duration of experience with tsetse control programs. The success of community-based interventions against tsetse will therefore depend on early engagements with

  13. Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda

    PubMed Central

    Mubiru, Denis; Byabasheija, Robert; Bwanika, John Baptist; Meier, Joslyn Edelstein; Magumba, Godfrey; Kaggwa, Flavia Mpanga; Abusu, Jackson Ojera; Opio, Alex Chono; Lodda, Charles Clarke; Patel, Jaanki; Diaz, Theresa

    2015-01-01

    Objective Evidence is limited on whether Integrated Community Case Management (iCCM) improves treatment coverage of the top causes of childhood mortality (acute respiratory illnesses (ARI), diarrhoea and malaria). The coverage impact of iCCM in Central Uganda was evaluated. Methods Between July 2010 and December 2012 a pre-post quasi-experimental study in eight districts with iCCM was conducted; 3 districts without iCCM served as controls. A two-stage household cluster survey at baseline (n = 1036 and 1042) and end line (n = 3890 and 3844) was done in the intervention and comparison groups respectively. Changes in treatment coverage and timeliness were assessed using difference in differences analysis (DID). Mortality impact was modelled using the Lives Saved Tool. Findings 5,586 Village Health Team members delivered 1,907,746 treatments to children under age five. Use of oral rehydration solution (ORS) and zinc treatment of diarrhoea increased in the intervention area, while there was a decrease in the comparison area (DID = 22.9, p = 0.001). Due to national stock-outs of amoxicillin, there was a decrease in antibiotic treatment for ARI in both areas; however, the decrease was significantly greater in the comparison area (DID = 5.18; p<0.001). There was a greater increase in Artemisinin Combination Therapy treatment for fever in the intervention areas than in the comparison area but this was not significant (DID = 1.57, p = 0.105). In the intervention area, timeliness of treatments for fever and ARI increased significantly higher in the intervention area than in the comparison area (DID = 2.12, p = 0.029 and 7.95, p<0.001, respectively). An estimated 106 lives were saved in the intervention area while 611 lives were lost in the comparison area. Conclusion iCCM significantly increased treatment coverage for diarrhoea and fever, mitigated the effect of national stock outs of amoxicillin on ARI treatment, improved timeliness of treatments for fever and ARI and saved

  14. A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda.

    PubMed

    Tashobya, Christine K; Dubourg, Dominique; Ssengooba, Freddie; Speybroeck, Niko; Macq, Jean; Criel, Bart

    2016-03-01

    In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards' method was used. The hierarchical cluster analysis was conducted on the basis of seven clusters determined for each year from 2003 to 2010, ranging from a cluster of good through moderate-to-poor performers. The characteristics and membership of clusters varied from year to year and were determined by the identity and magnitude of performance of the individual variables. Criticisms of the league table include: perceived unfairness, as it did not take into consideration district peculiarities; and being oversummarized and not adequately informative. Clustering organizes the many data points into clusters of similar entities according to an agreed set of indicators and can provide the beginning point for identifying factors behind the observed performance of districts. Although league table ranking emphasize summation and external control, clustering has the potential to encourage a formative, learning approach. More research is required to shed more light on factors behind observed performance of the different clusters. Other countries especially low-income countries that share many similarities with Uganda can learn from these experiences. PMID:26024882

  15. Gendered Distances: A Methodological Inquiry into Spatial Analysis as an Instrument for Assessing Gender Equality in Access to Secondary Schools in Mukono District, Uganda

    ERIC Educational Resources Information Center

    Wawro, Patrick R.

    2010-01-01

    This study focused on how accessibility to secondary schools in the Mukono District of Uganda is related to the sex and gender of the student and the distance that separates the student's home from the school they attend. This research is a methodological inquiry exploring the use of spatial analysis, specifically how cognitive and metric…

  16. A process evaluation of performance-based incentives for village health workers in Kisoro district, Uganda

    PubMed Central

    2014-01-01

    Background Designing effective incentive systems for village health workers (VHWs) represents a longstanding policy issue with substantial impact on the success and sustainability of VHW programs. Using performance-based incentives (PBI) for VHWs is an approach that has been proposed and implemented in some programs, but has not received adequate review and evaluation in the peer-reviewed literature. We conducted a process evaluation examining the use of PBI for VHWs in Kisoro, Uganda. In this system, VHWs are paid based on 20 indicators, divided among routine follow-up visits, health education activities, new patient identifications, sanitation coverage, and uptake of priority health services. Methods Surveys of VHWs (n = 30) and program supervisors (n = 7) were conducted to assess acceptability and feasibility. Interviews were conducted with all 8 program supervisors and with 6 purposively selected VHWs to gain a deeper understanding of their views on the PBI system. Program budget records were used to assess the costs of the program. Detailed payment records were used to assess the fairness of the PBI system with respect to VHWs’ gender, education level, and village location. Results In surveys and interviews, supervisors expressed high satisfaction with the PBI system, though some supervisors expressed concerns about possible negative effects from the variation in payments between VHWs and the uncertainty of reward for effort. VHWs perceived the system as generally fair, and preferred it to the previous payment system, but expressed a desire to be paid more. The annual program cost was $516 per VHW, with each VHW covering an average of 115 households. VHWs covering more households tended to earn more. There was some evidence that female gender was associated with higher earnings. Education level and proximity to the district hospital did not appear to be associated with earnings under the PBI system. Conclusions In a one-year pilot of PBI within a

  17. Influence of pregnancy perceptions on patterns of seeking antenatal care among women in reproductive age of Masaka District, Uganda.

    PubMed

    Atekyereza, Peter R; Mubiru, Kenneth

    2014-10-01

    Maternal mortality remains a challenge in Sub-Saharan Africa including Uganda. Antenatal Care (ANC) is one of the recommended measures to improve maternal and child health. However, the influence of pregnancy definition and perception on patterns of seeking regular and timely antenatal care among women in the reproductive age group (15-49 years) is not known. The objectives of this study were to: (i) understand the women's social definitions and perceptions on their pregnancy; (ii) understand the socio-cultural beliefs related to pregnancy among women of the reproductive age group; and, (iii) examine the influence of social definitions, perceptions and beliefs about pregnancy on women's antenatal care seeking behaviour patterns to inform the decentralised health care delivery system in Uganda. A total of 45 women, mothers and expectant women who were purposively selected from Kimanya sub county of Masaka district in Uganda participated in the study. Ten key informant interviews and four Focus Group Discussions (FGDs) were also conducted. Key findings indicate that the women's socio-definitions and perceptions of pregnancy influence their seeking behaviour on antenatal health care. To the women with a positive orientation towards antenatal care, pregnancy provides joy, happiness, pride, promotes their social status and safe-guards their marriage. Pregnancy is rewarding with care, love, support and gifts. Women who shun antenatal care perceive pregnancy to be a source of misery, sadness, pain and suffering. It is an uncomfortable and regrettable experience. Women also hold socio-cultural beliefs on pregnancy, which are culturally constructed and rooted in taboos, rituals and practices of their communities. It is therefore important to sensitise women and those who attend to them when they are pregnant to understand these perceptions and definitions to motivate them to seek antenatal and postnatal care for better maternal and child health. PMID:26891521

  18. Participatory assessment of animal health and husbandry practices in smallholder pig production systems in three high poverty districts in Uganda.

    PubMed

    Dione, Michel M; Ouma, Emily A; Roesel, Kristina; Kungu, Joseph; Lule, Peter; Pezo, Danilo

    2014-12-01

    While animal health constraints have been identified as a major limiting factor in smallholder pig production in Uganda, researchers and policy makers lack information on the relative incidence of diseases and their impacts on pig production. This study aimed to assess animal health and management practices, constraints and opportunities for intervention in smallholder pig value chains in three high poverty districts of Uganda. Semi-qualitative interview checklists through Focus Group Discussions (FGDs) were administered to 340 pig farmers in 35 villages in Masaka, Kamuli and Mukono districts. Quantitative data was obtained during the exercise through group consensus. Results of FGDs were further triangulated with secondary data and information obtained from key informant interviews. Findings show that pig keeping systems are dominated by tethering and scavenging in rural areas. In peri-urban and urban areas, intensive production systems are more practiced, with pigs confined in pens. The main constraints identified by farmers include high disease burden such as African swine fever (ASF) and parasites, poor housing and feeding practices, poor veterinary services, ineffective drugs and a general lack of knowledge on piggery management. According to farmers, ASF is the primary cause of pig mortality with epidemics occurring mainly during the dry season. Worms and ectoparasites namely; mange, lice and flies are endemic leading to stunted growth which reduces the market value of pigs. Diarrhoea and malnutrition are common in piglets. Ninety-three percent of farmers say they practice deworming, 37% practice ectoparasite spraying and 77% castrate their boars. Indigenous curative treatments include the application of human urine and concoctions of local herbs for ASF control and use of old engine oil or tobacco extracts to control ectoparasites. There is a need for better technical services to assist farmers with these problems. PMID:25458705

  19. Prevalence and risk factors of Echinococcus granulosus infection in dogs in Moroto and Bukedea districts in Uganda.

    PubMed

    Oba, Peter; Ejobi, Francis; Omadang, Leonard; Chamai, Martin; Okwi, Andrew Livex; Othieno, Emmanuel; Inangolet, Francis Olaki; Ocaido, Michael

    2016-02-01

    A cross sectional study was conducted in Moroto and Bukedea districts of Uganda from May to September 2013 to determine the prevalence and risk factors of Echinococcus granulosus infection in dogs. Fresh dog faecal samples were collected, preserved in 70 % ethanol, and later screened for presence of taeniid eggs using zinc chloride floatation method. Positive samples were confirmed by a copro-PCR (polymerase chain reaction) for E. granulosus using NADH dehydrogenase sub-unit 1 gene (NADH1) as a target molecular marker. Structured questionnaires and focus group discussions were used to collect quantitative and qualitative data for risk factor identification. Study sub-counties were selected by simple random sampling. Overall apparent prevalence of taeniid infection in dogs of 14.9 % (39/261, confidence interval 10.6-19.2) in both districts was recorded using the faecal floatation test. The sensitivity of the faecal floatation test was found to be 78 % (25/32), while the specificity was 93 % (215/229). Copro-PCR results revealed a true prevalence of 14.4 % (9.91-19.0, 95 % CI) in dogs in Moroto district and 7.4 % (2.14-12.60, 95 % CI) in Bukedea district. The overall true prevalence of cystic echinococcosis (CE) was 12.2 % (8.70-15.76, 95 % CI) in both districts. The major risk factors identified using logistic regression were uncontrolled access of dogs to animal slaughter facilities, higher cattle herd sizes and lack of knowledge about the disease. It was recommended that restricting dog access to infected tissues and public health education about epidemiology of CE should be done. PMID:26526956

  20. E-governance in the developing world in action: the case of DistrictNet in Uganda.

    PubMed

    Van Reijswoud, Victor; De Jager, Arjan

    2007-01-01

    E-Governance is a powerful tool to bring about change to the government processes in the developing world. E-governance operates at the cross roads between Information and Communication Technology and government processes and is divided in three overlapping domains: e-administration, e-services and e-society. In order to be successful, e-governance needs to be firmly embedded in the existing government processes, needs to be politically and technically supported by the governments and provide users reasons to go and stay on-line. In order to maximize the impact, process change needs to be considered part and parcel of e-governance. In this report we present and evaluate an e-governance programme in Uganda - East Africa. The programme, DistrictNet, tries to provide transparency at a local government level and improve the provision of public information through the implementation of ICT. DistrictNet started in 2002 and is on-going. The achievements of the programme are presented and evaluated against three domains of e-governance and the impact on the government processes. On the basis of the evaluation we elicit lessons learned to guide similar programmes at the local government levels in the developing world. PMID:17621772

  1. Responses to tuberculin among Zebu cattle in the transhumance regions of Karamoja and Nakasongola district of Uganda.

    PubMed

    Oloya, J; Opuda-Asibo, J; Djønne, B; Muma, J B; Matope, G; Kazwala, R; Skjerve, E

    2006-05-01

    Responses to tuberculin in Zebu cattle of the transhumant pastoral farming system in Karamoja region and Nakasongola district in the north-eastern and mid-central regions in Uganda, respectively, were investigated using a comparative intradermal tuberculin skin test. Of the 1864 cattle tested from 30 large units (superherds) in Karamoja and 7 herds in Nakasongola, a total of 28 animals from 19 herds (51.4%) tested positive. Inter-district tuberculin reactor prevalence variations seemed to be influenced by climate, with impact on both the management patterns and transmissibility of agent. High herd tuberculin reactor prevalence (51.4%) was attributed to widespread contacts and mixing of animals between herds. Low individual animal tuberculin test positivity (mean = 1.4%) was attributed to low transmissibility of the agent under the Karamoja climate, which is semi-arid, and to increased resistance due to non-specific response to environmental mycobacteria and natural selection, since there was no active control against bovine tuberculosis. Owing to similarities in management practices in Karamoja and widespread risk factors, it was difficult to identify which were more important, but variations in sources of drinking water pointed to provision of lake and borehole water during dry season as reducing the risk. Positive bovine tuberculin reactor prevalence and skin reactor status were related to age. PMID:17137129

  2. Perceptions about medical male circumcision and sexual behaviours of adults in rural Uganda: a cross sectional study

    PubMed Central

    Mukama, Trasias; Ndejjo, Rawlance; Musinguzi, Geofrey; Musoke, David

    2015-01-01

    Introduction Medical male circumcision is currently recognized as an additional important HIV preventive intervention to reduce the risk of heterosexually acquired HIV infection in men. However, sexual behaviours after medical circumcision can potentially reduce the expected benefits of the practice. This study explored the perceptions about medical male circumcision and sexual behaviours of adults in Kayunga district, Uganda. Methods A cross-sectional study was carried out among 393 respondents using a semi structured questionnaire. In addition, four focus group discussions were conducted. Quantitative data was analysed using STATA 12. Univariate, bivariate and multivariate analyses were carried out. Qualitative data was analysed thematically. Results The study established various perceptions about medical male circumcision and sexual behaviours. Majority 247 (64.5%) did not perceive circumcision as a practice that can lead men to have multiple sexual partners. Males were 3 times more likely to think that circumcision would lead to having multiple sexual partners than females (AOR=2.99, CI: 1.93-4.61). Only 89 (23.2%) believed that circumcision would lead to complacency and compromise the use of condoms to prevent against infection with HIV. Respondents who had education above primary were less likely to think that circumcision would compromise the use of condoms (AOR=0.49, CI: 0.31- 0.79). The perception that circumcised youths were less likely to abstain from sexual intercourse was less held among those with education above primary (AOR=0.58, CI: 0.37-0.91) and those older than 30 years (AOR=0.59, CI: 0.38-0.92). Conclusion There were gaps in knowledge and negative perceptions about MMC in the study community. Measures are needed to avert the negative perceptions by equipping communities with sufficient, accurate and consistent information about medical male circumcision and sexual behaviour. PMID:26985272

  3. Leptospira Seroprevalence and Risk Factors in Health Centre Patients in Hoima District, Western Uganda

    PubMed Central

    Pearson, Raewynne; Kankya, Clovice; Kajura, Charles; Alinaitwe, Lordrick; Kakooza, Steven; Pelican, Katharine M.; Travis, Dominic A.; Mahero, Michael; Boulware, David R.; Mugisha, Lawrence

    2016-01-01

    Background The burden of human leptospirosis in Uganda is unknown. We estimated the seroprevalence of Leptospira antibodies, probable acute/recent leptospirosis, and risk factors for seropositivity in humans in rural Western Uganda. Methodology and Principal Findings 359 non-pregnant adults visiting the Kikuube and Kigorobya Health Centers were sequentially recruited during March and April 2014. A health history survey and serum were collected from consented participants. Overall, 69% reported having fever in the past year, with 49% reporting malaria, 14% malaria relapse, 6% typhoid fever, 3% brucellosis, and 0% leptospirosis. We tested sera by microscopic agglutination test (MAT) against eight Leptospira serovars representing seven serogroups. Leptospira seroprevalence was 35% (126/359; 95%CI 30.2–40.3%) defined as MAT titer ≥ 1:100 for any serovar. The highest prevalence was against L. borgpetersenii Nigeria (serogroup Pyrogenes) at 19.8% (71/359; 95%CI 15.9–24.4%). The prevalence of probable recent leptospirosis (MAT titer ≥1:800) was 1.9% (95%CI 0.9–4.2%) and uniquely related to serovar Nigeria (serogroup Pyrogenes). Probable recent leptospirosis was associated with having self-reported malaria within the past year (p = 0.048). Higher risk activities included skinning cattle (n = 6) with 12.3 higher odds (95%CI 1.4–108.6; p = 0.024) of Leptospira seropositivity compared with those who had not. Participants living in close proximity to monkeys (n = 229) had 1.92 higher odds (95%CI 1.2–3.1; p = 0.009) of seropositivity compared with participants without monkeys nearby. Conclusions/Significance The 35% prevalence of Leptospira antibodies suggests that exposure to leptospirosis is common in rural Uganda, in particular the Nigeria serovar (Pyrogenes serogroup). Leptospirosis should be a diagnostic consideration in febrile illness and “smear-negative malaria” in rural East Africa. PMID:27487398

  4. Capacity of Health Facilities to Manage Hypertension in Mukono and Buikwe Districts in Uganda: Challenges and Recommendations

    PubMed Central

    Musinguzi, Geofrey; Bastiaens, Hilde; Wanyenze, Rhoda K.; Mukose, Aggrey; Van geertruyden, Jean-Pierre; Nuwaha, Fred

    2015-01-01

    Background The burden of chronic diseases is increasing in both low- and middle-income countries. However, healthcare systems in low-income countries are inadequately equipped to deal with the growing disease burden, which requires chronic care for patients. The aim of this study was to assess the capacity of health facilities to manage hypertension in two districts in Uganda. Methods In a cross-sectional study conducted between June and October 2012, we surveyed 126 health facilities (6 hospitals, 4 Health Center IV (HCIV), 23 Health Center III (HCIII), 41 Health Center II (HCII) and 52 private clinics/dispensaries) in Mukono and Buikwe districts in Uganda. We assessed records, conducted structured interviews with heads of facilities, and administered questionnaires to 271 health workers. The study assessed service provision for hypertension, availability of supplies such as medicines, guidelines and equipment, in-service training for hypertension, knowledge of hypertension management, challenges and recommendations. Results Of the 126 health facilities, 92.9% reported managing (diagnosing/treating) patients with hypertension, and most (80.2%) were run by non-medical doctors or non-physician health workers (NPHW). Less than half (46%) of the facilities had guidelines for managing hypertension. A 10th of the facilities lacked functioning blood pressure devices and 28% did not have stethoscopes. No facilities ever calibrated their BP devices except one. About a half of the facilities had anti-hypertensive medicines in stock; mainly thiazide diuretics (46%), beta blockers (56%) and calcium channel blockers (48.4%). Alpha blockers, mixed alpha & beta blockers and angiotensin II receptor antagonists were only stocked by private clinics/dispensaries. Most HCIIs lacked anti-hypertensive medicines, including the first line thiazide diuretics. Significant knowledge gaps in classification of patients as hypertensive were noted among respondents. All health workers (except 5

  5. Impact of tailings from the Kilembe copper mining district on Lake George, Uganda

    NASA Astrophysics Data System (ADS)

    Owor, Michael; Hartwig, Tina; Muwanga, Andrew; Zachmann, Dieter; Pohl, Walter

    2007-01-01

    The abandoned Kilembe copper mine in western Uganda is a source of contaminants, mobilised from mine tailings into R. Rukoki flowing through a belt of wetlands into Lake George. Water and sediments were investigated on the lakeshore and the lakebed. Metal associations in the sediments reflect the Kilembe sulphide mineralisation. Enrichment of metals was compared between lakebed sediments, both for wet and dry seasons. Total C in a lakebed core shows a general increment, while Cu and Co decrease with depth. The contaminants are predominant (> 65%) in the ≤ 63 μm sediment size range with elevated Cu and Zn (> 28%), while Ni, Pb and Co are low (< 18%) in all the fractions. Sequential extraction of Fe for lakeshore sediment samples reveals low Fe mobility. Relatively higher mobility and biological availability is seen for Co, Cu and S. Heavy metal contents in lake waters are not an immediate risk to the aquatic environment.

  6. THE GENERATION, USE AND DISPOSAL OF WASTE CRANKCASE OIL IN DEVELOPING COUNTRIES: A CASE FOR KAMPALA DISTRICT, UGANDA

    PubMed Central

    Ssempebwa, John C.; Carpenter, David O.

    2008-01-01

    Waste Crankcase Oil (WCO), the oil that is removed from motor engines during an oil change, is frequently discarded into the environment, resulting in pollution of both aquatic and terrestrial ecosystems. In some developing countries, this common hazardous material is not properly managed. In Uganda little is known about its generation, utilization, and disposal. These factors were investigated using in-depth interviews of a sample of mechanics from 379 motor repair garages and 109 fuel stations in the Kampala district. Most garages (94%) and fuel stations (96%) in the study area offered oil-changing services. On average, each garage produced 62 litres, and each fuel station produced 134 litres of WCO per week. In garages 35% was sold, 16% poured on the ground, 18% taken by vehicle owners and 31% given away for free. At fuel stations, 49% was picked by private collectors, 27% sold, 4% poured on the ground, 2% burnt, 13% taken by vehicle owners, and 6% given away for free. Uses of WCO included coating roofing timber and fencing posts, use in timber cutting, marking play grounds, and pest control in animals. Its disposal involved burning, and pouring in the environment. Lack of policy and information for proper handling of WCO contributed to the poor management of WCO exhibited. PMID:18513868

  7. Mixed-longitudinal growth of breastfeeding children in Moroto District, Uganda (Karamoja subregion). A loss of biological resiliency?

    PubMed

    Gray, Sandra; Akol, Hellen A; Sundal, Mary

    2008-01-01

    This study examines the pattern of growth, underlying growth velocity and nutritional status in a sample of thirty breastfeeding Karimojong children, aged from birth to three years. A mixed-longitudinal structure was adopted for the study, which was carried out between August and December, 2004, in two communities in Moroto District, Uganda. Monthly anthropometric and health examinations were administered to mothers and children during this interval. Children in the study were small at birth but grew relatively rapidly for their first six months. Thereafter they experienced falling off of growth in weight, length, and head circumference. Loss of growth velocity and deterioration in nutritional status after six months was a result of physiologic stress arising from high parasite loads, introduction of inappropriate weaning foods, and psychosocial stress associated with patterns of maternal behavior. Environmental and maternal effects on child growth were exacerbated by widespread armed violence and related subsistence change in these communities. Growth of these children reflects loss of growth plasticity resulting from worsening environmental and social conditions in Moroto in 2004. PMID:18464268

  8. Occurrence of porcine cysticercosis in free-ranging pigs delivered to slaughter points in Arapai, Soroti district, Uganda.

    PubMed

    Zirintunda, Gerald; Ekou, Justine

    2015-01-01

    Poverty, hunger and the need for production of pigs with meagre or zero inputs have made most farmers release their pigs to range freely, thus creating a pig-human cycle that maintains Taenia solium, the pig tapeworm and cause of porcine cysticercosis, in the ecosystem. A preliminary study was designed to establish the prevalence of porcine cysticercosis by postmortem examination of the tongue and carcass of free-range pigs from February to April 2014 in Arapai subcounty, Soroti district, eastern Uganda. The tongue of each pig was extended and examined before deep incisions were made and the cut surfaces were examined. The rest of the carcasses were examined for cysts. Out of 178 pigs examined, 32 were qualitatively positive for porcine cysticercosis, representing a prevalence of 18.0%. This high prevalence represents a marked risk to the communities in the study area of neurocysticercosis, a debilitating parasitic zoonosis. Proper human waste disposal by use of pit latrines, confinement of free-range pigs and treatment with albendazole and oxfendazole are recommended. PMID:26244682

  9. Supporting youth and community capacity through photovoice: Reflections on participatory research on maternal health in Wakiso district, Uganda.

    PubMed

    Musoke, David; Ndejjo, Rawlance; Ekirapa-Kiracho, Elizabeth; George, Asha S

    2016-01-01

    This paper reflects on the experiences of using photovoice to examine maternal health in Wakiso district, Uganda. The project involved 10 youth aged 18-29 years old, who were diverse in education, occupation, and marital status and identified by community leaders with researchers. By taking photos and sharing images and experiences in monthly meetings over five months, youth reported becoming more knowledgeable. They realised that they had common experiences but also reflected on and reinterpreted their circumstances. While they acquired self-confidence and enhanced their communication skills, they also initially faced community resistance regarding consent and lack of trust in their motives. Ethical practice in photovoice goes beyond institutional approval and individual consent. It includes extensively discussing the project with community members and building relationships with them. In certain instances, photos needed not to identify community members, or not be taken at all. Through these relationships and with improved capacity, youth engaged in individual instances of health education and advocacy, as well as spurred further local action through community dialogues. Researchers supporting photovoice must be open to learning alongside participants, flexible regarding study focus and processes, sustain interest and manage logistics, all while being reflective about the balance of power in such partnerships. PMID:27109246

  10. Community awareness about risk factors, presentation and prevention and obstetric fistula in Nabitovu village, Iganga district, Uganda

    PubMed Central

    2013-01-01

    Background Obstetric fistula is a worldwide problem that is devastating for women in developing countries. The cardinal cause of obstetric fistula is prolonged obstructed labour and delay in seeking emergency obstetric care. Awareness about obstetric fistula is still low in developing countries. The objective was to assess the awareness about risk factors of obstetric fistulae in rural communities of Nabitovu village, Iganga district, Eastern Uganda. Methods A qualitative study using focus group discussion for males and females aged 18-49 years, to explore and gain deeper understanding of their awareness of existence, causes, clinical presentation and preventive measures for obstetric fistula. Data was analyzed by thematic analysis. Results The majority of the women and a few men were aware about obstetric fistula, though many had misconceptions regarding its causes, clinical presentation and prevention. Some wrongly attributed fistula to misuse of family planning, having sex during the menstruation period, curses by relatives, sexually transmitted infections, rape and gender-based violence. However, others attributed the fistula to delays to access medical care, induced abortions, conception at an early age, utilization of traditional birth attendants at delivery, and some complications that could occur during surgical operations for difficult deliveries. Conclusion Most of the community members interviewed were aware of the risk factors of obstetric fistula. Some respondents, predominantly men, had misconceptions/myths about risk factors of obstetric fistula as being caused by having sex during menstrual periods, poor usage of family planning, being a curse. PMID:24321441

  11. Risk factors associated with occurrence of African swine fever outbreaks in smallholder pig farms in four districts along the Uganda-Kenya border.

    PubMed

    Nantima, Noelina; Ocaido, Michael; Ouma, Emily; Davies, Jocelyn; Dione, Michel; Okoth, Edward; Mugisha, Anthony; Bishop, Richard

    2015-03-01

    A cross-sectional survey was carried out to assess risk factors associated with occurrence of African swine fever (ASF) outbreaks in smallholder pig farms in four districts along Kenya-Uganda border. Information was collected by administering questionnaires to 642 randomly selected pig households in the study area. The study showed that the major risk factors that influenced ASF occurrence were purchase of pigs in the previous year (p < 0.000) and feeding of pigs with swill (p < 0.024). By employing cluster analysis, three clusters of pig production types were identified based on production characteristics that were found to differ significantly between districts. The most vulnerable cluster to ASF was households with the highest reported number of ASF outbreaks and composed of those that practiced free range at least some of the time. The majority of the households in this cluster were from Busia district in Uganda. On the other hand, the least vulnerable cluster to ASF composed of households that had the least number of pig purchases, minimal swill feeding, and less treatment for internal and external parasites. The largest proportion of households in this cluster was from Busia district Kenya. The study recommended the need to sensitize farmers to adopt proper biosecurity practices such as total confinement of pigs, treatment of swill, isolation of newly purchased pigs for at least 2 weeks, and provision of incentives for farmers to report suspected outbreaks to authorities and rapid confirmation of outbreaks. PMID:25616986

  12. Enhancing knowledge and awareness of biosecurity practices for control of African swine fever among smallholder pig farmers in four districts along the Kenya-Uganda border.

    PubMed

    Nantima, Noelina; Davies, Jocelyn; Dione, Michel; Ocaido, Michael; Okoth, Edward; Mugisha, Anthony; Bishop, Richard

    2016-04-01

    A study was undertaken along the Kenya-Uganda border in four districts of Tororo and Busia (Uganda) and Busia and Teso (Kenya) to understand smallholder farmers' knowledge, practices and awareness of biosecurity measures. Information was collected by administering questionnaires to 645 randomly selected pig households in the study area. In addition, focus group discussions were carried out in 12 villages involving 248 people using a standardized list of questions. The outcome suggested that there was a very low level of awareness of biosecurity practices amongst smallholder farmers. We conclude that adoption of specific biosecurity practices by smallholder farmers is feasible but requires institutional support. There is a clear requirement for government authorities to sensitize farmers using approaches that allow active participation of farmers in the design, planning and implementation of biosecurity practices to enable enhanced adoption. PMID:26922740

  13. Land slide disaster in eastern Uganda: rapid assessment of water, sanitation and hygiene situation in Bulucheke camp, Bududa district

    PubMed Central

    2011-01-01

    Background On 1st March 2010, a major landslide occurred on Mt. Elgon in Eastern Uganda. This was triggered by heavy rains that lasted over three months. The landslide buried three villages in Bududa district, killing over 400 and displacing an estimate of 5,000 people. A comprehensive assessment of water, sanitation and hygiene was urgently needed to inform interventions by the Ministries of Health, and Relief, Disaster Preparedness and Refugees, Uganda. Methods This was a cross-sectional study where both qualitative and quantitative data were collected two weeks after the disaster. Quantitative interviews involved 397 heads of households and qualitative methods comprised of 27 Key Informant interviews, four focus group discussions and observations. The survey quantified water safety (collection, treatment, storage) and hygiene practices. This was supplemented and triangulated with qualitative data that focused on community perceptions and beliefs regarding water and sanitation needs and practices. Quantitative data was entered in Epi-Info Version 3.2.2 software and then exported to SPSS Version 12 for analysis. Summary statistics and proportions were generated and bi-variable analysis performed for selected variables. Associations were assessed using odds ratios at 95% confidence intervals. Qualitative data was analyzed using content analysis. Results Qualitative results showed that there were strong traditional beliefs governing water use and human excreta disposal. The use of river Manafwa water for household consumption was observed to potentially lead to disease outbreaks. Water from this river was reported tastier and the community culturally saw no need to boil drinking water. Latrines were few (23 for 5000 people), shallow, dirty (70% reported flies, 60% fecal littering), not separated by sex and had limited privacy and no light at night. This affected their use. Males were 3 times more likely to wash hands with soap after latrine use than females (OR = 3

  14. Understanding low uptake of mass treatment for intestinal schistosomiasis among school children: a qualitative study in Jinja district, Uganda.

    PubMed

    Muhumuza, Simon; Olsen, Annette; Nuwaha, Fred; Katahoire, Anne

    2015-07-01

    Despite attempts to control intestinal schistosomiasis through school-based mass drug administration (MDA) with praziquantel using school teachers in Uganda, less than 30% of the school children take the treatment in some areas. The aim of the study was to understand why the uptake of praziquantel among school children is low and to suggest strategies for improved uptake. This was a cross-sectional qualitative study in which 24 focus group discussions and 15 key informant interviews were conducted 2 months after MDA. The focus group discussions were held with school children in twelve primary schools and the key informant interviews were held with school teachers, sub-county health assistants and the District Vector Control Officer. The study shows that the low uptake of praziquantel among school children is a result of a complex interplay between individual, interpersonal, institutional, community and public policy factors. The individual and interpersonal factors underpinning the low uptake include inadequate information about schistosomiasis prevention, beliefs and attitudes in the community about treatment of schistosomiasis and shared concerns among children and teachers about the side-effects of praziquantel, especially when the drug is taken on an empty stomach. The institutional, policy and community factors include inadequate preparation and facilitation of teachers and the school feeding policy, which requires parents to take responsibility for providing their children with food while at school, yet many parents cannot meet the cost of a daily meal due to the prevailing poverty in the area. It is concluded that strategies to improve uptake of praziquantel among school children need to be multi-pronged addressing not only the preparation and motivation of teachers and health education for children, but also the economic and political aspects of drug distribution, including the school feeding policy. PMID:24735860

  15. Identification of Echinococcus granulosus strains using polymerase chain reaction-restriction fragment length polymorphism amongst livestock in Moroto district, Uganda.

    PubMed

    Chamai, Martin; Omadang, Leonard; Erume, Joseph; Ocaido, Michael; Oba, Peter; Othieno, Emmanuel; Bonaventure, Straton; Kitibwa, Annah

    2016-01-01

    A descriptive study was conducted to identify the different strains of Echinococcus granulosus occurring in livestock in Moroto district, Uganda. Echinococcus cysts from 104 domestic animals, including cattle, sheep, goats and camels, were taken and examined by microscopy, polymerase chain reaction with restriction fragment length polymorphism and Sanger DNA sequencing. Echinococcus granulosus genotypes or strains were identified through use of Bioinformatics tools: BioEdit, BLAST and MEGA6. The major finding of this study was the existence of a limited number of E. granulosus genotypes from cattle, goats, sheep and camels. The most predominant genotype was G1 (96.05%), corresponding to the common sheep strain. To a limited extent (3.95%), the study revealed the existence of Echinococcus canadensis G6/7 in three (n = 3) of the E. granulosus-positive samples. No other strains of E. granulosus were identified. It was concluded that the common sheep strain of Echinococcus sensu stricto and G6/7 of E. canadensis were responsible for echinococcal disease in Moroto district, Uganda. PMID:27543147

  16. Profiles and outcome of traditional healing practices for severe mental illnesses in two districts of Eastern Uganda

    PubMed Central

    Abbo, Catherine

    2011-01-01

    Background The WHO estimates that more than 80% of African populations attend traditional healers for health reasons and that 40%–60% of these have some kind of mental illness. However, little is known about the profiles and outcome of this traditional approach to treatment. Objective The purpose of this study was to describe the profiles and outcome of traditional healing practices for severe mental illnesses in Jinja and Iganga districts in the Busoga region of Eastern Uganda. Methods Four studies were conducted. Study I used focus group discussions (FGDs) with case vignettes with local community members and traditional healers to explore the lay concepts of psychosis. Studies II and III concerned a cross-sectional survey of patients above 18 years at the traditional healer's shrines and study IV was made on a prospective cohort of patients diagnosed with psychosis in study III. Manual content analysis was used in study I; quantitative data in studies II, III, and IV were analyzed at univariate, bivariate, and multivariate levels to determine the association between psychological distress and socio-demographic factors; for study IV, factors associated with outcome were analyzed. One-way ANOVA for independent samples was the analysis used in Study IV. Results The community gave indigenous names to psychoses (mania, schizophrenia, and psychotic depression) and had multiple explanatory models for them. Thus multiple solutions for these problems were sought. Of the 387 respondents, the prevalence of psychological distress was 65.1%, where 60.2% had diagnosable current mental illness, and 16.3% had had one disorder in their lifetime. Over 80% of patients with psychosis used both biomedical and traditional healing systems. Those who combined these two systems seemed to have a better outcome. All the symptom scales showed a percentage reduction of more than 20% at the 3- and 6-month follow-ups. Conclusion Traditional healers shoulder a large burden of care of patients

  17. Health Seeking Behaviours among Caretakers of Children with Nodding Syndrome in Pader District - Northern Uganda: A Mixed Methods Study

    PubMed Central

    Atim, Pamela; Ochola, Emmanuel; Ssendagire, Stephen; Rutebemberwa, Elizeus

    2016-01-01

    Background Nodding syndrome is a neurological disorder which had affected about 3000 children with over 170 deaths in northern Uganda by 2012. With limited data on health seeking, the study aimed to assess the health seeking behavior and associated factors among caretakers of children with nodding syndrome in Pader district. Methods A mixed methods cross sectional study was conducted in July 2013 among 249 caretakers of children with nodding syndrome in three sub-counties of Pader. Respondents were consecutively interviewed using semi-structured questionnaires. Eleven key informants were additionally interviewed. We determined the associations of various factors with health care seeking and obtained adjusted odds ratios and 95% confidence intervals using logistic regression model. Quantitative data was analysed using Stata version 12 while qualitative data was analysed manually and quotes reported. Results Most caretakers, 78.3% (195/249) sought care first from a health facility, 12.9% (32/249) visited traditional healers and 8.8% (22/249) self-medicated. Of those who sought care from a health facility, 50% sought care after a month. Factors associated with improved care seeking included: Time taken to reach care 1–3 hours; adjusted odds ratio = 6.4 (95% CI = 2.96–14.03), time spent in care above five years; adjusted odds ratio = 12.0 (95% CI: 1.24–117.73) and changed care seeking place; adjusted odds ratio = 17.2 (95% CI: 3.64–81.67). Conclusion/ Recommendation Caretakers sought care from multiple places. One in five caretakers still sought care outside a formal health facility. Many respondents who sought care first from health facilities went late, at least one month after symptoms onset. Factors associated with health seeking included distance, duration in treatment and not having changing care provider. There is need for massive sensitization of community to enhance prompt care seeking. More research is needed to elucidate the cause, thus finding the

  18. Masculinity, social context and HIV testing: an ethnographic study of men in Busia district, rural eastern Uganda

    PubMed Central

    2014-01-01

    Background Uptake of HIV testing by men remains low in high prevalence settings in many parts of Africa. By focusing on masculinity, this study explores the social context and relations that shape men’s access to HIV testing in Mam-Kiror, Busia district, rural eastern Uganda. Methods From 2009–2010 in-depth interviews were undertaken with 26 men: nine being treated for HIV, eight who had tested but dropped out of treatment, six not tested but who suspected HIV infection and three with other health problems unrelated to HIV. These data were complemented by participant observation. Thematic analysis was undertaken. Results There were two main categories of masculinity in Mam-Kiror, one based on ‘reputation’ and the other on ‘respectability’, although some of their ideals overlapped. The different forms of masculine esteem led to different motives for HIV testing. Men positioned HIV testing as a social process understood within the social context and relationships men engaged in rather than an entirely self-determined enterprise. Wives’ inferior power meant that they had less influence on men’s testing compared to friends and work colleagues who discussed frankly HIV risk and testing. Couple testing exposed men’s extra-marital relationships, threatening masculine esteem. The fear to undermine opportunities for sex in the context of competition for partners was a barrier to testing by men. The construction of men as resilient meant that they delayed to admit to problems and seek testing. However, the respectable masculine ideal to fulfil responsibilities and obligations to family was a strong motivator to seeking an HIV test and treatment by men. Conclusion The two main forms of masculine ideals prevailing in Mam-Kiror in Busia led men to have different motives for HIV testing. Reputational masculinity was largely inconsistent with the requirements of couple testing, community outreach testing and the organisation of testing services, discouraging men

  19. Extent of Use of Aloe vera Locally Extracted Products for Management of Ailments in Communities of Kitagata Sub-county in Sheema District, Western Uganda

    PubMed Central

    Adams, Kamukama; Eliot, Twineomujuni; Gerald, Agaba

    2015-01-01

    Aloe vera is widely used locally in communities in Uganda as a medicinal plant. It is said to contain various nutrient substances and vitamins that have curative properties. It is said to heal a variety of diseases in various communities. However the extent of use of this potential medicinal plant in Uganda and the various ailments for which it is used and the treatment outcomes are not clearly established and documented. In this cross-sectional study, carried out in August 2012 in Kitagata sub-county in Sheema district in western Uganda, data was collected from 131 randomly selected adult respondents using an interviewer administered semi-structured questionnaire. Key informants interviews and focused group discussions were also carried out with purposively selected participants. Data were collected on social demographic characteristics, practices and beliefs about Aloe vera. The data were analyzed using Excel version 2007 and Epi_Info software. To get the proportion of the community that use Aloe vera, the number of respondents that use aloe vera was expressed as a percentage of the total number of respondents. It was found out that all the respondents (100%) know aloe vera plant, 96.1% think that it can cure and 84.7% have ever used it. 90.9% of the respondents believe that Aloe vera is effective in curing ailments. 82.9% of these strongly believe in Aloe vera’s effectiveness. The diseases reported included malaria (31%), wounds (23%), abdominal pains (16%) and skin diseases (9%) among others. It was significantly noted that all the participants who had ever used Aloe vera still believe in it. 92.0% respondents reported that they can recommend aloe vera to a friend or relative. Only one participant strongly disagrees that Aloe vera has any curative properties and has never used it. PMID:26855960

  20. "They don't care what happens to us." The situation of double orphans heading households in Rakai District, Uganda

    PubMed Central

    Dalen, Nina; Nakitende, Ann Jacqueline; Musisi, Seggane

    2009-01-01

    Background This article is based on information collected about the situation of double orphans who are heading households in Rakai District, Uganda. The information will be used as justification and guidance for planning actions to improve the situation of these and similar children. This research is thus the first step in an Action Research approach leading to specific interventions. The aim of this article is to describe the situation of these orphaned children, with an emphasis on the psychosocial challenges they face. Methods The study involved interviews, focus group discussions, observations and narratives. Forty-three heads of sibling-headed households participated. Information derived from informal discussions with local leaders is also included. The responses were analyzed using a modified version of Giorgi's psychological phenomenological method as described by Malterud [1]. Results Factors such as lack of material resources, including food and clothes, limited possibilities to attend school on a regular basis, vast responsibilities and reduced possibilities for social interaction all contribute to causing worries and challenges for the child heads of households. Most of the children claimed that they were stigmatized and, to a great extent, ignored and excluded from their community. The Local Council Secretary ("Chairman") seemed to be the person in the community most responsible and helpful, but some chairmen seemed not to care at all. The children requested counseling for themselves as well as for community members because they experienced lack of understanding from other children and from adult community members. Conclusion The children experienced their situation as a huge and complex problem for themselves as well as for people in their villages. However, the situation might improve if actions focused on practical and psychological issues as well as on sensitization about the children's situation could be initiated. In addition to the fact that

  1. Iron and zinc content of selected foods in the diet of schoolchildren in Kumi district, east of Uganda: a cross-sectional study

    PubMed Central

    2011-01-01

    Background Iron and zinc are essential micronutrients for humans and deficiency of the two elements is widespread in the world with the highest prevalence in less developed countries. There are few data on dietary intake of iron and zinc in Uganda, and no food composition table is available. There is hardly any widely published literature that clearly documents the quality of Ugandan children's diet. Thus information of both food intake and the concentration of these trace elements in local food ingredients are needed in order to assess daily intake. Methods The present study focused on the iron and zinc content in selected foods and intake of the micronutrients iron and zinc among schoolchildren in Kumi District, Uganda. Over a period of 4 weeks single 24-hour dietary recall interviews were carried out on a convenience sample of 178 schoolchildren (9-15 years old). Data from the dietary recalls was used when selecting foods for chemical analysis. Results Results from this study showed that the iron concentrations varied, and were high in some cereals and vegetables. The zinc concentrations in foods generally corresponded with results from other African countries (Mali and Kenya). Data from the 24-hour dietary recall showed that the daily Recommended Nutrient Intake (RNI) was met for iron but not for zinc. Conclusions The schoolchildren of Kumi district had a predominantly vegetable based diet. Foods of animal origin were consumed occasionally. The iron content in the selected foods was high and variable, and higher than in similar ingredients from Kenya and Mali, while the zinc concentrations were generally in accordance with reported values. The total daily zinc (mg) intake does not meet the daily RNI. The iron intake is adequate according to RNI, but due to iron contamination and reduced bioavailability, RNI may not be met in a vegetable based diet. More studies are needed to investigate possible sources of contamination. PMID:21827701

  2. Access to Education for Orphans and Vulnerable Children in Uganda: A Multi-District, Cross-Sectional Study Using Lot Quality Assurance Sampling from 2011 to 2013

    PubMed Central

    Crossland, Nadine; Valadez, Joseph J.

    2015-01-01

    Objectives This study estimates the proportion of Orphans and Vulnerable Children (OVC) attending school in 89 districts of Uganda from 2011 – 2013 and investigates the factors influencing OVC access to education among this population. Methods This study used secondary survey data from OVCs aged 5 – 17 years, collected using Lot Quality Assurance Sampling in 87 Ugandan districts over a 3-year period (2011 – 2013). Estimates of OVC school attendance were determined for the yearly time periods. Logistic regression was used to investigate the factors influencing OVC access to education. Results 19,354 children aged 5-17 were included in the analysis. We estimated that 79.1% (95% CI: 78.5% – 79.7%) of OVCs attended school during the 3-year period. Logistic regression revealed the odds of attending school were lower among OVCs from Western (OR 0.88; 95% CI: 0.79 – 0.99) and Northern (OR 0.64; 95% CI: 0.56 – 0.73) regions compared to the Central region. Female OVCs had a significantly higher odds of attending school (OR 1.09; 95% CI: 1.02 – 1.17) compared to their male counterparts. When adjusting for all variables simultaneously, we found the odds of school attendance reduced by 12% between 2011 and 2012 among all OVCs (OR 0.88; 95% CI: 0.81 – 0.97). Conclusion Our findings reinforce the need to provide continuing support to OVC in Uganda, ensuring they have the opportunity to attain an education. The data indicate important regional and gender variation that needs to be considered for support strategies and in social policy. The results suggest the need for greater local empowerment to address the needs of OVCs. We recommend further research to understand why OVC access to education and attendance varies between regions and improvement of district level mapping of OVC access to education, and further study to understand the particular factors impacting the lower school attendance of male OVCs. PMID:26181056

  3. Effect of School-based Human Papillomavirus (HPV) Vaccination on Adolescent Girls’ Knowledge and Acceptability of the HPV Vaccine in Ibanda District in Uganda

    PubMed Central

    Turiho, Andrew Kampikaho; Okello, Elialilia S.; Muhwezi, Wilson W.; Harvey, Steve; Byakika-Kibwika, Pauline; Meya, David; Katahoire, Anne R.

    2015-01-01

    From 2008 to 2011, schoolgirls were vaccinated against HPV in two districts in Uganda following sensitization. This study assessed girls’ knowledge of cervical cancer and HPV vaccine, and their acceptance of future vaccination of friends and hypothetical daughters. The cross-sectional, mixed methods comparative study was conducted in two districts. Univariate, bivariate, logistic regression and thematic analyses were done. HPV vaccination was positively associated with knowledge (Crude OR: 5.31, CI: 3.19–8.86; p = 0.000); but knowledge (Adjusted OR: 1.13, CI: 0.56–2.28; p = 0.73) and HPV vaccination (Adjusted OR: 0.92, CI: 0.16–5.36; p = 0.93) did not predict vaccine acceptability. Seemingly important motivations for vaccine acceptance were: its role in cancer prevention and advancement of reproductive health, minimal side effects, and positive peer role models. Major deterrents to vaccine acceptance were: rumours and misconceptions about possible side effects, perceived inadequate information about vaccine, and fear of side effects. PMID:25854092

  4. Effect of school-based human papillomavirus (hpv) vaccination on adolescent girls' knowledge and acceptability of the HPV vaccine in Ibanda District in Uganda.

    PubMed

    Turiho, Andrew Kampikaho; Okello, Elialilia S; Muhwezi, Wilson W; Harvey, Steve; Byakika-Kibwika, Pauline; Meya, David; Katahoire, Anne R

    2014-12-01

    From 2008 to 2011, schoolgirls were vaccinated against HPV in two districts in Uganda following sensitization. This study assessed girls' knowledge of cervical cancer and HPV vaccine, and their acceptance of future vaccination of friends and hypothetical daughters. The cross-sectional, mixed methods comparative study was conducted in two districts. Univariate, bivariate, logistic regression and thematic analyses were done. HPV vaccination was positively associated with knowledge (Crude OR: 5.31, CI: 3.19-8.86; p = 0.000); but knowledge (Adjusted OR: 1.13, CI: 0.56-2.28; p = 0.73) and HPV vaccination (Adjusted OR: 0.92, CI: 0.16-5.36; p = 0.93) did not predict vaccine acceptability. Seemingly important motivations for vaccine acceptance were: its role in cancer prevention and advancement of reproductive health, minimal side effects, and positive peer role models. Major deterrents to vaccine acceptance were: rumours and misconceptions about possible side effects, perceived inadequate information about vaccine, and fear of side effects. PMID:25854092

  5. Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono District, Uganda.

    PubMed

    Hansen, Kristian Schultz; Pedrazzoli, Debora; Mbonye, Anthony; Clarke, Sian; Cundill, Bonnie; Magnussen, Pascal; Yeung, Shunmay

    2013-03-01

    In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures. PMID:22589226

  6. Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono district, Uganda

    PubMed Central

    Hansen, Kristian Schultz; Pedrazzoli, Debora; Mbonye, Anthony; Clarke, Sian; Cundill, Bonnie; Magnussen, Pascal; Yeung, Shunmay

    2013-01-01

    In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures. PMID:22589226

  7. Menstrual hygiene management amongst schoolgirls in the Rukungiri district of Uganda and the impact on their education: a cross-sectional study

    PubMed Central

    Boosey, Robyn; Prestwich, Georgina; Deave, Toity

    2014-01-01

    Introduction An increasing number of studies have found that girls in low-income settings miss or struggle at school during menstruation if they are unable to manage their menstrual hygiene effectively. This study explores the menstrual hygiene practices and knowledge of girls at rural government primary schools in the Rukungiri district in Uganda and assesses the extent to which poor menstrual hygiene management (MHM) affects their education. Methods A self-administered questionnaire was completed by schoolgirls in six government-run primary schools in the Rukungiri district. Focus groups were held with girls from each school and semi-structured interviews were conducted with headteachers and female teachers from the participating schools. A toilet assessment was also conducted in each school. Results One hundred and forty schoolgirls completed the questionnaire. The girls reported a lack of access to adequate resources, facilities and accurate information to manage their menstrual hygiene effectively at school. They reported that, as a result, during menstruation they often struggle at school or miss school. Eighty-six girls (61.7%) reported missing school each month for menstrual-related reasons (mean 1.64, range 0-10, SD. 1.84). Conclusion It is common for girls who attend government-run primary schools in the Rukungiri district to miss school or struggle in lessons during menstruation because they do not have access to the resources, facilities, or information they need to manage for effective MHM. This is likely to have detrimental effects on their education and future prospects. A large-scale study is needed to explore the extent of this issue. PMID:25852796

  8. Lessons learned from engaging men in sexual and reproductive health as clients, partners and advocates of change in the Hoima district of Uganda

    PubMed Central

    Stern, Erin; Pascoe, Laura; Shand, Tim; Richmond, Samantha

    2015-01-01

    This study examined the impact of a three-year intervention project conducted in the Hoima district of Uganda, which sought to engage men in sexual and reproductive health as clients, equal partners and advocates of change. Structured surveys with 164 self-reported heterosexual men aged 18–54 years were used to assess knowledge and attitudes towards sexual and reproductive health. Data from these were analysed using Stata and SPSS. Additionally, five focus groups were conducted with the female partners and male beneficiaries of the project and with project peer educators. Four interviews were conducted with project staff and male beneficiaries. Data from these and the focus groups were analysed using a thematic approach. Following the intervention, a significantly greater number of men accessed, and supported their partners in accessing sexual health services services, had gained sexual and reproductive health awareness, reported sharing domestic duties and contraceptive decision-making, and displayed a decreased tolerance for domestic violence. It was more difficult to assess men's involvement and behaviours as advocates of change, which sheds light on the complexities of a gender transformative project and the importance of evaluating such projects from both men's and their partners' perspectives and at different levels of the male involvement model in sexual and reproductive health. PMID:25953243

  9. Knowledge and Attitudes of Parkinson's Disease in Rural and Urban Mukono District, Uganda: A Cross-Sectional, Community-Based Study.

    PubMed

    Kaddumukasa, Mark; Kakooza, Angelina; Kaddumukasa, Martin N; Ddumba, Edward; Mugenyi, Levi; Sajatovic, Martha; Katabira, Elly

    2015-01-01

    Background. Parkinson's disease (PD) negatively affects the quality of life. There is limited information on PD published from Africa. Lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care for individuals with PD. Methods. A cross-sectional survey was conducted in urban and rural Mukono district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants, interviewed on selected aspects of PD knowledge and attitudes. Results. Of the 377 participants, 47% were from urban settings and 68% (260/377) were women with a median age (IQR) of 34 (26-48) years. Half of the study respondents did not know the body part involved in or apparent cause of PD. Nearly 1/3 of individuals believed that PD is a form of insanity and 17% believed that PD is contagious. Rural dwellers were more likely to have incorrect knowledge regarding selected aspects of PD. Conclusions. Understanding the cause of PD is very limited in our setting. Some beliefs about PD aetiology may potentially worsen stigma and social isolation. This study highlights the need for increasing PD awareness in our settings. Public health approaches that improve knowledge are urgently needed to promote care access and community response to Parkinson's disease. PMID:26688774

  10. Knowledge and Attitudes of Parkinson's Disease in Rural and Urban Mukono District, Uganda: A Cross-Sectional, Community-Based Study

    PubMed Central

    Kaddumukasa, Mark; Kakooza, Angelina; Kaddumukasa, Martin N.; Ddumba, Edward; Mugenyi, Levi; Sajatovic, Martha; Katabira, Elly

    2015-01-01

    Background. Parkinson's disease (PD) negatively affects the quality of life. There is limited information on PD published from Africa. Lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care for individuals with PD. Methods. A cross-sectional survey was conducted in urban and rural Mukono district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants, interviewed on selected aspects of PD knowledge and attitudes. Results. Of the 377 participants, 47% were from urban settings and 68% (260/377) were women with a median age (IQR) of 34 (26–48) years. Half of the study respondents did not know the body part involved in or apparent cause of PD. Nearly 1/3 of individuals believed that PD is a form of insanity and 17% believed that PD is contagious. Rural dwellers were more likely to have incorrect knowledge regarding selected aspects of PD. Conclusions. Understanding the cause of PD is very limited in our setting. Some beliefs about PD aetiology may potentially worsen stigma and social isolation. This study highlights the need for increasing PD awareness in our settings. Public health approaches that improve knowledge are urgently needed to promote care access and community response to Parkinson's disease. PMID:26688774

  11. Acceptability and Utilization of Community Health Workers after the Adoption of the Integrated Community Case Management Policy in Kabarole District in Uganda

    PubMed Central

    Muhumuza, G; Mutesi, C; Mutamba, F; Ampuriire, P; Nangai, C

    2016-01-01

    Background Malaria, pneumonia and diarrhea remains to be the major causes of morbidity and mortality among children in Uganda. To address such challenges, the government adopted a national policy on Integrated Community Case Management (ICCM) for malaria, pneumonia and diarrhea in 2010. The aim of this study was to assess household access, utilization and acceptability of ICCM services in Kabarole District. Methods The study was carried out between 22nd November to 4th December, 2014 in Rwimi sub-county, Kabarole district. A cross sectional household survey was conducted amongst caretakers of children below 5 years of age and a total of 384 respondents were interviewed about distance from nearest health facility and community health worker, socio-demographic characteristics, type of housing, history of fever, health-seeking behavior, perceptions of quality and utilization of ICCM services. Data was cleaned, coded and analysed using STATA 14.0 to produce results. Results Most 53.1% of the studied children were males and their age ranged from 1–52 months. Nearly all the care takers, 97.1% (373/384) had utilized health services for their children in the three proceeding months to the study and of those, 0.5% (2/373) sought from a traditional healer, 8.6% (32/373) sought treatment at home, 27.3% (102/373) from community health worker, 27.3% (102/373) from government health unit and 36.2% (133/373) from non-government health units. The caretakers who stay near CHWs are more likely to utilize ICCM services than those staying near health facilities (P=0.001). The majority 65.6% of the caretakers stay near CHWs and use only 10 minutes to reach the CHWs. Trust in CHWs [AOR 0.85, 95%CI [0.641–1.135

  12. The prevalence of serum antibodies to tick-borne infections in Mbale District, Uganda: the effect of agro-ecological zone, grazing management and age of cattle.

    PubMed

    Rubaire-Akiiki, C; Okello-Onen, J; Nasinyama, G W; Vaarst, M; Kabagambe, E K; Mwayi, W; Musunga, D; Wandukwa, W

    2004-01-01

    Between August and October 2000, a cross-sectional study was conducted in smallholder dairy farms in Mbale District, Uganda to assess the prevalence of ticks and tick-borne diseases under different grazing systems and agro-ecological zones and understand the circumstances under which farmers operated. A questionnaire was administered to obtain information on dairy farm circumstances and practices. A total of 102 farms were visited and sera and ticks were collected from 478 animals. Sero-prevalence of tick-borne diseases was determined using an enzyme-linked immunoassay. Acaricides were used indiscriminately but the intensity of their use varied with the grazing system and zone. Cattle from different farms mixed for various reasons. During the dry seasons farmers have to get additional fodder from outside their farms that can result in importation of ticks. The prevalence of ticks and serum antibodies to tick-borne infections differed across the grazing systems and zones. The highest serum antibody prevalence (>60%) was recorded in the lowland zone under the free range and tethering grazing systems. The lowest tick challenge and serum antibody levels (<50%) were recorded in the midland and upland zones under a zero-grazing system. These findings suggest that endemic stability to East Coast Fever, babesiosis and anaplasmosis is most likely to have existed in the lowland zone, particularly, under the tethering and free-range grazing systems. Also, endemic stability for babesiosis existed in the upland zones. Endemic instability for East Coast Fever existed in the midland and upland zones. These structured observational studies are instrumental in planning of control strategies for ticks and tick borne diseases since production systems and the cattle population at high risk of the diseases in the district have been identified. PMID:15861224

  13. Gaps and gains from engaging districts stakeholders for community-based health professions education in Uganda: a qualitative study.

    PubMed

    Okello, Elialilia S; Nankumbi, Joyce; Ruzaaza, Gad Ndaruhutse; Bakengesa, Evelyn; Gumikiriza, Joy; Arubaku, Wilfred; Acio, Christine; Samantha, Mary; Matte, Michael

    2015-12-01

    Community-based education research and service (COBERS) is a brand of community-based education that has been adopted by the Medical Education and Service for All Ugandans consortium. The COBERS programme is aimed at equipping students in health professional education with the knowledge, attitudes and skills required to provide appropriate health care services. For sustainability purposes, the health professional training institutions have made efforts to involve various stakeholders in the implementation of the programme. However, the actual engagement process and outcome of such efforts have not been documented. This paper documents gaps and gains made in engaging district stakeholders for community-based education. Key informant interviews, focus group discussions and document review were used to collect data. Atlas.ti, computer software for qualitative data was used to aid analysis. The analysis revealed that the adopted engagement model has registered some gains including increased awareness among district leaders about potential opportunities offered by COBERS such as boosting of human resources at health facilities, opportunities for professional development for health care workers at health facilities, and establishment of linkages between prospective employees and employers. However, the engagement model left some gaps in terms of knowledge, awareness and ownership of the programme among some sections of stakeholders. The apparent information gap about the programme among district stakeholders, especially the political leadership, may hinder concerted partnership. The findings highlight the need for health professional education institutions to broaden the scope of actively engaged stakeholders with the district level. PMID:26556225

  14. In vitro Antibacterial Activity of Ocimum suave Essential Oils against Uropathogens Isolated from Patients in Selected Hospitals in Bushenyi District, Uganda

    PubMed Central

    Tibyangye, Julius; Okech, Matilda Angela; Nyabayo, Josephat Maniga; Nakavuma, Jessica Lukanga

    2015-01-01

    Aims To determine antibacterial activity of Ocimum suave essential oils against bacterial uropathogens. Study Design A cross sectional and experimental study. Place and Duration of Study Six selected hospitals in Bushenyi District, Uganda between June 2012 and July 2013. Methodology Clean catch midstream urine samples were collected and inoculated on Cystine Lysine Electrolyte Deficient (CLED) agar. The plates were incubated at 37°C for 24hrs to 48hrs. The O. suave essential oils were extracted by hydrodistillation of leaves for 4hrs using a Clevenger apparatus. The oil was collected and dried over anhydrous sodium sulphate (Na2SO4) and kept at 4°C till further use. The antimicrobial activity of O. suave essential oils against isolates was determined by agar well method. The MIC of O. suave essential oil extract was carried out by microbroth dilution method. Results Of the three hundred (300) midstream urine samples collected, 67(22.33%) had significant bacterial growth. Escherichia coli is the most common isolate (61.19%, n = 41). The essential oil from O. suave showed activity against isolates of E. coli, K. pneumoniae, S. aureus, E. feacalis, M. morganii, Citrobacter species, Enterobacter species and P. aeruginosa with mean zone of inhibition (ZI) ranging from 10–22 mm. The essential oils had no inhibitory activity on Acinetobacter species. The minimum inhibitory concentration (MIC) for O. suave essential oils ranged from 0.78 to 22 μg/ml. This study showed that O. suave essential oils had MIC value of 0.78 μg/ml against S. aureus and MIC values ranging from 3 to 22 μg/ml against the other tested isolates. Conclusion The most common uropathogen was E. coli (61.19% n = 41). O. suave essential oils exhibited antibacterial activity against majority of the uropathogens, except Acinetobacter species, mean ZI of 10–22 mm and MIC of 0.78 – 22 μg/ml. PMID:26120574

  15. Women's Acceptability of Misoprostol Treatment for Incomplete Abortion by Midwives and Physicians - Secondary Outcome Analysis from a Randomized Controlled Equivalence Trial at District Level in Uganda

    PubMed Central

    Cleeve, Amanda; Byamugisha, Josaphat; Gemzell-Danielsson, Kristina; Mbona Tumwesigye, Nazarius; Atuhairwe, Susan; Faxelid, Elisabeth; Klingberg-Allvin, Marie

    2016-01-01

    Objective This study aimed to assess women´s acceptability of diagnosis and treatment of incomplete abortion with misoprostol by midwives, compared with physicians. Methods This was an analysis of secondary outcomes from a multi-centre randomized controlled equivalence trial at district level in Uganda. Women with first trimester incomplete abortion were randomly allocated to clinical assessment and treatment with misoprostol by a physician or a midwife. The randomisation (1:1) was done in blocks of 12 and stratified for health care facility. Acceptability was measured in expectations and satisfaction at a follow up visit 14–28 days following treatment. Analysis of women’s overall acceptability was done using a generalized linear mixed-effects model with an equivalence range of -4% to 4%. The study was not masked. The trial is registered at ClinicalTrials.org, NCT 01844024. Results From April 2013 to June 2014, 1108 women were assessed for eligibility of which 1010 were randomized (506 to midwife and 504 to physician). 953 women were successfully followed up and included in the acceptability analysis. 95% (904) of the participants found the treatment satisfactory and overall acceptability was found to be equivalent between the two study groups. Treatment failure, not feeling calm and safe following treatment, experiencing severe abdominal pain or heavy bleeding following treatment, were significantly associated with non-satisfaction. No serious adverse events were recorded. Conclusions Treatment of incomplete abortion with misoprostol by midwives and physician was highly, and equally, acceptable to women. Trial Registration ClinicalTrials.gov NCT01844024 PMID:26872219

  16. “I Spent a Full Month Bleeding, I Thought I Was Going to Die…” A Qualitative Study of Experiences of Women Using Modern Contraception in Wakiso District, Uganda

    PubMed Central

    Kibira, Simon P. S.; Muhumuza, Christine; Bukenya, Justine N.; Atuyambe, Lynn M.

    2015-01-01

    Introduction There is high unmet need for family planning (FP) in Uganda as well as high contraceptive discontinuation rates. These contribute to the high fertility rates that in part are due to unplanned pregnancies. There are gaps in knowledge about experiences that couples go through while using contraceptives in their lives. This study explored women’s experiences during the course of their contraceptive use. Methods We conducted a qualitative study involving 30 women who had used modern contraception for at least one year in Wakiso district, central Uganda. We used in-depth interviews to obtain their personal accounts. Index women were approached through health officers at four health centres in the district. All ethical approvals and informed consent were obtained. We used conventional content analysis; identifying codes through open coding, on which basis categories were developed and grouped into overarching themes. Results Women’s accounts were summarised in the following themes: negative experiences with modern contraceptive use, motivation to continue using FP in spite of these negative experiences, the role of influential people, and discontinuation of use. Negative accounts dominated the experiences of most women but they expressed strong desire to continue using modern contraception even amidst all challenges. Health workers emerged as the most influential people that played a vital role in women’s decisions. Conclusion Varied negative experiences with modern contraception and misperceptions exist amidst a determination to continue use. Partner engagement, health service strengthening to improve side effects management and health worker skills, and engaging older women that have successfully used contraception as community champions, are potential strategies to support women’s contraceptive decisions. PMID:26524603

  17. District health planning at a time of transition: a critical review and lessons learnt from the implementation of regional planning in Uganda.

    PubMed

    Curtale, Filippo; Musila, Timothy; Opigo, Jimmy; Nantamu, Dyogo; Ezati, Isaac Alidria

    2016-05-01

    A quarter of a century after the Harare Declaration on Strengthening District Health Systems Based on Primary Health Care (1987) was conceived, district health teams (DHTs) are facing a markedly changed situation. Rapid population growth, urbanization, a rapidly developing private sector, and the increasing role of vertical programs and global initiatives have marginalized the planning process and weakened the entire district health system (DHS). The Ugandan Ministry of Health (MoH) responded to these challenges by beginning a review of district planning: a key action point of the Harare Declaration. The first step was a critical review of relevant literature, then central and district health staff were engaged with to provide their input in developing the new strategy. Through a field experiment started in 2012-13, and still underway, the MoH is developing an innovative regional approach to health planning, which aims to encompass the complexity of the new context of health care provision and coordinate all new actors (private health providers, projects and local government staff from other sectors) operating in the health sector. A strategic revision of the planning process represents an opportunity to develop an appropriate 'Theory of Change', intended as a broader approach of thinking about the entire DHS and the relative role and functions of the DHT. Leadership and stewardship capacities of MoH staff, at central and peripheral level, must be strengthened and supported to achieve the expected changes and results. PMID:27178674

  18. Information and Communication for Rural Innovation and Development: Context, Quality and Priorities in Southeast Uganda

    ERIC Educational Resources Information Center

    Sseguya, Haroon; Mazur, Robert; Abbott, Eric; Matsiko, Frank

    2012-01-01

    Purpose: To examine the status and priorities for agricultural information generation, dissemination and utilization in the context of agricultural innovation systems in southeast Uganda. Design/Methodology/Approach: Group discussions were conducted with six communities in Kamuli district, southeast Uganda. The focus was on information sources and…

  19. Assessing Community Understanding of Local Environmental Issues in Two Areas of Uganda

    ERIC Educational Resources Information Center

    Ferrie, Gina M.; Bettinger, Tammie L.; Kuhar, Christopher W.; Lehnhardt, Kathy; Apell, Peter; Kasoma, Panta

    2011-01-01

    Although there are many conservation education projects working in Uganda, there is currently little evaluation of educational initiatives in the communities. A survey was developed to better understand the environmental knowledge, attitudes, and behaviors of people in 2 districts of Uganda. The main environmental problem listed by the respondents…

  20. Acceptability and feasibility of using non-specialist health workers to deliver mental health care: stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda.

    PubMed

    Mendenhall, Emily; De Silva, Mary J; Hanlon, Charlotte; Petersen, Inge; Shidhaye, Rahul; Jordans, Mark; Luitel, Nagendra; Ssebunnya, Joshua; Fekadu, Abebaw; Patel, Vikram; Tomlinson, Mark; Lund, Crick

    2014-10-01

    Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental health care in LMICs by examining perceptions of primary care service providers (physicians, nurses, and community health workers), community members, and service users in one district in each of the five countries participating in the PRogramme for Improving Mental health carE (PRIME): Ethiopia, India, Nepal, South Africa, and Uganda. Thirty-six focus group discussions and 164 in-depth interviews were conducted at the pre-implementation stage between February and October 2012 with the objective of developing district level plans to integrate mental health care into primary care. Perceptions of the acceptability and feasibility of task-sharing were evaluated first at the district level in each country through open-coding and then at the cross-country level through a secondary analysis of emergent themes. We found that task-sharing mental health services is perceived to be acceptable and feasible in these LMICs as long as key conditions are met: 1) increased numbers of human resources and better access to medications; 2) ongoing structured supportive supervision at the community and primary care-levels; and 3) adequate training and compensation for health workers involved in task-sharing. Taking into account the socio-cultural context is fundamental for identifying local personnel who can assist in detection of mental illness and facilitate treatment and care as well as training, supervision, and service delivery. By recognizing the systemic challenges and sociocultural nuances that may influence task-sharing mental health care

  1. Costs Of Using “Tiny Targets” to Control Glossina fuscipes fuscipes, a Vector of Gambiense Sleeping Sickness in Arua District of Uganda

    PubMed Central

    Shaw, Alexandra P. M.; Tirados, Inaki; Mangwiro, Clement T. N.; Esterhuizen, Johan; Lehane, Michael J.; Torr, Stephen J.; Kovacic, Vanja

    2015-01-01

    Introduction To evaluate the relative effectiveness of tsetse control methods, their costs need to be analysed alongside their impact on tsetse populations. Very little has been published on the costs of methods specifically targeting human African trypanosomiasis Methodology/Principal Findings In northern Uganda, a 250 km2 field trial was undertaken using small (0.5 X 0.25 m) insecticide-treated targets (“tiny targets”). Detailed cost recording accompanied every phase of the work. Costs were calculated for this operation as if managed by the Ugandan vector control services: removing purely research components of the work and applying local salaries. This calculation assumed that all resources are fully used, with no spare capacity. The full cost of the operation was assessed at USD 85.4 per km2, of which USD 55.7 or 65.2% were field costs, made up of three component activities (target deployment: 34.5%, trap monitoring: 10.6% and target maintenance: 20.1%). The remaining USD 29.7 or 34.8% of the costs were for preliminary studies and administration (tsetse surveys: 6.0%, sensitisation of local populations: 18.6% and office support: 10.2%). Targets accounted for only 12.9% of the total cost, other important cost components were labour (24.1%) and transport (34.6%). Discussion Comparison with the updated cost of historical HAT vector control projects and recent estimates indicates that this work represents a major reduction in cost levels. This is attributed not just to the low unit cost of tiny targets but also to the organisation of delivery, using local labour with bicycles or motorcycles. Sensitivity analyses were undertaken, investigating key prices and assumptions. It is believed that these costs are generalizable to other HAT foci, although in more remote areas, with denser vegetation and fewer people, costs would increase, as would be the case for other tsetse control techniques. PMID:25811956

  2. Adherence of community caretakers of children to pre-packaged antimalarial medicines (HOMAPAK®) among internally displaced people in Gulu district, Uganda

    PubMed Central

    Kolaczinski, Jan H; Ojok, Naptalis; Opwonya, John; Meek, Sylvia; Collins, Andrew

    2006-01-01

    Background In 2002, home-based management of fever (HBMF) was introduced in Uganda, to improve access to prompt, effective antimalarial treatment of all fevers in children under 5 years. Implementation is through community drug distributors (CDDs) who distribute pre-packaged chloroquine plus sulfadoxine-pyrimethamine (HOMAPAK®) free of charge to caretakers of febrile children. Adherence of caretakers to this regimen has not been studied. Methods A questionnaire-based survey combined with inspection of blister packaging was conducted to investigate caretakers' adherence to HOMAPAK®. The population surveyed consisted of internally displaced people (IDPs) from eight camps. Results A total of 241 caretakers were interviewed. 95.0% (CI: 93.3% – 98.4%) of their children had received the correct dose for their age and 52.3% of caretakers had retained the blister pack. Assuming correct self-reporting, the overall adherence was 96.3% (CI: 93.9% – 98.7%). The nine caretakers who had not adhered had done so because the child had improved, had vomited, did not like the taste of the tablets, or because they forgot to administer the treatment. For 85.5% of cases treatment had been sought within 24 hours. Blister packaging was considered useful by virtually all respondents, mainly because it kept the drugs clean and dry. Information provided on, and inside, the package was of limited use, because most respondents were illiterate. However, CDDs had often told caretakers how to administer the treatment. For 39.4% of respondents consultation with the CDD was their reported first action when their child has fever and 52.7% stated that they consult her/him if the child does not get better. Conclusion In IDP camps, the HBMF strategy forms an important component of medical care for young children. In case of febrile illness, most caretakers obtain prompt and adequate antimalarial treatment, and adhere to it. A large proportion of malaria episodes are thus likely to be treated

  3. Introduction of mobile phones for use by volunteer community health workers in support of integrated community case management in Bushenyi District, Uganda: development and implementation process

    PubMed Central

    2014-01-01

    competence to initiate a community trial was established through performance monitoring. Conclusion Local information/communication consultants, working in concert with a university based department of pediatrics, can design and implement a robust mobile phone based system that may be anticipated to contribute to efficient delivery of iCCM by trained volunteer CHWs in rural settings in Uganda. PMID:25079241

  4. Multilingual Cultural Resources in Child-Headed Families in Uganda

    ERIC Educational Resources Information Center

    Namazzi, Elizabeth; Kendrick, Maureen E.

    2014-01-01

    This article reports on a study focusing on the use of multilingual cultural resources in child-headed households (CHHs) in Uganda's Rakai District. Using funds of knowledge and sociocultural perspectives on children's learning, we documented through ethnographic observations and interviews how children in four CHHs used multilingual…

  5. Prevalence of nodding syndrome--Uganda, 2012-2013.

    PubMed

    Iyengar, Preetha J; Wamala, Joseph; Ratto, Jeffrey; Blanton, Curtis; Malimbo, Mugagga; Lukwago, Luswa; Becknell, Steven; Downing, Robert; Bunga, Sudhir; Sejvar, James; Makumbi, Issa

    2014-07-18

    Nodding syndrome (NS) is a seizure disorder of unknown etiology, predominately affecting children aged 3-18 years in three sub-Saharan countries (Uganda, South Sudan, and Tanzania), with the primary feature of episodic head nodding. These episodes are thought to be one manifestation of a syndrome that includes neurologic deterioration, cognitive impairment, and additional seizure types. NS investigations have focused on clinical features, progression, and etiology; however, none have provided a population-based prevalence assessment using a standardized case definition. In March 2013, CDC and the Ugandan Ministry of Health (MOH) conducted a single-stage cluster survey to perform the first systematic assessment of prevalence of NS in Uganda using a new consensus case definition, which was modified during the course of the investigation. Based on the modified definition, the estimated number of probable NS cases in children aged 5-18 years in three northern Uganda districts was 1,687 (95% confidence interval [CI] = 1,463-1,912), for a prevalence of 6.8 (CI = 5.9-7.7) probable NS cases per 1,000 children aged 5-18 years in the three districts. These findings can guide the MOH to understand and provide the health-care resources necessary to address NS in northern Uganda, and provide a basis for future studies of NS in Uganda and in other areas affected by NS. PMID:25029112

  6. Runyakitara: Uganda's "New" Language.

    ERIC Educational Resources Information Center

    Bernsten, Jan

    1998-01-01

    Examined the emergence of Runyakitara as a new language in Uganda in the 1980s. The formation of Runyakitara through the realignment of four Western Bantu varieties illustrates the potential for the use of language as a resource in ethnic competition. Discusses the construction of Runyakitara in the context of the current political situation in…

  7. Barriers and facilitators in the provision of post-abortion care at district level in central Uganda – a qualitative study focusing on task sharing between physicians and midwives

    PubMed Central

    2014-01-01

    Background Abortion is restricted in Uganda, and poor access to contraceptive methods result in unwanted pregnancies. This leaves women no other choice than unsafe abortion, thus placing a great burden on the Ugandan health system and making unsafe abortion one of the major contributors to maternal mortality and morbidity in Uganda. The existing sexual and reproductive health policy in Uganda supports the sharing of tasks in post-abortion care. This task sharing is taking place as a pragmatic response to the increased workload. This study aims to explore physicians’ and midwives’ perception of post-abortion care with regard to professional competences, methods, contraceptive counselling and task shifting/sharing in post-abortion care. Methods In-depth interviews (n = 27) with health care providers of post-abortion care were conducted in seven health facilities in the Central Region of Uganda. The data were organized using thematic analysis with an inductive approach. Results Post-abortion care was perceived as necessary, albeit controversial and sometimes difficult to provide. Together with poor conditions post-abortion care provoked frustration especially among midwives. Task sharing was generally taking place and midwives were identified as the main providers, although they would rarely have the proper training in post-abortion care. Additionally, midwives were sometimes forced to provide services outside their defined task area, due to the absence of doctors. Different uterine evacuation skills were recognized although few providers knew of misoprostol as a method for post-abortion care. An overall need for further training in post-abortion care was identified. Conclusions Task sharing is taking place, but providers lack the relevant skills for the provision of quality care. For post-abortion care to improve, task sharing needs to be scaled up and in-service training for both doctors and midwives needs to be provided. Post-abortion care should further be

  8. Uganda's eco-rebirth.

    PubMed

    Lazarus, D

    1991-01-01

    In 1986, the Government of Uganda established the Ministry of Environmental Protection to meet the country's socioeconomic development needs without destroying the environment. A Ministry-supported village pilot project in the Gombe region promotes self-sufficiency in potable water, food, and energy and tests means to achieve ecologically sound management of sustainable food/energy/fodder production. The Ministry also serves to sensitize the public to environmental issues by encouraging Ugandan newspapers to report more environment-related stories. A newspaper story informed the government about fishermen along a 20 km stretch of the Nile River and in Lake Victoria who used dynamite to kill fish, including juvenile and noncommercial fish. Thus, the government quickly put a halt to dynamiting. The ministry also produces films on Uganda's environmental problems. Some of these problems include the indiscriminate destruction of forests (e.g., Mabira, Mt. Elgon, Kibale, Budongo, Bwindi, and Maramagambo) and farmlands along Lake Victoria. Further, Uganda is witnessing either killing or smuggling of its elephants, rhinos, insects, birds, reptiles, and primates. In 1988, the World Bank committed about US$33.5 million to activities to protect Uganda's forests. They include planting of exotic softwoods, timber harvesting from remaining forests, and reestablishment of self-sufficiency in fuelwoods. The government hopes that forest rehabilitation will bring back tourism which before the civil war was the country's second highest foreign exchange earner. In fact, the remaining forests house the world's greatest population densities of primates (e.g., mountain gorillas in the southwest) and many rate birds. The UN Environmental Program will write Uganda's environmental protection law and helps the Ministry to promote environmental and public awareness. PMID:12285370

  9. Introducing quality management into primary health care services in Uganda.

    PubMed Central

    Omaswa, F.; Burnham, G.; Baingana, G.; Mwebesa, H.; Morrow, R.

    1997-01-01

    In 1994, a national quality assurance programme was established in Uganda to strengthen district-level management of primary health care services. Within 18 months both objective and subjective improvements in the quality of services had been observed. In the examples documented here, there was a major reduction in maternal mortality among pregnant women referred to Jinja District Hospital, a reduction in waiting times and increased patient satisfaction at Masaka District Hospital, and a marked reduction in reported cases of measles in Arua District. Beyond these quantitative improvements, increased morale of district health team members, improved satisfaction among patients, and greater involvement of local government in the decisions of district health committees have been observed. At the central level, the increased coordination of activities has led to new guidelines for financial management and the procurement of supplies. District quality management workshops followed up by regular support visits from the Ministry of Health headquarters have led to a greater understanding by central staff of the issues faced at the district level. The quality assurance programme has also fostered improved coordination among national disease-control programmes. Difficulties encountered at the central level have included delays in carrying out district support visits and the failure to provide appropriate support. At the district level, some health teams tackled problems over which they had little control or which were overly complex; others lacked the management capacity for problem solving. PMID:9185368

  10. Petrophysical database of Uganda

    NASA Astrophysics Data System (ADS)

    Ruotoistenmäki, Tapio; Birungi, Nelson R.

    2015-06-01

    The petrophysical database of Uganda contains data on ca. 5800 rock samples collected and analyzed during 2009-2012 in international geological and geophysical projects covering the main part of the land area of Uganda. The parameters included are the susceptibilities and densities of all available field samples. Susceptibilities were measured from the samples from three directions. Using these parameters, we also calculated the ratios of susceptibility maxima/minima reflecting direction homogeneity of magnetic minerals, and estimated the iron content of paramagnetic samples and the magnetite content of ferrimagnetic samples. Statistical and visual analysis of the petrophysical data of Uganda demonstrated their wide variation, thus emphasizing their importance in analyzing the bedrock variations in three dimensions. Using the density-susceptibility diagram, the data can be classified into six main groups: 1. A low density and susceptibility group, consisting of sedimentary and altered rocks. 2. Low-susceptibility, felsic rocks (e.g. quartzites and metasandstones). 3. Paramagnetic, felsic rocks (e.g. granites). 4. Ferrimagnetic, magnetite-containing felsic rocks (e.g. granites). 5. Paramagnetic mafic rocks (e.g. amphibolites and dolerites). 6. Ferrimagnetic, mafic rocks containing magnetite and high-density mafic minerals (mainly dolerites). Moreover, analysis revealed that the parameter distributions of even a single rock type (e.g. granites) can be very variable, forming separate clusters. This demonstrates that the simple calculation of density or susceptibility averages of rock types can be highly erratic. For example, the average can lie between two groups, where only few, if any, samples exist. Therefore, estimation of the representative density and susceptibility must be visually verified from these diagrams. The areal distribution of parameters and their calculated derivatives generally correlate well with the regional distribution of lithological and

  11. Evaluation of multiplex real-time PCR for detection of Haemophilus ducreyi, Treponema pallidum, herpes simplex virus type 1 and 2 in the diagnosis of genital ulcer disease in the Rakai District, Uganda

    PubMed Central

    Suntoke, T R; Hardick, A; Tobian, A A R; Mpoza, B; Laeyendecker, O; Serwadda, D; Opendi, P; Gaydos, C A; Gray, R H; Wawer, M J; Quinn, T C; Reynolds, S J

    2009-01-01

    Objective: To develop a real-time PCR assay that reliably and accurately detects the predominant sexually transmitted aetiological agents of genital ulcer disease (GUD) (Haemophilus ducreyi, Treponema pallidum and herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2)) and to assess the use of real-time PCR diagnostic testing in a rural African field site. Methods: Two multiplex real-time PCR reactions were used to detect H ducreyi/and HSV-1/HSV-2 in ulcer swabs from 100 people with symptomatic genital ulcers in rural Rakai, Uganda. Results were compared with syphilis, HSV-1 and HSV-2 serology. Results: Of 100 GUD samples analysed from 43 HIV positive and 57 HIV negative individuals, 71% were positive for one or more sexually transmitted infection (STI) pathogens by real-time PCR (61% for HSV-2, 5% for T pallidum, 3% for HSV-1, 1% for H ducreyi and 1% for dual H ducreyi/HSV-2). The frequency of HSV in genital ulcers was 56% (32/57) in HIV negative individuals and 77% (33/43) in HIV positive individuals (p=0.037). Assay reproducibility was evaluated by repeat PCR testing in the USA with 96% agreement (κ=0.85). Conclusions: STI pathogens were detected in the majority of GUD swab samples from symptomatic patients in Rakai, Uganda, by real-time PCR. HSV-2 was the predominant cause of genital ulcers. Real-time PCR technology can provide sensitive, rapid and reproducible evaluation of GUD aetiology in a resource-limited setting. PMID:19066198

  12. The Varying Vulnerability of African Orphans: The Case of the Langi, Northern Uganda

    ERIC Educational Resources Information Center

    Oleke, Christopher; Blystad, Astrid; Moland, Karen Marie; Rekdal, Ole Bjorn; Heggenhougen, Kristian

    2006-01-01

    This article is based on a qualitative study carried out in Lira District, northern Uganda, to assess the situation of orphans cared for in extended families. The objective of the article is to bring attention to the varying vulnerability of different categories of orphans. The methods employed in data collection included ethnographic fieldwork,…

  13. Uganda opens new fronts.

    PubMed

    Tebere, R

    1991-03-01

    AIDS and HIV figures released in June 1990 by Uganda's AIDS Control Programme (ACP) prompted the revamping of the country's national AIDS initiative, the passage of legislation designed to stamp out sexual exploitation of minors and a reluctant pledge by President Yoweri Museveni to advocate condom use. Uganda has a massive AIDS prevention campaign estimated to reach 80% of the population, but AIDS cases are doubling every 6 months according to Health Minister Zack Kaheru. Sexually transmitted diseases (STDs) have been linked as a co-factor in HIV transmission, therefore treatment of STDs will be linked to the anti-AIDS campaign in free clinics for the treatment of STDs operating in Kampala and Jinja and in new ones planned for Mbale, Mbarara and Fort Portal. The Uganda Aids Commission was created in an effort to strengthen the ACP by insuring that all government departments address AIDS prevention. New laws designed to curb the spread of the disease by sexual contact raised the age of consent for sexual intercourse from 14 to 18 years of age, made prostitution and homosexuality illegal and redefined incest to include extended family members. President Museveni urged Ugandans to use condoms to protect themselves from HIV infection. Because condoms are not 100% reliable, and because their use is not a popular option among rural people due to cultural and religious beliefs, President Museveni and ACP Director Dr. Warren Namara agree that the ultimate weapon against AIDS is educating people to rethink their sexual attitudes and actions. Hopeful signs include more openness about AIDS and more seeking of information about AIDS among the people. PMID:12283896

  14. Environmental Systems and Local Actors: Decentralizing Environmental Policy in Uganda

    NASA Astrophysics Data System (ADS)

    Oosterveer, Peter; van Vliet, Bas

    2010-02-01

    In Uganda, environmental and natural resource management is decentralized and has been the responsibility of local districts since 1996. This environmental management arrangement was part of a broader decentralization process and was intended to increase local ownership and improve environmental policy; however, its implementation has encountered several major challenges over the last decade. This article reviews some of the key structural problems facing decentralized environmental policy in this central African country and examines these issues within the wider framework of political decentralization. Tensions have arisen between technical staff and politicians, between various levels of governance, and between environmental and other policy domains. This review offers a critical reflection on the perspectives and limitations of decentralized environmental governance in Uganda. Our conclusions focus on the need to balance administrative staff and local politicians, the mainstreaming of local environmental policy, and the role of international donors.

  15. Mission of the month: Uganda.

    PubMed

    Snead, B

    1988-04-01

    US Agency for International Development (USAID) assistance to Uganda has been interrupted several times due to Uganda's turbulent history since independence. Mission Director Richard Podol explains that because USAID is not a major donor to Uganda, an effort is made to maximize effectiveness by being cautious about how agency money is spent. USAID looks for critical gaps that are not being filled by other donor programs yet are essential to the development of Uganda at present and in the future. 1 such area is export promotion. Another area is macroeconomic reform. Agricultural rehabilitation is a major factor in the mission's strategy to restore Uganda prosperity. USAID has a package of interrelated projects that work to increase agricultural production and improve processing and marketing, all supported by appropriate economic policies. In 1983, USAID began to fund the Manpower for Agriculture Development (MFAD) Project to assist the MInistry of Agriculture and Makerere University in strengthening their agricultural research and training capabilities. Also designed to increase food production is USAID's 6-year and $20 million Cooperative Agriculture and Agribusiness Support project. IN the health sector, USAID's Family Health Initiatives project works cooperatively with US and international organizations in supporting the MInistry of Health and Ugandan private organizations in their efforts to implement family planning policies and programs. The missions' oral rehydration project is being implemented throughout Uganda to reduce child mortality and severe cases of childhood illness caused by diarrheal diseases. The US in 1986 made pledges toward the budget for UGanda's Acquired Immune Deficiency Syndrome (AIDS) program. Podol maintains that while there has been significant economic and political progress, the primary issue continues to be political, i.e,, can full peace be restored to Uganda. PMID:12315733

  16. Hepatitis E as a cause of acute jaundice syndrome in northern Uganda, 2010-2012.

    PubMed

    Gerbi, Gemechu B; Williams, Roxanne; Bakamutumaho, Barnabas; Liu, Stephen; Downing, Robert; Drobeniuc, Jan; Kamili, Saleem; Xu, Fujie; Holmberg, Scott D; Teshale, Eyasu H

    2015-02-01

    Hepatitis E virus (HEV) is a common cause of acute viral hepatitis in developing countries; however, its contribution to acute jaundice syndrome is not well-described. A large outbreak of hepatitis E occurred in northern Uganda from 2007 to 2009. In response to this outbreak, acute jaundice syndrome surveillance was established in 10 district healthcare facilities to determine the proportion of cases attributable to hepatitis E. Of 347 acute jaundice syndrome cases reported, the majority (42%) had hepatitis E followed by hepatitis B (14%), malaria (10%), hepatitis C (5%), and other/unknown (29%). Of hepatitis E cases, 72% occurred in Kaboong district, and 68% of these cases occurred between May and August of 2011. Residence in Kaabong district was independently associated with hepatitis E (adjusted odds ratio = 13; 95% confidence interval = 7-24). The findings from this surveillance show that an outbreak and sporadic transmission of hepatitis E occur in northern Uganda. PMID:25448237

  17. Hepatitis E as a Cause of Acute Jaundice Syndrome in Northern Uganda, 2010–2012

    PubMed Central

    Gerbi, Gemechu B.; Williams, Roxanne; Bakamutumaho, Barnabas; Liu, Stephen; Downing, Robert; Drobeniuc, Jan; Kamili, Saleem; Xu, Fujie; Holmberg, Scott D.; Teshale, Eyasu H.

    2015-01-01

    Hepatitis E virus (HEV) is a common cause of acute viral hepatitis in developing countries; however, its contribution to acute jaundice syndrome is not well-described. A large outbreak of hepatitis E occurred in northern Uganda from 2007 to 2009. In response to this outbreak, acute jaundice syndrome surveillance was established in 10 district healthcare facilities to determine the proportion of cases attributable to hepatitis E. Of 347 acute jaundice syndrome cases reported, the majority (42%) had hepatitis E followed by hepatitis B (14%), malaria (10%), hepatitis C (5%), and other/unknown (29%). Of hepatitis E cases, 72% occurred in Kaboong district, and 68% of these cases occurred between May and August of 2011. Residence in Kaabong district was independently associated with hepatitis E (adjusted odds ratio = 13; 95% confidence interval = 7–24). The findings from this surveillance show that an outbreak and sporadic transmission of hepatitis E occur in northern Uganda. PMID:25448237

  18. Prevalence of African swine fever virus in apparently healthy domestic pigs in Uganda

    PubMed Central

    2013-01-01

    Background African swine fever (ASF) is a contagious viral disease which can cause up to 100% mortality among domestic pigs leading to serious socio-economic impact on people’s livelihoods. ASF is endemic in Uganda and there is paucity of information on the epidemiology of the disease. The major aim of this study was to determine the seroprevalence and prevalence of African swine fever virus (ASFV) in apparently healthy slaughter pigs at Wambizi slaughterhouse in Kampala city, Uganda. We also estimated the presence of ASFV antibodies and circulating viral antigens in pigs from selected districts of Uganda during targeted surveillance. We analysed 540 and 181 blood samples collected from slaughter pigs and pigs from targeted surveillance districts respectively. Results The prevalence of ASFV in slaughter pigs was 52.96% (95% CI, 48.75-57.14) and 11.5% (95% CI, 9.06-14.45) by ELISA and PCR respectively. In surveillance districts, the proportion of ASFV positive pigs was 53.59% (95% CI, 46.33-60.71) and 0.55% (95% CI, 0.1-3.06) by ELISA and PCR respectively. Conclusion The study has found out a high seroprevalence of ASFV antibodies in apparently healthy slaughter pigs and also a high proportion of ASFV antibody seropositive pigs in surveyed districts in Uganda indicating exposure to ASFV. However, there was a lower prevalence of ASFV infection implying that there could be low virulent strains of ASFV circulating in domestic pigs in Uganda which requires further investigation. PMID:24369729

  19. An outbreak of Ebola in Uganda.

    PubMed

    Okware, S I; Omaswa, F G; Zaramba, S; Opio, A; Lutwama, J J; Kamugisha, J; Rwaguma, E B; Kagwa, P; Lamunu, M

    2002-12-01

    An outbreak of Ebola disease was reported from Gulu district, Uganda, on 8 October 2000. The outbreak was characterized by fever and haemorrhagic manifestations, and affected health workers and the general population of Rwot-Obillo, a village 14 km north of Gulu town. Later, the outbreak spread to other parts of the country including Mbarara and Masindi districts. Response measures included surveillance, community mobilization, case and logistics management. Three coordination committees were formed: National Task Force (NTF), a District Task Force (DTF) and an Interministerial Task Force (IMTF). The NTF and DTF were responsible for coordination and follow-up of implementation of activities at the national and district levels, respectively, while the IMTF provided political direction and handled sensitive issues related to stigma, trade, tourism and international relations. The international response was coordinated by the World Health Organization (WHO) under the umbrella organization of the Global Outbreak and Alert Response Network. A WHO/CDC case definition for Ebola was adapted and used to capture four categories of cases, namely, the 'alert', 'suspected', 'probable' and 'confirmed cases'. Guidelines for identification and management of cases were developed and disseminated to all persons responsible for surveillance, case management, contact tracing and Information Education Communication (IEC). For the duration of the epidemic that lasted up to 16 January 2001, a total of 425 cases with 224 deaths were reported countrywide. The case fatality rate was 53%. The attack rate (AR) was highest in women. The average AR for Gulu district was 12.6 cases/10 000 inhabitants when the contacts of all cases were considered and was 4.5 cases/10 000 if limited only to contacts of laboratory confirmed cases. The secondary AR was 2.5% when nearly 5000 contacts were followed up for 21 days. Uganda was finally declared Ebola free on 27 February 2001, 42 days after the last case

  20. Inclusion of Pupils with Intellectual Disabilities: Primary School Teachers' Attitudes and Willingness in a Rural Area in Uganda

    ERIC Educational Resources Information Center

    Ojok, Patrick; Wormnaes, Siri

    2013-01-01

    Teachers in regular schools have a responsibility to accommodate the needs and interests of all learners. The attitudes and willingness of teachers to include learners with intellectual disabilities in their classes in regular schools in a district with a semi-nomadic pastoral population in north-eastern Uganda was investigated. A survey of 125…

  1. The Effect of Land Tenure System on Women's Knowledge-Base and Resource Management in Manjiya County, Uganda

    ERIC Educational Resources Information Center

    Kagoda, Alice Merab

    2008-01-01

    This study examines the status of women in relationship to land ownership, the resources they are exposed to and management practices, consequently its effect on the environment of Manjiya County, Mbale District in (now Manafwa since 2008) Uganda. It was found out that low levels of education limit women's abilities of creativity and…

  2. Sexual and Reproductive Health Information Sources Preferred by Out-of-School Adolescents in Rural Southwest Uganda

    ERIC Educational Resources Information Center

    Nobelius, Ann-Maree; Kalina, Bessie; Pool, Robert; Whitworth, Jimmy; Chesters, Janice; Power, Robert

    2010-01-01

    This paper defines how out-of-school adolescents from Masaka District in rural southwest Uganda currently receive sexual and reproductive health information and how they would prefer to receive that information. Information adolescents feel they lack falls into three broad categories: sexual and reproductive health issues, the negotiation of sex…

  3. The Impact of the School-Based Psychosocial Structured Activities (PSSA) Program on Conflict-Affected Children in Northern Uganda

    ERIC Educational Resources Information Center

    Ager, Alastair; Akesson, Bree; Stark, Lindsay; Flouri, Eirini; Okot, Braxton; McCollister, Faith; Boothby, Neil

    2011-01-01

    Background: Children in northern Uganda have undergone significant psychosocial stress during the region's lengthy conflict. A Psychosocial Structured Activities (PSSA) program was implemented in 21 schools identified as amongst those most severely affected by conflict-induced displacement across Gulu and Amuru Districts. The PSSA intervention…

  4. Delayed School Entry in Uganda

    ERIC Educational Resources Information Center

    Moyi, Peter

    2011-01-01

    Since 1997 Uganda has seen a large increase in school enrolment. Despite this increased enrolment, universal education has remained elusive. Many children enrol in school, but not at the recommended age, and they drop out before completing school. This article focuses on one of these problems--delayed school entry. What household factors are…

  5. Discontinuation of cost sharing in Uganda.

    PubMed Central

    Burnham, Gilbert M.; Pariyo, George; Galiwango, Edward; Wabwire-Mangen, Fred

    2004-01-01

    OBJECTIVE: To assess the effects of ending cost sharing on use of outpatient services and how this was perceived by health workers and members of a health unit management committee. METHODS: From 10 districts across Uganda, 78 health facilities were selected. Attendance at these facilities was assessed for eight months before and 12 months after cost sharing ended. The data represented 1 966 522 outpatient visits. Perceptions about the impact of ending cost sharing were obtained from the 73 health workers and 78 members of the health unit management committee who were available. FINDINGS: With the end of cost sharing, the mean monthly number of new visits increased by 17 928 (53.3%), but among children aged <5 years the increase was 3611 (27.3%). Mean monthly reattendances increased by 2838 (81.3%) among children aged <5 years and 1889 (24.3%) among all people. Attendances for immunizations, antenatal clinics, and family planning all increased, despite these services having always been free. Health workers reported a decline in morale, and many health unit management committees no longer met regularly. CONCLUSION: Use of all services increased - even those that had never before been subject to fees. The loss of some autonomy by the health facility and diminished community governance of health facilities may have long term negative effects. PMID:15112007

  6. Towards improving hospital performance in Uganda and Zambia: reflections and opportunities for autonomy.

    PubMed

    Hanson, Kara; Atuyambe, Lynn; Kamwanga, Jolly; McPake, Barbara; Mungule, Oswald; Ssengooba, Freddie

    2002-07-01

    Hospitals have been relatively neglected although their high resource consumption implies that gains from improving the services they deliver may be substantial. Nevertheless, the challenges posed by hospital reforms are great. Hospital autonomy usually consists of both decentralisation, and a greater measure of exposure to market forces. In Uganda and Zambia, more traditional 'decentralisation' of authority to district level authorities includes district hospitals; and some measure of 'autonomy' (known as 'self-accounting status' in Uganda) has been applied to some or all second and third level referral hospitals. The hospital policies pursued in both countries present opportunities to tackle their hospital sectors. In Zambia, purchasing of services means that new incentives and policy mechanisms can come into play. Little advantage has been taken of these opportunities to date. In Uganda, there is no financial link between districts and higher levels of the system, but decentralisation of control over personnel is more advanced. These two components--the alignment of incentives (to promote access and quality for those intended to be covered by the public budget) and the effective decentralisation of control over key resources--seem to us the key tools to address the stubborn problems of hospitals. PMID:12173498

  7. Intestinal schistosomiasis among preschool children along the shores of Lake Victoria in Uganda.

    PubMed

    Nalugwa, A; Olsen, A; Tukahebwa, M E; Nuwaha, F

    2015-02-01

    Schistosomiasis, a disease caused by Schistosoma trematode parasites, affects hundreds of millions of people and accounts for more than 40% of the global health burden due to neglected tropical diseases. In Uganda, intestinal schistosomiasis is endemic in 73 out of 112 districts and about 55% of the population of 36 million individuals are at risk. There is scanty information on the status and burden of schistosomiasis in preschool children less than six years of age in Uganda. This study aimed to assess the status of Schistosoma mansoni infections in children aged 1-5 years in Uganda. S. mansoni prevalence and intensity of infection were examined in 3058 children from 5 districts along Lake Victoria shoreline, eastern Uganda. For each child one stool sample was collected on three consecutive days. The Kato-Katz technique was used to prepare stool smears on slides for microscopic examination. Short interviews with a standardized pre-tested questionnaire prepared in the local language (Lusoga) were administered to each caregiver to identify risk factors associated with S. mansoni infection. An overall S. mansoni prevalence of 39.3% (95% CI: 38.0-41.1%) was estimated out of the 3058 stool samples examined. The geometric mean intensity of S. mansoni among the infected children was 273 (95% CI: 241-305) eggs per gram of faeces. Both prevalence and intensity of infection increased linearly with age (P<0.0001) and were highest in the age group 49-60 months. Majority (61%) of the children, especially in the age group 12-24 months (84.2%; 95% CI: 75.6-90.1%), were lightly infected. Short interviews with caregivers revealed that preschool children, 1-5 years old, get exposed to S. mansoni infested waters through bathing, playing or swimming. It is important that the Uganda national control programme for schistosomiasis takes preschool children into consideration and that health education on transmission of schistosomiasis is delivered to the endemic communities regularly

  8. Nodding syndrome, western Uganda, 1994.

    PubMed

    Kaiser, Christoph; Rubaale, Tom; Tukesiga, Ephraim; Kipp, Walter; Asaba, George

    2015-07-01

    Nodding syndrome (NS) is a poorly understood condition, which was delineated in 2008 as a new epilepsy syndrome. So far, confirmed cases of NS have been observed in three circumscribed African areas: southern Tanzania, southern Sudan, and northern Uganda. Case-control studies have provided evidence of an association between NS and infection with Onchocerca volvulus, but the causation of NS is still not fully clarified. We report a case of a 15-year old boy with head nodding seizures and other characteristic features of NS from an onchocerciasis endemic area in western Uganda, with no contiguity to the hitherto known areas. We suggest that the existence of NS should be systematically investigated in other areas. PMID:25918208

  9. Epidemiological assessment of rinderpest surveillance and control in Uganda between 1990 and 1998.

    PubMed

    Otim, M O; Baumann, M P O; Berhanu, A; Tareke, F; Twinamasiko, E K; Van't Klooster, G

    2003-01-15

    Based on passive and active data, we report on an epidemiological assessment of surveillance and control of rinderpest (RP) in Uganda between 1990 and 1998. Active data were collected by administration of questionnaires to animal health personnel and their auxiliaries and to stockowners in six selected districts of eastern and northeastern Uganda. Passive data were extracted from vaccination and seromonitoring reports, and from field and laboratory reports. RP events were classified as "confirmed outbreaks", "suspected outbreaks" and "rumours". The classification of 56% of the RP events as "suspected outbreaks" indicates the difficulty in investigating disease outbreaks in Uganda. Although vaccination coverage and seroprevalence were <85% (the recommended target), they nevertheless corresponded well-reflecting effective vaccination. However, because of the low seroprevalence, a sizable population of cattle in Uganda remained at risk of RP. The agreement between the local and national disease reporting systems was low-to-moderate (kappa=0.39); this indicates inefficiency in disease reporting. Risk factors for RP outbreaks were cattle raids and communal grazing. Based on overlaid thematic maps of seroprevalence, vaccination coverage and RP events, close spatial and temporal associations were observed between cattle raids, transhumance and outbreaks and rumours. The high-risk areas were in the eastern and northeastern parts of the country. The results of this study support a phase approach of following the OIE pathway. PMID:12507853

  10. Women for women's health: Uganda.

    PubMed

    Andrews, C M

    1996-01-01

    The primary health care model targets social, political, and economic environments as key determinants of health for populations, as well as for individuals. If nursing in Uganda is to make a difference in health care outcomes and in the health of all Ugandans, nurses must look broadly at situations and be educated to practice primary health care nursing. After 14 years of civil war, Uganda is finally experiencing a period of reconstruction and rehabilitation: the whole infrastructure is undergoing a face-lift. Ugandan nurses recognize that their educational preparation has stagnated for many years and that it was not only the political unrest in their country that put them behind professionally. They realize that, given the new directions set by the government, they must become prepared to implement primary health care. They are demanding a university education so they may take their place alongside other health care providers prepared at the university level. Some of the most convincing arguments for a university program for nurses came from doctors at the university who spoke about the need to raise the standards of nursing practice, the quality of teachers, and the morale of practitioners. One nurse said: "If we lose hope for a BScN program, I think all the nurses will quit and we won't have any new students going into the profession." This program is designed to improve the health and well-being of all Ugandans, especially the most vulnerable groups of women and children in rural areas, through strengthening and expanding health services by targeting the educational preparation of nurses. Health planners in Uganda envision the professional nurse as key to the implementation of the national health policy of primary health care. University-educated nurses should be able to assess problems, make clinically sound decisions, and act appropriately within the scope of nursing practice. They should be able to interact and consult collegially with other health care

  11. Experiences of Parents with the Reading to Learn Approach: A Randomised Control Trial Initiative to Improve Literacy and Numeracy in Kenya and Uganda

    ERIC Educational Resources Information Center

    Abuya, Benta A.; Oketch, Moses; Ngware, Moses W.; Mutisya, Maurice; Musyoka, Peter K.

    2015-01-01

    Parental involvement in their children's schooling is in recognition that establishing the context in which a child attends school is important. Reading to Learn (RtL)was implemented in two districts of Kwale and Kinango in Kenya and of Amolatar and Dokolo in Uganda. This paper looks at parental involvement and their experiences with RtL. Data are…

  12. Determinants of child mortality in south-west Uganda.

    PubMed

    Vella, V; Tomkins, A; Nidku, J; Marshall, T

    1992-01-01

    Anthropometric and sociodemographic variables were taken from 4320 children in a baseline survey carried out in March-April 1988 in the district of Mbarara, south-west Uganda. After 12 months a follow-up survey assessed the mortality of the children during the preceding year. Lack of ownership of cattle, recent arrival in the village, using candles for lighting, being of birth order higher than 5 and having a father with less than 8 years of schooling were significantly associated with child mortality. The addition of mid-upper arm circumference significantly improved the logistic model of socioeconomic variables and mortality and did not diminish the predictive power of socioeconomic variables in relation to increased mortality. This suggests that nutritional status and specific socioeconomic factors are both, independently, important predictors of child mortality. PMID:1737806

  13. Men in despair: a qualitative psychological autopsy study of suicide in northern Uganda.

    PubMed

    Kizza, Dorothy; Knizek, Birthe Loa; Kinyanda, Eugene; Hjelmeland, Heidi

    2012-11-01

    The psychosocial circumstances surrounding men's suicide in postconflict Central Northern Uganda were investigated using qualitative psychological autopsy interviews. Records of 17 men who died by suicide were identified through police and local leaders in Internally Displaced Peoples' camps of Amuru and Gulu Districts. Two to five significant others were interviewed around each case. Data were analyzed by interpretative phenomenological analysis (IPA). Lost dignity and social value, lack of hope for the family's future, overwhelming family responsibility, and mental illness were circumstances found to have preceded the suicides. The protracted war in the Northern region of Uganda left men in rural communities feeling disempowered and disenfranchised. This may have contributed to suicidal behavior in some of them. Suicide prevention in this area needs to be multidisciplinary with an emphasis on helping both men and women understand and deal with the many social changes that have evolved over time and affected their traditional roles and responsibilities. PMID:23075801

  14. Towards Introducing Space Science in Uganda

    NASA Astrophysics Data System (ADS)

    Anguma, S.; Ayikoru, J.

    This paper discusses the strategies and importance of introducing space science in Uganda. It proposes that Mbarara University, as a new university focusing on science and technology, would be ideally situated to spearhead the introduction of space science in Uganda. It is our expectation that this will have a spin-off effect to other higher institutions of learning and that consequently space science will become fully incorporated into the national teaching curriculum for all schools in Uganda. Based on the fact that the Government has a deliberate policy of popularizing science and technology to accelerate national economic development, the introduction of space science in the school system is to be enhanced by these efforts. We have charted the way forward for space science in Uganda and outlined the conceptual framework illustrating the spin-off effect into the education system.

  15. Beyond slogans: lessons from Uganda's ABC experience.

    PubMed

    2004-02-01

    Between the late 1980s and mid-1990s, at a time when HIV/AIDS was well on its way toward ravaging Sub-Saharan Africa, Uganda achieved an extraordinary feat: It stopped the spread of HIV/AIDS in its tracks and saw the nation's rate of infection plummet. As word of the "Uganda miracle" spread, journalists, researchers, policymakers and advocates all descended to try to ascertain how it was accomplished. PMID:15230267

  16. Evaluation Of A Maternal Health Program In Uganda And Zambia Finds Mixed Results On Quality Of Care And Satisfaction.

    PubMed

    Kruk, Margaret E; Vail, Daniel; Austin-Evelyn, Katherine; Atuyambe, Lynn; Greeson, Dana; Grépin, Karen Ann; Kibira, Simon P S; Macwan'gi, Mubiana; Masvawure, Tsitsi B; Rabkin, Miriam; Sacks, Emma; Simbaya, Joseph; Galea, Sandro

    2016-03-01

    Saving Mothers, Giving Life is a multidonor program designed to reduce maternal mortality in Uganda and Zambia. We used a quasi-random research design to evaluate its effects on provider obstetric knowledge, clinical confidence, and job satisfaction, and on patients' receipt of services, perceived quality, and satisfaction. Study participants were 1,267 health workers and 2,488 female patients. Providers' knowledge was significantly higher in Ugandan and Zambian intervention districts than in comparison districts, and in Uganda there were similar positive differences for providers' clinical confidence and job satisfaction. Patients in Ugandan intervention facilities were more likely to give high ratings for equipment availability, providers' knowledge and communication skills, and care quality, among other factors, than patients in comparison facilities. There were fewer differences between Zambian intervention and comparison facilities. Country differences likely reflect differing intensity of program implementation and the more favorable geography of intervention districts in Uganda than in Zambia. National investments in the health system and provider training and the identification of intervention components most associated with improved performance will be required for scaling up and sustaining the program. PMID:26953307

  17. Uganda: stolen children, stolen lives.

    PubMed

    Omona, G; Matheson, K E

    1998-02-01

    This news article discusses conditions in Uganda due to the 12-year war that jeopardize the health and well-being of children. Since 1995 the rebel Sudan-backed Lord's Resistance Army (LRA) has secured new recruits to add to their diminishing numbers by abducting children. As many as 8000 children, ages 11 years and older, have been appropriated in the war effort. The children are abducted, trained as soldiers, and forced to commit brutal crimes and murders. Abducted girls are held as sex slaves and forced to marry. Those children who manage to escape need special psychological and medical interventions during their integration back into normal life. World Vision Uganda and Gulu Support the Children Organization (GUSCO) have set up psychosocial counseling programs to help these children overcome their traumatic experiences. The programs offer the children vocational training, trauma counseling, and reintegration into their families. Children return to their families within 3-6 weeks. The large number of children in need has resulted in difficult follow-up and lack of long-term support. The GUSCO reception center houses about 100 children, 15% of whom are girls. The philosophy of recovery is based on the view that 1) the children are survivors with individual resources and not sick victims; and 2) most of the children will experience a healing process when given protection and understanding. GUSCO uses a community participatory approach that includes children in decision-making and relies on local traditions. The psychosocial supportive environment helps children re-establish self-esteem, trust with other people, and a civilian identity. GUSCO works with families, local groups, teachers, and authorities. Reintegration follow-up occurs after 3 weeks, 3 months, 6 months, and 1 year. The international community should put pressure on Sudan to end its support of the LRA. PMID:9482324

  18. Another condom uproar in Uganda.

    PubMed

    Musoke, D

    1991-11-01

    A campaign to promote safe sex through the use of condoms has sparked a heated controversy in Uganda, as influential religious leaders have come out in opposition to a practice which they fear will lead to sexual promiscuity. The campaign, backed by the Ugandan government, is designed to halt the rapidly spreading AIDS epidemic. With 20,000 AIDS cases as of June 1991, Uganda leads all African countries in the number of reported cases. Additionally, it is estimated that some 7 million of the country's 17 million inhabitants are HIV-positive. This alarming situation forced President Yoweri Museveni to reverse his stance and come out in favor of the condom campaign. The campaign is being launched by the Ugandan pharmaceutical firm Armtrades Ltd with financial and technical support from USAID and the Ugandan government. The condom campaign, however, has aroused strong opposition from the religious community. Angered by advertisements advising Ugandans to "love carefully" by wearing condoms, Catholic Archbishop Emmanuel Wamala urged his followers in August to reject condoms, calling then an insult to the dignity of man. Following Wamala's lead, other top churchmen came out in opposition to the condom campaign at a recent AIDS prevention leadership conference. One of the clergymen present at the conference told Health Minister James Makumbi that the condom campaign will make young people indulge in uncontrolled sexual immorality. Moslem clerics have also stated their opposition to condoms, fearing sexual promiscuity. But the religious community itself has come under criticism for their opposition to condoms. Stressing that lives are at stake, the popular weekly Topic recently cautioned churchmen that this is not the time to engage in academic and moralistic debates. PMID:12285102

  19. Earth Science Education in Uganda

    NASA Astrophysics Data System (ADS)

    Barifaijo, E.

    1999-05-01

    Uganda has two Government funded universities, five operating private universities and four other universities are due to start soon. Geology was first taught in Uganda at Makerere University in 1968 within the Department of Geography. Through the leadership of Prof. Robert Macdonald it became established as a full department in August 1969 as part of the Faculty of Science. Both pure and applied geology are taught and the courses are designed to suit the current job market. At present, the three-term academic year is being replaced by a semester-based course unit system. At the same time, the 3:2:2 subject combination, requiring a student to do three subjects in first year and two subjects in both second and third years, is to be replaced by a major-minor subject combination. Currently, there are about 50 undergraduate students and four Ph.D. students in the Department. A student Geological Association acts as a forum for the exchange of information on matters of geological concern. An affirmative action policy has improved the intake of women students into the Department. On average, the number of women has increased from about 10% to 33.3% in the years 1984/85 to 1997/98. Their performance parallels that of the male students and they are readily employed. Of the eight members of academic staff, two are women. The Department of Geology has good links with regional and overseas universities through which a number of research programmes are currently supported. In addition, most of the training of manpower for the University and research programmes is supported by regional and international research agencies. Academic staff combine teaching with research and consultancy.

  20. Charter Districts.

    ERIC Educational Resources Information Center

    Lockwood, Anne Turnbaugh

    2002-01-01

    Interviews with superintendents of eight charter-school districts in four states: California, Florida, Georgia, and New Mexico. Describes advantages and disadvantages. Includes a list (with website addresses) of all current charter-school districts. (PKP)

  1. Postemergency health services for refugee and host populations in Uganda, 1999-2002.

    PubMed

    Orach, Christopher Garimoi; De Brouwere, Vincent

    Since 1990, Uganda has hosted an estimated 200?000 refugees in postemergency settlements interspersed within host communities. We investigated the extent to which obstetric needs were met in the refugee and host populations during 1999-2002. Between September and December, 2000, we retrospectively collected data from 1999 and 2000 on major obstetric interventions for absolute maternal indications from all five hospitals in Arua, Adjumani, and Moyo districts, Uganda. The same data were collected prospectively for 2001. We did community-based maternal mortality surveys on refugee and host populations in Adjumani district in 2002. Rates of major obstetric interventions were significantly higher for refugees than for the host population who live in the same rural areas as refugees (1.01% [95% CI 0.77-1.25] vs 0.45% [0.38-0.52]; p<0.0001). Rates of major obstetric interventions were also significantly higher for refugees than for the host population who live in rural areas without refugees (1.01% [0.77-1.25] vs 0.40% [0.36-0.44]; p<0.0001). Maternal mortality was 2.5 times higher in the host population than in refugees in the Adjumani district (322 per 100000 births [247-396] vs 130 [81-179]. Refugees had better access to health services than did the rural host population in the northern Ugandan communities that we surveyed. PMID:15313362

  2. Epidemiological Overview of African Swine Fever in Uganda (2001-2012).

    PubMed

    Kalenzi Atuhaire, David; Ochwo, Sylvester; Afayoa, Mathias; Norbert Mwiine, Frank; Kokas, Ikwap; Arinaitwe, Eugene; Ademun-Okurut, Rose Anna; Boniface Okuni, Julius; Nanteza, Ann; Ayebazibwe, Christosom; Okedi, Loyce; Olaho-Mukani, William; Ojok, Lonzy

    2013-01-01

    African swine fever (ASF) is a contagious viral disease, which can cause up to 100% mortality among domestic pigs. In Uganda there is paucity of information on the epidemiology of the disease, hence a study was carried out to elucidate the patterns of ASF outbreaks. Spatial and temporal analyses were performed with data collected monthly by the district veterinary officers (DVOs) and sent to the central administration at MAAIF from 2001 to 2012. Additionally, risk factors and the associated characteristics related to the disease were assessed based on semistructured questionnaires sent to the DVOs. A total of 388 ASF outbreaks were reported in 59 districts. Of these outbreaks, 201 (51.8%) were reported in districts adjacent to the national parks while 80 (20.6%) were adjacent to international borders. The number of reported ASF outbreaks changed over time and by geographical regions; however, no outbreak was reported in the North-Eastern region. ASF was ranked as second most important disease of pigs, and it occurred mostly during the dry season (P = 0.01). Pig movements due to trade (OR 15.5, CI 4.9-49.1) and restocking (OR 6.6, CI 2.5-17.3) were the major risk factors. ASF control strategies should focus on limiting pig movements in Uganda. PMID:26464916

  3. Acceptability of male circumcision for prevention of HIV infection among men and women in Uganda.

    PubMed

    Albert, Lisa M; Akol, Angela; L'Engle, Kelly; Tolley, Elizabeth E; Ramirez, Catalina B; Opio, Alex; Tumwesigye, Nazarius M; Thomsen, Sarah; Neema, Stella; Baine, Sebastian O

    2011-12-01

    In the last decade, three randomized controlled trials in Kenya, South Africa, and Uganda have shown that medical male circumcision (MMC) reduces the sexual transmission of HIV from women to men. Objectives of this assessment were to measure acceptability of adult MMC and circumcision of children to inform policies regarding whether and how to promote MMC as an HIV prevention strategy. This mixed-method study, conducted across four Ugandan districts, included a two-stage household survey of 833 adult males and 842 adult females, focus group discussions, and a health provider survey. Respondents' acceptability of MMC was positive and substantial after being informed about the results of recent randomized trials. In uncircumcised men, between 40% and 62% across the districts would consider getting circumcised. Across the four districts between 60% and 86% of fathers and 49% and 95% of mothers were supportive of MMC for sons. Widespread support exists among men and women in this study for promoting MMC as part of Uganda's current 'ABC + ' HIV prevention strategy. PMID:21732902

  4. Lack of effective communication between communities and hospitals in Uganda: a qualitative exploration of missing links

    PubMed Central

    Rutebemberwa, Elizeus; Ekirapa-Kiracho, Elizabeth; Okui, Olico; Walker, Damien; Mutebi, Aloysius; Pariyo, George

    2009-01-01

    Background Community members are stakeholders in hospitals and have a right to participate in the improvement of quality of services rendered to them. Their views are important because they reflect the perspectives of the general public. This study explored how communities that live around hospitals pass on their views to and receive feedback from the hospitals' management and administration. Methods The study was conducted in eight hospitals and the communities around them. Four of the hospitals were from three districts from eastern Uganda and another four from two districts from western Uganda. Eight key informant interviews (KIIs) were conducted with medical superintendents of the hospitals. A member from each of three hospital management boards was also interviewed. Eight focus group discussions (FGDs) were conducted with health workers from the hospitals. Another eight FGDs (four with men and four with women) were conducted with communities within a five km radius around the hospitals. Four of the FGDs (two with men and two with women) were done in western Uganda and the other four in eastern Uganda. The focus of the KIIs and FGDs was exploring how hospitals communicated with the communities around them. Analysis was by manifest content analysis. Results Whereas health unit management committees were supposed to have community representatives, the representatives never received views from the community nor gave them any feed back from the hospitals. Messages through the mass media like radio were seen to be non specific for action. Views sent through suggestion boxes were seen as individual needs rather than community concerns. Some community members perceived they would be harassed if they complained and had reached a state of resignation preferring instead to endure the problems quietly. Conclusion There is still lack of effective communication between the communities and the hospitals that serve them in Uganda. This deprives the communities of the right to

  5. Partnerships for Policy Development: A Case Study From Uganda's Costed Implementation Plan for Family Planning.

    PubMed

    Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta

    2016-06-20

    In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda's CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda's CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda's CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution. PMID:27353621

  6. Helicobacter pylori among patients with symptoms of gastroduodenal ulcer disease in rural Uganda

    PubMed Central

    Tsongo, Lawrence; Nakavuma, Jessica; Mugasa, Claire; Kamalha, Edwin

    2015-01-01

    Introduction To meet key millennium development goals, the rural population needs to be reached for health assessment and service delivery. Gastroduodenal ulcer disease is a common ailment affecting the health of people in Uganda. A cross-sectional study was conducted at Bwera Hospital in Kasese district of western Uganda, to establish the prevalence and predisposing factors of Helicobacter pylori among gastroduodenal ulcer disease patients. Methods A sample of 174 patients with symptoms of gastroduodenal ulcer disease was purposively obtained. Using two laboratory test methods, the prevalence of H. pylori among these patients was determined. A structured questionnaire was administered to participants to establish their demographic background and selected aspects of their lifestyle. Finally, the results obtained by enzyme-linked immunosorbent assay (ELISA) and immunochromatographic rapid test (IRT) were compared. Results We established the prevalence of H. pylori as 29.9% (52/174) by ELISA and 37.4% (65/174) by IRT. Cigarette smoking, poor sanitation, and lack of formal education were the significant predisposing factors with p-values <0.05. The two tests gave identical results in 87.9% of the patients. Discussion The prevalence of H. pylori by IRT and ELISA test methods was similar to what has been reported elsewhere in developed countries; but was lower than previously reported in developing countries including Uganda. The previous studies in Uganda were carried out in the urban population and on young children; and some used antibody-detection methods only, therefore leading to different prevalence as a result of difference in study population and methods. PMID:26560860

  7. Unintended pregnancy and abortion in Uganda.

    PubMed

    Hussain, Rubina

    2013-01-01

    Unintended pregnancy is common in Uganda, leading to high levels of unplanned births, unsafe abortions, and maternal injury and death. Because most pregnancies that end in abortion are unwanted, nearly all ill health and mortality resulting from unsafe abortion is preventable. This report summarizes evidence on the context and consequences of unintended pregnancy and unsafe abortion in Uganda, points out gaps in knowledge, and highlights steps that can be taken to reduce levels of unintended pregnancy and unsafe abortion, and, in turn, the high level of maternal mortality. PMID:23550324

  8. A climate trend analysis of Uganda

    USGS Publications Warehouse

    Funk, Christopher C.; Rowland, Jim; Eilerts, Gary; White, Libby

    2012-01-01

    This brief report, drawing from a multi-year effort by the U.S. Agency for International Development (USAID) Famine Early Warning Systems Network (FEWS NET), identifies observed changes in rainfall and temperature in Uganda, based on an analysis of a quality-controlled, long time series of station observations throughout Uganda. Extending recent trends forward, it also provides a current and near-future context for understanding the actual nature of climate change impacts in the country, and a basis for identifying climate adaptations that may protect and improve the country's food security.

  9. Ebola a reality of modern Public Health; need for Surveillance, Preparedness and Response Training for Health Workers and other multidisciplinary teams: a case for Uganda

    PubMed Central

    Bazeyo, William; Bagonza, James; Halage, Ali; Okure, Gildo; Mugagga, Malimbo; Musoke, Robert; Tumwebaze, Mathias; Tusiime, Suzan; Ssendagire, Steven; Nabukenya, Immaculate; Pande, Steven; Aanyu, Christine; Etajak, Samuel; Rutebemberwa, Elizeus

    2015-01-01

    Introduction West Africa is experiencing the largest ever reported Ebola outbreak. Over 20,000 people have been infected of which about 9000 have died. It is possible that lack of community understanding of the epidemic and lack of institutional memory and inexperienced health workers could have led to the rapid spread of the disease. In this paper, we share Uganda's experiences on how the capacity of health workers and other multidisciplinary teams can be improved in preparing and responding to Ebola outbreaks. Methods Makerere University School of Public Health in collaboration with the Ministry of Health and the African Field Epidemiology Network (AFENET), trained health care workers and other multidisciplinary teams from six border districts of Uganda so as to increase their alertness and response capabilities towards Ebola. We used participatory training methods to impart knowledge and skills and guided participants to develop district epidemic response plans. Communities were sensitized about Ebola through mass media, IEC materials, and infection control and prevention materials were distributed in districts. Results We trained 210 health workers and 120 other multidisciplinary team members on Ebola surveillance, preparedness and response. Evaluation results demonstrated a gain in knowledge and skills. Communities were sensitized about Ebola and Districts received person protective equipments and items for infection prevention. Epidemic Preparedness and Response plans were also developed. Conclusion Training of multidisciplinary teams improves the country's preparedness, alertness and response capabilities in controlling Ebola. West African countries experiencing Ebola outbreaks could draw lessons from the Uganda experience to contain the outbreak. PMID:26301008

  10. Developing Orthopaedic Trauma Capacity in Uganda: Considerations From the Uganda Sustainable Trauma Orthopaedic Program.

    PubMed

    OʼHara, Nathan N; OʼBrien, Peter J; Blachut, Piotr A

    2015-10-01

    Uganda, like many low-income countries, has a tremendous volume of orthopaedic trauma injuries. The Uganda Sustainable Trauma Orthopaedic Program (USTOP) is a partnership between the University of British Columbia and Makerere University that was initiated in 2007 to reduce the consequences of neglected orthopaedic trauma in Uganda. USTOP works with local collaborators to build orthopaedic trauma capacity through clinical training, skills workshops, system support, technology development, and research. USTOP has maintained a multidisciplinary approach to training, involving colleagues in anaesthesia, nursing, rehabilitation, and sterile reprocessing. Since the program's inception, the number of trained orthopaedic surgeons practicing in Uganda has more than doubled. Many of these newly trained surgeons provide clinical care in the previously underserved regional hospitals. The program has also worked with collaborators to develop several technologies aimed at reducing the cost of providing orthopaedic care without compromising quality. As orthopaedic trauma capacity in Uganda advances, USTOP strives to continually evolve and provide relevant support to colleagues in Uganda. PMID:26356209

  11. Predictive mapping of prospectivity for orogenic gold in Uganda

    NASA Astrophysics Data System (ADS)

    Herbert, Sarah; Woldai, Tsehaie; Carranza, Emmanuel John M.; van Ruitenbeek, Frank J. A.

    2014-11-01

    Integration of enhanced regional geo-datasets has facilitated new geological interpretation and modelling of prospectivity for orogenic gold in southwestern Uganda. The geo-datasets include historical geological maps, geological field data, digital terrain models, Landsat TM data and airborne geophysical data. The study area, bordered by the western branch of the East African Rift, covers a range of different aged terranes including the Archaean basement gneisses, Palaeoproterozoic volcano-sedimentary Buganda Toro Belt, Mesoproterozoic clastic sedimentary Karagwe Ankolean Belt and several outliers of undeformed Neoproterozoic sediments. The mineral systems approach to practical exploration targeting requires a framework to link conceptual models of mineralisation with available data. A conceptual model requires good understanding of key processes and their timing within the geodynamic history of an area. The challenge is that processes cannot be mapped, only their results or effects. In this study, a district-scale (1:100,000) investigation is considered appropriate given the scarcity of geological information and the absence of world-renowned gold deposits in southwestern Uganda. At this scale of orogenic gold mineral systems understanding, evidence for the source of gold, active pathways and the physical traps are considered critical. Following the mineral system approach, these processes critical to orogenic gold systems are translated into district-scale mappable proxies using available regional-scale datasets. Tectono-stratigraphic domains, mantle indicators and gold occurrences represent the “source of gold” as a critical process. Zones of hydrothermal alteration were extracted from radiometric data, structures involved in the orogenies and terrane contacts were extracted to represent the active pathway as a critical process and finally the physical throttle is represented by rheological contrasts and geological complexity. Then, the knowledge

  12. Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda

    PubMed Central

    Namazzi, Gertrude; Waiswa, Peter; Nakakeeto, Margaret; Nakibuuka, Victoria K.; Namutamba, Sarah; Najjemba, Maria; Namusaabi, Ruth; Tagoola, Abner; Nakate, Grace; Ajeani, Judith; Peterson, Stefan; Byaruhanga, Romano N.

    2015-01-01

    Background In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design This health system strengthening study, part of the Uganda Newborn Study (UNEST), aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase) in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC) unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with less than 40% of

  13. One World-One Health and neglected zoonotic disease: elimination, emergence and emergency in Uganda.

    PubMed

    Smith, James; Taylor, Emma Michelle; Kingsley, Pete

    2015-03-01

    This paper traces the emergence and tensions of an internationally constructed and framed One World-One Health (OWOH) approach to control and attempt to eliminate African Trypanosomiasis in Uganda. In many respects Trypanosomiasis is a disease that an OWOH approach is perfectly designed to treat, requiring an integrated approach built on effective surveillance in animals and humans, quick diagnosis and targeting of the vector. The reality appears to be that the translation of global notions of OWOH down to national and district levels generates problems, primarily due to interactions between: a) international, external actors not engaging with the Ugandan state; b) actors setting up structures and activities parallel to those of the state; c) actors deciding when emergencies begin and end without consultation; d) weak Ugandan state capacity to coordinate its own integrated response to disease; e) limited collaboration between core Ugandan planning activities and a weak, increasingly devolved district health system. These interrelated dynamics result in the global, international interventionalist mode of OWOH undermining the Coordinating Office for Control of Trypanosomiasis in Uganda (COCTU), the body within the Ugandan state mandated expressly with managing a sustainable One Health response to trypanosomiasis outbreaks in Uganda. This does two things, firstly it suggests we need a more grounded, national perspective of OWOH, where states and health systems are acknowledged and engaged with by international actors and initiatives. Secondly, it suggests that more support needs to be given to core coordinating capacity in resource-poor contexts. Supporting national coordinating bodies, focused around One Health, and ensuring that external actors engage with and through those bodies can help develop a sustained, effective OWOH presence in resource-poor countries, where after all most zoonotic disease burden remains. PMID:24984807

  14. Science, Technology and Innovation in Uganda

    ERIC Educational Resources Information Center

    Brar, Sukhdeep; Farley, Sara E.; Hawkins, Robert; Wagner, Caroline S.

    2010-01-01

    Science, Technology and Innovation in Uganda is part of the World Bank Studies series. These papers are published to communicate the results of the Bank's ongoing research and to stimulate public discussion. This study presents a unique methodology to view science, technology and innovation (STI) in developing countries. The study provides a set…

  15. Early Childhood Development Policy Advances in Uganda

    ERIC Educational Resources Information Center

    Ejuu, Godfrey

    2012-01-01

    Knowledge of the history and development of early childhood development in Uganda is paramount if we are to know how far we have come and where we are going. This article explores the introduction of early childhood development in Ugandan policy and government interventions from 1960 to 2011. Data was obtained from a review of available early…

  16. Institutional Efficiency in Selected Universities in Uganda

    ERIC Educational Resources Information Center

    Amina, Nakimuli; Turyahebwa, Abanis

    2015-01-01

    Universities are accountable This study looked into Institutional Efficiency in selected Universities in Central Uganda. The study was guided by the following objectives; Determine the level of institutional efficiency of the universities in terms of educational efficiency; research efficiency and community service efficiency. The study employed…

  17. Seroprevalence of histoplasmosis in Kampala, Uganda.

    PubMed

    Bahr, Nathan C; Sarosi, George A; Meya, David B; Bohjanen, Paul R; Richer, Sarah M; Swartzentruber, Samantha; Halupnick, Ryan; Jarrett, Deidre; Wheat, L Joseph; Boulware, David R

    2016-03-01

    Histoplasmosis is endemic to the Midwestern United States, but cases have been reported nearly worldwide. A 1970 study found 3.8% skin test sensitivity to Histoplasma capsulatum in Uganda but no systemic study of histoplasmosis exposure has occurred since the onset of the human immunodeficiency virus (HIV) pandemic. This study investigated the seroprevalence of H. capsulatum and sought previously undetected cases of histoplasmosis in Kampala, Uganda. Serum, cerebrospinal fluid (CSF) and/or urine specimens were obtained from HIV-infected persons with suspected meningitis. Specimens were tested for H. capsulatum IgG and IgM by enzyme immune assay and Histoplasma antigen. 147 of the 257 subjects who were enrolled had cryptococcal meningitis. Overall, 1.3% (2/151) of subjects were serum Histoplasma IgG positive, and zero of 151 were IgM positive. Antigen was not detected in any serum (n = 57), urine (n = 37, or CSF (n = 63) samples. Both subjects with serum Histoplasma IgG positivity had cryptococcal meningitis. Histoplasma capsulatum IgG was detected at low levels in persons with HIV/AIDS in Kampala, Uganda. Histoplasmosis is not widespread in Uganda but microfoci do exist. There appears to be no cross-reactivity between Cryptococcus neoformans and Histoplasma antigen testing, and cryptococcosis appears to be at most, a rare cause of positive Histoplasma IgG. PMID:26527637

  18. Seroprevalence of histoplasmosis in Kampala, Uganda

    PubMed Central

    Bahr, Nathan C; Sarosi, George A.; Meya, David B; Bohjanen, Paul R; Richer, Sarah M; Swartzentruber, Samantha; Halupnick, Ryan; Jarrett, Deidre; Wheat, L. Joseph; Boulware, David R

    2016-01-01

    Histoplasmosis is endemic to the Midwestern United States, but cases have been reported nearly worldwide. A 1970 study found 3.8% skin test sensitivity to Histoplasma capsulatum in Uganda but no systemic study of histoplasmosis exposure has occurred since the onset of the human immunodeficiency virus (HIV) pandemic. This study investigated the seroprevalence of H. capsulatum and sought previously undetected cases of histoplasmosis in Kampala, Uganda. Serum, cerebrospinal fluid (CSF) and/or urine specimens were obtained from HIV-infected persons with suspected meningitis. Specimens were tested for H. capsulatum IgG and IgM by enzyme immune assay and Histoplasma antigen. 147 of the 257 subjects who were enrolled had cryptococcal meningitis. Overall, 1.3% (2/151) of subjects were serum Histoplasma IgG positive, and zero of 151 were IgM positive. Antigen was not detected in any serum (n = 57), urine (n = 37, or CSF (n = 63) samples. Both subjects with serum Histoplasma IgG positivity had cryptococcal meningitis. Histoplasma capsulatum IgG was detected at low levels in persons with HIV/AIDS in Kampala, Uganda. Histoplasmosis is not widespread in Uganda but micro-foci do exist. There appears to be no cross-reactivity between Cryptococcus neoformans and Histoplasma antigen testing, and cryptococcosis appears to be at most, a rare cause of positive Histoplasma IgG. PMID:26527637

  19. Incidence and Severity of Maize Ear Rots and Factors Responsible for Their Occurrence in Uganda

    NASA Astrophysics Data System (ADS)

    Bigirwa, G.; Kaaya, A. N.; Sseruwu, G.; Adipala, E.; Okanya, S.

    Eleven major maize growing districts of Uganda were surveyed for three consecutive seasons between 2002 and 2003 to establish maize ear rot incidence and severity. Sternocarpella maydis and Fusarium species particularly F. graminearum and F. verticillioides were the identified maize ear rot causing fungi. Incidence of S. maydis ranged from 2.5 to 32.5% while that of Fusarium sp. was in the range of 1.9 and 15.3%. In districts of higher altitude (above 1,800 m above sea level) F. graminearum dominated in all seasons while in districts with an altitude between 900 and 1,500 m above sea level, S. maydis was the major cause of ear rots. This observation was attributed to differences in temperature, altitude and rainfall. There was a strong positive correlation (p = 0.001) between incidence and severity for S. maydis and a weak one for Fusarium sp. because the latter would rarely infect the entire cob unlike the former. All farmers expressed concern about the quality of maize due to ear rots and sort out infected grain after harvest. However, varied uses of infected grain were noted. For example, in Kapchorwa district 82% of the respondents indicated that the infected grain is used for making local brew because the moulds give it a good taste and aroma, while in Kamuli and Masaka districts, 36% use it as animal feed ingredient. This indicates that people and animals could be ingesting mycotoxins unknowingly thus the need for sensitization programmes.

  20. Partnerships for development: municipal solid waste management in Kasese, Uganda.

    PubMed

    Christensen, David; Drysdale, David; Hansen, Kenneth; Vanhille, Josefine; Wolf, Andreas

    2014-11-01

    Municipal solid waste management systems of many developing countries are commonly constrained by factors such as limited financial resources and poor governance, making it a difficult proposition to break with complex, entrenched and unsustainable technologies and systems. This article highlights strategic partnerships as a way to affect a distributed agency among several sets of stakeholders to break so-called path dependencies, which occur when such unsustainable pathways arise, stabilize and become self-reinforcing over time. Experiences from a North-South collaborative effort provide some lessons in such partnership building: In Uganda and Denmark, respectively, the World Wildlife Fund and the network organization access2innovation have mobilized stakeholders around improving the municipal solid waste management system in Kasese District. Through a municipal solid waste management system characterization and mapping exercise, some emergent lessons and guiding principles in partnership building point to both pitfalls and opportunities for designing sustainable pathways. First, socio-technical lock-in effects in the municipal solid waste management system can stand in the way of partnerships based on introducing biogas or incineration technologies. However, opportunities in the municipal solid waste management system can exist within other areas, and synergies can be sought with interlinking systems, such as those represented with sanitation. PMID:25378254

  1. Occurrence and diagnosis of Mansonella streptocerca in Uganda.

    PubMed

    Fischer, P; Bamuhiiga, J; Büttner, D W

    1997-01-01

    During filaria surveys Mansonella streptocerca was found for the first time in Uganda, in 12 widely scattered villages in the Bundibugyo district between the Ruwenzori mountains and the Ituri forest, an area not endemic for Onchocerca volvulus. The crude prevalence in 806 examined adult persons ranged from 5 to 89% with an average of 61%. In 148 children the prevalence was 36%. The geometric mean of microfilaria (mf) densities in adult mf carriers was 1.7 mf/mg skin and the community microfilarial loads ranged from 1.0 to 13.7 mf/skin snip. In 476 persons skin snips from the shoulder contained mf in 58% and those from the buttocks in 48%. Skin snips from 68 persons digested with collagenase showed that only 30-37% of the mf emerged during 24 h incubation at 30 degrees C in isotonic salt solution. An itching acute or more often chronic papular dermatitis, predominantly on the upper parts of the body, was the typical skin lesion observed in 24% of 177 M. streptocerca mf carriers. PMID:9083584

  2. A descriptive study on health workforce performance after decentralisation of health services in Uganda

    PubMed Central

    2012-01-01

    Background Uganda, like many developing countries, is committed to achieving the Millennium Development Goals (MDGs) by 2015. However, serious challenges prove to hamper the attainment of these goals, particularly the health related MDGs. A major challenge relates to the human resources for health. The health system in Uganda was decentralised in the 1990s. Despite the health sector reforms, the services have remained significantly deficient and performance of health workers is thought to be one of the contributing factors. The purpose of this study was, therefore, to investigate the performance of health workers after decentralisation of the health services in Uganda in order to identify and suggest possible areas for improvement. Methods A cross-sectional descriptive survey, using quantitative research methods was utilised. A structured self-administered questionnaire was used to collect quantitative data from 276 health workers in the districts of Kumi, Mbale, Sironko and Tororo in Eastern Uganda. The health workers included doctors, clinical officers, professional nurses and midwives. The sample was selected using stratified random sampling. The data was analysed using SPSS version 18.0 and included both univariate and bivariate analysis. The results were presented in tabular and text forms. Results The study revealed that even though the health workers are generally responsive to the needs of their clients, the services they provide are often not timely. The health workers take initiatives to ensure that they are available for work, although low staffing levels undermine these efforts. While the study shows that the health workers are productive, over half (50.4%) of them reported that their organisations do not have indicators to measure their individual performance. The findings indicate that the health workers are skilled and competent to perform their duties. In general, the results show that health workers are proficient, adaptive, proactive and client

  3. Strategies of Coping with Effective Teaching and Learning in Large Classes in Secondary Schools in Kampala District

    ERIC Educational Resources Information Center

    Sekiwu, Denis

    2009-01-01

    This study examines strategies of coping with teaching and learning in large classes in secondary schools in Kampala district. With the rapid technological, economic and social growth being realized in Uganda, demand for education is increasing every other day. Education is an investment needed for rapid social change. The need for education, as a…

  4. Between a rock and a hard place: stigma and the desire to have children among people living with HIV in northern Uganda

    PubMed Central

    Nattabi, Barbara; Li, Jianghong; Thompson, Sandra C; Orach, Christopher G; Earnest, Jaya

    2012-01-01

    Background HIV-related stigma, among other factors, has been shown to have an impact on the desire to have children among people living with HIV (PLHIV). Our objective was to explore the experiences of HIV-related stigma among PLHIV in post-conflict northern Uganda, a region of high HIV prevalence, high infant and child mortality and low contraception use, and to describe how stigma affected the desires of PLHIV to have children in the future. Methods Semi-structured interviews were conducted with 26 PLHIV in Gulu district, northern Uganda. The interviews, conducted in Luo, the local language, were audio recorded, transcribed and then translated into English. Thematic data analysis was undertaken using NVivo8 and was underpinned by the “Conceptual Model of HIV/AIDS Stigma”. Results HIV-related stigma continues to affect the quality of life of PLHIV in Gulu district, northern Uganda, and also influences PLHIV's desire to have children. PLHIV in northern Uganda continue to experience stigma in various forms, including internal stigma and verbal abuse from community members. While many PLHIV desire to have children and are strongly influenced by several factors including societal and cultural obligations, stigma and discrimination also affect this desire. Several dimensions of stigma, such as types of stigma (received, internal and associated stigma), stigmatizing behaviours (abusing and desertion) and agents of stigmatization (families, communities and health systems), either directly, or indirectly, enhanced or reduced PLHIV's desire to have more children. Conclusion The social-cultural context within which PLHIV continue to desire to have children must be better understood by all health professionals who hope to improve the quality of PLHIV's lives. By delineating the stigma process, the paper proposes interventions for reducing stigmatization of PLHIV in northern Uganda in order to improve the quality of life and health outcomes for PLHIV and their children

  5. Cattle movements and trypanosomes: restocking efforts and the spread of Trypanosoma brucei rhodesiense sleeping sickness in post-conflict Uganda

    PubMed Central

    2013-01-01

    Background The northwards spread of acute T. b. rhodesiense sleeping sickness in Uganda has been linked to cattle movements associated with restocking following the end to military conflict in 2006. This study examined the number of cattle traded from T. b. rhodesiense endemic districts, the prevalence of the parasite in cattle being traded and the level of trypanocidal treatment at livestock markets. Methods Between 2008 and 2009 interviews were carried out with government veterinarians from 20 districts in Uganda, 18 restocking organisations and numerous livestock traders and veterinarians. Direct observations, a review of movement permit records (2006 to 2008) and blood sampling of cattle (n = 1758) for detection of parasites were also conducted at 10 livestock markets in T. b. rhodesiense endemic districts. Results Records available from 8 out of 47 identified markets showed that 39.5% (5,238/13,267) of the inter-district cattle trade between mid-2006 and mid-2008 involved movement from endemic areas to pathogen-free districts. PCR analysis showed a prevalence of 17.5% T. brucei s.l. (n = 307/1758 [95% CI: 15.7-19.2]) and 1.5% T. b. rhodesiense (n = 26/1758 [95% CI: 0.9-2.0]) from these same markets. In a two-year period, between late-2006 to late-2008, an estimated 72,321 to 86,785 cattle (57, 857 by 18 restocking organisations and 10,214 to 24,679 by private traders) were imported into seven pathogen-free northern districts, including districts that were endemic for T. b. gambiense. Between 281 and 1,302 of these cattle were likely to have carried T. b. rhodesiense. While governmental organisations predominantly adhered to trypanocidal treatment, most Non-Governmental Organisations (NGOs) and private traders did not. Inadequate market infrastructure, poor awareness, the need for payment for drug treatments, and the difficulty in enforcing a policy of treatment at point of sale contributed to non-compliance. Conclusion With increasing private trade, preventing

  6. The history of syphilis in Uganda

    PubMed Central

    Davies, J. N. P.

    1956-01-01

    The circumstances of an alleged first outbreak of syphilis in Uganda in 1897 are examined and attention is drawn to certain features which render possible alternative explanations of the history of syphilis in that country. It is suggested that an endemic form of syphilis was an old disease of southern Uganda and that protective infantile inoculation was practised. The country came under the observation of European clinicians at a time when endemic syphilis was being replaced by true venereal syphilis. This process has now been completed, endemic syphilis has disappeared, and venereal syphilis is now widespread and a more serious problem than ever. This theory explains the observations of other writers and reconciles the apparent discrepancies between various reports. PMID:13404471

  7. Mind the Gap: House Structure and the Risk of Malaria in Uganda

    PubMed Central

    Wanzirah, Humphrey; Tusting, Lucy S.; Arinaitwe, Emmanuel; Katureebe, Agaba; Maxwell, Kilama; Rek, John; Bottomley, Christian; Staedke, Sarah G.; Kamya, Moses; Dorsey, Grant; Lindsay, Steve W.

    2015-01-01

    Background Good house construction may reduce the risk of malaria by limiting the entry of mosquito vectors. We assessed how house design may affect mosquito house entry and malaria risk in Uganda. Methods 100 households were enrolled in each of three sub-counties: Walukuba, Jinja district; Kihihi, Kanungu district; and Nagongera, Tororo district. CDC light trap collections of mosquitoes were done monthly in all homes. All children aged six months to ten years (n = 878) were followed prospectively for a total of 24 months to measure parasite prevalence every three months and malaria incidence. Homes were classified as modern (cement, wood or metal walls; and tiled or metal roof; and closed eaves) or traditional (all other homes). Results A total of 113,618 female Anopheles were collected over 6,765 nights. 6,816 routine blood smears were taken of which 1,061 (15.6%) were malaria parasite positive. 2,582 episodes of uncomplicated malaria were diagnosed after 1,569 person years of follow-up, giving an overall incidence of 1.6 episodes per person year at risk. The human biting rate was lower in modern homes than in traditional homes (adjusted incidence rate ratio (IRR) 0.48, 95% confidence interval (CI) 0.37–0.64, p<0.001). The odds of malaria infection were lower in modern homes across all the sub-counties (adjusted odds ratio 0.44, 95%CI 0.30–0.65, p<0.001), while malaria incidence was lower in modern homes in Kihihi (adjusted IRR 0.61, 95%CI 0.40–0.91, p = 0.02) but not in Walukuba or Nagongera. Conclusions House design is likely to explain some of the heterogeneity of malaria transmission in Uganda and represents a promising target for future interventions, even in highly endemic areas. PMID:25635688

  8. Factors Influencing Childhood Immunization in Uganda

    PubMed Central

    2013-01-01

    This paper investigates the factors associated with childhood immunization in Uganda. We used nationally-representative data from Uganda Demographic and Health Survey (UDHS) of 2006. Both bivariate and multivariate approaches were employed in the analysis. The bivariate approach involved generating average percentages of children who were immunized, with analysis of pertinent background characteristics. The multivariate approach involved employing maximum likelihood probit technique and generating marginal effects to ascertain the probability of being immunized, given the same background characteristics. It revealed that slightly over 50% of children in Uganda were fully immunized. Additionally, 89%, 24%, 52%, and 64% received BCG, DPT, polio and measles vaccines respectively. Factors which have a significant association with childhood immunization are: maternal education (especially at post-secondary level), exposure to media, maternal healthcare utilization, maternal age, occupation type, immunization plan, and regional and local peculiarities. Children whose mothers had post-secondary education were twice as likely to be fully immunized compared to their counterparts whose mothers had only primary education (p<0.01). Thus, gender parity in education enhancement efforts is crucial. There is also a need to increase media penetration, maternal healthcare utilization, and to ensure parity across localities and regions. PMID:23617212

  9. Factors which predict violence victimization in Uganda

    PubMed Central

    Fry, Lincoln

    2014-01-01

    Introduction Violence is a major public health issue, globally and on the African continent. This paper looks at Uganda and begins the process of identifying the factors that predict violence in that country. The purpose is to interpret the implications of the study results for violence prevention programs. Methods The study includes the responses of 2 399 Ugandans collected in 2011 by the Fifth Round of the Afrobarometer surveys. The study concentrates on 259 respondents who reported either they or someone else in their family had been the victim of violence, defined as being physically attacked, in the last year. Results Logistical regression analysis identified six factors that predict physical violence in Uganda. In order, these included being the victim of a property crime, age, gender, fear of crime in the home, poverty, and residential crowding. The surprising findings relate to what may be called target hardening, especially for those likely to be re-victimized. Respondents did tend to be re-victimized, with about 61 percent of violence victims also property crime victims. Fear of crime in home was another predictor of violence victimization, and many of these respondents had been crime victims. Conclusion These findings imply that target hardening should be the basis to begin to implement violence prevention programs in Uganda. The suggestion is crime prevention personnel/ law enforcement need to respond to reported incidents of property and/or violence victimization and attempt to prepare victims to protect both their premises and their persons in the future. PMID:25918575

  10. Factors influencing childhood immunization in Uganda.

    PubMed

    Bbaale, Edward

    2013-03-01

    This paper investigates the factors associated with childhood immunization in Uganda. We used nationally-representative data from Uganda Demographic and Health Survey (UDHS) of 2006. Both bivariate and multivariate approaches were employed in the analysis. The bivariate approach involved generating average percentages of children who were immunized, with analysis of pertinent background characteristics. The multivariate approach involved employing maximum likelihood probit technique and generating marginal effects to ascertain the probability of being immunized, given the same background characteristics. It revealed that slightly over 50% of children in Uganda were fully immunized. Additionally, 89%, 24%, 52%, and 64% received BCG, DPT, polio and measles vaccines respectively. Factors which have a significant association with childhood immunization are: maternal education (especially at post-secondary level), exposure to media, maternal healthcare utilization, maternal age, occupation type, immunization plan, and regional and local peculiarities. Children whose mothers had post-secondary education were twice as likely to be fully immunized compared to their counterparts whose mothers had only primary education (p < 0.01). Thus, gender parity in education enhancement efforts is crucial. There is also a need to increase media penetration, maternal healthcare utilization, and to ensure parity across localities and regions. PMID:23617212

  11. Dilemmas in Implementing Language Rights in Multilingual Uganda

    ERIC Educational Resources Information Center

    Namyalo, Saudah; Nakayiza, Judith

    2015-01-01

    Even after decades of uttering platitudes about the languages of Uganda, language policy pronouncements have invariably turned out to be public relations statements rather than blueprints for action. A serious setback for the right to linguistic equality and the right to use Uganda's indigenous languages has largely hinged on the language…

  12. Gender and Age-Appropriate Enrolment in Uganda

    ERIC Educational Resources Information Center

    Wells, Ryan

    2009-01-01

    Secondary school enrolment in Uganda has historically favoured males over females. Recently, however, researchers have reported that the secondary enrolment gender gap has significantly diminished, and perhaps even disappeared in Uganda. Even if gender parity is being achieved for enrolment broadly, there may be a gender gap concerning…

  13. Nodding Syndrome in Uganda: Field Observations, Challenges and Research Agenda

    PubMed Central

    Feldmeier, Hermann; Komazawa, Osuke; Moji, Kazuhiko

    2014-01-01

    This article summarizes observations made in Northern Uganda and a lecture given at the Nodding Syndrome Workshop in Nagasaki September 2013. The objective of the manuscript is to summarize the current knowledge on nodding syndrome and to provide an agenda for investigations into the epidemiology, pathophysiology, diagnosis and care management of nodding syndrome in Uganda. PMID:25425959

  14. Nodding syndrome in Uganda: field observations, challenges and research agenda.

    PubMed

    Feldmeier, Hermann; Komazawa, Osuke; Moji, Kazuhiko

    2014-06-01

    This article summarizes observations made in Northern Uganda and a lecture given at the Nodding Syndrome Workshop in Nagasaki September 2013. The objective of the manuscript is to summarize the current knowledge on nodding syndrome and to provide an agenda for investigations into the epidemiology, pathophysiology, diagnosis and care management of nodding syndrome in Uganda. PMID:25425959

  15. Alcohol, Substance Use and Psychosocial Competence of Adolescents in Selected Secondary Schools in Uganda: A Cross Sectional Survey

    PubMed Central

    Abbo, Catherine; Okello, Elialilia S.; Muhwezi, Wilson; Akello, Grace; Ovuga, Emilio

    2016-01-01

    Aims 1) To determine the nature and extent of alcohol and substance use and 2) To describe the relationship between alcohol use and psychosocial competence among secondary school youths in Northern and Central Uganda. Study Design This was a cross-sectional study. Place and Duration of study Departments of Mental Health, Gulu University (Northern Uganda) and Department of Psychiatry, Makerere University College of Health Sciences (Central Uganda) between September 2011 and April 2012. Methodology Four (4) and eight (8) secondary schools located in the rural and urban areas of Gulu and Kampala districts respectively were randomly selected to participate in the survey. A total of 3,200 students aged 12 to 24 years were recruited by proportionate multistage sampling. Data was collected using a socio-demographic questionnaire that included questions about nature and frequency of alcohol and substance use. A pre-tested self-administered survey questionnaire with scales to measure components of psychosocial competence (PSC) was administered. Data was entered in Epidata, and exported to SPSS version 16.0 for analysis. Psychosocial competence was classified as high or low depending on the responses in the sub-scales of decision making, self efficacy, empathy, emotional awareness, coping with stress and emotions, and accurate self-assessment and self-confidence. Results A total of 2,902 questionnaires comprising of 2,502, (86.2%) from Kampala district and 400 (13.8%)) from Gulu district were analyzed. Male to female ratio was 1:1 with an age range of 12 to 24 years and a mean of 16.5. About 70.1% had ever used alcohol and substances. Only 39.1% used substances regularly. The commonest substance used was alcohol (23.3%), followed by kuber (10.8%), khat (10.5%), aviation fuel (10.1%), cannabis (9.2%) and cigarettes (5.9%). Respondents from the Gulu district were twice more likely to use all substances. Users and regular users from the North Northern Uganda had lower

  16. Nodding syndrome in northern Uganda: overview and community perspectives.

    PubMed

    Mitchell, Katrina B; Kornfeld, Julie; Adiama, Joseph; Mugenyi, Andrew; Schmutzhard, Erich; Ovuga, Emilio; Kamstra, Jesse; Winkler, Andrea Sylvia

    2013-01-01

    The increasing prevalence of nodding syndrome in northern Uganda has generated a wide range of speculations with respect to etiology and natural history of and best possible medical treatment for this mysterious seizure disorder. Despite in-depth investigations by the United States Centers for Disease Control and Prevention and the Ministry of Health in Uganda, no clear causal factors have emerged. At the same time, northern Uganda communities are voicing concern for their lack of knowledge about nodding syndrome. The purpose of this commentary is to summarize northern Uganda community perceptions of this syndrome. These reflections demonstrate the need for larger investigations into the impact of nodding syndrome and other seizure disorders on local communities both in northern Uganda and throughout the world, in particular rural areas of resource poor countries. PMID:23207514

  17. Hypertension, Cardiovascular Risk Factors and Anti-Hypertensive Medication Utilization among HIV-infected Individuals in Rakai, Uganda

    PubMed Central

    Sander, Laura D.; Newell, Kevin; Ssebbowa, Paschal; Serwadda, David; Quinn, Thomas C.; Gray, Ronald H.; Wawer, Maria J.; Mondo, George; Reynolds, Steven

    2014-01-01

    Objectives To assess the prevalence of hypertension, elevated blood pressure and cardiovascular risk factors among HIV-positive individuals in rural Rakai District, Uganda. Methods We assessed 426 HIV-positive individuals in Rakai, Uganda from 2007 to 2010. Prevalence of hypertension and elevated blood pressure assessed by clinical measurement was compared to clinician-recorded hypertension in case report forms. Multiple logistic regression and z-tests were used to examine the association of hypertension and elevated blood pressure with age, sex, body mass index, CD4 cell count, and anti-retroviral treatment (ART) use. For individuals on anti-hypertensives, medication utilization was reviewed. Results The prevalence of hypertension (two elevated blood pressure readings at different time points) was 8.0% (95% CI: 5.4–10.6%), and that of elevated blood pressure (one elevated blood pressure reading) was 26.3% (95% CI: 22.1–30.5%). Age ≥50 years and higher body mass index were positively associated with elevated blood pressure. ART use, time on ART, and CD4 cell count were not associated with hypertension. 83% of subjects diagnosed with hypertension were on anti-hypertensive medications, most commonly beta-blockers and calcium channel blockers. Conclusions Hypertension is common among HIV-positive individuals in rural Uganda. PMID:25430847

  18. The Cost-Effectiveness of Supplementary Immunization Activities for Measles: A Stochastic Model for Uganda

    PubMed Central

    Johns, Benjamin; Nair, Divya; Nabyonga-Orem, Juliet; Fiona-Makmot, Braka; Simons, Emily; Dabbagh, Alya

    2011-01-01

    Supplemental Immunization Activities (SIAs) have become an important adjunct to measles control efforts in countries that endeavor to achieve higher levels of population immunity than can be achieved in a growing routine immunization system. Because SIAs are often supported with funds that have alternative uses, decision makers need to know how cost-effective they are compared with other options. This study integrated a dynamic stochastic model of measles transmission in Uganda (2010–2050) with a cost model to compare a strategy of maintaining Uganda's current (2008) levels of the first dose of routine measles-containing vaccine (MCV1) coverage at 68% with SIAs with a strategy using the same levels of MCV1 coverage without SIAs. The stochastic model was fitted with parameters drawn from district-level measles case reports from Uganda, and the cost model was fitted to administrative data from the Ugandan Expanded Program on Immunization and from the literature. A discount rate of 0.03, time horizon of 2010–2050, and a societal perspective on costs were assumed. Costs expressed in US dollars (2010) included vaccination costs, disease treatment costs including lost productivity of mothers, as well as costs of outbreaks and surveillance. The model estimated that adding on triennial SIAs that covered 95% of children aged 12–59 months to a system that achieved routine coverage rates of 68% would have an incremental cost-effectiveness ratio (ICER) of $1.50 ($US 2010) per disability-adjusted life year averted. The ICER was somewhat higher if the discount rate was set at either 0 or 0.06. The addition of SIAs was found to make outbreaks less frequent and lower in magnitude. The benefit was reduced if routine coverage rates were higher. This cost-effectiveness ratio compares favorably to that of other commonly accepted public health interventions in sub-Saharan Africa. PMID:21666151

  19. A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda†

    PubMed Central

    Tashobya, Christine K; Dubourg, Dominique; Ssengooba, Freddie; Speybroeck, Niko; Macq, Jean; Criel, Bart

    2016-01-01

    In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards’ method was used. The hierarchical cluster analysis was conducted on the basis of seven clusters determined for each year from 2003 to 2010, ranging from a cluster of good through moderate-to-poor performers. The characteristics and membership of clusters varied from year to year and were determined by the identity and magnitude of performance of the individual variables. Criticisms of the league table include: perceived unfairness, as it did not take into consideration district peculiarities; and being oversummarized and not adequately informative. Clustering organizes the many data points into clusters of similar entities according to an agreed set of indicators and can provide the beginning point for identifying factors behind the observed performance of districts. Although league table ranking emphasize summation and external control, clustering has the potential to encourage a formative, learning approach. More research is required to shed more light on factors behind observed performance of the different clusters. Other countries especially low-income countries that share many similarities with Uganda can learn from these experiences. PMID:26024882

  20. HIV/AIDS-associated beliefs and practices relating to diet and work in southeastern Uganda

    PubMed Central

    Komwa, Maction K.; Parker, Dawn C.

    2010-01-01

    To explore beliefs relating to diet, work, and HIV/AIDS among the Busoga of rural southeastern Uganda, a cross-sectional survey of 322 adults was conducted in 2007 in Mayuge district, Uganda. Of these adults, 56 were HIV-infected, 120 had a family member with HIV/AIDS, and 146 were in households without HIV-infected members. More than 74.2% of the adults knew someone with HIV/AIDS, and more than 90% correctly identified transmission modes and prevention methods of HIV. In total, 93.2% believed that a person with HIV should work fewer hours to conserve energy but all the three participant groups reported the same working hours. Also, 91.6% believed that a person with HIV infection should eat special nutritious foods, and the participants with HIV infection reported eating more fruits (p=0.020) and vegetables (p=0.012) than other participants. The participants expressed a consistent set of health beliefs about practices relating to HIV/AIDS. PMID:20214089

  1. The UNDP spends $2m. on grass-roots income-generation in Uganda.

    PubMed

    1994-01-01

    A $2 million UNDP project designed to provide assistance to those suffering from human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), is having problems finding its target population in Uganda. Staff cannot rely on many nongovernmental organizations (NGOs), so money is being directly channeled to villages via local leaders, who weed out the undeserving. Internationally, most funds are directed at prevention, education, and prediction of the social and economic impacts of the epidemic. However, the impact at the national, local, and family levels has gone unaddressed. The approach has been charitable, rather than sustainable. The aims of the project are as follows: 1) establishment of income generation programs for orphans, widows, low income survivors, and communities with large numbers of patients with AIDS; and 2) establishment of skills and resources in local groups to implement and manage the projects. 90 microprojects are currently funded in 20 of 39 Ugandan districts. Funds are channelled through the HIV/AIDS Grassroots Initiative Support Fund. The steering committee includes representatives of the Uganda AIDS Commission and the Ministry of Planning and Economic Development. In an effort to rehabilitate prostitutes in Kampala, $6000 was loaned to 21 women and 15 orphans to buy cooking and sewing equipment. Other income generation programs include carpentry and agricultural projects and piggeries. The project time has been extended by 18 months and funds have increased from $700,000 to $2,000,000. PMID:12288156

  2. Constraints to educational opportunities of orphans: a community-based study from northern Uganda.

    PubMed

    Oleke, C; Blystad, A; Fylkesnes, K; Tumwine, J K

    2007-03-01

    The objective of this article is to assess constraints on educational opportunities of orphans cared for within the extended family system in Lira district, northern Uganda. The data were collected through: review of school census records; ethnographic fieldwork; in-depth interviews with 21 community leaders, 45 heads of households caring for orphans and 35 orphans. Focus group discussions were held with men and women caring for orphans, community leaders and orphans. A household survey was conducted in 402 households caring for orphans. We found that very poor widows living on less than half a dollar per day head 48% of the households caring for orphans. The elderly heads of households were 3 times more likely to have all the children in their household in schools than the younger ones. Furthermore, the widowed and single heads of households were more likely to have all orphans in school than the married, and households that received external support offered better educational opportunities. Poverty, as indicated by lack of food while at school and heavy involvement of orphans in domestic labour, were identified as major constraints on orphans' schooling. There is an urgent need to support orphans' education in northern Uganda beyond the current Universal Primary Education efforts. The most vulnerable households need to be targeted, and the communities need to be sensitized to child labour, school meals and sex abuse. PMID:17453570

  3. Breeding Services and the Factors Influencing Their Use on Smallholder Dairy Farms in Central Uganda

    PubMed Central

    Kayiizi, Vincent; Owiny, David; Mburu, John

    2014-01-01

    Dairy cattle breeding is an important technology in the enhancement and promotion of dairy production in Uganda. The introduction of germplasm through AI is crucial to enhance the production potential of the local breeds. A study was conducted in six districts of Uganda in the central region using a questionnaire survey involving 450 randomly selected households to profile the dairy breeding services in use and investigate the factors that affect the success of dairy breeding focusing on AI. Adoption of the AI service was highly (P < 0.05) dependent on ava ilability of extension services, record keeping practice (P < 0.05), and availability of milk markets (P < 0.05). On the other hand AI adoption was independent of formal education, age of farmer, labor availability, and feed/water availability (P > 0.05). Use or nonuse of AI did not significantly (P > 0.05) influence the sex of the calf born. While preference for AI was marked, very few farmers actually used it. This implies that focus should be put on improved AI service delivery alongside improved extension services. PMID:24782940

  4. Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives

    PubMed Central

    2010-01-01

    Background High fertility among young people aged 15-24 years is a public health concern in Uganda. Unwanted pregnancy, unsafe induced abortions and associated high morbidity and mortality among young women may be attributed to low contraceptive use. This study aims at exploring reasons for low contraceptive use among young people. Methods In 16 focus group discussions, the views of young people about obstacles and enabling factors to contraceptive use in Mityana and Mubende districts, Uganda were explored. The groups were homogeneously composed by married and unmarried men and women, between the ages of 15-24. The data obtained was analyzed using qualitative content analysis. Results Young men and women described multiple obstacles to contraceptive use. The obstacles were categorized as misconceptions and fears related to contraception, gender power relations, socio-cultural expectations and contradictions, short term planning, and health service barriers. Additionally, young people recounted several enabling factors that included female strategies to overcome obstacles, changing perceptions to contraceptive use, and changing attitude towards a small family size. Conclusions Our findings suggest changing perceptions and behavior shift towards contraceptive use and a small family size although obstacles still exist. Personalized strategies to young women and men are needed to motivate and assist young people plan their future families, adopt and sustain use of contraceptives. Reducing obstacles and reinforcing enabling factors through education, culturally sensitive behavior change strategies have the potential to enhance contraceptives use. Alternative models of contraceptive service delivery to young people are proposed. PMID:20813069

  5. Health services for survivors of gender-based violence in northern Uganda: a qualitative study.

    PubMed

    Henttonen, Mirkka; Watts, Charlotte; Roberts, Bayard; Kaducu, Felix; Borchert, Matthias

    2008-05-01

    The 20-year war in northern Uganda has resulted in up to 1.7 million people being internally displaced, and impoverishment and vulnerability to violence amongst the civilian population. This qualitative study examined the status of health services available for the survivors of gender-based violence in the Gulu district, northern Uganda. Semi-structured interviews were carried out in 2006 with 26 experts on gender-based violence and general health providers, and availability of medical supplies was reviewed. The Inter-Agency Standing Committee (IASC) guidelines on gender-based violence interventions in humanitarian settings were used to prepare the interview guides and analyse the findings. Some legislation and programmes do exist on gender-based violence. However, health facilities lacked sufficiently qualified staff and medical supplies to adequately detect and manage survivors, and confidential treatment and counselling could not be ensured. There was inter-sectoral collaboration, but greater resources are required to increase coverage and effectiveness of services. Intimate partner violence, sexual abuse of girls aged under 18, sexual harassment and early and forced marriage may be more common than rape by strangers. As the IASC guidelines focus on sexual violence by strangers and do not address other forms of gender-based violence, we suggest the need to explore this issue further to determine whether a broader concept of gender-based violence should be incorporated into the guidelines. PMID:18513614

  6. Poverty creates the greatest risk for women in Uganda. Special report: women and HIV.

    PubMed

    Oywa, R

    1995-08-01

    Ugandan women are mothers and workers, and have important roles in the community. They often transfer part of their burden to their female children. All resources (land, labor, time) are controlled by men. Women are still properties to be inherited with the rest of their deceased husbands' estates. If a woman wants to stay in her husband's house, even if she is infected with human immunodeficiency virus (HIV) she has to care for her in-laws. Males make the decisions, and women, married or not, have no control over sexual relations, including safety. The acquired immunodeficiency syndrome (AIDS)/HIV epidemic has created thousands of orphans, widows, and destitute elderly. Many of the orphans, who are between 6 and 14 years of age, are running households. Many leave school because they cannot afford high school fees. Girls are affected more; 65% of girls and 16% of boys in Gulu district leave. Poorly educated, many girls and women turn to prostitution. Young girls (camp followers) follow rebel soldiers in northern Uganda from camp to camp; some are attached to particular men. An estimated 1.5 million Ugandans out of a total population of 17 million, are infected with HIV. The majority are between 15 and 45 years of age, the most productive age group. In rural Uganda, farming is labor-intensive; one death in a household can mean normal farming activities will not be completed. PMID:12289849

  7. Geothermal district heating systems

    NASA Astrophysics Data System (ADS)

    Budney, G. S.; Childs, F.

    1982-06-01

    Ten district heating demonstration projects and their present status are described. The projects are Klamath County YMCA, Susanville District Heating, Klamath Falls District Heating, Reno Salem Plaza Condominium, El Centro Community Center Heating/Cooling, Haakon School and Business District Heating, St. Mary's Hospital, Diamond Ring Ranch, Pagosa Springs District Heating, and Boise District Heating.

  8. Charter School Districts.

    ERIC Educational Resources Information Center

    Hill, Paul T.

    2002-01-01

    Discusses the difference between charter schools and charter districts (all schools in the district are chartered), why charter school districts are spreading, and how local school districts can become charter districts. Current laws in Arizona, California, Florida, Georgia, New Mexico, Oregon, and Texas allow charter districts. (PKP)

  9. Coping Strategies for Landslide and Flood Disasters: A Qualitative Study of Mt. Elgon Region, Uganda

    PubMed Central

    Osuret, Jimmy; Atuyambe, Lynn M; Mayega, Roy William; Ssentongo, Julius; Tumuhamye, Nathan; Mongo Bua, Grace; Tuhebwe, Doreen; Bazeyo, William

    2016-01-01

    Introduction: The occurrence of landslides and floods in East Africa has increased over the past decades with enormous Public Health implications and massive alterations in the lives of those affected. In Uganda, the Elgon region is reported to have the highest occurrence of landslides and floods making this area vulnerable. This study aimed at understanding both coping strategies and the underlying causes of vulnerability to landslides and floods in the Mt. Elgon region. Methods: We conducted a qualitative study in three districts of Bududa, Manafwa and Butalejja in the Mt. Elgon region in eastern Uganda. Six Focus Group Discussions (FGDs) and eight Key Informant Interviews (KIIs) were conducted. We used trained research assistants (moderator and note taker) to collect data. All discussions were audio taped, and were transcribed verbatim before analysis. We explored both coping strategies and underlying causes of vulnerability. Data were analysed using latent content analysis; through identifying codes from which basis categories were generated and grouped into themes. Results: The positive coping strategies used to deal with landslides and floods included adoption of good farming methods, support from government and other partners, livelihood diversification and using indigenous knowledge in weather forecasting and preparedness. Relocation was identified as unsustainable because people often returned back to high risk areas. The key underlying causes of vulnerability were; poverty, population pressure making people move to high risk areas, unsatisfactory knowledge on disaster preparedness and, cultural beliefs affecting people’s ability to cope. Conclusion: This study revealed that deep rooted links to poverty, culture and unsatisfactory knowledge on disaster preparedness were responsible for failure to overcome the effects to landslides and floods in disaster prone communities of Uganda. However, good farming practices and support from the government and

  10. Off-Grid Electricity Access and its Impact on Micro-Enterprises: Evidence from Rural Uganda

    NASA Astrophysics Data System (ADS)

    Muhoro, Peter N.

    The history of development shows convincingly that no country has substantially reduced poverty without massively increasing the use of electricity. The development of micro-enterprises in rural areas of Uganda is linked with increased access and use of electricity services. In this study, I combine quantitative and qualitative methods, including informal surveys, intra-business energy allocation studies and historical analysis, to analyze off-grid electricity access among micro-enterprises in rural western Uganda. I explore the linkages between of grid electricity access and the influence it has on micro- enterprises. Data is obtained from 56 micro-enterprises located in 11 village-towns within 3 districts in Uganda. In studying the micro-enterprises. the focus is on the services that are provided by electricity from modern energy carriers. The type of equipment used, forms of transportation, technical support, level of understanding and education of the entrepreneur, financing for energy equipment, and the role of donors are discussed in this thesis. Qualitative methods are used to allow for new insights and prioritization of concepts to emerge from the field rattier than from theory. Micro-enterprises in rural Uganda create income for the poor; they are resources for poverty reduction. With price adjustments, it becomes possible for those who live below the poverty line, nominally less than $1 a day, to afford the products and services and therefore mitigating the vicious cycle of poverty. Energy consumption among the micro-enterprises is at an average of 0.13kWh/day. The cost of accessing this amount of electricity attributes to about 50% of total revenue. I find that the "practices" used in off-grid electricity access lead to situations where the entrepreneurs have to evaluate pricing and output of products and services to generate higher profits. Such numbers indicate the need for appropriate technologies and profitable policies to be implemented. The data

  11. Domestic violence in rural Uganda: evidence from a community-based study.

    PubMed Central

    Koenig, Michael A.; Lutalo, Tom; Zhao, Feng; Nalugoda, Fred; Wabwire-Mangen, Fred; Kiwanuka, Noah; Wagman, Jennifer; Serwadda, David; Wawer, Maria; Gray, Ron

    2003-01-01

    Although domestic violence is an increasing public health concern in developing countries, evidence from representative, community-based studies is limited. In a survey of 5109 women of reproductive age in the Rakai District of Uganda, 30% of women had experienced physical threats or physical abuse from their current partner--20% during the year before the survey. Three of five women who reported recent physical threats or abuse reported three or more specific acts of violence during the preceding year, and just under a half reported injuries as a result. Analysis of risk factors highlights the pivotal roles of the male partner's alcohol consumption and his perceived human immunodeficiency virus (HIV) risk in increasing the risk of male against female domestic violence. Most respondents--70% of men and 90% of women--viewed beating of the wife or female partner as justifiable in some circumstances, posing a central challenge to preventing violence in such settings. PMID:12640477

  12. Financial management systems under decentralization and their effect on malaria control in Uganda.

    PubMed

    Kivumbi, George W; Nangendo, Florence; Ndyabahika, Boniface Rutagira

    2004-01-01

    A descriptive case study with multiple sites and a single level of analysis was carried out in four purposefully selected administrative districts of Uganda to investigate the effect of financial management systems under decentralization on malaria control. Data were primarily collected from 36 interviews with district managers, staff at health units and local leaders. A review of records and documents related to decentralization at the central and district level was also used to generate data for the study. We found that a long, tedious, and bureaucratic process combined with lack of knowledge in working with new financial systems by several actors characterized financial flow under decentralization. This affected the timely use of financial resources for malaria control in that there were funds in the system that could not be accessed for use. We were also told that sometimes these funds were returned to the central government because of non-use due to difficulties in accessing them and/or stringent conditions not to divert them to other uses. Our data showed that a cocktail of bureaucratic control systems, corruption and incompetence make the financial management system under decentralization counter-productive for malaria control. The main conclusion is that good governance through appropriate and efficient financial management systems is very important for effective malaria control under decentralization. PMID:15686065

  13. The milk delivery chain and presence of Brucella spp. antibodies in bulk milk in Uganda.

    PubMed

    Rock, Kim Toeroek; Mugizi, Denis Rwabiita; Ståhl, Karl; Magnusson, Ulf; Boqvist, Sofia

    2016-06-01

    This study examined the influence of informal milk delivery chains on the risk of human exposure to Brucella spp. through milk consumption in two regions of Uganda (Gulu and Soroti Districts). The work involved describing milk delivery chains, investigating brucellosis awareness amongst milk deliverers and determining the presence of Brucella spp. antibodies in cattle milk on delivery to primary collection points (boiling points and dairies). Milk samples (n = 331) were collected from deliverers at primary collection points and from street vendors at point of sale and analysed using indirect enzyme-linked immunosorbent assay (I-ELISA). A written questionnaire was used to collect data from deliverers (n = 279) on their milk delivery chains and their brucellosis awareness. The most common delivery points in Gulu District were small dairies and in Soroti District boiling points. The presence of Brucella spp. antibodies in milk samples was higher in Soroti (40 %) than in Gulu (11 %) (P < 0.0001). There are possible public health risk consequences of this finding as 42 % of deliverers in Soroti District reported drinking raw milk, compared with 15 % in Gulu District (P < 0.0001). Awareness of brucellosis was low, with 70 % of all milk deliverers reporting not having heard of the disease or the bacterium. Application of quality controls for milk (colour and odour) along the delivery chain varied depending upon supply and demand. This study provides evidence of the diversity of informal milk markets in low-income countries and of the potential public health risks of consuming unpasteurised milk. These results can be useful to those planning interventions to reduce brucellosis. PMID:27026231

  14. Safe motherhood voucher programme coverage of health facility deliveries among poor women in South-western Uganda.

    PubMed

    Kanya, Lucy; Obare, Francis; Warren, Charlotte; Abuya, Timothy; Askew, Ian; Bellows, Ben

    2014-07-01

    There has been increased interest in and experimentation with demand-side mechanisms such as the use of vouchers that place purchasing power in the hands of targeted consumers to improve the uptake of healthcare services in low-income settings. A key measure of the success of such interventions is the extent to which the programmes have succeeded in reaching the target populations. This article estimates the coverage of facility deliveries by a maternal health voucher programme in South-western Uganda and examines whether such coverage is correlated with district-level characteristics such as poverty density and the number of contracted facilities. Analysis entails estimating the voucher coverage of health facility deliveries among the general population and poor population (PP) using programme data for 2010, which was the most complete calendar year of implementation of the Uganda safe motherhood (SM) voucher programme. The results show that: (1) the programme paid for 38% of estimated deliveries among the PP in the targeted districts, (2) there was a significant negative correlation between the poverty density in a district and proportions of births to poor women that were covered by the programme and (3) improving coverage of health facility deliveries for poor women is dependent upon increasing the sales and redemption rates. The findings suggest that to the extent that the programme stimulated demand for SM services by new users, it has the potential of increasing facility-based births among poor women in the region. In addition, the significant negative correlation between the poverty density and the proportions of facility-based births to poor women that are covered by the voucher programme suggests that there is need to increase both voucher sales and the rate of redemption to improve coverage in districts with high levels of poverty. PMID:24173430

  15. Anthelmintic resistance in gastrointestinal nematodes in goats and evaluation of FAMACHA diagnostic marker in Uganda.

    PubMed

    Nabukenya, Immaculate; Rubaire-Akiiki, Chris; Olila, Deogracious; Muhangi, Denis; Höglund, Johan

    2014-10-15

    Gastrointestinal nematodes (GIN) are a challenge to goat production globally causing reduced growth, morbidity and mortality. We report here results of the first nation-wide anthelmintic resistance (AR) study and validation of assessment of clinical anaemia with FAMACHA eye scores in goats in Uganda. From August to December 2012 the efficacy of albendazole (7.5mg/kg), levamisole (10.5mg/kg) and ivermectin (0.3mg/kg) against strongyle nematodes was tested on 33 goat farms in Soroti, Gulu, Mpigi, Mbarara and Ssembabule districts of Uganda. Altogether 497 goats were subjected to a total of 45 different faecal egg count reduction tests (FECRT), each involving 5-20 goats. On one farm all substances were tested. Faecal and blood samples were collected and FAMACHA eye scores evaluated on the day of treatment and 15 days later. A questionnaire survey was conducted on frequency, type and dose of anthelmintics used, farm size and grazing management system. Examination of infective third stage larvae (L3) from pooled faecal cultures demonstrated Haemonchus to be the predominant genus (>75%). Resistance to at least one anthelmintic group was detected on 61% of the 33 farms and in 49% of the 45 test groups. Prevalence of resistance to ivermectin, levamisole and albendazole was respectively 58%, 52% and 38%. Correlation between pre-treatment packed cell volume determinations and FAMACHA scores (r(498) = -0.89) was significant. Paddock grazing system (Odds ratio 4.9, 95% CI 1.4-17.3) and large farm size of >40 goats (odds ratio 4.4, 95% CI 1.2-16.1) were significant predictors of AR. In all districts, resistance to all three anthelmintics was higher on large-scale goat farms practising mostly paddock grazing. Interestingly, resistance to albendazole, the most commonly used anthelmintic in Uganda, was lower than that to ivermectin and levamisole. We recommend adaptation of FAMACHA to goats to help restrict anthelmintic treatment to heavily infected individuals. This will limit

  16. Adolescents' perceptions of sexual coercion in Uganda.

    PubMed

    Birungi, Ruth; Nabembezi, Dennis; Kiwanuka, Julius; Ybarra, Michele; Bull, Sheana

    2011-12-01

    In Uganda, HIV prevalence remains high with young people at higher risk of infection than adults. Much is known about the sexual risk factors for HIV transmission among youths, including sexual encounters that are coerced. On the other hand, relatively little is known about the barriers to preventing sexual coercion and what strategies may overcome those barriers with adolescents. We conducted three focus group discussions with adolescents in an urban area in Uganda to understand their perceptions of sexual coercion, and to identify, from their point of view, how coercion can be addressed. Data were collected to inform the development of an Internet-based programme for young people, tailored to their HIV-information, motivation and behavioural-skills needs. The findings suggest that the participants perceived adults' coercion of young people as common. The secondary school participants also expressed confusion over what exactly constituted coercion. They acknowledged that young people lack skills to avoid coerced sex and felt it would be critical to give youths information on the circumstances in which coercion may occur and its links to HIV risk. Finally, the youths wanted specific skills and to be empowered to avoid sexual coercion and to report rape. The findings suggest that adolescents are open to discussions about this topic and they support the call for greater integration of coercion-reduction strategies in HIV-prevention programmes targeted at their age group. PMID:25865380

  17. Stakeholder analysis for a maternal and newborn health project in Eastern Uganda

    PubMed Central

    2013-01-01

    Background Based on the realization that Uganda is not on track to achieving Millennium Development Goals 4 and 5, Makerere University School of Public Health in collaboration with other partners proposed to conduct two community based maternal/newborn care interventions aimed at increasing access to health facility care through transport vouchers and use of community health workers to promote ideal family care practices. Prior to the implementation, a stakeholder analysis was undertaken to assess and map stakeholders’ interests, influence/power and position in relation to the interventions; their views regarding the success and sustainability; and how this research can influence policy formulation in the country. Methods A stakeholder analysis was carried out in March 2011 at national level and in four districts of Eastern Uganda where the proposed interventions would be conducted. At the national level, four key informant interviews were conducted with the ministry of health representative, Member of Parliament, and development partners. District health team members were interviewed and also engaged in a workshop; and at community level, twelve focus group discussions were conducted among women, men and motorcycle transporters. Results This analysis revealed that district and community level stakeholders were high level supporters of the proposed interventions but not drivers. At community level the mothers, their spouses and transporters were of low influence due to the limited funds they possessed. National level and district stakeholders believed that the intervention is costly and cannot be affordably scaled up. They advised the study team to mobilize and sensitize the communities to contribute financially from the start in order to enhance sustainability beyond the study period. Stakeholders believed that the proposed interventions will influence policy through modeling on how to improve the quality of maternal/newborn health services, male involvement

  18. Burden of injury during the complex political emergency in northern Uganda

    PubMed Central

    Lett, Ronald R.; Kobusingye, Olive Chifefe; Ekwaru, Paul

    2006-01-01

    Background War injury is a public health problem that warrants global attention. This study aims to determine the burden of injury during a complex emergency in sub-Saharan Africa. Methods To determine the magnitude, causes, distribution, risk factors and cumulative burden of injury in a population experiencing armed conflict in northern Uganda since 1986 and to evaluate the living conditions and access to care for injury victims, we took a multistage, stratified, random sampling from the Gulu district to determine the rates of injury from 1994 to 1999. The Gulu district is endemic for malaria, tuberculosis, HIV and malnutrition and has a high maternal death rate. It is 1 of 3 districts in northern Uganda affected by war since 1986. The study participants included 8595 people from 1475 households. Of these, 73.0% lived in temporary housing, 46.0% were internally displaced and 81.0% were under 35 years of age. Trained interviewers administered a 3-part household survey in the local language. Quantitative data on injury, household environment, health care and demography were analyzed. Qualitative data from part 3 of the survey will be reported elsewhere. A similar rural district (Mukono) not affected by war was used for comparison. We studied injury risk factors, mortality and disability rates, accumulated deaths, access to care and living conditions. Results Of the study population, 14% were injured annually: gunshot injuries were the leading cause of death. The annual death rate from war injury was 7.8/1000 (95% confidence interval [CI] 7.0–8.5) and the disability rate was 11.3/1000 (95% CI 10.4–12.2). The annual excess injury mortality was 6.85/1000. Only 4.5% of the injured were combatants. Fifty percent of the injured received first aid, but only 13.0% of those who died reached hospital. The injury mortality in Gulu was 8.35-fold greater than that for Mukono. Conclusions The crisis in Gulu can be considered a complex political emergency. Protracted conflicts

  19. Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda

    PubMed Central

    2014-01-01

    Background Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. Methods In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts

  20. The Uganda Newborn Study (UNEST): an effectiveness study on improving newborn health and survival in rural Uganda through a community-based intervention linked to health facilities - study protocol for a cluster randomized controlled trial

    PubMed Central

    2012-01-01

    Background Reducing neonatal-related deaths is one of the major bottlenecks to achieving Millennium Development Goal 4. Studies in Asia and South America have shown that neonatal mortality can be reduced through community-based interventions, but these have not been adapted to scalable intervention packages for sub-Saharan Africa where the culture, health system and policy environment is different. In Uganda, health outcomes are poor for both mothers and newborn babies. Policy opportunities for neonatal health include the new national Health Sector Strategic Plan, which now prioritizes newborn health including use of a community model through Village Health Teams (VHT). The aim of the present study is to adapt, develop and cost an integrated maternal-newborn care package that links community and facility care, and to evaluate its effect on maternal and neonatal practices in order to inform policy and scale-up in Uganda. Methods/Design Through formative research around evidence-based practices, and dialogue with policy and technical advisers, we constructed a home-based neonatal care package implemented by the responsible VHT member, effectively a Community Health Worker (CHW). This CHW was trained to identify pregnant women and make five home visits - two before and three just after birth - so that linkages will be made to facility care and targeted messages for home-care and care-seeking delivered. The project is improving care in health units to provide standardized care for the mother and the newborn in both intervention and comparison areas. The study is taking place in a new Demographic Surveillance Site in two rural districts, Iganga and Mayuge, in Uganda. It is a two-arm cluster randomized controlled design with 31 intervention and 32 control areas (villages). The comparison parishes receive the standard care already being provided by the district, but to the intervention villages are added a system for CHWs to visit the mother five times in her home during

  1. Insect pests of sweetpotato in Uganda: farmers' perceptions of their importance and control practices.

    PubMed

    Okonya, Joshua Sikhu; Mwanga, Robert Om; Syndikus, Katja; Kroschel, Jürgen

    2014-01-01

    Insect pests are among the most important constraints limiting sweetpotato (Ipomoea batatas) production in Africa. However, there is inadequate information about farmers' knowledge, perceptions and practices in the management of key insect pests. This has hindered development of effective pest management approaches for smallholder farmers. A standard questionnaire was used to interview individual sweetpotato farmers (n = 192) about their perception and management practices regarding insect pests in six major sweetpotato producing districts of Uganda. The majority (93%) of farmers perceived insect pests to be a very serious problem. With the exception of Masindi and Wakiso districts where the sweetpotato butterfly (Acraea acerata) was the number one constraint, sweetpotato weevils (Cylas puncticollis and C. brunneus) were ranked as the most important insect pests. Insecticide use in sweetpotato fields was very low being highest (28-38% of households) in districts where A. acerata infestation is the biggest problem. On average, 65% and 87% of the farmers took no action to control A. acerata and Cylas spp., respectively. Farmers were more conversant with the presence of and damage by A. acerata than of Cylas spp. as they thought that Cylas spp. root damage was brought about by a prolonged dry season. Different levels of field resistance (ability of a variety to tolerate damage) of sweetpotato landraces to A. acerata (eight landraces) and Cylas spp. (six landraces) were reported by farmers in all the six districts. This perceived level of resistance to insect damage by landraces needs to be investigated. To improve farmers' capabilities for sweetpotato insect pest management, it is crucial to train them in the basic knowledge of insect pest biology and control. PMID:25279278

  2. The Development of Professional Counseling in Uganda: Current Status and Future Trends

    ERIC Educational Resources Information Center

    Senyonyi, Ruth M.; Ochieng, Lois A.; Sells, James

    2012-01-01

    Professional counseling in Uganda has foundations in traditional cultures of its peoples, guidance offered in schools, and counseling to curb the HIV/AIDS epidemic. Currently, a definitive professional counselor profile in Uganda is being established. The Uganda Counselling Association continues the process of seeking legal authority to regulate…

  3. Uganda: The Challenge of Growth and Poverty Reduction. A World Bank Country Study.

    ERIC Educational Resources Information Center

    World Bank, Washington, DC.

    This report examines the outcomes of economic reform in Uganda and defines issues that Uganda must address in medium- and long-term strategies for poverty reduction. With a per capita income of approximately $220, Uganda is one of the poorest countries in the world. Its economy and social indicators bear the marks of nearly 15 years of political…

  4. School District Mergers: What One District Learned

    ERIC Educational Resources Information Center

    Kingston, Kathleen

    2009-01-01

    Throughout the planning process for a school district merger in a northwestern Pennsylvania school district, effective communication proved to be a challenge. Formed in 1932, this school district of approximately 1400 students was part of a utopian community; one established by a transportation system's corporation that was a major industrial…

  5. Getting closer to people: family planning provision by drug shops in Uganda

    PubMed Central

    Akol, Angela; Chin-Quee, Dawn; Wamala-Mucheri, Patricia; Namwebya, Jane Harriet; Mercer, Sarah Jilani; Stanback, John

    2014-01-01

    ABSTRACT Background: Private-sector drug shops are often the first point of health care in sub-Saharan Africa. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive methods and information is a promising high-impact practice for which more information is needed to fully document implementation experience and impact. Methods: Between September 2010 and March 2011, we trained 139 drug shop operators (DSOs) in 4 districts of Uganda to safely administer intramuscular DMPA (depot medroxyprogesterone acetate) contraceptive injections. In 2012, we approached 54 of these DSOs and interviewed a convenience sample of 585 of their family planning clients to assess clients' contraceptive use and perspectives on the quality of care and satisfaction with services. Finally, we compared service statistics from April to June 2011 from drug shops, community health workers (CHWs), and government clinics in 3 districts to determine the drug shop market share of family planning services. Results: Most drug shop family planning clients interviewed were women with low socioeconomic status. The large majority (89%) were continuing family planning users. DMPA was the preferred contraceptive. Almost half of the drug shop clients had switched from other providers, primarily from government health clinics, mostly as a result of more convenient locations, shorter waiting times, and fewer stock-outs in drug shops. All clients reported that the DSOs treated them respectfully, and 93% trusted the drug shop operator to maintain privacy. Three-quarters felt that drug shops offered affordable family planning services. Most of the DMPA clients (74%) were very satisfied with receiving their method from the drug shop and 98% intended to get the next injection from the drug shop. Between April and June 2011, clinics, CHWs, and drug shops in 3 districts delivered equivalent proportions of couple-years of protection, with drug shops leading marginally at 36

  6. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public... General Provisions § 28.3 Boundaries: The Community Development District; The Dune District; The Seashore... Community Development District, the Seashore District, and the Dune District. (b) The Community...

  7. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public... General Provisions § 28.3 Boundaries: The Community Development District; The Dune District; The Seashore... Community Development District, the Seashore District, and the Dune District. (b) The Community...

  8. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public... General Provisions § 28.3 Boundaries: The Community Development District; The Dune District; The Seashore... Community Development District, the Seashore District, and the Dune District. (b) The Community...

  9. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public... General Provisions § 28.3 Boundaries: The Community Development District; The Dune District; The Seashore... Community Development District, the Seashore District, and the Dune District. (b) The Community...

  10. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public... General Provisions § 28.3 Boundaries: The Community Development District; The Dune District; The Seashore... Community Development District, the Seashore District, and the Dune District. (b) The Community...

  11. A scoping study on task shifting; the case of Uganda

    PubMed Central

    2014-01-01

    Background Task shifting has been implemented in Uganda for decades with little documentation. This study’s objectives were to; gather evidence on task-shifting experiences in Uganda, establish its acceptability and perceptions among health managers and policymakers, and make recommendations. Methods This was a qualitative study. Data collection involved; review of published and gray literature, and key informant interviews of stakeholders in health policy and decision making in Uganda. Data was analyzed by thematic content analysis. Results Task shifting was the mainstay of health service delivery in Uganda. Lower cadre of health workers performed duties of specialized health workers. However, Uganda has no task shifting policy and guidelines, and task shifting was practiced informally. Lower cadre of health workers were deemed to be incompetent to handle shifted roles and already overworked, and support supervision was poor. Advocates of task shifting argued that lower cadre of health workers already performed the roles of highly trained health workers. They needed a supporting policy and support supervision. Opponents argued that lower cadre of health workers were; incompetent, overworked, and task shifting was more expensive than recruiting appropriately trained health workers. Conclusions Task shifting was unacceptable to most health managers and policy makers because lower cadres of health workers were; incompetent, overworked and support supervision was poor. Recruitment of existing unemployed well trained health workers, implementation of human resource motivation and retention strategies, and government sponsored graduates to work for a defined mandatory period of time were recommended. PMID:24754917

  12. Correlates of Depression among Caregivers of Children Affected by HIV/AIDS in Uganda: Findings from the Suubi-Maka Family Study

    PubMed Central

    Ssewamala, Fred M.

    2012-01-01

    This study uses the baseline (wave 1) data from a 4-year (2008-2012) longitudinal study called the Suubi-Maka family economic empowerment intervention for AIDS-orphaned children in Uganda funded by the National Institute of Mental Health (Grant # RMH081763A). Specifically, using baseline data from the Suubi-Maka study, this paper provides a contextualized understanding of depression levels among caregivers for AIDS-orphaned children in two rural communities heavily affected by AIDS in Uganda: Rakai and Masaka districts. Using baseline data collected from caregivers of children orphaned by AIDS (N=297) the study examines the factors that influence reported depression levels of caregivers of AIDS-orphaned children in rural communities of Uganda. We specifically use OLS regression methods. In the analysis we control for several demographic factors, including age, gender, assets, social support, and caregiving status. We find that caregivers’ reported economic status and social support system are highly correlated with caregivers’ reported depression scores. Specifically, caregivers with cash savings and a strong family support system reported better depression scores. These findings have implications for community development practice and programming. Specifically, the study highlights a need for family economic empowerment programs and, strengthened family support among caregivers for AIDS-orphaned children, especially those caregivers with reported poor mental health functioning. PMID:22375826

  13. Correlates of depression among caregivers of children affected by HIV/AIDS in Uganda: findings from the Suubi-Maka family study.

    PubMed

    Kagotho, Njeri; Ssewamala, Fred M

    2012-01-01

    This study uses the baseline (wave 1) data from a four-year (2008-2012) longitudinal study called the Suubi-Maka family economic empowerment intervention for AIDS-orphaned children in Uganda funded by the National Institute of Mental Health (Grant # RMH081763A). Specifically, using baseline data from the Suubi-Maka study, this article provides a contextualized understanding of depression levels among caregivers for AIDS-orphaned children in two rural communities heavily affected by AIDS in Uganda: Rakai and Masaka districts. Using baseline data collected from caregivers of children orphaned by AIDS (N=297) the study examines the factors that influence reported depression levels of caregivers of AIDS-orphaned children in rural communities of Uganda. We specifically use ordinary least squares regression methods. In the analysis we control for several demographic factors, including age, gender, assets, social support, and caregiving status. We find that caregivers' reported economic status and social support system are highly correlated with caregivers' reported depression scores. Specifically, caregivers with cash savings and a strong family support system reported better depression scores. These findings have implications for community development practice and programming. Specifically, the study highlights a need for family economic empowerment programs and, strengthened family support among caregivers for AIDS-orphaned children, especially those caregivers with reported poor mental health functioning. PMID:22375826

  14. Factors influencing modes of transport and travel time for obstetric care: a mixed methods study in Zambia and Uganda.

    PubMed

    Sacks, Emma; Vail, Daniel; Austin-Evelyn, Katherine; Greeson, Dana; Atuyambe, Lynn M; Macwan'gi, Mubiana; Kruk, Margaret E; Grépin, Karen A

    2016-04-01

    Transportation is an important barrier to accessing obstetric care for many pregnant and postpartum women in low-resource settings, particularly in rural areas. However, little is known about how pregnant women travel to health facilities in these settings. We conducted 1633 exit surveys with women who had a recent facility delivery and 48 focus group discussions with women who had either a home or a facility birth in the past year in eight districts in Uganda and Zambia. Quantitative data were analysed using univariate statistics, and qualitative data were analysed using thematic content analysis techniques. On average, women spent 62-68 min travelling to a clinic for delivery. Very different patterns in modes of transport were observed in the two countries: 91% of Ugandan women employed motorized forms of transportation, while only 57% of women in Zambia did. Motorcycle taxis were the most commonly used in Uganda, while cars, trucks and taxis were the most commonly used mode of transportation in Zambia. Lower-income women were less likely to use motorized modes of transportation: in Zambia, women in the poorest quintile took 94 min to travel to a health facility, compared with 34 for the wealthiest quintile; this difference between quintiles was ∼50 min in Uganda. Focus group discussions confirmed that transport is a major challenge due to a number of factors we categorized as the 'three A's:' affordability, accessibility and adequacy of transport options. Women reported that all of these factors had influenced their decision not to deliver in a health facility. The two countries had markedly different patterns of transportation for obstetric care, and modes of transport and travel times varied dramatically by wealth quintile, which policymakers need to take into account when designing obstetric transport interventions. PMID:26135364

  15. Do Maternal Knowledge and Attitudes towards Childhood Immunizations in Rural Uganda Correlate with Complete Childhood Vaccination?

    PubMed Central

    Vonasek, Bryan J.; Bajunirwe, Francis; Jacobson, Laura E.; Twesigye, Leonidas; Dahm, James; Grant, Monica J.; Sethi, Ajay K.; Conway, James H.

    2016-01-01

    Improving childhood vaccination coverage and timeliness is a key health policy objective in many developing countries such as Uganda. Of the many factors known to influence uptake of childhood immunizations in under resourced settings, parents’ understanding and perception of childhood immunizations has largely been overlooked. The aims of this study were to survey mothers’ knowledge and attitudes towards childhood immunizations and then determine if these variables correlate with the timely vaccination coverage of their children. From September to December 2013, we conducted a cross-sectional survey of 1,000 parous women in rural Sheema district in southwest Uganda. The survey collected socio-demographic data and knowledge and attitudes towards childhood immunizations. For the women with at least one child between the age of one month and five years who also had a vaccination card available for the child (N = 302), the vaccination status of this child was assessed. 88% of these children received age-appropriate, on-time immunizations. 93.5% of the women were able to state that childhood immunizations protect children from diseases. The women not able to point this out were significantly more likely to have an under-vaccinated child (PR 1.354: 95% CI 1.018–1.802). When asked why vaccination rates may be low in their community, the two most common responses were “fearful of side effects” and “ignorance/disinterest/laziness” (44% each). The factors influencing caregivers’ demand for childhood immunizations vary widely between, and also within, developing countries. Research that elucidates local knowledge and attitudes, like this study, allows for decisions and policy pertaining to vaccination programs to be more effective at improving child vaccination rates. PMID:26918890

  16. Do Maternal Knowledge and Attitudes towards Childhood Immunizations in Rural Uganda Correlate with Complete Childhood Vaccination?

    PubMed

    Vonasek, Bryan J; Bajunirwe, Francis; Jacobson, Laura E; Twesigye, Leonidas; Dahm, James; Grant, Monica J; Sethi, Ajay K; Conway, James H

    2016-01-01

    Improving childhood vaccination coverage and timeliness is a key health policy objective in many developing countries such as Uganda. Of the many factors known to influence uptake of childhood immunizations in under resourced settings, parents' understanding and perception of childhood immunizations has largely been overlooked. The aims of this study were to survey mothers' knowledge and attitudes towards childhood immunizations and then determine if these variables correlate with the timely vaccination coverage of their children. From September to December 2013, we conducted a cross-sectional survey of 1,000 parous women in rural Sheema district in southwest Uganda. The survey collected socio-demographic data and knowledge and attitudes towards childhood immunizations. For the women with at least one child between the age of one month and five years who also had a vaccination card available for the child (N = 302), the vaccination status of this child was assessed. 88% of these children received age-appropriate, on-time immunizations. 93.5% of the women were able to state that childhood immunizations protect children from diseases. The women not able to point this out were significantly more likely to have an under-vaccinated child (PR 1.354: 95% CI 1.018-1.802). When asked why vaccination rates may be low in their community, the two most common responses were "fearful of side effects" and "ignorance/disinterest/laziness" (44% each). The factors influencing caregivers' demand for childhood immunizations vary widely between, and also within, developing countries. Research that elucidates local knowledge and attitudes, like this study, allows for decisions and policy pertaining to vaccination programs to be more effective at improving child vaccination rates. PMID:26918890

  17. Economic effects of foot and mouth disease outbreaks along the cattle marketing chain in Uganda

    PubMed Central

    Baluka, Sylvia Angubua

    2016-01-01

    Aim: Disease outbreaks increase the cost of animal production; reduce milk and beef yield, cattle sales, farmers’ incomes, and enterprise profitability. The study assessed the economic effects of foot and mouth disease (FMD) outbreaks along the cattle marketing chain in selected study districts in Uganda. Materials and Methods: The study combined qualitative and quantitative study designs. Respondents were selected proportionally using simple random sampling from the sampling frame comprising of 224, 173, 291, and 185 farmers for Nakasongola, Nakaseke, Isingiro, and Rakai, respectively. Key informants were selected purposively. Data analysis combined descriptive, modeling, and regression analysis. Data on the socio-economic characteristics and how they influenced FMD outbreaks, cattle markets revenue losses, and the economic cost of the outbreaks were analyzed using descriptive measures including percentages, means, and frequencies. Results: Farmers with small and medium herds incurred higher control costs, whereas large herds experienced the highest milk losses. Total income earned by the actors per month at the processing level reduced by 23%. In Isingiro, bulls and cows were salvage sold at 83% and 88% less market value, i.e., a loss of $196.1 and $1,552.9 in small and medium herds, respectively. Conclusion: All actors along the cattle marketing chain incur losses during FMD outbreaks, but smallholder farmers are most affected. Control and prevention of FMD should remain the responsibility of the government if Uganda is to achieve a disease-free status that is a prerequisite for free movement and operation of cattle markets throughout the year which will boost cattle marketing. PMID:27397974

  18. Assessment of impact of climate change and adaptation strategies on maize production in Uganda

    NASA Astrophysics Data System (ADS)

    Kikoyo, Duncan A.; Nobert, Joel

    2016-06-01

    Globally, various climatic studies have estimated a reduction of crop yields due to changes in surface temperature and precipitation especially for the developing countries which is heavily dependent on agriculture and lacks resources to counter the negative effects of climate change. Uganda's economy and the wellbeing of its populace depend on rain-fed agriculture which is susceptible to climate change. This study quantified the impacts of climate change and variability in Uganda and how coping strategies can enhance crop production against climate change and/or variability. The study used statistical methods to establish various climate change and variability indicators across the country, and uses the FAO AquaCrop model to simulate yields under possible future climate scenarios with and without adaptation strategies. Maize, the most widely grown crop was used for the study. Meteorological, soil and crop data were collected for various districts representing the maize growing ecological zones in the country. Based on this study, it was found that temperatures have increased by up to 1 °C across much of Uganda since the 1970s, with rates of warming around 0.3 °C per decade across the country. High altitude, low rainfall regions experience the highest level of warming, with over 0.5 °C/decade recorded in Kasese. Rainfall is variable and does not follow a specific significant increasing or decreasing trend. For both future climate scenarios, Maize yields will reduce in excess of 4.7% for the fast warming-low rainfall climates but increase on average by 3.5% for slow warming-high rainfall regions, by 2050. Improved soil fertility can improve yields by over 50% while mulching and use of surface water management practices improve yields by single digit percentages. The use of fertilizer application needs to go hand in hand with other water management strategies since more yields as a result of the improved soil fertility leads to increased water stress, especially

  19. Advancing the application of systems thinking in health: understanding the dynamics of neonatal mortality in Uganda

    PubMed Central

    2014-01-01

    Background Of the three million newborns that die each year, Uganda ranks fifth highest in neonatal mortality rates, with 43,000 neonatal deaths each year. Despite child survival and safe motherhood programmes towards reducing child mortality, insufficient attention has been given to this critical first month of life. There is urgent need to innovatively employ alternative solutions that take into account the intricate complexities of neonatal health and the health systems. In this paper, we set out to empirically contribute to understanding the causes of the stagnating neonatal mortality by applying a systems thinking approach to explore the dynamics arising from the neonatal health complexity and non-linearity and its interplay with health systems factors, using Uganda as a case study. Methods Literature reviews and interviews were conducted in two divisions of Kampala district with high neonatal mortality rates with mothers at antenatal clinics and at home, village health workers, community leaders, healthcare decision and policy makers, and frontline health workers from both public and private health facilities. Data analysis and brainstorming sessions were used to develop causal loop diagrams (CLDs) depicting the causes of neonatal mortality, which were validated by local and international stakeholders. Results We developed two CLDs for demand and supply side issues, depicting the range of factors associated with neonatal mortality such as maternal health, level of awareness of maternal and newborn health, and availability and quality of health services, among others. Further, the reinforcing and balancing feedback loops that resulted from this complexity were also examined. The potential high leverage points include special gender considerations to ensure that girls receive essential education, thereby increasing maternal literacy rates, improved socioeconomic status enabling mothers to keep healthy and utilise health services, improved supervision, and

  20. Conflict of interest: use of pyrethroids and amidines against tsetse and ticks in zoonotic sleeping sickness endemic areas of Uganda

    PubMed Central

    2013-01-01

    Background Caused by trypanosomes and transmitted by tsetse flies, Human African Trypanosomiasis and bovine trypanosomiasis remain endemic across much of rural Uganda where the major reservoir of acute human infection is cattle. Following elimination of trypanosomes by mass trypanocidal treatment, it is crucial that farmers regularly apply pyrethroid-based insecticides to cattle to sustain parasite reductions, which also protect against tick-borne diseases. The private veterinary market is divided between products only effective against ticks (amidines) and those effective against both ticks and tsetse (pyrethroids). This study explored insecticide sales, demand and use in four districts of Uganda where mass cattle treatments have been undertaken by the ‘Stamp Out Sleeping Sickness’ programme. Methods A mixed-methods study was undertaken in Dokolo, Kaberamaido, Serere and Soroti districts of Uganda between September 2011 and February 2012. This included: focus groups in 40 villages, a livestock keeper survey (n = 495), a veterinary drug shop questionnaire (n = 74), participatory methods in six villages and numerous semi-structured interviews. Results Although 70.5% of livestock keepers reportedly used insecticide each month during the rainy season, due to a variety of perceptions and practices nearly half used products only effective against ticks and not tsetse. Between 640 and 740 litres of insecticide were being sold monthly, covering an average of 53.7 cattle/km2. Sales were roughly divided between seven pyrethroid-based products and five products only effective against ticks. In the high-risk HAT district of Kaberamaido, almost double the volume of non-tsetse effective insecticide was being sold. Factors influencing insecticide choice included: disease knowledge, brand recognition, product price, half-life and mode of product action, product availability, and dissemination of information. Stakeholders considered market restriction of non

  1. Assessing the effects of air temperature and rainfall on malaria incidence: an epidemiological study across Rwanda and Uganda.

    PubMed

    Colón-González, Felipe J; Tompkins, Adrian M; Biondi, Riccardo; Bizimana, Jean Pierre; Namanya, Didacus Bambaiha

    2016-01-01

    We investigate the short-term effects of air temperature, rainfall, and socioeconomic indicators on malaria incidence across Rwanda and Uganda from 2002 to 2011. Delayed and nonlinear effects of temperature and rainfall data are estimated using generalised additive mixed models with a distributed lag nonlinear specification. A time series cross-validation algorithm is implemented to select the best subset of socioeconomic predictors and to define the degree of smoothing of the weather variables. Our findings show that trends in malaria incidence agree well with variations in both temperature and rainfall in both countries, although factors other than climate seem to play an important role too. The estimated short-term effects of air temperature and precipitation are nonlinear, in agreement with previous research and the ecology of the disease. These effects are robust to the effects of temporal correlation. The effects of socioeconomic data are difficult to ascertain and require further evaluation with longer time series. Climate-informed models had lower error estimates compared to models with no climatic information in 77 and 60% of the districts in Rwanda and Uganda, respectively. Our results highlight the importance of using climatic information in the analysis of malaria surveillance data, and show potential for the development of climate informed malaria early warning systems. PMID:27063731

  2. Barriers to Condom Use among High Risk Men Who Have Sex with Men in Uganda: A Qualitative Study

    PubMed Central

    Musinguzi, Geofrey; Bastiaens, Hilde; Matovu, Joseph K. B.; Nuwaha, Fred; Mujisha, Geoffrey; Kiguli, Juliet; Arinaitwe, Jim; Van Geertruyden, Jean-Pierre; Wanyenze, Rhoda K.

    2015-01-01

    Background Unprotected sexual intercourse is a major risk factor for HIV transmission. Men who have sex with men (MSM) face challenges in accessing HIV prevention services, including condoms. However, there is limited in-depth assessment and documentation of the barriers to condom use among MSM in sub-Saharan Africa. In this paper, we examine the barriers to condom use among MSM in Uganda. Methods The data for this study were extracted from a larger qualitative study conducted among 85 self-identified adult (>18 years) MSM in 11 districts in Uganda between July and December 2013. Data on sexual behaviours and access and barriers to condom use were collected using semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. This paper presents an analysis of data for 33 MSM who did not use condoms at last sex, with a focus on barriers to condom use. Analysis was conducted using the content analysis approach. Results Six major barriers to condom use were identified: Difficulties with using condoms, access challenges, lack of knowledge and misinformation about condom use, partner and relationship related issues, financial incentives and socio-economic vulnerability, and alcohol consumption. Conclusion The findings suggest that several reasons account for lack of condom use among high-risk MSM. The findings are valuable to inform interventions needed to increase condom use among MSM. PMID:26172374

  3. Risk factors for herd-level bovine-tuberculosis seropositivity in transhumant cattle in Uganda.

    PubMed

    Oloya, J; Muma, J B; Opuda-Asibo, J; Djønne, B; Kazwala, R; Skjerve, E

    2007-08-16

    We investigated the prevalence and risk factors to positive herd-level tuberculin reactivity between October 2003 to May 2004 to bovine tuberculosis (BTB) in the four transhumant districts of Uganda: three districts (Karamoja region) of nomadic transhumance cattle rearing (30 superherds and 1522 cattle), and one district (Nakasongola) of fixed-transhumance (7 herds and 342 cattle). We used the comparative intradermal skin-test, sampled 50 animals per superherd/herd, and considered herd positive if there was at least one reactor. Of the 30 superherds under nomadic transhumance, 60% (95% CI 41.4, 79) were tuberculin-test positive; of the 7 fixed herds, 14.3% (95% CI -20.7, 49.2) were tuberculin test positive. The true herd prevalence was estimated at 46.6%. Many risk factors were collinear. The final multivariable logistic-regression model included: recent introductions from market (OR=3.4; 95% CI 1.1, 10.3), drinking water form mud holes during dry season (OR=49; 95% CI 9.1, 262), and the presence of monkeys (OR=0.08; 95% CI 0.0, 0.6) or warthogs (OR=0.1; 95% CI 0.0, 0.3). No association was found between herd size or number of herd contacts with reactors; it was probably masked by the effect of high between-herd interactions. Provision of water from mud holes in dry river beds and introductions of new animals are risk factors that might be targeted to control BTB in transhumance areas. PMID:17482694

  4. Assessing the implementation of performance management of health care workers in Uganda

    PubMed Central

    2013-01-01

    Background The performance management concept is relatively new to the Ugandan health sector. Uganda has been implementing health sector reforms for nearly two decades. The reforms included the introduction of the results-oriented management in the public sector and the decentralisation of the management of health care workers from central to local governments. This study examined the implementation of performance management of health care workers in order to propose strategies for improvement. Methods The study was a descriptive survey carried out in the Kumi, Mbale, Sironko and Tororo districts and utilising mixed research methodology. A self-administered questionnaire was used to collect quantitative data from the health care workers. A semi-structured interview guide was used to collect qualitative data from the health service managers. The sample for the quantitative method was selected using stratified random sampling. Purposive sampling was used to select health service managers. Quantitative data were analysed using Statistical Package for Social Sciences (version 18.0). Qualitative data were categorised according to the themes and analysed manually. Results The findings show that to some extent performance management is implemented in the health sector; however, there were loopholes in its implementation. There were inadequacies in setting performance targets and performance management planning was hardly done. Although many health care workers had job descriptions, the performance indicators and standards were not clearly defined and known to all workers and managers. Additionally the schedules for performance assessments were not always adhered to. There were limited prospects for career progression, inadequate performance feedback and poor rewarding mechanisms. Conclusions Performance management of health care workers is inadequately done in the districts. Performance management is a key component of attempts to improve health sector outcomes. As a

  5. Knowing hypertension and diabetes: Conditions of treatability in Uganda.

    PubMed

    Whyte, Susan Reynolds

    2016-05-01

    In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology for diagnosing and treating them. The response to the AIDS epidemic in Uganda provides an important context for, and contrast with, the emergence of hypertension and diabetes as social phenomena. Ethnographic fieldwork shows the interplay between experience of these conditions and the political economy of treatability. PMID:26233676

  6. Burden of tuberculosis in Kampala, Uganda.

    PubMed Central

    Guwatudde, David; Zalwango, Sarah; Kamya, Moses R.; Debanne, Sara M.; Diaz, Mireya I.; Okwera, Alphonse; Mugerwa, Roy D.; King, Charles; Whalen, Christopher C.

    2003-01-01

    OBJECTIVE: To determine the prevalence and incidence of tuberculosis in one of Uganda's poor peri-urban areas. METHODS: Multi-stage sampling was used to select a sample of households whose members were evaluated for presence of signs and/or symptoms of active tuberculosis; history of tuberculosis treatment; and relevant demographic, socioeconomic, and household environment characteristics. Patients with suspected tuberculosis underwent standardized evaluation for active disease. FINDINGS: A sample of 263 households with 1142 individuals was evaluated. Nineteen people were classified as having had tuberculosis during the one-year reference period (May 2001-April 2002): nine (47%) cases already had been diagnosed through the health care system, while 10 cases (53%) were diagnosed through the survey. The prevalences for all forms of tuberculosis and for sputum smear-positive tuberculosis were 14.0 (95% confidence interval (CI) 7.8-20.3) and 4.4 (CI = 0.83-7.89) per thousand, respectively. The incidences for all forms of tuberculosis and for sputum smear-positive tuberculosis were 9.2 (CI = 3.97-14.4) and 3.7 (CI = 0.39-6.95) per thousand per year, respectively. CONCLUSION: The rate of tuberculosis in this peri-urban community was exceptionally high and may be underestimated by current surveillance systems. The need for interventions aimed at reducing tuberculosis transmission in this, and other similar communities with high case rates, is urgent. PMID:14758406

  7. Birthing choices among the Sabiny of Uganda.

    PubMed

    Kwagala, Betty

    2013-01-01

    The paper examines maternal health-seeking behaviour among the Sabiny people of Eastern Uganda in relation to health policy ideals. It is based on a study of maternal health conducted between 2011 and 2012. Data were collected using in-depth interviews with mothers, focus group discussions with mothers and fathers and key informant interviews. The paper addresses what factors influence choice of place of delivery among the Sabiny. Findings reveal that the majority of Sabiny women opt for homebirths, with around one quarter delivering at health facilities. Some women would prefer to deliver at a health facility but do not manage to do so. Sabiny cultural beliefs and practices are a key factor influencing choice of place of birth. Comprehension of and accommodation to Sabiny concerns in available maternal health services is limited, highlighting the need to develop cultural competence among health workers and methods of accommodating (health-promoting) local practices. This should be accompanied by improved patient care and a narrowing of the gap between health workers and Sabiny communities by promoting outreach and community-based health interventions. The paper highlights how the implementation of policy might be tailored to specific local contexts. PMID:23777358

  8. The enigmatic nodding syndrome outbreak in northern Uganda: an analysis of the disease burden and national response strategies.

    PubMed

    Deogratius, Mwaka Amos; David, Kitara Lagoro; Christopher, Orach Garimoi

    2016-04-01

    To date, the cause of nodding syndrome (NS) remains unknown; however, efforts continue to establish risk factors and optimal symptomatic treatments. We documented the burden and national response strategies including involvement of key stakeholders in the management of the NS epidemic in order to inform future interventions against epidemics of undetermined aetiology. Data were collected through semi-structured interviews with selected leaders in the affected districts and at the Ministry of Health, and through review of documents. We participated in and analysed the proceedings of the first international scientific conference on NS held in Kampala in August 2012. We then analysed the chronology of the NS notification and the steps undertaken in the response plan. Over 3000 children have been affected by NS in northern Uganda; with an estimated case fatality of 6.7%. The first cases of NS were reported in 1997 in internally displaced people's camps in Kitgum district; however, response efforts by the Ministry of Health and partners towards understanding the disorder and establish management only commenced in 2009. Key strategies in response to the NS epidemic have included formation of a national and district task forces, development of training manual on NS and training of primary healthcare professionals on case diagnosis and clinical management, establishment of treatment and rehabilitation centres, surveillance and promotion of researches to further inform management of the syndrome. PMID:26116916

  9. Introducing malaria rapid diagnostic tests at registered drug shops in Uganda: limitations of diagnostic testing in the reality of diagnosis.

    PubMed

    Chandler, Clare I R; Hall-Clifford, Rachel; Asaph, Turinde; Pascal, Magnussen; Clarke, Siân; Mbonye, Anthony K

    2011-03-01

    In Uganda, around two thirds of medicines are procured from the private sector, mostly from drug shops. The introduction of malaria rapid diagnostic tests (RDTs) at drug shops therefore has the potential to make a significant contribution to targeting antimalarial drugs to those with malaria parasites. We undertook formative research in a district in Uganda in preparation for a randomised trial of RDTs in drug shops. In May to July 2009, we interviewed 9 drug shop workers, 5 health workers and 4 district health officials and carried out 10 focus group discussions with a total of 75 community members to investigate the role of drug shops and the potential for implementation of RDTs at these health care outlets. Drug shops were seen to provide an important service to community members, the nature of which is determined by responsiveness to client demands. However, drug shops hold a liminal status: in the eyes of different actors, these outlets are at once a shop and clinic; legitimate and illegitimate; and trusted and distrusted. Malaria treatment was found to be synonymous with diagnosis. Diagnostic testing was deemed useful in theory, and community members were curious about the results, with the expectation that a test would decrease uncertainty and help secure an end to illness. However, whether testing would be sought as a routine step in treatment decisions in practice is uncertain, since the appeal of the tests waned in light of their costs and potential for results to conflict with presumed diagnosis. Interventions that increase awareness of multiple causes and management of malaria-like illness will be needed to support the new rationalisation for malaria treatment represented by parasitological diagnosis. PMID:21349623

  10. Introducing malaria rapid diagnostic tests at registered drug shops in Uganda: Limitations of diagnostic testing in the reality of diagnosis.

    PubMed Central

    Hall-Clifford, Rachel; Asaph, Turinde; Magnussen, Pascal; Clarke, Siân; Mbonye, Anthony K

    2014-01-01

    In Uganda, around two thirds of medicines are procured from the private sector, mostly from drug shops. The introduction of malaria rapid diagnostic tests (RDTs) at drug shops therefore has the potential to make a significant contribution to targeting antimalarial drugs to those with malaria parasites. We undertook formative research in a district in Uganda in preparation for a randomised trial of RDTs in drug shops. In May to July 2009, we interviewed 9 drug shop workers, 5 health workers and 4 district health officials and carried out 10 focus group discussions with a total of 75 community members to investigate the role of drug shops and the potential for implementation of RDTs at these health care outlets. Drug shops were seen to provide an important service to community members, the nature of which is determined by responsiveness to client demands. However, drug shops hold a liminal status: in the eyes of different actors, these outlets are at once a shop and clinic; legitimate and illegitimate; and trusted and distrusted. Malaria treatment was found to be synonymous with diagnosis. Diagnostic testing was deemed useful in theory, and community members were curious about the results, with the expectation that a test would decrease uncertainty and help secure an end to illness. However, whether testing would be sought as a routine step in treatment decisions in practice is uncertain, since the appeal of the tests waned in light of their costs and potential for results to conflict with presumed diagnosis. Interventions that increase awareness of multiple causes and management of malaria-like illness will be needed to support the new rationalisation for malaria treatment represented by parasitological diagnosis. PMID:21349623

  11. SCALABLE AND SUSTAINABLE WATER HARVESTING IN RURAL UGANDA

    EPA Science Inventory

    Burgeoning population growth and declining natural sources of fish in the sub-Saharan Africa is driving an unsustainable destruction of wetlands and riparian buffers. Fish farming in Uganda is predominantly practiced by poor people in villages for subsistence with ponds of...

  12. Indigenous Adaptation: Uganda's Village Schools, ca. 1880-1937

    ERIC Educational Resources Information Center

    Hanson, Holly Elisabeth

    2010-01-01

    In Uganda, the implementation of universal primary education (UPE) in 1997 and universal secondary education (USE) in 2005 have led educational policy makers, teachers, parents, and students to seek creative solutions to the problem of ensuring educational quality as schools incorporate 4 million more students. Some Ugandans worry about…

  13. Universal Secondary Education in Uganda: The Head Teachers' Dilemma

    ERIC Educational Resources Information Center

    Chapman, David W.; Burton, Lisa; Werner, Jessica

    2010-01-01

    Uganda has received considerable international attention for being the first and, to date, only African country to adopt a policy of free universal secondary education (USE). However, the policy was adopted with little attention to system capacity or involvement of secondary head teachers, even though there is considerable research documenting the…

  14. Higher Education Research in Uganda: Problems and Prospects

    ERIC Educational Resources Information Center

    Owoeye, J. S.; Oyebade, S. A.

    2010-01-01

    Research is regarded as essential for development and the application of new knowledge for the benefit of society. Higher education in Uganda has expanded rapidly in the last 20 years. Universities have become the most important institutions in the achievement of national and international goals in enhancing the quality of life, wealth creation,…

  15. Environmental Education in the Formal Sector of Education in Uganda.

    ERIC Educational Resources Information Center

    Mucunguzi, P.

    1995-01-01

    Provides a critical review of the present state of environmental education in the formal sector of education in Uganda. Recommends an improved approach to formal environmental education based on a multidisciplinary foundation that embraces the biophysical environment, people, culture, politics, and socioeconomic systems. (LZ)

  16. A Review of Non-formal Environmental Education in Uganda.

    ERIC Educational Resources Information Center

    Mucunguzi, Patrick

    1995-01-01

    Reviews contemporary environmental education in Uganda. Presents a new approach that emphasizes the adoption of multidisciplinary, interdisciplinary, people-centered, and participatory programs in environmental concerns. Embraces the diversity of the biophysical, social, and economic environments and is closely associated with permanent…

  17. Christianity and Rural Community Literacy Practices in Uganda

    ERIC Educational Resources Information Center

    Openjuru, George Ladaah; Lyster, Elda

    2007-01-01

    In this article, we examine how Christianity provides the impetus for local literacy practices in a rural community in Uganda. These Christian literacy practices form a central part of the literacy activities of the community and are manifested in a variety of contexts from public to private, using a wide variety of readily available religious…

  18. Conservation and Education in Murchison Falls Conservation Area, Uganda

    ERIC Educational Resources Information Center

    Jordahl, Mark D.

    2005-01-01

    This thesis forms the foundation for a conservation education training manual to help guides in Murchison Falls National Park, Uganda, communicate to foreign visitors about conservation issues. For background information I used a combination of text-based research and interviews to examine the application of community conservation and…

  19. Successful Community Nutrition Programming: Lessons from Kenya, Tanzania, and Uganda.

    ERIC Educational Resources Information Center

    Iannotti, Lora; Gillespie, Stuart

    This report on the key findings from a series of assessments of successful community nutrition programming conducted in Kenya, Tanzania, and Uganda between 1999 and 2000. The aim of the assessments was to identify key lessons learned from the successful processes and outcomes in these programs. The report is divided into eight chapters: (1)…

  20. Uganda: Social Sectors. A World Bank Country Study.

    ERIC Educational Resources Information Center

    World Bank, Washington, DC.

    The objective of this report was to assist the Ugandan government in considering how its intended improvement in social services can be achieved over the decade of the 1990s. Part 1 provides the necessary background. Chapter 1 illustrates in which areas, and to what extent, Uganda is in a social deficit situation in comparison with other African…

  1. Interview with Jacques Bwira Hope Primary School Kampala, Uganda

    ERIC Educational Resources Information Center

    Harvard Educational Review, 2009

    2009-01-01

    Jacques Bwira arrived in Uganda in 2000, having fled the violent conflict in his native country, the Democratic Republic of Congo. Though he had trained and worked as a teacher in Congo, he feared that speaking only French would prevent him from making a living in his new home. The police officer who interrogated Jacques on arrival in the capital…

  2. Designing for action: adapting and implementing a community-based newborn care package to affect national change in Uganda

    PubMed Central

    Waiswa, Peter; Namazzi, Gertrude; Kerber, Kate; Peterson, Stefan

    2015-01-01

    Background There is a lack of literature on how to adapt new evidence-based interventions for maternal and newborn care into local health systems and policy for rapid scale-up, particularly for community-based interventions in low-income settings. The Uganda Newborn Study (UNEST) was a cluster randomised control trial to test a community-based care package which was rapidly taken up at national level. Understanding this process may help inform other studies looking to design and evaluate with scale-up in mind. Objective This study aimed to describe the process of using evidence to design a community-based maternal and newborn care package in rural eastern Uganda, and to determine the dissemination and advocacy approaches used to facilitate rapid policy change and national uptake. Design We reviewed UNEST project literature including meeting reports and minutes, supervision reports, and annual and midterm reports. National stakeholders, project and district staff were interviewed regarding their role in the study and perceptions of what contributed to uptake of the package under evaluation. Data related to UNEST formative research, study design, implementation and policy influence were extracted and analysed. Results An advisory committee of key players in development of maternal and newborn policies and programmes in Uganda was constituted from many agencies and disciplines. Baseline qualitative and quantitative data collection was done at district, community and facility level to examine applicability of aspects of a proposed newborn care package to the local setting. Data were summarised and presented to stakeholders to adapt the intervention that was ultimately tested. Quarterly monitoring of key activities and events around the interventions were used to further inform implementation. The UNEST training package, home visit schedule and behaviour change counselling materials were incorporated into the national Village Health Team and Integrated Community Case

  3. An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda

    PubMed Central

    2013-01-01

    Background Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Methods Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. Results The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and

  4. Comparison of HIV-related vulnerabilities between former child soldiers and children never abducted by the LRA in northern Uganda

    PubMed Central

    2013-01-01

    Background Thousands of former child soldiers who were abducted during the prolonged conflict in northern Uganda have returned to their home communities. Programmes that facilitate their successful reintegration continue to face a number of challenges. Although there is increasing knowledge of the dynamics of HIV infection during conflict, far less is known about its prevalence and implications for population health in the post-conflict period. This study investigated the effects of abduction on the prevalence of HIV and HIV-risk behaviours among young people in Gulu District, northern Uganda. An understanding of abduction experiences and HIV-risk behaviours is vital to both the development of effective reintegration programming for former child soldiers and the design of appropriate HIV prevention interventions for all young people. Methods In 2010, we conducted a cross-sectional study of 2 sub-counties in Gulu District. A demographic and behavioural survey was interview-administered to a purposively selected sample of 384 transit camp residents aged 15–29. Biological specimens were collected for HIV rapid testing in the field and confirmatory laboratory testing. Descriptive statistics were used to describe characteristics of abduction. Additionally, a gender-stratified bivariate analysis compared abductees’ and non-abductees’ HIV risk profiles. Results Of the 384 participants, 107 (28%) were former child soldiers (61% were young men and 39% were young women). The median age of participants was 20 and median age at abduction was 13. HIV prevalence was similar among former abductees and non-abductees (12% vs. 13%; p = 0.824), with no differences observed by gender. With respect to differences in HIV vulnerability, our bivariate analysis identified greater risky sexual behaviours in the past year for former abductees than non-abductees, but there were no differences between the two groups’ survival/livelihood activities and food insufficiency experiences

  5. District cooling in Scandinavia

    SciTech Connect

    Andersson, B.

    1996-11-01

    This paper will present the status of the development of district cooling systems in Scandinavia over the last 5 years. It will describe the technologies used in the systems that have been constructed as well as the options considered in different locations. It will identify the drivers for the development of the cooling business to-date, and what future drivers for a continuing development of district cooling in Sweden. To-date, approximately 25 different cities of varying sizes have completed feasibility studies to determine if district cooling is an attractive option. In a survey, that was conducted by the Swedish District Heating Association, some 25 cities expected to have district cooling systems in place by the year 2000. In Sweden, district heating systems with hot water is very common. In many cases, it is simply an addition to the current service for the district heating company to also supply district cooling to the building owners. A parallel from this can be drawn to North America where district cooling systems now are developing rapidly. I am convinced that in these cities a district heating service will be added as a natural expansion of the district cooling company`s service.

  6. Family structure effects on early sexual debut among adolescent girls in Rakai, Uganda

    PubMed Central

    Pilgrim, Nanlesta A.; Ahmed, Saifuddin; Gray, Ronald H.; Sekasanvu, Joseph; Lutalo, Tom; Nalugoda, Fred; Serwadda, David; Wawer, Maria J.

    2013-01-01

    This study assessed the association between household family structure and early sexual debut among adolescent girls, ages 15-19, in rural Rakai District, Uganda. Early sexual debut is associated with detrimental physical, emotional and social outcomes, including increased risk of HIV. However, research on the family's role on adolescents' sexual risk behaviors in sub-Sahara Africa has been minimal and rarely takes into account the varying family structures within which African adolescents develop. Using six rounds of survey data (2001-2008) from the Rakai Community Cohort Study, unmarried adolescent girls (n=1940) aged 15-17 at their baseline survey, were followed until age 19. Parametric survival models showed that compared to adolescent girls living with both biological parents, girls who headed their own household and girls living with step-fathers, grandparents, siblings, or other relatives had significantly higher hazards of early sexual debut before age 16. Adolescent girls were significantly more likely to debut sexually if neither parent resided in the household, either due to death or other reasons. In addition, absence of the living biological father from the home was associated with higher risk of sexual debut, regardless of the biological mother's presence in the home. Our study's findings suggest that family structure is important to adolescent girls' sexual behavior. There is need for research to understand the underlying processes, interactions and dynamics of both low and high risk family structures in order to devise and strategically target interventions targeted for specific types of family structures. PMID:25317199

  7. Increasing access to quality health care for the poor: Community perceptions on quality care in Uganda

    PubMed Central

    Kiguli, Julie; Ekirapa-Kiracho, Elizabeth; Okui, Olico; Mutebi, Aloysius; MacGregor, Hayley; Pariyo, George William

    2009-01-01

    This paper examines the community’s perspectives and perceptions on quality of health care delivery in two Uganda districts. The paper addresses community concerns on service quality. It focuses on the poor because they are a vulnerable group and often bear a huge burden of disease. Community views were solicited and obtained using eight focus group discussions, six in-depth and 12 key informant interviews. User perceptions and definitions of the quality of health services depended on a number of variables related to technical competence, accessibility to services, interpersonal relations and presence of adequate drugs, supplies, staff, and facility amenities. Results indicate that service delivery to the poor in the general population is perceived to be of low quality. The factors that were mentioned as affecting the quality of services delivered were inadequate trained health workers, shortage of essential drugs, poor attitude of the health workers, and long distances to health facilities. This paper argues that there should be an improvement in the quality of health services with particular attention being paid to the poor. Despite wide focus on improvement of the existing infrastructure and donor funding, there is still low satisfaction with health services and poor perceived accessibility. PMID:19936148

  8. Labia minora elongation as understood by Baganda male and female adolescents in Uganda.

    PubMed

    Martínez Pérez, Guillermo; Namulondo, Harriet; Tomás Aznar, Concepción

    2013-01-01

    Labia minora elongation is a common traditional female genital modification practice among the members of the Baganda ethnic group in Uganda. In 2002, a study carried out by the Padua Working Group on Female Genital Mutilation analysed how Baganda girls residing in Wakiso District graphically represented their experiences of labia minora elongation. In the present study, using the same methodology and in the same geographic setting 10 years later, we asked young men and women to prepare graphical representations of this rite. The purpose was to learn about how the practice is perceived and represented, describing the differences found in their testimonies, and comparing the findings with the former study. A total of 36 respondents (21 male and 15 female), aged between 9 and 15 years old participated in the study. The drawings were analysed using a three-themes analysis frame with a focus on setting, subject and operator. Differences were detected between how young women and men represented this practice. Educational interventions may be helpful to address the doubts, concerns, anxieties and misconceptions that Baganda youth may have concerning traditional genital practices. PMID:23905946

  9. Antiretroviral therapy and changing patterns of HIV stigmatisation in Entebbe, Uganda.

    PubMed

    Russell, Steve; Zalwango, Flavia; Namukwaya, Stella; Katongole, Joseph; Muhumuza, Richard; Nalugya, Ruth; Seeley, Janet

    2016-01-01

    Antiretroviral therapy (ART) has the potential to change processes of HIV stigmatisation. In this article, changing processes of stigmatisation among a group of people living with HIV (PLWH) on ART in Wakiso District, Uganda, are analysed using qualitative data from a study of PLWH's self-management of HIV on ART. There were 38 respondents (20 women, 18 men) who had been taking ART for at least 1 year. They were purposefully selected from government and non-government ART providers. Two in-depth interviews were held with each participant. Processes of reduced self-stigmatisation were clearly evident, caused by the recovery of their physical appearance and support from health workers. However most participants continued to conceal their status because they anticipated stigma; for example, they feared gossip, rejection and their status being used against them. Anticipated stigma was gendered: women expressed greater fear of enacted forms of stigma such as rejection by their partner; in contrast men's fears focused on gossip, loss of dignity and self-stigmatisation. The evidence indicates that ART has not reduced underlying structural drivers of stigmatisation, notably gender identities and inequalities, and that interventions are still required to mitigate and tackle stigmatisation, such as counselling, peer-led education and support groups that can help PLWH reconstruct alternative and more positive identities. A video abstract of this article can be found at: https://youtu.be/WtIaZJQ3Y_8. PMID:26382288

  10. Knowledge and Practices of In-Home Pesticide Use: A Community Survey in Uganda

    PubMed Central

    Nalwanga, Eva; Ssempebwa, John C.

    2011-01-01

    Many communities in low-income countries use in-home pesticides for the control of pests. Such use is often inadequately controlled. In this study, 100 households in Kireka ward, Wakiso district in Uganda were involved in a cross-sectional survey to assess pests, knowledge, and use patterns of pesticides. A structured pretested questionnaire was administered via personal interviews, and observational checklists were used. Mosquitoes were the most prevalent pests (83%), followed by cockroaches (69%) and rats (52%). Pesticides were the most preferred method for pest control (98%), with insecticide spray being the most common form of application (71.4%). Pesticide application was inappropriately done in many households mainly due to inadequate knowledge on use. Only 48% of the respondents read manufacturer's instructions for use. Information on what pesticide to use was obtained from friends (53.1%), points of sales (48%). Educational interventions particularly at points of sale would be a critical avenue for promoting safe use of pesticides in households. PMID:21776435

  11. Seismicity of the Rwenzori Region, Western Uganda

    NASA Astrophysics Data System (ADS)

    Lindenfeld, M.; Rümpker, G.; Schumann, A.; Woelbern, I.

    2008-12-01

    The 5000m high Rwenzori Mountains are situated within the western branch of the East African Rift System (EARS), close to the equator at the border between Uganda and the Democratic Republic of Congo. They represent a basement block within the rift whose origin and relation to the development of the EARS are focus of the RiftLink project (www.riftlink.org). To investigate crustal and upper mantle structure in conjunction with seismic activity on a regional and local scale, a temporary seismic network was deployed over an area of roughly 80 x 140 km and operated from May 2006 to the end of September 2007. The analysis of the registered data revealed high microseismic activity in the region. On average more than 800 events per month were located during the registration period with local magnitudes ranging from -0.5 up to 5.1. Few earthquakes are located within the Rwenzori massive itself. Most of the events occur east and west of the mountains with a pronounced concentration of activity at a depth of about 15 km. Vertical sections across the northern parts of the Rwenzories show, that west of the mountains (towards the rift valley) the focal depths range from 10 to 20 km, whereas the hypocenters go as deep as 30 km on the eastern side. This is in good agreement with Moho depths that were derived from receiver functions and are close to 22 km west and 30 km east of the Rwenzories. There is one exception, however. Approximately 30 km east of the northern mountain ridge, we located a cluster of 7 events exhibiting an anomalous depth of about 60 km that occurred within 20 days in September 2006. These events are unique, up to now we located no other earthquakes at similar depths. P-wave polarities were used to determine fault plane solutions of events that were recorded by an adequate number of stations. Nearly all source mechanisms reveal normal faulting with strike directions more or less parallel to the rift axis and extension forces perpendicular to it. However

  12. Prevalence of Pulmonary Tuberculosis among Prison Inmates at Mbarara Central Prison, South Western Uganda

    PubMed Central

    Owokuhaisa, Judith; Thokerunga, Eric; Bazira, Joel

    2015-01-01

    Aims This study was conducted to determine the prevalence of tuberculosis among prison inmates at Mbarara Central prison Design A cross sectional study was carried out at Mbarara Central Prison in Mbarara district, Kiswahili cell in Mbarara municipality among female and male prison in mates between June 2012 to August 2012. A questionnaire was administered to each prison inmate who consented in writing and two sputum specimens were collected and examined by Ziehl-Neelsen technique. Results At the time of the study, the prison had 900 inmates (both males and females). A total of 648 in mates were screened and 248 inmates enrolled in the study. Of the 248 inmates, 5 inmates were new cases of TB while 29 inmates were already on TB treatment. The median age of participants was 28 years (23.5-33 IQR) and 96.4% were males with majority (22.6%) coming from Mbarara as a home district. The participants had stayed in prison for a median duration of 2 years (1-3 IQR) and 23.7% had ever been in prison before. The median number of inmates per cell was 140 (138-149 IQR) and inmates (female and male) had a body mass index of 21.4 (19.9-22.6 IQR) and 20.2 (19.2-26.7 IQR) respectively. Of the inmates evaluated, 68.8% reported cough for 2 or more weeks. Other symptoms reported were weight loss (in 40.7%) and night sweats (in 35.8%). Of the 248 inmates evaluated, 95 inmates were tested for HIV and 4.1% were HIV serology positive. Conclusion The prevalence of TB in Mbarara Central prison South Western Uganda is low but calls for continued surveillance through regular TB screening. PMID:26949722

  13. Experiences of Sexual Coercion among Adolescent Women: Qualitative Findings from Rakai District, Uganda

    ERIC Educational Resources Information Center

    Wagman, Jennifer; Baumgartner, Joy Noel; Waszak Geary, Cindy; Nakyanjo, Neema; Ddaaki, William George; Serwadda, David; Gray, Ron; Nalugoda, Fred Kakaire; Wawer, Maria J.

    2009-01-01

    Limited data from low-income countries are available on the continuum of coercive experiences, the contexts in which they occur, and how adolescent women perceive and respond to coercion. This article presents results from focus group discussions and in-depth interviews with pregnant and never pregnant sexually active female adolescents, aged 15…

  14. Motivational Practices and Teachers' Performance in Jinja Municipality Secondary Schools, Jinja District, Uganda

    ERIC Educational Resources Information Center

    Justine, Nairuba

    2011-01-01

    The purpose of the study was to establish the effect of provision of fringe benefits and the nature of working conditions under motivational practices on teachers' performance in secondary schools. The study was qualitative and quantitative; and descriptive-correlation research design was used in the study. The researcher used purposive and simple…

  15. Active seeps, investment climate draw interest to Uganda

    SciTech Connect

    Patton, D.K.; Kashambuzi, R.; Rubondo, E.N.T.

    1995-05-01

    Production has not been established in Uganda, but the hydrocarbon generating capacity of its rift basin is clearly evident. Reports of oil seeps date to 1925 to observations by Wayland; who relates 52 hydrocarbon occurrences in and around Lake Albert. Although not all remain active, nine oil seeps in the rift basin are confirmed active at present. The Albertine graben, a part of the East African rift system, dominates the geology of Uganda. Other, larger basins of similar evolution in Africa include the Sirte basin and the Gulf of Suez basin. These prolific basins account for one third of Africa`s total reserves. The paper describes the geologic setting, reservoirs, source rocks, geologic seals, structures, exploration history, licenses available, and fiscal terms.

  16. The Role of Astronomy in Development: The Case of Uganda

    NASA Astrophysics Data System (ADS)

    Jurua, Edward

    2015-08-01

    Science and technology play a key role in economic development; and Universities have a direct stake in this process. A knowlwdge based ecomony requires scientific and technological expertise which are both strongly influenced by the strength of training in science and technology. However, in Uganda not many students opt for science subject at higher levels, and subsquently in the University. Therefore, there is need to encourage and motivate students to study science subjects in order for this to be successful. This can be achieved through introduction of stimulating subjects such as astronomy in the university curriculum. Astronomy is considered as the most appealing subject and an excellent tool for conveying scientific knowledge to young students. In this paper, the role astromony has played to motivate and interest students to study physics in Mbarara University of Science and Technology, in Uganda, is discussed.

  17. Soil Quality and Human Migration in Kenya and Uganda

    PubMed Central

    Gray, Clark L.

    2011-01-01

    Soil degradation is widely considered to be a key factor undermining agricultural livelihoods in the developing world and contributing to rural out-migration. To date, however, few quantitative studies have examined the effects of soil characteristics on human migration or other social outcomes for potentially vulnerable households. This study takes advantage of a unique longitudinal survey dataset from Kenya and Uganda containing information on household-level soil properties to investigate the effects of soil quality on population mobility. Random effects multinomial logit models are used to test for effects of soil quality on both temporary and permanent migration while accounting for a variety of potential confounders. The analysis reveals that soil quality significantly reduces migration in Kenya, particularly for temporary labor migration, but marginally increases migration in Uganda. These findings are consistent with several previous studies in showing that adverse environmental conditions tend to increase migration but not universally, contrary to common assumptions about environmentally-induced migration. PMID:22016577

  18. Rural sanitation problems in Uganda--institutional and management aspects.

    PubMed

    Mukungu, D M

    2000-01-01

    Rural Uganda faces a lot of problems caused by poor sanitation facilities such as pollution of water sources, a high rate of waterborne diseases, high expenditures on curative health care, and the threat of reduced educational performance of children through illness, early school drop out, especially of girls. Limited budgets and expenditures for the health sector, lack of staff, lack of accountability and transparency are important factors affecting sanitation status on the national level. Other restrictions can be found at the community level, e.g. taboos, cultural and customary beliefs, ignorance, poverty, or in soil conditions. To address the poor level of sanitation, the Government of Uganda has set up both a whole string of laws and guidelines and an institutional and management framework. One main emphasis was placed on the Participatory Hygiene and Sanitation Transformation Programme (PHAST) introduced in 1994 and since then adopted by several non-governmental organisations (NGO's). PMID:10842841

  19. Patterns and predictors of violence against children in Uganda: a latent class analysis

    PubMed Central

    Clarke, Kelly; Patalay, Praveetha; Allen, Elizabeth; Knight, Louise; Naker, Dipak; Devries, Karen

    2016-01-01

    Objective To explore patterns of physical, emotional and sexual violence against Ugandan children. Design Latent class and multinomial logistic regression analysis of cross-sectional data. Setting Luwero District, Uganda. Participants In all, 3706 primary 5, 6 and 7 students attending 42 primary schools. Main outcome and measure To measure violence, we used the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool—Child Institutional. We used the Strengths and Difficulties Questionnaire to assess mental health and administered reading, spelling and maths tests. Results We identified three violence classes. Class 1 (N=696 18.8%) was characterised by emotional and physical violence by parents and relatives, and sexual and emotional abuse by boyfriends, girlfriends and unrelated adults outside school. Class 2 (N=975 26.3%) was characterised by physical, emotional and sexual violence by peers (male and female students). Children in Classes 1 and 2 also had a high probability of exposure to emotional and physical violence by school staff. Class 3 (N=2035 54.9%) was characterised by physical violence by school staff and a lower probability of all other forms of violence compared to Classes 1 and 2. Children in Classes 1 and 2 were more likely to have worked for money (Class 1 Relative Risk Ratio 1.97, 95% CI 1.54 to 2.51; Class 2 1.55, 1.29 to 1.86), been absent from school in the previous week (Class 1 1.31, 1.02 to 1.67; Class 2 1.34, 1.10 to 1.63) and to have more mental health difficulties (Class 1 1.09, 1.07 to 1.11; Class 2 1.11, 1.09 to 1.13) compared to children in Class 3. Female sex (3.44, 2.48 to 4.78) and number of children sharing a sleeping area predicted being in Class 1. Conclusions Childhood violence in Uganda forms distinct patterns, clustered by perpetrator and setting. Research is needed to understand experiences of victimised children, and to develop mental health interventions for those with severe violence

  20. Determinants of personal demand for an AIDS vaccine in Uganda: contingent valuation survey.

    PubMed Central

    Bishai, David; Pariyo, George; Ainsworth, Martha; Hill, Kenneth

    2004-01-01

    OBJECTIVE: To assess the factors affecting demand for an HIV/AIDS vaccine among adults in their prime earning and childbearing years and the impact of vaccination on risk behaviour in a high-prevalence, low-income country. METHODS: A contingent valuation survey of 1677 adults aged 18-60 years was conducted in 12 districts in Uganda. Respondents were asked about a hypothetical vaccine to prevent HIV infection. Households were randomly assigned survey questionnaires with one of two levels of vaccine efficacy (50% or 95%) and one of five prices. The influence of demographic characteristics, vaccine efficacy, self-assessed risk of infection, price, and household assets on vaccine demand was assessed using multivariate regression analysis. FINDINGS: Altogether, 94% (1576/1677) of respondents would be willing to be vaccinated with a free HIV/AIDS vaccine; 31% (78/251) would not be willing to be vaccinated at a price of 5000 Ugandan shillings (2.86 U.S. dollars). Household wealth, vaccine price, and risk behaviour were significant determinants of individual demand. Demand was equally high for both low-efficacy and high-efficacy vaccines. Respondents believed that condom use would be slightly less necessary with a high-efficacy vaccine (655/825; 79.4%) than a low-efficacy vaccine (690/843; 81.8%). However, reported condom use with partners other than spouses in the absence of a vaccine was much lower (137/271; 50.6%), with 26% (175/670) of men and 9.5% (96/1007) of women reporting having had partners other than their spouses during the past year. CONCLUSION: The high demand for an AIDS vaccine of any level of efficacy can be explained by the heavy toll of AIDS in Uganda: 72% (990/1371) of respondents had lost a family member to the disease. An AIDS vaccine would be self-targeting: those with a greater chance of becoming infected and spreading HIV would be more likely to seek a vaccine, improving the efficiency of vaccination programmes. However,,high levels of risk

  1. Uptake of Mass Drug Administration Programme for Schistosomiasis Control in Koome Islands, Central Uganda

    PubMed Central

    Tuhebwe, Doreen; Bagonza, James; Kiracho, Elizabeth Ekirapa; Yeka, Adoke; Elliott, Alison M.; Nuwaha, Fred

    2015-01-01

    Introduction Schistosomiasis is one of the neglected tropical diseases targeted for elimination in Uganda through the Mass Drug Administration (MDA) programme. Praziquantel has been distributed using community resource persons in fixed sites and house-to-house visits; however the uptake is still below target coverage. In 2011/2012 MDA exercise, uptake stood at 50% yet WHO target coverage is 75% at community level. We assessed the uptake of MDA and the associated factors in Koome Islands, Central Uganda. Methods In March 2013, we conducted a mixed methods cross sectional study in 15 randomly selected villages. We interviewed a total of 615 respondents aged 18 years and above using semi structured questionnaires and five key informants were also purposively selected. Univariate and multivariate analysis was done. MDA uptake was defined as self reported swallowing of praziquantel during the last (2012) MDA campaign. We conducted key informant interviews with Ministry of Health, district health personnel and community health workers. Results Self reported uptake of praziquantel was 44.7% (275/615), 95% confidence interval (CI) 40.8–48.7%. Of the 275 community members who said they had swallowed praziquantel, 142 (51.6%) reported that they had developed side effects. Uptake of MDA was more likely if the respondent was knowledgeable about schistosomiasis transmission and prevention (adjusted odds ratio [AOR] 1.85, 95% CI 1.22–2.81) and reported to have received health education from the health personnel (AOR 5.95, 95% CI 3.67–9.65). Service delivery challenges such as drug shortages and community health worker attrition also influenced MDA in Koome Islands. Conclusions Uptake of MDA for schistosomiasis control in Koome was sub optimal. Lack of knowledge about schistosomiasis transmission and prevention, inadequate health education and drug shortages are some of the major factors associated with low uptake. These could be addressed through routine health education

  2. Animal Reservoirs of Zoonotic Tungiasis in Endemic Rural Villages of Uganda

    PubMed Central

    Mutebi, Francis; Krücken, Jürgen; Feldmeier, Hermann; Waiswa, Charles; Mencke, Norbert; Sentongo, Elizabeth; von Samson-Himmelstjerna, Georg

    2015-01-01

    Background Animal tungiasis is believed to increase the prevalence and parasite burden in humans. Animal reservoirs of Tunga penetrans differ among endemic areas and their role in the epidemiology of tungiasis had never been investigated in Uganda. Methods and Findings To identify the major animal reservoirs of Tunga penetrans and their relative importance in the transmission of tungiasis in Uganda, a cross sectional study was conducted in animal rearing households in 10 endemic villages in Bugiri District. T. penetrans infections were detected in pigs, dogs, goats and a cat. The prevalences of households with tungiasis ranged from 0% to 71.4% (median 22.2) for animals and from 5 to 71.4% (median 27.8%) for humans. The prevalence of human tungiasis also varied among the population of the villages (median 7%, range 1.3–37.3%). Pig infections had the widest distribution (nine out of 10 villages) and highest prevalence (median 16.2%, range 0–64.1%). Pigs also had a higher number of embedded sand fleas than all other species combined (p<0.0001). Dog tungiasis occurred in five out of 10 villages with low prevalences (median of 2%, range 0–26.9%). Only two goats and a single cat had tungiasis. Prevalences of animal and human tungiasis correlated at both village (rho = 0.89, p = 0.0005) and household (rho = 0.4, p<0.0001) levels. The median number of lesions in household animals correlated with the median intensity of infection in children three to eight years of age (rho = 0.47, p<0.0001). Animal tungiasis increased the odds of occurrence of human cases in households six fold (OR = 6.1, 95% CI 3.3–11.4, p<0.0001). Conclusion Animal and human tungiasis were closely associated and pigs were identified as the most important animal hosts of T. penetrans. Effective tungiasis control should follow One Health principles and integrate ectoparasites control in animals. PMID:26473360

  3. Two Severe Cases of Tungiasis in Goat Kids in Uganda

    PubMed Central

    Mutebi, Francis; Krücken, Jürgen; Mencke, Norbert; Feldmeier, Hermann; von Samson-Himmelstjerna, Georg; Waiswa, Charles

    2016-01-01

    Tungiasis ensues from the penetration and burrowing of female sand fleas (Tunga spp.; Siphonaptera: Tungidae) in the skin of mammals. There are few case reports of severe tungiasis in goats and in these cases the Tunga species were not in most cases clearly identified. Two cases of severe tungiasis caused by Tunga penetrans in goat kids from tungiasis-endemic rural Uganda are reported. These are the first severe cases of tungiasis in goats reported from outside South America. PMID:27012871

  4. Recommendations for Control of East African Sleeping Sickness in Uganda

    PubMed Central

    Kotlyar, Simon

    2010-01-01

    East African sleeping sickness, caused by Trypanosoma brucei rhodesiense, is prominent in Uganda and poses a serious public health challenge in the region. This publication attempts to provide key components for designing a strategy for a nationwide initiative to provide insecticide-treatment of the animal reservoir to control T. b. rhodesiense. The contents of this article will focus on insecticide-based vector control strategies, monitoring and evaluation framework, and knowledge gaps required for future initiatives. PMID:20300417

  5. Implementing a Palliative Care Nurse Leadership Fellowship Program in Uganda.

    PubMed

    Downing, Julia; Leng, Mhoira; Grant, Liz

    2016-05-01

    Global oncology and palliative care needs are increasing faster than the available capacity to meet these needs. This is particularly marked in sub-Saharan Africa, where healthcare capacity and systems are limited and resources are stretched. Uganda, a country of 35.6 million people in eastern Africa, faces the challenges of a high burden of communicable disease and a rising number of cases of non-communicable disease, including cancer. The vast majority of patients in Uganda are diagnosed with cancer too late for curative treatment to be an option because of factors like poor access to healthcare facilities, a lack of health education, poverty, and delays resulting from seeking local herbal or other traditional remedies. This article describes an innovative model of nurse leadership training in Uganda to improve the delivery of palliative care. The authors believe this model can be applicable to other low- and middle-income countries, where health resources are constrained and care needs are great.
. PMID:27105201

  6. Open access, open education resources and open data in Uganda

    PubMed Central

    Salvo, Ivana Di; Mwoka, Meggie; Kwaga, Teddy; Rukundo, Priscilla Aceng; Ernest, Dennis Ssesanga; Osaheni, Louis Aikoriogie; John, Kasibante; Shafik, Kasirye; de Sousa, Agostinho Moreira

    2015-01-01

    As a follow up to OpenCon 2014, International Federation of Medical Students’ Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in Uganda which encompasses the scientific community, librarians, academia, researchers and students. The IFMSA students held the workshop with the support of: Consortium for Uganda University Libraries (CUUL), The Right to Research Coalition, Electronic Information for Libraries (EIFL), Makerere University, International Health Sciences University (IHSU), Pan African Medical Journal (PAMJ) and the Centre for Health Human Rights and Development (CEHURD). All these organizations are based or have offices in Kampala. The event culminated in a meeting with the Science and Technology Committee of Parliament of Uganda in order to receive the support of the Ugandan Members of Parliament and to make a concrete change for Open Access in the country. PMID:26327966

  7. Open access, open education resources and open data in Uganda.

    PubMed

    Salvo, Ivana Di; Mwoka, Meggie; Kwaga, Teddy; Rukundo, Priscilla Aceng; Ernest, Dennis Ssesanga; Osaheni, Louis Aikoriogie; John, Kasibante; Shafik, Kasirye; de Sousa, Agostinho Moreira

    2015-01-01

    As a follow up to OpenCon 2014, International Federation of Medical Students' Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in Uganda which encompasses the scientific community, librarians, academia, researchers and students. The IFMSA students held the workshop with the support of: Consortium for Uganda University Libraries (CUUL), The Right to Research Coalition, Electronic Information for Libraries (EIFL), Makerere University, International Health Sciences University (IHSU), Pan African Medical Journal (PAMJ) and the Centre for Health Human Rights and Development (CEHURD). All these organizations are based or have offices in Kampala. The event culminated in a meeting with the Science and Technology Committee of Parliament of Uganda in order to receive the support of the Ugandan Members of Parliament and to make a concrete change for Open Access in the country. PMID:26327966

  8. Dismantling reified African culture through localised homosexualities in Uganda.

    PubMed

    Nyanzi, Stella

    2013-01-01

    Uganda's Anti-Homosexuality Bill of 2009 aimed at protecting the cherished culture of the people against emergent threats to the traditional heterosexual family. The Bill's justification, however, lay in myopic imaginings of a homogenous African-ness and pedestrian oblivion to pluralities within African sexualities. This paper revisits the debate that homosexuality is 'un-African'. Rhetoric analysis of the Anti-Homosexuality Bill exposes how dominant discourses of law, medicine, religion, geography and culture reinforce the view that homosexuality is foreign to Africa. Based on ethnography in contemporary Uganda, I explore how self-identified same-sex-loving individuals simultaneously claim their African-ness and their homosexuality. Their strategies include ethnic belonging, membership to kinship structures, making connections with pre-colonial histories of homosexuality, civic participation in democratic processes, national identity, organising of lesbian, gay, bisexual, transgender, intersex and questioning support groups, language and nomenclature, visibility and voice in local communal activities, solidarity and adherence to cultural rituals. In present-day Uganda, same-sex-loving men, women and transgender people variously assert their African-ness. PMID:23767462

  9. Strain differentiation of Onchocerca volvulus from Uganda using DNA probes.

    PubMed

    Fischer, P; Bamuhiiga, J; Kilian, A H; Büttner, D W

    1996-04-01

    Polymerase chain reaction (PCR) combined with non-radioactive DNA hybridization was applied for the detection and characterization of a 150 bp tandem repeat of Onchocerca volvulus. DNA of worms from western Uganda was amplified and then probed with a digoxygenin-labelled oligonucleotide, specific for the forest form of O. volvulus and compared to samples from various African countries. Hybridization was only observed with PCR products from the forest in Liberia, south-eastern Ghana, Benin and southern Cameroon, but not with worms from Uganda or the savannah in Burkina Faso and northern Ghana. A nested PCR using primers derived form the forest form-specific DNA sequence confirmed these results. Morphometric studies revealed length differences between the microfilariae of Ugandan O. volvulus to those of West Africa, especially to those of the savannah in Burkina Faso. It is concluded that the forest/savannah classification of O. volvulus from West Africa is not suitable for Simulium neavei-transmitted O. volvulus from Uganda. PMID:8935951

  10. Characterization by isoenzyme electrophoresis of Trypanozoon stocks from sleeping sickness endemic areas of south-east Uganda.

    PubMed Central

    Enyaru, J. C.; Odiit, M.; Gashumba, J. K.; Carasco, J. F.; Rwendeire, A. J.

    1992-01-01

    An epidemic of sleeping sickness, which started in 1976 in a focus within the county of Luuka in Central Busoga, has spread to cover the three districts of Busoga and large parts of the neighbouring districts of Tororo and Mukono. Forty-three isolates of the subgenus Trypanozoon from Busoga and Tororo (27 from man, 9 from cows, 2 from pigs and 5 from tsetse flies) were compared by thin-layer starch-gel electrophoresis for seven enzymes. Thirty zymodemes were identified; 17 of them were found circulating in the human population. The zymodemes seen previously in Busoga were still circulating together with several new ones. Of the 16 isolates from cattle, pigs and tsetse flies, only two had the same profile, indicating a high degree of diversity. Two zymodemes from cows and a pig were identical to those found in man, implicating domestic stock in the transmission of human disease in south-east Uganda. A computer analysis of the results produced six main zymodeme groups. One comprised only isolates from man; two were composed of isolates from man, domestic animals and tsetse; and three consisted of stocks from domestic animals only. These groups quite probably indicate the different cycles of transmission involving man, tsetse fly and domestic stock. PMID:1464150