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Ikara, B., P. Ebusu, N. Mugisha, and J. Orem. "Little Hands Beating Cancer: Building Resource Capacity for Cancer Control in Sub-Saharan Africa." Journal of Global Oncology 4, Supplement 2 (2018): 125s. http://dx.doi.org/10.1200/jgo.18.22300.
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Background and context: Uganda Child Cancer Foundation (UCCF) is a nongovernmental organization that was formed in 2006, as an in-house fundraising charity for Uganda Cancer Institute (UCI). UCCF mobilizes treatment and social support for vulnerable children battling cancer and advocates for cancer control in Uganda. It is mainly managed by childhood cancer survivors/volunteers and individuals directly affected by cancer. Children Caring about Cancer (3C) program is a strategic approach through which UCCF supports children in schools to start cancer clubs which are called 3C clubs. Aim: The main aim is to create a platform through which school going children are empowered with knowledge and experiences to enable them appreciate the cancer burden and create opportunities for them to develop and implement interventions addressing the burden of cancer at their level. Strategy/Tactics: UCCF works closely with UCI in cancer control, UCI is a Uganda Ministry of Health national technical arm of government. UCCF was formed to raise awareness about cancer in the communities and public especially with the young people and also to support children with cancer, UCCF reaches high school students and teachers with cancer education and awareness through the ministry of education and school administration structures. UCCF runs a social media campaign dabbed #3ChildrenCaringAboutCancer which uses activities done by the clubs as posts targeting children, policy makers and the community. In addition, UCCF launched a national children cancer conference in 2016 as a unique platform for stakeholder engagements and for highlighting work the children are doing in cancer control. Program/Policy process: The UCCF-3C recruits and works with children in schools by establishing cancer clubs. The clubs run activities geared toward cancer awareness, patient support and community outreach/advocacy. The clubs are headed by patrons and student-led club executives. The executive is responsible for leadership and recruitment of fellow young people through a child to child process. The patrons are trained to act as mentors to the executive to support various 3C programs in school. The patrons have an interschool committee that enables them to network and plan to support the children and club needs. UCCF works with the UCI to coordinate 3C club activities, patrons, and students leaders in sustaining the clubs in schools. Outcomes: In 85 3C school clubs formed, the program has reached; 85,000 children, 3000 teachers and over 170,000 guardians. Young people have been able to contribute to cancer control in Uganda through cancer awareness, advocacy and patient support. What was learned: Children Caring about Cancer (3C) program is strategic for building resource capacity for sustainable cancer control in Uganda.
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de Haas, Billie, and Inge Hutter. "Teachers’ professional identities in the context of school-based sexuality education in Uganda—a qualitative study." Health Education Research 35, no. 6 (2020): 553–63. http://dx.doi.org/10.1093/her/cyaa044.
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Abstract School-based sexuality education makes teachers important gatekeepers of students’ access to information about sexual and reproductive health and rights. The school setting has the potential to reach large numbers of students. However, teachers’ professional identities may go beyond, differ from or even conflict with the qualities required of sexuality educators. To gain a better understanding of the role of professional identity in the delivery of school-based sexuality education, this study used cultural schema theory to study teachers’ professional identities, and how these motivate them to provide sexuality education. In-depth interviews were conducted with 40 sexuality education teachers at secondary schools in Kampala, the capital of Uganda. Sexuality education lessons were observed to validate the findings from the interviews. Results identified five cultural schemas of professional identity: (i) upholder of ethics and regulations; (ii) authority figure; (iii) counsellor and guide; (iv) role model; and (v) guardian. The study concludes that teachers’ cultural schemas of professional identity motivate them to adhere to moral discourses of abstinence and sexual innocence. To support teachers in taking more comprehensive approaches to sexuality education, it is important that they receive adequate teacher training and support from the Ugandan government, the school administration and the wider community.
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Kagaari, James, Kirabo Nakasiita, Edward Ntare, et al. "Children’s conceptions of peace in two Ugandan primary schools: Insights for peace curriculum." Research in Comparative and International Education 12, no. 1 (2017): 9–25. http://dx.doi.org/10.1177/1745499917698299.
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Oppenheimer urged communities all over the world to study how children come to understand peace, conflict, and war. Set in various countries, their review of studies, as well as more recent examinations reveal trends in how children view these phenomena, often differing by gender, age, and extent to which they were exposed to highly dangerous and traumatizing situations, like being forced to be child soldiers or sex slaves. No such research has been published in the contemporary post-war Uganda context. Using focus group methodology, we asked: How might Ugandan primary school children’s stories about peace (traditional and otherwise) help them navigate conflict? What sorts of conflicts do these children observe in their home, school, and community, and how do they describe peace as being resolved by themselves or others? The purpose of our study was to contribute to the knowledge base on peace education in Uganda and to ultimately develop written materials that students can use as part of their learning in their respective schools. Local studies like this one are relevant to the global situation because racial and economic conditions are global phenomena. The local manifestations can speak to those racial and economic conditions as perspectives not often used to put the global situation in relief. This paper explores the findings related to the children’s overarching conceptions of peace and their ideas of peacebuilding, including activities that both hinder and encourage peace. The voices of the children speak strongly of the connection between peace and access to basic necessities in the community.
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Macnab, Andrew, Arabat Kasangaki, and Faith Gagnon. "Health Promoting Schools Provide Community-Based Learning Opportunities Conducive to Careers in Rural Practice." International Journal of Family Medicine 2011 (April 7, 2011): 1–5. http://dx.doi.org/10.1155/2011/892518.
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The World Health Organization conceived “health-promoting schools” as a means of providing the information and support systems necessary for the worldwide changes in behavior that are needed to improve health globally and decrease health care costs. We developed and evaluated a model of progressively implementing health-promoting schools with support from university medical school trainees in Canada and Uganda. The model uses oral health as a medium for establishing rapport and success around a topic with little stigma. The evaluation involved questionnaires of the Canadian trainees about practice intentions before and after involvement in the health-promoting schools to determine whether community-based learning in health-promoting schools resulted in more trainees planning to work in rural areas or underserved countries. We found that Canadian medical trainees cited their personal involvement and perceived ability to effect significant and identifiable positive change in both the school children and the community as reasons why they were more willing to practice in rural or under-served areas.
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MUHUMUZA, SIMON, ANNETTE OLSEN, FRED NUWAHA, and ANNE KATAHOIRE. "UNDERSTANDING LOW UPTAKE OF MASS TREATMENT FOR INTESTINAL SCHISTOSOMIASIS AMONG SCHOOL CHILDREN: A QUALITATIVE STUDY IN JINJA DISTRICT, UGANDA." Journal of Biosocial Science 47, no. 4 (2014): 505–20. http://dx.doi.org/10.1017/s002193201400011x.
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SummaryDespite attempts to control intestinal schistosomiasis through school-based mass drug administration (MDA) with praziquantel using school teachers in Uganda, less than 30% of the school children take the treatment in some areas. The aim of the study was to understand why the uptake of praziquantel among school children is low and to suggest strategies for improved uptake. This was a cross-sectional qualitative study in which 24 focus group discussions and 15 key informant interviews were conducted 2 months after MDA. The focus group discussions were held with school children in twelve primary schools and the key informant interviews were held with school teachers, sub-county health assistants and the District Vector Control Officer. The study shows that the low uptake of praziquantel among school children is a result of a complex interplay between individual, interpersonal, institutional, community and public policy factors. The individual and interpersonal factors underpinning the low uptake include inadequate information about schistosomiasis prevention, beliefs and attitudes in the community about treatment of schistosomiasis and shared concerns among children and teachers about the side-effects of praziquantel, especially when the drug is taken on an empty stomach. The institutional, policy and community factors include inadequate preparation and facilitation of teachers and the school feeding policy, which requires parents to take responsibility for providing their children with food while at school, yet many parents cannot meet the cost of a daily meal due to the prevailing poverty in the area. It is concluded that strategies to improve uptake of praziquantel among school children need to be multi-pronged addressing not only the preparation and motivation of teachers and health education for children, but also the economic and political aspects of drug distribution, including the school feeding policy.
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Nakiwala, Aisha Sembatya. "From recipients to partners: children in malaria education in Uganda." Health Education 116, no. 2 (2016): 202–19. http://dx.doi.org/10.1108/he-03-2014-0036.
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Purpose – Health education that integrates community participation is essential for malaria control. However, children’s participation is not generally as active as that of adults, thus turning children into recipients, as opposed to partners in malaria control. The purpose of this paper is to develop a better understanding of how children can transform from mere recipients to active partners in malaria control efforts, by exploring the implementation of a school health education program in Uganda. Design/methodology/approach – A qualitative multi-case study involving six schools where the health education program was implemented was undertaken, using six focus group discussions with 72 school children and respondent interviews with 14 teachers and district health promotion staff. Findings – Children acted as health messengers, offered peer support and engaged in environmental management to minimize mosquito breeding. The benefits of the school malaria program included increasing access to malaria information, boosting malaria knowledge, improving children’s self-esteem and their skill as health educators. However, implementation was undermined by hostility from adults, inadequate time and tight school schedules, which should be addressed in future malaria programs. Practical implications – The findings suggest that children can play an important role in malaria programs. Therefore, programs should be sufficiently structured to facilitate children’s participation. Practitioners should be encouraged to be conscious of the applicability of the health promoting school approach to malaria control. Originality/value – This research facilitated a more comprehensive understanding of the role children can play in malaria control, thus providing a basis for their involvement in malaria programs. It also adds to a relatively scarce area of literature on the school health-malaria control nexus.
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Sadigh, Mitra, Jamie Sarfeh, and Robert Kalyesubula. "The retention of ACCESS nursing assistant graduates in rural Uganda." Journal of Nursing Education and Practice 8, no. 1 (2017): 94. http://dx.doi.org/10.5430/jnep.v8n1p94.
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Background: In 2004, the African Community Center for Social Sustainability (ACCESS) established a Nursing Assistant School in Nakaseke, a rural district in Uganda, to address the region’s severe shortage of healthcare resources. A survey conducted in July 2014 assessed the retention of its graduates in rural healthcare work.Methods: A survey aimed at evaluating the retention of ACCESS graduates in rural areas was created with the help of local stakeholders, focusing on demographics, the training program, employment, career development goals, and community impact. A short-form telephone survey was administered to graduates living outside Nakaseke, and a long-form in-person survey to graduates residing close to the school. Quantitative data was analyzed using standard statistical software, and qualitative data via identification of common themes.Results: Thirty-seven participants were contacted using telephone numbers stored in a database containing information for 109 graduates. The mean participant age was 24 years, and 86.5% were female. Nearly all worked in healthcare (91.1%), primarily in health clinics (37.14%) and pharmacies (33.33%) in communities they described as rural (80%), low-resource (60%), and underserved (25.7%). Most graduates planned to continue working in healthcare (85.3%) in rural areas (61.3%). All felt that their work positively impacts their community.Conclusions: The ACCESS nursing assistant training program provided a stepping stone for trainees while contributing to increased health service provision to the community. Rural-focused location and school curriculum, along with confidence building, may help retain nursing assistant trainees in underserved areas.
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Merrill, Katherine G., Louise Knight, Judith R. Glynn, Elizabeth Allen, Dipak Naker, and Karen M. Devries. "School staff perpetration of physical violence against students in Uganda: a multilevel analysis of risk factors." BMJ Open 7, no. 8 (2017): e015567. http://dx.doi.org/10.1136/bmjopen-2016-015567.
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ObjectiveTo conduct a multilevel analysis of risk factors for physical violence perpetration by school staff against Ugandan students.DesignMultilevel logistic regression analysis of cross-sectional survey data from 499 staff and 828 caregivers of students at 38 primary schools, collected in 2012 and 2014 during the Good Schools Study.SettingLuwero District, Uganda.Main outcome measurePast-week use of physical violence by school staff against students was measured using the International Society for the Prevention of Child Abuse and Neglect 'Child Abuse Screening Tool- Child International' and the WHO Multi-Country Study on Women’s Health and Domestic Violence against Women.ResultsOf 499 staff, 215 (43%) reported perpetration of physical violence against students in the past week. Individual risk factors associated with physical violence perpetration included being a teacher versus another type of staff member (p<0.001), approving of physical discipline practices (p<0.001), having children (p<0.01), being age 30–39 years (p<0.05), using physical violence against non-students (p<0.05) and being a victim of intimate partner violence (IPV) (p<0.05). We observed weak evidence (p=0.06) that male staff members who had been a victim of IPV showed higher odds of violence perpetration compared with male staff who had not been a victim of IPV. No evidence was observed for school- or community-level risk factors.ConclusionsPhysical violence perpetration from school staff is widespread, and interventions are needed to address this issue. Staff who have been victims of violence and who use violence against people other than students may benefit from additional interventions. Researchers should further investigate how school and community contexts influence staff’s physical violence usage, given a lack of associations observed in this study.
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Sendagala, Samuel, John Senkusu, George William Lubwama, Danstan Bagenda, Micheal Muyonga, and Wolfgang Hladik. "Suicide Ideation, School Absenteeism and Physical Violence among Secondary School Students in Kampala, Uganda." International Journal of Public Health Science (IJPHS) 7, no. 4 (2018): 293. http://dx.doi.org/10.11591/ijphs.v7i4.14589.
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<p><span lang="EN-US">School youth in many African countries face a range of non-infectious health risks, in addition to the infectious disease burden typical in resource-limited settings. We examined self-reported health behaviors associated with suicide ideation, school absenteeism and physical violence among secondary school students in Kampala, Uganda. We conducted a cross-sectional three-stage cluster-based survey among students aged &gt;=15 years, and/or enrolled in forms 3–6 (grades 9-12) in 54 secondary schools in Kampala. Interview data were collected with a standardised electronic questionnaire through computer-assisted self-interviewing and results were weighted for sample design and non-response. Pearson’s chi-square and logistic regression methods were used for bivariate and multivariate analysis respectively. Bullying among female respondents was positively associated with suicide ideation (aOR=1.73). In multivariate analysis, suicidal ideation was positively associated with a lifetime exposure to illicit drug use (aOR=1.76), serious injury (aOR=1.67) or school absenteeism (aOR=1.46). School absenteeism was positively associated with serious injury (aOR=1.59), history of alcohol consumption (aOR=1.55), bullying (aOR=1.52) and suicide ideation (aOR=1.45). Serious injury (aOR=2.89), a life-time history of illicit drug use (aOR=2.65), recent history of having been bullied (aOR=2.38), physical activity (aOR=2.12), suicide ideation (aOR=1.58), school absenteeism (aOR=1.57) were associated with having been engaged in physical violence. Bullying, serious injury and illicit drug use were associated with suicidal ideation, school absenteeism and physical violence. Concerted efforts should be considered by education authorities, parents and the community to tackle these risky behaviors. </span></p>
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Scheel, John R., Yamile Molina, Benjamin O. Anderson, et al. "Breast Cancer Beliefs as Potential Targets for Breast Cancer Awareness Efforts to Decrease Late-Stage Presentation in Uganda." Journal of Global Oncology, no. 4 (December 2018): 1–9. http://dx.doi.org/10.1200/jgo.2016.008748.
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Purpose To assess breast cancer beliefs in Uganda and determine whether these beliefs are associated with factors potentially related to nonparticipation in early detection. Methods A survey with open- and close-ended items was conducted in a community sample of Ugandan women to assess their beliefs about breast cancer. Linear regression was used to ascertain associations between breast cancer beliefs and demographic factors potentially associated with early detection, including socioeconomic factors, health care access, prior breast cancer knowledge, and personal detection practices. Results Of the 401 Ugandan women surveyed, most had less than a primary school education and received medical care at community health centers. Most women either believed in or were unsure about cultural explanatory models for developing breast cancer (> 82%), and the majority listed these beliefs as the most important causes of breast cancer (69%). By comparison, ≤ 45% of women believed in scientific explanatory risks for developing breast cancer. Although most believed that regular screening and early detection would find breast cancer when it is easy to treat (88% and 80%, respectively), they simultaneously held fatalistic attitudes toward their own detection efforts, including belief or uncertainty that a cure is impossible once they could self-detect a lump (54%). Individual beliefs were largely independent of demographic factors. Conclusion Misconceptions about breast cancer risks and benefits of early detection are widespread in Uganda and must be addressed in future breast cancer awareness efforts. Until screening programs exist, most breast cancer will be self-detected. Unless addressed by future awareness efforts, the high frequency of fatalistic attitudes held by women toward their own detection efforts will continue to be deleterious to breast cancer early detection in sub-Saharan countries like Uganda.
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Rujumba, Joseph, Mathias Akugizibwe, Nicole E. Basta, and Cecily Banura. "Why don’t adolescent girls in a rural Uganda district initiate or complete routine 2-dose HPV vaccine series: Perspectives of adolescent girls, their caregivers, healthcare workers, community health workers and teachers." PLOS ONE 16, no. 6 (2021): e0253735. http://dx.doi.org/10.1371/journal.pone.0253735.
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Introduction Vaccination with the 2-dose HPV vaccine series among adolescent girls in Uganda remains low after almost 5 years since the vaccine was included into the routine national immunization program and barriers are not well understood. Objective We explored barriers that prevent eligible girls from initiating or completing the recommended 2-dose HPV vaccine series in Oyam District, Northern Uganda. Methods A qualitative study was conducted in Oyam District, Northern Uganda. Forty interviews were conducted with adolescent girls, their caregivers, Village Health Team Members, health workers and school administrators involved in HPV vaccination. All interviews were audio recorded and transcribed. NVivo version 11 was used for data management and content thematic approach for analysis guided by the Social Ecological Model. Results At individual level, low levels of knowledge about the vaccine, girls’ frequent mobility between vaccine doses, school absenteeism and drop out, fear of injection pain and discouragement from caregivers or peers were key barriers. At the health facilities level, reported barriers included: few healthcare workers, inadequate knowledge about HPV vaccine, limited social mobilization and community engagement to promote the vaccine, limited availability of the HPV vaccine, unreliable transportation, lack of reminder strategies after the first dose of the vaccine, lack of vaccination strategy for out-of-school girls and un-friendly behaviour of some healthcare workers. Concerns about safety and efficacy of the vaccine, negative religious and cultural beliefs against vaccination, rumors and misconceptions about the vaccine, mistrust in government intentions to introduce the new vaccine targeting girls, busy schedules and the gendered nature of care work were key community level barriers. Conclusion Our study revealed an interplay of barriers at individual, health facility and community levels, which prevent initiation and completion of HPV vaccination among adolescent girls. Strengthening HIV vaccination programs and ensuring high uptake requires providing appropriate information to the girls plus the community, school and health facility stakeholders; addressing cold chain challenges as well as adequate training of vaccinators to enable them respond to rumors about HPV vaccination.
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Nkuruho, Tumwine, Cuthbert Isingoma, and Teresa Senserrick. "School Road Safety Education in Uganda: Progress and Lessons Learned." Journal of Road Safety 32, no. 1 (2021): 45–51. http://dx.doi.org/10.33492/jrs-d-20-00266.
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The Uganda Road Accident Reduction Network Organisation (URRENO) is a non-profit, non-government organisation (NGO) mandated in 1997. From a modest pilot project funded by the World Bank in 2003, it has become a leader in the development, implementation and advocacy for road safety education in primary schools across Uganda. Through URRENO efforts, the pilot program was adopted as the national curriculum and was shown to improve students’ road safety skills and behaviours and reduce their involvement in crashes from 15% to 5%. Many other related worthwhile initiatives followed, including: improvements in pedestrian facilities; integrated road safety publicity and enforcement campaigns; and expansion of road safety NGOs to supplement Government efforts. Lessons learned of value for like organisations include: striving to collect and analyse data to attain a project evidence base; building strong partnerships with influential individuals, community groups, businesses and Government stakeholders; adopting participatory approaches in which stakeholders and beneficiaries play significant roles in project implementation; and building capacities and empowering beneficiaries. URRENO continues in its efforts to strengthen and further roll-out the road safety education curriculum across Uganda, following evidence that transfers of trained teachers has contributed to decayed expertise and attention to road safety, particularly among schools in rural areas. URRENO will continue to strive to empower young people to learn and strengthen their capacity in road safety, to grow out of dependence and become independent safe road users.
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Musoke, David, Rawlance Ndejjo, Abdullah Ali Halage, Simon Kasasa, John C. Ssempebwa, and David O. Carpenter. "Drinking Water Supply, Sanitation, and Hygiene Promotion Interventions in Two Slum Communities in Central Uganda." Journal of Environmental and Public Health 2018 (2018): 1–9. http://dx.doi.org/10.1155/2018/3710120.
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Poor water, sanitation, and hygiene (WASH) continue to contribute to the high prevalence of diarrhoeal diseases in low-income countries such as Uganda particularly in slums. We implemented a 3-year WASH project in two urban slums in Uganda with a focus on safe drinking water and improvement in sanitation. The project implemented community and school interventions in addition to capacity building initiatives. Community interventions included home improvement campaigns, clean-up exercises, water quality assessment, promotion of drinking safe water through household point-of-use chlorination, promotion of hand washing, and support towards solid waste management. In schools, the project supported health clubs and provided them with “talking compound” messages. The capacity building initiatives undertaken included training of youth and community health workers. Project evaluation revealed several improvements in WASH status of the slums including increase in piped water usage from 38% to 86%, reduction in use of unprotected water sources from 30% to 2%, reduction in indiscriminate disposal of solid waste from 18% to 2%, and increase in satisfaction with solid waste management services from 40% to 92%. Such proactive and sustainable community interventions have the potential to not only improve lives of slum inhabitants in developing countries but also create lasting impact.
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Moodley, Shreya, Arabat Kasangaki, and Andrew J. Macnab. "Education in Global Health: Experience in Health-Promoting Schools Provides Trainees with Defined Core Competencies." ISRN Education 2012 (March 13, 2012): 1–7. http://dx.doi.org/10.5402/2012/718303.
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Introduction. Medical education has defined essential “universal” core competencies. The value of global health education gained through participation in a health-promoting school project was assessed using Canada’s CanMEDS roles and competencies. Methods. The project involved health care trainees in delivery of “Brighter Smiles,” a global health education program addressing children’s oral health in Canada and Uganda based on the WHO health-promoting (HP) school model. Multidisciplinary teams first visit a Canadian First Nations community for an introduction to HP schooling, team building, and experience working in different cultural environments and then have 4–6 weeks of global health project delivery in rural HP schools in Uganda in partnership with local College of Health Sciences trainees/faculty. Learning opportunities afforded were evaluated by conventional questionnaire and pilot categorization against the 7 CanMEDS roles (divided into 126 core competencies). Results. All collaborator and health Advocate competencies and 16/17 of the communicator roles were addressed. Overall, project experience included 88 (70%) of the 126 competencies. Conclusions. This pilot suggests CanMEDS criteria can be used to effectively evaluate trainee participation in HP school program delivery, allowing the comprehensive educational opportunities to acquire global health knowledge and skills reported by conventional evaluation to be formally categorized against defined educational roles and competencies.
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Delzer, Mackenzie E., Anthony Kkonde, and Ryan M. McAdams. "Viewpoints of pregnant mothers and community health workers on antenatal care in Lweza village, Uganda." PLOS ONE 16, no. 2 (2021): e0246926. http://dx.doi.org/10.1371/journal.pone.0246926.
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Background Uganda is a low-income country with high fertility, adolescent birth, and maternal mortality rates. How Ugandan Ministry of Health antenatal education guidelines have been implemented into standardized health education and how pregnant women utilize health facilities remains unclear. Objective We aimed to determine how women obtain education during pregnancy, what guidelines health educators follow, and what barriers exist to receiving antenatal care in Lweza Village, Uganda. Methods Household surveys were conducted with women in Lweza who were or had previously been pregnant. Focus group discussions were conducted with community members and Lweza Primary School teachers. Interviews were conducted with key informants, including midwives, a traditional birth attendant, a community leader, and a Village Health Team member. Data collection was done in English along with a Luganda translator. Results Of the 100 household surveys conducted, 86% of women did not meet the WHO recommendation of 8 antenatal appointments during their pregnancies. Reasons cited for inadequate visits included facing long wait times (>7 h) at health facilities, getting education from family or traditional healers, or being told to delay antenatal care until 6 months pregnant. Informant interviews revealed that no standardized antenatal education program exists. Respondents felt least educated on family planning and postpartum depression, despite 37% of them reporting symptoms consistent with postpartum depression. Education was also lacking on the use of traditional herbs, although most women (60%) reported using them during pregnancy. Conclusions Most women in Lweza do not receive 8 antenatal appointments during their pregnancies or any standardized antenatal education. Educational opportunities on family planning, postpartum depression, and the safety of traditional herbs during pregnancy exist. Future studies should focus on ways to overcome barriers to antenatal care, which could include implementing community-based education programs to improve health outcomes for women in Lweza Village.
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Scheel, John R., Yamile Molina, Donald L. Patrick, et al. "Breast Cancer Downstaging Practices and Breast Health Messaging Preferences Among a Community Sample of Urban and Rural Ugandan Women." Journal of Global Oncology 3, no. 2 (2017): 105–13. http://dx.doi.org/10.1200/jgo.2015.001198.
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Purpose Among a community sample of Ugandan women, we provide information about breast cancer downstaging practices (breast self-examination, clinical breast examination [CBE]) and breast health messaging preferences across sociodemographic, health care access, and prior breast cancer exposure factors. Methods Convenience-based sampling was conducted to recruit Ugandan women age 25 years and older to assess breast cancer downstaging practices as well as breast health messaging preferences to present early for a CBE in the theoretical scenario of self-detection of a palpable lump (breast health messaging preferences). Results The 401 Ugandan women who participated in this survey were mostly poor with less than a primary school education. Of these women, 27% had engaged in breast self-examination, and 15% had undergone a CBE. Greater breast cancer downstaging practices were associated with an urban location, higher education, having a health center as a regular source of care, and receiving breast cancer education ( P < .05). Women indicated a greater breast health messaging preference from their provider (66%). This preference was associated with a rural location, having a health center as a regular source of care, and receiving breast cancer education ( P < .05). Conclusion Most Ugandan women do not participate in breast cancer downstaging practices despite receipt of breast cancer education. However, such education increases downstaging practices and preference for messaging from their providers. Therefore, efforts to downstage breast cancer in Uganda should simultaneously raise awareness in providers and support improved education efforts in the community.
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Dewyer, A., A. Scheel, E. Okello, et al. "PO602 The Burden of Group A Streptococcal Disease Among School Children In Uganda." Global Heart 13, no. 4 (2018): 507. http://dx.doi.org/10.1016/j.gheart.2018.09.464.
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Guwatudde, David, Pilvikki Absetz, Peter Delobelle, et al. "Study protocol for the SMART2D adaptive implementation trial: a cluster randomised trial comparing facility-only care with integrated facility and community care to improve type 2 diabetes outcomes in Uganda, South Africa and Sweden." BMJ Open 8, no. 3 (2018): e019981. http://dx.doi.org/10.1136/bmjopen-2017-019981.
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IntroductionType 2 diabetes (T2D) is increasingly contributing to the global burden of disease. Health systems in most parts of the world are struggling to diagnose and manage T2D, especially in low-income and middle-income countries, and among disadvantaged populations in high-income countries. The aim of this study is to determine the added benefit of community interventions onto health facility interventions, towards glycaemic control among persons with diabetes, and towards reduction in plasma glucose among persons with prediabetes.Methods and analysisAn adaptive implementation cluster randomised trial is being implemented in two rural districts in Uganda with three clusters per study arm, in an urban township in South Africa with one cluster per study arm, and in socially disadvantaged suburbs in Stockholm, Sweden with one cluster per study arm. Clusters are communities within the catchment areas of participating primary healthcare facilities. There are two study arms comprising a facility plus community interventions arm and a facility-only interventions arm. Uganda has a third arm comprising usual care. Intervention strategies focus on organisation of care, linkage between health facility and the community, and strengthening patient role in self-management, community mobilisation and a supportive environment. Among T2D participants, the primary outcome is controlled plasma glucose; whereas among prediabetes participants the primary outcome is reduction in plasma glucose.Ethics and disseminationThe study has received approval in Uganda from the Higher Degrees, Research and Ethics Committee of Makerere University School of Public Health and from the Uganda National Council for Science and Technology; in South Africa from the Biomedical Science Research Ethics Committee of the University of the Western Cape; and in Sweden from the Regional Ethical Board in Stockholm. Findings will be disseminated through peer-reviewed publications and scientific meetings.Trial registration numberISRCTN11913581; Pre-results.
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Bannink, Femke, Johnny R. J. Fontaine, Richard Idro, and Geert Van Hove. "Cognitive Abilities of Pre- and Primary School Children with Spina Bifida in Uganda." International Journal of Educational Psychology 5, no. 3 (2016): 249. http://dx.doi.org/10.17583/ijep.2016.2075.
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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 cognitive scores between children and siblings. Logistic regression analyses were used to study predictive demographic, impairment specific, and environmental factors of cognitive functioning. Children with spina bifida in Uganda had lower cognitive outcomes compared to their siblings. Cognitive outcomes were predicted by age, household income, motor functioning, and schooling. Better motor functioning was predicted by age, the presence of hydrocephalus, and parental support. Continence management was predicted by parental support and household income. Schooling was predicted by age, household income, and motor functioning. Limited access to neurosurgery and rehabilitative care, and schooling had a negative effect on cognitive functioning. Children of parents who have support had better motor functioning, and continence management. A holistic approach for children with spina bifida and their families, including community based rehabilitation; ensuring social support and livelihoods for parents; and access to health and education services can contribute to better cognitive outcomes.
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Ploutz, Michelle, Twalib Aliku, Tyler Bradley-Hewitt, et al. "Child and teacher acceptability of school-based echocardiographic screening for rheumatic heart disease in Uganda." Cardiology in the Young 27, no. 1 (2016): 82–89. http://dx.doi.org/10.1017/s1047951116000159.
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AbstractIntroductionRheumatic heart disease causes substantial morbidity in children in low-income countries. School-based echocardiographic screening has been suggested as a means to identify children with latent disease; however, little is known about the experience of children and teachers participating in screenings. The aim of our study was to assess students’ and teachers’ experience of school-based echocardiographic screening and identify areas for improvement.Materials and methodsA school-based echocardiographic screening programme was conducted in five schools in Northern Uganda in 2013. After 8 months, an age- and gender-stratified population that included 5% of the participating students and teachers completed a questionnaire via an in-person interview. Responses were reviewed by question and coded to identify key themes.ResultsA total of 255 students (mean 10.7 years; 48% male) and 35 teachers participated in our study. In total, 95% of the students and 100% of the teachers were happy to have participated in the screening; however, students reported feeling scared (35%) and nervous (48%) during the screening process. Programmatic strengths included the following: knowing one’s health status, opportunity to receive treatment, and staff interactions. Although 43% of the patients did not suggest a change with open-ended questioning, concerns regarding privacy, fear of the screening process, and a desire to include others in the community were noted.DiscussionSchool-based echocardiographic rheumatic heart disease screening was well received by students and teachers. Future programmes would likely benefit from improved pre-screening education regarding the screening process and diagnosis of rheumatic heart disease. Furthermore, education of teachers and students could improve screening perception and establish realistic expectations regarding the scope of screening.
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Kreniske, Philip, Stephanie Grilo, Neema Nakyanjo, Fred Nalugoda, Jason Wolfe, and John S. Santelli. "Narrating the Transition to Adulthood for Youth in Uganda: Leaving School, Mobility, Risky Occupations, and HIV." Health Education & Behavior 46, no. 4 (2019): 550–58. http://dx.doi.org/10.1177/1090198119829197.
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School enrollment, mobility, and occupation are each important factors to consider when examining HIV (human immunodeficiency virus) infection risk among youth in sub-Saharan Africa. Through an analysis of narrative life histories from 30 HIV-positive and 30 HIV-negative youth (aged 15-24 years), matched on gender, age, and village and purposively selected and interviewed from the Rakai Community Cohort Study, this article shows the complex connection between leaving school, mobility, and occupation with implications for HIV risk. We identified a pattern of risk factors that was present in many more HIV-positive than HIV-negative youth life stories. These HIV-positive youth shared a similar pathway during their transition to adulthood: After leaving school, they moved in search of occupations; they then engaged in risky occupations before eventually returning to their home village. Linking the lines of inquiry on school enrollment, mobility, and risky occupations, our findings have important implications for adolescent health research, practice, and policy in Uganda and across sub-Saharan Africa and the developing world.
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Skylstad, Vilde, Harriet Aber, Victoria Bakken, et al. "Child alcohol use disorder in Eastern Uganda: screening, diagnostics, risk factors and management of children drinking alcohol in Uganda (TREAT C-AUD): a mixed-methods research protocol." BMJ Paediatrics Open 5, no. 1 (2021): e001214. http://dx.doi.org/10.1136/bmjpo-2021-001214.
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BackgroundFollowing a finding of alcohol use among children aged 5–8 years old in Mbale, Uganda, this project investigates the magnitude of alcohol and substance use among children ged 6–13 years old and related household, community, school, health system and clinical factors.MethodsThe project includes four larger work packages (WPs). WP1 comprises management, WP2 and 3 include the scientific components and WP4 includes integration of results, dissemination, policy and implementation advice. This protocol presents the planned research work in WP 2 and 3. WP2 comprises the adaptation and validation of the alcohol use screening tool Car-Relax-Alone-Forget-Family and Friends-Trouble (CRAFFT) to the age group and setting. WP3 comprises four substudies (SS). SS1 is a cross-sectional community household survey with an estimated sample size of 3500 children aged 6–13 years and their caregivers. We apply cluster sampling and systematic sampling within the clusters. Data collection includes a structured questionnaire for caregiver and child, measuring social and demographic factors, mental health status, alcohol and substance use, nutrition history and anthropometry. Urine samples from children will be collected to measure ethyl glucuronide (EtG), a biological marker of alcohol intake. Further, facilitators, barriers and response mechanisms in the health system (SS2) and the school system (SS3) is explored with surveys and qualitative assessments. SS4 includes qualitative interviews with children. Analysis will apply descriptive statistics for the primary outcome of establishing the magnitude of alcohol drinking and substance use, and associated factors will be assessed using appropriate regression models. The substudies will be analysed independently, as well as inform each other through mixed methods strategies at the stages of design, analysis, and dissemination.Ethics and disseminationData protection and ethical approvals have been obtained in Uganda and Norway, and referral procedures developed. Dissemination comprises peer-reviewed, open access research papers, policy recommendations and intersectoral dialogues.Trial registration numberClinicaltrials.gov 29.10.2020 (#NCT04743024).
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Tugume, Patience, Mukadasi Buyinza, Esezah Kakudidi, et al. "Non-Timber Forest Products Trade and Community Livelihoods around Mabira Central Forest Reserve, Uganda." Journal of Agricultural Studies 4, no. 4 (2016): 1. http://dx.doi.org/10.5296/jas.v4i4.9482.
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This paper generates data on the diversity and value of non- timber forest products (NTFPs) traded in markets adjacent to Mabira Central forest reserve. The objective of the study was to evaluate the contribution of NTFPs trade to the livelihoods of traders’ households. Quarterly market surveys and field observations were conducted in eleven markets in 2014. All NTFPs traders were interviewed using semi structured questionnaires. Simple profitability method was used to determine the profit margins of the traded products. The per capita value of NTFPs traded was calculated and was highest for drums ($ 3,101) and lowest for winnowing trays ($3). All products had profit margins above 60%. Income generated from NTFP trade was used to cater for other essential needs in households like payment of school fees, medical treatment, buying food and other household items. NTFP trade has potential of improving the lives of traders through establishment of NTFP enterprises. In order for such enterprises to be successful forest products traded must be harvested sustainably to ensure consistent supply of the products. Multipurpose species like Markhamia lutea, Phoenix reclinata, Raphia farinifera and Calmus sp. should be domesticated to minimize pressure on the forest. Keywords: Market, non-timber forest products, trade, profitability, income, Mabira, livelihood
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Pilgrim, Nanlesta A., Saifuddin Ahmed, Ronald H. Gray, et al. "Multiple sexual partnerships among female adolescents in rural Uganda: the effects of family structure and school attendance." International Journal of Adolescent Medicine and Health 27, no. 3 (2015): 319–28. http://dx.doi.org/10.1515/ijamh-2014-0032.
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Abstract Background: A better understanding is needed of the contextual factors that influence HIV risk behaviors among female adolescents in sub-Saharan Africa. The objectives of this study were to assess the influence of family structure on lifetime sexual partners and on the number of sexual partners in the last year among female adolescents in rural Rakai, Uganda. In addition, the study assessed whether the influence of family structure on these outcomes differed by the school attendance status of the adolescents. Methods: The sample consisted of 2337 unmarried adolescent girls, aged 15–19, enrolled in the Rakai Community Cohort Study. The last survey interview within the time period of 2001–2008 available for each girl was used. Analyses were stratified by age (15–17 year olds and 18–19 year olds) and school status. Multinomial logistic and poisson regressions were used. Results: Living in a household with a biological father was protective against both outcomes. Family structure was not associated with the outcomes among in-school adolescents but it was significantly associated with the outcomes among out-of-school adolescents. Conclusion: The findings suggest that understanding the familial context in which female adolescents develop, as well as its interaction with school attendance, is important for HIV prevention efforts. Both research and programmatic initiatives must consider the interplay between the family and school domains when considering ways to reduce HIV acquisition among adolescent women.
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Nabugoomu, Josephine, Gloria Seruwagi, Kitty Corbett, Edward Kanyesigye, Susan Horton, and Rhona Hanning. "Needs and Barriers of Teen Mothers in Rural Eastern Uganda: Stakeholders’ Perceptions Regarding Maternal/Child Nutrition and Health." International Journal of Environmental Research and Public Health 15, no. 12 (2018): 2776. http://dx.doi.org/10.3390/ijerph15122776.
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For adolescent mothers in rural Eastern Uganda, nutrition and health may be compromised by many factors. Identifying individual and environmental needs and barriers at local levels is important to inform community-based interventions. This qualitative study used interviews based on constructs from social cognitive theory. 101 adolescent mothers, family members, health-related personnel and community workers in Budondo sub-county (Jinja district), eastern Uganda were interviewed. Young mothers had needs, related to going back to school, home-based small businesses; social needs, care support and belonging to their families, employment, shelter, clothing, personal land and animals, medical care and delivery materials. Barriers to meeting their needs included: lack of skills in income generation and food preparation, harsh treatment, pregnancy and childcare costs, lack of academic qualifications, lack of adequate shelter and land, lack of foods to make complementary feeds for infants, insufficient access to medicines, tailored health care and appropriate communications. Using the social cognitive framework, this study identified myriad needs of young mothers and barriers to improving maternal/child nutrition and health. Adolescent-mother-and-child-friendly environments are needed at local levels while continuing to reduce broader socio-cultural and economic barriers to health equity. Findings may help direct future interventions for improved adolescent maternal/child nutrition and health.
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Ponelis, Shana Rachel, and Philliam Adoma. "Diffusion of open source integrated library systems in academic libraries in Africa." Library Management 39, no. 6-7 (2018): 430–48. http://dx.doi.org/10.1108/lm-05-2017-0052.
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Purpose Libraries globally automate their operations and services using integrated library systems (ILS) to increase operational efficiency and meet the ever-evolving demands of their users. Open source ILS (OS ILS) has become more popular globally. The purpose of this paper is to better understand the diffusion of OS ILS in academic libraries in Uganda. Design/methodology/approach Rogers’ diffusion of innovation (DoI) supplemented by the fit-viability theory was used as a theoretical framework. A questionnaire was developed based on extant literature and distributed electronically to representative members of a Ugandan university library association. Findings The diffusion of OS ILS in Ugandan academic libraries approximates the S-curve expected based on DoI. Ugandan academic libraries are adopting OS ILS for more flexibility to meet changing needs at what is perceived as an affordable cost but not all are fully satisfied. Koha is the most adopted OS ILS and is also being considered by all libraries without any ILS or a proprietary ILS. The information and communication technology (ICT) infrastructure, organizational procurement policies and national procurement legislation, human resource capacity and limited finances are barriers to diffusion. The total cost of ownership and technical skills required are of particular concern for OS ILS. Research limitations/implications The research was limited to a single African country and the recommendations may not be transferable to other African countries. Future research can expand the survey, the countries studied and/or address the methodological limitations of this study. Practical implications When embarking upon library automation using OS ILS or migrating to an OS ILS solution libraries should consider their ICT infrastructure, local support community, available training and be realistic about the costs. Local library associations should provide guidance on OS ILS selection, ongoing training, and opportunities for knowledge sharing. LIS schools should consider expanding their curriculum to include library automation and, in Uganda incorporate training on Koha as OS ILS. Libraries and library associations should advocate to reduce restrictive organizational procurement policies and national procurement legislation. Originality/value Studies on country-level diffusion of ILS are comparatively few, particularly in African countries. This is the first country-level study of OS ILS diffusion in Uganda. This study can positively impact future patterns of diffusion for optimal deployment of OS ILS software by informing academic libraries, university management, library association, LIS schools, and policymakers in Uganda and across the African continent, and encouraging academics and researchers to teach and study library automation using OS ILS.
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Westoby, Peter, and Kristen Lyons. "The Place of Social Learning and Social Movement in Transformative Learning." Journal of Transformative Education 15, no. 3 (2017): 223–40. http://dx.doi.org/10.1177/1541344617696970.
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This article analyses the sustainability school (SS) program of the National Association of Professional Environmentalists (NAPE), Uganda. The focus is on how the social network, enabled by the SS program, fosters social and transformative learning. The significance of this approach to community-based education for social change, including in the context of resource conflict and displacement, is considered. Findings focus on the local-level impacts of the program, including the ways in which collective and community organizing, and educational methodology shape both social and transformative learning. Discussion considers the importance of not only the “social” element of transformative learning but the need—within conflict and dangerous contexts—to link the social explicitly to building organization and a social movement that provides a structural container for people to engage in critical thinking and social action.
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Miles, Susie, Lorraine Wapling, and Julia Beart. "Including Deaf Children in Primary Schools in Bushenyi, Uganda: a community-based initiative." Third World Quarterly 32, no. 8 (2011): 1515–25. http://dx.doi.org/10.1080/01436597.2011.604523.
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Kim, Jangsaeng. "Education of Canaan Farmers School and African Community Development -Case Study on John Bosco’s Kakiri Village Development in Uganda-." Theological Forum 96 (June 30, 2019): 95–127. http://dx.doi.org/10.17301/tf.2019.06.96.95.
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Strzok S.J., James. "Ready to Change the World? Start Here!: What Are Jesuits Doing in East Africa?" Journal of Jesuit Studies 3, no. 4 (2016): 577–92. http://dx.doi.org/10.1163/22141332-00304003.
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This article represents a case study of Jesuit activities in Kenya, Tanzania and Uganda, specifically regarding sustainable practices, through a reflection of the author’s own itinerary. It highlights some of the opportunities that construction and infrastructure development offers for harnessing solar energy and utilizing eco-friendly methods, such as hydraform technology, bio-latrines as a means of methane gas production, solar energy, and especially geothermal energy as an abundant resource in Kenya’s Great Rift Valley. Additionally, the article outlines the crucial role of trees in ecosystems as a constructive means of responding to climate change based on the process of carbon capture, while illustrating tree planting as a service in an educational context. Particular focus is given to the sibling schools of St Peter Claver High School and Ocer Campion Jesuit College in Dodoma, the capital of Tanzania, which constitute a model of sorts exhibiting these best practices for the community.
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Van Hout, Marie-Claire, Max Bachmann, Jeffrey V. Lazarus, et al. "Strengthening integration of chronic care in Africa: protocol for the qualitative process evaluation of integrated HIV, diabetes and hypertension care in a cluster randomised controlled trial in Tanzania and Uganda." BMJ Open 10, no. 10 (2020): e039237. http://dx.doi.org/10.1136/bmjopen-2020-039237.
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IntroductionIn sub-Saharan Africa, the burden of non-communicable diseases (NCDs), particularly diabetes mellitus (DM) and hypertension, has increased rapidly in recent years, although HIV infection remains a leading cause of death among young-middle-aged adults. Health service coverage for NCDs remains very low in contrast to HIV, despite the increasing prevalence of comorbidity of NCDs with HIV. There is an urgent need to expand healthcare capacity to provide integrated services to address these chronic conditions.Methods and analysisThis protocol describes procedures for a qualitative process evaluation of INTE-AFRICA, a cluster randomised trial comparing integrated health service provision for HIV infection, DM and hypertension, to the current stand-alone vertical care. Interviews, focus group discussions and observations of consultations and other care processes in two clinics (in Tanzania, Uganda) will be used to explore the experiences of stakeholders. These stakeholders will include health service users, policy-makers, healthcare providers, community leaders and members, researchers, non-governmental and international organisations. The exploration will be carried out during the implementation of the project, alongside an understanding of the impact of broader structural and contextual factors.Ethics and disseminationEthical approval was granted by the Liverpool School of Tropical Medicine (UK), the National Institute of Medical Research (Tanzania) and TASO Research Ethics Committee (Uganda) in 2020. The evaluation will provide the opportunity to document the implementation of integration over several timepoints (6, 12 and 18 months) and refine integrated service provision prior to scale up. This synergistic approach to evaluate, understand and respond will support service integration and inform monitoring, policy and practice development efforts to involve and educate communities in Tanzania and Uganda. It will create a model of care and a platform of good practices and lessons learnt for other countries implementing integrated and decentralised community health services.Trial registration numberISRCTN43896688; Pre-results.
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Kiggundu, Amin Tamale. "Constraints to Urban Planning and Management of Secondary Towns in Uganda." Indonesian Journal of Geography 46, no. 1 (2014): 12. http://dx.doi.org/10.22146/ijg.4986.
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Many towns in Uganda are growing at an unprecedented rate. By 2030 more than 50% of Ugandans will beliving in urban centres. This rapid growth of urban centres in Uganda provides for economic opportunities for manyurban residents. It also poses various challenges such as urban sprawl, emergence of informal settlements as well asurban poverty. Over 60% of the urban residents in Uganda live in the informal settlements with no basic services andinfrastructure such as piped water, decent housing, good roads, sewerage systems as well as schools and health centres.This paper aims to examine and understand the constraints to urban planning and management of secondary towns inUganda. Using an eclectic mix of research methods such as face to face interviews targeting key informants, a questionnairesurvey as well as observation, the study found that the current modernist planning approach has not achieved itsintended goal of promoting orderly urban development and improve service delivery in the secondary towns. The studyalso revealed that the urban residents are rarely involved in planning. Besides, there is an apparent mismatch betweenwhat is taught at the local planning schools and what is required in terms of planning in the secondary towns. To addressthese intractable urban challenges, it is critical that the current planning education and curriculum are reviewed to producecreative and imaginative planners that can respond more effectively to the community problems, adopt a strategyto promote strategic spatial planning that is more participatory, carry out public awareness campaigns about the need forproper planning of towns and adopt a strategy for promoting innovative funding programmes such as municipal bonds,use of the stock exchange to mobilise the required investable funds, allow the private sector to access institutional fundssuch as the employee provident fund and promote public-private partnerships.
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Olaniyi, Alice Kolawole, Shallon Atuheire, Lesley Lally, et al. "The Effects of Group Sand play on the Psychological Health and Resilience of Street Children and Adolescents in Uganda." Journal of Symbols & Sandplay Therapy 12, no. 1 (2021): 235–68. http://dx.doi.org/10.12964/jsst.21006.
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The authors analysed the effects of group Sandplay therapy on adolescents' psychological health and resilience in a mixed-method research. They explored and categorized the themes these adolescents expressed during therapy. Fifteen children (n=15) were recruited for the study; (Boarding school children = 5; Day school children = 5; Street children = 5). The selection process was conducted in cooperation with an orphanage in Kabale, Uganda. The children who participated in the study underwent a forty-five-minute sand play therapy every week for nine weeks. The SDQ and RCADS were administered to the groups both pre- and post-intervention, with the data entered and analysed using SPSS. Group sandplay was found to significantly decrease the adolescents' internalizing problems such as anxiety and depression, while their resilience had also significantly improved. The narrative analysis, in turn, yielded seven themes: basic needs; community-love-celebration; giving help-leadership-empowerment; security-danger, recreation-self-development-self-nurturance, education, and seeking help-faith.
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Javadi, Dena, John Ssempebwa, John Bosco Isunju, et al. "Implementation research on sustainable electrification of rural primary care facilities in Ghana and Uganda." Health Policy and Planning 35, Supplement_2 (2020): ii124—ii136. http://dx.doi.org/10.1093/heapol/czaa077.
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Abstract Access to energy is essential for resilient health systems; however, strengthening energy infrastructure in rural health facilities remains a challenge. In 2015–19, ‘Powering Healthcare’ deployed solar energy solutions to off-grid rural health facilities in Ghana and Uganda to improve the availability of maternal and child health services. To explore the links between health facility electrification and service availability and use, the World Health Organization (WHO), in partnership with Dodowa Health Research Centre and Makerere University School of Public Health, carried out an implementation research study. The objectives of this study were to (1) capture changes in service availability and readiness, (2) describe changes in community satisfaction and use and (3) examine the implementation factors of sustainable electrification that affect these changes. Data were collected through interviews with over 100 key informants, focus group discussions with over 800 community members and health facility assessment checklist adapted from the WHO’s Service Availability and Readiness Assessment tool. Implementation factors were organized using Normalization Process Theory constructs. The study found that access to energy is associated with increased availability of health services, access to communication technologies, appropriate storage of vaccines and medicines, enhanced health worker motivation and increased community satisfaction. Implementation factors associated with improved outcomes include stakeholder engagement activities to promote internalization, provision of materials and information to encourage participation, and establishment of relationships to support integration. Barriers to achieving outcomes are primarily health systems challenges—such as drug stockouts, lack of transportation and poor amenities—that continue to affect service availability, readiness and use, even where access to energy is available. However, through appropriate implementation and integration of sustainable electrification, strengthened energy infrastructure can be leveraged to catalyze investment in other components of functioning health systems. Improving access to energy in health facilities is, therefore, necessary but not sufficient for strengthening health systems.
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Bannink, Femke, Richard Idro, and Geert Van Hove. "“I Like to Play with My Friends”: Children with Spina Bifida and Belonging in Uganda." Social Inclusion 4, no. 1 (2016): 127–41. http://dx.doi.org/10.17645/si.v4i1.630.
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This paper describes experiences of living and belonging from the perspectives of Ugandan children with spina bifida and their siblings and parents. We explored belonging at micro, meso and macro level taking into consideration African Childhood Disability Studies, central concepts of family, cultural conceptions of disability, poverty, and the notion of ‘ubuntu’, and using child-friendly culturally adjusted interview methods including play. Whilst children with spina bifida had a strong sense of belonging at household level, they experienced more difficulties engaging in larger social networks, including school. Poverty and stigma were important barriers to inclusion. We propose strengthening the network at family level, where the environment is more enabling for the children to find a place of belonging and support, and expanding investment and awareness at community and national level.
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Natukunda, Agnes, Gyaviira Nkurunungi, Ludoviko Zirimenya, et al. "Effect of intermittent preventive treatment for malaria with dihydroartemisinin-piperaquine on immune responses to vaccines among rural Ugandan adolescents: randomised controlled trial protocol B for the ‘POPulation differences in VACcine responses’ (POPVAC) programme." BMJ Open 11, no. 2 (2020): e040427. http://dx.doi.org/10.1136/bmjopen-2020-040427.
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IntroductionDrivers of lower vaccine efficacy and impaired vaccine-specific immune responses in low-income versus high-income countries, and in rural compared with urban settings, are not fully elucidated. Repeated exposure to and immunomodulation by parasite infections may be important. We focus on Plasmodium falciparum malaria, aiming to determine whether there are reversible effects of malaria infection on vaccine responses.Methods and analysisWe have designed a randomised, double-blind, placebo-controlled, parallel group trial of intermittent preventive malaria treatment versus placebo, to determine effects on vaccine response outcomes among school-going adolescents (9 to 17 years) from malaria-endemic rural areas of Jinja district (Uganda). Vaccines to be studied comprise BCG vaccine on day ‘zero’; yellow fever, oral typhoid and human papilloma virus vaccines at week 4; and tetanus/diphtheria booster vaccine at week 28. Participants in the intermittent preventive malaria treatment arm will receive dihydroartemisinin/piperaquine (DP) dosed by weight, 1 month apart, prior to the first immunisation, followed by monthly treatment thereafter. We expect to enrol 640 adolescents. Primary outcomes are BCG-specific interferon-γ ELISpot responses 8 weeks after BCG immunisation and for other vaccines, antibody responses to key vaccine antigens at 4 weeks after immunisation. In secondary analyses, we will determine effects of monthly DP treatment (versus placebo) on correlates of protective immunity, on vaccine response waning, on whether there are differential effects on priming versus boosting immunisations, and on malaria infection prevalence. We will also conduct exploratory immunology assays among subsets of participants to further characterise effects of the intervention on vaccine responses.Ethics and disseminationEthics approval has been obtained from relevant Ugandan and UK ethics committees. Results will be shared with Uganda Ministry of Health, relevant district councils, community leaders and study participants. Further dissemination will be done through conference proceedings and publications.Trial registration numberCurrent Controlled Trials identifier: ISRCTN62041885.
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Nkurunungi, Gyaviira, Ludoviko Zirimenya, Jacent Nassuuna, et al. "Effect of intensive treatment for schistosomiasis on immune responses to vaccines among rural Ugandan island adolescents: randomised controlled trial protocol A for the ‘POPulation differences in VACcine responses’ (POPVAC) programme." BMJ Open 11, no. 2 (2021): e040426. http://dx.doi.org/10.1136/bmjopen-2020-040426.
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IntroductionSeveral licensed and investigational vaccines have lower efficacy, and induce impaired immune responses, in low-income versus high-income countries and in rural, versus urban, settings. Understanding these population differences is essential to optimising vaccine effectiveness in the tropics. We suggest that repeated exposure to and immunomodulation by chronic helminth infections partly explains population differences in vaccine response.Methods and analysisWe have designed an individually randomised, parallel group trial of intensive versus standard praziquantel (PZQ) intervention against schistosomiasis, to determine effects on vaccine response outcomes among school-going adolescents (9–17 years) from rural Schistosoma mansoni-endemic Ugandan islands. Vaccines to be studied comprise BCG on day ‘zero’; yellow fever, oral typhoid and human papilloma virus (HPV) vaccines at week 4; and HPV and tetanus/diphtheria booster vaccine at week 28. The intensive arm will receive PZQ doses three times, each 2 weeks apart, before BCG immunisation, followed by a dose at week 8 and quarterly thereafter. The standard arm will receive PZQ at week 8 and 52. We expect to enrol 480 participants, with 80% infected with S. mansoni at the outset.Primary outcomes are BCG-specific interferon-γ ELISpot responses 8 weeks after BCG immunisation and for other vaccines, antibody responses to key vaccine antigens at 4 weeks after immunisation. Secondary analyses will determine the effects of intensive anthelminthic treatment on correlates of protective immunity, on waning of vaccine response, on priming versus boosting immunisations and on S. mansoni infection status and intensity. Exploratory immunology assays using archived samples will enable assessment of mechanistic links between helminths and vaccine responses.Ethics and disseminationEthics approval has been obtained from relevant ethics committes of Uganda and UK. Results will be shared with Uganda Ministry of Health, relevant district councils, community leaders and study participants. Further dissemination will be done through conference proceedings and publications.Trial registration numberISRCTN60517191.
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Bannink, Femke. "Social inclusion, care and belonging of children with spina bifida: perspectives from Uganda." Afrika Focus 30, no. 1 (2017): 129–35. http://dx.doi.org/10.1163/2031356x-03001009.
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This study presents a situation analysis on daily functioning, caregiving, and inclusion of children with spina bifida in Uganda. 139 children with spina bifida and their families from 4 regions in Uganda participated in this study. Findings show how a complex play of cultural values, globalization and access to biomedical care determines knowledge, and negative attitudes about, and perception of children with spina bifida. Families and private non for profit organisations are the main providers of care of the children. Children with spina bifida had a more negative perception of themselves, were Jess likely to be in school, and had lower cognitive outcome compared to their siblings. Daily functioning and social inclusion were affected by motor function, incontinence, lack of support for caregivers, low household income, limited resources and knowledge of inclusive teaching, bullying, and inaccessibility of public transport, roads, and buildings. Positive experiences of belonging were found at family and household level and were closely related to the ‘ubuntu’ concept. When a child belongs, the child has a chance to live, to participate, to become, to be included. To facilitate inclusion, families need to be supported, and negative attitudes and behaviour of community members, teachers, and health workers need to be addressed.
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Scheel, Amy, Isaac Ssinabulya, Twalib Aliku, et al. "Community study to uncover the full spectrum of rheumatic heart disease in Uganda." Heart 105, no. 1 (2018): 60–66. http://dx.doi.org/10.1136/heartjnl-2018-313171.
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ObjectiveEstimates of the prevalence of rheumatic heart disease (RHD) in many endemic countries are limited to samples of children attending schools, which generate an incomplete picture of disease burden in communities. The present study conducted household-based RHD screening in a representative community in Gulu district, Uganda.MethodsMembers of households identified through a two-stage cluster-sampling approach between the ages of 5 years and 50 years were invited to undergo limited cardiac testing with a handheld echocardiogram to assess for the presence of RHD. Suspicious cases underwent confirmatory echocardiogram with a fully functional machine.ResultsOf the 2453 community members screened, 2.45% (95% CI 1.87% to 3.14%) showed echocardiographic evidence of RHD with 1.26% (95% CI 0.860% to 1.79%) having definite RHD. The overall prevalence of RHD among participants <20 years was 2.52% (95% CI 1.78% to 3.45%), with a borderline prevalence of 1.97% (95% CI 1.33% to 2.82%) and a definite prevalence of 0.544% (95% CI 0.235% to 1.07%). Prevalence rates among youth increased with age and peaked in the age group of 16–20 years. The overall adult prevalence (>20 years) of RHD was 2.34% (95% CI 1.49% to 3.49%). The majority of definite cases were mild (81%) and marked by mitral regurgitation and associated morphological valve changes (71%).ConclusionOur data reveal a high prevalence of undiagnosed RHD within an endemic community and fill a critical gap in RHD epidemiology in African adults.
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Aheisibwe, Irene. "Bridging education gap in higher institutions of learning using Bloom’s taxonomy of educational objectives." African Educational Research Journal 9, no. 1 (2021): 69–74. http://dx.doi.org/10.30918/aerj.91.20.213.
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In Uganda, there is a problem of graduate unemployment which has caused teachers, employers, policymakers, and the entire community to appreciate a critical role in bridging the existing gaps in education. This study examined how Bloom’s Taxonomy of Educational Objectives can be used in bridging the education gap in higher institutions of learning. A cross-sectional descriptive survey design, with 180 participants, purposively selected was involved. The study was conducted in two public universities and one private university in South Western Uganda. Data was mainly collected using interviews and focus group discussions. Ethically, permission was sought from relevant authorities, the purpose of the study was clearly explained, participation was purely voluntary and confidentiality was ensured. Respondents described the cognitive domain as activities of the mind, affective domain as the ways in which people deal with situations emotionally and the psychomotor domain as the skills attained. The study suggests using cognitive, affective and psychomotor methods of teaching. The study recommends need to directly teach higher order thinking skills, shift from pedagogy to andragogy, instructors of higher institutions of learning should wisely select sources of content, determine how to present that content effectively, and assess students’ progress in relation to that content and activities that promote psychomotor learning especially apprenticeship, internship and school practice should be encouraged.
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Jeong, Bok Gyo, and Sara Compion. "Characteristics of women’s leadership in African social enterprises: The Heartfelt Project, Bright Kids Uganda and Chikumbuso." Emerald Emerging Markets Case Studies 11, no. 2 (2021): 1–22. http://dx.doi.org/10.1108/eemcs-11-2019-0305.
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Learning outcomes This trio of cases is appropriate for upper-level undergraduate classes or for postgraduate programs in non-profit management, leadership and community development, international development, global studies, women’s and gender studies and social entrepreneurship. It allows the instructors and students to engage with classical leadership tenets and emerging social entrepreneurship literature. Upon completion of the case study discussion and assignments, students will be able to: identify diverse obstacles that African women face in starting social enterprises; understand the ways that African women leaders build a social dimension to their enterprise; and identify characteristics of women’s leadership and critique the value of women’s leadership for establishing sustainable social enterprises. Case overview/synopsis The case stories of the three African social enterprises portray how female leaders have fostered sustainable organisations through prioritising social, over economic and governance investments. Martha Letsoalo, a former domestic worker, founded the Heartfelt Project in South Africa, which now employs fifteen women, ships products all around the world and enriches the community of Makapanstad with its workshop, training and education centre. Victoria Nalongo Namusisi, daughter of a fisherman in rural Uganda, founded Bright Kids Uganda, a thriving care facility, school and community centre that educates vulnerable children, empowers victims of gender-based violence and distributes micro-loans to female entrepreneurs. Gertrude, abandoned in Lusaka, Zambia, founded Chikumbuso, a home of resilience and remembrance to educate children and offer women employment in a cooperative business. Each case documents the founding years of the social enterprise and outlines some of the shared women’s leadership approaches. The case dilemma focuses on why and how women start social enterprises in socially and economically difficult contexts. Complexity academic level This trio of cases is appropriate for undergraduate or graduate-level programs in non-profit management, leadership and community development, international development, global studies and social entrepreneurship. Supplementary materials Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes. Subject code CSS 3: Entrepreneurship. Supplementary materials Teaching notes are available for educators only.
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Nyeko, Jolly P. Tumurhairwe, Alan Pence, and Gordon E. Barnes. "HOME ENVIRONMENT FACTORS AND ECD EXPOSURE PREDICT SCHOOL ENTRY AND GRADE PROGRESSION: A STUDY FROM A PERI-URBAN COMMUNITY IN CENTRAL UGANDA, AFRICA." International Journal of Child, Youth and Family Studies 6, no. 4-1 (2015): 662–79. http://dx.doi.org/10.18357/ijcyfs.641201515051.
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Esau, Daniel, Pak To Ho, Geoffrey K. Blair, et al. "Engaging youth in rural Uganda in articulating health priorities through Photovoice." Global Health Promotion 24, no. 3 (2016): 59–67. http://dx.doi.org/10.1177/1757975915614167.
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Youth living in rural Uganda represent over 20% of the country’s population. Despite the size of this demographic segment of the population, there is a paucity of data on their health priorities. Engaging people in understanding their own health status has proven to be an effective mechanism for health promotion. The objective of this study was to use Photovoice, a community-based, participatory action research methodology, to understand the current health priorities of youth living in rural Uganda. Thirty-two students between the ages of 13 and 17 were recruited from four schools within the region of Soroti, Uganda. Participants were given a disposable camera and were asked to photograph situations that contributed or detracted from their health status. The cameras were then returned to the investigators and each photo taken by the participant was reviewed with the investigators during a semi-structured interview. Codes were applied to the photographs and organized into overarching themes. Each participant chose one to two photos that were most representative of their health priorities for a secondary analysis. Participants provided 499 photos that met the eligibility criteria. The most common themes presented in the photographs were ‘hygiene’ ( n = 73, 12.4%), ‘nutrition’ ( n = 69, 11.7%), and ‘cleanliness’ ( n = 48, 8%). ‘Hygiene’ ( n = 6, 14.6%) and ‘exercise’ ( n = 6, 14.6%) were the most common priorities articulated in the representative photographs. Photovoice proved to be an effective method to assess and express the health concerns of youth in rural Uganda. Study participants were able to articulate their health concerns and priorities through photographs and reflect on opportunities for health promotion through subsequent interviews.
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Siyao, Peter Onauphoo, Fidelia M. Whong, Ebenezer Martin-Yeboah, and Annet Namamonde. "Academic libraries in four Sub-Saharan Africa countries and their role in propagating open science." IFLA Journal 43, no. 3 (2017): 242–55. http://dx.doi.org/10.1177/0340035217712263.
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The study aims at examining libraries in four Sub-Saharan Africa countries and their role in propagating open science. It also seeks to explore existing open science practices, ascertain the level of participation of academic libraries in open science activities, identify the strategies used in marketing open science platforms and enumerate the challenges hindering the success of open science in the selected countries. The study was guided by the qualitative school of thought where the researcher builds a complex, holistic picture, analyses words, and reports detailed views of informants, and conducts the study in a natural setting. The study employed the multiple case study research design approach to assess how academic libraries in Ghana, Nigeria, Tanzania and Uganda promote open science. The findings show that there are few scholarly journals which exist in open access for most African academies in Ghana, Nigeria, Tanzania and Uganda. Though not massively adopted, open access institutional repositories have been used to preserve and publicize the digital contents in some academic institutions in Africa such as theses, dissertations, administrative and heritage materials, conference proceedings as well as pre-prints and post-print of journal articles. The study recommends the intensification of open science advocacy in academic libraries in Sub-Saharan Africa; institutions should ensure that there is a stable electricity supply as well as reliable internet connectivity, introducing regular training on emerging media technologies to the community members and strengthening the libraries consortium in Sub-Saharan Africa as an enabling platform to share intellectual productivity of their member countries.
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Rwanyonga, Twesigye Consilous, Mbaziira Mike, and Aisha Nakubulwa. "Child Sexual Abuse in Schools: Preliminary Indication for Enhancement of Universal Primary Education and Community (EUPEC Project)—Uganda." Journal of Psychology in Africa 19, no. 1 (2009): 103–6. http://dx.doi.org/10.1080/14330237.2009.10820265.
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Bwire, Godfrey, Mellisa Roskosky, Anne Ballard, et al. "Use of surveys to evaluate an integrated oral cholera vaccine campaign in response to a cholera outbreak in Hoima district, Uganda." BMJ Open 10, no. 12 (2020): e038464. http://dx.doi.org/10.1136/bmjopen-2020-038464.
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ObjectivesTo evaluate the quality and coverage of the campaign to distribute oral cholera vaccine (OCV) during a cholera outbreak in Hoima, Uganda to guide future campaigns of cholera vaccine.DesignSurvey of communities targeted for vaccination to determine vaccine coverage rates and perceptions of the vaccination campaign, and a separate survey of vaccine staff who carried out the campaign.SettingHoima district, Uganda.ParticipantsRepresentative clusters of households residing in the communities targeted for vaccination and staff members who conducted the vaccine campaign.ResultsAmong 209 households (1274 individuals) included in the coverage survey, 1193 (94%; 95% CI 92% to 95%) reported receiving at least one OCV dose and 998 (78%; 95% CI 76% to 81%) reported receiving two doses. Among vaccinated individuals, minor complaints were reported by 71 persons (5.6%). Individuals with ‘some’ education (primary school or above) were more knowledgeable regarding the required OCV doses compared with non-educated (p=0.03). Factors negatively associated with campaign implementation included community sensitisation time, staff payment and problems with field transport. Although the campaign was carried out quickly, the outbreak was over before the campaign started. Most staff involved in the campaign (93%) were knowledgeable about cholera control; however, 29% did not clearly understand how to detect and manage adverse events following immunisation.ConclusionThe campaign achieved high OCV coverage, but the surveys provided insights for improvement. To achieve high vaccine coverage, more effort is needed for community sensitisation, and additional resources for staff transportation and timely payment for campaign staff is required. Pretest and post-test assessment of staff training can identify and address knowledge and skill gaps.
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Wagner, Glenn, Yashodhara Rana, Sebastian Linnemayr, James Balya, and Lydia Buzaalirwa. "A Qualitative Exploration of the Economic and Social Effects of Microcredit among People Living with HIV/AIDS in Uganda." AIDS Research and Treatment 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/318957.
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HIV medical care, including antiretroviral therapy (ART), is often successful in restoring physical health and functioning. But in developing countries, HIV medical care is often insufficient to achieve social and economic health, and hence innovative economic support programs are much needed. We conducted semistructured interviews with 30 adults receiving ART and microcredit loans operated by Uganda Cares. Using content analysis, we explored the impact of the microcredit loans on the economic, social, and psychological well-being of respondents. Most respondents indicated that the microcredit loans played a positive role in their lives, helped them to keep their children in school and sustain their families, and improved their self-esteem and status in the community. In addition, we also found significant positive knowledge spill-over and network effects in the program with regard to business management and support. However, more than half of the participants indicated experiencing repayment problems either personally or with other group members due to unexpected emergencies and sickness. These findings highlight that microcredit programs have the potential of being an economic support system for HIV clients trying to reestablish their livelihoods, especially in resource-constrained settings, though more research is needed to determine the overall economic viability of such programs.
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Wajja, Anne, Milly Namutebi, Barbara Apule, et al. "Lessons from the first clinical trial of a non-licensed vaccine among Ugandan adolescents: a phase II field trial of the tuberculosis candidate vaccine, MVA85A." Wellcome Open Research 3 (September 19, 2018): 121. http://dx.doi.org/10.12688/wellcomeopenres.14736.1.
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Background: A more effective vaccine for tuberculosis (TB) is a global public health priority. Vaccines under development will always need evaluation in endemic settings, most of which have limited resources. Adolescents are an important target population for a new TB vaccine and for other vaccines which are relevant at school-age. However, in most endemic settings there is limited experience of trials of investigational products among adolescents, and adolescents are not routinely vaccinated. Methods: We used Modified vaccinia Ankara-expressing Ag85A (MVA85A), a well-tolerated candidate vaccine for tuberculosis, to assess the effect of Schistosoma mansoni infection on vaccine immunogenicity among Ugandan adolescents in primary school. We describe here the challenges and lessons learned in designing and implementing this first clinical trial among Ugandan adolescents using a non-licensed vaccine. Results: The school based immunization study was feasible and adhered to Good Clinical Practice principles. Engagement with the community and all stakeholders was critical for successful implementation of the trial. Creative and adaptable strategies were used to address protocol-specific, operational and logistical challenges. This study provided lessons and solutions that can be applied to other trials among adolescents in similar settings elsewhere, and to school-based immunization programs. Conclusion: Sufficient time and resources should be planned for community preparation and sensitization to ensure buy in and acceptance of a project of this kind. This trial shows that challenges to implementing early field trials in Africa are not insurmountable and that necessary well-planned high-quality ethical trials are feasible and should be encouraged. Trial Registration: ClinicalTrials.gov NCT02178748 03/06/2014
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Musoke, David, Freddy Eric Kitutu, Lawrence Mugisha, et al. "A One Health Approach to Strengthening Antimicrobial Stewardship in Wakiso District, Uganda." Antibiotics 9, no. 11 (2020): 764. http://dx.doi.org/10.3390/antibiotics9110764.
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Antimicrobial stewardship (AMS), as one of the global strategies to promote responsible use of antimicrobials to prevent antimicrobial resistance (AMR), remains poor in many low-and middle-income countries (LMICs). We implemented a project aimed at strengthening AMS in Wakiso district, Uganda using a One Health approach. A total of 86 health practitioners (HPs), including animal health workers, and 227 community health workers (CHWs) participated in training workshops, and over 300 pupils from primary schools were sensitized on AMR, AMS, and infection prevention and control (IPC). We further established two multidisciplinary online communities of practice (CoPs) for health professionals and students, with a current membership of 321 and 162, respectively. In addition, a Medicine and Therapeutics Committee (MTC) was set up at Entebbe Regional Referral Hospital. The project evaluation, conducted three months after training, revealed that the majority of the HPs (92.2%) and CHWs (90.3%) reported enhanced practices, including improved hand washing (57.3% and 81.0%, respectively). In addition, 51.5% of the HPs reported a reduction in the quantity of unnecessary antibiotics given per patient. This project demonstrates that AMS interventions using a One Health approach can promote understanding of the prudent use of antimicrobials and improve practices at health facilities and in communities.
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Mujjuzi, Ibrahim, Paul Mutegeki, Sarah Nabuwufu, et al. "Care Burden and Coping Strategies among Caregivers of Paediatric HIV/AIDS in Northern Uganda: A Cross-Sectional Mixed-Method Study." AIDS Research and Treatment 2021 (September 13, 2021): 1–14. http://dx.doi.org/10.1155/2021/6660337.
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Background. Family caregivers provide the bulk of care to children living with HIV. This places an enormous demand and care burden on the caregivers who often struggle to cope in various ways, some of which may be maladaptive. This may adversely affect their quality of care. Very little literature exists in resource-limited contexts on the burden of care experienced by caregivers on whom children living with HIV/AIDS depend for their long-term care. We assessed care burden and coping strategies among the caregivers of paediatric HIV/AIDS patients in Lira district, northern Uganda. Methods. A mixed-method cross-sectional study was conducted among 113 caregivers of paediatric HIV patients attending the ART clinic at a tertiary healthcare facility in Lira district, northern Uganda. A consecutive sampling method was used to select participants for the quantitative study, while 15 respondents were purposively sampled for the qualitative data. Quantitative data were collected using standard interviewer-administered questionnaires, while in-depth interview guides were used to collect qualitative data. Data were entered, cleaned, and analysed using SPSS version 23. Qualitative data were analysed thematically. Results. The majority of the caregivers, 65.5% (74), experienced mild-to-moderate burden. The mean burden scores significantly differed by caregivers’ age ( P = 0.017 ), marital status ( P = 0.017 ), average monthly income ( P = 0.035 ), and child’s school attendance ( P = 0.039 ). Accepting social support, seeking spiritual support, and reframing were the three most commonly used strategies for coping. Marital status and occupation were, respectively, positively and negatively correlated with information-seeking as a coping strategy, while monthly income was positively correlated with psychosocial support as a strategy. Seeking community support was negatively correlated with the duration of the child’s care. Conclusions. Our findings show that care burden is a common problem among the caregivers of children living with HIV in the study context.