Fuller, Anthony T; Haglund, Michael M; Lim, Stephanie; Mukasa, John; Muhumuza, Michael; Kiryabwire, Joel; Ssenyonjo, Hussein; Smith, Emily R
Pediatric neurosurgical cases have been identified as an important target for impacting health disparities in Uganda, with over 50% of the population being less than 15 years of age. The objective of the present study was to evaluate the effects of the Duke-Mulago collaboration on pediatric neurosurgical outcomes in Mulago National Referral Hospital. We performed retrospective analysis of all pediatric neurosurgical cases who presented at Mulago National Referral Hospital in Kampala, Uganda, to examine overall, preprogram (2005-2007), and postprogram (2008-2013) outcomes. We analyzed mortality, presurgical infections, postsurgical infections, length of stay, types of procedures, and significant predictors of mortality. Data on neurosurgical cases was collected from surgical logbooks, patient charts, and Mulago National Referral Hospital's yearly death registry. Of 820 pediatric neurosurgical cases, outcome data were complete for 374 children. Among children who died within 30 days of a surgical procedure, the largest group was less than a year old (45%). Postinitiation of the Duke-Mulago collaboration, we identified an overall increase in procedures, with the greatest increase in cases with complex diagnoses. Although children ages 6-18 years of age were 6.66 times more likely to die than their younger counterparts preprogram, age was no longer a predictive variable postprogram. When comparing pre- and postprogram outcomes, mortality among pediatric patients within 30 days after a neurosurgical procedure increased from 4.3% to 10.0%, mortality after 30 days increased slightly from 4.9% to 5.0%, presurgical infections decreased by 4.6%, and postsurgery infections decreased slightly by 0.7%. Our data show the provision of more complex neurological procedures does not necessitate improved outcomes. Rather, combining these higher-level procedures with essential pre- and postoperative care and continued efforts in health system strengthening for pediatric neurosurgical
... basic obstetric ultrasound. Keywords: Ultrasound; obstetric; teaching; Uganda; low-resource; curriculum. .... tic and hands-on training were provided by one trainer. (HKA) who at the time .... any formal teaching session. Additionally, the study ...
Bakwatanisa, Bosco; Enywaku, Alfred; Kiwanuka, Martin; Lamunu, Claire; Mbowa, Nicholas; Mukiibi, Denis; Namayega, Catherine; Ngabirano, Beryl; Ntambi, Henry; Reichert, William
Students in Biomaterials BBE3102 at Makerere University in Kampala, Uganda were assigned semester long group projects in the first semester of the 2014-15 academic year to determine the biomaterials type and usage in Mulago National Referral Hospital, which is emblematic of large public hospitals across East Africa. Information gathering was conducted through student interviews with Mulago physicians because there were no archival records. The students divided themselves into seven project groups covering biomaterials use in the areas of wound closure, dental and oral surgery, cardiology, burn care, bone repair, ophthalmology and total joint replacement. As in the developed world, the majority of biomaterials used in Mulago are basic wound closure materials, dental materials, and bone fixation materials, all of which are comparatively inexpensive, easy to store, and readily available from either the government or local suppliers; however, there were significant issues with the implant supply chain, affordability, and patient compliance and follow-up in cases where specialty expertise and expensive implants were employed. © 2015 Wiley Periodicals, Inc.
Full Text Available Pregnancy-associated malaria is a major global health concern. To assess the Plasmodium falciparum burden in pregnancy we conducted a cross-sectional study at Mulago Hospital in Kampala, Uganda. Malaria prevalence by each of three measures—peripheral smear, placental smear, and placental histology was 9% (35/391, 11.3% (44/389, and 13.9% (53/382 respectively. Together, smear and histology data yielded an infection rate of 15.5% (59/380 of active infections and 4.5% (17/380 of past infections; hence 20% had been or were infected when giving birth. A crude parity dependency was observed with main burden being concentrated in gravidae 1 through gravidae 3. Twenty-two percent were afflicted by anaemia and 12.2% delivered low birthweight babies. Active placental infection and anaemia showed strong association (OR=2.8 whereas parity and placental infection had an interactive effect on mean birthweight (P=.036. Primigravidae with active infection and multigravidae with past infection delivered on average lighter babies. Use of bednet protected significantly against infection (OR=0.56 whilst increased haemoglobin level protected against low birthweight (OR=0.83 irrespective of infection status. Albeit a high attendance at antenatal clinics (96.8%, there was a poor coverage of insecticide-treated nets (32% and intermittent preventive antimalarial treatment (41.5%.
Nantanda, Rebecca; Ostergaard, Marianne S; Ndeezi, Grace
Asthma is the most common chronic childhood illness, with rapidly increasing prevalence in low-income countries. Among young children, asthma is often under-diagnosed.We investigated the factors associated with asthma among under-fives presenting with acute respiratory symptoms at Mulago hospital...
Wandabwa, J; Doyle, P; Todd, J; Ononge, S; Kiondo, P
To determine the risk factors for severe postpartum haemorrhage. A case control study. Mulago hospital labour wards, Kampala, Uganda. One hundred and six mothers with severe postpartum haemorrhage were recruited between 15th November 2001 and 30th November 2002 and were compared with 500 women who had normal delivery. The predictors for postpartum haemorrhage were co-existing hypertension (O.R 9.3, 95% CI: 1.7-51.7), chronic anaemia (OR 17.3, 95% CI: 9.5-31.7), low socio economic background (OR 5.3, 95% CI: 3.0, 9.2), past history of postpartum haemorrhage (OR 3.6, 95% CI: 1.1-11.8), previous delivery by Caesarean section (OR 7.5, 95% CI: 3.5-14.3), long birth interval of more than sixty months (OR 5.2, 95% CI: 2.1-13.0), prolonged third stage (OR 49.1, 95% CI: 8.8-342.8) and non use of oxytocics (OR 4.3%, 95% CI: 1.2-15.3). Severe postpartum haemorrhage is common in our environment and is associated with a high maternal morbidity and mortality. The determinants of postpartum haemorrhage are useful in identifying mothers at risk and together with the services of a skilled birth attendant at delivery will prevent postpartum haemorrhage and reduce the maternal morbidity and mortality associated with this condition. In our study, the following risk factors were identified: pre-existing hypertension, chronic anaemia, low socio-economic background, history of postpartum haemorrhage, previous delivery by Caesarean section, longbirth interval of more than sixty months, prolonged third stage and non use of oxytocics were found to be significant.
Kiwanuka, Tusuubira S; Ononge, Sam; Kiondo, Paul; Namusoke, Fatuma
Antenatal iron supplementation is a cost effective way of reducing iron deficiency anaemia among pregnant women in resource limited countries like Uganda. Poor adherence to iron supplements has limited its effectiveness in reducing maternal anaemia as evidenced by the high burden of iron deficiency anemia in Sub-saharan Africa. The aim of this study was to determine the level of and factors associated with adherence to iron supplementation among women attending antenatal clinic at Mulago National Referral Hospital, Kampala, Uganda. Three hundred and seventy pregnant women were recruited in a cross sectional survey in Mulago National Referral Hospital antenatal clinic after informed consent between February and April 2014. Levels of adherence to iron supplements were assessed using visual analogue scale and factors associated collected using an interviewer administered questionnaire. About 12% (11.6%) of the mothers attending the antenatal clinic adhered to iron supplements over 30 day period. Mothers who had had four or more antenatal visits prior to the survey [odds ratio (OR) = 1.49, 95% confidence interval (CI) 1.12-1.97], had more than 2 week supply of iron supplements in the previous visit (OR 2.81, 95% CI 1.02-1.09), prior health education (OR 1.56, 95% CI 1.07-2.29) were more likely to adhere to iron supplements. Inadequate drug supplies and fear for side effects were the main reasons why participants missed the iron supplements. There was low adherence to iron supplements among mothers attending antenatal clinic at Mulago National Referral Hospital. We recommend a national evaluation of adherence to iron supplements and look at ways of increasing adherence.
Kinengyere, Patience; Kizito, Samuel; Kiggundu, John Baptist; Ampaire, Anne; Wabulembo, Geoffrey
Childhood visual impairment (CVI) has not been given due attention. Knowledge of CVI is important in planning preventive measures. The aim of this study was determine the prevalence, etiology and the factors associated with childhood visual impairment among the children attending the eye clinic in Mulago National Referral Hospital. This was a cross sectional hospital based study among 318 children attending the Mulago Hospital eye clinic between January 2015 to March 2015. Ocular and general history was taken and patient examination done. The data generated was entered by Epidata and analyzed by STATA 12. The prevalence of CVI was 42.14%, 134 patients with 49 patients (15.41%) having moderate visual impairment, 45 patients (14.15%) having severe visual impairment and 40 patients (12.58%) presenting with blindness. Significant predictors included; increasing age, delayed developmental milestones and having abnormal corneal, refractive and fundus findings. There is a high burden of visual impairment among children in Uganda. It is vital to screen all the children presenting to hospital for visual impairment. Majority of the causes of the visual impairment are preventable.
Kaye, Dan K; Mirembe, Florence M; Bantebya, Grace; Johansson, Annika; Ekstrom, Anna Mia
To investigate whether domestic violence during pregnancy is a risk factor for antepartum hospitalization or low birthweight (LBW) delivery. A prospective cohort study was conducted in Mulago hospital, Kampala, Uganda, among 612 women recruited in the second pregnancy trimester and followed up to delivery, from May 2004 through July 2005. The exposure (physical, sexual or psychological violence during pregnancy) was assessed using the Abuse Assessment Screen. The relative and attributable risks of LBW and antepartum hospitalization were estimated using multivariate logistic regression analysis. The 169 women [27.7% 95% CI (24.3-31.5%)] who reported domestic violence during pregnancy did not differ significantly from the unexposed regarding sociodemographic characteristics, but differed significantly (P violence was 3.78 (95% CI 2.86-5.00). Such women had a 37% higher risk of obstetric complications (such as hypertension, premature rupture of membranes and anaemia) that necessitated antepartum hospitalization [RR 1.37 (95% CI 1.01-1.84)]. In this pregnancy cohort, domestic violence during pregnancy was a risk factor for LBW delivery and antepartum hospitalization.
Nakubulwa, Sarah; Kaye, Dan K; Bwanga, Freddie; Tumwesigye, Nazarius Mbona; Mirembe, Florence M
Inflammatory mediators that weaken and cause membrane rupture are released during the course of genital infections among pregnant women. We set out to determine the association of common genital infections (Trichomonas vaginalis, syphilis, Neisseria gonorrhea, Chlamydia trachomatis, Group B Streptococcus, Bacterial vaginosis, Herpes Simplex Virus Type 2 and candidiasis) and premature rupture of membranes in Mulago hospital, Uganda. We conducted an unmatched case-control study among women who were in the third trimester of pregnancy at New Mulago hospital, Uganda. The cases had PROM and the controls had intact membranes during latent phase of labour in the labour ward. We used interviewer-administered questionnaires to collect data on socio-demographic characteristics, obstetric and medical history. Laboratory tests were conducted to identify T. vaginalis, syphilis, N. gonorrhea, C. trachomatis, Group B Streptococcus, Bacterial vaginosis, Herpes Simplex Virus Type 2 (HSV-2) and candidiasis. Logistic regression models were used to estimate the odds ratios (OR) and 95% CI of the association between genital infections and PROM. There was an association between PROM and abnormal vaginal discharge (OR = 2.02, 95% CI 1.10-3.70 and AOR = 2.30, 95% CI 1.18-4.47), presence of candidiasis (OR = 0.27, 95% CI 0.14-0.52 and AOR = 0.22, 95% CI 0.10-0.46) and T. vaginalis (OR = 2.98, 95% CI 1.18-7.56 and AOR = 4.22, 95% CI 1.51-11.80). However, there was no association between PROM and presence of C. trachomatis (OR = 2.05, 95% CI 0.37-11.49) and HSV-2 serostatus (OR = 1.15, 95% CI 0.63-2.09). Few or no patients with Bacterial vaginosis, Neisseria gonorrhoea, Group B streptococcus or syphilis were identified among the cases and controls. Co-infection of Trichomoniasis and candidiasis was not associated with PROM (AOR = 1.34, 95% CI 0.16-11.10). Co infection with T. vaginalis and C. trachomatis was associated with PROM (OR = 3.09, 95% CI 1.21-7.84 and AOR = 4.22, 95% CI 1
Full Text Available Abstract Background Lactose intolerance is a common complication of diarrhoea in infants with malnutrition and a cause of treatment failure. A combination of nutritional injury and infectious insults in severe protein energy malnutrition reduces the capacity of the intestinal mucosa to produce lactase enzyme necessary for the digestion of lactose. The standard management of severe malnutrition involves nutritional rehabilitation with lactose-based high energy formula milk. However, some of these children may be lactose intolerant, possibly contributing to the high rate of unfavorable treatment outcomes. This study was therefore designed to establish the prevalence of lactose intolerance and associated factors in this population. Methods A descriptive cross sectional study involving 196 severely malnourished children with diarrhoea aged 3-60 months was done in Mwanamugimu Nutrition Unit (MNU, Mulago hospital between October 2006 and February 2007. Results During the study period, 196 severely malnourished children with diarrhoea were recruited, 50 (25.5% of whom had evidence of lactose intolerance (stool reducing substance ≥ 1 + [0.5%] and stool pH Other factors that were significantly associated with lactose intolerance on bi-variate analysis included: young age of 3-12 months; lack of up to-date immunization; persistent diarrhoea; vomiting; dehydration, and abdominal distension. Exclusive breastfeeding for less than 4 months and worsening of diarrhoea on initiation of therapeutic milk were the other factors. Conclusions The prevalence of lactose intolerance in this study setting of 25.5% is relatively high. Routine screening by stool pH and reducing substances should be performed especially in the severely malnourished children with diarrhoea presenting with oedematous malnutrition, perianal skin erosion, higher mean stool frequency and having had ≥2 diarrhoea episodes in the previous 3 months. Use of lactose-free diets such as yoghurt
Michael G Kawooya
Full Text Available Objectives: Uganda, has limited health resources and improving performance of personnel involved in imaging is necessary for efficiency. The objectives of the study were to develop and pilot imaging user performance indices, document non-tangible aspects of performance, and propose ways of improving performance. Materials and Methods: This was a cross-sectional survey employing triangulation methodology, conducted in Mulago National Referral Hospital over a period of 3 years from 2005 to 2008. The qualitative study used in-depth interviews, focus group discussions, and self-administered questionnaires, to explore clinicians′ and radiologists′ performancerelated views. Results: The study came up with following indices: appropriate service utilization (ASU, appropriateness of clinician′s nonimaging decisions (ANID, and clinical utilization of imaging results (CUI. The ASU, ANID, and CUI were: 94%, 80%, and 97%, respectively. The clinician′s requisitioning validity was high (positive likelihood ratio of 10.6 contrasting with a poor validity for detecting those patients not needing imaging (negative likelihood ratio of 0.16. Some requisitions were inappropriate and some requisition and reports lacked detail, clarity, and precision. Conclusion: Clinicians perform well at imaging requisition-decisions but there are issues in imaging requisitioning and reporting that need to be addressed to improve performance.
Kawooya, Michael G.; Pariyo, George; Malwadde, Elsie Kiguli; Byanyima, Rosemary; Kisembo, Harrient
Objectives: Uganda, has limited health resources and improving performance of personnel involved in imaging is necessary for efficiency. The objectives of the study were to develop and pilot imaging user performance indices, document non-tangible aspects of performance, and propose ways of improving performance. Materials and Methods: This was a cross-sectional survey employing triangulation methodology, conducted in Mulago National Referral Hospital over a period of 3 years from 2005 to 2008. The qualitative study used in-depth interviews, focus group discussions, and self-administered questionnaires, to explore clinicians’ and radiologists’ performancerelated views. Results: The study came up with following indices: appropriate service utilization (ASU), appropriateness of clinician's nonimaging decisions (ANID), and clinical utilization of imaging results (CUI). The ASU, ANID, and CUI were: 94%, 80%, and 97%, respectively. The clinician's requisitioning validity was high (positive likelihood ratio of 10.6) contrasting with a poor validity for detecting those patients not needing imaging (negative likelihood ratio of 0.16). Some requisitions were inappropriate and some requisition and reports lacked detail, clarity, and precision. Conclusion: Clinicians perform well at imaging requisition-decisions but there are issues in imaging requisitioning and reporting that need to be addressed to improve performance. PMID:23230543
Aliku, Twalib O; Lubega, Sulaiman; Lwabi, Peter; Oketcho, Michael; Omagino, John O; Mwambu, Tom
Heart disease is a disabling condition and necessary surgical intervention is often lacking in many developing countries. Training of the superspecialties abroad is largely limited to observation with little or no opportunity for hands on experience. An approach in which open heart surgeries are conducted locally by visiting teams enabling skills transfer to the local team and helps build to build capacity has been adopted at the Uganda Heart Institute (UHI). We reviewed the progress of open heart surgery at the UHI and evaluated the postoperative outcomes and challenges faced in conducting open heart surgery in a developing country. Medical records of patients undergoing open heart surgery at the UHI from October 2007 to June 2012 were reviewed. A total of 124 patients underwent open heart surgery during the study period. The commonest conditions were: venticular septal defects (VSDs) 34.7% (43/124), Atrial septal defects (ASDs) 34.7% (43/124) and tetralogy of fallot (TOF) in 10.5% (13/124). Non governmental organizations (NGOs) funded 96.8% (120/124) of the operations, and in only 4 patients (3.2%) families paid for the surgeries. There was increasing complexity in cases operated upon from predominantly ASDs and VSDs at the beginning to more complex cases like TOFs and TAPVR. The local team independently operated 19 patients (15.3%). Postoperative morbidity was low with arrhythmias, left ventricular dysfunction and re-operations being the commonest seen. Post operative sepsis occurred in only 2 cases (1.6%). The overall mortality rate was 3.2. Open heart surgery though expensive is feasible in a developing country. With increased direct funding from governments and local charities to support open heart surgeries, more cardiac patients access surgical treatment locally.
Neema, S; Atuyambe, L M; Otolok-Tanga, E; Twijukye, C; Kambugu, A; Thayer, L; McAdam, K
Stigma has been associated with chronic health conditions such as HIV/AIDS, leprosy, tuberculosis, Mental illness and Epilepsy. Different forms of stigma have been identified: enacted stigma, perceived stigma, and self stigma. Stigma is increasingly regarded as a key driver of the HIV/AIDS epidemic and has a major impact on public health interventions. The initiative was to provide activities in the clinic while patients waited to be seen by healthcare professionals. It was envisaged this would contribute to reduction of clinic based stigma felt by clients. This was a repeated cross-sectional survey (October-November 2005 and March-April 2007) that was conducted at the Infectious Diseases Institute clinic (IDC) at Mulago, the national referral hospital in Uganda. We utilized quantitative (survey) and qualitative (key informants, focus group discussions) methods to collect the data. Data were collected on stigma before the creativity initiative intervention was implemented, and a second phase survey was conducted to assess effectiveness of the interventions. Clients who attended the IDC before the creativity intervention were about twice as likely to fear catching an infection as those who came after the intervention. The proportion that had fears to be seen by a friend or relative at the clinic decreased. Thus during the implementation of the Creativity intervention, HIV related stigma was reduced in this clinic setting. The creativity intervention helped to build self esteem and improved communication among those attending the clinic; there was observed ambiance at the clinic and clients became empowered, with creative, communication and networking skills. Improved knowledge and communication are key in addressing self stigma among HIV positive individuals.
... management in surgery. Knowing which patient to operate and those at high risk of developing complications contributes significantly to the quality of surgical care and cost reduction. The postoperative complications of patients who underwent Laparotomy in Mulago Hospital were studied using POSSUM scoring system.
Information on dental caries among patients attending Mulago Hospital is scarce. Yet knowledge of the pattern of caries can be used to plan preventive and treatment interventions. This study describes the pattern of dental caries (in terms of age group, tooth and tooth surface and gender) among patients attending the ...
the best outcome in patients with Cervical Spine injury ICSI}. ... which indicates the likely level and pattern of injury ... All trauma patients with altered level ... from arrival In hospital to review bya clinician. ... one ofthe 29 patierns had an op-en mouth view taken. .... Domeier, H_ M. Time reliability of pre-hospital c inical.
from arrival in hospital to review by a clinician. Figure i of adequate cervical spine X-rays(22, 25). High pick-up summarizes our findings. rates are only attained with adequate X-rays. Studies done elsewhere have shown that up to 45% of initial. Clinical evaluation: Not all patients were assessed for. X-rays are inadequate.
Objective: To explore knowledge, attitudes and practices of health workers in Mulago hospital towards domestic violence prevention and management, especially violence during pregnancy. Methods: From 5th to 25th March 2000, self-administered pre-coded questionnaires were given to a purposively selected sample of ...
Dec 2, 2004 ... consecutive patients operated for femoral hernia over a period of twelve months. Results: There were ... The age ranged from 42 years to 70 years old with a mean of 54.6 years old. All the .... cholecystectomy. At this point in ...
Operative time, postoperative pain, duration taken to return to work, postoperative complications, wound healing rate and patient's ... the average post-operative pain scores (P-value = 0.054). No difference in the need for extra analgesia was ... standardized pre-operative preparation and post- operative management.
Dec 2, 2004 ... The commonest complications were fever (40 patients) jaundice (30 patients). 10 patients died ... Resection. 4. Total. 51. Table 6. Result And Complication N=51. Complications. No. Of Patients. Fever. 40. Jaundice. 30. Sepsis. 25. Biliary Leakage. 5. Table 7. ... our hospital. Otherwise the concept now is to.
de Graaf, J D; Kajja, I; Bimenya, G S; Postma, Maarten; Smit Sibinga, C.Th.
BACKGROUND: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. MATERIALS AND
patients referred to the Radiology department with knee joint pathology were studied. ..... In Uganda, rugby and soccer sports are dominated by the elite .... Detection of Joint Effusions Academic Emergency Medicine Volume 8, Number 4 361- ...
Louis, Bayo; Steven, Buyungo; Margret, Nakiwala; Ronald, Nabimba; Emmanuel, Luyinda; Tadeo, Nsubuga; Namagembe, Imelda; Kasangaki, Arabat; Cecily, Banura
The World Health Organization defines low birth weight (LBW) as a new born having a weight of less than 2,500 g at birth. Low birth weight is one of the major determinants of perinatal survival, infant morbidity and mortality as well as the risk of developmental disabilities and illnesses in future lives. WHO estimates that about 30 million low birth weight babies are born annually (23.4% of all births) and they often face short and long term health consequences. Whereas the global prevalence of LBW has slightly declined, the rate in many developing countries is still quite high. In Uganda, low birth weight among teenage mothers is a problem. Our study aimed to estimate the prevalence of and identify the factors associated with low birth weight among teenage mothers in New Mulago hospital. We conducted an analytical cross sectional study among teenage mothers who delivered from new Mulago Hospital Complex labour suite from August 2013 to August 2014. Trained interviewers, administered pre-tested questionnaires to consecutive mothers to obtain information on their socio-demographic characteristics, obstetric history and child factors. Odds ratios and P -values were calculated to determine the relationship between independent and dependent variables. We also used descriptive statistics for the quantitative data. A total of 357 teenage mothers were enrolled on the study. Their mean age was 18 years (Range 13-19), majority, 98.4% aged 15-19 years. The prevalence of LBW was 25.5%. Pre-term delivery (OR = 3.3032 P = 0.0001) and multiple pregnancies (OR = 0.165 P = 0.039) were associated with LBW. Malaria, young maternal age and ANC attendance were not associated with LBW. Child factors such as birth order, congenital anomalies and sex of the baby were also not associated with LBW. The prevalence of LBW is high among teenage mothers, pre-term delivery and multiple pregnancies were associated factors with LBW. Health professional's need to address teenage maternal health
Kilyewala, C; Alenyo, R; Ssentongo, R
Blood transfusion, a practice under re-evaluation in general, remains common among thermal burn patients due to the hematological alterations associated with burns that manifest as anemia. Today advocacy is for restrictive blood transfusion taking into account individual patient characteristics. We went out to identify the parameters that may determine transfusion requirement and the time to blood transfusion for thermal burn patients in Mulago Hospital in order to build statistics and a basis to standardize future practice and Hospital protocol. 112 patients with thermal burns were enrolled into a prospective cohort study conducted in the Surgical Unit of the Accidents and Emergency Department and Burns Unit of Mulago Hospital. Relevant data on pre-injury, injury and post-injury factors was collected including relevant laboratory investigations and treatment modalities like surgical intervention. Patients were clinically followed up for a maximum period of 28 days and we identified those that were transfused. 22.3% of patients were transfused. The median time to transfusion was 17 days from time of injury and varied with different patient characteristics. The median pre-transfusion hemoglobin (Hb) level was 8.2 g/dL. Transfusion was significantly related to; admission to the intensive care unit (p = 0.001), a body mass index (BMI) burn surface area (TBSA) >20 (p = 0.049), pre-existing illness (p = 0.046), and white blood cell (WBC) count 12,000/μL (p = 0.05). Pre-existing illnesses, a low BMI, TBSA of >20%, admission to the intensive care unit and abnormalities in the WBC count are useful predictors of blood transfusion among thermal burns patients admitted to Mulago Hospital. The precise time to transfusion from time of burns injury cannot be generalized. With close monitoring of each individual patient lies the appropriateness and timeliness of their management.
Full Text Available Abstract Background Mulago National Referral Hospital (MNRH, Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23 and focus group discussions (n=7 were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies, staff inadequacies (knowledge, motivation, and professionalism, overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism
Results: The prevalence was 20%. The mean age was 47 years 10 months. The majority, 62.3% of patients had mechanical or simple back pain with no definable patho-anatomic causative factor (non-specific). 19.1% had nerve root compression due to prolapsed intervertebral discs. 17.2% had serious spinal pathology due ...
Conclusion: This original teaching intervention is an effective method to improve ... In ad- dition, no teaching or testing material is available in the literature that can be used to carry ..... trasound in rural areas using a tablet platform and mobile.
de Graaf J
Full Text Available Background: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. Materials and Methods: An observational study on three wards of Mulago Hospital. Physicians, paramedics, nurses, medical students and nurse students were observed using two questionnaires. For comparison, a limited observational study was performed in the University Medical Centre Groningen (UMCG in Groningen, The Netherlands. Results: In Mulago Hospital guidelines for blood transfusion practice were not easily available. Medical staff members work on individual professional levels. Students perform poorly due to inconsistency in their supervision. Documentation of blood transfusion in patient files is scarce. There is no immediate bedside observation, so transfusion reactions and obstructions in the blood transfusion flow are not observed. Conclusion: The poor blood transfusion practice is likely to play a role in the morbidity and mortality of patients who receive a blood transfusion. There is a need for a blood transfusion policy and current practical guidelines.
Kagoya, Harriet Rachel; Kibuule, Dan; Mitonga-Kabwebwe, Honoré; Ekirapa-Kiracho, Elizabeth; Ssempebwa, John C
The realisation of patients' rights in resource-constrained and patient-burdened public health care settings in Uganda remains an obstacle towards quality health care delivery, health care-seeking behaviour and health outcomes. Although the Uganda Patients' Charter of 2009 empowers patients to demand quality care, inequitable access and abuse remain common. The study aimed to assess level of awareness of, responsiveness to and practice of patients' rights amongst patients and health workers (HWs) at Uganda's national referral hospital, Mulago Hospital in Kampala. A three-phase cross-sectional questionnaire-based descriptive survey was conducted amongst 211 patients, 98 HWs and 16 key informants using qualitative and quantitative data collection methods. The study was conducted in May-June 2012, 2.5 years after the launch of the Uganda Patients' Charter. At least 36.5% of patients faced a challenge regarding their rights whilst seeking health care. Most of the patients (79%) who met a challenge never attempted to demand their rights. Most patients (81.5%) and HWs (69.4%) had never heard of the Uganda Patients' Charter. Awareness of patients' rights was significantly higher amongst HWs (70%) than patients (40%) ( p bribe HWs with money to access care, and political, socio-economic and tribal status. Awareness of, responsiveness to and practice of patients' rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel, multichannel, patient-centred approach that incorporates social services and addresses intrinsic patient, HW and health system factors to strengthen patients' rights issues at the hospital.
Kibuule, Dan; Mitonga-Kabwebwe, Honoré; Ekirapa-Kiracho, Elizabeth; Ssempebwa, John C.
Abstract Background The realisation of patients’ rights in resource-constrained and patient-burdened public health care settings in Uganda remains an obstacle towards quality health care delivery, health care-seeking behaviour and health outcomes. Although the Uganda Patients’ Charter of 2009 empowers patients to demand quality care, inequitable access and abuse remain common. Aim The study aimed to assess level of awareness of, responsiveness to and practice of patients’ rights amongst patients and health workers (HWs) at Uganda's national referral hospital, Mulago Hospital in Kampala. Methods A three-phase cross-sectional questionnaire-based descriptive survey was conducted amongst 211 patients, 98 HWs and 16 key informants using qualitative and quantitative data collection methods. The study was conducted in May–June 2012, 2.5 years after the launch of the Uganda Patients’ Charter. Results At least 36.5% of patients faced a challenge regarding their rights whilst seeking health care. Most of the patients (79%) who met a challenge never attempted to demand their rights. Most patients (81.5%) and HWs (69.4%) had never heard of the Uganda Patients’ Charter. Awareness of patients’ rights was significantly higher amongst HWs (70%) than patients (40%) (p bribe HWs with money to access care, and political, socio-economic and tribal status. Conclusion and recommendations Awareness of, responsiveness to and practice of patients’ rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel, multichannel, patient-centred approach that incorporates social services and addresses intrinsic patient, HW and health system factors to strengthen patients’ rights issues at the hospital. PMID:24563777
Charles Okot Odongo
Full Text Available Intermittent preventive treatment of malaria in pregnancy with sulphadoxine-pyrimethamine (SP-IPTp is widely used to reduce the incidence of adverse pregnancy outcomes. As a monitor for continued effectiveness of this intervention amidst SP resistance, we aimed to assess malaria burden among pregnant women who use or do not use SP-IPTp. In a descriptive cohort study at Mulago Hospital, Kampala, 87 women who received two supervised doses of SP-IPTp were followed up until delivery. Controls were pregnant women presenting in early labour without history of SP-IPTp. Histopathological investigation for placental malaria (PM was performed using the Bulmer classification criterion. Thirty-eight of the 87 women returned for delivery and 33 placentas were successfully collected and processed along with 33 placentas from SP nonusers. Overall, 12% (4/33 of the users had evidence of PM compared to 48% (16/33 of nonusers. Among nonusers, 17/33, 8/33, 2/33, and 6/33 had no placental infection, active infection, active-chronic infection, and past-chronic infection, respectively. Among users, respective proportions were 29/33, 2/33, 0/33, and 2/33. No difference in birth weights was apparent between the two groups, probably due to a higher proportion of infections occurring later in pregnancy. Histological evidence here suggests that SP continues to offer substantial benefit as IPTp.
Kutamba, E; Lubega, S; Mugalu, J; Ouma, J; Mupere, E
Hypoglycemia is a major cause of morbidity and mortality among preterm infants and its management remains a challenge in resource limited settings. Use of dextrose infusion by the recommended infusion pumps is not feasible in our environment due to their high costs and yet the current use of mini dextrose boluses with syringes as adapted at Mulago national referral and tertiary teaching hospital has unknown efficacy in prevention of hypoglycemia. We determined the efficacy of dextrose infusions by burettes versus two hourly dextrose boluses in prevention of hypoglycemia among preterms admitted in the first 72 hours at Special Care Unit, Mulago Hospital. One hundred and forty preterms aged 0 to 24 hours of life were randomized to receive 10% IV dextrose either as mini boluses or by infusion using burettes in an open label clinical trial. Blood glucose was measured at 0, two hourly for next 6 hours, 6 hourly for next 12 hours and thereafter 12 hourly until end of 72 hours following admission. Primary end point was incidence of hypoglycemia (random blood sugar (RBS) dextrose infusion was computed using 1-RR. From February 2012 to April 2012, 68 preterms in the bolus arm and 72 in the infusion arm were studied. Hypoglycemia was detected in 34% (48/140). The incidence of hypoglycemia in the bolus arm was 59% (40/68) compared to 11% (8/72) in the infusion arm (RR; 0.19, 95% CI; 0.09-0.37). Efficacy (1-RR) of infusion by burettes versus boluses in prevention of hypoglycemia among preterms was 0.81 (95% CI; 0.63-0.90). Continuous 10% dextrose infusion by burettes reduced the incidence of hypoglycemia by 81% in the first 72 hours of admission compared to two hourly 10% mini dextrose boluses among preterms admitted at Special Care Unit, Mulago Hospital. (ClinicalTrials.gov Identifier: NCT01688674).
Background: Non-adherence to diabetes treatment leads to poor glucose control and increases the risk of disease complications. The prevalence and factors associated with non-adherence in resource limited settings should be determined so as to lower the impact of a disease that is on the increase, on the health systems ...
Kiguli, S.; Mafigiri, D.; Nakigudde, J.; Dalen, J. Van; Vleuten, C.P.M. van der
OBJECTIVE: Little data exist on patients' expectations and communication desires during medical consultation in Non-Western settings. We conducted a qualitative study to compare expectations and communication desires of sick children's caregivers at Mulago Hospital, Uganda, to those of patients in
Kiguli, Sarah; Mafigiri, David; Nakigudde, Janet; van Dalen, Jan; van der Vleuten, Cees
Little data exist on patients' expectations and communication desires during medical consultation in Non-Western settings. We conducted a qualitative study to compare expectations and communication desires of sick children's caregivers at Mulago Hospital, Uganda, to those of patients in Western countries. Three Focus Group Interviews and three Key Informant Interviews were conducted with 24 caregivers of sick children in Mulago Hospital Kampala, Uganda. An interview guide adapted from the Calgary-Cambridge Guide was used to conduct focus group and Key Informant Interviews. Two investigators worked independently to review transcripts and analyse them for content and emerging themes. Caregivers of sick children in Mulago Hospital expect attending doctors to build a relationship with them, by demonstrating the verbal and nonverbal skills outlined in the CCG including maintaining eye contact, using appropriate gestures and voice during communication, and being nonjudgmental. The communication needs and expectations of caregivers of sick children in Mulago Hospital are similar to those of patients and caregivers in Western countries. The CCG can be used as a training guide to enhance the communication skills of current and future doctors in Mulago Hospital. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Nabeta, Henry W; Kasolo, Josephine; Kiggundu, Reuben K; Kiragga, Agnes N; Kiguli, Sarah
Vitamin D deficiency is a world-wide epidemic with recent estimates indicating that greater than 50% of the global population is at risk. In Uganda, 80% of healthy community children in a survey were found to be vitamin D insufficient. Protein-energy malnutrition is likely to be associated with vitamin D intake deficiency. The aim of this study was to determine the prevalence of vitamin D deficiency and the associated factors among children admitted with protein-energy malnutrition to the pediatrics wards of Mulago hospital in Kampala, Uganda. Consecutive sampling was done with 158 children, aged 6-24 months, enrolled in a cross sectional study. One hundred and seventeen malnourished and 41 non malnourished children were enrolled from the Acute Care unit, pediatrics in-patient wards, outpatient and immunization clinics, following informed consent obtained from the children's parents/guardians. Children with protein energy malnutrition were categorized based on anthropometric measurements of weight-for-height and weight for length compared with the recommended WHO reference Z-score. Serum 25-hydroxyvitamin D, calcium and phosphate were assayed. One hundred seventeen malnourished and 41 non malnourished children were enrolled. The majority of study participants were male, 91 (57.6%). The mean serum vitamin D levels among the malnourished was 32.5 mmol/L (±12.0 SD) and 32.2 mmol/L (10.9 SD) among the malnourished, p = 0.868. Fifteen (36.6%) of the non malnourished children and 51 (43.6%) of the malnourished had suboptimal levels, p = 0.689. Malnourished children admitted with meningitis and cerebral palsy had lower serum vitamin D levels than those with other infections. There was no statistically significant difference in vitamin D values between the malnourished and non malnourished children. Clinicians should actively screen for children for serum vitamin D levels regardless of nutritional status.
Kaye Dan K
Full Text Available Abstract Background Adolescence is a transitional stage from childhood to adulthood that is characterized by physical, physiological, psychosocial and behavioral changes that are influenced to a large extent by the age, culture and socialization of the individual. To explore what adolescent mothers perceive as their struggles during the period of transition from childhood to parenthood (through motherhood and to describe strategies employed in coping with stress of pregnancy, motherhood and parenthood. Methods Longitudinal qualitative study involving twenty two in-depth interviews and six focus group discussions among pregnant adolescents who were followed from pregnant to delivery, from January 2004 to August 2005. Participant were selected by theoretical sampling and data was analyzed using grounded theory. Results Overall, young adolescents reported more anxiety, loss of self esteem (when they conceived, difficulty in accessing financial, moral and material support from parents or partners and stigmatization by health workers when they sought care from health facilities. Three strategies by which adolescent mothers cope with parenting and pregnancy stress that were described as utilizing opportunities (thriving, accommodating the challenges (bargaining and surviving, or failure (despairing, and varied in the extent to which they enabled adolescents to cope with the stress. Conclusion Adolescents on the transition to motherhood have variable needs and aspirations and utilize different strategies to cope with the stress of pregnancy and parenthood.
Haglund, Michael M; Warf, Benjamin; Fuller, Anthony; Freischlag, Kyle; Muhumuza, Michael; Ssenyonjo, Hussein; Mukasa, John; Mugamba, John; Kiryabwire, Joel
Neurosurgery in Uganda was virtually non-existent up until late 1960s. This changed when Dr. Jovan Kiryabwire spearheaded development of a neurosurgical unit at Mulago Hospital in Kampala. His work ethic and vision set the stage for rapid expansion of neurosurgical care in Uganda.At the beginning of the 2000s, Uganda was a country of nearly 30 million people, but had only 4 neurosurgeons. Neurosurgery's progress was plagued by challenges faced by many developing countries, such as difficulty retaining specialists, lack of modern hospital resources, and scarce training facilities. To combat these challenges 2 distinct programs were launched: 1 by Dr. Benjamin Warf in collaboration with CURE International, and the other by Dr. Michael Haglund from Duke University. Dr. Warf's program focused on establishing a facility for pediatric neurosurgery. Dr. Haglund's program to increase neurosurgical capacity was founded on a "4 T's Paradigm": Technology, Twinning, Training, and Top-Down. Embedded within this paradigm was the notion that Uganda needed to train its own people to become neurosurgeons, and thus Duke helped establish the country's first neurosurgery residency training program.Efforts from overseas, including the tireless work of Dr. Benjamin Warf, have saved thousands of children's lives. The influx of the Duke Program caused a dynamic shift at Mulago Hospital with dramatic effects, as evidenced by the substantial increase in neurosurgical capacity. The future looks bright for neurosurgery in Uganda and it all traces back to a rural village where 1 man had a vision to help the people of his country. Copyright © 2017 by the Congress of Neurological Surgeons.
Raymond Mbayo Mwebaze
Full Text Available BACKGROUND: Peripheral arterial disease (PAD is one of the recognised diabetic macro vascular complications. It is a marker of generalised systemic atherosclerosis and is closely associated with symptomatic coronary and cerebrovascular disease, hence significant morbidity and mortality. Among African adult diabetic populations, screening and diagnosis of PAD is frequently suboptimal. The aim of this study was to determine the prevalence and associated clinical factors of PAD in adult ambulatory diabetic patients attending the outpatient diabetic clinic of Mulago national referral and teaching hospital, Kampala Uganda. METHODS: In this descriptive cross sectional study, 146 ambulatory adult diabetic patients were studied. Information about their socio-demographic and clinical characteristics, fasting lipid profile status, blood pressure, glycated haemoglobin (HbA1c levels and presence of albuminuria was collected using a pre tested questionnaire. Measurement of ankle brachial index (ABI to assess for PAD, defined as a ratio less than 0.9 was performed using a portable 5-10 MHz Doppler device. Clinical factors associated with PAD were determined by comparing specific selected characteristics in patients with PAD and those without. RESULTS: The mean age/standard deviation of the study participants was 53.9/12.4 years with a male predominance (75, 51.4%. PAD was prevalent in 57 (39% study participants. Of these, 34 (59.6% had symptomatic PAD. The noted clinical factors associated with PAD in this study population were presence of symptoms of intermittent claudication and microalbuminuria. CONCLUSIONS: This study documents a high prevalence of PAD among adult ambulatory Ugandan diabetic patients. Aggressive screening for PAD using ABI measurement in adult diabetic patients should be emphasised in Uganda especially in the presence of symptoms of intermittent claudication and microalbuminuria.
Mworozi Edison A
Full Text Available Abstract Background Rotavirus remains the commonest cause of severe dehydrating diarrhea among children worldwide. Children in developing countries die more because of several factors including poorer access to hydration therapy and greater prevalence of malnutrition. Hitherto, the magnitude of rotavirus disease in Uganda has remained unknown. This study was therefore done to determine the prevalence and factors associated with rotavirus infection among children aged 3-59 months admitted with acute diarrhea to paediatric emergency ward of Mulago Hospital, Uganda Methods Three hundred and ninety children, aged between 3-59 months with acute diarrhoea were recruited. The clinical history, socio-demographic characteristics, physical examination findings and laboratory investigations were recorded. Stool samples were tested for rotavirus antigens using the DAKO IDEIA rotavirus EIA detection kit. Results The prevalence of rotavirus infection was 45.4%. On multivariate analysis rotavirus was significantly associated with a higher education (above secondary level of the mother [OR 1.8; 95% CI 1.1-2.7]; dehydration [OR 1.8; 95% CI 1.1-3.0] and breastfeeding [OR 2.6; 95% CI 1.4-4.0]. Although age was significantly associated with rotavirus on bivariate analysis; this association disappeared on multivariate analysis. No significant association was found between rotavirus infection and nutritional status, HIV status and attendance of day care or school. Conclusions Rotavirus infection is highly prevalent among children with acute diarrhoea admitted to Mulago Hospital in Uganda.
Full Text Available Abstract Background There is now convincing evidence that in industrialized countries therapeutic hypothermia for perinatal asphyxial encephalopathy increases survival with normal neurological function. However, the greatest burden of perinatal asphyxia falls in low and mid-resource settings where it is unclear whether therapeutic hypothermia is safe and effective. Aims Under the UCL Uganda Women's Health Initiative, a pilot randomized controlled trial in infants with perinatal asphyxia was set up in the special care baby unit in Mulago Hospital, a large public hospital with ~20,000 births in Kampala, Uganda to determine: (i The feasibility of achieving consent, neurological assessment, randomization and whole body cooling to a core temperature 33-34°C using water bottles (ii The temperature profile of encephalopathic infants with standard care (iii The pattern, severity and evolution of brain tissue injury as seen on cranial ultrasound and relation with outcome (iv The feasibility of neurodevelopmental follow-up at 18-22 months of age Methods/Design Ethical approval was obtained from Makerere University and Mulago Hospital. All infants were in-born. Parental consent for entry into the trial was obtained. Thirty-six infants were randomized either to standard care plus cooling (target rectal temperature of 33-34°C for 72 hrs, started within 3 h of birth or standard care alone. All other aspects of management were the same. Cooling was performed using water bottles filled with tepid tap water (25°C. Rectal, axillary, ambient and surface water bottle temperatures were monitored continuously for the first 80 h. Encephalopathy scoring was performed on days 1-4, a structured, scorable neurological examination and head circumference were performed on days 7 and 17. Cranial ultrasound was performed on days 1, 3 and 7 and scored. Griffiths developmental quotient, head circumference, neurological examination and assessment of gross motor function were
Mujasi, Paschal N; Asbu, Eyob Z; Puig-Junoy, Jaume
Hospitals represent a significant proportion of health expenditures in Uganda, accounting for about 26 % of total health expenditure. Improving the technical efficiency of hospitals in Uganda can result in large savings which can be devoted to expand access to services and improve quality of care. This paper explores the technical efficiency of referral hospitals in Uganda during the 2012/2013 financial year. This was a cross sectional study using secondary data. Input and output data were obtained from the Uganda Ministry of Health annual health sector performance report for the period July 1, 2012 to June 30, 2013 for the 14 public sector regional referral and 4 large private not for profit hospitals. We assumed an output-oriented model with Variable Returns to Scale to estimate the efficiency score for each hospital using Data Envelopment Analysis (DEA) with STATA13. Using a Tobit model DEA, efficiency scores were regressed against selected institutional and contextual/environmental factors to estimate their impacts on efficiency. The average variable returns to scale (Pure) technical efficiency score was 91.4 % and the average scale efficiency score was 87.1 % while the average constant returns to scale technical efficiency score was 79.4 %. Technically inefficient hospitals could have become more efficient by increasing the outpatient department visits by 45,943; and inpatient days by 31,425 without changing the total number of inputs. Alternatively, they would achieve efficiency by for example transferring the excess 216 medical staff and 454 beds to other levels of the health system without changing the total number of outputs. Tobit regression indicates that significant factors in explaining hospital efficiency are: hospital size (p Uganda.
Mugambe, R.K.; Ssempebwa, J.C.; Tumwesigye, N.M.; Vliet, van B.J.M.; Adedimeji, A.
Aim The aim of this study was to assess the management, characteristics and generation of healthcare waste (HCW) in public and private hospitals in Kampala City, Uganda. Methods We employed mainly qualitative methods through the use of a waste inventory, observations, document review and key
Full Text Available In recent years, there has been a global effort to tackle the problem of child malnutrition that is still the underlying cause of death of at least 3.1 million children annually. Uganda and Tanzania are among the 22 countries with higher prevalence of child malnutrition. However, these two countries are true examples of how it is possible to reduce this scourge through simple, low-cost strategies. In 2010 I had the opportunity to learn and understand childhood malnutrition through a postgraduate course in Tanzania and Uganda – the East African Short Course in Tropical Medicine from London School of Hygiene and Tropical Medicine (LSHTM. Beginning with a review of concepts and definitions of childhood malnutrition and the links between development and nutrition, this article moves on to summarise a learning experience from Uganda and Tanzania related to the progress and effectiveness of ‘hospital-based” and ‘community-specific’ interventions.
Lubega, Irene; Ndugwa, Christopher M; Mworozi, Edison A; Tumwine, James K
Sickle cell anaemia is prevalent in sub Saharan Africa. While α+-thalassaemia is known to modulate sickle cell anaemia, its magnitude and significance in Uganda have hitherto not been described. To determine the prevalence of α+thalassaemia among sickle cell anaemia patients in Mulago Hospital and to describe the clinical and laboratory findings in these patients. A cross sectional study was carried out on patients with sickle cell anaemia in Kampala. Dried blood spots were used to analyze for the deletional α+ thalassaemia using multiplex polymerase chain reaction. Of the 142 patients with sickle cell anaemia, 110 (77.5%) had the αα+thalassaemia deletion. The gene frequency of (-α) was 0.425. Ninety one percent (100/110) of those with α+thalassaemia were heterozygous (αα/α-). Amongst the patients older than 60 months, 15 (83.3%) of those without αα+thalassaemia had significant hepatomegaly of greater than 4 cm compared to 36 (45.6%) of those with α+thalassaemia (p=0.003). The gene frequency of (-α) of 0.425 noted in this study is higher than that reported from many places in Africa. Concurrent alpha thalassemia might be a protective trait against significant hepatomegaly in sickle cell anaemia patients more than 60 months of age at Mulago hospital.
Michael G Kawooya
Full Text Available Objectives : The first objective of the study was to develop an index termed as the ′Imaging Coverage′ (IC, for measuring the performance of the imaging health systems. This index together with the Hospital-Based Utilization (HBU would then be calculated for five Ugandan hospitals. Second, was to relate the financial resources and existing health policy to the performance of the imaging systems. Materials and Methods: This was a cross-sectional survey employing the triangulation methodology, conducted in Mulago National Referral Hospital. The qualitative study used cluster sampling, in-depth interviews, focus group discussions, and self-administered questionnaires to explore the non-measurable aspects of the imaging systems′ performances. Results: The IC developed and tested as an index for the imaging system′s performance was 36%. General X-rays had the best IC followed by ultrasound. The Hospital-Based Utilization for the five selected hospitals was 186 per thousand and was the highest for general radiography followed by ultrasound. Conclusion: The IC for the five selected hospitals was 36% and the HBU was 186 per thousand, reflecting low performance levels, largely attributable to inadequate funding. There were shortfalls in imaging requisitions and inefficiencies in the imaging systems, financing, and health policy. Although the proportion of inappropriate imaging was small, reducing this inappropriateness even further would lead to a significant total saving, which could be channeled into investigating more patients. Financial resources stood out as the major limitation in attaining the desired performance and there is a need to increase budget funding so as to improve the performance of the imaging health systems.
Namiiro Flavia B
Full Text Available Abstract Background Healthy infants typically regain their birth weight by 21 days of age; however, failure to do so may be due to medical, nutritional or environmental factors. Globally, the incidence of low birth weight deliveries is high, but few studies have assessed the postnatal weight changes in this category of infants, especially in Africa. The aim was to determine what proportion of LBW infants had not regained their birth weight by 21 days of age after discharge from the Special Care Unit of Mulago hospital, Kampala. Methods A cross sectional study was conducted assessing weight recovery of 235 LBW infants attending the Kangaroo Clinic in the Special Care Unit of Mulago Hospital between January and April 2010. Infants aged 21 days with a documented birth weight and whose mothers gave consent to participate were included in the study. Baseline information was collected on demographic characteristics, history on pregnancy, delivery and postnatal outcome through interviews. Pertinent infant information like gestation age, diagnosis and management was obtained from the medical records and summarized in the case report forms. Results Of the 235 LBW infants, 113 (48.1% had not regained their birth weight by 21 days. Duration of hospitalization for more than 7 days (AOR: 4.2; 95% CI: 2.3 - 7.6; p value Conclusion Failure to regain birth weight among LBW infants by 21 days of age is a common problem in Mulago Hospital occurring in almost half of the neonates attending the Kangaroo clinic. Currently, the burden of morbidity in this group of high-risk infants is undetected and unaddressed in many developing countries. Measures for consideration to improve care of these infants would include; discharge after regaining birth weight and use of total parenteral nutrition. However, due to the pressure of space, keeping the baby and mother is not feasible at the moment hence the need for a strong community system to boost care of the infant. Close
Siddharthan, Trishul; Rabin, Tracy; Canavan, Maureen E; Nassali, Faith; Kirchhoff, Phillip; Kalyesubula, Robert; Coca, Steven; Rastegar, Asghar; Knauf, Felix
The majority of non-communicable disease related deaths occur in low- and middle-income countries. Patient-centered care is an essential component of chronic disease management in high income settings. To examine feasibility of implementation of a validated patient-centered education tool among patients with heart failure in Uganda. Mixed-methods, prospective cohort. A private and public cardiology clinic in Mulago National Referral and Teaching Hospital, Kampala, Uganda. Adults with a primary diagnosis of heart failure. PocketDoktor Educational Booklets with patient-centered health education. The primary outcomes were the change in Patient Activation Measure (PAM-13), as well as the acceptability of the PocketDoktor intervention, and feasibility of implementing patient-centered education in outpatient clinical settings. Secondary outcomes included the change in satisfaction with overall clinical care and doctor-patient communication. A total of 105 participants were enrolled at two different clinics: the Mulago Outpatient Department (public) and the Uganda Heart Institute (private). 93 participants completed follow up at 3 months and were included in analysis. The primary analysis showed improved patient activation measure scores regarding disease-specific knowledge, treatment options and prevention of exacerbations among both groups (mean change 0.94 [SD = 1.01], 1.02 [SD = 1.15], and 0.92 [SD = 0.89] among private paying patients and 1.98 [SD = 0.98], 1.93 [SD = 1.02], and 1.45 [SD = 1.02] among public paying patients, pmanagement as well as satisfaction with doctor-patient communication and overall care in Uganda. Our results show that printed booklets are locally appropriate, highly acceptable and feasible to implement in an LMIC outpatient setting across socioeconomic groups.
Nabukenya, Anne M; Matovu, Joseph K B; Wabwire-Mangen, Fred; Wanyenze, Rhoda K; Makumbi, Fredrick
Epilepsy is a devastating disorder that impacts on patients' quality of life, irrespective of use of anti epileptic drugs (AEDs). This study estimates the health-related quality of life (HRQOL) and its associated predictors among epilepsy patients receiving AEDs. A total of 175 epilepsy patients already receiving AED for at least 3 months were randomly selected and interviewed from mental clinics at Mulago and Butabika national referral hospitals in Uganda between May - July 2011. A HRQOL index, the primary outcome, was constructed using items from Quality Of Life in Epilepsy Inventory (QOLIE-31) and the Hospital Anxiety and Depression Scale (HADS) questionnaires. The internal consistency and adequacy of these items was also computed using Cronbach's alpha and Kaiser-Meyer-Olkin tests. Partial correlations were used to evaluate the contribution of the health dimensions (mental, psychological, social, physical functioning and emotional well being) and, multiple linear regressions to determine factors independently associated with HRQOL. Just about half of the respondents (54%) were males, and nearly two thirds (62%) had received AEDs for at least 12 months. The average age was 26.6 years (SD = 11.1). The overall HRQOL mean score was 58 (SD = 13) on a scale of 0-100. The average scores of different dimensions or subscales ranged from 41 (physical) to 65 (psychological). At least three quarters (75%) of all subscales had good internal consistency and adequacy. The largest variations in the overall HRQOL were explained by social and mental functioning; each accounting for about 30% of the difference in the HRQOL but seizure control features explained a little (6%) variation. Factors negatively associated with HRQOL were poly-therapy (-1.16, p = 0.01) and frequency of seizures (-2.29, p = 0.00). Other factors associated with overall HRQOL included drug side effects, sex, marital status and education. Duration on AEDs was not a significant predictor of HRQOL. The HRQOL
Nabirye, Rose C; Brown, Kathleen C; Pryor, Erica R; Maples, Elizabeth H
To assess levels of occupational stress, job satisfaction and job performance among hospital nurses in Kampala, Uganda; and how they are influenced by work and personal characteristics. Occupational stress is reported to affect job satisfaction and job performance among nurses, thus compromising nursing care and placing patients' lives at risk. Although these factors have been studied extensively in the US and Europe, there was a need to explore them from the Ugandan perspective. A correlational study was conducted with 333 nurses from four hospitals in Kampala, Uganda. A questionnaire measuring occupational stress, job satisfaction and job performance was used. Data were analysed using descriptive statistics and anova. There were significant differences in levels of occupational stress, job satisfaction and job performance between public and private not-for-profit hospitals, nursing experience and number of children. Organizational differences between public and private not-for-profit hospitals influence the study variables. On-the-job training for nurse managers in human resource management to increase understanding and advocacy for organizational support policies was recommended. Research to identify organizational, family or social factors which contribute to reduction of perceived occupational stress and increase job satisfaction and job performance was recommended. 2011 Blackwell Publishing Ltd.
Full Text Available Jackson Orem,1–3 Sven Sandin,1 Caroline E Weibull,1 Michael Odida,4 Henry Wabinga,4 Edward Mbidde,2,3 Fred Wabwire-Mangen,5 Chris JLM Meijer,6 Jaap M Middeldorp,6 Elisabete Weiderpass1,7,81Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; 2Uganda Cancer Institute, 3School of Medicine, 4School of Biomedical Sciences, 5School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda; 6Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands; 7Cancer Registry of Norway, Oslo; Department of Community Medicine, University of Tromsø, Tromsø, Norway; 8Samfundet Folkhälsan, Helsinki, FinlandBackground: Correct diagnosis is key to appropriate treatment of cancer in children. However, diagnostic challenges are common in low-income and middle-income countries. The objective of the present study was to assess the agreement between a clinical diagnosis of childhood non-Hodgkin lymphoma (NHL assigned in Uganda, a pathological diagnosis assigned in Uganda, and a pathological diagnosis assigned in The Netherlands.Methods: The study included children with suspected NHL referred to the Mulago National Referral Hospital, Kampala, Uganda, between 2004 and 2008. A clinical diagnosis was assigned at the Mulago National Referral Hospital, where tissue samples were also obtained. Hematoxylin and eosin-stained slides were used for histological diagnosis in Uganda, and were re-examined in a pathology laboratory in The Netherlands, where additional pathological, virological and serological testing was also carried out. Agreement between diagnostic sites was compared using kappa statistics.Results: Clinical and pathological diagnoses from Uganda and pathological diagnosis from The Netherlands was available for 118 children. The agreement between clinical and pathological diagnoses of NHL assigned in Uganda was 91% (95% confidence interval [CI] 84–95; kappa 0.84; P < 0
Chemotherapeutics Research Laboratory, the Government of Uganda ... tions informed Uganda's information ... to improve its management and build information technology systems. The hospital ... volunteers to refer sick children to medical.
Alema, O N; Martin, D O; Okello, T R
Upper gastrointestinal bleeding (UGIB) is a common emergency medical condition that may require hospitalization and resuscitation, and results in high patient morbidity. Upper gastrointestinal endoscopy is the preferred investigative procedure for UGIB because of its accuracy, low rate of complication, and its potential for therapeutic interventions. To determine the endoscopic findings in patients presenting with UGIB and its frequency among these patients according to gender and age in Lacor hospital, northern Uganda. The study was carried out at Lacor hospital, located at northern part of Uganda. The record of 224 patients who underwent endoscopy for upper gastrointestinal bleeding over a period of 5 years between January 2006 and December 2010 were retrospectively analyzed. A total of 224 patients had endoscopy for UGIB which consisted of 113 (50.4%) males and 111 (49.6%) females, and the mean age was 42 years ± SD 15.88. The commonest cause of UGIB was esophagealvarices consisting of 40.6%, followed by esophagitis (14.7%), gastritis (12.6%) and peptic ulcer disease (duodenal and gastric ulcers) was 6.2%. The malignant conditions (gastric and esophageal cancers) contributed to 2.6%. Other less frequent causes of UGIB were hiatus hernia (1.8), duodenitis (0.9%), others-gastric polyp (0.4%). Normal endoscopic finding was 16.1% in patients who had UGIB. Esophageal varices are the commonest cause of upper gastrointestinal bleeding in this environment as compared to the west which is mainly peptic ulcer disease.
Full Text Available The objective of this manuscript was to examine existing hospital accreditation systems in three East African countries (Uganda, Kenya and Tanzania, assess attitudes and opinions of key stakeholders regarding hospital accreditation systems in the region, and identify lessons regarding sustainable and effective implementation of hospital accreditation systems in resource-limited countries. National hospital accreditation systems were found in Kenya and Tanzania. Uganda’s accreditation system, known as Yellow Star, had been suspended. Attitudes and opinions of key stakeholders almost unanimously supported the idea of establishing new national hospital accreditation programs, but opinions differed regarding whether that system should be operated by the government or a private independent organization. Our analysis supports the following lessons regarding accreditation systems in the region: (1 self-funding mechanisms are critical to long-term success; (2 external assessments occurred more frequently in our focus countries than accreditation systems in developed countries; (3 Kenya has established framework for providing financial incentives to highly performing hospitals, but these links need to be strengthened; and (4 automatic accreditation of governmental health facilities in Kenya and Tanzania illustrate the potential hazard of public authorities overseeing accreditation programs.
Full Text Available The objective of this manuscript was to examine existing hospital accreditation systems in three East African countries (Uganda, Kenya and Tanzania, assess attitudes and opinions of key stakeholders regarding hospital accreditation systems in the region, and identify lessons regarding sustainable and effective implementation of hospital accreditation systems in resource-limited countries. National hospital accreditation systems were found in Kenya and Tanzania. Uganda’s accreditation system, known as Yellow Star, had been suspended. Attitudes and opinions of key stakeholders almost unanimously supported the idea of establishing new national hospital accreditation programs, but opinions differed regarding whether that system should be operated by the government or a private independent organization. Our analysis supports the following lessons regarding accreditation systems in the region: (1 self--‐funding mechanisms are critical to long-term success; (2 external assessments occurred more frequently in our focus countries than accreditation systems in developed countries; (3 Kenya has established framework for providing financial incentives to highly performing hospitals, but these links need to be strengthened; and (4 automatic accreditation of governmental health facilities in Kenya and Tanzania illustrate the potential hazard of public authorities overseeing accreditation programs.
An ethical review committee consisting of medical scientists, social scientists, and lawyers has been established by the Ugandan government to oversee individuals and institutions conducting biomedical research. The research of Professor Sali, who produced and marketed Mariandina as a cure for acquired immunodeficiency syndrome (AIDS), is not recognized, according to Dr. Jeremiah Twa-twa, Registrar of the National Medical Council. Professor Sali had been given six months to produce an acceptable protocol, with controls, that demonstrated the efficacy of the drug. He had stated previously that his patients received a minimum of six tablets daily of Mariandina A, B, or J; thousands are said to have been treated. Professor Sali, who returned to Uganda in 1990 with a 100,000-pound loan to produce the drug, advised his patients to sell everything they owned in order to pay for their treatment, according to Major Ruranga Rubaramira (head of a joint clinical council). The Uganda AIDS Commission is also considering the use of herbs in the treatment of AIDS; nine Western-trained researchers are collaborating with herbalists in studies that have shown promising results. Dr. Donna Kabatesi, who heads a clinic that uses both herbs and Western medicine in the treatment of AIDS patients at Mulago hospital, believes herbs are equally effective for some purposes.
Full Text Available Abstract Background Sickle cell anaemia (SCA is a major chronic health problem in Uganda. In patients with SCA, the level of foetal haemoglobin (HbF has been found to be important in influencing the clinical course of the disease. Thus populations with high levels of HbF like those in Saudi Arabia have been described as having a milder clinical course with fewer complications as compared to populations with lower levels. Disease modifying drugs can increase the Hb F levels and modify the presentation of SCA. Methods This was a cross sectional study in which we determined foetal haemoglobin levels and examined the relationship between HbF levels and disease severity in SCA patients in Mulago Hospital, Kampala, Uganda. We consecutively enrolled 216 children aged 1 year to 18 years with SCA attending the Sickle Cell Clinic at Mulago Hospital whose guardians had given consent. The history included age at onset of initial symptoms and diagnosis, number of hospitalisations and blood transfusions and other complications of SCA (cardiovascular accidents, avascular hip necrosis and priapism. A detailed physical examination was performed to assess the current state and help describe the disease severity for each patient. Blood samples were drawn for HbF levels. HbF levels ≥10% was defined as high. Results Of the 216 children, (80 37% had HbF levels ≥10%. Significant correlations were observed between HbF level and several clinical parameters independent of age including age at diagnosis (p value 0.013, number of hospitalisations (p value 0.024 and transfusions (p value 0.018 since birth. Conclusion A third of the children with SCA attending the Sickle cell clinic in Mulago Hospital have high HbF levels. Higher HbF level is associated with later onset of symptoms and presentation, and less severe disease characterised by fewer hospitalisations and blood transfusions. We suggest HbF levels should be determined at initial contact for patients with SCA to
Kakyo, T A; Xiao, L D
The aim of this study was to understand nurse ward managers perceived challenges in the rural healthcare setting in Uganda. The health workforce, essential medicines and equipment and political unrest are the main factors affecting the international community in addressing the hefty disease burden in World Health Organization African regions. Nurse ward managers have an important role to play to mitigate these factors in health facilities in these regions through leadership, supervision and support for staff. This study utilized interpretive phenomenology based on Gadamer's hermeneutical principles. Eleven nurse managers from two rural public hospitals in Uganda were interviewed. Those with more than a 2-year experience in their management role were invited to participate in the study. Nurse managers pointed out four major challenges with staffing, while they worked in the rural healthcare settings. These are summarized into themes: 'Numbers do matter'; 'I cannot access them when I need them at work'; 'Challenges in dealing with negative attitudes'; and 'Questioning own ability to manage health services'. Health facilities in rural areas face extremely low staff-to-patient ratio, a high level of workload, lack of essential medicines and equipment, low salaries and delayed payment for staff. Nurse managers demonstrated situation-based performance to minimize the impact of these challenges on the quality and safety of patient care, but they had less influence on policy and resource development. It is imperative to mobilize education for nurse ward managers to enable them to improve leadership, management skills and to have a greater impact on policy and resource development. © 2018 International Council of Nurses.
Epaenetus A. Awuzu
Full Text Available Various studies have reported that abuse of cannabis is a risk factor for psychosis. The aims of this study were to determine the prevalence of delta 9-tetrahydrocanabinol (Δ 9 -THC, a major metabolite of cannabis, in psychiatric patients in Uganda, and to assess the diagnostic capacity of two referral mental health hospitals to screen patients for exposure to cannabis in Uganda. Socio-demographic characteristics of the patients were collected through questionnaires and review of medical records. Urine samples were collected from 100 patients and analyzed using Δ 9 -THC immunochromatographic kit (Standard Diagnostics®, South Korea. Seventeen percent of the patients tested positive for Δ 9 -THC residues in their urine. There was strong association ( p < 0.05 between history of previous abuse of cannabis and presence of Δ 9 -THC residues in the urine. Alcohol, cocaine, heroin, pethidine, tobacco, khat and kuber were the other substances abused in various combinations. Both referral hospitals lacked laboratory diagnostic kits for detection of cannabis in psychiatric patients. In conclusion, previous abuse of cannabis is associated with occurrence of the residues in psychiatric patients, yet referral mental health facilities in Uganda do not have the appropriate diagnostic kits for detection of cannabis residues as a basis for evidence-based psychotherapy.
Gravely, Shannon; Nyamurungi, Kellen Namusisi; Kabwama, Steven Ndugwa; Okello, Gabriel; Robertson, Lindsay; Heng, Kelvin Khow Chuan; Ndikum, Achiri Elvis; Oginni, Adeniyi Samuel; Rusatira, Jean Christophe; Kakoulides, Socrates; Huffman, Mark D; Yusuf, Salim; Bianco, Eduardo
Objective This study evaluated knowledge, opinions and compliance related to Uganda’s comprehensive smoke-free law among hospitality venues in Kampala Uganda. Design This multi-method study presents cross-sectional findings of the extent of compliance in the early phase of Uganda’s comprehensive smoke-free law (2 months postimplementation; pre-enforcement). Setting Bars, pubs and restaurants in Kampala Uganda. Procedure and participants A two-stage stratified cluster sampling procedure was us...
Obua, Thomas Ocwa; Adome, Richard Odoi; Kutyabami, Paul; Kitutu, Freddy Eric; Kamba, Pakoyo Fadhiru
Pharmacists are invaluable resources in health care. Their expertise in pharmacotherapy and medicine management both ensures that medicines of appropriate quality are available in health facilities at the right cost and are used appropriately. Unfortunately, some countries like Uganda have shortage of pharmacists in public health facilities, the dominant providers of care. This study investigated the factors that affect the occupancy of pharmacist positions in Uganda's public hospitals, including hiring patterns and job attraction and retention. A cross-sectional survey of 91 registered pharmacists practicing in Uganda and desk review of records from the country's health care worker (HCW) recruiting agency was done in the months of May, June, and July, 2016. Pharmacist interviews were done using self-administered structured questionnaire and analyzed by descriptive statistics and chi-square test. Slight majority (53%) of the interviewed pharmacists work in two sectors. About 60% of the pharmacists had ever applied for public hospital jobs. Of those who received offers (N = 46), 30% had declined them. Among those who accepted the offers (N = 41), 41% had already quit. Meanwhile, the pace of hiring pharmacists into Uganda's public sector is too slow. Low socio-economic status of family in childhood (χ 2 = 2.77, p = 0.10), admission through matriculation and diploma scheme (χ 2 = 2.37, p = 0.12), internship in countryside hospitals (χ 2 = 2.24, p = 0.13), working experience before pharmacy school (χ 2 = 2.21, p = 0.14), salary expectation (χ 2 = 1.76, p = 0.18), and rural secondary education (χ 2 = 1.75, p = 0.19) favored attraction but in a statistically insignificant manner. Retention was most favored by zero postgraduate qualification (χ 2 = 4.39, p = 0.04), matriculation and diploma admission scheme (χ 2 = 2.57, p = 0.11), and working experience in private sector (χ 2 = 2
Michael G Kawooya
Full Text Available Introduction: Uganda has limited health resources. It is important to measure the need for imaging in order to set policy and plan for imaging services. Objectives: The first specific objective was to develop and apply four imaging needs indices on a case study basis, in five selected Ugandan hospitals. The indices were: Imaging Load (IL, Imaging Burden (IB, Type Specific Imaging Burden (TSIB, and Disease Specific Imaging Burden (DSIB. The second objective was to explore the perceptions of the patient, referring clinician, and radiologist regarding the values, meaning, and objective of imaging in patient care. Materials and Methods: This was a cross-sectional survey employing triangulation methodology, conducted in 5 Ugandan hospitals over a period of 3 years during 2005 - 2008. The subjects were divided into four clusters: Obstetrics and gynecology (obs/gynae, surgery, internal medicine, and pediatrics. For the quantitative component of the study, data from case notes was used to calculate the indices. The qualitative component explored the non-measurable aspects of imaging needs from the clinician′s, radiologist′s, and patient′s perspective. Results: A total of 1961 patient case notes were studied. The IB was 460 per 1000 hospital patients per year. The highest TSIB was for ultrasound at 232 per 1000 hospital patients per year, followed by 191 patients for general X-ray. The majority of the patients interviewed had special desires, expectations, and misconceptions. Conclusions: There is a high IB of 460 per thousand patient populations per year, mainly due to ultrasound. The majority of the patients have perceptions, misconceptions, beliefs, and values which influence the need for imaging. There is a need to address the medical and non-tangible imaging needs of the patient and to counteract imaging-related misconceptions and over-expectations. Public awareness of the value, capabilities, limitations, and adverse effects of various
Kristensen, Kia Hee Schultz; Wiese, Maria; Rytter, Maren Johanne Heilskov; Özçam, Mustafa; Hansen, Lars Hestbjerg; Namusoke, Hanifa; Friis, Henrik; Nielsen, Dennis Sandris
Severe acute malnutrition (SAM) among children remains a major health problem in many developing countries. SAM manifests in both an oedematous and a non-oedematous form, with oedematous malnutrition in its most severe form also known as kwashiorkor. The pathogenesis of both types of malnutrition in children remains largely unknown, but gut microbiota (GM) dysbiosis has recently been linked to oedematous malnutrition. In the present study we aimed to assess whether GM composition differed between Ugandan children suffering from either oedematous or non-oedematous malnutrition. As part of an observational study among children hospitalized with SAM aged 6-24 months in Uganda, fecal samples were collected at admission. Total genomic DNA was extracted from fecal samples, and PCR amplification was performed followed by Denaturing Gradient Gel Electrophoresis (DGGE) and tag-encoded 16S rRNA gene-targeted high throughput amplicon sequencing. Alpha and beta diversity measures were determined along with ANOVA mean relative abundance and G-test of independence followed by comparisons between groups. Of the 87 SAM children included, 62% suffered from oedematous malnutrition, 66% were boys and the mean age was 16.1 months. GM composition was found to differ between the two groups of children as determined by DGGE (p = 0.0317) and by high-throughput sequencing, with non-oedematous children having lower GM alpha diversity (p = 0.036). However, beta diversity analysis did not reveal larger differences between the GM of children with oedematous and non-oedematous SAM (ANOSIM analysis, weighted UniFrac, R = -0.0085, p = 0.584; unweighted UniFrac, R = 0.0719, p = 0.011). Our results indicate that non-oedematous SAM children have lower GM diversity compared to oedematous SAM children, however no clear compositional differences were identified.
Masembe, Ishak Kamaradi
This study was an analysis of the effect of strategic planning on procurement of medicals in Uganda's regional referral hospitals (RRH's). Medicals were defined as essential medicines, medical devices and medical equipment. The Ministry of Health (MOH) has been carrying out strategic planning for the last 15 years via the Health Sector Strategic Plans. Their assumption was that strategic planning would translate to strategic procurement and consequently, availability of medicals in the RRH's. However, despite the existence of these plans, there have been many complaints about expired drugs and shortages in RRH's. For this purpose, a third variable was important because it served the role of mediation. A questionnaire was used to obtain information on perceptions of 206 respondents who were selected using simple random sampling. 8 key informant interviews were held, 2 in each RRH. 4 Focus Group Discussions were held, 1 for each RRH, and between 5 and 8 staff took part as discussants for approximately three hours. The findings suggested that strategic planning was affected by funding to approximately 34% while the relationship between funding and procurement was 35%. The direct relationship between strategic planning and procurement was 18%. However when the total causal effect was computed it turned out that strategic planning and the related variable of funding contributed 77% to procurement of medicals under the current hierarchical model where MOH is charged with development of strategic plans for the entire health sector. Since even with this contribution there were complaints, the study proposed a new model called CALF which according to a simulation, if adopted by MOH, strategic planning would contribute 87% to effectiveness in procurement of medicals.
Musisi, S; Akena, D; Nakimuli-Mpungu, E; Abbo, C; Okello, J
Nodding Syndrome (NS), previously called Nodding Disease, is a chronic and debilitating illness affecting thousands of children aged 3-18 years in post-conflict Northern Uganda and South Sudan. Characterised by malnutrition, stunted growth, mental retardation and seizures, some researchers have designated it as epilepsy. With reports appearing in Northern Uganda in1997, NS reached epidemic proportions around 2000-2003 when people were moved into Internally Displaced People's (IDP) camps. Investigations for infections (onchocerciasis) and toxins have been inconclusive as to cause, treatment or outcome. No study has addressed the possible relationship of NS to childhood war-trauma experiences. To explore a possible relationship of exposure to prolonged war-trauma and the emergence of epidemic NS in Northern Uganda. This study was a case-series descriptive psychiatric naturalistic field observations of NS cases from homesteads in Northern Uganda and psychiatric investigations and treatment of NS cases referred to Mulago National Referral and Teaching Hospital. Detailed Psychiatric clinical evaluations and field observations revealed that NS children had been exposed to severe war-related psychological and physical trauma as well as non-specific CNS insults including untreated CNS infections/infestations and malnutrition possibly causing seizures. Many children suffered post-traumatic stress disorder (PTSD) and depression. NS could present as an association of childhood complex PTSD, (called Developmental Trauma Disorder), occurring in the chronically war-traumatised children of Northern Uganda, complicated by severe prolonged depression with its characteristic symptoms of psychomotor retardation, anxiety, anhedonia and anorexia. This, coupled with food shortages, resulted in malnutrition, wasting and stunted growth with severe avitaminoses. Many children had seizures. All this calls for multi-disciplinary treatment approaches.
Background: The perinatal mortality of 70 deaths per 1,000 total births in Uganda is unacceptably high. Perinatal death audits are important for improvement of perinatal care and reduction of perinatal morality. We integrated perinatal death audits in routine care, and describe its effect on perinatal mortality rate at Nsambya ...
Muwazi, Louis; Rwenyonyi, Charles Mugisha; Nkamba, Moses; Kutesa, Annet; Kagawa, Mike; Mugyenyi, Godfrey; Kwizera, Godfrey; Okullo, Isaac
Literature reports have indicated an increase in research evidence suggesting association between periodontal disease and the risk of pre-term birth (PTB) and low birth weight (LBW). Periodontal diseases in Uganda have been documented as a public health problem, but their association to adverse pregnancy outcomes is unknown. This study was conducted to assess the association between periodontital diseases in postpartum mothers and PTB and LBW of babies in Mulago and Mbarara referral hospitals. This was a cross sectional study using medical records, clinical examination and oral interview of mothers at the two tertiary health facilities. Mothers with singleton babies from Mulago (n = 300) and Mbarara Hospital (n = 100) were recruited for the study. The women were clinically examined for periodontal disease by 2 trained and calibrated dentists. Data on PTB and LBW were retrieved from medical records. The data were analyzed to determine the relationship between the four parameters for periodontal disease (bleeding gingiva, periodontal pockets, gingival recession and calculus with plaque deposits) and the adverse pregnancy outcomes. Frequency distribution was used to describe the data. Bivariate and multivariate analyses were used to study the association between the periodontal diseases and adverse pregnancy outcomes. Approximately 26% and 29% of the postpartum mothers examined had bleeding gingiva and periodontal pockets of 4 mm or more deep, respectively. Advanced periodontitis i.e. pocket depth ≥ 6 mm was recorded in 13 (3.6%) of the mothers. Calculus with plaque deposits were recorded in 86% (n = 343) of the mothers. Gingival recession was recorded in 9.0% of the mothers and significantly and directly related to birth weight (p Periodontal conditions of postpartum mothers in this study were found to be better than previously reported amongst the Ugandan population. Bivariate analysis showed a significant association only between gingival
204 patients with mechanical back pain were enrolled in the study, after screening all consecutive new adult patients referred with low back pain as the major complaint. A validated modified Oswestry instrument was used to collect data. Nine daily activities: sleep, sex, lifting, traveling, social and recreational activities, ...
as anaechoic area bounded by the joint capsule. A simple effusion was anaechoic. Diffuse increase in echogenicity suggested infection or haemoarthrosis. Simple bursitis was depicted as anechoic fluid, with or without septa (fig 1A). In chronic bursitis, there was bursal thickening seen as a band of moderate echogenicity.
Sep 3, 2013 ... Arch Dis Child Fetal Neonatal Ed 2003;88:F359-. F64. 21. López-Herce J, Dorao P, Elola P, Delgado MA,. Ruza F, Madero R. Frequency and prophylaxis of upper gastrointestinal hemorrhage in critically ill children: a prospective study comparing the efficacy of almagate, ranitidine and sucralfate. Crit Care ...
Background: Low back pain is sufficiently disabling and a common cause of disability particularly during the productive middle years of adult life. Disability implies interference with daily activities. Objective: To assess and document the disability associated with low back pain in terms of sick leave days, interference with ...
They were followed up and compared to five hundred women (controls) who had normal deliveries. Outcome variables: Socio-demographic characteristics, familial history, medical history, gynaecological and obstetric history. Results: The risk factors for severe abruptio placenta were low socio economic status (OR 10.5 ...
Mwebaza, Ivan; Katende, Godfrey; Groves, Sara; Nankumbi, Joyce
Pressure ulcers have been identified as a major burden of hospitalization worldwide, and nurses are at the forefront of prevention. The purpose of this study was to determine the nurses' knowledge and practices regarding risk factors, prevention, and management of pressure ulcers at a teaching hospital in Uganda. The study employed a descriptive cross-sectional design. Fifty-six Ugandan registered practicing nurses were sampled. A composite self-administered questionnaire and an observation checklist were utilized. The nurses had limited knowledge about critical parameters of pressure ulcers. Prevention practices were observed to be unreliable and uncoordinated related to a significant shortage of staff and logistics for pressure ulcer prevention. Nurses had poor access to current literature on pressure ulcer prevention. Translation of nurses' knowledge into practice is possible if barriers like staff shortage, pressure relieving devices provision, and risk assessment tools are addressed at Mulago. PMID:24707398
Full Text Available Pressure ulcers have been identified as a major burden of hospitalization worldwide, and nurses are at the forefront of prevention. The purpose of this study was to determine the nurses’ knowledge and practices regarding risk factors, prevention, and management of pressure ulcers at a teaching hospital in Uganda. The study employed a descriptive cross-sectional design. Fifty-six Ugandan registered practicing nurses were sampled. A composite self-administered questionnaire and an observation checklist were utilized. The nurses had limited knowledge about critical parameters of pressure ulcers. Prevention practices were observed to be unreliable and uncoordinated related to a significant shortage of staff and logistics for pressure ulcer prevention. Nurses had poor access to current literature on pressure ulcer prevention. Translation of nurses’ knowledge into practice is possible if barriers like staff shortage, pressure relieving devices provision, and risk assessment tools are addressed at Mulago.
Erika van den Bogaart
Full Text Available BACKGROUND AND METHODOLOGY: Due to geographic overlap of malaria and visceral leishmaniasis (VL, co-infections may exist but have been poorly investigated. To describe prevalence, features and risk factors for VL-malaria co-infections, a case-control analysis was conducted on data collected at Amudat Hospital, Uganda (2000-2006 by Médecins sans Frontières. Cases were identified as patients with laboratory-confirmed VL and malaria at hospital admission or during hospitalization; controls were VL patients with negative malaria smears. A logistic regression analysis was performed to study the association between patients' characteristics and the occurrence of the co-infection. RESULTS: Of 2414 patients with confirmed VL, 450 (19% were positively diagnosed with concomitant malaria. Most co-infected patients were males, residing in Kenya (69%. While young age was identified by multivariate analysis as a risk factor for concurrent VL and malaria, particularly the age groups 0-4 (odds ratio (OR: 2.44; 95% confidence interval (CI: 1.52-3.92 and 5-9 years (OR: 2.23, 95% CI: 1.45-3-45, mild (OR: 0.53; 95% CI: 0.32-0.88 and moderate (OR: 0.45; 95% CI: 0.27-0.77 anemia negatively correlated with the co-morbidity. VL patients harboring skin infections were nearly three times less likely to have the co-infection (OR: 0.35; 95% CI: 0.17-0.72, as highlighted by the multivariate model. Anorexia was slightly more frequent among co-infected patients (OR: 1.71; 95% CI: 0.96-3.03. The in-hospital case-fatality rate did not significantly differ between cases and controls, being 2.7% and 3.1% respectively (OR: 0.87; 95% CI: 0.46-1.63. CONCLUSIONS: Concurrent malaria represents a common condition among young VL patients living in the Pokot region of Kenya and Uganda. Although these co-morbidities did not result in a poorer prognosis, possibly due to early detection of malaria, a positive trend towards more severe symptoms was identified, indicating that routine
Olok, Geoffrey Tabo; Yagos, Walter Onen; Ovuga, Emilio
E-health is an essential information sharing tool in healthcare management and delivery worldwide. However, utilization of e-health may only be possible if healthcare professionals have positive attitudes towards e-health. This study aimed to determine the relationships between healthcare professionals' attitudes towards e-health, level of ICT skills and e-Health use in healthcare delivery in government and private hospitals in northern Uganda. Cross-sectional survey design was used. Sixty-eight medical doctors in three government hospitals and four private hospitals in Northern Uganda participated in the study. A pretested self-administered questionnaire was used to collect the required data. Data was analysed using SPSS software Version 19. Out of the 68 respondents, 39 (57.4 %) reported access to computer and 29 (48.5 %) accessed Internet in the workplace. Majority of healthcare professionals had positive attitudes towards e-health attributes (mean 3.5). The level of skills was moderate (mean 3.66), and was the most important and significant predictor of ICT use among healthcare professionals (r = .522, p < .001); however, attitudes towards e-health attributes did not contribute significantly in predicting e-health use. The findings suggest need for hospitals managements to strengthen e-health services in healthcare delivery in Northern Uganda.
Gravely, Shannon; Nyamurungi, Kellen Namusisi; Kabwama, Steven Ndugwa; Okello, Gabriel; Robertson, Lindsay; Heng, Kelvin Khow Chuan; Ndikum, Achiri Elvis; Oginni, Adeniyi Samuel; Rusatira, Jean Christophe; Kakoulides, Socrates; Huffman, Mark D; Yusuf, Salim; Bianco, Eduardo
This study evaluated knowledge, opinions and compliance related to Uganda's comprehensive smoke-free law among hospitality venues in Kampala Uganda. This multi-method study presents cross-sectional findings of the extent of compliance in the early phase of Uganda's comprehensive smoke-free law (2 months postimplementation; pre-enforcement). Bars, pubs and restaurants in Kampala Uganda. A two-stage stratified cluster sampling procedure was used to select hospitality sites stratified by all five divisions in Kampala. A total of 222 establishments were selected for the study. One hospitality representative from each of the visited sites agreed to take part in a face-to-face administered questionnaire. A subsample of hospitality venues were randomly selected for tobacco air quality testing (n=108). Data were collected between June and August 2016. Knowledge and opinions of the smoke-free law among hospitality venue staff and owners. The level of compliance with the smoke-free law in hospitality venues through: (1) systematic objective observations (eg, active smoking, the presence of designated smoking areas, 'no smoking' signage) and (2) air quality by measuring the levels of tobacco particulate matter (PM 2.5 ) in both indoor and outdoor venues. Active smoking was observed in 18% of venues, 31% had visible 'no smoking' signage and 47% had visible cigarette remains. Among interviewed respondents, 57% agreed that they had not been adequately informed about the smoke-free law; however, 90% were supportive of the ban. Nearly all respondents (97%) agreed that the law will protect workers' health, but 32% believed that the law would cause financial losses at their establishment. Indoor PM 2.5 levels were hazardous (267.6 µg/m 3 ) in venues that allowed smoking and moderate (29.6 µg/m 3 ) in smoke-free establishments. In the early phase of Uganda's smoke-free law, the level of compliance in hospitality venues settings in Kampala was suboptimal. Civil society and the
Morgan, Melissa C; Nambuya, Harriet; Waiswa, Peter; Tann, Cally; Elbourne, Diana; Seeley, Janet; Allen, Elizabeth; Lawn, Joy E
Kangaroo mother care (KMC) for stable neonates ≤2000 g (g) is associated with decreased mortality, sepsis, hypothermia, and length of stay compared to conventional care. The World Health Organization states that KMC "should be initiated… as soon as newborns are clinically stable " . However, the majority of deaths occur in unstable neonates. We aimed to determine the proportion of admitted neonates meeting proposed instability criteria, assess the feasibility of providing KMC to unstable neonates, and evaluate the acceptability of this intervention to parents and providers at Jinja Regional Referral Hospital in Uganda. This was a mixed-methods study. We recorded data including birthweight, chronological age, and treatments administered from medical charts, and calculated the percentage of clinically unstable neonates, defined as the need for ≥2 medical therapies in the first 48 hours of admission. We enrolled a sample of neonates meeting pre-defined instability criteria. Mothers were counselled to provide KMC as close to continuously as possible. We calculated the median duration of KMC per episode and per day. To explore acceptability, we conducted semi-structured interviews with parents and newborn unit care providers, and analysed data using the thematic content approach. We included 254 neonates in the audit, 10 neonates in the feasibility sub-study, and 20 participants in the acceptability sub-study. Instability criteria were easily implementable, identifying 89% of neonates as unstable in the audit. The median duration of individual KMC episodes ranged from 115 to 134 minutes. The median daily duration ranged from 4.5 to 9.7 hours. Seventy-five percent of interviewees felt KMC could be used in neonates concurrently receiving other medical therapies. Barriers included lack of resources (beds/space, monitoring devices), privacy issues, inadequate education, and difficulties motivating mothers to devote time to KMC. Recommendations included staff
Semeere, Aggrey S; Nakanjako, Damalie; Ddungu, Henry; Kambugu, Andrew; Manabe, Yukari C; Colebunders, Robert
Malnutrition is common among HIV-infected individuals and is often accompanied by low serum levels of micronutrients. Vitamin B-12 deficiency has been associated with various factors including faster HIV disease progression and CD4 depletion in resource-rich settings. To describe prevalence and factors associated with sub-optimal vitamin B-12 levels among HIV-infected antiretroviral therapy (ART) naïve adults in a resource-poor setting, we performed a cross-sectional study with a retrospective chart review among individuals attending either the Mulago-Mbarara teaching hospitals' Joint AIDS Program (MJAP) or the Infectious Diseases Institute (IDI) clinics, in Kampala, Uganda. Logistic regression was used to determine factors associated with sub-optimal vitamin B-12. The mean vitamin B-12 level was 384 pg/ml, normal range (200-900). Sub-optimal vitamin B-12 levels (ART (CD4ART-naïve adult clinic population in urban Uganda. We recommend prospective studies to further clarify the causal relationships of sub-optimal vitamin B-12, and explore the role of vitamin B-12 supplementation in immune recovery.
Renee Yuen-Jan Hsia
Full Text Available Globally, 90% of road crash deaths occur in the developing world. Children in Africa bear the major part of this burden, with the highest unintentional injury rates in the world. Our study aims to better understand injury patterns among children living in Kampala, Uganda and provide evidence that injuries are significant in child health. Trauma registry records of injured children seen at Mulago Hospital in Kampala were analysed. This data was collected when patients were seen initially and included patient condition, demographics, clinical variables, cause, severity, as measured by the Kampala trauma score, and location of injury. Outcomes were captured on discharge from the casualty department and at two weeks for admitted patients. From August 2004 to August 2005, 872 injury visits for children <18 years old were recorded. The mean age was 11 years (95% CI 10.9–11.6; 68% (95% CI 65–72% were males; 64% were treated in casualty and discharged; 35% were admitted. The most common causes were traffic crashes (34%, falls (18% and violence (15%. Most children (87% were mildly injured; 1% severely injured. By two weeks, 6% of the patients admitted for injuries had died and, of these morbidities, 16% had severe injuries, 63% had moderate injuries and 21% had mild injuries. We concluded that, in Kampala, children bear a large burden of injury from preventable causes. Deaths in low severity patients highlight the need for improvements in facility-based care. Further studies are necessary to capture overall child injury mortality and to measure chronic morbidity owing to sequelae of injuries.
'I think my body has become addicted to those tablets'. Chronic heart failure patients' understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda.
Full Text Available Patients with heart failure in Uganda present for health care with advanced structural heart disease, have repeated hospitalizations and poorly controlled disease symptoms. The reasons for these are unclear. Literature from other settings shows that patients' understanding of their illness and their beliefs influence their health related behaviour. The study aimed to explore the beliefs of patients with heart failure, their understanding of their illness and its treatment, and how this influenced their health related behaviour to inform future health education programs, information and palliative care services.Serial qualitative in-depth interviews were conducted with Heart Failure patients who were purposively sampled and recruited in Mulago National Referral Hospital until thematic saturation was reached. In-depth interviews were conducted at three time points over the course of their illness with intervals of 3 months between interviews. A grounded theory approach was used in data analysis. The University of Edinburgh ethics committee, Mulago Hospital Research Ethics committee and the Uganda National Council of Science and Technology (Reference numbers D/GC/178; MREC 33, SS 3083 respectively approved the research.A total of 40 face to face qualitative longitudinal interviews (36-patient alone, 4 paired-patient and family carer, were conducted with 21 patients. The findings revealed that heart failure patients were unaware of the symptoms of the illness and their definition of illness differed from that of health professionals. Patients understood their diagnosis, cause of illness, prognosis and the importance of the medicines differently from health professionals, and had insufficient information on self-care. Lay beliefs were used to explain many aspects of the illness and treatments. All these influenced where patients sought care and their adherence to treatment, self-care and follow up leading to uncontrolled disease.There is a high level
Lundberg, Patric; Nakasujja, Noeline; Musisi, Seggane; Thorson, Anna Ekéus; Cantor-Graae, Elizabeth; Allebeck, Peter
We investigated prevalence of past-year sexual risk behavior and sexual violence exposure in persons with severe mental illness (SMI) in Uganda, and compared results to general population estimates. We also investigated whether persons with SMI reporting sexual risk behavior and sexual violence exposure were more likely to be HIV-infected. We included 602 persons consecutively discharged from Butabika Hospital, Kampala, Uganda, February to April 2010. We asked about past-year number of sexual partners and condom use. We assessed sexual violence with the World Health Organization Violence Against Women Instrument. We performed HIV testing. We used data from 2011 Uganda Demographic and Health Survey for comparison. Women with SMI had more sexual risk behavior and more sexual violence exposure than women in the general population. We found no difference in sexual risk behavior in men. Sexual risk behavior was associated with HIV infection in men, but not women. Sexual violence exposure was not associated with HIV infection in women. Findings suggest that SMI exacerbates Ugandan women's sexual vulnerability. Public health practitioners, policymakers, and legislators should act to protect health and rights of women with SMI in resource-poor settings.
Background: Microvascular free tissue transfer is an important method for reconstructing complex surgical and traumatic defects, allowing single stage reconstruction in most instances. This study reviews the first 19 consecutive free tissue transfer (free flap) reconstructions at Mengo hospital, Department of Plastic and ...
Objective: To compare fetal outcomes among grand multiparous (para 5-9) and multiparous (para 2-4) delivering in Mulago hospital, Uganda. Design: Prospective cohort study. Setting: Mulago hospital, Uganda. Subjects: One hundred and fifty six grand multiparous and multiparous women were recruited on admission in ...
Full Text Available Abstract Background Improved availability of antiretroviral therapy in sub-Saharan Africa is intended to benefit all eligible HIV-infected patients; however in reality antiretroviral services are mainly offered in urban hospitals. Poor rural patients have difficulty accessing the drugs, making the provision of antiretroviral therapy inequitable. Initial tests of community-based treatment programs in Uganda suggest that home-based treatment of HIV/AIDS may equal hospital-based treatment; however the literature reveals limited experiences with such programs. The research This intervention study aimed to; 1 assess the effectiveness of a rural community-based ART program in a subcounty (Rwimi of Uganda; and 2 compare treatment outcomes and mortality in a rural community-based antiretroviral therapy program with a well-established hospital-based program. Ethics approvals were obtained in Canada and Uganda. Results and outcomes Successful treatment outcomes after two years in both the community and hospital cohorts were high. All-cause mortality was similar in both cohorts. However, community-based patients were more likely to achieve viral suppression and had good adherence to treatment. The community-based program was slightly more cost-effective. Per capita costs in both settings were unsustainable, representing more than Uganda’s Primary Health Care Services current expenditures per person per year for all health services. The unpaid community volunteers showed high participation and low attrition rates for the two years that this program was evaluated. Challenges and successes Key successes of this study include the demonstration that antiretroviral therapy can be provided in a rural setting, the creation of a research infrastructure and culture within Kabarole’s health system, and the establishment of a research collaboration capable of enriching the global health graduate program at the University of Alberta. Challenging questions about the
economic factors between 68 patients .... 50,000 Uganda shillings (Ug. Shs) compared to only 19.9% of the controls (1 US $ = Ug shs 1500). ... the majority of the affected patients in this study had a family income of below 50,000 Ug. shs per month.
Joint Clinical Research Centre, Kampala, Uganda. 2. Department of ... School of Medicine, Makerere University College of Health Sciences, Mulago Hospital, Kampala, Uganda. Abstract ..... Rodrigues DSS, Medeiros EAS, Weckx LY, Bonnez.
Full Text Available Introduction: In Africa, traumatic brain injuries frequently result from road traffic injuries and assaults. Despite limited resources and the high costs of life-saving neurosurgical interventions, secondary brain injury prevention has the potential for improving outcomes. However, nurses and other medical personnel infrequently monitor vital signs, blood sugar, and pulse oximetry and only sporadically re-assess neurological status. Methods: In one-on-one, semi-structured interviews, 27 nurses from Mulago Hospital’s emergency centre, a tertiary care trauma hospital in Kampala, Uganda, provided feedback regarding a traumatic brain injury-focused education session and use of a nursing chart for detecting secondary brain injury. The interviews explored the nurses’ confidence and perceived barriers to long-term chart implementation and traumatic brain injury care, as well as their ideas for improving this intervention. Interviews were audio recorded, transcribed, and coded using ATLAS.ti: Qualitative Data Analysis and Research Software (Cleverbridge, Inc., Chicago, USA and Microsoft Word and Excel (Microsoft Office, Redmond, USA for thematic content analysis. Results: Key findings identified in the interviews included the nurses’ attitudes toward the chart and their feelings of increased confidence in assessing and caring for these patients. The main barriers to continuous implementation included inadequate staffing and resources. Conclusion: Nurses were receptive to the education session and nursing chart, and felt that it increased their confidence and improved their ability to care for traumatic brain injured patients. However, lack of supplies, overwhelming numbers of patients, and inadequate staffing interfered with consistent monitoring of patients. The nurses offered various suggestions for improving traumatic brain injury care that should be further investigated. More research is needed to assess the applicability of a standardised
Ziganshin, Bulat A; Yausheva, Liliya M; Sadigh, Mitra; Ziganshina, Anna P; Pichugin, Arseniy A; Ziganshin, Ayrat U; Sadigh, Majid
Global health is a new concept in Russia. There has been an ongoing academic collaboration between the Yale School of Medicine in the United States and Makerere University College of Health Sciences in Uganda since 2010, and the US Western Connecticut Health Network/University of Vermont College of Medicine since 2012, to introduce global health concepts to Kazan State Medical University (KSMU) in Russia. The purpose was to educate Russian physicians and medical trainees about the practice of clinical medicine and medical education, as well as the general practice of global health in culturally diverse, resource-limited settings. The aim of this study was to evaluate the initial outcomes of this multi-institutional partnership and to assess the impact of the global health elective on the participants and on KSMU. Participants were selected to attend a 6-week elective in global health at Mulago Hospital in Kampala, Uganda. The elective consisted of clinical experience, education about Uganda's common diseases, and region-specific sociocultural classes. It included a predeparture orientation and, upon return, completion of a standard questionnaire to assess the program's impact. Since 2010, there have been 20 KSMU members (4 medical students, 4 interns, 9 residents, 2 fellows, and 1 faculty member) who have participated in the program. As a result of the elective, the participants reported increased knowledge of tropical medicine (70%) and HIV/AIDS (75%), and 95% reported increased cultural sensitivity and desire to work with the underserved. The majority noted a very positive impact of their careers (90%) and personal life (80%). KSMU established the first successful collaborative program in global health education in Russia, leading to the integration of tropical medicine and global health courses in medical school curriculum. This elective has proven highly effective in introducing the concept of global health to faculty, fellows, residents, and medical students
Take, Naoki; Byakika, Sarah; Tasei, Hiroshi; Yoshikawa, Toru
This study aimed at analyzing the effect of 5S practice on staff motivation, patients' waiting time and patient satisfaction with health services at hospitals in Uganda. Double-difference estimates were measured for 13 Regional Referral Hospitals and eight General Hospitals implementing 5S practice separately. The study for Regional Referral Hospitals revealed 5S practice had the effect on staff motivation in terms of commitment to work in the current hospital and waiting time in the dispensary in 10 hospitals implementing 5S, but significant difference was not identified on patient satisfaction. The study for General Hospitals indicated the effect of 5S practice on patient satisfaction as well as waiting time, but staff motivation in two hospitals did not improve. 5S practice enables the hospitals to improve the quality of services in terms of staff motivation, waiting time and patient satisfaction and it takes as least four years in Uganda. The fourth year since the commencement of 5S can be a threshold to move forward to the next step, Continuous Quality Improvement.
patients with stroke attending Mulago National Referral Hospital in Uganda, a teaching hospital for Makerere ... introduction of rehabilitation services should target to maximize their functional recovery. ..... Lancet 2006;367, 1747-1757. 13.
Obai, Gerald; Odongo, Pancras; Wanyama, Ronald
Anaemia is a public health problem affecting over 1.62 billion people globally. It affects all age groups of people and is particularly more prevalent in pregnant women. Africa carries a high burden of anaemia; in Uganda 24 % of women of child bearing age have anaemia. Pregnant women living in poverty are at greater risk of developing iron deficiency anaemia. The objective of this study was to determine the prevalence of anaemia and the associated risk factors in pregnant women attending antenatal care at Gulu and Hoima Regional Hospitals in Northern and Western Uganda respectively. We conducted a cross sectional study in Gulu and Hoima Regional Hospitals from July to October 2012. Our study participants were pregnant women attending antenatal care. Socio-demographic data were collected using structured questionnaires and blood samples were collected for haemoglobin estimation. Haemoglobin concentration was determined using an automated analyzer closed mode of blood sampling. Data were analysed using Stata version 12. Odds ratio was used as a measure of association, with 95% confidence interval; and independent risk factors for anaemia were investigated using logistic regression analyses. Ethical approval was obtained from Gulu University Research Ethics Committee and written informed consent was obtained from each study participant. The overall prevalence of anaemia was 22.1%; higher in Gulu (32.9%) than in Hoima (12.1%), p prevalence of mild anaemia was 23%, moderate anaemia was 9%, and severe anaemia was 0.8%, while in Hoima, the prevalence of mild anaemia was 9%, moderate anaemia was 2.5%, and severe anaemia was 0.5%. Independent risk factors for anaemia were: being a housewife [Adjusted Odds Ratio (AOR) = 1.7, 95% CI: 1.05-2.68]; and being a resident in Gulu (AOR = 3.6, 95% CI: 2.41-5.58). The prevalence of anaemia in pregnant women in Gulu is higher than in Hoima. Amongst pregnancy women, being a housewife is an independent risk factor for anaemia
Background: Oxidative stress plays a role in the aetiology of pre-eclampsia and vitamin C may prevent pre-eclampsia. Objective: To determine the association between plasma vitamin C and pre-eclampsia in Mulago Hospital, Kampala, Uganda. Methods: This case-control study was conducted at Mulago Hospital from 1st ...
Hague, Ben; Sills, Jenny; Thompson, Andrew R
Despite the worthy intentions of international health partnerships between high-income countries and countries with developing economies, the tangible benefits are rarely evaluated, limiting the assessment of the achievements of such collaborations. The present study used longitudinal qualitative methods to examine the individual and organisational benefits of a partnership between a National Health Service (NHS) mental health Trust in the United Kingdom and a mental health referral hospital in Northern Uganda. Benefits to UK staff and organisational development were benchmarked against an existing framework of healthcare competencies. Partnership involvement was beneficial to UK staff, by increasing awareness of diversity, and in enhancing ability to work flexibly and as a team. There were clear benefits expressed with regards to the partnership having the potential to enhance organisational reputation and staff morale. The findings from this study demonstrate that international partnerships are experienced as being of tangible value for healthcare staff from high-income countries, providing opportunities for the development of recognised healthcare competencies. In this study there was also some evidence that staff involvement might also provide wider organisational benefits.
Osingada, Charles Peter; Nalwadda, Gorrette; Ngabirano, Tom; Wakida, John; Sewankambo, Nelson; Nakanjako, Damalie
High disease burden and scarcity of healthcare resources present complex ethical dilemmas for nurses working in developing countries. We assessed nurses' knowledge in ethics and their perceptions about Continuous Nurses' Ethics Education (CNEE) for in-service nurses. Using an anonymous, pre-tested self-administered questionnaire, we assessed nurses' knowledge in basic ethics concepts at three regional hospitals in Uganda. Adequate knowledge was measured by a score ≥50% in the knowledge assessment test. Nurses' perceptions on CNEE were assessed using a six-point Likert scale. Of 114 nurses, 91% were female; with mean age 44.7 (SD 10) years. Half were diploma, 47 (41%) certificates, 6 (5%) bachelors' degrees and one masters' level training. Overall, 18 (16%) scored ≥50% in the ethics knowledge test. Nurses with diploma or higher level of nursing training were less likely to fail the ethics knowledge than certificate-level nurses (OR 0.14, 95% CI: 0.02-0.7). Only 45% had ever attended at least one CNEE session and up to 93% agreed that CNEE is required to improve nurses' ethics knowledge and practice. Nurses exhibited low knowledge in ethics and positive attitudes towards CNEE. We recommend structured CNEE programs to address basic concepts in nursing ethics and their application in clinical practice.
Dresser, Caleb; Periyanayagam, Usha; Dreifuss, Brad; Wangoda, Robert; Luyimbaazi, Julius; Bisanzo, Mark
Acute surgical care services in rural Sub-Saharan Africa suffer from human resource and systemic constraints. Developing emergency care systems and task sharing aspects of acute surgical care addresses many of these issues. This paper investigates the degree to which specialized non-physicians practicing in a dedicated Emergency Department contribute to the effective and efficient management of acute surgical patients. This is a retrospective review of an electronic quality assurance database of patients presenting to an Emergency Department in rural Uganda staffed by non-physician clinicians trained in emergency care. Relevant de-identified clinical data on patients admitted directly to the operating theater from 2011 to 2014 were analyzed in Microsoft Excel. Overall, 112 Emergency Department patients were included in the analysis and 96% received some form of laboratory testing, imaging, medication, or procedure in the ED, prior to surgery. 72% of surgical patients referred by ED received preoperative antibiotics, and preoperative fluid resuscitation was initiated in 65%. Disposition to operating theater was accomplished within 3 h of presentation for 73% of patients. 79% were successfully followed up to assess outcomes at 72 h. 92% of those with successful follow-up reported improvement in their clinical condition. The confirmed mortality rate was 5%. Specialized non-physician clinicians practicing in a dedicated Emergency Department can perform resuscitation, bedside imaging and laboratory studies to aid in diagnosis of acute surgical patients and arrange transfer to an operating theater in an efficient fashion. This model has the potential to sustainably address structural and human resources problems inherent to Sub-Saharan Africa's current acute surgical care model and will benefit from further study and expansion.
Full Text Available In sub-Saharan Africa, a shortage of trained health professionals and limited geographical access to health facilities present major barriers to the expansion of antiretroviral therapy (ART. We tested the utility of a health centre (HC/community-based approach in the provision of ART to persons living with HIV in a rural area in western Uganda.The HIV treatment outcomes of the HC/community-based ART program were evaluated and compared with those of an ART program at a best-practice regional hospital. The HC/community-based cohort comprised 185 treatment-naïve patients enrolled in 2006. The hospital cohort comprised of 200 patients enrolled in the same time period. The HC/community-based program involved weekly home visits to patients by community volunteers who were trained to deliver antiretroviral drugs to monitor and support adherence to treatment, and to identify and report adverse reactions and other clinical symptoms. Treatment supporters in the homes also had the responsibility to remind patients to take their drugs regularly. ART treatment outcomes were measured by HIV-1 RNA viral load (VL after two years of treatment. Adherence was determined through weekly pill counts.Successful ART treatment outcomes in the HC/community-based cohort were equivalent to those in the hospital-based cohort after two years of treatment in on-treatment analysis (VL≤400 copies/mL, 93.0% vs. 87.3%, p = 0.12, and in intention-to-treat analysis (VL≤400 copies/mL, 64.9% and 62.0%, p = 0.560. In multivariate analysis patients in the HC/community-based cohort were more likely to have virologic suppression compared to hospital-based patients (adjusted OR = 2.47, 95% CI 1.01-6.04.Acceptable rates of virologic suppression were achieved using existing rural clinic and community resources in a HC/community-based ART program run by clinical officers and supported by lay volunteers and treatment supporters. The results were equivalent to those of a
Department of Psychiatry, Mulago hospital/Makerere University College of Health Sciences, Kampala, Uganda. 6. World Health ... As part of the Ugandan Ministry of Health clinical management ... Clustering in space or time with similar cases.
... women delivering in Mulago National Referral Hospital, Kampala, Uganda. .... Vol 13, No 4 (2013), Prevalence of noise induced hearing loss among employees at ... severity and risk factors of allergic disorders among people in south India ...
Cox, Janneke A; Lukande, Robert L; Kalungi, Sam; Van Marck, Eric; Van de Vijver, Koen; Kambugu, Andrew; Nelson, Ann M; Manabe, Yukari C; Colebunders, Robert
Minimal invasive but accurate methods to establish the cause of death in HIV-infected patients are needed. We studied the agreement in cause of death between blind and ultrasound-guided needle autopsy and complete autopsy in HIV-infected patients in Uganda. We subsequently performed a blind and ultrasound-guided needle autopsy followed by a complete autopsy in HIV-infected adults who died during hospitalization. Two teams of pathologists reviewed the tissue from either the needle autopsies or the complete autopsy and formulated the major diagnoses, that is, diseases directly contributing to death. The primary outcome was concordance in major diagnosis between needle and complete autopsies. We performed 96 blind needle and complete autopsies and 95 ultrasound-guided needle autopsies. Concordance in major diagnosis between blind needle and complete autopsy was 50%. For the main major diagnosis, tuberculosis (TB) concordance was higher (71%; P autopsy identified at least 1 major diagnosis in 60% of patients; and in 46%, there was complete concordance for all major diagnoses. The main reason for discordance was sampling error of the lesion. Concordance with the addition of ultrasound guidance was 52% for all major diagnoses and 79% for TB. Major diagnoses were mainly identified in tissue cores from the liver (76%) and the spleen (82%). Blind needle autopsy identified half of the major diagnosis. The addition of ultrasound guidance did not significantly improve the performance of needle autopsy. Needle autopsy is a valuable method to confirm causes of death in HIV-infected patients, especially for highly prevalent diseases like TB.
Kajja, I.; Kyeyune, D.; Bimenya, G. S.; Sibinga, C. T. S.
Aim: To identify where and why delays occur in Uganda blood banks. Background: The timely provision and supply of safe and efficacious blood components to hospitals depends on sound systems in the processing blood banks. Poorly managed systems lead to apparent blood shortages in hospitals and
Sserwadda, Ivan; Lukenge, Mathew; Mwambi, Bashir; Mboowa, Gerald; Walusimbi, Apollo; Segujja, Farouk
Nosocomial infections are a major setback in the healthcare delivery system especially in developing countries due to the limited resources. The roles played by medical care equipment and work surfaces in the transmission of such organisms have inevitably contributed to the elevated mortality, morbidity and antibiotic resistances. A total 138 samples were collected during the study from Kawolo general hospital. Swab samples were collected from various work surfaces and fomites which consisted of; beds, sink taps, infusion stands, switches, work tables and scissors. Cultures were done and the susceptibility patterns of the isolates were determined using Kirby Bauer disc diffusion method. Data was analyzed using Stata 13 and Microsoft Excel 2013 packages. A total of 44.2% (61/138) of the collected swab specimens represented the overall bacterial contamination of the sampled articles. Staphylococcus aureus and Klebsiella pneumoniae accounted for the highest bacterial contaminants constituting of 75.4% (46/61) and 11.5% (7/61) respectively. Infusion stands and patient beds were found to have the highest bacterial contamination levels both constituting 19.67% (12/61). The highest degree of transmission of organisms to patients was found to be statistically significant for patient beds with OR: 20.1 and P-value 8X10 - 4 . Vancomycin, ceftriaxone and ciprofloxacin were the most effective antibiotics with 100%, 80% and 80% sensitivity patterns among the isolates respectively. Multi-drug resistant (MDR) Staphylococcus aureus accounted for 52% (24/46) with 4% (1/24) classified as a possible extensively drug resistant (XDR) whereas Gram negative isolates had 27% (4/15) MDR strains out of which 50%(2/4) were classified as possible pan-drug resistant (PDR). The high prevalence of bacterial contaminants in the hospital work environment is an indicator of poor or ineffective decontamination. The study findings reiterate the necessity to formulate drug usage policies and re
Naddumba, E K
Approximately 2000 lives are lost in Uganda annually through road traffic accidents. In Kampala, they account for 39% of all injuries, primarily in males aged 16-44 years. They are a result of rapid motorization and urbanization in a country with a poor economy. Uganda's population is an estimated 28 million with a growth rate of 3.4% per year. Motorcycles and omnibuses, the main taxi vehicles, are the primary contributors to the accidents. Poor roads and drivers compound the situation. Twenty-three orthopaedic surgeons (one for every 1,300,000 people) provide specialist services that are available only at three regional hospitals and the National Referral Hospital in Kampala. The majority of musculoskeletal injuries are managed nonoperatively by 200 orthopaedic officers distributed at the district, regional and national referral hospitals. Because of the poor economy, 9% of the national budget is allocated to the health sector. Patients with musculoskeletal injuries in Uganda frequently fail to receive immediate care due to inadequate resources and most are treated by traditional bonesetters. Neglected injuries typically result in poor outcomes. Possible solutions include a public health approach for prevention of road traffic injuries, training of adequate human resources, and infrastructure development.
Full Text Available Abstract Background Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits. Methods We conducted a qualitative study using eight focus group discussions with a total of 82 participants (16 men, 46 women and 20 health workers. We aimed to better understand factors that influence usage of available reproductive health care services and how they would relate to cervical cancer screening, as well as identify feasible interventions to improve cervical cancer screening uptake. Results Barriers identified after framework analysis included ignorance about cervical cancer, cultural constructs/beliefs about the illness, economic factors, domestic gender power relations, alternative authoritative sources of reproductive health knowledge, and unfriendly health care services. We discuss how these findings may inform future planned screening programmes in the Ugandan context. Conclusion Knowledge about cervical cancer among Ugandan women is very low. For an effective cervical cancer-screening programme, awareness about cervical cancer needs to be increased. Health planners need to note the power of the various authoritative sources of reproductive health knowledge such as paternal aunts (Sengas and involve them in the awareness campaign. Cultural and economic
Harriet R. Kagoya
Conclusion and recommendations: Awareness of, responsiveness to and practice of patients’ rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel, multichannel, patient-centred approach that incorporates social services and addresses intrinsic patient, HW and health system factors to strengthen patients’ rights issues at the hospital.
Nakimuli, Annettee; Mbalinda, Scovia N; Nabirye, Rose C; Kakaire, Othman; Nakubulwa, Sarah; Osinde, Michael O; Kakande, Nelson; Kaye, Dan K
Neonatal near miss cases occur more often than neonatal deaths and could enable a more comprehensive analysis of risk factors, short-term outcomes and prognostic factors in neonates born to mothers with severe obstetric complications. The objective was to assess the incidence, presentation and perinatal outcomes of severe obstetric morbidity in two referral hospitals in Central Uganda. A prospective cohort study was conducted between March 1, 2013 and February 28, 2014, in which all newborns from cases of severe pregnancy and childbirth complications were eligible for inclusion. The obstetric conditions included obstetric haemorrhage, hypertensive disorders, obstructed labour, chorioamnionitis and pregnancy-specific complications such as malaria, anemia and premature rupture of membranes. Still births, neonatal deaths and neonatal near miss cases (defined using criteria that employed clinical features, presence of organ-system dysfunction and management provided to the newborns were compiled). Stratified and multivariate logistic regression analysis was conducted to identify risk factors for perinatal death. Of the 3100 mothers, 192 (6.2%) had abortion complications. Of the remainder, there were 2142 (73.1%) deliveries, from whom the fetal outcomes were 257 (12.0%) still births, 369 (17.2%) neonatal deaths, 786 (36.7%) neonatal near misses and 730 (34.1%) were newborns with no or minimal life threatening complications. Of the 235 babies admitted to the neonatal intensive care unit (NICU), the main reasons for admission were prematurity for 64 (26.8%), birth asphyxia for 59 (23.7%), and grunting respiration for 26 (11.1%). Of the 235 babies, 38 (16.2%) died in the neonatal period, and of these, 16 died in the first 24 hours after admission. Ruptured uterus caused the highest case-specific mortality of 76.8%, and led to 16.9% of all newborn deaths. Across the four groups, there were significant differences in mean birth weight, p = 0.003. Antepartum hemorrhage
McCurdie, Fiona Katherine; Moffatt, Joanne; Jones, Kevin
Kitovu Hospital in Masaka, Uganda, is a leading obstetric fistula repair centre in the country with the highest rates of fistula in the world. In this retrospective case review, the regional incidence and causative factors were studied in patients with vesicovaginal fistula (VVF) who were admitted at Kitovu Hospital. Fistula history included severity (ICIQ score), causes and outcomes of VVF were measured. Women suffered with symptoms of VVF for an average of 4.97 years with an average ICIQ severity score of 7.21. Patients travelled an average distance of 153 km and the majority travelled by public transport. Rates of prolonged labour were high. 69% of fistula-causing delivery resulted in stillbirth and 12% resulted in early neonatal death. Following surgery, 94% of patients were dry on discharge. Impact statement What is already known on this subject? Vesicovaginal fistula (VVF) is a severe, life-changing injury. Although largely eradicated from the Western world thanks to modern obstetric practice, VVF is still highly prevalent in developing countries where factors such as young childbearing age and poor access to emergency obstetric care increase the incidence (Wall et al. 2005 ). At the current rate of fistula repair, it is estimated that it would take 400 years to treat those already suffering with fistula, providing that no new cases emerged (Browning and Patel 2004 ). What do the results of this study add? The Ugandan women in this study reiterate tales of foetal loss, social isolation and epic journeys in search of fistula repair, as previously described in the literature. The study offers some hope for prompt help-seeking during labour and after fistulas are developed. It demonstrates the success of fistula repairs at Kitovu Hospital but highlights the paucity of service provision across Uganda. What are the implications of these findings for clinical practice and/or further research? Further epidemiological research is required to quantify the true
Aggrey S Semeere
Full Text Available Malnutrition is common among HIV-infected individuals and is often accompanied by low serum levels of micronutrients. Vitamin B-12 deficiency has been associated with various factors including faster HIV disease progression and CD4 depletion in resource-rich settings. To describe prevalence and factors associated with sub-optimal vitamin B-12 levels among HIV-infected antiretroviral therapy (ART naïve adults in a resource-poor setting, we performed a cross-sectional study with a retrospective chart review among individuals attending either the Mulago-Mbarara teaching hospitals' Joint AIDS Program (MJAP or the Infectious Diseases Institute (IDI clinics, in Kampala, Uganda. Logistic regression was used to determine factors associated with sub-optimal vitamin B-12. The mean vitamin B-12 level was 384 pg/ml, normal range (200-900. Sub-optimal vitamin B-12 levels (<300 pg/ml were found in 75/204 (36.8%. Twenty-one of 204 (10.3% had vitamin B-12 deficiency (<200 pg/ml while 54/204 (26.5% had marginal depletion (200-300 pg/ml. Irritable mood was observed more among individuals with sub-optimal vitamin B-12 levels (OR 2.5, 95% CI; 1.1-5.6, P=0.03. Increasing MCV was associated with decreasing serum B-12 category; 86.9 fl (± 5.1 vs. 83 fl (± 8.4 vs. 82 fl (± 8.4 for B-12 deficiency, marginal and normal B-12 categories respectively (test for trend, P=0.017. Compared to normal B-12, individuals with vitamin B-12 deficiency had a longer known duration of HIV infection: 42.2 months (± 27.1 vs. 29.4 months (± 23.8; P=0.02. Participants eligible for ART (CD4<350 cells/µl with sub-optimal B-12 had a higher mean rate of CD4 decline compared to counterparts with normal B-12; 118 (± 145 vs. 22 (± 115 cells/µl/year, P=0.01 respectively. The prevalence of a sub-optimal vitamin B-12 was high in this HIV-infected, ART-naïve adult clinic population in urban Uganda. We recommend prospective studies to further clarify the causal relationships of sub
Dieleman, Marjolein; Bwete, Vincent; Maniple, Everd; Bakker, Mirjam; Namaganda, Grace; Odaga, John; van der Wilt, Gert Jan
Staff shortages could harm the provision and quality of health care in Uganda, so staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed 'to identify the influence of HIV/AIDS on staff working in general hospitals at district level in rural areas and to explore support required and offered to deal with HIV/AIDS in the workplace'. Its results were to inform strategies to mitigate the impact of HIV/AIDS on hospital staff. A cross-sectional study with qualitative and quantitative components was implemented during two weeks in September 2005. Data were collected in two government and two faith-based private not-for-profit hospitals purposively selected in rural districts in Uganda's Central Region. Researchers interviewed 237 people using a structured questionnaire and held four focus group discussions and 44 in-depth interviews. HIV/AIDS places both physical and, to some extent, emotional demands on health workers. Eighty-six per cent of respondents reported an increased workload, with 48 per cent regularly working overtime, while 83 per cent feared infection at work, and 36 per cent reported suffering an injury in the previous year. HIV-positive staff remained in hiding, and most staff did not want to get tested as they feared stigmatization. Organizational responses were implemented haphazardly and were limited to providing protective materials and the HIV/AIDS-related services offered to patients. Although most staff felt motivated to work, not being motivated was associated with a lack of daily supervision, a lack of awareness on the availability of HIV/AIDS counselling, using antiretrovirals and working overtime. The specific hospital context influenced staff perceptions and experiences. HIV/AIDS is a crucially important contextual factor, impacting on working conditions in various ways. Therefore, organizational responses should be
Full Text Available Abstract Background Staff shortages could harm the provision and quality of health care in Uganda, so staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed 'to identify the influence of HIV/AIDS on staff working in general hospitals at district level in rural areas and to explore support required and offered to deal with HIV/AIDS in the workplace'. Its results were to inform strategies to mitigate the impact of HIV/AIDS on hospital staff. Methods A cross-sectional study with qualitative and quantitative components was implemented during two weeks in September 2005. Data were collected in two government and two faith-based private not-for-profit hospitals purposively selected in rural districts in Uganda's Central Region. Researchers interviewed 237 people using a structured questionnaire and held four focus group discussions and 44 in-depth interviews. Results HIV/AIDS places both physical and, to some extent, emotional demands on health workers. Eighty-six per cent of respondents reported an increased workload, with 48 per cent regularly working overtime, while 83 per cent feared infection at work, and 36 per cent reported suffering an injury in the previous year. HIV-positive staff remained in hiding, and most staff did not want to get tested as they feared stigmatization. Organizational responses were implemented haphazardly and were limited to providing protective materials and the HIV/AIDS-related services offered to patients. Although most staff felt motivated to work, not being motivated was associated with a lack of daily supervision, a lack of awareness on the availability of HIV/AIDS counselling, using antiretrovirals and working overtime. The specific hospital context influenced staff perceptions and experiences. Conclusion HIV/AIDS is a crucially important contextual factor, impacting on working conditions
Bwire, Godfrey; Malimbo, Mugagga; Maskery, Brian; Kim, Young Eun; Mogasale, Vittal; Levin, Ann
Introduction In 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed available cholera surveillance data from Uganda and assessed the sufficiency of these data to inform country-specific strategies for cholera vaccination. Methods The Uganda Ministry of Health conducts cholera surveillance to guide cholera outbreak control activities. This includes reporting the number of cases based on a standardized clinical definition plus systematic laboratory testing of stool samples from suspected cases at the outset and conclusion of outbreaks. This retrospective study analyzes available data by district and by age to estimate incidence rates. Since surveillance activities focus on more severe hospitalized cases and deaths, a sensitivity analysis was conducted to estimate the number of non-severe cases and unrecognized deaths that may not have been captured. Results Cholera affected all ages, but the geographic distribution of the disease was very heterogeneous in Uganda. We estimated that an average of about 11,000 cholera cases occurred in Uganda each year, which led to approximately 61–182 deaths. The majority of these cases (81%) occurred in a relatively small number of districts comprising just 24% of Uganda's total population. These districts included rural areas bordering the Democratic Republic of Congo, South Sudan, and Kenya as well as the slums of Kampala city. When outbreaks occurred, the average duration was about 15 weeks with a range of 4–44 weeks. Discussion There is a clear subdivision between high-risk and low-risk districts in Uganda. Vaccination efforts should be focused on the high-risk population. However, enhanced or sentinel surveillance activities should be undertaken to better quantify the endemic disease burden and high-risk populations
Oriada, R.; Byakagaba, A.; Kiza, M.; Magembe, M.
Like Many African countries, Uganda is not Immune to the problem of illicit trafficking of Nuclear and Radioactive materials. This has been worsened by the porosity of the Ugandan Borders. There is control on the few Entry points and much of the border line does not have adequate control on what enters and leaves the country. Uganda is also used as a transit route with the neighboring countries like Sudan, Democratic Republic of Congo, Kenya,Tanzania.
SOCIAL JUSTICE, HEALTH AND POVERTY IN UGANDA John Barugahare Injustice in Uganda manifests in many ways. One most serious, yet least discussed social injustice, is inequity in Health. Although there are two equally important aims of health systems – efficiency and equity, in Uganda too much focus has been on ensuring efficiency and as a consequence concerns of equity have been relegated. Ultimately, health policy in Uganda has disproportionately negatively affected the poor’s livelihoods in g...
Soft Tissue Sarcoma in Uganda. Gakwaya AM, Jombwe J. East and Central African journal of Surgery Volume 10 Number 2 – December 2005. 88. Original Article. Soft Tissue Sarcoma in Uganda. A.M. Gakwaya1, J. Jombwe2, 1Senior Consultant Surgeon, 2Senior registrar, Dept. Of Surgery Mulago. Hospital Complex ...
International Criminal Court (ICC) investigations into the LRA activities. ... and the rebel movements in northern Uganda, see Human Rights Watch 2003, and ... the ICC, Luis Moreno Ocampo, met at Hotel Intercontinental, Hyde Park, London, ..... expunge criminal liability for war crimes and crimes against humanity, appear.
Dr. Paul Mead, a medical officer at CDC, discusses his article on Plague in Uganda. Created: 1/25/2018 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 1/25/2018.
Orem, Jackson; Sandin, Sven; Mbidde, Edward; Mangen, Fred Wabwire; Middeldorp, Jaap; Weiderpass, Elisabete
Epstein-Barr virus (EBV) has been linked to malignancies and chronic inflammatory conditions. In this study, EBV detection was compared in children with non-Hodgkin's lymphoma and children with chronic inflammatory conditions, using samples and data from a case-control study carried out at the Mulago National Referral Hospital between 2004 and 2008. EBV viral load was measured in saliva, whole blood and white blood cells by real-time PCR. Serological values for IgG-VCA, EBNA1, and EAd-IgG were compared in non-Hodgkin's lymphoma and chronic inflammatory conditions; and in Burkitt's lymphoma and other subtypes of non-Hodgkin's lymphoma. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated. Of the 127 children included (87 males and 40 females; median age 7 years, range 2-17), 96 had non-Hodgkin's lymphoma (46 Burkitt's lymphoma and 50 other non-Hodgkin's lymphoma), 31 had chronic inflammatory conditions, and only 10% were HIV-positive. The most common clinical presentations for all disease categories considered were fever, night sweats, and weight loss. EBV viral load in whole blood was elevated in Burkitt's lymphoma compared to other non-Hodgkin's lymphoma (OR 6.67, 95% CI 1.32, 33.69; P-value = 0.04), but EBV viral loads in saliva and white blood cells were not different in any of the disease categories considered. A significant difference in EAd-IgG was observed when non-Hodgkin's lymphoma was compared with chronic inflammatory conditions (OR 0.19, 95% CI 0.07, 0.51; P-value = 0.001). When compared to chronic inflammatory conditions, EBV viral load was elevated in Burkitt's lymphoma, and EA IgG was higher in non-Hodgkin's lymphoma. This study supports an association between virological and serological markers of EBV and childhood non-Hodgkin's lymphoma, irrespective of subtype, in Uganda. © 2014 Wiley Periodicals, Inc.
This study was conducted to assess the status of safe motherhood in Uganda. A total of 97 health units, 30 hospitals, and 67 lower health units were included in the sample. Altogether, 335,682 deliveries, 302 maternal deaths, and 2,978 abortions were documented over a period of one year, with a computed abortion ratio ...
Sigei, Charles; Odaga, John; Mvundura, Mercy; Madrid, Yvette; Clark, Andrew David
Rotavirus vaccines have the potential to prevent a substantial amount of life-threatening gastroenteritis in young African children. This paper presents the results of prospective cost-effectiveness analyses for rotavirus vaccine introduction for Kenya and Uganda. In each country, a national consultant worked with a national technical working group to identify appropriate data and validate study results. Secondary data on demographics, disease burden, health utilization, and costs were used to populate the TRIVAC cost-effectiveness model. The baseline analysis assumed an initial vaccine price of $0.20 per dose, corresponding to Gavi, the Vaccine Alliance stipulated copay for low-income countries. The incremental cost-effectiveness of a 2-dose rotavirus vaccination schedule was evaluated for 20 successive birth cohorts from the government perspective in both countries, and from the societal perspective in Uganda. Between 2014 and 2033, rotavirus vaccination can avert approximately 60,935 and 216,454 undiscounted deaths and hospital admissions respectively in children under 5 years in Kenya. In Uganda, the respective number of undiscounted deaths and hospital admission averted is 70,236 and 329,779 between 2016 and 2035. Over the 20-year period, the discounted vaccine program costs are around US$ 80 million in Kenya and US$ 60 million in Uganda. Discounted government health service costs avoided are US$ 30 million in Kenya and US$ 10 million in Uganda (or US$ 18 million including household costs). The cost per disability-adjusted life-year (DALY) averted from a government perspective is US$ 38 in Kenya and US$ 34 in Uganda (US$ 29 from a societal perspective). Rotavirus vaccine introduction is highly cost-effective in both countries in a range of plausible 'what-if' scenarios. The involvement of national experts improves the quality of data used, is likely to increase acceptability of the results in decision-making, and can contribute to strengthened national
Dieleman, Marjolein; Bwete, Vincent; Maniple, Everd; Bakker, Mirjam; Namaganda, Grace; Odaga, John; van der Wilt, Gert Jan
Staff shortages could harm the provision and quality of health care in Uganda, so staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed 'to identify the influence of
Dieleman, Marjolein; Bwete, Vincent; Maniple, Everd; Bakker, Mirjam; Namaganda, Grace; Odaga, John; van der Wilt, Gert Jan
BACKGROUND: Staff shortages could harm the provision and quality of health care in Uganda, so staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed 'to identify the
Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...
Riiser, Nina Milling
Socio economic conditions in Uganda causes the youth to be caught between childhood and adulthood. They are young people moving towards adulthood, with no option of becoming independent. How does volunteering affect the youth and why does the youth volunteer? Does the youth get closer to adulthood by volunteering and what di they gain? Socio economic conditions in Uganda causes the youth to be caught between childhood and adulthood. They are young people moving towards adulthood, with no o...
Gomes, Iva; Pereira, Vania; Gomes, Verónica
The Karimojong, an African group from the Karamoja region of Northeast Uganda, were genetically analysed using a decaplex system for X chromosome short tandem repeats (X-STRs). A total of 255 individuals (117 males and 138 females) were genotyped for the following loci: DXS8378, DXS9898, DXS7133......, with gene diversities of 84.79% and 83.94%, respectively. The less discriminating locus observed was DXS7133, with a gene diversity of 39.79%. High overall values of power of discrimination were obtained for female (1 in 1.8 x 10(10)) and male samples (1 in 1.6 x 10(6)), as well as high power of exclusion...
Background : The recommended antibiotic treatment of bacterial meningitis has come under scrutiny following frequent reports of in-vitro resistance by the common causative organisms to penicillin and chloramphenicol. Objective : The study recorded the causative organisms, antibiotic sensitivity patterns and outcome of ...
A 64-year old traditional birth attendant (TBA), Zowe Namasiga, in Kyobe county in the Rakai district of Uganda, delivered her 1st baby when she was 12 years old. She learned how to deliver babies by watching her father deliver babies. She married at 14 and had 7 children of her own. She delivered 2 of her own children all alone. She attended a 1-week workshop for TBAs hosted by World Vision International and attended by 52 other TBAs. The medical services that exist in rural Uganda and tend to be of low quality. The leading problem for pregnant women in Rakai district in insufficient transport. The closest clinic is 8 miles away from where the workshop was held, but it has no midwives and the staff are not trained to deliver babies. The ratio of midwife to women of reproductive age in Rakai district is 1:5000. Ms. Namasiga has to refer high risk patients to Kitovu Hospital, a distance of 62 km. In the workshop, illustrations of male and female reproductive systems helped them learn that the uterus is not connected to the digestive system. The TBAs learned about the importance of hygiene and of encouraging women to seek prenatal care and to receive tetanus toxoid injections. The workshop taught them how to identify high risk women and to refer them to the hospital. Few women go to the hospital, though, because town midwives do not treat them kindly. One participant described how she keeps premature babies alive: wraps them and places them in a circle of 5-liter metal cans filled with warm water. TBAs are concerned about AIDS. In fact, the last grandchild Ms. Namasiga delivered was born to parents with AIDS. She delivers babies with her bare hands, but now asks for payment so she can buy gloves to protect her cracked hands. Most TBAs care for AIDS orphans. TBAs assist at 90% of deliveries in this rural district.
1Division of Medicine and Therapeutics, Centre for Medical Education, The Queen's ... This audit of prescribing practices explores recent trends at Kitovu Hospital, Uganda ..... This creates a cycle of poor ... interventions to remedy these is vital.
The Prevalence Overexpression Of C-Erbb-2 Oncoprotein In Carcinoma Of The Prostate-. Mulago Hospital. R. Alenyo1, M. Odida2, S Watya1. 1Department of Surgery, 2Department of Pathology, Makerere University, Kampala – Uganda. Correpondence to: Dr. Rose Alenyo, Email: Rose Alenyo ,.
Uganda Heart Institute, Mulago Hospital Complex. Abstract. Background: Cardiovascular dysfunction is a recognized complication of HIV infection in children. Cardiac complications of HIV usually occur late in the course of the disease; they may be associated with drug therapy, and hence become more common as therapy ...
Items 101 - 150 of 2005 ... Vol 81, No 4 (2004):, Anorexia nervosa in Kenya, Abstract PDF. FG Njenga, RN Kangethe. Vol 80, No 3 (2003):, Antenatal and intrapartum risk factors for birth asphyxia among emergency obstetric referrals in Mulago Hospital, Kampala, Uganda, Details PDF. D Kaye. Vol 94, No 7 (2017), Antenatal ...
Meat inspection for human consumption is a legal requirement in many a part of the world, but the reliability for this routine procedure to detect ... Ikoona E, Kalyesubula I, Kawuma M. Ocular manifestations in paediatric HIV/AIDS patients in Mulago Hospital,. Uganda. African Health Sciences 2003: 3(2) 83 – 86. 6. Anyama N ...
Objective: To explore the methods, reasons and decision-making process for termination of pregnancy among adolescents and older women, in Mulago hospital, Kampala, Uganda. Design: Comparative study. Subjects: Nine hundred and forty two women seeking postabortion care, of which 333 had induced abortion (of ...
Sct?ior ikfeclical O[ficcr. Department of Orthopaeclics, Mulago Hospital, Makerere University, Kampala, Uganda. Key Words: Sciatic nerve palsy, intramuscular injections, children, quinine dil~ydrochloride. The purpose of this paper is to show that, in children, gluteal injection of quinine dihydrochloride (QDH) may result in ...
Gestational trophoblastic disease following complete hydatidiform mole in Mulago Hospital, Kampala, Uganda. ... The main outcome measures were pre- and post-evacuation serum hCG levels and complications associated with oral methotrexate use. Results : The prevalence of CHM was 3.42 per 1,000 deliveries.
Conjoined (Siamese) twins in Zambia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. L Munkonge ... Outcome of major trauma at Mulago Hospital in Uganda. Assessment using the TRISS methodology · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT
article/47733 2018-05-04T16:06:07Z ajar:ART Factors associated with conception among ... In a cross-sectional study, 385 HIV-positive women in the labour ward at Mulago Hospital, Uganda, were interviewed using a structured questionnaire.
Namutebi, S K
During its work in Rakai district, CONCERN recognized that women lack property/inheritance rights, a situation which increases their vulnerability to HIV infection. Widows are being disinherited of all their properties, including their marital homes. Since many of these women lack both education and skills, their survival often depends upon either marrying again or engaging in sex work. Many women are ignorant of their rights under the national law. Lawyers from the Ugandan Women Lawyers Association help women and children understand their rights, but they do not provide continuously available services. CONCERN therefore initiated a program of community-based legal educators (paralegals) selected by village communities and recommended by local leaders. The paralegals must be over age 28 years, respected by the community, able to maintain confidentiality, and have participated in previous HIV/AIDS sensitization work. Selected candidates are subsequently trained by lawyers from a governmental ministry in the basics of the law pertaining to sexual abuse, marriage, inheritance, divorce, domestic violence, children's rights and responsibilities, and the legal system in Uganda, as well as referrals, gender sensitization, and adult education methods. The paralegals now provide awareness seminars in their communities which include brainstorming, role plays, use of picture codes, group discussions, and lectures.
The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...
Current status of Uganda Kob (Kobus Kob Thomasi Neumann) in Toro Game Reserve, Uganda. ... As part of a biological assessment of Toro Game Reserve, the status of Uganda kob Kobus kob Thomasi ... AJOL African Journals Online.
Mastenbroek, A.; Ntare, Bonny
One of the major bottlenecks limiting farmers’ access to good quality seed for food crops in Uganda is the shortage of early generation seed (EGS - breeder and foundation) to produce sufficient quantities of certified and/or quality declared) to satisfy the needs of farmers. A national study was
Jury, Mark R.
This study analyzes large-scale controls on Uganda's rainfall. Unlike past work, here, a May-October season is used because of the year-round nature of agricultural production, vegetation sensitivity to rainfall, and disease transmission. The Uganda rainfall record exhibits steady oscillations of ˜3 and 6 years over 1950-2013. Correlation maps at two-season lead time resolve the subtropical ridge over global oceans as an important feature. Multi-variate environmental predictors include Dec-May south Indian Ocean sea surface temperature, east African upper zonal wind, and South Atlantic wind streamfunction, providing a 33% fit to May-Oct rainfall time series. Composite analysis indicates that cool-phase El Niño Southern Oscillation supports increased May-Oct Uganda rainfall via a zonal overturning lower westerly/upper easterly atmospheric circulation. Sea temperature anomalies are positive in the east Atlantic and negative in the west Indian Ocean in respect of wet seasons. The northern Hadley Cell plays a role in limiting the northward march of the equatorial trough from May to October. An analysis of early season floods found that moist inflow from the west Indian Ocean converges over Uganda, generating diurnal thunderstorm clusters that drift southwestward producing high runoff.
A joint International Monetary Fund-World Bank team conducted an assessment update of Uganda's financial system in connection with the Financial Sector Assessment Program (FSAP) in November, 2004. The purpose of the mission was to help the Ugandan authorities identify financial system strengths and weaknesses with a view to implementing an action plan to increase the system's contribution ...
Notes: Observations of Butterfly Migrations in Uganda, 2002 · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Ian Deshmukh, 111-114. http://dx.doi.org/10.4314/uj.v48i1.23007 ...
Nakyanzi, Josephine Katabaazi; Kitutu, Freddy Eric; Oria, Hussein; Kamba, Pakoyo Fadhiru
The expiry of medicines in the supply chain is a serious threat to the already constrained access to medicines in developing countries. We investigated the extent of, and the main contributing factors to, expiry of medicines in medicine supply outlets in Kampala and Entebbe, Uganda. A cross-sectional survey of six public and 32 private medicine outlets was done using semi-structured questionnaires. The study area has 19 public medicine outlets (three non-profit wholesalers, 16 hospital stores/pharmacies), 123 private wholesale pharmacies and 173 retail pharmacies, equivalent to about 70% of the country's pharmaceutical businesses. Our findings indicate that medicines prone to expiry include those used for vertical programmes, donated medicines and those with a slow turnover. Awareness about the threat of expiry of medicines to the delivery of health services has increased. We have adapted training modules to emphasize management of medicine expiry for pharmacy students, pharmacists and other persons handling medicines. Our work has also generated more research interest on medicine expiry in Uganda. Even essential medicines expire in the supply chain in Uganda. Sound coordination is needed between public medicine wholesalers and their clients to harmonize procurement and consumption as well as with vertical programmes to prevent duplicate procurement. Additionally, national medicine regulatory authorities should enforce existing international guidelines to prevent dumping of donated medicine. Medicine selection and quantification should be matched with consumer tastes and prescribing habits. Lean supply and stock rotation should be considered.
in the capitals. In my dissertation I propose to change that focus. Partly by paying particular attention to rural politics, partly through a discussion of democracy in a longer-term perspective using a broader definition of democracy and finally through a discussion of democracy as effective political...... participation rather than only form al rights. I shall do so by analysing the Resistance Councils (RCs) in Uganda....
Nielsen, Jannie; Whyte, Susan Reynolds
testing to be provided for a fee at the hospital, in the private wing or through the services of a patient organization. Because the glucometer strips are relatively expensive, many patients went for months without testing their glucose levels. An additional problem was the need to obtain strips...... that matched the available glucometer (about 30 types were found in the areas visited). Economic constraints were exacerbated by costs for transport to the limited number of diabetes treatment facilities. Conclusion There is a severe lack of free diabetes testing and treatment possibilities in Uganda. Health...
Hughes, Holly R; Kayiwa, John; Mossel, Eric C; Lutwama, Julius; Staples, J Erin; Lambert, Amy J
In April 2016, a yellow fever outbreak was detected in Uganda. Removal of contaminating ribosomal RNA in a clinical sample improved the sensitivity of next-generation sequencing. Molecular analyses determined the Uganda yellow fever outbreak was distinct from the concurrent yellow fever outbreak in Angola, improving our understanding of yellow fever epidemiology.
Kiwanuka, J K; Ttendo, S S; Eromo, E; Joseph, S E; Duan, M E; Haastrup, A A; Baker, K; Firth, P G
We evaluated the effectiveness of anesthesia education delivered via Internet videoconferencing between the Massachusetts General Hospital, Boston, MA, and Mbarara Regional Referral Hospital, Uganda. This is a prospective educational study. The setting is the education in 2 hospitals in Uganda and the United States. The subjects are anesthesia residents. The interventions are anesthesia education lectures delivered in person and via Internet videoconferencing. The average pre-lecture and post-lecture scores of the local, remote, and combined audiences were compared. Post-lecture test scores improved over pre-lecture scores: local audience, 59% ± 22% to 81% ± 16%, P = .0002, g = 1.144; remote audience, 51% ± 19% to 81% ± 8%, P Internet videoconferencing. This technique may be useful to expand educational capacity and international cooperation between academic institutions, a particular priority in the growing field of global health. Copyright © 2015 Elsevier Inc. All rights reserved.
Kato, Simon Kagambirwe
In this study I examined the implementation of tax policy reforms at Uganda Revenue Authority. In particular, I examined the impact of the tax policy reforms implemented since the restructuring of Uganda Revenue Authority in 2005. Although Uganda's taxation system is a vital area of study, it has not gotten enough attention from researchers. This is because, in the Ugandan and generally African developing countries context, taxation involves vital and, to a large ex...
Jagger, Pamela; Shively, Gerald
Using data from 433 firms operating along Uganda's charcoal and timber supply chains we investigate patterns of bribe payment and tax collection between supply chain actors and government officials responsible for collecting taxes and fees. We examine the factors associated with the presence and magnitude of bribe and tax payments using a series of bivariate probit and Tobit regression models. We find empirical support for a number of hypotheses related to payments, highlighting the role of queuing, capital-at-risk, favouritism, networks, and role in the supply chain. We also find that taxes crowd-in bribery in the charcoal market.
Nabyonga Orem, Juliet; Mugisha, Frederick; Kirunga, Christine; Macq, Jean; Criel, Bart
Inadequate health financing is one of the major challenges health systems in low-income countries currently face. Health financing reforms are being implemented with an increasing interest in policies that abolish user fees. Data from three nationally representative surveys conducted in Uganda in 1999/2000, 2002/03 and 2005/06 were used to investigate the impact of user fee abolition on the attainment of universal coverage objectives. An increase in illness reporting was noted over the three surveys, especially among the poorer quintiles. An increase in utilization was registered in the period immediately following the abolition of user fees and was most pronounced in the poorest quintile. Overall, there was an increase in utilization in both public and private health care delivery sectors, but only at clinic and health centre level, not at hospitals. Our study shows important changes in health-care-seeking behaviour. In 2002/03, the poorest population quintile started using government health centres more often than private clinics whereas in 1999/2000 private clinics were the main source of health care. The richest quintile has increasingly used private clinics. Overall, it appears that the private sector remains a significant source of health care. Following abolition of user fees, we note an increase in the use of lower levels of care with subsequent reductions in use of hospitals. Total annual average expenditures on health per household remained fairly stable between the 1999/2000 and 2002/03 surveys. There was, however, an increase of US$21 in expenditure between the 2002/03 and 2005/06 surveys. Abolition of user fees improved access to health services and efficiency in utilization. On the negative side is the fact that financial protection is yet to be achieved. Out-of-pocket expenditure remains high and mainly affects the poorer population quintiles. A dual system seems to have emerged where wealthier population groups are switching to the private sector.
The Uganda Journal of Agricultural Sciences (UJAS) (ISSN: 1026-0919) is a peer reviewed journal ... It should bear a background statement to originate the idea or research problem; ... Truly new procedures should be described in detail.
target the physical, economic, political and social development of Uganda. Although ... affordable quality health care and education, clean environment and green ..... focuses on preventive, curative and palliative medical services (Doyal and .... representation, tolerance, equity and constructive dialogues and openness to.
Oct 20, 2008 ... to receive increasing political, business and academic attention. In Uganda, ... Arising from this, poverty performance tracking has also lacked focus, ...... those already married was high for women (7%) compared to men (3%).
Zirnask, Villu, 1966-
Maailma tervishoiuorganisatsiooni (WHO) statistika järgi tarbivad maailmas kõige enam alkoholi Uganda elanikud - aastas 17,6 liitrit puhast alkoholi vanema kui 15-aastase elaniku kohta. Lisaks tabel alkoholi tarbimise kohta maailmas
The Icelandic International Development Agency (ICEIDA) has requested The Netherlands Institute of Fisheries Research (RIVO) to organize a sensory workshop in Uganda. ICEIDA is establishing a fisheries laboratory in Uganda in cooperation with the Ugandan government. One of the tasks within this
PROMOTING ACCESS TO AFRICAN RESEARCH ... Insecticide use and practices among cotton farmers in northern Uganda ... Socio-economic aspects of goat farming enterprise in Teso region, Uganda · EMAIL FREE FULL TEXT EMAIL ...
Full Text Available This article deals with the statistical data and analysis con-cerning poverty among the young people in Uganda. The poverty is continuously ascending, with the most affected region being Northern Uganda. The major cause of poverty in Uganda has been the “South-North divide” fuelled by poor political leadership, that divides people along the lines of politics and ethnicity. Poverty has caused many young people of Northern Uganda to resort to rebellion against the government currently in power. This has led to unending political instability and civil strife most especially in Northern Uganda. In this article atten-tion is given to the conflict in Northern Uganda and attempts are made to propose some amicable resolutions. The discussion includes the current poverty scenario in Northern Uganda and possible strategies for reducing the poverty rate that has caused much damage in Northern Uganda.
Wollum, Alexandra; Dansereau, Emily; Fullman, Nancy; Achan, Jane; Bannon, Kelsey A; Burstein, Roy; Conner, Ruben O; DeCenso, Brendan; Gasasira, Anne; Haakenstad, Annie; Hanlon, Michael; Ikilezi, Gloria; Kisia, Caroline; Levine, Aubrey J; Masters, Samuel H; Njuguna, Pamela; Okiro, Emelda A; Odeny, Thomas A; Allen Roberts, D; Gakidou, Emmanuela; Duber, Herbert C
Considerable debate exists concerning the effects of antiretroviral therapy (ART) service scale-up on non-HIV services and overall health system performance in sub-Saharan Africa. In this study, we examined whether ART services affected trends in non-ART outpatient department (OPD) visits in Kenya and Uganda. Using a nationally representative sample of health facilities in Kenya and Uganda, we estimated the effect of ART programs on OPD visits from 2007 to 2012. We modeled the annual percent change in non-ART OPD visits using hierarchical mixed-effects linear regressions, controlling for a range of facility characteristics. We used four different constructs of ART services to capture the different ways in which the presence, growth, overall, and relative size of ART programs may affect non-ART OPD services. Our final sample included 321 health facilities (140 in Kenya and 181 in Uganda). On average, OPD and ART visits increased steadily in Kenya and Uganda between 2007 and 2012. For facilities where ART services were not offered, the average annual increase in OPD visits was 4·2% in Kenya and 13·5% in Uganda. Among facilities that provided ART services, we found average annual OPD volume increases of 7·2% in Kenya and 5·6% in Uganda, with simultaneous annual increases of 13·7% and 12·5% in ART volumes. We did not find a statistically significant relationship between annual changes in OPD services and the presence, growth, overall, or relative size of ART services. However, in a subgroup analysis, we found that Ugandan hospitals that offered ART services had statistically significantly less growth in OPD visits than Ugandan hospitals that did not provide ART services. Our findings suggest that ART services in Kenya and Uganda did not have a statistically significant deleterious effects on OPD services between 2007 and 2012, although subgroup analyses indicate variation by facility type. Our findings are encouraging, particularly given recent recommendations
Margaret N. Wandera
Full Text Available Infant oral mutilation (IOM is a traditional method of extracting un-erupted teeth practiced in several Sub-Saharan African countries including Uganda. This practice is referred to as “ebinyo” by Bantu-speaking Ethnic groups, though it has several terms depending on cultural group and researcher. The un-erupted tooth is gouged out as a cure for medical symptoms in infants that include high fevers and diarrhea. The spreading of IOM practice in African populations is blamed on poor health literacy with regard to the common childhood illnesses. One study in Uganda revealed that adverse cases following IOM seen in the hospital peaked in tandem with the malaria and diarrheal disease cases. This paper is a review of the practice with a particular focus on Uganda as presented in literature compiled from PubMed, Dentaid, Google Scholar, Local Uganda sources, and the authors’ observations. The paper explains reason for the persistence of the practice, and to further inform on IOM to health practitioners who were previously unaware of the practice.
Zikusooka, C M; Kyomuhang, R; Orem, J N; Tumwine, M
Health care financing provides the resources and economic incentives for operating health systems and is a key determinant of health system performance. Equitable financing is based on: financial protection, progressive financing and cross-subsidies. This paper describes Uganda's health care financing landscape and documents the key equity issues associated with the current financing mechanisms. We extensively reviewed government documents and relevant literature and conducted key informant interviews, with the aim of assessing whether Uganda's health care financing mechanisms exhibited the key principles of fair financing. Uganda's health sector remains significantly under-funded, mainly relying on private sources of financing, especially out-of-pocket spending. At 9.6 % of total government expenditure, public spending on health is far below the Abuja target of 15% that GoU committed to. Prepayments form a small proportion of funding for Uganda's health sector. There is limited cross-subsidisation and high fragmentation within and between health financing mechanisms, mainly due to high reliance on out-of-pocket payments and limited prepayment mechanisms. Without compulsory health insurance and low coverage of private health insurance, Uganda has limited pooling of resources, and hence minimal cross-subsidisation. Although tax revenue is equitable, the remaining financing mechanisms for Uganda are inequitable due to their regressive nature, their lack of financial protection and limited cross-subsidisation. Overall, Uganda's current health financing is inequitable and fragmented. The government should take explicit action to promote equitable health care financing by establishing pre-payment schemes, enhancing cross-subsidisation mechanisms and through appropriate integration of financing mechanisms.
were collected at the inlet and outlet of the waste water treatment plant (WWTP) at Kiteezi landfill site. A ... some trace elements and also defined as elements with ... concerns regarding the environmental contamination .... ml plastic bottles.
The Land Act 1998. ➢. Women's movement Struggle over land – the lost co- ownership clause. ➢. Section 40 Consent clause- Protection of family land/ restrictions on the transfer of land by family members. ➢. (Section 57) Establishment of District Land. Boards- where at least one third must be women ...
Recent on station and on-farm studies suggest the major diseases threatening banana biodiversity in Uganda include: 1)Black sigatoka which severely affects all East African Highland (EA-AAA) banana cultivars and a range of introduced genotypes; 2) Fusarium wilt which affects several introduced genotypes though all EA ...
Our funding helped develop the Uganda Health Information Network, an electronic ... Hand-held computers, mobile caching services, and mobile telephones enable ... Now used in hundreds of health centres, the technology has enhanced healthcare ... promote land policies that are fair to women; stimulate high-quality, ...
This book is about engendering local governance. It explores the euphoria with which Uganda's decentralization policy took centre stage as a sufficient driver to engender local development responsiveness and accountability. Using a case study of AFARD in Nebbi district, it shows first that
In sub-Saharan Africa, many children die from diarrhea, acute respiratory illness and malaria, despite the fact that there are well recognized, inexpensive and highly effective treatments for these ailments. Healthy Child Uganda (HCU), a Ugandan-Canadian partnership, has been operating a village health volunteer program ...
The paper discusses the concept and philosophy of copyright. It also discusses copyright infringement with special reference to ICT. Furthermore, the paper examines international provisions related to copyright and reviews the Copyright Law Model. The paper also identifies gaps in the Uganda Copyright Bill, 2002 and ...
physical aggression, deprivation, hunger and family separation, among others, for over twenty years. ... by various types of sexual crimes of rape (including marital rape), defilement and child .... insecurity and civil strife raged in northern Uganda mainly between the government ...... The Daily Monitor of September 28, 2007.
Uganda Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 47 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription ...
This study presents the relevance of interdisciplinary education, the crisis in which Uganda's education system is, where specialisation is at its peak. It analyses the form of the present curriculum, which leaves the learner in state of dilemma. The author again shows the need for interdisciplinarity, tries to find out whether ...
Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K
There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health system policymaking (EIHSP) in Cameroon and Uganda since 2006. This comparative historical case study of Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda using multiple methods comprised (i) a descriptive documentary analysis for a narrative historical account, (ii) an interpretive documentary analysis of the context, profiles, activities and outputs inventories and (iii) an evaluative survey of stakeholders exposed to evidence briefs produced and policy dialogues organized by the KTPs. Both initiatives benefited from the technical and scientific support from the global EVIPNet resource group. EVIPNet Cameroon secretariat operates with a multidisciplinary group of part-time researchers in a teaching hospital closely linked to the ministry of health. REACH-PI Uganda secretariat operates with a smaller team of full time staff in a public university. Financial resources were mobilized from external donors to scale up capacity building, knowledge management, and linkage and exchange activities. Between 2008 and 2012, twelve evidence briefs were produced in Cameroon and three in Uganda. In 2012, six rapid evidence syntheses in response to stakeholders' urgent needs were produced in Cameroon against 73 in Uganda between 2010 and 2012. Ten policy dialogues (seven in Cameroon and three in Uganda) informed by pre-circulated evidence briefs were well received. Both KTPs contributed to developing and testing new resources and tools for EIHSP. A network of local and global experts has created new spaces for evidence informed deliberations on priority health policy issues related to MDGs. This descriptive historical account of two KTPs housed in government
Topic: ACCESS TO INFORMATION, LEGISLATION, REGULATIONS ... Region: North of Sahara, South of Sahara, Colombia, Ghana, Uganda, Tanzania ... ENVIRONMENTAL HEALTH, AGRICULTURAL POLICY, ENVIRONMENTAL POLICY.
Mellerup, Natja; Sørensen, Bjarke Lund; Kuriigamba, Gideon K.
BACKGROUND: Complications of unsafe abortion are a major contributor to maternal deaths in developing countries. This study aimed to evaluate the clinical assessment for life-threatening complications and the following management in women admitted with complications from abortions at a rural...... abortion and by trimester. Actual management was compared to the audit criteria and presented by descriptive statistics. RESULTS: Fifty six per cent of the women were in second trimester. Abortion complications were distributed as follows: 53 % incomplete abortions, 28 % threatened abortions, 12...... % inevitable abortions, 4 % missed abortions and 3 % septic abortions. Only one of 238 cases met all criteria of optimal clinical assessment and management. Thus, vital signs were measured in 3 %, antibiotic criteria was met in 59 % of the cases, intravenous fluid resuscitation was administered to 35...
prior to the above presentation and review of systems were unremarkable. General examination revealed a ... syndrome or disease, massive osteolysis, disappearing bone disease, vanishing bone disease, idiopathic ... patient symptoms and anatomic location. Medical treatment involves, radiation therapy, anti-osteoclastic.
Elizabeth D. Yuan
Full Text Available Background: Imaging the World-Africa (ITWA is a registered non-governmental organization aimed at distributing low-cost ultrasound services at health centres in rural Uganda. Yet, studies demonstrate that the majority of mothers continue to deliver with unregulated traditional birth attendants (TBAs in their local villages. It has been suggested that the unregulated practices of TBAs has contributed to the high rate of maternal and fetal mortality. A greater understanding of the roles of TBAs in the management of pregnancy and delivery is needed. Purpose: The purpose of this report is to provide the international community with a greater understanding of TBA practices as well as an assessment of their willingness for future collaboration. Methods: Three TBAs from different nearby villages attended a meeting with ITWA in Kamuli District, Uganda. The meeting included an interview and an educational session. A test on the management principles of common obstetric complications was administered at the beginning and end of the meeting to assess baseline knowledge and the effect of the interaction. Results: The meeting with the TBAs provided valuable qualitative information about TBA clinical experience, the value of TBAs to the community and TBA understanding of ultrasound. On the pre-educational test, the TBAs had a limited understanding of pregnancy complications and conditions in which it would be safer for a mother to deliver at a hospital. After the educational session, the TBAs performed statistically significantly better on the post-test (p=0.03. Conclusion: The open conversation with the TBAs provided valuable information on the current role of TBAs in rural Uganda. Our experience with the TBAs demonstrates that TBAs are willing to engage with trained healthcare providers. Collaboration between TBAs and health centers in Uganda has the potential to bring to light previously unknown barriers and create solutions to better maternal and fetal
Nielsen, Jannie; Bahendeka, Silver K.; Bygbjerg, Ib C.
Non-communicable diseases including type 2 diabetes (T2D) are increasing rapidly in most Sub-Saharan African (SSA) countries like Uganda. Little attention has been given to how patients with T2D try to achieve treatment when the availability of public health care for their disease is limited......, as is the case in most SSA countries. In this paper we focus on the landscape of availability of care and the therapeutic journeys of patients within that landscape. Based on fieldwork in south-western Uganda including 10 case studies, we explore the diabetes treatment options in the area and what it takes...... to access the available treatment. We analyse the resources patients need to use the available treatment options, and demonstrate that the patients’ journeys to access and maintain treatment are facilitated by the knowledge and support of their therapy management groups. Patients access treatment more...
This book is about engendering local governance. It explores the euphoria with which Uganda's decentralization policy took centre stage as a sufficient driver to engender local development responsiveness and accountability. Using a case study of AFARD in Nebbi district, it shows first that decentralized governance is gendered and technocratic as grassroots women's effective participation is lacking. Second, it shows that the insertion of women in local governance is merely a symbolic politica...
Andrews, C M; Rottman, C J; Lematia, R M
Imagine that you are a woman living in rural Uganda. Your husband has returned to the city to work as a manual labourer. With a toddler playing alongside, you work long hot hours in the field to provide for your family. For weeks you have run a low-grade fever which you suspect is related to your advancing pregnancy. As traditional medicines have provided no relief, you sacrifice a day in the field and wait in line for care at a medical clinic outpost that is staffed one day a week. Nearing your turn, you hear a rumour that the government now requires payment in advance for care. As you and most of the others waiting in line do not have money, you leave together and arrange to pool resources from a community project so that you can all return to the clinic next week. Your pain increases and your productivity goes down. When the clinic day finally comes, the nurse does not show up because her own children need food and she prefers to earn ready cash by selling crafts in the market rather than work at the clinic for barely subsistence pay. The story does not end here, nor does that of countless other women in Uganda, including the caregivers. The difficulties are ongoing. And meeting health needs in Uganda as in many countries in Sub-Sahara Africa is complex and challenging.
Kapiriri, Lydia; Norheim, Ole Frithjof; Martin, Douglas K
The objectives of this study were (1) to describe the process of healthcare priority setting in Ontario-Canada, Norway and Uganda at the three levels of decision-making; (2) to evaluate the description using the framework for fair priority setting, accountability for reasonableness; so as to identify lessons of good practices. We carried out case studies involving key informant interviews, with 184 health practitioners and health planners from the macro-level, meso-level and micro-level from Canada-Ontario, Norway and Uganda (selected by virtue of their varying experiences in priority setting). Interviews were audio-recorded, transcribed and analyzed using a modified thematic approach. The descriptions were evaluated against the four conditions of "accountability for reasonableness", relevance, publicity, revisions and enforcement. Areas of adherence to these conditions were identified as lessons of good practices; areas of non-adherence were identified as opportunities for improvement. (i) at the macro-level, in all three countries, cabinet makes most of the macro-level resource allocation decisions and they are influenced by politics, public pressure, and advocacy. Decisions within the ministries of health are based on objective formulae and evidence. International priorities influenced decisions in Uganda. Some priority-setting reasons are publicized through circulars, printed documents and the Internet in Canada and Norway. At the meso-level, hospital priority-setting decisions were made by the hospital managers and were based on national priorities, guidelines, and evidence. Hospital departments that handle emergencies, such as surgery, were prioritized. Some of the reasons are available on the hospital intranet or presented at meetings. Micro-level practitioners considered medical and social worth criteria. These reasons are not publicized. Many practitioners lacked knowledge of the macro- and meso-level priority-setting processes. (ii) Evaluation
Region: Uganda, North of Sahara, South of Sahara. Program: Think Tank Initiative. Total Funding: CA$ 1,845,170.00. Institutional Support : Makerere Institute of Social Research (MISR). Project. Makerere Institute of Social Research (MISR), Uganda, is the former East African Institute of Social and Economic Research ...
Good quality Antenatal Care (ANC) provides opportunity to detect and respond to risky maternal conditions. This study assessed quality of ANC services in eastern Uganda with a goal of benchmarking implications for interventions. Methods Data was collected from 15 health facilities in Eastern Uganda to establish capacity ...
Information communication technology use pattern by women tree farmers in Buzaya county, Kamuli district, Uganda · EMAIL FREE FULL TEXT EMAIL FREE FULL ... The effect of intercropping maize with lablab on grain and fodder production in small holder dairy farming systems in Masaka district, Uganda · EMAIL FREE ...
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…
Namyalo, Saudah; Nakayiza, Judith
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…
Okech, S.H.; Gold, C.S.; Bagamba, F.; Masanza, M.; Tushemereirwe, W.; Ssennyonga, J.
The International Institute of Tropical Agriculture and the Uganda National Banana Research Programme tested and evaluated selected cultural management options for the banana weevil through on-farm farmer participatory research in Ntungamo district, Uganda between 1996 and 003. A farmer adoption
The team that carried out the Survey of Language Use and Language Teaching in Eastern Africa (with specific reference to Uganda) was non-committal on stating the number of languages there are in Uganda. In the end, they mentioned 63 languages/dialects which fall into 5 groups based on broad lexical and grammatical ...
This paper examines the environment within which Uganda can be productively involved in the process of building an information society for industrial development. There are concerted efforts by the government of Uganda and civil society organisations in the country towards the development of information literacy and ...
Mastenbroek, A.; Chebet, A.; Muwanika, C.T.; Adong, C.J.; Okot, F.; Otim, G.; Birungi, J.; Kansiime, M.; Oyee, P.; Ninsiima, P.
The training manual is developed in Uganda to train partner organisations in coaching farmer groups to become sustainable local seed businesses. It introduces the Integrated Seed Sector Development Programme in Uganda and the concept of local seed businesses (LSBs). The manual has 5 modules covering
Uganda Journal of Agricultural Sciences, 2000, 5: 13- 15. Printed in Uganda. ... cassava tuber yield. Production costs of I kg of seed were Shs 1200, 2000 and 3700 for centro ... of cassava are the second most important staple food of those ...
Conclusion: We observed significant gender differences in the prevalence of obesity among young adults in Uganda. Contrary to expectation, we did not observe significant rural-urban differences in the prevalence of overweight. Keywords: Obesity; overweight; prevalence; Uganda; young adults. African Health Sciences ...
The survey and discussion focus on the challenges to quality education in Uganda. It is over136 years since formal education was introduced in Uganda by the Christian Missionaries in 1877 and 1879. These were Anglican and Roman Catholic Missionaries respectively. Given the plethora of implicit and explicit challenges ...
Econometric methods were used to estimate the supply and demand functions for Uganda's coffee using time series data for the period 1971-91. Eight major importing countries for Uganda's coffee: U.S., U.K., Japan, France, Italy, Spain, Germany, and the Netherlands were considered in export demand analysis.
Full Text Available Background: Crimean–Congo hemorrhagic fever (CCHF is the most geographically widespread tick-borne viral infection. Outbreaks of CCHF in sub-Saharan Africa are largely undetected and thus under-reported. On November 9, 2015, the National Viral Hemorrhagic Fever Laboratory at the Uganda Virus Research Institute received an alert for a suspect VHF case in a 33-year-old male who presented with VHF compatible signs and symptoms at Mengo Hospital in Kampala. Methods: A blood sample from the suspect patient was tested by RT-PCR for CCHF and found positive. Serological testing on sequential blood specimens collected from this patient showed increasing anti-CCHFV IgM antibody titers, confirming recent infection. Repeat sampling of the confirmed case post recovery showed high titers for anti-CCHFV-specific IgG. An epidemiological outbreak investigation was initiated following the initial RT-PCR positive detection to identify any additional suspect cases. Results: Only a single acute case of CCHF was detected from this outbreak. No additional acute CCHF cases were identified following field investigations. Environmental investigations collected 53 tick samples, with only 1, a Boophilus decoloratus, having detectable CCHFV RNA by RT-PCR. Full-length genomic sequencing on a viral isolate from the index human case showed the virus to be related to the DRC (Africa 2 lineage. Conclusions: This is the fourth confirmed CCHF outbreak in Uganda within 2 years after more than 50 years of no reported human CCHF cases in this country. Our investigations reaffirm the endemicity of CCHFV in Uganda, and show that exposure to ticks poses a significant risk for human infection. These findings also reflect the importance of having an established national VHF surveillance system and diagnostic capacity in a developing country like Uganda, in order to identify the first cases of VHF outbreaks and rapidly respond to reduce secondary cases. Additional efforts should focus on
War and AIDS-related mortality in Uganda have created an estimated 1.2 million orphans in the country. Child welfare advocates and nongovernmental organizations (NGOs) have therefore been working together for the past 4 years under an umbrella organization to coordinate efforts for vulnerable children. The Uganda Community-Based Association for Child Welfare (UCOBAC), links people and organizations involved in child advocacy, facilitates relations between the government and NGOs, and helps to strengthen the capacity of NGOs to identify and implement projects. UCOBAC emphasizes community-based initiatives which allow children to remain in their own communities instead of being institutionalized. One example of such an approach is a vocational skills training program in Rakai district established to help young orphans trying to make it on their own. More than 300 youths had benefitted from the program as of December 1994 and plans are underway to expand the program to 10 more districts. UCOBAC is also training communities and NGOs to identify and implement viable projects, and helps child welfare organizations by serving as a network for sharing information. UCOBAC came into existence in October 1990 with 93 members, including 57 local NGOs, 17 international NGOs, and 19 individual members. The organization has since established local offices in 35 of Uganda's 39 districts. UNICEF has thus far provided about US$130,000 for UCOBAC activities and will continue to fund local NGO initiatives through UCOBAC. UCOBAC, however, is giving priority to becoming financially independent of UNICEF within a couple of years. Future projects include an inventory of NGO child welfare projects, a child welfare resource library, and networking workshops with NGOs and government policymakers.
Full Text Available The aim of the paper is to explore factors associated with home or hospital delivery in rural Uganda. Qualitative interviews with recently-delivered women in rural Uganda and statistical analysis of data from the 2011 Ugandan Demographic and Health Survey (DHS to assess the association between socio-demographic and cultural factors and delivery location in multivariable regression models. In the DHS, 61.7% (of 4907 women had a facility-based delivery (FBD; in adjusted analyses, FBD was associated with an urban setting [adjusted odds ratio (aOR 3.38, 95% confidence interval (CI 2.66 to 4.28], the upper wealth quintile (aOR: 3.69, 95%CI 2.79 to 3.87 and with secondary education (aOR: 3.07, 95%CI 2.37 to 3.96. In interviews women quoted costs and distance as barriers to FBD. Other factors reported in interviews to be associated with FBD included family influence, perceived necessity of care (weak women needed FBD, and the reputation of the facility (women bypassed local facilities to deliver at better hospitals. Choosing a FBD is a complex decision and education around the benefits of FBD should be combined with interventions designed to remove barriers to FBD.
John R.S. Tabuti
Full Text Available Indigenous knowledge (IK has a role to play for households and community well-being in Uganda. However, IK is undergoing significant change and is on the decline in Uganda because of factors such as acculturation or the loss of IK through exposure to external cultures. In this paper we review some of the roles of, and threats to, IK with particular reference to the local community of Kaliro District. We make some recommendations on how to conserve IK in Kaliro and elsewhere in Uganda. Key words: traditional knowledge, conservation, traditional medicine, ethnobotany
An advertisement in the Uganda weekly Topic printed in 1990 is the center of the controversy over whether promoting condom use to prevent AIDS is really promoting immorality and promiscuity. The ad states: "The bible may save your soul but this condom will save you life." Critics have called the ad blasphemy for showing a condom package alongside the Bible; claimed the condom fools people into thinking they are safe from AIDS; and blamed the practice of supplying condoms for the moral decadence that is destroying the country. In contrast the national AIDS Control Program (ACP) believes that supplying university students, who may be the group at highest risk, with condoms, is wise because they at lest know how to use them properly. A spokesman for the ACP said that the condom is one of the limited options that exist to fight the life-threatening epidemic. Present Museven changed his views to November 1990 from a policy of encouraging abstinence and monogamy, to promoting condoms. This change in government policy coincided with the report of 17,422 cases of AIDS, and the estimate that 1.3 million people in Uganda are infected with HIV.
Destination(s):. Ghana, Tanzania, Uganda, Kenya. Airfare: $11,661.09. Other. Transportation: $35.15. Accommodation: $2,629.22. Meals and. Incidentals: $773.08. Other: $547.65. Total: $15,646.19. Comments: 2015-2016 Travel and Hospitality Expense. Reports for Joanne Charette, Vice-President,. Corporate Strategy ...
Project. Kenya, Tanzania and Uganda have adopted new land laws, policies and institutional arrangements to accommodate decentralization of land administration and management. Start Date: June 30, 2008 ... Topic: EPIDEMIOLOGY, WEATHER, EPIDEMICS, MALARIA, PROPHYLAXIS, Disease control. Region: Kenya ...
African Journal on Conflict Resolution ... The International Criminal Court (ICC) commenced investigation of the armed conflict in Uganda in 2004. ... It also addresses the problem of assessing the impact of law on conflict through the use of an ...
Feb 22, 2016 ... methods were used to validate results obtained from the .... TABLE 2. Agronomic information on organic pineapple production in Uganda ..... management, which makes the value chain expensive ..... A handbook for value ...
May 29, 2015 ... were the people of Northern Uganda region, where the defeated armies re- ..... power (Museveni 1989) was back-tracking to manipulate the constitution. .... is important to term limits because I know what my president believes ...
Prof. Adipala Ekwamu
3Ministry of Water and Environment, Climate Change Unit, P. O. Box 2811, Kampala, Uganda ... (r=0.99). Precipitation has influenced vegetative biomass in the cattle corridor as there is a positive .... since they are cloud free (Campbell, 2006).
Using ICTs to Address Water Challenges in Uganda ... the adaptive capacity of communities to address the issue of climate-induced water stress. ... It will do so by testing the electronic dissemination of seasonal forecasts, early warning ...
15 janv. 2012 ... Using ICTs to Address Water Challenges in Uganda ... adaptive capacity of communities to address the issue of climate-induced water stress. ... It will do so by testing the electronic dissemination of seasonal forecasts, early ...
Nov 10, 2010 ... Physicians and health care workers working in locations without fixed-line ... face serious problems in sharing and accessing critical medical and public ... to be a powerful tool for doctors and health care workers in Uganda.
Région: Ethiopia, Thailand, Uganda, Zambia, Norway, United Kingdom. Programme: ... Sujet: YOUTH UNEMPLOYMENT, LOW INCOME GROUPS, SOCIAL PROBLEMS, ECONOMIC GROWTH, DATA ANALYSIS, EMPLOYMENT STABILITY, Poverty alleviation, EMPLOYMENT CREATION, POLICY MAKING. Région: Kenya ...
In the early stages, Uganda's soils were considered fertile and little was done to improve productivity in a systematic way. ... labour costs. ... introduction of cash crops [cotton, tobacco, coffee or tea] .... opening of phosphate mine near Tororo;.
Supporting business opportunities for rural women in east and southern Africa. Project. Women in Zimbabwe, Kenya, and Uganda experience disadvantages and gender inequalities in labour and ... Start Date: Tuesday, August 11, 2015.
Topic: YOUTH UNEMPLOYMENT, LOW INCOME GROUPS, SOCIAL ... New research will explore the potential of community participation in Uganda and South ... as well as a cornerstone to good governance and the fight against corruption.
forming farmers' associations, leveraging mobile money technologies to reduce distance, and streamlining application procedures could bolster agricultural credit demand in Uganda. ...... analysis was collected for the latter's M.Sc. dissertation.
. It was guided by the following objectives; to investigating whether the number of antenatal Care visits, maternal education, age, area and region of residence had any effect on maternal mortality in Uganda. Descriptive statistics are used to ...
locations in Uganda, to determine the adaptability of introduced mungbean genotypes, and identify ... The six test multi-locations were grouped into two candidate mega-environments for ..... interactions: Challenges and opportunities for.
Consumption of fast-food in Uganda is becoming an increasingly important ... to study the consumption and expenditure behaviour of consumers of fast-food in ... to restaurant negatively influenced the probability of fast-food consumption and ...
This project will attempt to assess the performance health systems in Uganda and ... the impoverishing effect of out-of-pocket payment for catastrophic health events. ... IDRC and key partners will showcase critical work on adaptation and ...
African Health Sciences ... salivary gland tumors as defined by WHO classification (1991), is accepted world-wide but little is available in the literature ... Objective: To outline the clinicopathological features of salivary gland tumors in Uganda.
Panafrican Research Agenda on the Integration of ICTs in Education - Phase I ... Developer Network : Open Source Personal Digital Assistant Software for ... the anti-retroviral therapy in Free State province, South Africa (102411); Uganda ...
Epiphany Picho Odubuker
The purpose of the study was to investigate the relationship between Leadership Styles and job satisfaction among the staff of Uganda Management Institute. A descriptive cross-sectional survey design was used with a sample size being 118. Purposive, stratified and systematic sampling techniques were used to select respondents. Data analysis involved frequencies and percentages, Spearman rank Order correlation, coefficient of determination, regression, and ANOVA. There was a strong positive re...
The paper aims at mapping out the Mobile Telecommunications Industry in Uganda with a view to identify areas for further research in a systematic and more detailed way. The economic and social upgrading/downgrading conceptual framework to guide the Capturing the Gains research agenda was used in this process. The paper briefly presents the mobile phone domains, emphasising the relevant parts for Uganda, which include; software development, sales and marketing, mobile service provision and end...
Midtvåge, Runa; Hiranandani, Vanmala Sunder; Nambuanyi, Lekunze Ransom
• Midtvåge, R., Hiranandani, V. S., & Lekunze, R. (2014). Promoting food security of low income women in central Uganda. Poster presentation, Sustainability Science Congress, University of Copenhagen, Denmark, October 22-24, 2014.......• Midtvåge, R., Hiranandani, V. S., & Lekunze, R. (2014). Promoting food security of low income women in central Uganda. Poster presentation, Sustainability Science Congress, University of Copenhagen, Denmark, October 22-24, 2014....
infections, anemia , tetanus, malaria, and tuberculosis. Incidence of AIDS quite high, reaching epidemic proportivns in southern areas. Uganda had...attributed to illness. Other fatal illnesses included anemia , tetanus, and whoop- ing cough, but some people also died of malnutrition. An estimat- ed...185 Persian Gulf States 550-89 Tunisia 550-42 Peru 550-80 Turkey 550-72 Philippines 550-74 Uganda 550-162 Poland 550-97 Uruguay 550-181 Portugal 550-71
Larson, Donald W.; Mbowa, Swaibu
Strategic marketing issues and challenges face maize seed marketing firms as farmers increasingly adopt hybrid varieties in a modernizing third world country such as Uganda. The maize seed industry of Uganda has changed dramatically from a government owned, controlled, and operated industry to a competitive market oriented industry with substantial private firm investment and participation. The new maize seed industry is young, dynamic, growing and very competitive. The small maize seed marke...
Tran, Tu M; Fuller, Anthony T; Butler, Elissa K; Makumbi, Fredrick; Luboga, Samuel; Muhumuza, Christine; Ssennono, Vincent F; Chipman, Jeffrey G; Galukande, Moses; Haglund, Michael M
To quantify the burden of surgical conditions in Uganda. Data on the burden of disease have long served as a cornerstone to health policymaking, planning, and resource allocation. Population-based data are the gold standard, but no data on surgical burden at a national scale exist; therefore, we adapted the Surgeons OverSeas Assessment of Surgical Need survey and conducted a nation-wide, cross-sectional survey of Uganda to quantify the burden of surgically treatable conditions. The 2-stage cluster sample included 105 enumeration areas, representing 74 districts and Kampala Capital City Authority. Enumeration occurred from August 20 to September 12, 2014. In each enumeration area, 24 households were randomly selected; the head of the household provided details regarding any household deaths within the previous 12 months. Two household members were randomly selected for a head-to-toe verbal interview to determine existing untreated and treated surgical conditions. In 2315 households, we surveyed 4248 individuals: 461 (10.6%) reported 1 or more conditions requiring at least surgical consultation [95% confidence interval (CI) 8.9%-12.4%]. The most frequent barrier to surgical care was the lack of financial resources for the direct cost of care. Of the 153 household deaths recalled, 53 deaths (34.2%; 95% CI 22.1%-46.3%) were associated with surgically treatable signs/symptoms. Shortage of time was the most frequently cited reason (25.8%) among the 11.6% household deaths that should have, but did not, receive surgical care (95% CI 6.4%-16.8%). Unmet surgical need is prevalent in Uganda. There is an urgent need to expand the surgical care delivery system starting with the district-level hospitals. Routine surgical data collection at both the health facility and household level should be implemented.
Denis K Byarugaba
Full Text Available The increasing availability of complete influenza virus genomes is deepening our understanding of influenza evolutionary dynamics and facilitating the selection of vaccine strains. However, only one complete African influenza virus sequence is available in the public domain. Here we present a complete genome analysis of 59 influenza A/H3N2 viruses isolated from humans in Uganda during the 2008 and 2009 season. Isolates were recovered from hospital-based sentinel surveillance for influenza-like illnesses and their whole genome sequenced. The viruses circulating during these two seasons clearly differed from each other phylogenetically. They showed a slow evolution away from the 2009/10 recommended vaccine strain (A/Brisbane/10/07, instead clustering with the 2010/11 recommended vaccine strain (A/Perth/16/09 in the A/Victoria/208/09 clade, as observed in other global regions. All of the isolates carried the adamantane resistance marker S31N in the M2 gene and carried several markers of enhanced transmission; as expected, none carried any marker of neuraminidase inhibitor resistance. The hemagglutinin gene of the 2009 isolates differed from that of the 2008 isolates in antigenic sites A, B, D, and to a lesser extent, C and E indicating evidence of an early phylogenetic shift from the 2008 to 2009 viruses. The internal genes of the 2009 isolates were similar to those of one 2008 isolate, A/Uganda/MUWRP-050/2008. Another 2008 isolate had a truncated PB1-F2 protein. Whole genome sequencing can enhance surveillance of future seasonal changes in the viral genome which is crucial to ensure that selected vaccine strains are protective against the strains circulating in Eastern Africa. This data provides an important baseline for this surveillance. Overall the influenza virus activity in Uganda appears to mirror that observed in other regions of the southern hemisphere.
Earthquake occurrence in Uganda is mostly related to East Africa Rift System. The country's western border lies within the Western branch of this system while the Eastern branch is only 200 km from its eastern border. The two tectonic features contribute to seismicity in Uganda. These are the Aswar shear zone running from Nimule at the border of Uganda and Sudan, to Mount Elgon on the Eastern border and Katonga fault break which cuts across the country from the foot hills of mount Rwenzori to the Western side of Lake Victoria. This unique tectonic setting makes Uganda one of most seismically active countries on the African continet as exemplified by some destructive earthquakes that have hit the country. For this reason the Government of uganda is in the process of setting up an earthquake monitoring system, the National Seismological Network, with efficient detectability, efficient data transmission and processing facilities so that earthquakes in Uganda can be properly assessed and seismic hazard studies of the country cunducted. The objectives of the said network, the seismic developments for the last two decades and its current satus are described
Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif
Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural-urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.
Christopher R. Stark
Full Text Available Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda. Methods and Materials: Imaging the World Africa (ITWA is the registered non-governmental organization division of Imaging the World (ITW, a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of regionally supplied biopsy kits. Results: A surgeon at a rural regional referral hospital was successfully trained and certified to perform ultrasound-guided percutaneous breast core biopsies. Affordable and safe biopsy kits were created using locally available medical supplies with the cost of each kit totaling $10.62 USD. Conclusion: Successful implementation of an ultrasound-guided percutaneous breast core biopsy program in the resource-limited setting is possible and can be made sustainable through incorporation of local health care personnel and regionally supplied biopsy materials. Our hope is that ITWA’s initial experience in rural Uganda can serve as a model for similar programs in the future.
Danielsen, Solveig; Matsiko, Frank; Mutebi, Emmanuel
coverage, Regularity/timeliness and Quality of plant healthcare. Field work was carried out over 15 months between July 2010 and September 2011 in 13 districts in the eastern, central and western parts of Uganda. A total of 205 plant clinic sessions were held in the period. The plant clinics received 2...... from the clinics to diagnostic laboratories. Although the plant clinics have become part of Ministry policy and districts showed increasing interest and commitment, there are some structural barriers that made it difficult for the districts to institutionalise the clinics and for the Ministry to play...... their leading role. A mismatch between institutional mandates/authority and allocated resources limited the scope of the actions both at district and national level. The plant clinics risk ‘falling between the two chairs’ of extension and pest and disease control. Finding a solid institutional base...
Full Text Available Land use without adequate soil erosion control measures is continuously increasing the risk of soil erosion by water mainly in developing tropical countries. These countries are prone to environmental disturbance due to high population growth and high rainfall intensity. The aim of this study is to assess the state of soil erosion by water in Uganda at national and district levels, for various land cover and land use (LCLU types, in protected areas as well to predict the impact of support practices on soil loss reduction. Predictions obtained using the Revised Universal Soil Loss Equation (RUSLE model indicated that the mean rate of soil loss risk in Uganda’s erosion‐prone lands was 3.2 t∙ha−1∙y−1, resulting in a total annual soil loss of about 62 million tons in 2014. About 39% of the country’s erosion‐prone lands were comprised of unsustainable mean soil loss rates >1 t∙ha−1∙y−1. Out of 112 districts in Uganda, 66 districts were found to have unsustainable estimated soil loss rates >1 t∙ha−1∙y−1. Six districts in Uganda were found to have mean annual soil loss rates of >10 t∙ha−1∙y−1: Bududa (46.3 t∙ha−1∙y−1, Kasese (37.5 t∙ha−1∙y−1, Bundibugyo (28.9 t∙ha−1∙y−1, Bulambuli (20.9 t∙ha−1∙y−1, Sironko (14.6 t∙ha−1∙y−1 and Kotido (12.5 t∙ha−1∙y−1. Among the LCLU types, the highest soil loss rates of 11 t∙ha−1∙y−1 and 10.6 t∙ha−1∙y−1 were found in moderate natural forest and dense natural forest, respectively, mainly due to their locations in highland areas characterized by steep slopes ranging between 16% to 21% and their high rainfall intensity, ranging from 1255 mm∙y−1 to 1292 mm∙y−1. Only five protected areas in Uganda were found to have high mean estimated mean soil loss rates >10 t∙ha−1∙y−1: Rwenzori Mountains (142.94 t∙ha−1∙y−1, Mount Elgon (33.81 t∙ha−1∙y−1, Bokora corridor (12.13 t∙ha−1∙y−1
Betson, Martha; Nejsum, Peter; Llewellyn-Hughes, Julia
. Microsatellite analysis using eight loci provided evidence for high gene flow between worm populations from the two villages but comparing these worms with others obtained in a prior study on Unguja, Zanzibar, confirmed little genetic exchange and mixing of worm populations between the two areas. By adding......Despite the common occurrence of ascariasis in southwestern Uganda, helminth control in the region has been limited. To gain further insights into the genetic diversity of Ascaris in this area, a parasitological survey in mothers (n=41) and children (n=74) living in two villages, Habutobere...... and Musezero, was carried out. Adult Ascaris worms were collected from infected individuals by chemo-expulsion using pyrantel pamoate treatment. Genetic diversity within these worms was assessed by inspection of DNA sequence variation in a mitochondrial marker and length polymorphism at microsatellite loci...
I examine the role of household permanent income in determining who bribes and how much they bribe in health care in Uganda. I find that rich patients are more likely than other patients to bribe in public health care: doubling household expenditure increases the bribery probability by 1.2 percentage points compared to a bribery rate of 17%. The income elasticity of the bribe amount is about 0.37. Bribes in the Ugandan public sector appear to be fees-for-service extorted from the richer patients amongst those exempted by government policy from paying the official fees. Bribes in the private sector appear to be flat-rate fees paid by patients who do not pay official fees. I do not find evidence that the public health care sector is able to price discriminate less effectively than public institutions with less competition from the private sector. Copyright 2010 Elsevier B.V. All rights reserved.
Full Text Available Abstract Background Couple HIV Counseling and Testing (CHCT is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda. Methods The study was conducted in two sub-counties in a rural district (Mukono district about 28 km east of the capital Kampala, using a descriptive and explorative qualitative research design. Specifically, we conducted focus group discussions and key informant interviews with HIV focal persons, village health team (VHT members, religious leaders and political leaders. We also interviewed persons in couple relationships. Data was analysed using NVivo 8 software. Ethical clearance was received from the Mengo Hospital Research Review Board and from the Uganda National Council of Science and Technology. Results The study was conducted from June 2013 to July 2013 We conducted 4 focus group discussions, 10 key informant interviews and interviewed 53 persons in couple relationships. None of the participants were a couple. The women were 68% (36/53 and 49% (26/53 of them were above 29 years old. The motivators of CHCT uptake were; perceived benefit of HIV testing, sickness of a partner or child in the family and suspicion of infidelity. Other important motivators were men involvement in antenatal care (ANC attendance and preparation for marriage. Conclusion The motivators for CHCT uptake included the perceived benefit of HIV testing, sickness of a partner or child, preparation for marriage, lack of trust among couples and men involvement in antenatal care. Greater
Kwesiga, Brendan; Ataguba, John E; Abewe, Christabel; Kizza, Paul; Zikusooka, Charlotte M
Equity in health care entails payment for health services according to the capacity to pay and the receipt of benefits according to need. In Uganda, as in many African countries, although equity is extolled in government policy documents, not much is known about who pays for, and who benefits from, health services. This paper assesses both equity in the financing and distribution of health care benefits in Uganda. Data are drawn from the most recent nationally representative Uganda National Household Survey 2009/10. Equity in health financing is assessed considering the main domestic health financing sources (i.e., taxes and direct out-of-pocket payments). This is achieved using bar charts and standard concentration and Kakwani indices. Benefit incidence analysis is used to assess the distribution of health services for both public and non-public providers across socio-economic groups and the need for care. Need is assessed using limitations in functional ability while socioeconomic groups are created using per adult equivalent consumption expenditure. Overall, health financing in Uganda is marginally progressive; the rich pay more as a proportion of their income than the poor. The various taxes are more progressive than out-of-pocket payments (e.g., the Kakwani index of personal income tax is 0.195 compared with 0.064 for out-of-pocket payments). However, taxes are a much smaller proportion of total health sector financing compared with out-of-pocket payments. The distribution of total health sector services benefitsis pro-rich. The richest quintile receives 19.2% of total benefits compared to the 17.9% received by the poorest quintile. The rich also receive a much higher share of benefits relative to their need. Benefits from public health units are pro-poor while hospital based care, in both public and non-public sectors are pro-rich. There is a renewed interest in ensuring equity in the financing and use of health services. Based on the results in this paper
Nannozi, Victoria; Wobudeya, Eric; Matsiko, Nicholas; Gahagan, Jacqueline
Couple HIV Counseling and Testing (CHCT) is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda. The study was conducted in two sub-counties in a rural district (Mukono district) about 28 km east of the capital Kampala, using a descriptive and explorative qualitative research design. Specifically, we conducted focus group discussions and key informant interviews with HIV focal persons, village health team (VHT) members, religious leaders and political leaders. We also interviewed persons in couple relationships. Data was analysed using NVivo 8 software. Ethical clearance was received from the Mengo Hospital Research Review Board and from the Uganda National Council of Science and Technology. The study was conducted from June 2013 to July 2013 We conducted 4 focus group discussions, 10 key informant interviews and interviewed 53 persons in couple relationships. None of the participants were a couple. The women were 68% (36/53) and 49% (26/53) of them were above 29 years old. The motivators of CHCT uptake were; perceived benefit of HIV testing, sickness of a partner or child in the family and suspicion of infidelity. Other important motivators were men involvement in antenatal care (ANC) attendance and preparation for marriage. The motivators for CHCT uptake included the perceived benefit of HIV testing, sickness of a partner or child, preparation for marriage, lack of trust among couples and men involvement in antenatal care. Greater attention to enhancers of CHCT programming is needed in trying to
Francis Adyanga Akena
Full Text Available Uganda’s health care sector is choking with various challenges, such as poor physical infrastructure, inadequate professionals to run the few existing health centers, poor culture of adherence to professional ethical standards by some health care practitioners, shortages of medicines in most government hospitals/health centers, and corruption. Most of the challenges are more endemic in rural areas. It is on the above premise that this article discusses some of the challenges that health centers face in provision of care to the increasing number of HIV/AIDS patients in hard-to-reach rural communities in northern Uganda and the implications of such challenges on the economy. Uganda’s success in the fight against HIV/AIDS in the early 1990s was globally applauded because of its aggressive grassroots behavioral change crusades aimed at reducing the number of sexual partners. The success inspired a wave of financial aid programs from the US government to fight the disease across the developing world. However, the success was short-lived as the rate of HIV/AIDS infection in Uganda is currently rising, with the health care system struggling to provide care for the ballooning number of patients. To contribute to the curtailing cases of new infections, this article discuses the integration of the traditional authority and knowledge system in the national HIV/AIDS care and prevention program along with the biomedical approach currently being used.
Sileo, Katelyn M; Wanyenze, Rhoda K; Lule, Haruna; Kiene, Susan M
Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda. Participants were 258 women who attended antenatal care at a rural Ugandan hospital. We used logistic regression models in SPSS to identify determinants of family planning service uptake and contraceptive use postpartum. Statistically significant predictors of uptake of family planning services included: education (AOR = 3.03, 95 % CI 1.57-5.83), prior use of contraceptives (AOR = 7.15, 95 % CI 1.58-32.37), partner communication about contraceptives (AOR = 1.80, 95 % CI 1.36-2.37), and perceived need of contraceptives (AOR = 2.57, 95 % CI 1.09-6.08). Statistically significant predictors of contraceptive use since delivery included: education (AOR = 2.04, 95 % CI 1.05-3.95), prior use of contraceptives (AOR = 10.79, 95 % CI 1.40-83.06), and partner communication about contraceptives (AOR = 1.81, 95 % CI 1.34-2.44). Education, partner communication, and perceived need of family planning are key determinants of postpartum family planning service uptake and contraceptive use, and should be considered in antenatal and postnatal family planning counseling.
Senyonyi, Ruth M.; Ochieng, Lois A.; Sells, James
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…
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…
Ploss, Brittany; Abdelgadir, Jihad; Smith, Emily R; Fuller, Anthony; Nickenig Vissoci, Joao Ricardo; Muhindo, Alex; Galukande, Moses; Haglund, Michael M
There is a significant burden of unmet surgical need in many low- and middle-income countries (>80% in parts of Africa). This need is even larger for specialties such as neurosurgery. Surgical capacity tools have been developed and used to assess needs and plan for resource allocation. This study piloted a new tool to assess neurosurgical capacity and describes its use. A surgical capacity tool was adapted to assess neurosurgical capacity. An expert panel of neurosurgeons and researchers reviewed the Surgeons OverSeas PIPES (personnel, infrastructure, procedures, equipment, and supplies) assessment and added additional items essential to perform common neurosurgery procedures. This tool was then piloted at 3 public hospitals in Uganda and each hospital was given a score of neurosurgical capacity. At 1 hospital, 3 respondents were asked to answer the survey to assess reliability. The hospital with the largest neurosurgery caseload and 5 neurosurgeons scored the highest on our survey, followed by a regional hospital with 1 practicing neurosurgeon. The third hospital, without a neurosurgeon, scored the lowest on the scale. At the hospital that completed the reliability assessment, scores were varied between respondents. NeuroPIPES survey scores were in keeping with the number of neurosurgeons and respective caseloads of each hospital. However, the variation in scores between respondents at the same hospital suggests that adaptations could be made to the tool that may improve reliability and validity. The methodology used to create NeuroPIPES may be successfully applied to a variety of other surgical subspecialties for similar assessments. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available 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
Full Text Available Effective utilization of quality business information is crucial in attaining long-term and sustainable economic growth of the Small and Medium Enterprises (SMEs. It is established that SMEs in northern Uganda operate in a business environment that is characterized by fragmented and incomplete information. It is a situation where an awareness of markets, technology, policies, regulations and finance is limited because businesses fail to receive timely business information. This article reports a portion of the results of a larger study using a descriptive design with survey research and other techniques. The study examined the problems SMEs in northern Uganda face in accessing business information; identified problems information providers face in providing business information to the SMEs in the region and attempted to establish whether SMEs in northern Uganda use public libraries in accessing business information as should be expected. The study’s respondents included the SMEs, information providers and business policy makers with the response rate of 87.3%; 72% and 85% respectively. The article proposes strategic interventions for business information to be accessed by the SMEs. It concludes that there is a need for Uganda and, in particular, northern Uganda to develop a strategy for business information access by the SMEs
Terence Epule Epule
Full Text Available Climate projections in Sub-Saharan Africa (SSA forecast an increase in the intensity and frequency of droughts with implications for maize production. While studies have examined how maize might be affected at the continental level, there have been few national or sub-national studies of vulnerability. We develop a vulnerability index that combines sensitivity, exposure and adaptive capacity and that integrates agroecological, climatic and socio-economic variables to evaluate the national and spatial pattern of maize yield vulnerability to droughts in Uganda. The results show that maize yields in the north of Uganda are more vulnerable to droughts than in the south and nationally. Adaptive capacity is higher in the south of the country than in the north. Maize yields also record higher levels of sensitivity and exposure in the north of Uganda than in the south. Latitudinally, it is observed that maize yields in Uganda tend to record higher levels of vulnerability, exposure and sensitivity towards higher latitudes, while in contrast, the adaptive capacity of maize yields is higher towards the lower latitudes. In addition to lower precipitation levels in the north of the country, these observations can also be explained by poor soil quality in most of the north and socio-economic proxies, such as, higher poverty and lower literacy rates in the north of Uganda.
Full Text Available Abstract Background The Ugandan government recognizes mental health as a serious public health and development concern, and has of recent implemented a number of reforms aimed at strengthening the country's mental health system. The aim of this study was to provide a profile of the current mental health policy, legislation and services in Uganda. Methods A survey was conducted of public sector mental health policy and legislation, and service resources and utilisation in Uganda, in the year 2005, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS Version 2.2. Results Uganda's draft mental health policy encompasses many positive reforms, including decentralization and integration of mental health services into Primary Health Care (PHC. The mental health legislation is however outdated and offensive. Services are still significantly underfunded (with only 1% of the health expenditure going to mental health, and skewed towards urban areas. Per 100,000 population, there were 1.83 beds in mental hospitals, 1.4 beds in community based psychiatric inpatient units, and 0.42 beds in forensic facilities. The total personnel working in mental health facilities were 310 (1.13 per 100,000 population. Only 0.8% of the medical doctors and 4% of the nurses had specialized in psychiatry. Conclusion Although there have been important developments in Uganda's mental health policy and services, there remains a number of shortcomings, especially in terms of resources and service delivery. There is an urgent need for more research on the current burden of mental disorders and the functioning of mental health programs and services in Uganda.
Nardo-Marina, Amina Nielsen; Williams, Thomas N; Olupot-Olupot, Peter
BACKGROUND: There are a paucity of data on epistaxis as it pertains to sickle cell anaemia. Some case studies suggest epistaxis to be a significant complication in patients with sickle cell anaemia in sub-Saharan Africa; however, no robust studies have sought to establish the epidemiology...... or pathophysiology of this phenomenon. METHODS: We conducted a case-control study with the aim of investigating the importance of epistaxis among children presenting with sickle cell anaemia at the Mbale Regional Referral Hospital in eastern Uganda. Cases were children aged 2-15 years with an existing diagnosis...... of laboratory confirmed sickle cell anaemia, while controls were children without sickle cell anaemia who were frequency matched to cases on the basis of age group and gender. The frequency and severity of epistaxis was assessed using a structured questionnaire developed specifically for this study. Odds ratios...
Kjær, Anne Mette; Ulriksen, Marianne Sandvad
-building with regard to mobilizing resources for social development. In the paper we analyse how political economy factors affect revenue raising and social spending priorities in Uganda. We establish a theoretical framework based on the political settlement theory, within which we explore instances of revenue bargain......-making. The first two instances relate to the actual mobilization of resources, whereas the third example focuses on bargains over spending priorities within a given revenue base. We find that in Uganda, a low-income country with competing political factions, there are specific challenges to mobilizing resources......This synthesis paper brings together the research findings from four papers prepared by the Uganda team as a part of the UNRISD Politics of Domestic Resource Mobilization for Social Development project, which addresses three broad themes: bargaining and contestation, key relations, and institution...
Nanyunja, Miriam; Nabyonga Orem, Juliet; Kato, Frederick; Kaggwa, Mugagga; Katureebe, Charles; Saweka, Joaquim
Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ) was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.
Full Text Available Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.
Salvo, Ivana Di; Mwoka, Meggie; Kwaga, Teddy; Rukundo, Priscilla Aceng; Ernest, Dennis Ssesanga; Osaheni, Louis Aikoriogie; John, Kasibante; Shafik, Kasirye; de Sousa, Agostinho Moreira
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.
Omaswa, F; Burnham, G; Baingana, G; Mwebesa, H; Morrow, R
Uganda's National Quality Assurance Program was established in 1994 to monitor the process of decentralization of primary health care services. Guidelines were developed to address problems (e.g., in obtaining health funds channeled through local government) identified at district meetings. Bringing together District Health Teams with local administrators and political leaders to share responsibility for strengthening health services has been a significant program achievement. A smoother functioning referral system from health units to district hospitals has resulted. The response to a measles outbreak in the Arua district in 1993-94 confirmed the utility of the quality management approach. Weaknesses in the district cold chain, problems with diagnostic accuracy, and a poorly functioning information system were identified as key causative factors, and corrective action in these areas led to a subsequent decline in measles cases. Patient dissatisfaction with long waiting times at Masaka Hospital was another concern addressed through the quality assurance approach. Five salient areas were identified for action: low health worker morale, supply shortages, inadequate supervision by hospital management, poor patient flow, and inefficient drug dispensing. As a result, long delays were eliminated and utilization of hospital outpatient services increased by 28%.
Abeya, Fardous Charles; Lumori, Boniface Amanee Elias; Akello, Suzan Joan; Annex, Brian H; Buda, Andrew J; Okello, Samson
We sought to estimate the incidence and predictors of all-cause mortality 6 months after heart failure hospitalization in Uganda. Mbarara Heart Failure Registry is a cohort of patients hospitalized with a clinical diagnosis of heart failure at Mbarara Regional Referral Hospital, Uganda. We measured serum electrolytes, cardiac markers, and echocardiograms. All participants were followed until death or end of 6 months. We used Fine and Gray models to estimate the incidence and predictors all-cause mortality. A total of 215 participants were enrolled, 141 (66%) were women, and mean age 53 (standard deviation 22) years. Nineteen (9%) had diabetes, 40 (19%) had HIV, and 119 (55%) had hypertension. The overall incidence of all-cause mortality was 3.58 (95% CI 2.92, 4.38) per 1000 person-days. Men had higher incidence of death compared to women (4.02 vs 3.37 per 1000 person-days). The incidence of all-cause mortality during hospitalization was almost twice that of in the community (27.5 vs 14.77 per 1000 person-days). In adjusted analysis, increasing age, NYHA class IV, decreasing renal function, smoking, each unit increase in serum levels of Potassium, BNP, and Creatine kinase-MB predicted increased incidence of 6 months all-cause death whereas taking beta-blockers and having an index admission on a weekend compared to a week day predicted survival. There is a high incidence of all-cause mortality occurring in-hospital among patients hospitalized with heart failure in rural Uganda. Heart failure directed therapies should be instituted to curb heart failure-related mortality. Copyright © 2017 Elsevier B.V. All rights reserved.
Saleh, Amgad A; Esele, J P; Logrieco, Antonio; Ritieni, Alberto; Leslie, John F
Finger millet (Eleusine coracana) is a subsistence crop grown in Sub-Saharan Africa and the Indian Sub-continent. Fusarium species occurring on this crop have not been reported. Approximately 13% of the Fusarium isolates recovered from finger millet growing at three different locations in eastern Uganda belong to Fusarium verticillioides, and could produce up to 18,600 µg/g of total fumonisins when cultured under laboratory conditions. These strains are all genetically unique, based on AFLP analyses, and form fertile perithecia when crossed with the standard mating type tester strains for this species. All but one of the strains is female-fertile and mating-type segregates 13:20 Mat-1:Mat-2. Three new sequences of the gene encoding translation elongation factor 1-α were found within the population. These results indicate a potential health risk for infants who consume finger millet gruel as a weaning food, and are consistent with the hypothesis that F. verticillioides originated in Africa and not in the Americas, despite its widespread association with maize grown almost anywhere worldwide.
Ssentanda, Medadi Erisa
Full Text Available This paper aims to explain the trend of mother tongue (MT education in Uganda by examining particularly government’s practices towards MT education. MT education was (reintroduced in Uganda in 2006/2007 due to disappointing literacy acquisition by learners with the hope of improving literacy skills among particularly rural children. Based on data gathered from rural government and private schools in rural areas, this paper questions what exactly it is that government seeks to reclaim, restore and/or rejuvenate in Uganda’s education system via MT education.
Mbonye, Anthony K; Magnussen, Pascal
Uganda experiences a high disease burden of malaria, infectious and non-communicable diseases. Recent data shows that malaria is the leading cause of morbidity and mortality among all age groups, while HIV prevalence is on the increase and there is re-emergence of viral haemorrhagic fevers and ch...... and cholera epidemics. In order to respond to the above situation, a team of researchers, policy makers, civil society and the media was formed in order to build a collaboration that would help in discussing appropriate strategies to mitigate the high disease burden in Uganda....
Okware, S I; Omaswa, F G; Zaramba, S; Opio, A; Lutwama, J J; Kamugisha, J; Rwaguma, E B; Kagwa, P; Lamunu, M
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
Namazzi, Elizabeth; Kendrick, Maureen E.
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 cultural…
Bat community patterns in Uganda are examined in relation to their occurrence in the different vegetation zones of the country. The data available so far cover only three of the country's floristic regions. These data suggest that the northern drier region U1 has more microchiropteran bats and that species diversity of ...
Jun 23, 2014 ... Information and technology: Improving food security in Uganda ... knowledge to make decisions about planting, harvesting, and managing livestock, but ... to be effective for minimizing risks and increasing agricultural productivity. ... In time, this network of information – made possible by digital technology ...
Wichern, Jannike; Wijk, van Mark T.; Descheemaeker, Katrien; Frelat, Romain; Asten, van Piet J.A.; Giller, Ken E.
Despite continuing economic growth, Uganda faces persistent challenges to achieve food security. The effectiveness of policy and development strategies to help rural households achieve food security must improve. We present a novel approach to relate spatial patterns of food security to livelihood
demographic and health indicators.1 The data showed a high growth rate in excess of 3% ... an integrated form with all other health care needs including promotive and ... In 1999 the government of Uganda (Ministry of Health) developed a ten .... The usual drug procurement system was strengthened with a special project.
Strategic nutrient management of field pea in southwestern Uganda. ... African Journal of Food, Agriculture, Nutrition and Development ... Strategic nutrient management requires that the most limiting nutrient is known in order to provide a foundation for designing effective and sustainable soil fertility management ...
Shoemaker, Trevor; Balinandi, Stephen; Campbell, Shelley; Wamala, Joseph Francis; McMullan, Laura K.; Downing, Robert; Lutwama, Julius; Mbidde, Edward; Ströher, Ute; Rollin, Pierre E.; Nichol, Stuart T.
Two large outbreaks of Ebola hemorrhagic fever occurred in Uganda in 2000 and 2007. In May 2011, we identified a single case of Sudan Ebola virus disease in Luwero District. The establishment of a permanent in-country laboratory and cooperation between international public health entities facilitated rapid outbreak response and control activities. PMID:22931687
Owoeye, J. S.; Oyebade, S. A.
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,…
Project. This project examines employment creation for youth and women in Africa, focusing on small and medium enterprises (SMEs) in the tourism sector. Region: Mauritius, Tanzania, Uganda. Program: Employment and Growth. Total Funding: CA$ 646,600.00. Why don't they fight: A study to examine youth responses to ...
under-five mortality rate is 90 per 1,000 live births. ... 46% to 52% but still below the worldwide target of 90% (Uganda Bureau of Statistics. (UBOS) and ICF ... detrimental child-survival effects of parental poverty and low educational attainment.
Bagamba, F.; Burger, C.P.J.; Tushemereirwe, W.K.
The highland cooking banana (Musa spp., AAA-EA genome) is the most important crop in the East African Great Lakes region. In Uganda, production has expanded and productivity increased in the country’s southwest and declined in the Central region where the crop has traditional roots. Analyzing crop
Citrus is one of the largest fruit crops grown in Uganda ... of several citrus industries in Asia and. Africa (da Graca ... role in transmission of HLB, psyllid feeding ... The Indian Ocean islands of Reunion and ..... Pacific Grove, California: Duxbury ...
Background: When guns fell silent in the post conflict northern Uganda, another form of physical injuries has come in place, Domestic Violence also commonly referred to as Gender based violence. This injury from violence leading to physical trauma is one of the leading public health problems in this region. We describe ...
In addition, the success is attributed to the policy which allowed many actors to participate in the fight against the disease. The primary focus of this article is to map the process of social capital generation by NGOs and how social capital benefits enhance mitigation of HIV/AIDS challenges in Uganda. The key to social capital ...
Results: Uganda's health sector remains significantly under-funded, mainly relying on private sources of financing, especially out-of-pocket spending. At 9.6 % of total government expenditure, public spending on health is far below the Abuja target of 15% that GoU committed to. Prepayments form a small proportion of ...
Poverty, gender, lack of information, and lack of resilience measures were some of the factors promoting vulnerability to disasters. Conclusion: As Uganda develops a disaster risk reduction and response plan, it ought to prioritize epidemics of infectious diseases, drought/famine, conflicts and environmental degradation as ...
Using data from the 2004 National Survey of Adolescents, multivariate logistic regression models were fitted to examine the strength of the association between risky sexual behavior and perceived risk among 12-19-year-old adolescents in Uganda. After controlling for other correlates of sexual behavior such as age, ...
Schramm, Stine; Kaducu, Felix Ocaka; Aas Smedemark, Siri
OBJECTIVE: To determine the prevalence of adult malnutrition and associated risk factors in a post-conflict area of northern Uganda. METHODS: A cross-sectional community survey was performed from September 2011 to June 2013. All registered residents in Gulu Health and Demographic Surveillance...
Serosurvey of Brucella abortus in cattle and goats in central and southern Uganda · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. J Nakavuma, T. Kibirige Ssebunya, J. Opuda Asibo, 13-18 ...
Significantly, with resettlement after the war, most people are still deprived of basic source of livelihood, which still continues as a factor in the spread of HIV infection. Key Words: HIV & AIDS, Deprivation, Susceptibility, Vulnerability, Deaths, IDP camps, Northern Uganda, Paimol, Pader. Résumé. Cette étude se concentre ...
Background: The rate of unintentional child injuries in sub-Saharan Africa is at 53.1 per 100,000, The highest for low income regions, data on these injuries and associated factors among children in Uganda is very scanty. Most child injuries are related to the way of life in rural communities typically burns from charcoal ...
Beyond ICT4D: New Media Research in Uganda is a collection of ethnographic reports from diverse perspectives of those living at the other end of the African ICT pyramid. Crucially, these texts refocus on the so-called "ICT4D" debate away from the standard western lens, which depicts users in the
This article reviews the role of the print media in conflict resolution. Using Northern Uganda as a case study, the article seeks to demonstrate that the press can effectively be used either to fuel conflict in a region or to reduce conflict in a region. The article seeks to demonstrate the role played by the print media in conflict and ...
Dreise, Marieke; Galiwango, George; Hodges, Andrew
Objective: The purpose of the study was to estimate the need for resources for cleft repairs in Uganda by determining the overall incidence of oral-facial clefts and the ratio of isolated cleft lip to isolated cleft palate to cleft lip and palate. Design: A 1-year prospective study was implemented
Background: Aid groups estimate that since 1086 when the war conflicts in Northern Uganda started, over 30,000 people have died in the insurgency and over 20,000 people have remained maimed. Arising from the conflict, innocent civilians have had their limbs, lips, eyes, ears, noses, breasts, fingers and toes cut off.
In recent years ULA has emphasized advocacy, and contributed to progress towards new legislation (freedom of information, copyright, the National Library Act) and policies (school libraries, East African Community e-government strategy) of importance to the library and information field in Uganda and beyond.
Proportion of patients in the Uganda rheumatic heart disease registry with advanced ... of Cardiology guidelines on the management of valvular heart disease. ... disease that require surgical treatment yet they cannot access this therapy due to ... By Country · List All Titles · Free To Read Titles This Journal is Open Access.
Anthelmintic efficacy of Albendazole, Levamisole and Ivermectin against gastrointestinal nematode (GIN) infections in goats on natural pastures in Gomba District, Uganda · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. G Nsereko, P Emudong, JW Magona, ...
In order to identify independent predictors for home delivery, 211 women from 21 clusters, who had a delivery in the previous one year, were interviewed in Rakai District, Uganda, from June 2 to 30, 1997. Mothers answered questions regarding socio-economic, local, reproductive and self-efficacy variables and whether ...
An approach in which open heart surgeries are conducted locally by visiting teams enabling skills transfer to the local team and helps build to build capacity has been adopted at the Uganda Heart Institute (UHI). Objectives: We reviewed the progress of open heart surgery at the UHI and evaluated the postoperative ...
Since the rise to power of the Movement government under the leadership of Yoweri Museveni in 1986, Uganda has largely been show-cased as an emerging democracy on the continent. Among other things, Museveni's regime has been acclaimed for the restoration of periodic national elections, the making of the ...
Wellens, Inneke Hilda Werner
At present, about 25,000 Nubi live scattered over the towns of Uganda and Kenya. Their language, Nubi, has been called an Arabic creole. Nubi is Arabic, since about 90% of its vocabulary is of Arabic nature. It is termed a creole, since many of its structural and developmental features resemble
African Crop Science Journal, Vol. 22, Issue ... Bulindi Zonal Agricultural Research and Development Institute, P. O. Box 101, Hoima, Uganda .... latitudes 0o 57' 44.89" and 1o 40' 42.76" North and ..... Percent of small East African goat in herd.
A series of biodiversity and socio-economic surveys carried out in the Sango Bay area of southern Uganda revealed high biodiversity values for some taxa in some sites. Use of this biodiversity and reliance on it by local communities was widespread. Biodiversity scores were given to all species and these were coupled with ...
The study analyses the problem of professional integrity of teachers in Uganda and explores solutions. It analyses the difficult conditions under which Ugandan teachers work, reports on the professional dilemmas that they face, and on the serious issues of failings of professional integrity. The
Date de début : 16 août 2010. End Date: 22 octobre 2014. Sujet: INCOME GENERATION, Food security, AGRICULTURAL RESOURCES, RESOURCES MANAGEMENT, PASTORALISTS, HEALTH HAZARDS, DISEASE VECTORS. Région: Africa, South of Sahara, Uganda. Programme: Alimentation, environnement et santé.
There is also a strong indication of species turnover amongst the forest interior birds in these forests. The fact that, together and over time these small forests supported 37 forest interior species, suggests that, collectively, small forests (of which there are many in Uganda) do have conservation value. The evidence of species ...
The Ecosystem Approach to Fisheries Management agitates for provision of Marine Protected Areas (MPAs) which seem to be effective in developed countries. However, efforts to control artisanal fisheries through protection have not been adequately assessed. The Uganda portion of Lake Edward, Kazinga channel and ...
Information on weeds of cassava (Manihot esculenta Crantz) in eastern Africa is limited. The objective of this study was to establish the status of weed flora in selected cassava growing regions of Uganda. This study was conducted in 2013 at Abi Zonal Agricultural Research and Development Institute; (AbiZARDI) in Arua, ...
Apr 21, 2006 ... English · Français ... CASE STUDY: Kampala, Uganda — From the ground up: Urban ... Azuba has used this kind of evidence to convert more than one ... a bottomup approach was needed to draft ordinances that would work.
Okot-Okumu, J.; Oosterveer, P.J.M.
After presenting background information on urbanization in Uganda, the chapter provides an overview of sanitation in the urban centres, where different social classes reside in separate zones. Factors determining sanitation provision and the use of sanitary facilities particularly in the informal
A case report: the first successful cochlear implant in Uganda. Richard Byaruhanga1, J. ... The patient was a 23 year old male whose presenting com- plaint was inability to .... Custom Sound by Cochlear (the company that manu- factures the ...
2014a,b). This pest thus poses a serious threat to both coffee and cocoa production in Uganda, and therefore, calls for prompt comprehensive mitigation actions (Kagezi et al., 2013a,b, 2014a,b,c,d). Damage is caused by the female beetle by boring a characteristic pin-sized entry hole into the attacked seedlings and/or.
The globally Vulnerable Grey Parrot (Psittacus erithacus) has been seen in Kampala, Uganda's capital city, in increasing numbers in recent years. This apparently new behaviour of a typically forest species is helped by the presence of many large trees, which provide roosting and nesting sites, and fruiting trees where they ...
Dec 2, 2004 ... Background: In Uganda, foot deformities of various kinds and complexities are common. The aim of this study was to evaluate ... Conclusion: In the developing world triple arthrodesis still has a role to play in treatment of feet deformities. The results ... on flat ground, high stepping gait, moderate deformity ...
The study delved into the values transmitted in Universities in Uganda. Data were collected from a sample of 850 respondents who were drawn from faith-based, for–profit and public universities in the country. It was found that material, social/ public, personal and religious values are transmitted to students in the selected ...
Schramm, Stine; Sodemann, Morten
This chapter outlines the prevalence and high-risk groups for adult undernutrition and discusses the social, behavioral, and structural mechanisms that can lead to food insecurity and undernutrition in a post-conflict setting like northern Uganda. In summary, adult undernutrition is higher in the...
Eesti üliõpilaskondade liidu juhatuse aseesimees M.-L. Alop kirjutab vastuse M. Heidmetsa artiklile 6. jaan. Eesti Päevalehes "Eestis nagu Ugandas", kus tõstatati Eestis üldise õppemaksu kehtestamise vajadus, mis vähendab vähem kindlustatute võimalusi kõrgharidust omandada
In this manuscript we explored the priorities of various eHealth stakeholders in Uganda to inform the eHealth policy review process. ... standard (31 postings), leadership and governance (22 postings), strategic planning (21 postings), infrastructure(14 postings), financial management (2 postings) and others (6 postings).
A full-diallel mating design involving three resistant and three susceptible rice cultivars was used to produce F1 and F2 progenies in a screen-house at the National Crop Resources Research Institute (NaCRRI), Namulonge in Uganda. The parents and F2 populations were challenged with the Xanthomonas oryzae ...
In Uganda most cancers to the exception of bladder and penis are increasing in incidence. The incidence of cancer of stomach is 5.6/100,000 from 0.8/100,000 in the 1960s a seven fold increase.The purpose of this guideline document is to highlight the salient points in gastric cancer diagnosis and treatment in the ...
This study assessed the extent and trend of landuse/cover change in Soroti District, Uganda. A series of systematically corrected Orthorectified Landsat imageries of 1973, 1986 and 2001 were downloaded from the Landsat website. The images were analysed using unsupervised classification approach and the land-use/ ...
Conclusion: Information about risk factors revealed in individual interviews and by the midwives taking a history was incongruent. Any approach for management of STIs, which is built on self-reported risk factors, needs careful assessment of reliability. Keywords: Adolescents, Risk factors, reliability, STI, Uganda
Sujet: INTELLECTUAL PROPERTY, ACCESS TO INFORMATION, ELECTRONIC PUBLISHING. Région: Uganda, South Africa, South of Sahara. Financement total : CA$ 364,627.00. Droits d'auteur et accès au savoir en Afrique. Projet. Le débat actuel sur les politiques visant la propriété intellectuelle et sur l'incidence de ...
to document women's experiences of the armed conflict in Uganda and women's .... Lobbying and advocacy to address structural inequalities and gendered .... women on the ground were asking us as a Coalition how the method would address .... comprehensive solutions): Women's concerns and the Juba peace process.
This paper seeks to demonstrate the usefulness of the data held at the National Biodiversity Data Bank (NBDB) situated at Makerere University Institute of Environment and Natural Resources (MUIENR). We assess its value as a potential planning tool, based on the growing evidence that Uganda aspires to a robust ...
In this paper, we use survey (n=87) and interview (n=30) data to investigate orientations towards future childbearing among people receiving antiretroviral treatment and their family members in western Uganda. We investigate how reproductive options are perceived, by those receiving treatment and those closest to them, ...
Soil erosion is a serious problem in the densely populated Uganda highlands and previous interventions were ineffective. This study, on the Ngenge watershed, Mount Elgon, was aimed at developing policy for the implementation of a new strategy for solving the problem, Integrated Watershed
Waller & Bridge) attacks arabic a coffee in most African arabica coffee growing countries. The disease was first recorded in Uganda in 1959 and surveys on the disease indicated that up to 50% crop losses were being incurred. Most of the ...
Scientia Militaria: South African Journal of Military Studies. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 40, No 2 (2012) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Butterflies of Uganda: Memories ...
Thyroid Dysfunction among Young Adults in Uganda. ... The mean age of participants was 23 years, there were slightly more males 1.3:1. ... The prevalence of thyroid dysfunction in this cohort was low but falls in the range found elsewhere.
Clark, Emily; Goodhart, Clare
The total fertility rate in Uganda is 5.9 children per woman, and women admit to having nearly two more children than they actually want. The maternal mortality rate remains stubbornly high. Family planning saves lives. It prevents maternal deaths by delaying motherhood, helping women limit their family size and avoid unwanted pregnancies. It also reduces infant mortality. USHAPE (Ugandan Sexual Health and Pastoral Education) is an initiative run in conjunction with the Royal College of General Practitioners in south-west Uganda. USHAPE aims to disseminate positive messages about modern contraception in an attempt to dispel fears and misconceptions and address the high rate of unmet need. The aim was to determine the rate of unmet need for family planning among women of reproductive age in the population local of Kisiizi hospital and to use the successful USHAPE model to train health workers to address this need. 100 patients were screened in the outpatient department to determine the level of unmet need by asking 2 questions. Level 1 training aims enhance every staff member's knowledge, so that the responsibility for family planning is adopted by the whole institution. Level 2 trains clinicians to become full family planning providers, with the necessary communication, educational and practical skills. The screening for unmet need for contraception revealed that 51% have an unmet need, which is higher than the national average of 38%. Sixty-eight members of staff at Kisiizi trained to a basic level and a further 32 staff have been trained to Level 2 higher level. The USHAPE approach has begun to tackle some of the barriers to accessing family planning, but there are further areas which need development. Our cascade model of training, involves training Ugandan USHAPE trainers with the aim of future scale up and long-term development.
Full Text Available Vitamin K deficiency bleeding (VKDB in infancy is a serious but preventable cause of mortality or permanent disability. Lack of epidemiologic data for VKDB in sub-Saharan Africa hinders development and implementation of effective prevention strategies. We used convenience sampling to consecutively enroll mothers delivering in a southwestern Uganda Hospital. We collected socio-demographic and dietary information, and paired samples of maternal venous and neonatal cord blood for the immunoassay of undercarboxylated prothrombin (PIVKA-II, a sensitive marker of functional vitamin K (VK insufficiency. We used univariable and multivariable logistic regression models to identify predictors of VK insufficiency. We detected PIVKA-II of ≥0.2 AU (Arbitrary Units per mL/mL (indicative of VK insufficiency in 33.3% (47/141 of mothers and 66% (93/141 of newborns. Importantly, 22% of babies had PIVKA-II concentrations ≥5.0 AU/mL, likely to be associated with abnormal coagulation indices. We found no significant predictors of newborn VK insufficiency, including infant weight (AOR (adjusted odds ratio 1.85, 95% CI (confidence interval 0.15–22.49, gender (AOR 0.54, 95% CI 0.26–1.11, term birth (AOR 0.72, 95% CI 0.20–2.62, maternal VK-rich diet (AOR 1.13, 95% CI 0.55–2.35 or maternal VK insufficiency (AOR 0.99, 95% CI 0.47–2.10. VK insufficiency is common among mothers and newborn babies in southwestern Uganda, which in one fifth of babies nears overt deficiency. Lack of identifiable predictors of newborn VK insufficiency support strategies for universal VK prophylaxis to newborns to prevent VKDB.
Okello, Samson; Churchill, Cristina; Owori, Rogers; Nasasira, Benson; Tumuhimbise, Christine; Abonga, Charles Lagoro; Mutiibwa, David; Christiani, David C.; Corey, Kathleen E.
Despite the high rates and regional variation of esophageal squamous cell carcinoma (ESCC) in East Africa, the contributions of smoking and alcohol to the ESCC burden in the general population are unknown. We conducted a case-control study of patients presenting for upper gastrointestinal endoscopic examination at Mbarara Regional Referral Hospital, Uganda. Sociodemographic data including smoking and alcohol intake were collected prior to endoscopy. Cases were those with histological diagnosis of ESCC and controls were participants with normal endoscopic examination and gastritis/duodentitis or normal histology. We used odds ratios associated with ESCC risk to determine the population attributable fractions for smoking, alcohol use, and a combination of smoking and alcohol use among adults aged 30 years or greater who underwent upper gastrointestinal endoscopy. Our study consisted of 67 cases and 142 controls. Median age was 51 years (IQR 40–64); and participants were predominantly male (59 %). Dysphagia and/or odynophagia as indications for endoscopy were significantly more in cases compared to controls (72 % vs 6 %, p < 0.0001). Male gender and increasing age were statistically associated with ESCC. In the unadjusted models, the population attributable fraction of ESCC due to male gender was 55 %, female gender - 49 %, smoking 20 %, alcohol 9 % and a combination of alcohol & smoking 15 %. After adjusting for gender and age, the population attributable fraction of ESCC due to smoking, alcohol intake and a combination of alcohol & smoking were 16, 10, and 13 % respectively. In this population, 13 % of esophageal squamous cell carcinoma cases would be avoided if smoking and alcohol use were discontinued. These results suggest that other important risk factors for ESCC in southwestern Uganda remain unknown
Kwesiga, Brendan; Zikusooka, Charlotte M; Ataguba, John E
Background Direct out-of-pocket payments for health care are recognised as limiting access to health care services and also endangering the welfare of households. In Uganda, such payments comprise a large portion of total health financing. This study assesses the catastrophic and impoverishing impact of paying for health care out-of-pocket in Uganda. Methods Using data from the Uganda National Household Surveys 2009/10, the catastrophic impact of out-of-pocket health care payments is defined ...
Buckle, Geoffrey C; Collins, Jennifer Pfau; Sumba, Peter Odada; Nakalema, Beccy; Omenah, Dorine; Stiffler, Kristine; Casper, Corey; Otieno, Juliana A; Orem, Jackson; Moormann, Ann M
Survival rates for children diagnosed with Burkitt lymphoma (BL) in Africa are far below those achieved in developed countries. Late stage of presentation contributes to poor prognosis, therefore this study investigated factors leading to delays in BL diagnosis and treatment of children in Uganda and western Kenya. Guardians of children diagnosed with BL were interviewed at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JTRH) and Uganda Cancer Institute (UCI) from Jan-Dec 2010. Information on sociodemographics, knowledge, attitudes, illness perceptions, health-seeking behaviors and prior health encounters was collected using a standardized, pre-tested questionnaire. Eighty-two guardians were interviewed (20 JTRH, 62 UCI). Median "total delay" (1st symptoms to BL diagnosis) was 12.1 weeks [interquartile range (IQR) 4.9-19.9] in Kenya and 12.9 weeks (IQR 4.3-25.7) in Uganda. In Kenya, median "guardian delay" (1st symptoms to 1st health encounter) and "health system delay" (1st health encounter to BL diagnosis) were 9.0 weeks (IQR 3.6-15.7) and 2.0 weeks (IQR 1.6-5.8), respectively. Data on guardian and health system delay in Uganda were only available for those with system delay 2.6 weeks (range 0.1-16.0), and total delay 10.7 weeks (range 1.7-154.3). Guardians in Uganda reported more health encounters than those in Kenya (median 5, range 3-16 vs. median 3, range 2-6). Among Kenyan guardians, source of income was the only independent predictor of delay, whereas in Uganda, guardian delay was influenced by guardians' beliefs on the curability of cancer, health system delay, by guardians' perceptions of cancer as a contagious disease, and total delay, by the number of children in the household and guardians' role as caretaker. Qualitative findings suggest financial costs, transportation, and other household responsibilities were major barriers to care. Delays from symptom onset to BL treatment were considerable given the rapid growth rate of this
Paina, Ligia; Bennett, Sara; Ssengooba, Freddie; Peters, David H
Many full-time Ugandan government health providers take on additional jobs - a phenomenon called dual practice. We describe the complex patterns that characterize the evolution of dual practice in Uganda, and the local management practices that emerged in response, in five government facilities. An in-depth understanding of dual practice can contribute to policy discussions on improving public sector performance. A multiple case study design with embedded units of analysis was supplemented by interviews with policy stakeholders and a review of historical and policy documents. Five facility case studies captured the perspective of doctors, nurses, and health managers through semi-structured in-depth interviews. A causal loop diagram illustrated interactions and feedback between old and new actors, as well as emerging roles and relationships. The causal loop diagram illustrated how feedback related to dual practice policy developed in Uganda. As opportunities for dual practice grew and the public health system declined over time, government providers increasingly coped through dual practice. Over time, government restrictions to dual practice triggered policy resistance and protest from government providers. Resulting feedback contributed to compromising the supply of government providers and, potentially, of service delivery outcomes. Informal government policies and restrictions replaced the formal restrictions identified in the early phases. In some instances, government health managers, particularly those in hospitals, developed their own practices to cope with dual practice and to maintain public sector performance. Management practices varied according to the health manager's attitude towards dual practice and personal experience with dual practice. These practices were distinct in hospitals. Hospitals faced challenges managing internal dual practice opportunities, such as those created by externally-funded research projects based within the hospital. Private
Leerlooijer, J.N.; Bos, A.E.R.; Ruiter, R.A.C.; Reeuwijk, van M.A.J.; Rijsdijk, E.; Nshakira, N.; Kok, G.
Background A large proportion of unmarried teenage mothers in Uganda face physical, psychological, and social problems after pregnancy and childbirth, such as obstetric complications, lack of education, and stigmatisation in their communities. The Teenage Mothers Project (TMP) in Eastern Uganda
6Lecturer in the Institute of peace and strategic studies, Gulu University .... serves as the teaching hospital for Gulu University Medical School located in Gulu ..... disparity13,19, power hunger, lack of self control (behavioral disorder)20. Another ...
Shumba, Constance Sibongile; Kielmann, Karina; Witter, Sophie
An in-depth understanding of how organizational culture is experienced by health workers (HWs), and influences their decisions to leave their jobs is a fundamental, yet under-examined, basis for forming effective retention strategies. This research examined HWs' working experiences and perceptions of organisational culture within private-not-for-profit, largely mission-based hospitals, and how this influenced retention. Thirty-two HWs, including managers, in 19 health facilities in Uganda were interviewed using a semi-structured topic guide. Interview transcripts were analysed using thematic content analysis. Interviews showed that the organizational culture was predominantly hierarchical, with non-participative management styles which emphasized control and efficiency. HWs and managers held different perceptions of the organizational culture. While the managers valued results and performance, HWs valued team work, recognition and participative management. The findings of this study indicate that organizational culture influences retention of HWs in health facilities and provide a useful context to inform health care managers in the PNFP sub-sector in Uganda and similar contexts. To improve retention of HWs, a gradual shift in organizational culture will be necessary, focussing on the values, beliefs and perceptions which have the greatest influence on observable behaviour.
Monica H. Swahn
Full Text Available This paper examines problem drinking, alcohol-related violence, and homelessness among youth living in the slums of Kampala—an understudied population at high-risk for both alcohol use and violence. This study is based on a cross-sectional survey conducted in 2014 with youth living in the slums and streets of Kampala, Uganda (n = 1134, who were attending Uganda Youth Development Link drop-in centers. The analyses for this paper were restricted to youth who reported current alcohol consumption (n = 346. Problem drinking patterns were assessed among youth involved in alcohol-related violence. Mediation analyses were conducted to examine the impact of homelessness on alcohol-related violence through different measures of problem drinking. Nearly 46% of youth who consumed alcohol were involved in alcohol-related violence. Problem drinkers were more likely to report getting in an accident (χ2 = 6.8, df = 1, p = 0.009, having serious problems with parents (χ2 = 21.1, df = 1, p < 0.0001 and friends (χ2 = 18.2, df = 1, p < 0.0001, being a victim of robbery (χ2 = 8.8, df = 1, p = 0.003, and going to a hospital (χ2 = 15.6, df = 1, p < 0.0001. For the mediation analyses, statistically significant models were observed for frequent drinking, heavy drinking, and drunkenness. Interventions should focus on delaying and reducing alcohol use in this high-risk population.
Forrester, Joseph D; Apangu, Titus; Griffith, Kevin; Acayo, Sarah; Yockey, Brook; Kaggwa, John; Kugeler, Kiersten J; Schriefer, Martin; Sexton, Christopher; Ben Beard, C; Candini, Gordian; Abaru, Janet; Candia, Bosco; Okoth, Jimmy Felix; Apio, Harriet; Nolex, Lawrence; Ezama, Geoffrey; Okello, Robert; Atiku, Linda; Mpanga, Joseph; Mead, Paul S
Plague is a highly virulent fleaborne zoonosis that occurs throughout many parts of the world; most suspected human cases are reported from resource-poor settings in sub-Saharan Africa. During 2008-2016, a combination of active surveillance and laboratory testing in the plague-endemic West Nile region of Uganda yielded 255 suspected human plague cases; approximately one third were laboratory confirmed by bacterial culture or serology. Although the mortality rate was 7% among suspected cases, it was 26% among persons with laboratory-confirmed plague. Reports of an unusual number of dead rats in a patient's village around the time of illness onset was significantly associated with laboratory confirmation of plague. This descriptive summary of human plague in Uganda highlights the episodic nature of the disease, as well as the potential that, even in endemic areas, illnesses of other etiologies might be being mistaken for plague.
Forrester, Joseph D.; Apangu, Titus; Griffith, Kevin; Acayo, Sarah; Yockey, Brook; Kaggwa, John; Kugeler, Kiersten J.; Schriefer, Martin; Sexton, Christopher; Ben Beard, C.; Candini, Gordian; Abaru, Janet; Candia, Bosco; Okoth, Jimmy Felix; Apio, Harriet; Nolex, Lawrence; Ezama, Geoffrey; Okello, Robert; Atiku, Linda; Mpanga, Joseph
Plague is a highly virulent fleaborne zoonosis that occurs throughout many parts of the world; most suspected human cases are reported from resource-poor settings in sub-Saharan Africa. During 2008–2016, a combination of active surveillance and laboratory testing in the plague-endemic West Nile region of Uganda yielded 255 suspected human plague cases; approximately one third were laboratory confirmed by bacterial culture or serology. Although the mortality rate was 7% among suspected cases, it was 26% among persons with laboratory-confirmed plague. Reports of an unusual number of dead rats in a patient’s village around the time of illness onset was significantly associated with laboratory confirmation of plague. This descriptive summary of human plague in Uganda highlights the episodic nature of the disease, as well as the potential that, even in endemic areas, illnesses of other etiologies might be being mistaken for plague. PMID:28820134
Nalubwama, Sylvia Muwanga; Mugisha, Anthony; Vaarst, Mette
Development in organic farming has been stimulated by farmers and consumers becoming interested in healthy food products and sustainable environment. Organic agriculture is a holistic production management system which is based on the principles of health, ecology, care, and fairness. Organic...... development in Uganda has focused more on the crop sector than livestock sector and has primarily involved the private sector, like organic products export companies and non-governmental organizations. Agriculture in Uganda and many African countries is predominantly traditional, less mechanized......, and is usually associated with minimum use of chemical fertilizers, pesticides, and drugs. This low external input agriculture also referred to as “organic by default” can create basis for organic farming where agroecological methods are introduced and present an alternative in terms of intensification...
Hayer, Manvir Kaur
This paper sets out to explore Ugandan young women's definitions and perceptions of sexual coercion. A qualitative study was conducted with seven young women in rural Uganda. Participants filmed videos, wrote stories, made drawings and participated in transect walks before analysing their data through formal and informal discussions. Forced sex is defined narrowly to mean only rape. Verbal forms of sexual coercion were recognised, but only after some discussion. Verbal coercion is referred to as "abusing" or "convincing". Young women are commonly pressured into consenting to have sex, despite what they really want, owing to the socio-cultural circumstances. Young women in Uganda are significantly tolerant of sexual coercion. This tolerance appears to arise from power differentials between genders, and the socio-cultural environment shaping their lives. The paper improves understanding of young women's definitions and perceptions of sexual coercion, which is essential to provide effective violence prevention programmes. It also suggests that further research is warranted in this field.
This chapter addresses private sector investment in the production of households renewable energy technologies (RETs) and provides recommendations for the large-scale manufacture and dissemination of these RETs in Uganda. The following four RETs are examined in detail: improved households cookstoves, institutional stoves, biomass briquettes and biogas. The household energy sector in Uganda relies heavily on biomass, with fuelwood providing 95.5 per cent, followed by charcoal which accounts for 2.7 per cent. Petroleum products and electricity contribute 1.4 per cent and 0.5 per cent, respectively. Charcoal and fuelwood are used mainly in the open fire and the traditional metal stove whose efficiencies are very low. In parts of the country where the fuelwood deficit is imminent, agricultural wastes are the major substitutes. (Author)
University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....
Information communication technology has increased globalisation in higher learning institution all over the world. This has been achieved through introduction of systems that ease operations related to information handling in the institutions. The paper assessed and analysed the information systems security performance status in higher learning institutions of Uganda. The existing policies that govern the information security have also been analysed together with the current status of inform...
Full Text Available Cattle and poultry enterprises are among the major contributors to food security and socioeconomic empowerment of households in Uganda. However, various diseases constrain their productivity. A two-year retrospective study between April 2012 and March 2014 was conducted using records for cattle and poultry diseases diagnosed at the Central Diagnostic Laboratory (CDL to determine prevalent diseases in Uganda. The laboratory received 836 samples from poultry (36.3% and cattle (63.7%. Of the 836 samples, 47.5% had a definitive diagnosis of disease causation. Most of the cattle and poultry diseases diagnosed were protozoan diseases (39.3% followed by bacterial (21.4%, viral (17.1%, helminthiasis (11.1%, nutritional diseases (4% and others (7.1%. For poultry, viral diseases (29.5% and protozoan diseases (27.1% especially newcastle disease (44.3% and coccidiosis (100% respectively, were the most diagnosed. While for cattle, hemo-protozoan parasites (52.1% were the most prevalent, of which 92.9% were east coast fever infection. Bacterial infection (20.5% in cattle were the second most diagnosed diseases and mastitis was the most diagnosed (46.2%. In summary, coccidioisis, collibacillosis, newcastle disease, gumboro disease, and avian helminthiasis were the most prevalent poultry diseases while in cattle, east coast fever, helminthiasis, mastitis, brucellosis and rabies were the most frequently diagnosed diseases. This study has identified the major diseases that hinder poultry and cattle production in Uganda. The data generated by CDL could be used for surveillance, monitoring and designing strategic interventions for control of poultry and cattle diseases in Uganda. Keywords: Coccidiosis, Collibacillosis, East coast fever, Mastitis, Newcastle disease, Rabies
Mabumba, E D; Mugyenyi, P; Batwala, V; Mulogo, E M; Mirembe, J; Khan, F A; Liljestrand, J
Despite current efforts to combat HIV/AIDS through behavioural change, ingrained socio-cultural practices such as widow inheritance in south-western Uganda has not changed. Low education, unemployment, dowry, widows' socioeconomic demands and the inheritor's greed for the deceased's wealth, influence widow inheritance. Voluntary counselling and testing is needed for the widows and their inheritors; formal dowry should be removed from marriage and widow inheritance stripped of its sexual component.
Paul Emong; Lawrence Eron
Background: Uganda has embraced inclusive education and evidently committed itself to bringing about disability inclusion at every level of education. Both legal and non-legal frameworks have been adopted and arguably are in line with the intent of the Convention on the Rights of Persons with Disabilities (CRPD) on education. The CRPD, in Article 24, requires states to attain a right to education for persons with disabilities without discrimination and on the basis of equal opportunities at a...
This paper examines the financial system reforms in the context of financial sector deepening, and strategy for financial sector development and inclusion in Uganda. Results suggest that the indicators of financial sector development are largely as they were in 1996 and that the actual gains from financial inclusion strategies are small. Evidence suggests a weak link between financial deepening and financial usage by firms and households. It finds the acclaimed success (by policy makers and s...
Elbert Thomas; Pfeiffer Anett
Abstract Background The population in Northern Uganda has been exposed to extreme levels of traumatic stress and thousands abducted forcibly became rebel combatants. Methods Using structured interviews, the prevalence and severity of posttraumatic stress disorder (PTSD), depression and anxiety was assessed in 72 former abducted adults, 62 of them being former child soldiers. Results As retrospective reports of exposure to traumatic stress increased, anxiety and PTSD occurrence increased (r = ...
Bjorvatn, Kjetil; Tungodden, Bertil
We report from the first randomized controlled trial of a development program targeting people with disabilities: a village savings‐ and loans program in rural Uganda. We find that it has had a strong, positive impact on the lives of the disabled participants, through providing access to financial services and strengthening locus of control. Our results suggest that such programs may represent a promising tool to empowering people living with disabilities in developing countries, but al...
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.
James R.K. Kagaari
Full Text Available Orientation: This article focused on the need for improved employer-employee relationships in order for public universities in Uganda to achieve their intended objectives.Research purpose: The purpose of this article was to review the need for appropriate employer-employee relationships that will ensure quality services and service delivery in public universities in Uganda.Motivation for the study: The researchers set out to examine why managers of public universities in Uganda were continuously paying less attention to the needs of the employees.Research design, approach and method: A descriptive research design was employed and 12 respondents, purposively selected from 4 public universities, were interviewed. Data were recorded, transcribed and analysed using Nvivo software. This article is based on the perspective of agency theory, and discussed the contractual relationship between management and employees. The agency theory was deemed necessary because of its contribution to organisational literature.Main findings: There is a need to create and nurture a collegial working climate that promotes quality interactions through information sharing. This results in creating and retaining motivated and committed employees, and also helps to overcome the paradox of balancing the high demand for university education whilst offering quality services.Practical/managerial implications: Managers have to continuously monitor and accommodate employee needs and demands.Contribution/value-add: The potential value of the paper is its function as a guide for public universities to have visionary managers that will introduce new approaches to managing public universities in a competitive global environment.
Nalubwama, Sylvia Muwanga; Mugisha, Anthony; Vaarst, Mette
Development in organic farming has been stimulated by farmers and consumers becoming interested in healthy food products and sustainable environment. Organic agriculture is a holistic production management system which is based on the principles of health, ecology, care, and fairness. Organic development in Uganda has focused more on the crop sector than livestock sector and has primarily involved the private sector, like organic products export companies and non-governmental organizations. Agriculture in Uganda and many African countries is predominantly traditional, less mechanized, and is usually associated with minimum use of chemical fertilizers, pesticides, and drugs. This low external input agriculture also referred to as "organic by default" can create basis for organic farming where agroecological methods are introduced and present an alternative in terms of intensification to the current low-input/low-output systems. Traditional farming should not be confused with organic farming because in some cases, the existing traditional practices have consequences like overstocking and less attention to soil improvement as well as to animal health and welfare, which is contrary to organic principles of ecology, fairness, health, and care. Challenges of implementing sustainable organic practices in the Ugandan livestock sector threaten its future development, such as vectors and vector-borne diseases, organic feed insufficiency, limited education, research, and support to organic livestock production. The prospects of organic livestock development in Uganda can be enhanced with more scientific research in organic livestock production under local conditions and strengthening institutional support.
Thummalachetty, Nityanjali; Mathur, Sanyukta; Mullinax, Margo; DeCosta, Kelsea; Nakyanjo, Neema; Lutalo, Tom; Brahmbhatt, Heena; Santelli, John S
Low contraceptive uptake and high unmet need for contraception remain significant issues in Uganda compared to neighboring countries such as Kenya, Ethiopia, and Rwanda. Although prior research on contraceptive uptake has indicated that male partners strongly influence women's decisions around contraceptive use, there is limited in-depth qualitative research on knowledge and concerns regarding modern contraceptive methods among Ugandan men. Using in-depth interviews (N = 41), this qualitative study investigated major sources of knowledge about contraception and perceptions of contraceptive side effects among married Ugandan men. Men primarily reported knowledge of contraceptives based on partner's experience of side effects, partner's knowledge from health providers and mass media campaigns, and partner's knowledge from her peers. Men were less likely to report contraceptive knowledge from health care providers, mass media campaigns, or peers. Men's concerns about various contraceptive methods were broadly associated with failure of the method to work properly, adverse health effects on women, and severe adverse health effects on children. Own or partner's human immunodeficiency virus (HIV) status did not impact on contraceptive knowledge. Overall, we found limited accurate knowledge about contraceptive methods among men in Uganda. Moreover, fears about the side effects of modern contraceptive methods appeared to be common among men. Family planning services in Uganda could be significantly strengthened by renewed efforts to focus on men's knowledge, fears, and misconceptions.
Full Text Available Abstract Background Low contraceptive uptake and high unmet need for contraception remain significant issues in Uganda compared to neighboring countries such as Kenya, Ethiopia, and Rwanda. Although prior research on contraceptive uptake has indicated that male partners strongly influence women’s decisions around contraceptive use, there is limited in-depth qualitative research on knowledge and concerns regarding modern contraceptive methods among Ugandan men. Methods Using in-depth interviews (N = 41, this qualitative study investigated major sources of knowledge about contraception and perceptions of contraceptive side effects among married Ugandan men. RESULTS: Men primarily reported knowledge of contraceptives based on partner’s experience of side effects, partner’s knowledge from health providers and mass media campaigns, and partner’s knowledge from her peers. Men were less likely to report contraceptive knowledge from health care providers, mass media campaigns, or peers. Men’s concerns about various contraceptive methods were broadly associated with failure of the method to work properly, adverse health effects on women, and severe adverse health effects on children. Own or partner’s human immunodeficiency virus (HIV status did not impact on contraceptive knowledge. Conclusions Overall, we found limited accurate knowledge about contraceptive methods among men in Uganda. Moreover, fears about the side effects of modern contraceptive methods appeared to be common among men. Family planning services in Uganda could be significantly strengthened by renewed efforts to focus on men’s knowledge, fears, and misconceptions.
Christine Echookit Akellol
Full Text Available The development of environmental regulatory framework in Uganda was initiated by the national environment action planning process in 1990, as a realization that environment needed special focus. As a result of the said process environmental policy and law were developed. The 1995 constitutional of the Republic of Uganda was among the first ever such constitution in the East African region to deliberately enshrine the right to a decent environment and to provide for sustainable development, in addition to the principle that natural resources are held in trust for the people and should be responsibly managed for their benefit. Following the constitution, a number of environment legislations were enacted and others were revised to take into account environmental cardinal principles and considerations, including embedding in them environmental regulatory provisions. Hence, in addition to the framework of National Environment Act, a number of environment sect oral legislation exists and environmental management is spread throughout the respective institutions responsible for aspects of the environment. It is therefore safe to say that Uganda has developed a lot of legislation on the environment but the challenge remains that of developing more regulations under the relevant parent Acts, effective monitoring and enforcement.
Jeremy I. Schwartz
Full Text Available Background: The burden of non-communicable diseases (NCDs in low- and middle-income countries (LMICs is accelerating. Given that the capacity of health systems in LMICs is already strained by the weight of communicable diseases, these countries find themselves facing a double burden of disease. NCDs contribute significantly to morbidity and mortality, thereby playing a major role in the cycle of poverty, and impeding development. Methods: Integrated approaches to health service delivery and healthcare worker (HCW training will be necessary in order to successfully combat the great challenge posed by NCDs. Results: In 2013, we formed the Uganda Initiative for Integrated Management of NCDs (UINCD, a multidisciplinary research collaboration that aims to present a systems approach to integrated management of chronic disease prevention, care, and the training of HCWs. Discussion: Through broad-based stakeholder engagement, catalytic partnerships, and a collective vision, UINCD is working to reframe integrated health service delivery in Uganda.
violence' (p 125). The penultimate chapter, by Ali Mazrui, (Between Domestic Policy and Regional Power: The Role of. Ideology in Uganda) argues that President Museveni's Uganda has played a greater role in regional politics under the guise of Pan-Africanism than the erstwhile leaders of the country. To this end, the.
Kikulwe, E.M.; Wesseler, J.H.H.; Falck-Zepeda, J.
The introduction of a genetically modified (GM) banana (Musa spp.) in Uganda is not without controversy. It is likely to generate a wide portfolio of concerns as the technology of genetic engineering is still in its early stages of development in Uganda. The purpose of this study is to show how
Hungi, Njora; Ngware, Moses; Mahuro, Gerald; Muhia, Nelson
The paper uses multilevel analysis procedures to examine individual- and group-level learning barriers that have the greatest impact on pupil achievement in Uganda. The data for this study were collected in 2014 among 2711 Grade 6 pupils attending 82 schools in two rural districts of Iganga and Mayuge in Uganda. Data used in this paper are part of…
Mujuni, John Bosco
In 2003-2007, the government of Uganda through the Ministry of Education and Sports (MoES), under the umbrella of UPHOLD and in Partnership with USAID, introduced cooperative learning as a "student-centered teaching approach" in some selected districts and schools in Uganda. This dissertation explored the current state and practice of…
Achen, Stella; Openjuru, George Ladaah
Hollywood movies are popular in Uganda. This paper reports a study that investigated access to English-language Hollywood movies in Uganda, by way of an ethnographic audience study carried out in slum areas of the city of Kampala. The researchers visited and participated in the watching and reviewing of English-language movies in makeshift video…
Ochieng, A.; Ahebwa, W.M.; Visseren-Hamakers, I.J.
Uganda reintroduced sport hunting in 2001. The policy was piloted around Lake Mburo National Park and later replicated around other protected areas. This chapter analyses the development, implementation and impact of sport hunting policy in Uganda. We do so through literature review, document
Aug 12, 2013 ... 1Department of Geography, Geo-Informatics and Climatic Sciences, Makerere University, Uganda. 2Africa Innovations Institute, Kampala, Uganda. 3Department of Biology, Gulu ..... research activities under the project “Adaptation to the. Impact of Climate Variability on Food and Health Security in the Cattle ...
Lincove, Jane Arnold
This study uses household survey data to estimate determinants of schooling in Uganda, with a model that includes the price of school. Uganda's universal education policy offered free tuition, fees, and supplies to up to four children per family, including two daughters. The empirical method includes an estimation of a child-specific price of…
Grace, André P.
Political, cultural and social fallout following the introduction of the anti-homosexuality bill in Uganda in 2009 intensified fabrication of an anti-gay public pedagogy of negation and nemesis that fuelled the passage of the Anti-Homosexuality Act, 2014. The Government of Uganda, conventional Anglicanism and US evangelical Christianity were all…
Book review of: Neoliberal Moral Economy: Capitalism, Socio-Cultural Change & Fraud in Uganda by Jörg Wiegratz. London and New York, Rowman & Littlefield, 2016, 375 pp. ISBN 9781783488537.......Book review of: Neoliberal Moral Economy: Capitalism, Socio-Cultural Change & Fraud in Uganda by Jörg Wiegratz. London and New York, Rowman & Littlefield, 2016, 375 pp. ISBN 9781783488537....
Beans are an important food product that contribute to nutritional security, income generation, and employment in Kenya and Uganda. Although beans are typically consumed ... Institution. National Agricultural Research Organization. Pays d' institution. Uganda. Site internet. http://www.cgiar.org/hosted/naro/naro.htm ...
The objectives were to highlight the burden of overweight and obesity as an additional area of importance for the malnutrition agenda in Uganda and to provide evidence-based considerations for stakeholders involved. Introduction: Mirroring other Low- and Middle-Income Countries (LMICs), Uganda is experiencing a ...
Baine, Euzobia M. Mugisha
This paper examines ways in which privatisation of education is affecting the search for gender justice through education focusing on Uganda's higher education institutions (HEIs). Since 1988 when the first private university was opened, the winds of change have swept Uganda's higher education sector to change how it is financed and managed. The…
Full Text Available Abstract Background The National Health Policy 2000 - 2009 and Health sector strategic plans I & II emphasized that Primary Health Care (PHC would be the main strategy for national development and would be operationalized through provision of the minimum health care package. Commitment was to spend an increasing proportion of the health budget for the provision of the basic minimum package of health services which was interpreted to mean increasing spending at health centre level. This analysis was undertaken to gain a better understanding of changes in the way recurrent funding is allocated in the health sector in Uganda and to what extent it has been in line with agreed policy priorities. Methods Government recurrent wage and non-wage expenditures - based on annual releases by the Uganda Ministry of Finance, Planning and Economic Development were compiled for the period 1997/1998 to financial year 2007/2008. Additional data was obtained from a series of Ministry of Health annual health sector reports as well as other reports. Data was verified by key government officials in Ministry of Finance, Planning and Economic Development and Ministry of Health. Analysis of expenditures was done at sector level, by the different levels in the health care system and the different levels of care. Results There was a pronounced increase in the amount of funds released for recurrent expenditure over the review period fueled mainly by increases in the wage component. PHC services showed the greatest increase, increasing more than 70 times in ten years. At hospital level, expenditures remained fairly constant for the last 10 years with a slight reduction in the wage component. Conclusion The policy aspiration of increasing spending on PHC was attained but key aspects that would facilitate its realization were not addressed. At any given level of funding for the health sector, there is need to work out an optimal balance in investment in the different inputs to
Mubeezi, Mary P; Gidman, Janice
This paper will report on the findings of a qualitative research study exploring mentorship in a rural hospital in Uganda. It explored how mentors perceived their roles and their own knowledge and skills in mentoring nurse students. Participants were confident in their ability to teach clinical skills, but they identified gaps in relation to the application of theory to these skills and they the need to update their own knowledge and to act more on their own initiative. The paper reports on the nature of the relationship between mentor and students, the teaching approaches used and the challenges of the role. Recommendations are proposed to develop a bespoke Ugandan curriculum to prepare mentors for their role, and to provide additional support, to enhance students' experiences of learning in this context. Copyright © 2017. Published by Elsevier Ltd.
U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
Full Text Available Abstract Background Obstructed labour is still a major cause of maternal morbidity and mortality and of adverse outcome for newborns in low-income countries. The aim of this study was to investigate the role of individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. Methods A review was performed on 12,463 obstetric records for the year 2006 from six hospitals located in south-western Uganda and 11,180 women records were analysed. Multivariate logistic regression analyses were applied to control for probable confounders. Results Prevalence of obstructed labour for the six hospitals was 10.5% and the main causes were cephalopelvic disproportion (63.3%, malpresentation or malposition (36.4% and hydrocephalus (0.3%. The risk of obstructed labour was statistically significantly associated with being resident of a particular district [Isingiro] (AOR 1.39, 95% CI: 1.04-1.86, with nulliparous status (AOR 1.47, 95% CI: 1.22-1.78, having delivered once before (AOR 1.57, 95% CI: 1.30-1.91 and age group 15-19 years (AOR 1.21, 95% CI: 1.02-1.45. The risk for perinatal death as an adverse outcome was statistically significantly associated with districts other than five comprising the study area (AOR 2.85, 95% CI: 1.60-5.08 and grand multiparous status (AOR 1.89, 95% CI: 1.11-3.22. Women who lacked paid employment were at increased risk of obstructed labour. Perinatal mortality rate was 142/1000 total births in women with obstructed labour compared to 65/1000 total births in women without the condition. The odds of having maternal complications in women with obstructed labour were 8 times those without the condition. The case fatality rate for obstructed labour was 1.2%. Conclusions Individual socio-demographic and health system factors are strongly associated with obstructed labour and its adverse outcome in south-western Uganda. Our study provides baseline information which may be used by
Albutt, Katherine; Yorlets, Rachel R; Punchak, Maria; Kayima, Peter; Namanya, Didacus B; Anderson, Geoffrey A; Shrime, Mark G
Five billion people lack access to safe, affordable, and timely surgical and anesthesia care. Significant challenges remain in the provision of surgical care in low-resource settings. Uganda is no exception. From September to November 2016, we conducted a mixed-methods countrywide surgical capacity assessment at 17 randomly selected public hospitals in Uganda. Researchers conducted 35 semi-structured interviews with key stakeholders to understand factors related to the provision of surgical care. The framework approach was used for thematic and explanatory data analysis. The Ugandan public health care sector continues to face significant challenges in the provision of safe, timely, and affordable surgical care. These challenges can be broadly grouped into preparedness and policy, service delivery, and the financial burden of surgical care. Hospital staff reported challenges including: (1) significant delays in accessing surgical care, compounded by a malfunctioning referral system; (2) critical workforce shortages; (3) operative capacity that is limited by inadequate infrastructure and overwhelmed by emergency and obstetric volume; (4) supply chain difficulties pertaining to provision of essential medications, equipment, supplies, and blood; (5) significant, variable, and sometimes catastrophic expenditures for surgical patients and their families; and (6) a lack of surgery-specific policies and priorities. Despite these challenges, innovative strategies are being used in the public to provide surgical care to those most in need. Barriers to the provision of surgical care are cross-cutting and involve constraints in infrastructure, service delivery, workforce, and financing. Understanding current strengths and shortfalls of Uganda's surgical system is a critical first step in developing effective, targeted policy and programming that will build and strengthen its surgical capacity.
Chalikakis, K.; Hammache, Y.; Nawa, A.; Slinski, K.; Petropoulos, G.; Muteesasira, A.
Northern Uganda has been devastated by more than 20 years of open conflict by the LRA (Lord's Resistance Army) and the Government of Uganda. This war has been marked by extreme violence against civilians, who had been gathered in protected IDP (Internally Displaced Persons) camps. At the height of the displacement in 2007, the UN office for coordination of humanitarian affairs, estimated that nearly 2.5 million people were interned into approximately 220 camps throughout Northern Uganda. With the improved security since mid-2006, the people displaced by the conflict in Northern Uganda started to move out of the overcrowded camps and return either to their villages/parishes of origin or to resettlement/transit sites. However, basic water, sanitation and hygiene infrastructure in the return areas or any new settlements sites are minimal. People returning to their villages of origin encounter a situation where in many cases there is no access to safe water. Since 1998 ACF (Action Against Hunger, part of the Action Contre la Faim International Network) activities have been concentrated in the Acholi and Lango regions of Northern Uganda. ACF's WASH (Water, sanitation and hygiene) department interventions concern sanitation infrastructure, hygiene education and promotion as well as water points implementation. To ensure safe water access, actions are focused in borehole construction and traditional spring rehabilitation, also called "protected" springs. These activities follow the guidelines as set forth by the international WASH cluster, led by UNICEF. A three year project (2008-2010) is being implemented by ACF, to monitor the available groundwater resources in Northern Uganda. The main objectives are: 1. to monitor the groundwater quality from existing water points during different hydrological seasons, 2. to identify, if any, potential risks of contamination from population concentrations and displacement, lack of basic infrastructure and land use, and finally 3. to
Richard, Menya; Kim, Jonghyun
Radioactive materials refer to any materials that spontaneously emit ionizing radiation and of which the radioactivity per gram is greater than 0.002 micro-curie. They include: spent nuclear fuel, nuclear wastes, medical sources i.e. Co-60, industrial sources i.e. Cs-137, Am-241:Be, Ra-226, and sources for research. In view of the rising reported cancer cases in Uganda, which might be as a result of radiation exposure due to constant transportation of radioactive materials i.e. industrial sources, a risk analysis was thought of and undertaken for the country's safety evaluation and improvement. It was therefore important to undertake a risk assessment of the actual and potential radiation exposure during the transportation process. This paper explains a study undertaken for transport risk assessment of the impact on the environment and the people living in it, from exposure to radioactivity during transportation of the industrial sources in Uganda. It provides estimates of radiological risks associated with visualized transport scenarios for the highway transport mode. This is done by calculating the human health impact and radiological risk from transportation of the sources along Busia transport route to Hoima. Busia is the entry port for the sources whilst Hoima, where various industrial practices that utilize sources like oil explorations are centered. During the study, a computer code RADTRAN-6 was used. The overall collective dose for population and package transport crew are 3.72E-4 and 1.69E-4 person-sievert respectively. These are less than the exemption value recommended by the IAEA and Uganda Regulatory Authority for public implying that no health effects like cancer are to be expected. Hence the rising cancer cases in the country are not as a result of increased transportation of radioactive materials in the Industrial sector
Kipp, Walter; Tindyebwa, Denis; Rubaale, Tom; Karamagi, Ednah; Bajenja, Ellen
We conducted 16 in-depth interviews with family caregivers of AIDS patients in three rural districts in western Uganda. They were selected from a client visitation list of the home-based care program for AIDS patients, based on volunteer participation. Family caregivers reported huge problems associated with providing the necessary psychological, social, and economic care. They also said that the physical and emotional demands of caregiving are overwhelming daily challenges. Most support to AIDS patients provided by family, friends, and the churches. The study highlights the great burden of caregivers, in sub-Saharan Africa who most often are elderly women and young girls. This study examine, the burden and related health issues of family caregivers, primarily women, for AIDS patients in Uganda. It was part of a broad research project using qualitative methods on family caregiving in the home environment in sub-Saharan Africa. As the requirements for family care giving are often overwhelming for women under the conditions as they exist in Uganda and in other developing countries, it constitutes a gender issue of great importance that has not been appreciated fully in the international literature. Family caregiving is also of international relevance, as HIV/AIDS is a global pandemic of previously unknown proportions. In many poor countries, family caregiving is the most common and often the only care that AIDS patients receive, because clinic-based care often is not available close to home or is not affordable. Therefore, family caregiver support programs to alleviate this burden are essential for all those countries where HIV/AIDS is prevalent. Family caregiver burden encompasses medical, social, and economic issues at the household level, which requires an interdisciplinary approach in order to fully understand and appreciate the different dimensions of the family caregiver burden and its negative impact on the lives of so many women in so many countries.
Richard, Menya; Kim, Jonghyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)
Radioactive materials refer to any materials that spontaneously emit ionizing radiation and of which the radioactivity per gram is greater than 0.002 micro-curie. They include: spent nuclear fuel, nuclear wastes, medical sources i.e. Co-60, industrial sources i.e. Cs-137, Am-241:Be, Ra-226, and sources for research. In view of the rising reported cancer cases in Uganda, which might be as a result of radiation exposure due to constant transportation of radioactive materials i.e. industrial sources, a risk analysis was thought of and undertaken for the country's safety evaluation and improvement. It was therefore important to undertake a risk assessment of the actual and potential radiation exposure during the transportation process. This paper explains a study undertaken for transport risk assessment of the impact on the environment and the people living in it, from exposure to radioactivity during transportation of the industrial sources in Uganda. It provides estimates of radiological risks associated with visualized transport scenarios for the highway transport mode. This is done by calculating the human health impact and radiological risk from transportation of the sources along Busia transport route to Hoima. Busia is the entry port for the sources whilst Hoima, where various industrial practices that utilize sources like oil explorations are centered. During the study, a computer code RADTRAN-6 was used. The overall collective dose for population and package transport crew are 3.72E-4 and 1.69E-4 person-sievert respectively. These are less than the exemption value recommended by the IAEA and Uganda Regulatory Authority for public implying that no health effects like cancer are to be expected. Hence the rising cancer cases in the country are not as a result of increased transportation of radioactive materials in the Industrial sector.
Salgado, Mariana; Wendland, Melanie; Rodriguez, Damaris; Bohren, Meghan A; Oladapo, Olufemi T; Ojelade, Olubunmi A; Mugerwa, Kidza; Fawole, Bukola
The "Better Outcomes in Labor Difficulty" (BOLD) project used a service design process to design a set of tools to improve quality of care during childbirth by strengthening linkages between communities and health facilities in Nigeria and Uganda. This paper describes the Passport to Safer Birth concept and the tools developed as a result. Service design methods were used to identify facilitators and barriers to quality care, and to develop human-centered solutions. The service design process had three phases: Research for Design, Concept Design, and Detail Design, undertaken in eight hospitals and catchment communities. The service concept "Better Beginnings" comprises three tools. The "Pregnancy Purse" provides educational information to women throughout pregnancy. The "Birth Board" is a visual communication tool that presents the labor and childbirth process. The "Family Pass" is a set of wearable passes for the woman and her supporter to facilitate communication of care preferences. The Better Beginnings service concept and tools form the basis for the promotion of access to information and knowledge acquisition, and could improve communication between the healthcare provider, the woman, and her family during childbirth. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.
Longenecker, Christopher T; Kalra, Ankur; Okello, Emmy; Lwabi, Peter; Omagino, John O; Kityo, Cissy; Kamya, Moses R; Webel, Allison R; Simon, Daniel I; Salata, Robert A; Costa, Marco A
In this case study, we describe an ongoing approach to develop sustainable acute and chronic cardiovascular care infrastructure in Uganda that involves patient and provider participation. Leveraging strong infrastructure for HIV/AIDS care delivery, University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University have partnered with U.S. and Ugandan collaborators to improve cardiovascular capabilities. The collaboration has solicited innovative solutions from patients and providers focusing on education and advanced training, penicillin supply, diagnostic strategy (e.g., hand-held ultrasound), maternal health, and community awareness. Key outcomes of this approach have been the completion of formal training of the first interventional cardiologists and heart failure specialists in the country, establishment of 4 integrated regional centers of excellence in rheumatic heart disease care with a national rheumatic heart disease registry, a penicillin distribution and adherence support program focused on retention in care, access to imaging technology, and in-country capabilities to treat advanced rheumatic heart valve disease. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.
Beyond ICT4D: New Media Research in Uganda is a collection of ethnographic reports from diverse perspectives of those living at the other end of the African ICT pyramid. Crucially, these texts refocus on the so-called "ICT4D" debate away from the standard western lens, which depicts users in the developing world as passive receivers of Western technological development, towards Ugandans whose use and production of technologies entail innovations from the ground up. It is this ‘other’ everyday...
Danielsen, Solveig; Mutebi, Emmanuel
Four mobile (or community-based) plant health clinics were started in Uganda on a pilot basis in 2005 as an attempt to ensure better plant health advisory services for small-scale farmers. This new way of delivering primary plant healthcare to farmers has attracted wider interest and the Ministry......, Makerere University and CABI. The purpose of this study was to gather results and lessons learned from the pilot period to inform future plant clinic interventions. The study covers issues of organisation and management, clinic operation and performance as well as clinic use and preliminary evidence...
Akena Adyanga, Francis
This study examines African Indigenous Science (AIS) in higher education in Uganda. To achieve this, I use anticolonial theory and Indigenous knowledge discursive frameworks to situate the subjugation of Indigenous science from the education system within a colonial historical context. These theories allow for a critical examination of the intersection of power relations rooted in the politics of knowledge production, validation, and dissemination, and how this process has become a systemic and complex method of subjugating one knowledge system over the other. I also employ qualitative and autoethnographic research methodologies. Using a qualitative research method, I interviewed 10 students and 10 professors from two universities in Uganda. My research was guided by the following key questions: What is African Indigenous Science? What methodology would help us to indigenize science education in Uganda? How can we work with Indigenous knowledge and anticolonial theoretical discursive frameworks to understand and challenge the dominance of Eurocentric knowledge in mainstream education? My research findings revealed that AIS can be defined in multiple ways, in other words, there is no universal definition of AIS. However, there were some common elements that my participants talked about such as: (a) knowledge by Indigenous communities developed over a long period of time through a trial and error approach to respond to the social, economic and political challenges of their society. The science practices are generational and synergistic with other disciplines such as history, spirituality, sociology, anthropology, geography, and trade among others, (b) a cumulative practice of the use, interactions with and of biotic and abiotic organism in everyday life for the continued existence of a community in its' totality. The research findings also indicate that Indigenous science is largely lacking from Uganda's education curriculum because of the influence of colonial and
Lett, Ronald R; Kobusingye, Olive Chifefe; Ekwaru, Paul
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. 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. 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. The crisis in Gulu can be considered a complex political emergency. Protracted conflicts should not be ignored because of a low
Sabbit, B.; Tungotyo, T.D
The total installed electricity capacity is 595.8 MW mainly hydropower, cogeneration from biomass and thermal power. The Installed Capacity is expected to rise to about 802 MW in 2011 with commissioning of Bujagali hydropower Plant currently under construction, and other mini hydropower plants. Current contribution to the Energy Supply Pattern: Electricity 1.1%, Oil products 9.5% and Biomass 89.4%. (Uganda Energy balance, 2009). The need to drift from use of Biomass as source of energy prompted the consideration of energy supply options which are environmentally friendly. This includes the energy efficiency campaigns, renewable energy technologies and NPP. Uganda government intends to substantially increase power generation capacity in the next 20 years of which nuclear will have significant contribution. Legal framework has been put in place and currently building of capacity through training of young scientists. Ministry of Energy and Mineral Development is the home of all the energy Sector programmes including the nuclear Energy Programme. The Atomic Energy Act 2008 has been promulgated and the Atomic Energy Council was established to regulate the peaceful application of Atomic energy. The Council is mandated to provide protection and safety of individuals, society and the environment from the dangers resulting from ionizing radiation
James R.K. Kagaari
Research purpose: The purpose of this article was to review the need for appropriate employer-employee relationships that will ensure quality services and service delivery in public universities in Uganda. Motivation for the study: The researchers set out to examine why managers of public universities in Uganda were continuously paying less attention to the needs of the employees. Research design, approach and method: A descriptive research design was employed and 12 respondents, purposively selected from 4 public universities, were interviewed. Data were recorded, transcribed and analysed using Nvivo software. This article is based on the perspective of agency theory, and discussed the contractual relationship between management and employees. The agency theory was deemed necessary because of its contribution to organisational literature. Main findings: There is a need to create and nurture a collegial working climate that promotes quality interactions through information sharing. This results in creating and retaining motivated and committed employees, and also helps to overcome the paradox of balancing the high demand for university education whilst offering quality services. Practical/managerial implications: Managers have to continuously monitor and accommodate employee needs and demands. Contribution/value-add: The potential value of the paper is its function as a guide for public universities to have visionary managers that will introduce new approaches to managing public universities in a competitive global environment.
Nielsen, Jannie; Bahendeka, Silver K; Bygbjerg, Ib C; Meyrowitsch, Dan W; Whyte, Susan R
Non-communicable diseases including type 2 diabetes (T2D) are increasing rapidly in most Sub-Saharan African (SSA) countries like Uganda. Little attention has been given to how patients with T2D try to achieve treatment when the availability of public health care for their disease is limited, as is the case in most SSA countries. In this paper we focus on the landscape of availability of care and the therapeutic journeys of patients within that landscape. Based on fieldwork in south-western Uganda including 10 case studies, we explore the diabetes treatment options in the area and what it takes to access the available treatment. We analyse the resources patients need to use the available treatment options, and demonstrate that the patients' journeys to access and maintain treatment are facilitated by the knowledge and support of their therapy management groups. Patients access treatment more effectively, if they and their family have money, useful social relations, and knowledge, together with the capacity to communicate with health staff. Patients coming from households with high socio-economic status (SES) are more likely to have all of these resources, while for patients with low or medium SES, lack of economic resources increases the importance of connections within the health system.
Emong, Paul; Eron, Lawrence
Uganda has embraced inclusive education and evidently committed itself to bringing about disability inclusion at every level of education. Both legal and non-legal frameworks have been adopted and arguably are in line with the intent of the Convention on the Rights of Persons with Disabilities (CRPD) on education. The CRPD, in Article 24, requires states to attain a right to education for persons with disabilities without discrimination and on the basis of equal opportunities at all levels of education. Despite Uganda's robust disability legal and policy framework on education, there is evidence of exclusion and discrimination of students with disabilities in the higher education institutions. The main objective of this article is to explore the status of disability inclusion in higher education and strategies for its realisation, using evidence from Emong's study, workshop proceedings where the authors facilitated and additional individual interviews with four students with disabilities by the authors. The results show that there are discrimination and exclusion tendencies in matters related to admissions, access to lectures, assessment and examinations, access to library services, halls of residence and other disability support services. The article recommends that institutional policies and guidelines on support services for students with disabilities and special needs in higher education be developed, data on students with disabilities collected to help planning, collaboration between Disabled Peoples Organisations (DPO's) strengthened to ensure disability inclusion and the establishment of disability support centres.
Lagoro, David Kitara; Arony, Denis Anywar
Nodding Syndrome (NS) is a childhood neurological disorder characterized by atonic seizures, cognitive decline, school dropout, muscle weakness, thermal dysfunction, wasting and stunted growth. There are recent published information suggesting associations between Nodding Syndrome (NS) with cerebrospinal fluid (CSF) VGKC antibodies and serum leiomidin-1 antibody cross reacting with Onchocerca Volvulus ( OV ). These findings suggest a neuro-inflammatory cause of NS and they are important findings in the search for the cause of Nodding Syndrome. These observations perhaps provide further, the unique explanation for the association between Nodding Syndrome and Onchocerca Volvulus . Many clinical and epidemiological studies had shown a significant correlation between NS and infestation with a nematode, Onchocerca volvulus which causes a disease, Onchocerciasis , some of which when left untreated can develop visual defect ("River Blindness"). While these studies conducted in Northern Uganda and Southern Sudan indicate a statistically significant association with ( OV infection (using positive skin snips), we observe that ( OV is generally endemic in many parts of Sub Saharan Africa and Latin America and that to date, no NS cases have been recorded in those regions. This letter to the Editor is to provide additional information on the current view about the relationship between Nodding Syndrome and Onchocerca Volvulus as seen in Northern Uganda.
Dodge, C P
Uganda had one of the best health care delivery systems in Africa. The decade of misrule by Amin saw a collapse of the country and an exodus of doctors and other professions. The 1979 liberation war and subsequent political instability and insecurity further aggravated the poor health services then available. When political stability was temporarily restored in December 1980 the cash crop export sector took priority over social services and the health budget declined to only 3.5% compared to a former level of 7.5% of government budget. Emergencies in West Nile, Karamoja and the Luwero triangle continued to plague rehabilitation efforts upto 1985. Alternate strategies for improving health are proposed including female education, increased budget allocations, food and nutrition policy and health information. Uganda's prospect for rebuilding the health services has begun with immunization, control of diarrhoeal diseases, nutrition surveillance in Karamoja and an essential drugs programme, but the success of these is dependent upon political stability and improvement in overall security.
Full Text Available Objective: Evaluate implementation of misoprostol for postabortion care (MPAC in two African countries. Design: Qualitative, program evaluation. Setting: Twenty-five public and private health facilities in Rift Valley Province, Kenya, and Kampala Province, Uganda. Sample: Forty-five MPAC providers, health facility managers, Ministry of Health officials, and non-governmental (NGO staff involved in program implementation. Methods and main outcome measures: In both countries, the Ministry of Health, local health centers and hospitals, and NGO staff developed evidence-based service delivery protocols to introduce MPAC in selected facilities; implementation extended from January 2009 to October 2010. Semi-structured, in-depth interviews evaluated the implementation process, identified supportive and inhibitive policies for implementation, elicited lessons learned during the process, and assessed provider satisfaction and providers’ impressions of client satisfaction with MPAC. Project reports were also reviewed. Results: In both countries, MPAC was easy to use, and freed up provider time and health facility resources traditionally necessary for provision of PAC with uterine aspiration. On-going support of providers following training ensured high quality of care. Providers perceived that many women preferred MPAC, as they avoided instrumentation of the uterus, hospital admission, cost, and stigma associated with abortion. Appropriate registration of misoprostol for use in the pilot, and maintaining supplies of misoprostol, were significant challenges to service provision. Support from the Ministry of Health was necessary for successful implementation; lack of country-based standards and guidelines for MPAC created challenges. Conclusions: MPAC is simple, cost-effective and can be readily implemented in settings with high rates of abortion-related mortality.
Dec 7, 2012 ... College of Business and Management Science, Makerere University, ... with a high level of improved inputs use as well as productivity . .... Western Uganda spent on average three times more on hiring labour (UGX 0.051.
Nalugwa, A.; Olsen, Annette; Tukahebwa, M. E.
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...
The state of digitisation of the land registry operations in Uganda. ... establish the challenges and chart strategies to overcome the challenges faced by stakeholders. ... The authors recommend strengthening the management of both paper and ...
Bagorogoza, J.; de Waal, A.; van den Herik, H.J.; van de Walle, B.A.
Purpose: The purpose of the study is to examine the knowledge management practices of financial institutions in Uganda, in order to understand how these practices influence the high performance organisation factors and thereby the performance of the financial institutions.
Tumwine, J.; Frinking, H.D.; Jeger, M.J.
Cultural control measures against tomato late blight (Phytophthora infestans) were evaluated in six field experiments over 3 years in Uganda. Each experiment included sanitation (removal of diseased plant tissues), fungicide (mancozeb) application, and an untreated control, as standard treatments.
Clet Wandui Masiga
Full Text Available The Cartagena Protocol on Biosafety to the Convention on Biological Diversity is an internationally binding instrument addressing issues of biosafety. Biosafety refers to the need to protect human health and the environment from the possible adverse effects of the products of modern biotechnology. Accordingly all countries to the convention are required to put in place regulatory mechanisms to enhance the safety of biotechnology in the context of the Convention’s overall goal of reducing all potential threats to biological diversity, while taking into account the risks to human health. Therefore each country party to the convention has its own procedures to enact laws to guide the safe use of biotechnology. In Uganda the process involves the drafting of the bill by the first parliamentary counsel, approval by cabinet, first reading at the parliament, committal to the responsible parliamentary sessional committee, tabling of the bill for public hearing, consultations, and final approval. In Uganda, the Committee on Science and Technology is responsible for the Biosafety Bill. In March 2013, the Committee tabled the bill for public hearing and submissions from public institutions. There were comments supporting the passage of the Bill and comments in objection.The reasons for objection are mainly due to precaution, speculation, lack of knowledge about biotechnology and biosafety, and alleged influence from biosafety entrepreneurs. This article reviews these public views, revealing controversy and possible consensus to pass the bill.
Full Text Available Obesity is one of the fastest growing health problems in Uganda and across the world and its rising prevalence is placing additional strain on medical resources. At its simplest level obesity is a consequence of unhealthy lifestyles. Preventing its spread in Uganda will rest on the ability of society to motivate individuals to make positive healthy choices in their daily lives and many of the same techniques may be applicable to the situation in South Sudan.
Bürgerkriege haben für die betroffenen Länder verheerende Auswirkungen auf soz-ialer, wirtschaftlicher, medizinischer und politischer Ebene. In einer epidemiologischen Studie, die im West-Nil Gebiet von Sudan und Uganda durchgeführt wurde, sollten die psychischen Folgen des sudanesischen Bürgerkrieges untersucht werden. Dabei wurden drei Populationen miteinander verglichen: Sudanesen, die im Sudan verblieben waren (n =664), Flüchtlinge, die aus dem Sudan nach Uganda geflohen waren (n = 1240) ...
Nalugya-Sserunjogi, Joyce; Rukundo, Godfrey Zari; Ovuga, Emilio; Kiwuwa, Steven M.; Musisi, Seggane; Nakimuli-Mpungu, Etheldreda
Background Depression in adolescents constitutes a global public health concern. However, data on its prevalence and associated factors are limited in low income countries like Uganda. Methods Using a cross-sectional descriptive study design, 519 adolescent students in 4 secondary schools in Mukono district, Uganda, were randomly selected after meeting study criteria. The 4 school types were: boarding mixed (boys and girls) school; day mixed school; girls? only boarding school; and, boys? onl...
Obowna, Marios; Abuka, Charles Augustine
Uganda faced a number of challenges at the time of embarking on financial sector reforms. These challenges were complicated by decades of economic mismanagement and political instability that had prevailed in the country. In particular, there were concerns about the inadequacy of a critical mass of skilled and experienced financial sector players. This shortcoming inherently induced undue impediments to Uganda's corporate reporting regime. Further shortcoming were related to the lack of compr...
Heun, Michael; Schlink, Torsten
The objective of this paper is to implement a prototype of a currency crisis model as part of an early warning system framework for Uganda. The financial systems of developing countries like Uganda are especially vulnerable and therefore robust instruments to predict crises are needed. Our model is based on the signals approach developed by Kaminsky, Lizondo and Reinhart (1998) and Kaminsky and Reinhart (1999). The basic idea of the signals approach is to monitor several indicators that tend ...
In Uganda, about 3 million households consume tomato. However, tomato yields (10 ton/ ha) are low due to poor agronomic practices, lack of high yielding and disease resistant varieties, and pests (Varela, 1995; Hansen, 1990; Defrancq, 1989). Viral diseases are the third major cause of low tomato productivity in Uganda. Therefore, a survey was conducted; symptoms observed on tomato were categorized, and screened for both ribonucleic and deoxyribonucleic acid tomato viruses. Genetic identity fo...
Bwire, Godfrey; Ali, Mohammad; Sack, David A.; Nakinsige, Anne; Naigaga, Martha; Debes, Amanda K.; Ngwa, Moise C.; Brooks, W. Abdullah; Garimoi Orach, Christopher
Background Despite advance in science and technology for prevention, detection and treatment of cholera, this infectious disease remains a major public health problem in many countries in sub-Saharan Africa, Uganda inclusive. The aim of this study was to identify cholera hotspots in Uganda to guide the development of a roadmap for prevention, control and elimination of cholera in the country. Methodology/Principle findings We obtained district level confirmed cholera outbreak data from 2011 t...
Bouchard, Maryse; Kohler, Jillian C; Orbinski, James; Howard, Andrew
Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants' experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher wages and benefits for workers could be
Full Text Available Abstract Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct
Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher
Kusemererwa, Donna; Alban, Anita; Obua, Ocwa Thomas; Trap, Birna
To ascertain equity in financing for essential medicines and health supplies (EMHS) in Uganda, this paper explores the relationships among government funding allocations for EMHS, patient load, and medicines availability across facilities at different levels of care. We collected data on EMHS allocations and availability of selected vital medicines from 43 purposively sampled hospitals and the highest level health centers (HC IV), 44 randomly selected lower-level health facilities (HC II, III), and from over 400 facility health information system records and National Medical Stores records. The data were analyzed to determine allocations per patient within and across levels of care and the effects of allocations on product availability. EMHS funding allocations per patient varied widely within facilities at the same level, and allocations per patient between levels overlapped considerably. For example, HC IV allocations per patient ranged from US$0.25 to US$2.14 (1:9 ratio of lowest to highest allocation), and over 75 % of HC IV facilities had the same or lower average allocation per patient than HC III facilities. Overall, 43 % of all the facilities had optimal stock levels, 27 % were understocked, and 30 % were overstocked. Using simulations, we reduced the ratio between the highest and lowest allocations per patient within a level of care to less than two and eliminated the overlap in allocation per patient between levels. Inequity in EMHS allocation is demonstrated by the wide range of funding allocations per patient and the corresponding disparities in medicines availability. We show that using patient load to calculate EMHS allocations has the potential to improve equity significantly. However, more research in this area is urgently needed. The article does not report any results of human participants. It is implemented in collaboration with the Uganda's Ministry of Health, Pharmacy Division.
Mwaka, Amos D; Wabinga, Henry R; Mayanja-Kizza, Harriet
There are limited data on perceptions of health professionals on challenges faced by cervical cancer patients seeking healthcare in the developing countries. We explored the views of operational level health professionals on perceived barriers to cervical screening and early help-seeking for symptomatic cervical cancer and the proposed remedies to the challenges. Fifteen key informant interviews were held with health professionals including medical directors, gynecologists, medical officers, nurses and midwives in the gynecology and obstetrics departments of two hospitals in northern Uganda during August 2012 to April 2013. We used content analysis techniques to analyze the data. Health professionals' perceived barriers to cervical cancer care included: (i) patients and community related barriers e.g. lack of awareness on cervical cancer and available services, discomfort with exposure of women's genitals and perceived pain during pelvic examinations, and men's lack of emotional support to women (ii) individual healthcare professional's challenges e.g. inadequate knowledge and skills about cervical cancer management; (iii) health facility related barriers e.g. long distances and lack of transport to cervical cancer screening and care centers, few gynecologists and lack of pathologists, delayed histology results, lack of established palliative care services and inadequate pain control; and (iv) health policy challenges e.g. lack of specialized cancer treatment services, and lack of vaccination for human papilloma virus. Other challenges included increased number of cervical cancer patients and late stage of cervical cancer at presentations. Operational level healthcare professionals in northern Uganda reported several practical challenges facing cervical cancer care that influence their decisions, management goals and practices. The challenges and proposed remedies can inform targeted interventions for early detection, management, and control of cervical cancer in
Kaleebu, P; Kamali, A; Seeley, J; Elliott, A M; Katongole-Mbidde, E
For the past 25 years, the Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS has conducted research on HIV-1, coinfections and, more recently, on non-communicable diseases. Working with various partners, the research findings of the Unit have contributed to the understanding and control of the HIV epidemic both in Uganda and globally, and informed the future development of biomedical HIV interventions, health policy and practice. In this report, as we celebrate our silver jubilee, we describe some of these achievements and the Unit's multidisciplinary approach to research. We also discuss the future direction of the Unit; an exemplar of a partnership that has been largely funded from the north but led in the south. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Maly, Christina; McClendon, Katherine A; Baumgartner, Joy Noel; Nakyanjo, Neema; Ddaaki, William George; Serwadda, David; Nalugoda, Fred Kakaire; Wawer, Maria J; Bonnevie, Erika; Wagman, Jennifer A
The leading causes of death and disability among Ugandan female adolescents aged 15 to 19 years are pregnancy complications, unsafe abortions, and childbirth. Despite these statistics, our understanding of how girls perceive adolescent pregnancy is limited. This qualitative study explored the social and contextual factors shaping the perceptions of adolescent pregnancy and childbirth among a sample of 12 currently pregnant and 14 never pregnant girls living in the rural Rakai District of Uganda. Interviews were conducted to elicit perceived risk factors for pregnancy, associated community attitudes, and personal opinions on adolescent pregnancy. Findings indicate that notions of adolescent pregnancy are primarily influenced by perceptions of control over getting pregnant and readiness for childbearing. Premarital pregnancy was perceived as negative whereas postmarital pregnancy was regarded as positive. Greater understanding of the individual and contextual factors influencing perceptions can aid in development of salient, culturally appropriate policies and programs to mitigate unintended adolescent pregnancies.
Corbin, Joanne N
This exploratory qualitative study considers the subjective resettlement experiences of children forced into armed conflict in Northern Uganda from the perspectives of 11 former child combatants and 11 adult community members. A thematic analysis was performed on the narrative data. The bioecological model was used to provide a conceptual framework for key themes. Major findings included the overarching impact of ongoing armed conflict on returnees' lives, the important role of the family in supporting children's resettlement, the harassment of former child soldiers by community members, and the community's inability to support systematically the returning children in tangible ways. This study recommends that humanitarian services at all levels strengthen the capacity of families to care for the material and psychoemotional needs of former child soldiers within their communities.
Mubiru, Drake N.; Komutunga, Everline; Agona, Ambrose
, the number of rainy days during this critical period of crop growth is decreasing, which possibly means that crops grown in this season are prone to climatic risks and therefore in need of appropriate adaptation measures. A time-series analysis of the maximum daily temperature clearly revealed an increase......Uganda is vulnerable to climate change as most of its agriculture is rain-fed; agriculture is also the backbone of the economy, and the livelihoods of many people depend upon it. Variability in rainfall may be reflected in the productivity of agricultural systems and pronounced variability may...... in temperature, with the lower limits of the ranges of daily maximums increasing faster than the upper limits. Finally, this study has generated information on seasonal rainfall characteristics that will be vital in exploiting the possibilities offered by climatic variability and also offers opportunities...
Whyte, Susan Reynolds; Park, Sung-Joon; Odong, George
Background : WHO and Uganda’s Ministry of Health emphasize the need to address the growing burden of non-communicable diseases (NCDs). Treatment for these conditions is urgent in northern Uganda where war has negatively affected both health and the public health care system. Objectives : We aimed...... to explore the recognized presence of selected chronic conditions in the out-patient population and to relate this ‘visibility’ to the ability of health units to diagnose and treat them. Methods : At six health facilities we reviewed patient registers for one month to determine the frequency of hypertension...... : The four conditions are relatively invisible in the outpatient population. Greater visibility would be facilitated by regular clinic days for hypertension and diabetes, availability and regular use of diagnostic instruments, and a more reliable supply of the relevant medicines....
Full Text Available The leading causes of death and disability among Ugandan female adolescents aged 15 to 19 years are pregnancy complications, unsafe abortions, and childbirth. Despite these statistics, our understanding of how girls perceive adolescent pregnancy is limited. This qualitative study explored the social and contextual factors shaping the perceptions of adolescent pregnancy and childbirth among a sample of 12 currently pregnant and 14 never pregnant girls living in the rural Rakai District of Uganda. Interviews were conducted to elicit perceived risk factors for pregnancy, associated community attitudes, and personal opinions on adolescent pregnancy. Findings indicate that notions of adolescent pregnancy are primarily influenced by perceptions of control over getting pregnant and readiness for childbearing. Premarital pregnancy was perceived as negative whereas postmarital pregnancy was regarded as positive. Greater understanding of the individual and contextual factors influencing perceptions can aid in development of salient, culturally appropriate policies and programs to mitigate unintended adolescent pregnancies.
Kjær, Anne Mette; Therkildsen, Ole
Much of the relevant literature on Africa downplays the salience of elections for policy-making and implementation. Instead, the importance of factors such as clientelism, ethnicity, organized interest group and donor influence, is emphasized. We argue that, in addition, elections now motivate...... political elites to focus on policies they perceive to be able to gain votes. This is based on analyses of six landmark decisions made during the last fifteen years in the social, productive and public finance sectors in Tanzania and Uganda. Such policies share a number of key characteristics......: they are clearly identifiable with the party in power; citizens country-wide are targeted; and policy implementation aim at immediate, visible results. The influence of elections on policy making and implementation could therefore be more significant in countries where elections are more competitive than...
Full Text Available In October 2009, a private member introduced the Anti-Homosexuality Bill to Uganda’s Parliament for consideration. This article analyzes the Bill within a broader context of transnational antigay activism, specifically the diverse ways that antigay activism in Uganda is shaped by global dynamics (such as the U.S. Christian Right’s pro-family agenda and local forms of knowledge and concerns over culture, national identity, and political and socio-economic issues/interests. This article lends insight into how transnational antigay activism connects to and reinforces colonial-inspired scripts about “African” sexuality and the deepening power inequalities between the global North and South under global neoliberalism, and raises some important questions about how the racial and gender politics of the U.S. Christian Right’s pro-family agenda travel and manifest within the Ugandan context.
Sims-Williams, Helen J; Sims-Williams, Hugh P; Mbabazi Kabachelor, Edith; Warf, Benjamin C
Children surviving after spina bifida repair often have significant disability, the consequences of which may be more profound in low-income countries. The aim of this cross-sectional study was to measure quality of life (QOL) reported by children with spina bifida in Uganda, and to define factors associated with QOL. QOL was measured using both the Health Utilities Index (HUI3) Tool and a visual analogue scale (VAS) marked from 0 to 10. In keeping with the WHO definition of QOL, further analysis was conducted using subjective QOL scores (using the VAS). Multivariate regression was used to investigate the association between VAS scores and prespecified variables: age, sex, hydrocephalus, mobility, urinary continence, school attendance and family size. Sixty two of 68 surviving children aged 10-14 were able to complete all aspects of the assessment. There was poor correlation between the VAS and HUI3 Tool (Pearson correlation 0.488). On multivariate regression, the following variables were associated with a significant change in the 10-point VAS (change in score; 95% CI): male sex (-1.45; -2.436 to -0.465), urinary continence (1.681; 0.190 to 3.172), large family size (-1.775; -2.773 to -0.777) and hydrocephalus (-1.382; -2.374 to -0.465). Urinary continence and family size are potentially modifiable, the former by simple and inexpensive medical management. Enhanced investment in community-based rehabilitation and support is urgently needed. Delivery of family planning services is a national priority in Uganda, and should be discussed with families as part of holistic care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Baalwa, J; Byarugaba, B B; Kabagambe, E K; Kabagambe, K E; Otim, A M
Obesity in young adults is rising and predicts diabetes and cardiovascular diseases later in life. Data on prevalence and determinants of obesity in developing countries are needed for primary prevention. To determine the prevalence of overweight and obesity in young adults in urban (Kampala city) and rural areas (Kamuli District) of Uganda. Cross-sectional survey of 683 randomly selected young adults aged 18-30 years. Obesity was defined as body mass index (BMI) > 30 kg/m(2) and overweight as BMI > 25 kg/m(2). Distribution of BMI by socio-demographic characteristics was determined. Of the 683 participants, 50.5% were female and 53.2% were from Kampala. The overall prevalence of obesity and overweight was 2.3% and 10.4%, respectively. The prevalence of obesity was 4.4% in Kampala and 0% in Kamuli while the prevalence of overweight was 10.2% and 10.6% in Kampala and Kamuli, respectively. Compared to males, females were more likely to be obese (2.9% vs. 1.8%) or overweight (17.4% vs. 3.3%). Residing in the city, alcohol consumption, smoking, non-engagement in sports activities, commuting to school by taxi or private vehicle and being from a rich family were the main factors significantly associated (Pobesity. Being female (p = 0.0001) and not engaging in any sports activities (P = 0.002) were two factors significantly associated with being overweight. We observed significant gender differences in the prevalence of obesity among young adults in Uganda. Contrary to expectation, we did not observe significant rural-urban differences in the prevalence of overweight.
Kiene, Susan M; Lule, Haruna; Sileo, Katelyn M; Silmi, Kazi Priyanka; Wanyenze, Rhoda K
Intimate partner violence (IPV), alcohol use, and depression are key vulnerabilities for HIV in Uganda, and taken together may have a synergistic effect on risk. Our objective was to investigate the associations between depression, IPV, and alcohol use and HIV-risk indicators among a sample of outpatients in rural Uganda, and the effect of co-occurrence of these factors on HIV-risk indicators. In a structured interview we collected data on high-risk sexual behavior, depression symptoms, emotional and physical IPV, and alcohol use, as well as a blood sample for HIV and syphilis tests and a urine sample for chlamydia and gonorrhea tests from 325 male and female outpatients receiving provider-initiated HIV testing and counseling (PITC) at a public hospital outpatient clinic in rural Uganda. We used logistic regression and generalized linear modeling to test independent associations between depression, IPV, and alcohol use and HIV-risk indicators, as well as the effect of co-occurrence on HIV-risk indicators. Twelve percent of men and 15% of women had two or more of the following conditions: depression, IPV, and alcohol use; another 29% of men and 33% of women had 1 condition. Each condition was independently associated with HIV risk behavior for men and women, and for women, depression was associated with testing positive for HIV or a sexually transmitted infection (STI). Men with one condition (AOR 2.32, 95% CI 1.95-2.77) and two or more conditions (AOR 12.77, 95% CI 7.97-20.47) reported more high risk sex acts compared to those with no potential co-occurring conditions. For men, experiencing two or more conditions increased risky sex more than one alone (χ 2 24.68, p risk for risky sex (AOR 2.18, 95% CI 1.64-2.91). We also found preliminary evidence suggesting synergistic effects between depression and emotional IPV and between alcohol use and depression. This study demonstrates the co-occurrence of depression, IPV, and alcohol use in men and women in an
Kristensen, Kia Hee Schultz; Wiese, Maria; Rytter, Maren Johanne Heilskov
BACKGROUND: Severe acute malnutrition (SAM) among children remains a major health problem in many developing countries. SAM manifests in both an oedematous and a non-oedematous form, with oedematous malnutrition in its most severe form also known as kwashiorkor. The pathogenesis of both types...... of malnutrition in children remains largely unknown, but gut microbiota (GM) dysbiosis has recently been linked to oedematous malnutrition. In the present study we aimed to assess whether GM composition differed between Ugandan children suffering from either oedematous or non-oedematous malnutrition. METHODOLOGY......-encoded 16S rRNA gene-targeted high throughput amplicon sequencing. Alpha and beta diversity measures were determined along with ANOVA mean relative abundance and G-test of independence followed by comparisons between groups. Of the 87 SAM children included, 62% suffered from oedematous malnutrition, 66...
Kajja, Isaac; Bimenya, Gabriel S.; Smit Sibinga, Cees Th.
Blood as a transplant is not free of risks. Clinicians and patients ought to know the parameters of a transfusion informed consent. A mixed methodology to explore patients' and clinicians' knowledge and opinions of administration and strategies to improve the transfusion informed consent process was
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Andrew, R R
A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.
Biggeri, M; Nannini, M; Putoto, G
Community health insurance (CHI) aims to provide financial protection and facilitate health care access among poor rural populations. Given common operational challenges that hamper the full development of the scheme, there is need to undertake systematic feasibility studies. These are scarce in the literature and usually they do not provide a comprehensive analysis of the local context. The present research intends to adopt a mixed-methods approach to assess ex-ante the feasibility of CHI. In particular, eight preconditions are proposed to inform the viability of introducing the micro insurance. A case study located in rural northern Uganda is presented to test the effectiveness of the mixed-methods procedure for the feasibility purpose. A household survey covering 180 households, 8 structured focus group discussions, and 40 key informant interviews were performed between October and December 2016 in order to provide a complete and integrated analysis of the feasibility preconditions. Through the data collected at the household level, the population health seeking behaviours and the potential insurance design were examined; econometric analyses were carried out to investigate the perception of health as a priority need and the willingness to pay for the scheme. The latter component, in particular, was analysed through a contingent valuation method. The results validated the relevant feasibility preconditions. Econometric estimates demonstrated that awareness of catastrophic health expenditures and the distance to the hospital play a critical influence on household priorities and willingness to pay. Willingness is also significantly affected by socio-economic status and basic knowledge of insurance principles. Overall, the mixed-methods investigation showed that a comprehensive feasibility analysis can shape a viable CHI model to be implemented in the local context. Copyright © 2018 Elsevier Ltd. All rights reserved.
Three public health projects in Uganda and Sierra Leone are used to illustrate a new approach to construction of health buildings in villages. Emphasis is placed on community involvement. The health projects were comprehensive and relied on health education, employment of local village health workers, and establishment of village health committees. The objective of community involvement was described as encouragement of people to change their own diets and living conditions. This approach to primary health care is considered to be a strong basis for sustainable social development. Each of the three communities initiated the building projects slightly differently. There was a range of structures: traditional meeting halls, simple rooms with imported materials and a pit latrine, new buildings combining local and imported materials and labor, new nontraditional buildings, rehabilitated existing nontraditional buildings with imported labor and materials, and temporary mobile clinics. Community involvement was at different levels. All three projects were the result of a combined effort of national governments or mission hospitals, nongovernmental organizations, and the host community. The following should be considered before beginning construction: a suitable site, appropriate staff accommodation, the likely motivation of the host community, seasonality, local materials available, availability of skilled labor, and design. A plan of work during construction should include a building design, site supervision, transportation of local and non-local materials, unskilled labor, and skilled labor. Village health committees with or without government help would be responsible for maintenance of buildings after construction. A key feature of this approach is the assessment of the community's ability and capacity to contribute.
Full Text Available Due to the dual critical shortages of acute care and healthcare workers in resource-limited settings, many people suffer or die from conditions that could be easily treated if existing resources were used in a more timely and effective manner. In order to address this preventable morbidity and mortality, a novel emergency midlevel provider training program was developed in rural Uganda. This is the first study that assesses this unique application of a task-shifting model to acute care by evaluating the outcomes of 10,105 patients.Nurses participated in a two-year training program to become midlevel providers called Emergency Care Practitioners at a rural district hospital. This is a retrospective analysis of the Emergency Department's quality assurance database, including three-day follow-up data. Case fatality rates (CFRs are reported as the percentage of cases with a specific diagnosis that died within three days of their Emergency Department visit.Overall, three-day mortality was 2.0%. The most common diagnoses of patients who died were malaria (n=60, pneumonia (n=51, malnutrition (n=21, and trauma (n=18. Overall and under-five CFRs were as follows: malaria, 2.0% and 1.9%; pneumonia, 5.5% and 4.1%; and trauma, 1.2% and 1.6%. Malnutrition-related fatality (all cases <18 years old was 6.5% overall and 6.8% for under-fives.This study describes the outcomes of emergency patients treated by midlevel providers in a resource-limited setting. Our fatality rates are lower than previously published regional rates. These findings suggest this model of task-shifting can be successfully applied to acute care in order to address the shortage of emergency care services in similar settings as part of an integrated approach to health systems strengthening.
Lwanga, H; Atuyambe, L; Sempewo, H; Lumala, A; Byaruhanga, R N B
Globally, low involvement of men in maternal health care services remains a problem to health care providers and policy makers. Men's support is essential for making women's world better. There are increasing debates among policymakers and researchers on the role of men in maternal health programs, which is a challenge in patriarchal societies like Uganda. The aim of the study was to assess companionship during delivery; men's perception and experiences during pregnancy and delivery. This was a descriptive exploratory study using a qualitative approach. This study involved 16 male participants who were present in the labor room during the delivery of their child. In-depth interviews (IDIs) were the main data collection methods used in the study. Purposive sampling was used to select participants who share particular characteristics with the potential of providing rich, relevant, and diverse data. The interviews were tape-recorded with the permission of the participants; in addition, the interviewer took notes. Each interview lasted between 30 and 45 min. The transcripts were entered into ATLAS.ti for analysis. Manifest content analysis was used. The major themes were; feelings about attending child birth, responsibilities during child birth, positive experiences and negative experiences about child birth. Men are willing to participate in child birth and should be encouraged as many are the decision makers in the family. Admission of men into the delivery room, improves family togetherness. The women felt loved and treasured. The men reported bondage to their partners and new born. Men's involvement in the child birth process was associated with a more perceived bondage with the partner and the newborn. Their presence helped to promote a calm and successful child birth process. Hospitals should work on measures encouraging male involvement.
Farber, S Harrison; Vissoci, Joao Ricardo Nickenig; Tran, Tu M; Fuller, Anthony T; Butler, Elissa K; Andrade, Luciano; Staton, Catherine; Makumbi, Fredrick; Luboga, Samuel; Muhumuza, Christine; Namanya, Didacus B; Chipman, Jeffrey G; Galukande, Moses; Haglund, Michael M
Globally, a staggering five billion people lack access to adequate surgical care. Sub-Saharan Africa represents one of the regions of greatest need. We sought to understand how geographic factors related to unmet surgical need (USN) in Uganda. We performed a geographic information system analysis of a nationwide survey on surgical conditions performed in 105 enumeration areas (EAs) representing the national population. At the district level, we determined the spatial autocorrelation of the following study variables: prevalence of USN, hub distance (distance from EA to the nearest surgical center), area of coverage (geographic catchment area of each center), tertiary facility transport time (average respondent-reported travel time), and care availability (rate of hospital beds by population and by district). We then used local indicators of spatial association (LISA) and spatial regression to identify any significant clustering of these study variables among the districts. The survey enumerated 4248 individuals. The prevalence of USN varied from 2.0-45 %. The USN prevalence was highest in the Northern and Western Regions. Moran's I bivariate analysis indicated a positive correlation between USN and hub distance (p = 0.03), area of coverage (p = 0.02), and facility transport time (p = 0.03). These associations were consistent nationally. The LISA analysis showed a high degree of clustering among sets of districts in the Northern Sub-Region. This study demonstrates a statistically significant association between USN and the geographic variables examined. We have identified the Northern Sub-Region as the highest priority areas for financial investment to reduce this unmet surgical disease burden.
Shumba, Constance Sibongile; Kabali, Kenneth; Miyonga, Jonathan; Mugadu, Jairus; Lakidi, Luke; Kerchan, Patrick; Tumwesigye, Tonny
Client satisfaction surveys are important in evaluating quality of the healthcare processes and contribute to health service improvements by assisting health program managers to develop appropriate strategies. The goal of this study was to assess clients' level of satisfaction with services provided by private-not-for-profit member health facilities affiliated to Uganda Protestant Medical Bureau. This was a cross-sectional descriptive study using an interviewer-administered questionnaire conducted in 254/278 (91%) of UPMB member health facilities between 27th April and 14th July 2014 among 927 clients. The tool measured ten dimensions of the care-seeking experience namely; health facility access; waiting time; health providers; support staff; rights; payments; facilities and environment; consent; confidentiality; and the overall care seeking experience. Logistic regression was utilised for multivariate analysis. Overall client satisfaction was found to be high within the UPMB network (84.2%). Most of the client satisfaction dimensions were rated above 70% except payments and rights. There was evidence of association with marital status; single/never married were 3.05 times more likely to be dissatisfied compared to widowed. Clients attending HCIII were less likely to be dissatisfied compared to those attending HCII (OR=0.51, 95% CI: 0.25-1.05). Post-secondary education (OR=1.79; 95% CI 1.01-3.17), being formally employed (OR=2.78, 95% CI: 0.91-8.48) or unemployed (OR=3.34, 95% CI: 1.00-11.17), attendance at a hospital (OR=2.15, 95% CI: 1.36- 3.41) were also associated with high dissatisfaction levels with payments. This study found a high level of satisfaction with services in the UPMB network but recorded low client satisfaction with the dimensions of rights and payments. Health workers should take time to explain rights and entitlement as well as charges levied to clients.
This thesis examines the socio-economic effects of oil industry on the people of Kabaale Village, Hoima, and Bunyoro region in Uganda. The thesis analyses the current political economy of Uganda and how Uganda is prepared to utilize the proceeds from the oil industry for the development of the country and its people. In addition, the research examines the effects of industry on the people of Uganda by analyzing how the people of Kabaale in Bunyoro region were affected by the plans to construct oil refinery in their region. This field research was done using qualitative methods and the Historical Materialism theoretical framework guided the study. The major findings include; displacement of people from land especially women, lack of accountability from the leadership, and less citizen participation in the policy formulation and oil industry. Ugandans, East Africans and the wider Pan-African world need to re-organize their socio-economic structure to enable people own means of production; participate and form labor organizations. Additionally, there is a need for oil producing African countries to unite and setup and oil fund for resources and investment instead of relying on foreign multinationals or become rentier states.
Nattabi, Barbara; Li, Jianghong; Thompson, Sandra C.; Orach, Christopher G.; Earnest, Jaya
HIV-related stigma continues to persist in several African countries including Uganda. This study quantified the burden of stigma and examined factors associated with stigma among 476 people living with HIV (PLHTV) in Gulu, northern Uganda. Data were collected between February and May 2009 using the HIV/AIDS Stigma Instrument-PLWA. Females more…
This research report traces all the main developments in IMF-World Bank policies in Uganda. Most of the material concerns the three IMF standby arrangements with Uganda for 1981-1984 and the World Bank Group's Structural Adjustment Programmes. These programmes introduced two contradictory policies
United Nations Educational, Scientific and Cultural Organization (UNESCO), 2006
The Building Capacities for Non formal Education and Life Skills Programmes project in Uganda was implemented by Uganda Youth Development Link (UYDEL) with financial and technical support from UNESCO--Section for Literacy and non Formal Education in 2004-05; aiming at assisting vulnerable and marginalised youth affected by HIV/AIDS and other risk…
Basheka, Benon C.; Nabwire, Addah
This paper examines the relationship between budget planning and the quality of educational services at Kyambogo University in Uganda. We argue that the manner in which the university's budget planning activities are conducted determines in a significant way (by 76.8%) the quality of the services offered by public universities in Uganda. The…
This paper explores causes of differences in estimates of poverty incidence in Uganda since the early 1990s as measured by the Uganda Bureau of Statistics and the World Bank. While both sets of estimates from the two organisations show a declining trend in poverty incidence there are important differences in the levels of poverty, the speed of the…
Wokadala, J.; Barungi, M.
The study establishes whether government spending on private universal secondary education (USE) schools is equitable across quintiles disaggregated by gender and by region in Uganda. The study employs benefit incidence analysis tool on the Uganda National Panel Survey (UNPS 2009/10) data to establish the welfare impact of public subsidy on…
Full Text Available Background. Good postoperative analgesic management improves maternal satisfaction and care of the neonate. Postoperative pain management is a challenge in Mulago Hospital, yet ketamine is accessible and has proven benefit. We determined ketamine’s postoperative analgesic effects. Materials and Methods. We did an RCT among consenting parturients that were randomized to receive either intravenous ketamine (0.25 mg/kg or placebo after spinal anesthetic. Pain was assessed every 30 mins up to 24 hours postoperatively using the numerical rating scale. The first complaint of pain requiring treatment was noted as “time to first breakthrough pain.” Results. We screened 100 patients and recruited 88 that were randomized into two arms of 44 patients that received either ketamine or placebo. Ketamine group had 30-minute longer time to first breakthrough pain and lower 24-hour pain scores. Postoperative diclofenac consumption was lesser in the ketamine group compared to placebo and Kaplan-Meier graphs showed a higher probability of experiencing breakthrough pain earlier in the placebo group. Conclusion. Preincision intravenous ketamine (0.25 mg/kg offered 30-minute prolongation to postoperative analgesia requirement with reduced 24-hour pain scores. We recommend larger studies to explore this benefit. This trial is registered with Pan African Clinical Trial Registry number PACTR201404000807178.
Mayega, R W; Wafula, M R; Musenero, M; Omale, A; Kiguli, J; Orach, G C; Kabagambe, G; Bazeyo, W
Most countries in sub-Saharan Africa have not conducted a disaster risk analysis. Hazards and vulnerability analyses provide vital information that can be used for development of risk reduction and disaster response plans. The purpose of this study was to rank disaster hazards for Uganda, as a basis for identifying the priority hazards to guide disaster management planning. The study as conducted in Uganda, as part of a multi-country assessment. A hazard, vulnerability and capacity analysis was conducted in a focus group discussion of 7 experts representing key stakeholder agencies in disaster management in Uganda. A simple ranking method was used to rank the probability of occurance of 11 top hazards, their potential impact and the level vulnerability of people and infrastructure. In-terms of likelihood of occurance and potential impact, the top ranked disaster hazards in Uganda are: 1) Epidemics of infectious diseases, 2) Drought/famine, 3) Conflict and environmental degradation in that order. In terms of vulnerability, the top priority hazards to which people and infrastructure were vulnerable were: 1) Conflicts, 2) Epidemics, 3) Drought/famine and, 4) Environmental degradation in that order. Poverty, gender, lack of information, and lack of resilience measures were some of the factors promoting vulnerability to disasters. As Uganda develops a disaster risk reduction and response plan, it ought to prioritize epidemics of infectious diseases, drought/famine, conflics and environmental degradation as the priority disaster hazards.
Basaza, Robert; Kinegyere, Alison; Mutatina, Boniface; Sewankambo, Nelson
The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies. Documents such as the government reports and unpublished literature were also included in the search. Key informant interviews and a policy dialogue were conducted, and an expert working group guided the study. The KT sustainability issues identified were: the absence of a specific unit within the health sector to coordinate and synthesize research; health worker not familiar with KT activities and not often used. Furthermore, Uganda lacks a mechanism to sustain its current national health frameworks or platforms, and does not have a system to ensure the sustained coordination of existing national health KT platforms. The policy options proposed include: (i) the identification of a KT champion; (ii) the establishment of an operational KT framework; (iii) KT capacity building for researchers and research users, as well as policy and decision makers. The sustainability of KT will be influenced by the prevailing context and concerns within healthcare both in Uganda and internationally. Furthermore, the availability of resources for KT advocacy, communication, and program design will impact on the sustainability of Uganda's KT activities.
Mbonye, Anthony K; Wamala, Joseph F; Nanyunja, Miriam; Opio, Alex; Makumbi, Issa; Aceng, Jane Ruth
There has been a rapid spread of Ebola Viral Hemorrhagic disease in Guinea, Liberia and Sierra Leone since March 2014. Since this is the first time of a major Ebola outbreak in West Africa; it is possible there is lack of understanding of the epidemic in the communities, lack of experience among the health workers to manage the cases and limited capacities for rapid response. The main objective of this article is to share Uganda's experience in controlling similar Ebola outbreaks and to suggest some lessons that could inform the control of the Ebola outbreak in West Africa. The article is based on published papers, reports of previous Ebola outbreaks, response plans and experiences of individuals who have participated in the control of Ebola epidemics in Uganda. Lessons learnt: The success in the control of Ebola epidemics in Uganda has been due to high political support, effective coordination through national and district task forces. In addition there has been active surveillance, strong community mobilization using village health teams and other community resources persons, an efficient laboratory system that has capacity to provide timely results. These have coupled with effective case management and infection control and the involvement of development partners who commit resources with shared responsibility. Several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda. West African countries experiencing Ebola outbreaks could draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic.
Wilson B. Asea
Full Text Available This article formulates a new approach to combating corruption in Uganda. In pursuit of this research, the author highlights the chronicity of corruption in Uganda, which is uniformly political and bureaucratic. Bureaucratic corruption takes place in service delivery and rule enforcement. It has two sides: demand-induced and supply-induced. Political corruption occurs at high levels of politics. There are ‘political untouchables’ and businessmen who are above the law and above institutional control mechanisms. The established institutions of checks and balances in Uganda have assiduously continued to have a limited bearing on corruption. Neither coherent anti-corruption norms nor severe formal sanctions are able to dishearten certain politicians and civil servants in Uganda from the deviant behaviour of structural corruption. Corruption is a spiritual departure from the law and standard of God. It is an action conceived in the human mind and carried out by the corrupt. Therefore, corruption deterrence not only lies in sound public financial management systems but depends to a large extent on having people with positive human character in all aspects of national life. This article thus provides the framework of corruption and discusses the manifestation of political and bureaucratic corruption in Uganda. It also exegetes the biblical stance regarding corruption. Finally, it proposes a panacea for combating political and bureaucratic corruption.
Heum, Per; Mwakali, Jackson A.; Ekern, Ole Fredrik; Byaruhanga, Jackson N.M.; Koojo, Charles A.; Bigirwenkya, Naptali K.
In realization of the petroleum industry potential, Uganda's Oil and Gas policy seeks to optimize wealth creation from the industry to enhance the welfare of the citizens. This study has examined how Uganda may benefit from the participation of Ugandans and Ugandan firms in the petroleum activities. In the literature this is frequently referred to by applying the term local content. Local in this sense, however, refers to national as opposed to international or foreign contributions. Thus, we apply the concept national content to avoid any misunderstanding. Focus of our study has been on identifying the opportunities, gaps and challenges posed by the petroleum industry to recommend necessary measures to maximize the benefits of national content otherwise defined as national participation.The study has examined lessons Uganda may draw on from other countries and from the economic literature on industrial growth and national wealth. Furthermore, the specific point of departure for Uganda with regard to expected petroleum activities, Uganda's industrial base and its human resource base, has been investigated. On this basis, the study has made its recommendations.(eb)
Catrina A MacKenzie
Full Text Available Approximately 2.5 billion barrels of commercially-viable oil, worth $2 billion in annual revenue for 20 years, were discovered under the Ugandan portion of the Albertine Rift in 2006. The region also contains seven of Uganda's protected areas and a growing ecotourism industry. We conducted interviews and focus groups in and around Murchison Falls Protected Area, Uganda's largest, oldest, and most visited protected area, to assess the interaction of oil exploration with the three primary conservation policies employed by Uganda Wildlife Authority: protectionism, neoliberal capital accumulation, and community-based conservation. We find that oil extraction is legally permitted inside protected areas in Uganda, like many other African countries, and that the wildlife authority and oil companies are adapting to co-exist inside a protected area. Our primary argument is that neoliberal capital accumulation as a conservation policy actually makes protected areas more vulnerable to industrial exploitation because nature is commodified, allowing economic value and profitability of land uses to determine how nature is exploited. Our secondary argument is that the conditional nature of protected area access inherent within the protectionist policy permits oil extraction within Murchison Falls Protected Area. Finally, we argue that community-based conservation, as operationalized in Uganda, has no role in defending protected areas against oil industrialisation.
Full Text Available Recent studies reveal that teachers are more likely to engage in high-risk sexual behavior compared to the rest of the adult population. Yet the education sector could be a major vehicle for imparting knowledge and skills of avoiding and/or coping with the pandemic. This study set out to establish HIV risk behaviors among teachers in Uganda, to inform the design of a behavior change communication strategy for HIV prevention among teachers. It was a cross sectional rapid assessment conducted among primary and secondary school teachers in Kampala and Kalangala districts, in Uganda. A total of 183 teachers were interviewed. HIV risk behavior, in this study was measured as having multiple sexual partners and/or sex with a partner of unknown status without using a condom. We also considered transactional/sex for favors and alcohol use as exposures to HIV risk behavior. Odds ratios (OR and their corresponding 95% confidence intervals (CI were calculated. All data analysis was performed using SPSS version 17.0 and EPI Info Version 3.5.1. Forty five per cent of teachers reported having multiple concurrent sexual partners in the last three months, of these, only 24% acknowledged having used a condom at their last sexual encounter yet only 9.8% knew their partners’ HIV status. Teachers below 30years of age were more likely to have two or more concurrent sexual partners (OR 2.6, CI 1.31-5.34 compared to those above 30 years. Primary school teachers were less likely to involve with partners of unknown HIV status compared to secondary school teachers (OR 0.43, CI 0.19-0.97. Teachers aged below 30 years were also more likely to engage with partners of unknown HIV status compared to those above 30 years (OR 2.47, CI 1.10-5.59. Primary teachers were also less likely to have given or received gifts, money or other favors in exchange for sex (OR 0.24, CI 0.09-0.58. Teachers engage in risky sexual behaviors, which lead to HIV infection. There is need to promote
Farmer, Jenny; Langan, Charlie; Gimona, Alessandro; Poggio, Laura; Smith, Jo
Land use change in Uganda's wetlands has received very little research attention. Peat soils dominate the papyrus wetlands of the south west of the country, but the areas they are found in have been increasingly converted to potato cultivation. Our research in Uganda set out to (a) document both the annual use of and changes to these soils under potato cultivation, and (b) the extent and condition of these soils across wetland systems. During our research we found it was necessary to develop locally appropriate protocols for sampling and analysis of soil characteristics, based on field conditions and locally available resources. Over the period of one year we studied the use of the peat soil for potato cultivation by smallholder farmers in Ruhuma wetland and measured changes to surface peat properties and soil nutrients in fields over that time. Farmer's use of the fields changed over the year, with cultivation, harvesting and fallow periods, which impacted on soil micro-topography. Measured soil properties changed over the course of the year as a result of the land use, with bulk density, nitrogen content, potassium and magnesium all reducing. Comparison of changes in soil carbon stocks over the study period were difficult to make as it was not possible to reach the bottom of the peat layer. However, a layer of fallow weeds discarded onto the soil prior to preparation of the raised potato beds provided a time marker which gave insight into carbon losses over the year. To determine the peatland extent, a spatial survey was conducted in the Kanyabaha-Rushebeya wetland system, capturing peat depths and key soil properties (bulk density, organic matter and carbon contents). Generalised additive models were used to map peat depth and soil characteristics across the system, and maps were developed for these as well as drainage and land use classes. Comparison of peat cores between the two study areas indicates spatial variability in peat depths and the influence of
Full Text Available Self-medication with antimicrobial agents is a common form of self-care among patients globally with the prevalence and nature differing from country to country. Here we assessed the prevalence and predictors of antimicrobial self-medication in post-conflict northern Uganda. A cross-sectional study was carried out using structured interviews on 892 adult (≥18 years participants. Information on drug name, prescriber, source, cost, quantity of drug obtained, and drug use was collected. Households were randomly selected using multistage cluster sampling method. One respondent who reported having an illness within three months in each household was recruited. In each household, information was obtained from only one adult individual. Data was analyzed using STATA at 95% level of significance. The study found that a high proportion (75.7% of the respondents practiced antimicrobial self-medication. Fever, headache, lack of appetite and body weakness were the disease symptoms most treated through self-medication (30.3%. The commonly self-medicated antimicrobials were coartem (27.3%, amoxicillin (21.7%, metronidazole (12.3%, and cotrimoxazole (11.6%. Drug use among respondents was mainly initiated by self-prescription (46.5% and drug shop attendants (57.6%. On average, participants obtained 13.9±8.8 (95%CI: 12.6-13.8 tablets/capsules of antimicrobial drugs from drug shops and drugs were used for an average of 3.7±2.8 days (95%CI: 3.3-3.5. Over half (68.2% of the respondents would recommend self-medication to another sick person. A high proportion (76% of respondents reported that antimicrobial self-medication had associated risks such as wastage of money (42.1%, drug resistance (33.2%, and masking symptoms of underlying disease (15.5%. Predictors of self-medication with antimicrobial agents included gender, drug knowledge, drug leaflets, advice from friends, previous experience, long waiting time, and distance to the health facility. Despite
Full Text Available Abstract Background While the association of human papillomavirus (HPV with cervical cancer is well established, the influence of HIV on the risk of this disease in sub-Saharan Africa remains unclear. To assess the risk of invasive cervical carcinoma (ICC associated with HIV and HPV types, a hospital-based case-control study was performed between September 2004 and December 2006 in Kampala, Uganda. Incident cases of histologically-confirmed ICC (N=316 and control women (N=314, who were visitors or care-takers of ICC cases in the hospital, were recruited. Blood samples were obtained for HIV serology and CD4 count, as well as cervical samples for HPV testing. HPV DNA detection and genotyping was performed using the SPF10/DEIA/LiPA25 technique which detects all mucosal HPV types by DEIA and identifies 25 HPV genotypes by LiPA version 1. Samples that tested positive but could not be genotyped were designated HPVX. Odds ratios (OR and 95% confidence intervals (CI were calculated by logistic regression, adjusting for possible confounding factors. Results For both squamous cell carcinoma (SCC and adenocarcinoma of the cervix, statistically significantly increased ORs were found among women infected with HPV, in particular single HPV infections, infections with HPV16-related types and high-risk HPV types, in particular HPV16, 18 and 45. For other HPV types the ORs for both SCC and adenocarcinoma were not statistically significantly elevated. HIV infection and CD4 count were not associated with SCC or adenocarcinoma risk in our study population. Among women infected with high-risk HPV types, no association between HIV and SCC emerged. However, an inverse association with adenocarcinoma was observed, while decrease in CD4 count was not associated with ICC risk. Conclusions The ORs for SCC and adenocarcinoma were increased in women infected with HPV, in particular single HPV infections, infections with HPV16- and 18-related types, and high-risk HPV types
Coleman Paul G
Full Text Available Abstract Background Zoonotic sleeping sickness, or HAT (Human African Trypanosomiasis, caused by infection with Trypanosoma brucei rhodesiense, is an under-reported and neglected tropical disease. Previous assessments of the disease burden expressed as Disability-Adjusted Life Years (DALYs for this infection have not distinguished T.b. rhodesiense from infection with the related, but clinically distinct Trypanosoma brucei gambiense form. T.b. rhodesiense occurs focally, and it is important to assess the burden at the scale at which resource-allocation decisions are made. Methods The burden of T.b. rhodesiense was estimated during an outbreak of HAT in Serere, Uganda. We identified the unique characteristics affecting the burden of rhodesiense HAT such as age, severity, level of under-reporting and duration of hospitalisation, and use field data and empirical estimates of these to model the burden imposed by this and other important diseases in this study population. While we modelled DALYs using standard methods, we also modelled uncertainty of our parameter estimates through a simulation approach. We distinguish between early and late stage HAT morbidity, and used disability weightings appropriate for the T.b. rhodesiense form of HAT. We also use a model of under-reporting of HAT to estimate the contribution of un-reported mortality to the overall disease burden in this community, and estimate the cost-effectiveness of hospital-based HAT control. Results Under-reporting accounts for 93% of the DALY estimate of rhodesiense HAT. The ratio of reported malaria cases to reported HAT cases in the same health unit was 133:1, however, the ratio of DALYs was 3:1. The age productive function curve had a close correspondence with the HAT case distribution, and HAT cases occupied more patient admission time in Serere during 1999 than all other infectious diseases other than malaria. The DALY estimate for HAT in Serere shows that the burden is much greater
Luboga, Sam; Hagopian, Amy; Ndiku, John; Bancroft, Emily; McQuide, Pamela
Uganda faces a colossal shortages of human resources for health. Previous literature has largely focused on those who leave. This paper reports on a study of physicians working in 18 public and private facilities in Uganda as part of a larger study of more than 641 hospital-based health workers in Uganda. We report what could entice physicians to stay longer, satisfaction with current positions, and future career intentions. This study took place in 18 Ugandan hospitals. We describe the 49 physicians who participated in 11 focus groups and the 63 physicians who completed questionnaires, out of a larger sample of 641 health workers overall. Only 37% of physicians said they were satisfied with their jobs, and 46% reported they were at risk of leaving the health sector or the country. After compensation, the largest contributors to dissatisfaction among physicians were quality of management, availability of equipment and supplies (including drugs), quality of facility infrastructure, staffing and workload, political influence, community location, and professional development. Physicians in our study were highly dissatisfied, with almost half the sample reporting a risk to leave the sector or the country. The established link in literature between physician dissatisfaction and departure from the health system suggests national and regional policy makers should consider interventions that address the contributors to dissatisfaction identified in our study. Copyright © 2010 John Wiley & Sons, Ltd.
Greater involvement of HIV-infected peer-mothers in provision of reproductive health services as "family planning champions" increases referrals and uptake of family planning among HIV-infected mothers.
Mudiope, Peter; Musingye, Ezra; Makumbi, Carolyne Onyango; Bagenda, Danstan; Homsy, Jaco; Nakitende, Mai; Mubiru, Mike; Mosha, Linda Barlow; Kagawa, Mike; Namukwaya, Zikulah; Fowler, Mary Glenn
In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic. The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification and referral of HIV Positive mothers in need of FP services; and accompanied referred mothers to FP clinics. We compiled and compared the average proportions of mothers in need that were referred and took up FP in the pre-intervention (3 months), intervention (6 months), and post-intervention(3 months) periods using interrupted time series with segmented regression models with an autoregressive term of one. Overall, during the intervention, the proportion of referred mothers in need of FP increased by 30.4 percentage points (P family planning can be a valuable addition to clinic staff in limited-resource settings. The study provides additional evidence on the utilization of peer mothers in HIV care, improves health services uptake including family planning which is a common practice in many donor supported programs. It also provides evidence that may be used to advocate for policy revisions in low-income countries to include peers as support staff especially in busy clinic settings with poor services uptake.
Mbonye, Anthony K; Clarke, Sîan E; Lal, Sham
BACKGROUND: Malaria is a major public health problem in Uganda and the current policy recommends introduction of rapid diagnostic tests for malaria (RDTs) to facilitate effective case management. However, provision of RDTs in drug shops potentially raises a new set of issues, such as adherence...... to RDTs results, management of severe illnesses, referral of patients, and relationship with caretakers. The main objective of the study was to examine the impact of introducing RDTs in registered drug shops in Uganda and document lessons and policy implications for future scale-up of malaria control...... in the private health sector. METHODS: A cluster-randomized trial introducing RDTs into registered drug shops was implemented in central Uganda from October 2010 to July 2012. An evaluation was undertaken to assess the impact and the processes involved with the introduction of RDTs into drug shops, the lessons...
Engebretsen, Ingunn Marie Stadskleiv; Tylleskär, Thorkild; Wamani, Henry; Karamagi, Charles; Tumwine, James K
Child under-nutrition is a leading factor underlying child mortality and morbidity in Sub-Saharan Africa. Several studies from Uganda have reported impaired growth, but there have been few if any community-based infant anthropometric studies from Eastern Uganda. The aim of this study was to describe current infant growth patterns using WHO Child Growth Standards and to determine the extent to which these patterns are associated with infant feeding practices, equity dimensions, morbidity and use of primary health care for the infants. A cross-sectional survey of infant feeding practices, socio-economic characteristics and anthropometric measurements was conducted in Mbale District, Eastern Uganda in 2003; 723 mother-infant (0-11 months) pairs were analysed. Infant anthropometric status was assessed using z-scores for weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age (WAZ). Dependent dichotomous variables were constructed using WLZ growth among Ugandan infants.
Denis Rwabiita Mugizi
Full Text Available Brucellosis is endemic in livestock and humans in Uganda and its transmission involves a multitude of risk factors like consumption of milk from infected cattle. To shed new light on the epidemiology of brucellosis in Uganda the present study used phenotypic and molecular approaches to delineate the Brucella species, biovars, and genotypes shed in cattle milk. Brucella abortus without a biovar designation was isolated from eleven out of 207 milk samples from cattle in Uganda. These isolates had a genomic monomorphism at 16 variable number tandem repeat (VNTR loci and showed in turn high levels of genetic variation when compared with other African strains or other B. abortus biovars from other parts of the world. This study further highlights the usefulness of MLVA as an epidemiological tool for investigation of Brucella infections.
Anying, Irene Winnie; Gausset, Quentin
Northern Uganda has been plagued by a long and violent civil war that lasted from 1996 to 2006, during which 2.5 million people were internally displaced and placed in camps. During the conflict, Uganda adopted a new constitution and a new land act that recognised customary land tenure and the role...... played by customary institutions in resolving land disputes. Following the cessation of hostilities in 2006, people began to go back “home”, and many land conflicts ensued. Because women are generally considered as particularly vulnerable in land conflicts, they have received much attention from...... the Ugandan government, international donors, and NGOs. This article focuses on how women make use of the existing legal pluralism in Uganda to defend their interests in land disputes. It argues that land conflicts are often proxies of social conflicts, which play a major role in women's opting for customary...
Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus
BACKGROUND: Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality...... of care in the private sector that provides almost a half of health services in Uganda. METHODS: A survey was conducted from August to October 2014 within 57 parishes in Mukono district, central Uganda. The selected parishes had a minimum of 200 households and at least one registered drug shop, pharmacy...... the factors that most influenced correct treatment of fever in pregnancy. CONCLUSION: Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health sector...
Basañez, Irving; Nakku, Doreen; Stangl, Susan; Wanna, George B
Hearing loss in children is a common entity worldwide. We examined the prevalence and etiology of hearing loss among primary school children in Mbarara, Uganda. Cross-sectional study in primary school children aged 5-14 was performed to determine the prevalence of hearing loss. Ugandan primary school children were screened for disabling hearing loss (threshold >30dB) and confirmatory audiometry was performed on those who failed the screening. There were 639 children screened. Thirty-five (5.5%) of children screened failed and were referred for further testing. Two children were lost to follow-up. The percentage of children with true hearing loss was 3.1%. The incidence of failed hearing screening and hearing loss in Mbarara, Uganda is similar to other populations. Hearing loss is a significant problem in Uganda and efforts should be made for primary, secondary, and tertiary prevention of hearing loss. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Samson Omuudu OTENGEI
Full Text Available The study investigates the key determinants of brand loyalty in full service restaurants in Uganda. The study used a quantitative research approach and adopted a cross sectional correlation survey design to test the study hypotheses. A total of 348 completed questionnaires collected from 116 restaurants were used in the analysis. To the best of our knowledge, this is the first study to propose a model that examines the key determinants of brand loyalty in full service restaurants in Uganda. The findings from the study revealed that dining experience and restaurant image were significant predictors of brand loyalty in full service restaurants in Uganda and customer satisfaction was not a significant predictor of guest loyalty. Despite its managerial implications, several limitations of the study call for further empirical enquiry.
Lassen Kaspersen, Line; Føyn, Tullik Helene Ystanes
This paper investigates price transmission for agricultural commodities between world markets and the Ugandan market in an attempt to determine the impact of world market prices on the Ugandan market. Based on the realization that price formation is not a static concept, a dynamic vector...... price relations, i.e. the price variations between geographically separated markets in Uganda and the world markets. Our analysis indicates that food markets in Uganda, based on our study of sorghum price transmission, are not integrated into world markets, and that oil prices are a very determining...... autoregressive (VAR) model is presented. The prices of Robusta coffee and sorghum are examined, as both of these crops are important for the domestic economy of Uganda – Robusta as a cash crop, mainly traded internationally, and sorghum for consumption at household level. The analysis focuses on the spatial...
Andrea A Kim
Full Text Available Several approaches have been used for measuring HIV incidence in large areas, yet each presents specific challenges in incidence estimation.We present a comparison of incidence estimates for Kenya and Uganda using multiple methods: 1 Epidemic Projections Package (EPP and Spectrum models fitted to HIV prevalence from antenatal clinics (ANC and national population-based surveys (NPS in Kenya (2003, 2007 and Uganda (2004/2005; 2 a survey-derived model to infer age-specific incidence between two sequential NPS; 3 an assay-derived measurement in NPS using the BED IgG capture enzyme immunoassay, adjusted for misclassification using a locally derived false-recent rate (FRR for the assay; (4 community cohorts in Uganda; (5 prevalence trends in young ANC attendees. EPP/Spectrum-derived and survey-derived modeled estimates were similar: 0.67 [uncertainty range: 0.60, 0.74] and 0.6 [confidence interval: (CI 0.4, 0.9], respectively, for Uganda (2005 and 0.72 [uncertainty range: 0.70, 0.74] and 0.7 [CI 0.3, 1.1], respectively, for Kenya (2007. Using a local FRR, assay-derived incidence estimates were 0.3 [CI 0.0, 0.9] for Uganda (2004/2005 and 0.6 [CI 0, 1.3] for Kenya (2007. Incidence trends were similar for all methods for both Uganda and Kenya.Triangulation of methods is recommended to determine best-supported estimates of incidence to guide programs. Assay-derived incidence estimates are sensitive to the level of the assay's FRR, and uncertainty around high FRRs can significantly impact the validity of the estimate. Systematic evaluations of new and existing incidence assays are needed to the study the level, distribution, and determinants of the FRR to guide whether incidence assays can produce reliable estimates of national HIV incidence.
Kiguli, Sarah; Mubuuke, Roy; Baingana, Rhona; Kijjambu, Stephen; Maling, Samuel; Waako, Paul; Obua, Celestino; Ovuga, Emilio; Kaawa-Mafigiri, David; Nshaho, Jonathan; Kiguli-Malwadde, Elsie; Bollinger, Robert; Sewankambo, Nelson
Uganda, like the rest of Africa, is faced with serious health challenges including human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS), other infectious diseases and increasing non-communicable diseases, yet it has a significant shortage of health workers. Even the few health workers available may lack desired competencies required to address current and future health challenges. Reducing Uganda's disease burden and addressing health challenges requires Ugandan medical schools to produce health workers with the necessary competencies. This study describes the process which a consortium of Ugandan medical schools and the Medical Education Partnership for Equitable Services to all Ugandans (MESAU) undertook to define the required competencies of graduating doctors in Uganda and implement competency-based medical education (CBME). A retrospective qualitative study was conducted in which document analysis was used to collect data employing pre-defined checklists, in a desktop or secondary review of various documents. These included reports of MESAU meetings and workshops, reports from individual institutions as well as medical undergraduate curricula of the different institutions. Thematic analysis was used to extract patterns from the collected data. MESAU initiated the process of developing competencies for medical graduates in 2011 using a participatory approach of all stakeholders. The process involved consultative deliberations to identify priority health needs of Uganda and develop competencies to address these needs. Nine competence domain areas were collaboratively identified and agreed upon, and competencies developed in these domains. Key successes from the process include institutional collaboration, faculty development in CBME and initiating the implementation of CBME. The consortium approach strengthened institutional collaboration that led to the development of common competencies desired of all medical graduates to
Mulisya, Olivier; Roberts, Drucilla J.; Sengupta, Elizabeth S.; Agaba, Elly; Laffita, Damaris; Tobias, Tusabe; Mpiima, Derrick Paul; Henry, Lugobe; Augustine, Ssemujju; Abraham, Masinda; Hillary, Twizerimana; Mugisha, Julius
Objective. We sought to determine the prevalence of and factors associated with hydatidiform molar gestations amongst patients undergoing uterine evacuation at Mbarara Regional Referral Hospital (MRRH), Mbarara, Uganda. Methods. This was a cross-sectional study carried out from November 2016 to February 2017. All patients admitted for uterine evacuation for nonviable pregnancy were included. The study registered 181 patients. Data were collected on sociodemographics, medical conditions, obste...
Groundnuts (Arachis hypogaea L.) are on high demand in Uganda. There is, therefore, an urgent need to improve groundnut yields through breeding. The main objectives besides yield are the following: 1. To improve disease resistance: (a) rosette virus transmitted by aphids (Aphis craccivora); (b) leafspot caused by Cercospora arachidicola (early) and Cercosporidium personatum (late). 2. To advance the maturity period of high yielding varieties so as to fit better into the rainfall pattern of the main growing areas. 3. To improve seed uniformity, seed size and quality (protein, oil). 4. To reduce plant height by shortening the internodes so as to have more flower production near the ground. For mutation breeding three erect groundnut cultivars were used, Roxo a recommended commercial variety; Red Beauty (Bl) a recommended local variety and No. 534 a tan skinned variety. Seeds of the three varieties were irradiated in 1976 at the FAO/IAEA Agricultural Section of the IAEA Laboratory Seibersdorf, with 1500 rad of fast neutrons (Nf) or 20 krad of 60 Co gamma rays. The pedigree method of selection was used until M9. During 1985 and 1986, seven mutant selections of Red Beauty and one from Roxo were tested in replicated yield trials. Results are given. On the basis of plot yields some of the Red Beauty mutant lines outyielded the parent but not the commercial variety Roxo
Henry Mwanaki Alinaitwe
Full Text Available Engaging in lean construction efforts could prove to be highly rewarding for building firms in Uganda. However, lean construction is risky and can be disastrous if not properly managed. Lean production efforts in some other countries have not been successful due to the many barriers to its successful implementation. To enable sound lean construction efforts and to increase the chances of success in eliminating waste, a thorough investigation of the barriers is essential. This study presents 31 barriers and investigates their influence (strength on the success of lean construction initiatives. Structured interviews were carried out with technical managers of building firms to assess their perception of the barriers to lean production based on their experience at their firms. The strongest barrier is the provision of inputs exactly when required. Additionally, the barriers were ranked according to the ease of overcoming each. The easiest barrier to overcome is keeping the required items in the right place. Finally, a graphical aid is provided to enable decision makers to concentrate their efforts on the influential (strong, yet easy to overcome barriers. A lack of buildable designs and a participative management style for the workforce are the most important barriers to successful waste reduction in terms of strength and ease of overcoming. On the other hand, a lack of an organisational culture that supports teamwork, a lack of prefabrication and a lack of knowledgeable and skilled workers are regarded as low in strength, and at the same time difficult to overcome.
OVUGA, EMILIO; BOARDMAN, JED; WASSERMAN, DANUTA
There is little information on the current mental health of University students in Uganda. The present study was carried out to determine the prevalence of depressed mood and suicidal ideation among students at Makerere University. Two student samples participated. Sample I comprised 253 fresh students admitted to all faculties at the University in the academic year 2000/2001, selected by a simple random sampling procedure. Sample II comprised 101 students admitted to the Faculty of Medicine during the academic year 2002/2003. The prevalence of depressed mood was measured using the 13-item Beck Depression Inventory (BDI). The prevalence of depressed mood (BDI score 10 or more) was significantly higher in sample I (16.2%) than sample II (4.0%). Sample I members were significantly more likely than those of sample II to report lifetime and past week suicide ideation. Thus, there is a high prevalence of mental health problems among the general population of new students entering Makerere University and this is significantly higher than for new students in the Faculty of Medicine. PMID:16757997
Nyenje, P. M.; Havik, J.; Foppen, J. W.; Uhlenbrook, S.
Groundwater in unsewered urban areas is heavily contaminated by onsite sanitation activities and is believed to be an important source of nutrients ex-filtrating into streams and thus contributing to eutrophication of Lakes in urban areas. Currently the fate of nutrients and especially phosphorus leached into groundwater in such areas is not well known. In this study, we undertook an extensive investigation of groundwater in Bwaise slum, Kampala Uganda to understand the distribution and fate of sanitation-related nutrients N and P that are leached into groundwater. Transects of monitoring wells were installed in Bwaise slum and downstream of the slum. From these wells, water levels were measured and water quality analyses done to understand the distribution and composition of the nutrients, how they evolve downstream and the possible subsurface processes affecting their fate during transport. These findings are necessary to evaluate the risk of eutrophication posed by unsewered areas in urban cities and to design/implement sanitation systems that will effectively reduce the enrichment of these nutrients in groundwater. Key words: fate, groundwater, nutrients, processes, slums
Full Text Available Since the rise to power of the Movement government under the leadership of Yoweri Museveni in 1986, Uganda has largely been show-cased as an emerging democracy on the continent. Among other things, Museveni's regime has been acclaimed for the restoration of periodic national elections, the making of the Constitution and the overall promotion of democratic governance, most especially through the adoption of a decentralised system with a commendable institutional and legal framework. Decentralisation is believed to promote service delivery at the local level, accountability for government resources by local leaders, and the involvement of the masses in local planning and the implementation of government programmes. It is now over twenty years since decentralisation was adopted as a system of government but the quality of service delivery and the accountability for government resources at the local level remains just as deplorable as the extent to which the masses are involved in the planning and implementation of government programmes in their localities. This paper examines the challenges that inhibit the realisation of the noble objectives of decentralisation, notwithstanding the apparently impressive institutional and legal framework.
Parsons Thomas D
Full Text Available Abstract Background Few studies have examined cognitive functioning of HIV positive patients in sub-Saharan Africa. It cannot be assumed that HIV positive patients in Africa exhibit the same declines as patients in high-resource settings, since there are differences that may influence cognitive functioning including nutrition, history of concomitant disease, and varying HIV strains, among other possibilities. Part of the difficulty of specifying abnormalities in neuropsychological functioning among African HIV positive patients is that there are no readily available African normative databases. The purpose of the current study was to evaluate the pattern of neuropsychological performance in a sample of HIV positive patients in comparison to HIV negative control subjects in Uganda. Methods The neuropsychological test scores of 110 HIV positive patients (WHO Stage 2, n = 21; WHO Stage 3, n = 69; WHO Stage 4, n = 20 were contrasted with those of 100 control subjects on measures of attention/concentration, mental flexibility, learning/memory, and motor functioning. Results Analysis of covariance (ANCOVA revealed significant group differences on measures of verbal learning and memory, speed of processing, attention and executive functioning between HIV seropositive and seronegative subjects. Conclusion Ugandan patients with HIV demonstrated relative deficits on measures of verbal learning and memory, speed of processing, attention, and executive functioning compared to HIV negative controls. These results from a resource limited region where clades A and D are prevalent are consistent with previous findings in the developed world where clade B predominates.
Up to June 1974 areas in Uganda totalling 8600km 2 have been successfully reclaimed from tsetse fly infestation by ground spray of 3% dieldrin water emulsions. A search for equally effective but less persistent and toxic compounds against tsetse flies has been unsuccessful. Fourteen insecticide formulations have been tested for their persistence on tree bark surfaces and, therefore, their availability and toxicity to the target tsetse flies. Only those compounds with a high immediate insecticidal activity (some higher than dieldrin) like endosulfan, Chlorfenvinphos and propoxur could merit further consideration in tsetse control. While some were toxic to tsetse as fresh deposits, they lacked sufficient persistence. A study of the environmental implication from the continued use of the highly persistent and toxic dieldrin has provided useful data on residues likely to be found both in terrestrial and aquatic fauna and flora. These are generally low. Moreover, there is evidence of degradation in some fish species (Protopterus aethiopicus and Clarias). Also, dilution factors and adsorption involving the muddy nature of water run-off, etc., and controlled burning of grasses after tsetse eradication would tend to inactivate the residual insecticide and protect aquatic systems. The general findings have indicated less risk than anticipated of the environmental contamination from tsetse control by application of persistent and toxic insecticides. (author)
Full Text Available Uganda lies almost wholly within the Nile Basin and is a country characterised as well-endowed with water resources. Receiving considerable inflows of aid since the early 1990s, some of this aid emerging after the 1992 Earth Summit in Rio de Janeiro enabled the country to begin a process of Integrated Water Resources Management (IWRM, taking the lead from Chapter 18 of Agenda 21. With a focus on more comprehensively managing the country’s critical water endowment amidst growing pressure on the resource, bilateral technical assistance and financial support played a large part in backstopping these national efforts. Nevertheless, in spite of this support and government backing, some two decades later implementation on the ground remains thin and the exercise of IWRM in practice is limited. This paper examines the Ugandan IWRM experience and identifies complex political-economy issues lying at the heart of current challenges. It argues that rarely is there likely to be an easy fix to sustainable financing and suggests the need for stronger citizen engagement and buy-in to the wider logic of IWRM to support longer-term effectiveness and sustainability.
Christensen, David; Drysdale, David; Hansen, Kenneth; Vanhille, Josefine; Wolf, Andreas
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. © The Author(s) 2014.
Kanyamurwa, J M; Ampek, G T
AIDS has been reported in Africa to push households into poverty and chronic food insecurity. At the same time there are reports of significant household resilience to AIDS. This study explored how a mature epidemic in rural Uganda has affected rural farming households. It focused on gender differences in the experience of AIDS and, in particular, household capabilities to sustain livelihoods. The study compared the vulnerability of male- and female-headed households in relation to their ability to mitigate human resource losses, as well as their access to natural and physical resources, to social networks and to finance capital for production. The findings suggest that when rural households are affected by AIDS, depleting productive resources and directing resources towards immediate needs, there are gender differences in responses to, and in impacts of, the epidemic due to the different resources available to male- and female- headed households. Female-headed households were found to be more vulnerable to AIDS than male-headed counterparts. Women's remarriage opportunities were lower than men's, they faced greater risk of losing control over land and livestock and they accessed less state and private sector support. Women-headed households were more dependent on livelihood support from non-governmental organizations, which were found to provide both welfare and credit support to female-headed households affected by AIDS. Women were found to play an important role in social networks and resources at community level but themselves received little support from many formal community networks and services.
In 1996, an 18-month-old settlement created for 55,000 Sudanese refugees in northern Uganda came under attack by Ugandan rebels. By March 1997, the entire population of the settlement had migrated in search of safety. Because the refugees lost their livelihoods and cultivated fields, they had to adopt short-term coping strategies to acquire food. Two Oxfam researchers gathering information during this period for use in program planning and monitoring found that coping strategies included 1) hazarding dangerous journeys (women risked rape or abduction; men risked beating, looting, killing, or abduction) to harvest crops; 2) seeking piece-work employment; 3) exchanging sex for food; and 4) depleting assets. The crisis was particularly severe for single people (especially those with children). In families where the women but not the men could find employment, some men took on household responsibilities. As malnutrition increased, health declined. Observed changes to household gender relations included new sexual divisions of labor, assumption by females of decision-making power, increased domestic quarreling, and marital break-down (especially in cases where women had been raped). On the community level, women assumed more responsibility as men withdrew socially or left the settlement. These findings point to the importance of providing refugees with seeds, with small loans to stimulate business, and with the means to rebuild their sense of community.
Negin, Joel; Geddes, Louise; Brennan-Ing, Mark; Kuteesa, Monica; Karpiak, Stephen; Seeley, Janet
Sexual behavior among older adults with HIV in Sub-Saharan Africa has been understudied despite the burgeoning of this population. We examined sexual behavior among older adults living with HIV in Uganda. Participants were eligible for the study if they were 50 years of age or older and living with HIV. Quantitative data were collected through face-to-face interviews, including demographic characteristics, health, sexual behavior and function, and mental health. Of respondents, 42 were men and 59 women. More than one-quarter of these HIV-positive older adults were sexually active. A greater proportion of older HIV-positive men reported being sexually active compared to women (54 vs. 15%). Among those who are sexually active, a majority never use condoms. Sixty-one percent of men regarded sex as at least somewhat important (42%), while few women shared this opinion (20%). Multivariate logistic regression analyses revealed that odds of sexual activity in the past year were significantly increased by the availability of a partner (married/cohabitating), better physical functioning, and male gender. As more adults live longer with HIV, it is critical to understand their sexual behavior and related psychosocial variables in order to improve prevention efforts.
Full Text Available Abstract Background The population in Northern Uganda has been exposed to extreme levels of traumatic stress and thousands abducted forcibly became rebel combatants. Methods Using structured interviews, the prevalence and severity of posttraumatic stress disorder (PTSD, depression and anxiety was assessed in 72 former abducted adults, 62 of them being former child soldiers. Results As retrospective reports of exposure to traumatic stress increased, anxiety and PTSD occurrence increased (r = .45. 49% of respondents were diagnosed with PTSD, 70% presented with symptoms of depression, and 59% with those of anxiety. In a multiple linear regression analysis four factors could best explain the development of PTSD symptoms: male respondents (sex living in an IDP-Camp (location with a kinship murdered in the war (family members killed in the war and having experienced a high number of traumatic events (number of traumatic events were more likely to develop symptoms of PTSD than others. In disagreement to a simple dose-response-effect though, we also observed a negative correlation between the time spent with the rebels and the PTSD symptom level. Conclusions Former abductees continue to suffer from severe mental ill-health. Adaptation to the living condition of rebels, however, may lower trauma-related mental suffering.
Mbule, Marjorie A; Byaruhanga, Yusuf B; Kabahenda, Magaret; Lubowa, Abdulrahman
In spite of intervention efforts, in Uganda, as in other developing countries, high levels of anaemia among pregnant women continue. Anaemia among women of reproductive age (15-49 years) is a matter of national concern. This study was carried out to assess determinants of anaemia in Kiboga district. This was a single cross-sectional, descriptive survey. The anaemia status of the pregnant women was determined by measuring their haemoglobin levels. Possible determinant factors including socio-economic characteristics, knowledge, attitudes, practices and food intake were assessed using a structured questionnaire. Results showed that the prevalence of anaemia among pregnant women in Kiboga district was high enough (63.1%) to be described as a severe public health problem. The uptake and utilisation of the public-health intervention package to combat anaemia in pregnancy was low, with iron/folic acid supplementation at 13.2%, use of intermittent preventive treatment of malaria 45.4%, and use of de-worming medicines 14.5%. Women from households without a functional radio were 2.07 times more likely be anaemic (95%CI, 1.08-3.00) compared with women from households where there was a functional radio. There was little awareness and functional knowledge about anaemia among pregnant women. The high prevalence of anaemia observed in Kiboga district can be attributed to poverty and limited access to nutrition and health education information which lead to low uptake and utilization of the public-health intervention package to combat anaemia in pregnancy.
Hearst, Norman; Kajubi, Phoebe; Hudes, Esther Sid; Maganda, Albert K; Green, Edward C
Uganda was one of the first countries to substantially reduce HIV rates through behavior change, but these gains have not continued in recent years. Little is known about what messages Ugandans are currently hearing about AIDS prevention, what they themselves believe to be important prevention strategies, and how these beliefs are associated with behavior. We interviewed men and women aged between 20 and 39 in two poor peri-urban areas of Kampala, using a random sample, cross-sectional household survey design. Respondents provided detailed reports of sexual behavior over the past six months, the main prevention message they are currently hearing about AIDS, and their own ranking of the importance of prevention strategies. Condom use was the main AIDS prevention message that respondents reported hearing, followed by getting tested. These were also what respondents themselves considered most important, followed closely by faithfulness. Abstinence was the lowest ranked strategy, but a higher ranking for this prevention strategy was the only one consistently associated with less risky behavior. A higher ranking for condoms was associated with higher levels of risk behavior, while the ranking of testing made no difference in any behavior. These results present challenges for AIDS prevention strategies that rely primarily on promoting condoms and testing. HIV prevention programs need to assess their impact on behavior.
U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...
Kiene, Susan M; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K
There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health-behaviour-change theories to contraceptive use among this population. This study tested the Theory of Planned Behaviour's ability to predict contraceptive-use-related behaviours among post-partum women in rural Uganda. Results gave modest support to the theory's application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries. © The Author(s) 2013.
Nathan D. Vogt
Full Text Available Despite heavy pressure and disturbance, state property regimes have stemmed deforestation within protected areas of the West Mengo region of Uganda for over 50 yr. In this manuscript, we reconstruct the process of creation and maintenance of forest reserve boundaries in the West Mengo region of Uganda to identify why these boundaries have largely remained stable over the long term under conditions in which they may be predicted to fail. The dramatic boundary stability in West Mengo we attribute to key aspects of institutional design and enforcement of boundaries.
Rukundo, Godfrey Zari; Mishara, Brian; Kinyanda, Eugene
There is a paucity of data on the prevalence of suicidality in HIV/AIDS, and associated psychological factors in sub-Saharan Africa, shown to be high in Uganda. Yet, the region accounts for over 70% of the world HIV burden. Our study used a cross-sectional survey of 226 HIV-positive (HIV+) adults and adolescents (aged 15-17 years) in Mbarara, Uganda. The relationship between suicidality and depressed mood, anxiety symptoms, state anger, self-esteem, trait anger and hopelessness was examined; anger was the predominant factor in suicidality, suggesting that anger management could potentially lower the prevalence of suicidality. © The Author(s) 2016.
Daar Abdallah S
Full Text Available Abstract Background Uganda has a long history of health research, but still faces critical health problems. It has made a number of recent moves towards building science and technology capacity which could have an impact on local health, if innovation can be fostered and harnessed. Methods Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 30 people from across the science-based health innovation system, including government officials, researchers in research institutes and universities, entrepreneurs, international donors, and non-governmental organization representatives. Results Uganda has a range of institutions influencing science-based health innovation, with varying degrees of success. However, the country still lacks a coherent mechanism for effectively coordinating STI policy among all the stakeholders. Classified as a least developed country, Uganda has opted for exemptions from the TRIPS intellectual property protection regime that include permitting parallel importation and providing for compulsory licenses for pharmaceuticals. Uganda is unique in Africa in taking part in the Millennium Science Initiative (MSI, an ambitious though early-stage $30m project, funded jointly by the World Bank and Government of Uganda, to build science capacity and encourage entrepreneurship through funding industry-research collaboration. Two universities – Makerere and Mbarara – stand out in terms of health research, though as yet technology development and commercialization is weak. Uganda has several incubators which are producing low-tech products, and is beginning to move into higher-tech ones like diagnostics. Its pharmaceutical industry has started to create partnerships which encourage innovation. Conclusions Science-based health product innovation is in its early stages in Uganda, as are policies for guiding
This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.
Full Text Available Abstract Background While there are biomedical drugs for managing diabetes mellitus, some patients with diabetes use traditional medicine. The aim of the study was to explore why patients with diabetes use traditional medicine for the treatment of diabetes. Methods The study was conducted in Iganga and Bugiri districts in Eastern Uganda using four focus group discussions (FGDs with patients with diabetes; two with female patients and two with male patients, thirteen key informant interviews (KIIs; nine with health workers working with patients with diabetes and four with herbalists. FGDs and KIIs focused on what respondents perceived as reasons for patients with diabetes taking traditional medicine. Analysis was done using content analysis. Results Reasons for taking traditional medicine included finding difficulties accessing hospitals, diabetic drugs being out of stock, traditional medicine being acceptable and available within community, as well as being supplied in big quantities. Others were traditional medicine being cheaper than biomedical treatment and payment for it being done in installments. Traditional medicine was also more convenient to take and was marketed aggressively by the herbalists. Influence of family and friends as well as traditional healers contributed to use of traditional medicine. Conclusions Possibilities of putting diabetic drugs at facilities closer to patients need to be considered and health facilities should have a constant supply of diabetic drugs. Community members need to be sensitized on the proper treatment for diabetes mellitus and on the dangers of taking traditional medicine.
Full Text Available Persons with severe mental illness (SMI engage in risky sexual behaviours and have high prevalence of HIV in high-income countries. Little is known about sexual behaviours and HIV risk among persons with SMI in sub-Saharan Africa. In this qualitative study we explored how SMI may influence sexual risk behaviours and sexual health risks in Uganda. Individual semi-structured interviews were conducted with 7 male and 13 female psychiatric patients aged 18-49 years. Participants were interviewed in hospital when clinically stable and capable of giving informed consent. Interview transcripts were analysed using manifest content analysis, generating the categories: (1 casual sex during illness episodes, (2 rape by non-partners, (3 exploitation by partners, (4 non-monogamous partners, and (5 sexual inactivity. Our findings suggest that SMI exacerbated sexual vulnerability in the women interviewed, by contributing to casual sex, to exploitative and non-monogamous sexual relationships, and to sexual assault by non-partners. No link could be established between SMI and increased sexual risk behaviours in the men interviewed, due to a small sample of men, and given that men's accounts showed little variability. Our findings also suggest that SMI caused sexual inactivity due to decreased sexual desire, and in men, due to difficulties forming an intimate relationship. Overall, our study highlights how SMI and gender inequality can contribute to the shaping of sexual risk behaviours and sexual health risks, including HIV risk, among persons with SMI in this Ugandan setting.
Objectives To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. Background A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Methods Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Results Qualitative thematic analysis revealed two major themes: (1) belief that any given patient’s metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. Conclusion As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness. PMID:29041798
Full Text Available Background. Regular clinic attendance for antiretroviral (ARV drug refills is important for successful clinical outcomes in HIV management. Methods. Clinic attendance for ARV drug refills and medication adherence using a clinic-based pill count in 392 adult patients receiving antiretroviral therapy (ART in a district hospital in Uganda were prospectively monitored over a 28-week period. Results. Of the 2267 total scheduled clinic visits, 40 (1.8% were missed visits. Among the 392 clients, 361 (92% attended all appointments for their refills (regular attendance. Clinic attendance for refills was statistically significantly associated with medication adherence with regular attendant clients having about fourfold greater odds of achieving optimal (≥95% medication adherence [odds ratio (OR=3.89, 95% CI: 1.48 to 10.25, exact P=.013]. In multivariate analysis, clients in age category 35 years and below were less likely to achieve regular clinic attendance. Conclusion. Monitoring of clinic attendance may be an objective and effective measure and could be a useful adjunct to an adherence measure such as pill counting in resource-constrained settings. Where human resource constraints do not allow pill counts or other time-consuming measures, then monitoring clinic attendance and acting on missed appointments may be an effective proxy measure.
Nazarius M Tumwesigye
Full Text Available Road traffic injuries are the eighth leading cause of death globally and the most affected are young people aged 15-29. By 2030 road traffic deaths will become the fifth leading cause of death unless urgent action is taken. Motorcyclists are among the most vulnerable road users and in Uganda they contribute 41% of all road traffic injuries. This paper establishes factors associated with the injuries of commercial motorcycle riders also known as boda-boda riders in Kampala, Uganda's capital city.The study was matched case-control with a case being a boda-boda rider that was seen at one of the 5 major city hospitals with a road traffic injury while a control was a boda-boda rider that was at the parking stage where the case operated from before the injury. The sample size was 289 riders per arm and data collection took 7 months. A structured questionnaire was used to collect data on background and exposing factors. Being matched case-control data conditional logistic regression was used in the analysis.Factors independently associated with injury among motorcyclists were younger age group, being a current alcohol drinker (OR = 2.30, 95%CI: 1.19-4.45, lower engine capacity (<100 cc (OR = 5.03, 95%CI: 2.91-8.70, riding experience of less than 3 years, not changing a motorcycle in past 1 year (OR = 2.04, 95%CI: 1.19-3.52, riding for a longer time in a day (OR = 6.05, 95%CI: 2.58-14.18 and sharing a motorcycle (OR = 8.25, 95%CI:2.62-25.9. Other factors associated with injury were low level of knowledge of traffic rules, being stopped by police for checks on condition of motorcycle/license/insurance, working till late.More road safety sensitization is required among riders to raise awareness against sharing motorcycles, working for a longer time and alcohol consumption. Police enforcement of drink-driving laws should include riders of commercial motorcycles. Investigate the validity of motorcycle riding licenses and test the riding competency of all
Musinguzi, Geofrey; Bastiaens, Hilde; Wanyenze, Rhoda K; Mukose, Aggrey; Van Geertruyden, Jean-Pierre; Nuwaha, Fred
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. 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. 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, 1.9%) indicated that they
Full Text Available Background: People diagnosed with diabetes mellitus are increasing in sub-Saharan Africa and prompt care seeking depends on perceptions of the illness. Objective: The objective was to explore perceptions of diabetes in rural areas.Method: We conducted a qualitative, explorative and descriptive study in rural eastern Uganda. Eight focus group discussions with community members were conducted. Community members were presented with a story about a person with diabetes symptoms and their perceptions of the diagnosis and treatment elicited. Four focus group discussions with people with diabetes and seven key informant interviews with health workers were conducted. Respondents were asked how the community interpreted symptoms of diabetes, its causes and whether it was curable. Manifest content analysis was used.Results: Some respondents thought people with diabetes symptoms had HIV or were bewitched. Causes of diabetes mentioned included consuming too much fatty food. Some respondents thought diabetes is transmitted through air, sharing utensils with or sitting close to people with diabetes. Some respondents thought that diabetes could heal fast whilst others thought it was incurable. Conclusion: Misdiagnosis may cause delay in seeking proper care. Preventive programmes could build on people’s thinking that too much fatty food causes diabetes to promote diets with less fat. The perception of diabetes as a contagious disease leads to stigmatisation and affects treatment seeking. Seeing diabetes as curable could create patient expectations that may not be fulfilled in the management of diabetes. Rural communities would benefit from campaigns creating awareness of prevention, symptoms, diagnosis and management of diabetes.
Full Text Available Abstract This article is the second article in the Human Resources for Health journal's first quarterly feature. The series of seven articles has been contributed by Management Sciences for Health (MSH under the theme of leadership and management in public health and will be published article-by-article over the next few weeks. The journal invited Dr Manuel M. Dayrit, Director of the WHO Department of Human Resources for Health and former Minister of Health for the Philippines to launch the feature with an opening editorial to be found in the journal's blog. This article – number two in the series – describes the experience of the Family Life Education Programme (FLEP, a reproductive health program that provides community-based health services through 40 clinics in five districts of Uganda, in improving retention and performance by using the Management Sciences for Health (MSH Human Resource Management Rapid Assessment Tool. A few years ago, the FLEP of Busoga Diocese began to see an increase in staff turnover and a decrease in overall organizational performance. The workplace climate was poor and people stopped coming for services even though there were few other choices in the area. An external assessment found the quality of the health care services provided was deficient. An action plan to improve their human resource management (HRM system was developed and implemented. To assess the strengths and weaknesses of their system and to develop an action plan, they used the Rapid Assessment Tool. The tool guides users through a process of prioritizing and action planning after the assessment is done. By implementing the various recommended changes, FLEP established an improved, responsive HRM system. Increased employee satisfaction led to less staff turnover, better performance, and increased utilization of health services. These benefits were achieved by cost-effective measures focused on professionalizing the organization's approach to HRM.
Devries, Karen M; Child, Jennifer C; Allen, Elizabeth; Walakira, Eddy; Parkes, Jenny; Naker, Dipak
Violence against children from school staff is anecdotally common in low- and middle-income countries, but data on prevalence and associations with mental health and educational outcomes are lacking. We report data from a cross-sectional survey conducted in June and July 2012 in Luwero District, Uganda. Forty-two primary schools representing 80% of students in the district were randomly selected; 100% agreed to participate. The International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional; Strengths and Difficulties Questionnaire; and reading, spelling, and math tests were administered. We present descriptive statistics and logistic regression models, accounting for the complex sampling scheme used in the survey. We surveyed 3706 students and 577 school staff members; 93.3% (SE 1.0%) of boys and 94.2% (SE 1.6%) of girls attending primary school reported lifetime experience of physical violence from a school staff member, and >50% reported experience in the past week. Past-week physical violence was associated with increased odds of poor mental health and, for girls, double the odds of poor educational performance (adjusted odds ratio = 1.78, 95% confidence interval = 1.19-2.66). For boys, significant interactions were present. Despite a ban on corporal punishment in Ugandan schools since 1997, the use of violence against students is widespread and associated with poor mental health and educational performance. School violence may be an important but overlooked contributor to disease burden and poor educational performance in low- and middle-income settings.
Kihembo, Christine; Masiira, Ben; Lali, William Z; Matwale, Gabriel K; Matovu, Joseph K B; Kaharuza, Frank; Ario, Alex R; Nabukenya, Immaculate; Makumbi, Issa; Musenero, Monica; Zhu, Bao-Ping; Nanyunja, Miriam
AbstractPodoconiosis, a noninfectious elephantiasis, is a disabling neglected tropical disease. In August 2015, an elephantiasis case-cluster was reported in Kamwenge District, western Uganda. We investigated to identify the disease's nature and risk factors. We defined a suspected podoconiosis case as onset in a Kamwenge resident of bilateral asymmetrical lower limb swelling lasting ≥ 1 month, plus ≥ 1 of the following associated symptoms: skin itching, burning sensation, plantar edema, lymph ooze, prominent skin markings, rigid toes, or mossy papillomata. A probable case was a suspected case with negative microfilaria antigen immunochromatographic card test (ruling out filarial elephantiasis). We conducted active case-finding. In a case-control investigation, we tested the hypothesis that the disease was caused by prolonged foot skin exposure to irritant soils, using 40 probable case-persons and 80 asymptomatic village control-persons, individually matched by age and sex. We collected soil samples to characterize irritants. We identified 52 suspected (including 40 probable) cases with onset from 1980 to 2015. Prevalence rates increased with age; annual incidence (by reported onset of disease) was stable over time at 2.9/100,000. We found that 93% (37/40) of cases and 68% (54/80) of controls never wore shoes at work (Mantel-Haenszel odds ratio [OR MH ] = 7.7; 95% [confidence interval] CI = 2.0-30); 80% (32/40) of cases and 49% (39/80) of controls never wore shoes at home (OR MH = 5.2; 95% CI = 1.8-15); and 70% (27/39) of cases and 44% (35/79) of controls washed feet at day end (versus immediately after work) (OR = 11; 95% CI = 2.1-56). Soil samples were characterized as rich black-red volcanic clays. In conclusion, this reported elephantiasis is podoconiosis associated with prolonged foot exposure to volcanic soil. We recommended foot hygiene and universal use of protective shoes.
Full Text Available INTRODUCTION: Targeting most-at-risk individuals with HIV preventive interventions is cost-effective. We developed gender-specific indices to measure risk of HIV among sexually active individuals in Rakai, Uganda. METHODS: We used multivariable Cox proportional hazards models to estimate time-to-HIV infection associated with candidate predictors. Reduced models were determined using backward selection procedures with Akaike's information criterion (AIC as the stopping rule. Model discrimination was determined using Harrell's concordance index (c index. Model calibration was determined graphically. Nomograms were used to present the final prediction models. RESULTS: We used samples of 7,497 women and 5,783 men. 342 new infections occurred among females (incidence 1.11/100 person years, and 225 among the males (incidence 1.00/100 person years. The final model for men included age, education, circumcision status, number of sexual partners, genital ulcer disease symptoms, alcohol use before sex, partner in high risk employment, community type, being unaware of a partner's HIV status and community HIV prevalence. The Model's optimism-corrected c index was 69.1 percent (95% CI = 0.66, 0.73. The final women's model included age, marital status, education, number of sex partners, new sex partner, alcohol consumption by self or partner before sex, concurrent sexual partners, being employed in a high-risk occupation, having genital ulcer disease symptoms, community HIV prevalence, and perceiving oneself or partner to be exposed to HIV. The models optimism-corrected c index was 0.67 (95% CI = 0.64, 0.70. Both models were well calibrated. CONCLUSION: These indices were discriminative and well calibrated. This provides proof-of-concept that population-based HIV risk indices can be developed. Further research to validate these indices for other populations is needed.
Full Text Available This study focuses on empowering women both in peri-urban and rural areas through mushroom production. It was conducted in Kampala Metropolitan area-Uganda, during October 2016. It focused on estimating profits, conducting benefit-cost analysis/ratio (BCR and return on investment (ROI, finding reasons as to why women involved in the mushroom production and identifying the constraints of mushroom farming from the perspective of women as well as the possible solutions to the constraints. 29 women were interviewed face to face through the use of the questionnaires. The study revealed an average net profit of 3,464.28 US dollars, BCR of 3.84 and ROI of 2.84 per farm in a period of three months. Our study revealed that mushroom production is a profitable enterprise for women. The major reason for women to involve in mushroom was to earn income. However, a range of other reasons was given such as fast maturity of mushrooms, availability of market, healthy benefits of mushrooms, etc. were the most important reasons. The problems faced by women farmers were ranked from the most pressing problem to the least pressing problem in this order; Low market prices per kilogram of mushroom, scarcity of cotton during some seasons, poor quality mushroom spawn supplied to farmers by breeders, inadequate extension, and advisory services were the most observed problems among others. The suggested solutions were organizing farmers into groups or cooperatives in order to negotiate for better markets locally and abroad together with the help of government, researchers to carry out more research on the suitability of other substrates like bagasse other than relying on only cotton, ensuring that mushroom spawn breeders conform to the set standards of quality spawn production and re-equipping local extension workers with knowledge regarding mushroom production among others.
Ellis, Amanda; Manuel, Claire; Blackden, C. Mark
Uganda is a leader in Sub-Saharan Africa, in recognizing linkages between economic growth and gender issues. These linkages are critical for achieving the Millennium Development Goals. The study assesses the legal and administrative barriers faced by women, as identified by the Bank's Foreign Investment Advisory Service (FIAS) and the International Finance Corporation's (IFC) Gender-Entrep...
Bannink, Femke; Fontaine, Johnny R. J.; Idro, Richard; van Hove, Geert
This study investigates cognitive abilities of pre/primary school children without and with spina bifida in Uganda. Qualitative semi structured interviews and quantitative functioning scales measurements were combined and conducted with 133 parents, 133 children with spina bifida, and 35 siblings. ANCOVA was used to test for differences in…
Depuis 2003, le partenariat canado-ougandais Enfants en santé Ouganda - Healthy Children Uganda (HCU) a mis en oeuvre un programme de bénévolat en santé dans 175 villages. ... A new website and resource library will help improve developing country registration and information systems for vital events.
Lucas, Adrienne M.; McEwan, Patrick J.; Ngware, Moses; Oketch, Moses
Primary school enrollments have increased rapidly in sub-Saharan Africa, spurring concerns about low levels of learning. We analyze field experiments in Kenya and Uganda that assessed whether the Reading to Learn intervention, implemented by the Aga Khan Foundation in both countries, improved early-grade literacy as measured by common assessments.…
Bovine tuberculosis is a ‘neglected zoonosis’ and its contribution to the proportion of Mycobacterium tuberculosis complex infections in humans is unknown. A retrospective study on archived Mycobacterium tuberculosis complex (MTC) isolates from a reference laboratory in Uganda was undertaken to iden...
The research was carried out among banana-farming households in the districts of Masaka and Kabarole in Uganda. A gendered livelihood approach was used. The research focused on the identification of critical factors that need to be taken into consideration in the development of relevant policies for
TERMS Network Analysis, Economic Networks, Entrepreneurial Ecosystems , Economic Development, Data Collection 16. SECURITY CLASSIFICATION OF: 17...the Project Synopsis, Developing Network Models of Entrepreneurial Ecosystems in Developing Economies, on the Network Science Center web site.) A...Thomas visited Kampala, Uganda in support of an ongoing Network Science Center project to develop models of entrepreneurial networks. Our Center has
The Land Act (1998), which aims at reforming land tenure relations in Uganda, is therefore one of the most far-reaching legislation enacted by the National Resistance Movement (NRM) government. The new tenure system aims at supporting agricultural development through the functioning of a land market, establishing ...
Sendagire, Ibrahim; Cobelens, Frank; Kambugu, Andrew; Konde-Lule, Joseph; Schim van der Loeff, Maarten
Background: Access to antiretroviral treatment (ART) has improved greatly in many parts of the world, including Uganda, yet, many patients delay to start ART even when registered within the HIV services. We assessed, in a routine ambulatory care setting, what proportion of patients start ART late
Rijsdijk, L.E.; Lie, R.; Bos, A.E.R.; Leerlooijer, J.N.; Kok, G.
This paper presents the findings from an explorative study comparing sexual and reproductive health and rights (SRHR) against local realities for young people in Uganda. This was done by analysing statements by Ugandan adolescents extracted from focus group discussions relating to two SRHRs central
This dissertation examines the competiveness of the fair trade tea value chain through a comparative study of the conventional and fair trade tea value chains in Kabarole district, Uganda. By examining this economically important subject, it clarifies the process by which value chains compete for