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1
Roby, Jini L., and Stacey A. Shaw. "Evaluation of a Community-Based Orphan Care Program in Uganda." Families in Society: The Journal of Contemporary Social Services 89, no. 1 (January 2008): 119–28. http://dx.doi.org/10.1606/1044-3894.3716.
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In response to the orphan crisis in sub-Saharan Africa, the international child welfare community has agreed on a model that aims to increase the capacity of families and communities. Yet, little is known thus far about the service content and efficacy of programs based on the model. This project examined a community-based program in Uganda that provides support and assistance to families raising orphaned and other vulnerable children. Findings suggest that the households' need in certain categories, such as housing and food security, decreased significantly after services were received. Children's senses of belonging and permanency appeared promising. The program's strengths are discussed with recommended changes, as well as implications for policy, practice, and further research.
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Nshakira-Rukundo, Emmanuel, Essa Chanie Mussa, Nathan Nshakira, Nicolas Gerber, and Joachim von Braun. "Impact of community-based health insurance on utilisation of preventive health services in rural Uganda: a propensity score matching approach." International Journal of Health Economics and Management 21, no. 2 (February 10, 2021): 203–27. http://dx.doi.org/10.1007/s10754-021-09294-6.
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AbstractThe effect of voluntary health insurance on preventive health has received limited research attention in developing countries, even when they suffer immensely from easily preventable illnesses. This paper surveys households in rural south-western Uganda, which are geographically serviced by a voluntary Community-based health insurance scheme, and applied propensity score matching to assess the effect of enrolment on using mosquito nets and deworming under-five children. We find that enrolment in the scheme increased the probability of using a mosquito net by 26% and deworming by 18%. We postulate that these findings are partly mediated by information diffusion and social networks, financial protection, which gives households the capacity to save and use service more, especially curative services that are delivered alongside preventive services. This paper provides more insight into the broader effects of health insurance in developing countries, beyond financial protection and utilisation of hospital-based services.
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Grain, Kari, Tonny Katumba, Dennis Kirumira, Rosemary Nakasiita, Saudah Nakayenga, Eseza Nankya, Vicent Nteza, and Micheal Ssegawa. "Co-Constructing Knowledge in Uganda: Host Community Conceptions of Relationships in International Service-Learning." Journal of Experiential Education 42, no. 1 (January 7, 2019): 22–36. http://dx.doi.org/10.1177/1053825918820677.
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Background: The social justice goals of service-learning programs are often contingent upon strong relationships with host community members. Given this common narrative, it is necessary to extend our understanding of relationships in international service-learning (ISL), particularly as they are conceptualized by host community members. Purpose: This study engaged seven Ugandan coresearchers in a participatory project to examine the community impacts of a long-term ISL program facilitated by the University of British Columbia (UBC) and based in Kitengesa, Uganda. Methodology/Approach: Thematic analysis of photovoice data from photos, interviews, and focus groups reveals key impacts that are premised on friendships, educational relationships, and relationships for social change. Findings/Conclusions: The article illustrates a host community conceptualization of ISL that positions relationships not as a precursor to ISL done well, but as the success in itself. Extending from this study is a critical discussion of the nuanced, social justice–oriented tensions that arise in the participatory research and co-analysis process. Implications: Institutions often assess the impact of ISL and other experiential education programs in terms of student learning, but findings suggest that social justice goals may be better achieved through an emphasis on relationships and knowledge as conceptualized by host community members.
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Museba, Tapiwanashe James, Edmore Ranganai, and Gianfranco Gianfrate. "Customer perception of adoption and use of digital financial services and mobile money services in Uganda." Journal of Enterprising Communities: People and Places in the Global Economy 15, no. 2 (February 22, 2021): 177–203. http://dx.doi.org/10.1108/jec-07-2020-0127.
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Purpose This paper aims to investigate the impact of fintech, mobile money and digital financial services in Uganda and factors impacting adoption of the services. The study will also determine their social impact through financial inclusion in the Ugandan market. Design/methodology/approach This study covers the adoption and use of fintech, mobile money and digital financial services in Uganda. A case study approach was used through a survey questionnaire for 400 randomly selected participants within the Kampala region. Questionnaire was designed to measure customer perception of digital financial services and adoption including mobile money and agency banking. Findings The adoption of mobile money services is driven by mobile devices penetration and the need for access to financial products and services for the unbanked. Results support CGAP (2013) that observed that mobile money adoption was based on two key variables: social network and social interactions of the customer and a segment of customers who can be described as mobile technology leaders (early adopters). There has been positive impact on person to person transfers, grocery payments and mobile money providers have to continue to simplify the access to financial services and bring convenience to the bottom of the pyramid. And mobile money positively impacts sustainable developmental goals covering Gender Equality (SDG5), SDG 8 – Decent Work and Economic Growth; expanding financial inclusion through mobile money and SDG 10 – Reduce Inequalities. Research limitations/implications This study has limitations commonly prevalent with qualitative research, including the small size limited to Kampala and challenges of making generalisations beyond this context. Practical implications The paper might serve as a valuable source of information for government and fintech companies in developing the digital financial services ecosystem as well as for students and academics for further case studies in this area. Originality/value This paper serves as one of the first qualitative research papers concerning mobile money and digital financial services adoption, solely focused on Uganda. Its value is in its showcasing of the importance of mobile money among customers in emerging markets.
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Liebling, Helen Jane, Hazel Rose Barrett, and Lillian Artz. "Sexual and gender-based violence and torture experiences of Sudanese refugees in Northern Uganda: health and justice responses." International Journal of Migration, Health and Social Care 16, no. 4 (October 12, 2020): 389–414. http://dx.doi.org/10.1108/ijmhsc-10-2019-0081.
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Purpose This British Academy/Leverhulme-funded research (Grant number: SG170394) investigated the experiences and impact of sexual and gender-based violence (SGBV) and torture on South Sudanese refugees’ health and rights and the responses of health and justice services in Northern Uganda. Design/methodology/approach It involved thematic analysis of the narratives of 20 men and 41 women refugees’ survivors of SGBV and torture; this included their experiences in South Sudan, their journeys to Uganda and experiences in refugee settlements. In total, 37 key stakeholders including health and justice providers, police, non-government and government organisations were also interviewed regarding their experiences of providing services to refugees. Findings All refugees had survived human rights abuses carried out in South Sudan, on route to Uganda and within Uganda. Incidents of violence, SGBV, torture and other human rights abuses declined significantly for men in Uganda, but women reported SGBV incidents. The research demonstrates linkages between the physical, psychological, social/cultural and justice/human rights impact on women and men refugees, which amplified the impact of their experiences. There was limited screening, physical and psychological health and support services; including livelihoods and education. Refugees remained concerned about violence and SGBV in the refugee settlements. While they all knew of the reporting system for such incidents, they questioned the effectiveness of the process. For this reason, women opted for family reconciliation rather than reporting domestic violence or SGBV to the authorities. Men found it hard to report incidences due to high levels of stigma and shame. Research limitations/implications Refugees largely fled South Sudan to escape human rights abuses including, persecution, SGBV and torture. Their experiences resulted in physical, psychological, social-cultural and justice effects that received limited responses by health and justice services. An integrated approach to meeting refugees’ needs is required. Practical implications The authors make recommendations for integrated gender sensitive service provision for refugees including more systematic screening, assessment and treatment of SGBV and torture physical and emotional injuries combined with implementation of livelihoods and social enterprises. Social implications The research demonstrates that stigma and shame, particularly for male refugee survivors of SGBV and torture, impacts on ability to report these incidents and seek treatment. Increasing gender sensitivity of services to these issues, alongside provision of medical treatment for injuries, alongside improved informal justice processes, may assist to counteract shame and increase disclosure. Originality/value There is currently a lack of empirical investigation of this subject area, therefore this research makes a contribution to the subject of understanding refugees’ experiences of SGBV and torture, as well as their perceptions of service provision and response. This subject is strategically important due to the pressing need to develop integrated, gendered and culturally sensitive services that listen to the voices and draw on the expertise of refugees themselves while using their skills to inform improvements in service responses and policy.
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Widner, Jennifer, and Alexander Mundt. "Researching social capital in Africa." Africa 68, no. 1 (January 1998): 1–24. http://dx.doi.org/10.2307/1161145.
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Scholars in several disciplines have recently turned their attention to the effects of community characteristics on attitudes and behaviour. ‘Social capital’ figures prominently in this new literature. This article explores the influence of trust, optimism, voluntarism and other standard components of social capital on political participation and institutional performance in two African contexts: Uganda and Botswana. It concludes that generalised trust and participation in social clubs help shape decisions to participate in formal politics, although their influence is dwarfed by gender and urbanisation. However, social capital bears no clear relation to institutional performance, as measured by residents' levels of satisfaction with government services.
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ILUKOR, J., R. BIRNER, P. B. RWAMIGISA, and N. NANTIMA. "THE PROVISION OF VETERINARY SERVICES: WHO ARE THE INFLUENTIAL ACTORS AND WHAT ARE THE GOVERNANCE CHALLENGES? A CASE STUDY OF UGANDA." Experimental Agriculture 51, no. 3 (January 16, 2015): 408–34. http://dx.doi.org/10.1017/s0014479714000398.
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SUMMARYAs a result of continued fiscal challenges from the late 1980s to date, the government of Uganda liberalized and decentralized the provision of veterinary services. As a result, many actors are involved in providing veterinary services without adequate regulation and supervision. With the resurgence of infectious diseases, and increased economic and health risks, especially to the rural poor, there is the need to understand relational patterns of actors to ensure good governance, and address emerging and re-emerging risks of animal diseases. A participatory mapping tool called Process Net-Map was used to identify relevant actors and assess their influence in the delivery of clinical and preventive veterinary services in both pastoral and intensive livestock production systems. The tool also served to elicit governance challenges in veterinary service delivery. The results reveal that important social relations in veterinary service delivery include the following: (1) Cooperation between private veterinarians and paraprofessionals as well as private veterinarians and government veterinarians in intensive production systems; and (2) cooperation between NGOs, government veterinarians and community-based animal health workers in pastoral areas. Staff absenteeism, insufficient and unpredictable budgets, weak legislation, exclusion of technical staff from the decision-making process and policy illogicality were identified as major governance problems of veterinary service delivery. The paper concludes that given the existing fiscal challenges, the key to improving animal service delivery in Uganda is getting priorities, policies and institutions right.
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Atuhaire, Ruth, Robert Wamala, Leonard K. Atuhaire, and Elizabeth Nansubuga. "Regional differentials in early antenatal care, health facility delivery and early postnatal care among women in Uganda." Journal of Economics and Behavioral Studies 13, no. 4(J) (September 4, 2021): 17–30. http://dx.doi.org/10.22610/jebs.v13i4(j).3174.
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This study aimed at examining regional differentials in maternal healthcare services in Uganda. Using a sample of 1,521 women of reproductive ages (15-49) from Eastern and Western sub-regions of Uganda, and non-linear Oaxaca’ Blinder Multivariate Decomposition method, we assessed differentials in utilization of early antenatal care, health facility delivery and early postnatal care services among the women, henceforth, establishing main predictors of regional inequalities that will enable policymakers to make better evenly interventions and focused decisions. The study reveals that differentials in the utilization of maternal healthcare services are not only hindered by social and economic barriers, but also widespread disparities in the utilization of existing services. Significant differentials were attributed to both variation in women’s characteristics and effects of coefficients. Findings showed that the gap in early antenatal care would reduce on average by 31.6% and 34.7% of differences in availability of community health workers and media exposure respectively, were to disappear. Furthermore, the gap would increase on average by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth respectively. The gap in health facility delivery would reduce on average by 24.6% and 37.2% of differences in community health worker availability and media exposure were to disappear respectively and increase on average by 54.9% in the absence of variations in effects of maternal education. The gap in EPNC would reduce on average by 18.5% and 17.17% of differences in maternal education and community health worker availability were to disappear respectively and increase on average by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth respectively. Progress towards equitable maternal health care should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.
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Seeley, J., U. Wagner, J. Mulemwa, J. Kengeya-kayondo, and D. Mulder. "The development of a community-based HIV/AIDS counselling service in a rural area in Uganda." AIDS Care 3, no. 2 (April 1991): 207–17. http://dx.doi.org/10.1080/09540129108253064.
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Anyango, Mary, Regis Zombeire Kamaduuka, and Maria Goretti Kaahwa. "Performance Management and Quality of Lecturers’ Services at Makerere University." East African Journal of Education Studies 2, no. 1 (December 1, 2020): 161–72. http://dx.doi.org/10.37284/eajes.2.1.243.
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The purpose of this study was to establish the relationship between goal setting and quality of lecturers’ services. This was based on the deteriorating quality of lecturers’ services in Makerere University, the pioneer university in Uganda. The study was a cross-sectional survey, targeting academic staff in College of Humanity and Social Sciences (CHUSS), College of Commerce and Business Administration (CoBAMS) and College of Education and External Studies (CEES). These lecturers were selected using simple random sampling technique. Data was collected using a self-administered questionnaire. It was analysed using Pearson’s correlation coefficient index and regression analysis techniques. Results revealed that there was a highly positive significant impact between goal setting and quality of lecturers’ services (teaching, research supervision, writing and publication, and finally community services). It was hence concluded that goal setting is a strong predictor of quality of lecturers’ services. Thus, a recommendation that once lecturers’ quality of services is to be enhanced at Makerere University there should be high engagement of lecturers on boards, council, senate to influence decisions geared towards achieving university objectives missions and goals.
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Kamulegeya, Louis H., Joseph Ssebwana, Wilson Abigaba, John M. Bwanika, and Davis Musinguzi. "Mobile Health in Uganda: A Case Study of the Medical Concierge Group." East Africa Science 1, no. 1 (March 25, 2019): 9–14. http://dx.doi.org/10.24248/easci.v1.iss1.12.
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The ubiquity of mobile phones offers an opportunity for a paradigm change in health-care delivery, which may offer solutions to some of the challenges faced by the health sector in Uganda. The Medical Concierge Group (TMCG) is a digital health company, headquartered in Uganda, which leverages on mobile phone-based platforms – such as short messaging service (SMS), voice calling – and social media to deliver health services. Just over two-thirds (68%) of users of TMCG’s services are males between 18 and 30 years of age. SMS reminders have improved the honouring of health facility appointments among HIV-positive clients, from 60% to 90%; retention rates at supported health facilities have improved from 45% to 89%. Furthermore, information dissemination has been achieved via mobile SMS, wherein subscribers can access health content on diverse topics – such as HIV/AIDS prevention and family planning – by sending messages to a pre-defined short code to a phone line. Over 900 beneficiaries have accessed health content via SMS subscriptions. Social media platforms, including Facebook and Twitter, are used for health information dissemination and have enabled a wider reach to over 13 million beneficiaries accessing health information on TMCG’s Facebook page alone. Tailoring mobile phone-based health content to meet the target beneficiaries’ needs is critical for TMCG’s impact and uptake. With rising rates of phone ownership and Internet connectivity in Uganda, mobile phones offer an affordable and proven adoptable avenue to overcome the chronic challenges faced by the health sector.
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Kamulegeya, Louis H., Joseph Ssebwana, Wilson Abigaba, John M. Bwanika, and Davis Musinguzi. "Mobile Health in Uganda: A Case Study of the Medical Concierge Group." East Africa Science 1, no. 1 (March 25, 2019): 9–14. http://dx.doi.org/10.24248/easci.v1.iss1.3.
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The ubiquity of mobile phones offers an opportunity for a paradigm change in health-care delivery, which may offer solutions to some of the challenges faced by the health sector in Uganda. The Medical Concierge Group (TMCG) is a digital health company, headquartered in Uganda, which leverages on mobile phone-based platforms – such as short messaging service (SMS), voice calling – and social media to deliver health services. Just over two-thirds (68%) of users of TMCG’s services are males between 18 and 30 years of age. SMS reminders have improved the honouring of health facility appointments among HIV-positive clients, from 60% to 90%; retention rates at supported health facilities have improved from 45% to 89%. Furthermore, information dissemination has been achieved via mobile SMS, wherein subscribers can access health content on diverse topics – such as HIV/AIDS prevention and family planning – by sending messages to a pre-defined short code to a phone line. Over 900 beneficiaries have accessed health content via SMS subscriptions. Social media platforms, including Facebook and Twitter, are used for health information dissemination and have enabled a wider reach to over 13 million beneficiaries accessing health information on TMCG’s Facebook page alone. Tailoring mobile phone-based health content to meet the target beneficiaries’ needs is critical for TMCG’s impact and uptake. With rising rates of phone ownership and Internet connectivity in Uganda, mobile phones offer an affordable and proven adoptable avenue to overcome the chronic challenges faced by the health sector.
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Kamulegeya, Louis H., Joseph Ssebwana, Wilson Abigaba, John M. Bwanika, and Davis Musinguzi. "Mobile Health in Uganda: A Case Study of the Medical Concierge Group." East Africa Science 1, no. 1 (March 25, 2019): 9–14. http://dx.doi.org/10.24248/easci.v1i1.3.
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The ubiquity of mobile phones offers an opportunity for a paradigm change in health-care delivery, which may offer solutions to some of the challenges faced by the health sector in Uganda. The Medical Concierge Group (TMCG) is a digital health company, headquartered in Uganda, which leverages on mobile phone-based platforms – such as short messaging service (SMS), voice calling – and social media to deliver health services. Just over two-thirds (68%) of users of TMCG’s services are males between 18 and 30 years of age. SMS reminders have improved the honouring of health facility appointments among HIV-positive clients, from 60% to 90%; retention rates at supported health facilities have improved from 45% to 89%. Furthermore, information dissemination has been achieved via mobile SMS, wherein subscribers can access health content on diverse topics – such as HIV/AIDS prevention and family planning – by sending messages to a pre-defined short code to a phone line. Over 900 beneficiaries have accessed health content via SMS subscriptions. Social media platforms, including Facebook and Twitter, are used for health information dissemination and have enabled a wider reach to over 13 million beneficiaries accessing health information on TMCG’s Facebook page alone. Tailoring mobile phone-based health content to meet the target beneficiaries’ needs is critical for TMCG’s impact and uptake. With rising rates of phone ownership and Internet connectivity in Uganda, mobile phones offer an affordable and proven adoptable avenue to overcome the chronic challenges faced by the health sector.
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Schramm, Stine, Jannie Nielsen, Felix O. Kaducu, Ceaser L. Okumu, Emilio Ovuga, and Morten Sodemann. "Post-conflict household structures and underweight: a multilevel analysis of a community-based study in northern Uganda." Public Health Nutrition 21, no. 15 (June 18, 2018): 2725–34. http://dx.doi.org/10.1017/s1368980018001581.
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AbstractObjectiveTo examine associations between household-level characteristics and underweight in a post-conflict population.DesignNutritional status of residents in the Gulu Health and Demographic Surveillance Site was obtained during a community-based cross-sectional study, ~6 years after the civil war. Household-level factors included headship, polygamy, household size, child-to-adult ratio, child crowding, living with a stunted or overweight person, deprived area, distance to health centre and socio-economic status. Multilevel logistic regression models examined associations of household and community factors with underweight, calculating OR, corresponding 95 % CI and intraclass correlation coefficients. Effect modification by gender and age was examined by interaction terms and stratified analyses.SettingRural post-conflict area in northern Uganda.SubjectsIn total, 2799 households and 11 312 individuals were included, representing all age groups.ResultsLiving in a female-headed v. male-headed household was associated (OR; 95 % CI) with higher odds for underweight among adult men (2·18; 1·11, 4·27) and girls <5 years (1·51; 0·97, 2·34), but lower odds among adolescent women aged 13–19 years (0·46; 0·22, 0·97). Higher odds was seen for residents living in deprived areas (1·37; 0·97, 1·94), with increasing distance to health services (P-trend <0·05) and among adult men living alone v. living in an average-sized household of seven members (3·23; 1·22, 8·59). Residents living in polygamous households had lower odds for underweight (0·79; 0·65, 0·97).ConclusionsThe gender- and age-specific associations between household-level factors and underweight are likely to reflect local social capital structures. Adapting to these is crucial before implementing health and nutrition interventions.
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Stranger-Johannessen, Espen, Marlene Asselin, and Ray Doiron. "New perspectives on community library development in Africa." New Library World 116, no. 1/2 (January 12, 2015): 79–93. http://dx.doi.org/10.1108/nlw-05-2014-0063.
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Purpose – The purpose of this paper is to discuss the constraints of and opportunities for the role of African community libraries in development, using an ecological framework for library development. Design/methodology/approach – Drawing on a review of the literature and the three authors’ own experiences, the paper critically examines community libraries, mainly from Uganda and Ethiopia, and frames the analysis within an ecological framework of library development. Findings – There are many examples of community libraries that realize various elements of the ecological framework (context/environment, equity/social justice, partnerships/interactions, and action/research). Practical implications – The ecological framework further developed in this paper helps community library leaders to critically examine their programmes and services and develop strategies for further growth, and suggests closer collaboration between community librarians, local communities, and researchers. Originality/value – This paper addresses the need to move beyond community library research on the predominant outputs (library statistics) and outcomes (societal value/impact) models, adding a critical perspective of the larger social and political structures that limit and shape the development of community libraries.
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King, Rachel, Zubayiri Sebyala, Moses Ogwal, George Aluzimbi, Rose Apondi, Steven Reynolds, Patrick Sullivan, and Wolfgang Hladik. "How men who have sex with men experience HIV health services in Kampala, Uganda." BMJ Global Health 5, no. 4 (April 2020): e001901. http://dx.doi.org/10.1136/bmjgh-2019-001901.
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In sub-Saharan Africa, men who have sex with men (MSM) are socially, largely hidden and face disproportionate risk for HIV infection. Attention to HIV epidemics among MSM in Uganda and elsewhere in sub-Saharan Africa has been obscured by repressive governmental policies, criminalisation, stigma and the lack of basic epidemiological data describing these epidemics. In this paper, we aim to explore healthcare access, experiences with HIV prevention services and structural barriers to using healthcare services in order to inform the acceptability of a combination HIV prevention package of services for men who have sex with men in Uganda. We held focus group discussions (FGDs) with both MSM and healthcare providers in Kampala, Uganda, to explore access to services and to inform prevention and care. Participants were recruited through theoretical sampling with criteria based on ability to answer the research questions. Descriptive thematic coding was used to analyse the FGD data. We described MSM experiences, both negative and positive, as they engaged with health services. Our findings showed that socio-structural factors, mediated by psychological and relational factors impacted MSM engagement in care. The socio-structural factors such as stigma, homophobia and policy issues emerged strongly as did the mediating factors such as relations with specific health staff and a social support structure. A combination intervention addressing structural, social and psychological barriers could have an impact even in the precarious policy environment where this study was conducted.
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Muhumuza, Richard, Andrew Sentoogo Ssemata, Ayoub Kakande, Nadia Ahmed, Millicent Atujuna, Mangxilana Nomvuyo, Linda-Gail Bekker, et al. "Exploring Perceived Barriers and Facilitators of PrEP Uptake among Young People in Uganda, Zimbabwe, and South Africa." Archives of Sexual Behavior 50, no. 4 (May 2021): 1729–42. http://dx.doi.org/10.1007/s10508-020-01880-y.
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Abstract Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. Few studies have explored adolescents and young people’s perspectives toward PrEP. We conducted 24 group discussions and 60 in-depth interviews with males and females aged 13–24 years in Uganda, Zimbabwe, and South Africa between September 2018 and February 2019. We used the framework approach to generate themes and key concepts for analysis following the social ecological model. Young people expressed a willingness to use PrEP and identified potential barriers and facilitators of PrEP uptake. Barriers included factors at individual (fear of HIV, fear of side effects, and PrEP characteristics), interpersonal (parental influence, absence of a sexual partner), community (peer influence, social stigma), institutional (long waiting times at clinics, attitudes of health workers), and structural (cost of PrEP and mode of administration, accessibility concerns) levels. Facilitators included factors at individual (high HIV risk perception and preventing HIV/desire to remain HIV negative), interpersonal (peer influence, social support and care for PrEP uptake), community (adequate PrEP information and sensitization, evidence of PrEP efficacy and safety), institutional (convenient and responsive services, provision of appropriate and sufficiently resourced services), and structural (access and availability of PrEP, cost of PrEP) levels. The findings indicated that PrEP is an acceptable HIV prevention method. PrEP uptake is linked to personal and environmental factors that need to be considered for successful PrEP roll-out. Multi-level interventions needed to promote PrEP uptake should consider the social and structural drivers and focus on ways that can inspire PrEP uptake and limit the barriers.
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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 (October 24, 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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Kayaga, Sam. "Soft systems methodology for performance measurement in the Uganda water sector." Water Policy 10, no. 3 (June 1, 2008): 273–84. http://dx.doi.org/10.2166/wp.2008.153.
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Water and sanitation services in developing countries are delivered in an extremely complex institutional environment, characterised by “soft” problems, that is problems with significant political and social components whose “what” and “how” cannot be defined early in the intervention process. A problem situation common in developing countries depicting “soft” characteristics is how to improve the effectiveness and efficacy of existing performance measurement systems to track the progress towards achievement of water/sanitation-related Millennium Development Goals (MDGs). Such problem situations are better handled using soft systems methodology (SSM), a methodology recommended by Professor Checkland and his research colleagues at Lancaster University, UK. In 2003, SSM was applied in an intervention that aimed to improve performance measurement systems in the Uganda water/sanitation sector. Through strong participation of the key stakeholders, a team of researchers with their local counterparts in Uganda developed and field tested a performance measurement framework. According to an evaluation by the international donor community, policy makers and managers in the sector, the past three annual water/sanitation sector performance reports compiled using the performance measurement framework have depicted a progressive qualitative improvement.
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Asasira, Justus, and Frank Ahimbisibwe. "Public-Private Partnership in Health Care and Its Impact on Health Outcomes: Evidence from Ruharo Mission Hospital in Uganda." International Journal of Social Science Studies 6, no. 12 (December 27, 2018): 79. http://dx.doi.org/10.11114/ijsss.v6i12.3911.
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Background: Uganda’s government has embraced private provision of social services including health care. The involvement of private providers is an indicator that the public facilities are not sufficient enough to meet the high demands of the ever-increasing population. This has been done through partnership arrangements. This paper discusses the impact of Public-Private Partnership (PPP) in health care outcomes of the local population and opportunities for improving health outcomes, challenges facing private providers in a low income setting.Methodology: Data were collected using qualitative methods in January 2017 through interview (using semi-structured questions) at Ruharo Mission Hospital (RMH) administration, health workers, district health office and used a structured questionnaire for patients/clients. This was a nascent study, with a sample size of 22 respondents. The hospital has three departments; Organized Useful Rehabilitation Services (OURS), General Medical Services (GMS) and Eye Department (ED). All the departments of the hospital were represented in this study.Results: The hospital is a Church of Uganda project and runs a budget of 5 billion shillings ($ 1,351,351.4) annually, had multiple sources of funding including PHC funding annually and that, health services were delivered adequately to clients. Much as some services were accessed at no costs, other services like eye treatment were found expensive on the side of clients. The hospital’s hybrid mode of delivering health services through outreaches and facility-based services was cherished, however it had no ambulance and relied only on a hospital van.Conclusions and Recommendations: Our study concluded that if private providers are supported under the partnership arrangement, they can adequately deliver services to the clients and decongest the public facilities. We recommend that the government devote funds to support the hospital through employing more sub-seconded staff, procuring medicines, and ambulances to enable it to subsidize services especially eye treatment and other services not supported under the partnership.
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Logie, Carmen Helen, Moses Okumu, Simon Mwima, Peter Kyambadde, Robert Hakiza, Irungu Peter Kibathi, and Emmanuel Kironde. "Sexually transmitted infection testing awareness, uptake and diagnosis among urban refugee and displaced youth living in informal settlements in Kampala, Uganda: a cross-sectional study." BMJ Sexual & Reproductive Health 46, no. 3 (December 23, 2019): 192–99. http://dx.doi.org/10.1136/bmjsrh-2019-200392.
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BackgroundSexually transmitted infection (STI) prevention needs among urban refugee and displaced youth are understudied. The study objective was to explore factors associated with the STI prevention cascade (STI services awareness, testing, diagnosis) among urban refugee and displaced youth in Kampala, Uganda.MethodsWe implemented a cross-sectional survey with youth aged 16–24 years in informal settlements in Kampala. We conducted bivariate and multivariable logistic regression analyses to identify social ecological (intrapersonal, interpersonal, community) level factors associated with STI testing services awareness, lifetime STI testing, and lifetime STI diagnosis.ResultsParticipants (n=445; mean age 19.3, SD 2.6, years) included young women (n=333, 74.8%) and young men (n=112, 25.2%). Less than half (43.8%) were aware of community STI services. One-quarter (26.1%) reported lifetime STI testing. Of these, 39.5% reported a lifetime STI diagnosis. In multivariable analyses among young women, age, lifetime sex partners, and lower adolescent sexual and reproductive health (SRH)-related stigma were associated with STI services awareness; and age, lower adolescent SRH-related stigma, and food security were associated with STI testing. Among young men, time in Uganda and lower HIV-related stigma were associated with STI services awareness; and age, condom self-efficacy, and increased adolescent SRH-related stigma were associated with testing. Lifetime sex partners, lower condom self-efficacy, and lower adolescent SRH-related stigma were associated with lifetime STI diagnosis.ConclusionsSocial ecological factors including stigma (adolescent SRH-related, HIV-related) were associated with STI testing and diagnosis among young urban refugees. Gender, age and stigma-tailored strategies can advance the STI prevention cascade among urban young refugees.
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Kastner, Jasmine, Lynn T. Matthews, Ninsiima Flavia, Francis Bajunirwe, Susan Erikson, Nicole S. Berry, and Angela Kaida. "Antiretroviral Therapy Helps HIV-Positive Women Navigate Social Expectations for and Clinical Recommendations against Childbearing in Uganda." AIDS Research and Treatment 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/626120.
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Understanding factors that influence pregnancy decision-making and experiences among HIV-positive women is important for developing integrated reproductive health and HIV services. Few studies have examined HIV-positive women’s navigation through the social and clinical factors that shape experiences of pregnancy in the context of access to antiretroviral therapy (ART). We conducted 25 semistructured interviews with HIV-positive, pregnant women receiving ART in Mbarara, Uganda in 2011 to explore how access to ART shapes pregnancy experiences. Main themes included: (1) clinical counselling about pregnancy is often dissuasive but focuses on the importance of ART adherence once pregnant; (2) accordingly, women demonstrate knowledge about the role of ART adherence in maintaining maternal health and reducing risks of perinatal HIV transmission; (3) this knowledge contributes to personal optimism about pregnancy and childbearing in the context of HIV; and (4) knowledge about and adherence to ART creates opportunities for HIV-positive women to manage normative community and social expectations of childbearing. Access to ART and knowledge of the accompanying lowered risks of mortality, morbidity, and HIV transmission improved experiences of pregnancy and empowered HIV-positive women to discretely manage conflicting social expectations and clinical recommendations regarding childbearing.
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Plourde, Kate F., Geeta Nanda, Elise Healy, Dennis Kibwola, Phoebe Mutonyi, Michael Ochwo, Francis Okello, and Joy Cunningham. "Implementation of Anyaka Makwiri: A Multicomponent Mentoring Program for Adolescent Girls and Young Women in Uganda." Journal of Youth Development 16, no. 2-3 (July 14, 2021): 278–86. http://dx.doi.org/10.5195/jyd.2021.1003.
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This article describes the development and implementation of the Anyaka Makwiri program and summarizes results from the qualitative assessment of participant experiences. Anyaka Makwiri is a multicomponent mentoring program developed for adolescent girls and young women (AGYW) ages 15 to 24 in Gulu, Uganda. The comprehensive program consisted of a curriculum covering sexual and reproductive health (SRH), financial capabilities, soft skills, and gender-based violence and gender equality; activities designed to improve participants’ social connectedness; optional onsite testing for sexually transmitted infections (STIs), HIV, and pregnancy along with STI treatment; group-based savings; and links to SRH services, including contraceptive and gender-based violence services. The program was implemented over a 6-month period and reached 490 AGYW. Findings are derived from routine program-monitoring data including administrative records, de-identified service statistics, and baseline surveys. In addition, this article summarizes some of the key findings from qualitative interviews with both mentors and AGYW participants, conducted at the conclusion of the program. Participants generally had a favorable view of the mentoring program, particularly in terms of the curriculum topics they were exposed to, and mentors were also positive about their experiences. Despite the program’s many successes there were some implementation challenges, the most prominent being intermittent participant attendance due to a variety of difficulties. The lessons learned from the implementation of Anyaka Makwiri provide valuable insights for the design and implementation of multicomponent mentoring programs for AGYW.
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Ssaka, Mustafa, Charles Lwanga, Tunc Eren, and Orhan Alimoglu. "Community use of masks as a preventive measure for Covid-19 in Kabale district of Uganda." International Journal of Human and Health Sciences (IJHHS) 5, no. 2 (October 4, 2020): 267. http://dx.doi.org/10.31344/ijhhs.v5i2.274.
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Coronavirus disease 2019 (Covid-19) caused a global pandemic and by June 1st, 2020, the global numbers of Covid-19 cases reached six million with more than 370,000 deaths. Community-wide mask wearing may contribute to the control of Covid-19 by reducing the amount of emission of infected saliva and respiratory droplets from persons with subclinical or mild Covid-19. However, use of masks in public and in health care facilities has been controversial as different organizations and agencies established different guidelines. In Uganda, not any reports on mask utilization practices have been published yet. Therefore, this report aims at documenting mask use practices, as observed in our interactions with non-Covid-19 patients and their relatives at Kabale regional referral hospital as well as Kabale town residents. It was observed that many non-Covid-19 patients and the relatives of hospitalized patients only wear their masks on reaching the hospital premises while community members of Kabale town wear their masks only in the presence of security agencies and individuals in the public only wear masks in places where they would be refused from services without masks. Wearing of masks in public places and health care facilities together with other preventive measures including hand hygiene, social distancing and wearing of full personal protective equipment for health care providers working on Covid-19 patients are key measures in preventing the spread of infection. There is an increased need for intensified community educational activities on public awareness of the importance of appropriate use of masks.International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 267-270
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Mubangizi, John C., and Prenisha Sewpersadh. "A Human Rights-based Approach to Combating Public Procurement Corruption in Africa." African Journal of Legal Studies 10, no. 1 (August 18, 2017): 66–90. http://dx.doi.org/10.1163/17087384-12340015.
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Corruption is a threat to human rights as it erodes accountability and violates many international human rights conventions. It also undermines basic principles and values like equality, non-discrimination, human dignity, and social justice – especially in African countries where democratic systems and institutional arrangements are less developed than in most European, Asian and American countries. Corruption occurs in both the public and private sectors and affects human rights by deteriorating institutions and diminishing public trust in government. Corruption impairs the ability of governments to fulfil their obligations and ensure accountability in the implementation and protection of human rights – particularly socio-economic rights pertinent to the delivery of economic and social services. This is because corruption diverts funds into private pockets – impeding delivery of services, and thereby perpetuating inequality, injustice and unfairness. This considered, the focus of this paper is on public procurement corruption. It is argued that by applying a human rights-based approach to combating public procurement corruption, the violation of human rights – particularly socio-economic rights – can be significantly reduced. Through a human rights-based approach, ordinary people can be empowered to demand transparency, accountability and responsibility from elected representatives and public officials – particularly those involved in public procurement. In the paper, reference is made to selected aspects of the national legal frameworks of five African countries: South Africa, Uganda, Kenya, Nigeria and Botswana.
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Waaswa, Andrew, and Felix Satognon. "Development and the Environment: Overview of the Development Planning Process in Agricultural Sector, in Uganda." Journal of Sustainable Development 13, no. 6 (October 12, 2020): 1. http://dx.doi.org/10.5539/jsd.v13n6p1.
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The social component of the environment associated mostly with human activities has significantly imposed a threat to the only life-support systems of the earth. Uganda made adjustments in its planning process to prioritize environment conservation. However, in the recent past years, mostly between 2013 and 2017, the country stretched its resources to increase agricultural production, both livestock and crops. The objective of this study was to establish and document the development and the environment conservation strategies at global and regional levels with an overview on the development planning process in agricultural sector, in Uganda. The results showed that the sustainable development plans with participatory approach at international, regional, national and local or community levels are the best methods to cope with and reduce the negative impacts of man’s activities on the environment. The understanding of the complexes of the environment is very important to ensure the relationship between the social, economic and environmental protection for a sustainable development. The results also indicated that in Uganda, the agriculture industry made consistent efforts to increase agricultural production by 431,161 hectares and livestock heads by 7,878,000 (cattle, sheep, goats, pigs, and poultry) between 2013 and 2017. This increased agricultural greenhouse gas emission due to the use of synthetic fertilizers, burning of the cleared grasses, and use of manures applied to boost soil fertility and the reduction in the trees that sequester CO2. This study recommended that the agricultural sector should opt for sustainable agriculture by adopting practices like use of multipurpose crops that can offer environmental services like binding soil particles together to control erosion as well as yielding more food products. Dual-purpose livestock breeds should be adopted to avoid immense numbers that serve different purposes that will probably lead to increased GHG emissions.
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Mazzi, Micheal, Francis Bajunirwe, Emmanuel Aheebwe, Simpson Nuwamanya, and Fred N. Bagenda. "Proximity to a community health worker is associated with utilization of malaria treatment services in the community among under-five children: a cross-sectional study in rural Uganda." International Health 11, no. 2 (September 28, 2018): 143–49. http://dx.doi.org/10.1093/inthealth/ihy069.
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Tumwesigye, Samuel, Lisa-Marie Hemerijckx, Alfonse Opio, Jean Poesen, Matthias Vanmaercke, Ronald Twongyirwe, and Anton Van Rompaey. "Who and Why? Understanding Rural Out-Migration in Uganda." Geographies 1, no. 2 (August 25, 2021): 104–23. http://dx.doi.org/10.3390/geographies1020007.
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Rural–urban migration in developing countries is considered to be a key process for sustainable development in the coming decades. On the one hand, rural–urban migration can contribute to the socioeconomic development of a country. On the other hand, it also leads to labor transfer, brain-drain in rural areas, and overcrowded cities where planning is lagging behind. In order to get a better insight into the mechanisms of rural–urban migration in developing countries, this paper analyzes motivations for rural–urban migration from the perspective of rural households in Uganda. A total of 1015 rural households located in southwestern Uganda were surveyed in 2019. A total of 48 percent of these households reported having at least one out-migrant. By means of logistic regression modeling, the likelihood for rural out-migration was assessed using household- and community-level socioeconomic characteristics as predictors. The results show that most out-migrants are from relatively wealthy households with a higher-than-average education level. Typically, these households are located in villages that are well connected with urban centers. Poor households in remote locations send significantly fewer migrants because of their limited access to migration information and poor transport networks. From these findings, the following policy recommendations are made: Firstly, efforts should be made to extend basic social services, including quality education, towards rural areas. Secondly, in order to reduce socially disruptive long-distance migration and the eventual overcrowding and sprawls of major cities, government investments should be oriented towards the upgrading of secondary towns, which can offer rural out-migrants rewarding employment and business opportunities.
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Porter, Holly E. "Mango Trees, Offices and Altars: The Role of Relatives, Non-governmental Organisations and Churches After Rape in Northern Uganda." International Journal on Minority and Group Rights 22, no. 3 (July 17, 2015): 309–34. http://dx.doi.org/10.1163/15718115-02203002.
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This article reflects on why so many women never access justice or take advantage of available services after rape in northern Uganda. It focuses on roles of three prominent non-governmental actors: lineage-based kinship authority, churches, and non-governmental organisations examining the parts they played after 94 instances of rape in this study and more broadly, how they have shaped notions of rape and appropriate responses to it. Evidence from this study (participant observation over three years and 187 in-depth interviews) suggests that although non-governmental organizations and churches have impacted evolution of social norms, reactions to wrongdoing are primarily decided by extended family structures, and are subject to a primary value of social harmony.
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Mutamba, Byamah B., Jeremy C. Kane, Joop T. V. M. de Jong, James Okello, Seggane Musisi, and Brandon A. Kohrt. "Psychological treatments delivered by community health workers in low-resource government health systems: effectiveness of group interpersonal psychotherapy for caregivers of children affected by nodding syndrome in Uganda." Psychological Medicine 48, no. 15 (February 15, 2018): 2573–83. http://dx.doi.org/10.1017/s0033291718000193.
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BackgroundDespite increasing evidence for the benefits of psychological treatments (PTs) in low- and middle-income countries, few national health systems have adopted PTs as standard care. We aimed to evaluate the effectiveness of a group interpersonal psychotherapy (IPT-G) intervention, when delivered by lay community health workers (LCHWs) in a low-resource government health system in Uganda. The intended outcome was reduction of depression among caregivers of children with nodding syndrome, a neuropsychiatric condition with high morbidity, mortality and social stigma.MethodsA non-randomized trial design was used. Caregivers in six villages (n = 69) received treatment as usual (TAU), according to government guidelines. Caregivers in seven villages (n = 73) received TAU as well as 12 sessions of IPT-G delivered by LCHWs. Primary outcomes were caregiver and child depression assessed at 1 and 6 months post-intervention.ResultsCaregivers who received IPT-G had a significantly greater reduction in the risk of depression from baseline to 1 month [risk ratio (RR) 0.25, 95% confidence interval (CI) 0.10–0.62] and 6 months (RR 0.33, 95% CI 0.11–0.95) post-intervention compared with caregivers who received TAU. Children of caregivers who received IPT-G had significantly greater reduction in depression scores than children of TAU caregivers at 1 month (Cohen's d = 0.57, p = 0.01) and 6 months (Cohen's d = 0.54, p = 0.03). Significant effects were also observed for psychological distress, stigma and social support among caregivers.ConclusionIPT-G delivered within a low-resource health system is an effective PT for common mental health problems in caregivers of children with a severe neuropsychiatric condition and has psychological benefits for the children as well. This supports national health policy initiatives to integrate PTs into primary health care services in Uganda.
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Bongomin, George Okello Candiya, John C. Munene, Joseph Mpeera Ntayi, and Charles Akol Malinga. "Nexus between financial literacy and financial inclusion." International Journal of Bank Marketing 36, no. 7 (October 1, 2018): 1190–212. http://dx.doi.org/10.1108/ijbm-08-2017-0175.
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Purpose Premised on the argument that cognition structures the way how individuals think and make decisions, the purpose of this paper is to test the interaction effect of cognition in the relationship between financial literacy and financial inclusion of the poor in rural Uganda. Design/methodology/approach The study used cross-sectional research design and quantitative data were collected and analyzed using Statistical Package for Social Sciences. Baron and Kenny guidelines were adopted to test for existence of moderating effect of cognition in the relationship between financial literacy and financial inclusion of the poor in rural Uganda. Furthermore, ModGraph excel software was used to establish the magnitude of moderating effect of cognition in the relationship between financial literacy and financial inclusion of the poor in rural Uganda. Findings The results revealed that cognition significantly moderate the relationship between financial literacy and financial inclusion of the poor in rural Uganda. In addition, both cognition and financial literacy also have direct effects on financial inclusion of the poor in rural Uganda. Research limitations/implications The study adopted cross-sectional research design and data were collected by use of only questionnaires. Future studies through longitudinal research design may be employed. Besides, further studies using interviews may be adopted. Furthermore, this study collected data from only tier 3 financial institutions, thus, ignoring the other financial institutions. Future studies could focus on financial institutions under the other tiers. Practical implications The findings from the study enlightens policy-makers, managers of financial institutions, and financial inclusion advocates on the importance of cognition in enhancing financial literacy among the poor, especially in rural Uganda. Cognition combined with financial literacy helps the poor to make wise financial decisions and choices toward consuming financial services and products provided by formal financial institutions. This leads to increased scope of financial inclusion of the poor in rural Uganda. Therefore, advocates of financial literacy should assess community cultural cognition and utilize them to design and fashion effective financial literacy interventions that can promote financial inclusion. Originality/value The study uses Baron and Kenny and ModGraph excel software to test for the interaction effect of cognition in the relationship between financial literacy and financial inclusion of the poor in rural Uganda. While several studies exist worldwide on financial inclusion, this study is the first to test the interaction effect of cognition in the relationship between financial literacy and financial inclusion of the poor in rural areas in a developing country context.
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Ruzagira, Eugene, Kathy Baisley, Anatoli Kamali, and Heiner Grosskurth. "Factors associated with uptake of home-based HIV counselling and testing and HIV care services among identified HIV-positive persons in Masaka, Uganda." AIDS Care 30, no. 7 (February 20, 2018): 879–87. http://dx.doi.org/10.1080/09540121.2018.1441967.
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Jack, B. Kelsey, and Seema Jayachandran. "Self-selection into payments for ecosystem services programs." Proceedings of the National Academy of Sciences 116, no. 12 (August 2, 2018): 5326–33. http://dx.doi.org/10.1073/pnas.1802868115.
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Designers and funders of payments for ecosystem services (PES) programs have long worried that payments flow to landholders who would have conserved forests even without the program, undermining the environmental benefits (“additionality”) and cost-effectiveness of PES. If landholders self-select into PES programs based on how much conservation they were going to undertake anyway, then those who were planning to conserve should always enroll. This paper discusses the less-appreciated fact that enrollment is often based on other factors too. The hassle of signing up or financial costs of enrollment (e.g., purchasing seedlings) can affect who participates in a PES program. These enrollment costs reduce overall take-up, and, importantly, they can also influence the composition of landholders who select into the program—and thereby the program’s environmental benefits per enrollee. Enrollment costs can increase a program’s benefits per enrollee if they are systematically higher for (and thus deter enrollment by) landholders who would have conserved anyway. Alternatively, enrollment costs can dampen per-enrollee benefits if their correlation with status-quo conservation is in the opposite direction. We illustrate these points with evidence from two studies of randomized trials of PES programs aimed at increasing forest cover in Uganda and Malawi. We also discuss how in other sectors, such as social welfare, policy designers have purposefully adjusted the costs of program enrollment to influence the composition of participants and improve cost-effectiveness. We propose that these ideas for targeting could be incorporated into the design of PES programs.
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Mfitumukiza, David, Bernard Barasa, and Ntale Emmanuel. "Ecosystem-based Adaptation to Drought among Agro-pastoral Farmers: Opportunities and Constraints in Nakasongola District, Central Uganda." Environmental Management and Sustainable Development 6, no. 2 (April 28, 2017): 31. http://dx.doi.org/10.5296/emsd.v6i2.11132.
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Understanding the context and importance of ecosystem-based adaptation (EbA) by agro-pastoralists is important for building climate resilient social and ecological systems amidst the changing climate. A cross-sectional survey was conducted to examine the EbA to drought by the smallholder farmers in Nakasongola District where a total of 100 respondents were randomly selected and subjected to interviews. To supplement on this information, a land use/cover spatial dataset of 2016 for Uganda was obtained and analysed to characterise and quantify the distribution of ecosystems utilised by the agro-pastoralists in the District. The spatial results revealed that the grassland (1524.6sq.km) and agricultural (agroecosystem) (779.1sq.km) ecosystems were the largest ecosystems followed by the forest/woodland and freshwater ecosystems in terms of coverage. The farmers perceived severe droughts to occur between December to January for the last 30 years with an average of 4 years return period. The agro and grassland ecosystems were the main contributors of drought adaptation opportunities compared to the freshwater and forest/woodland ecosystems. The direct and indirect opportunities involved goods and services such as water provision, mulching materials, food provision, fuelwood, regulation of air quality and water flow. However, the major constraints to EbA included rampant deforestation, limited knowledge on ecosystem conservation and overgrazing. Thus increasing water supplies for domestic and agricultural production is more likely increase the farmer’s adaptation to drought.
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Fred, Mayanja. "Physiotherapy for the sequelae of physical torture: Uganda’s experience." South African Journal of Physiotherapy 55, no. 4 (November 30, 1999): 29. http://dx.doi.org/10.4102/sajp.v55i4.579.
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The paper discusses the African Centre for treatment and rehabilitation of torture victims (ACTV) which was established in Uganda in 1993. The ACTV is a nongovernmental organisation offering treatment to the victims of torture. Professional staff at the centre include a physiotherapist, clinical psychologist, social worker, psychiatrist and psychiatric nurses. Specialised medical services outside of these areas that may be required, are provided by outside specialists.Torture commonly involves both physical and psychological abuse and is often administered by individuals on behalf of an institution or organisation with the aim of punishing or intimidating a victim or attempting to obtain information from a victim. Physical torture may involve beatings, kickings, tyings, suspensions in forced positions, hard labour and other such physical abuse.Apart from offering treatment and rehabilitation services the ACTV aims to raise awareness in the public arena concerning the plight of torture victims through workshops and seminars conducted in hospitals, schools and other institutions. Services are carried out both at the centre and in the community where satellite centres have been established. Referrals to the ACTV come from a wide variety of sources including, hospitals, human rights institutions, community leaders and self-referral.From July to December 1997 the physiotherapist working at the centre conducted a survey of clients referred to the ACTV. During this period 309 people were referred to the centre; 45% male and 55% female. (See table below)In this survey approximately 90% of the clients were referred for physiotherapy and 10% were referred to other specialists. It was reported that 97% of the victims showed improvement following treatment although the criteria for this are not discussed.An emphasis regarding the respectful and ethical handling of clients is emphasised throughout the paper. For example, not pursuing a particular line of questioning should the client not want to answer a particular question; avoiding the use of equipment that may remind the client of their torture (eg. ropes and certain electrotherapy apparatus) and listening carefully to the client’s regarding their treatment.
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Eshun-Wilson, Ingrid, Ajibola A. Awotiwon, Ashley Germann, Sophia A. Amankwaa, Nathan Ford, Sheree Schwartz, Stefan Baral, and Elvin H. Geng. "Effects of community-based antiretroviral therapy initiation models on HIV treatment outcomes: A systematic review and meta-analysis." PLOS Medicine 18, no. 5 (May 28, 2021): e1003646. http://dx.doi.org/10.1371/journal.pmed.1003646.
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Background Antiretroviral therapy (ART) initiation in the community and outside of a traditional health facility has the potential to improve linkage to ART, decongest health facilities, and minimize structural barriers to attending HIV services among people living with HIV (PLWH). We conducted a systematic review and meta-analysis to determine the effect of offering ART initiation in the community on HIV treatment outcomes. Methods and findings We searched databases between 1 January 2013 and 22 February 2021 to identify randomized controlled trials (RCTs) and observational studies that compared offering ART initiation in a community setting to offering ART initiation in a traditional health facility or alternative community setting. We assessed risk of bias, reporting of implementation outcomes, and real-world relevance and used Mantel–Haenszel methods to generate pooled risk ratios (RRs) and risk differences (RDs) with 95% confidence intervals. We evaluated heterogeneity qualitatively and quantitatively and used GRADE to evaluate overall evidence certainty. Searches yielded 4,035 records, resulting in 8 included studies—4 RCTs and 4 observational studies—conducted in Lesotho, South Africa, Nigeria, Uganda, Malawi, Tanzania, and Haiti—a total of 11,196 PLWH. Five studies were conducted in general HIV populations, 2 in key populations, and 1 in adolescents. Community ART initiation strategies included community-based HIV testing coupled with ART initiation at home or at community venues; 5 studies maintained ART refills in the community, and 4 provided refills at the health facility. All studies were pragmatic, but in most cases provided additional resources. Few studies reported on implementation outcomes. All studies showed higher ART uptake in community initiation arms compared to facility initiation and refill arms (standard of care) (RR 1.73, 95% CI 1.22 to 2.45; RD 30%, 95% CI 10% to 50%; 5 studies). Retention (RR 1.43, 95% CI 1.32 to 1.54; RD 19%, 95% CI 11% to 28%; 4 studies) and viral suppression (RR 1.31, 95% CI 1.15 to 1.49; RD 15%, 95% CI 10% to 21%; 3 studies) at 12 months were also higher in the community-based ART initiation arms. Improved uptake, retention, and viral suppression with community ART initiation were seen across population subgroups—including men, adolescents, and key populations. One study reported no difference in retention and viral suppression at 2 years. There were limited data on adherence and mortality. Social harms and adverse events appeared to be minimal and similar between community ART initiation and standard of care. One study compared ART refill strategies following community ART initiation (community versus facility refills) and found no difference in viral suppression (RD −7%, 95% CI −19% to 6%) or retention at 12 months (RD −12%, 95% CI −23% to 0.3%). This systematic review was limited by few studies for inclusion, poor-quality observational data, and short-term outcomes. Conclusions Based on data from a limited set of studies, community ART initiation appears to result in higher ART uptake, retention, and viral suppression at 1 year compared to facility-based ART initiation. Implementation on a wider scale necessitates broader exploration of costs, logistics, and acceptability by providers and PLWH to ensure that these effects are reproducible when delivered at scale, in different contexts, and over time.
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Musiimenta, Angella, Wilson Tumuhimbise, Niels Pinkwart, Jane Katusiime, Godfrey Mugyenyi, and Esther C. Atukunda. "A mobile phone-based multimedia intervention to support maternal health is acceptable and feasible among illiterate pregnant women in Uganda: Qualitative findings from a pilot randomized controlled trial." DIGITAL HEALTH 7 (January 2021): 205520762098629. http://dx.doi.org/10.1177/2055207620986296.
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Background Uganda’s maternal mortality rate remains unacceptably high. Mobile phones can potentially provide affordable means of accessing maternal health services even among the otherwise hard-to-reach populations. Evidence about the acceptability and feasibility of mobile phone-based interventions targeting illiterate women, however, is limited. Objective To assess the acceptability and feasibility of a mobile phone-based multimedia application (MatHealth app) to support maternal health amongst illiterate pregnant women in rural southwestern Uganda. Methods 80 pregnant women initiating antenatal care from Mbarara regional referral hospital were enrolled in a pilot randomized controlled trial and followed until six weeks after delivery. The 40 women in the intervention group received a MatHealth app composed of educational videos/audios, clinic appointment reminders, and the calling function. Qualitative interviews on acceptability of this technology were carried out with 30 of the intervention participants. An inductive, content analytic approach was used to analyze qualitative data. Quantitative feasibility data were recorded and summarized descriptively. Results Participants reported that the intervention is acceptable as it enabled them adopt good maternal health practices, enhanced social support from spouses, provided clinic appointment reminders, and facilitated communication with healthcare providers. Challenges included: phone sharing (74%), accidental deletion of the application 15 (43%), lack of electricity 15 (43%), and inability to set up a reminder function 20 (57%). Conclusion The MatHealth app is an acceptable and feasible intervention among illiterate women, in a resource limited setting. Future efforts should focus on optimized application design, spouse orientation, and incorporating economic support to overcome the challenges we encountered.
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Bukenya, Dominic, Janet Seeley, Grace Tumwekwase, Elizabeth Kabunga, and Eugene Ruzagira. "How Follow-Up Counselling Increases Linkage to Care Among HIV-Positive Persons Identified Through Home-Based HIV Counselling and Testing: A Qualitative Study in Uganda." SAGE Open 10, no. 1 (January 2020): 215824401990016. http://dx.doi.org/10.1177/2158244019900166.
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We investigated how follow-up counselling had increased linkage to HIV care in a trial of referral to care and follow-up counseling, compared to referral to care only, for participants diagnosed as HIV-positive through home-based HIV counseling and testing. We carried out a cross-sectional qualitative study. Using random stratified sampling, we selected 43 trial participants (26 [60%] in the intervention arm). Sample stratification was by sex, distance to an ART facility, linkage, and nonlinkage to HIV care. Twenty-six in-depth interviews were conducted with participants in the intervention arm: 17 people who had linked to HIV care and 9 who had not linked after 6 months of follow-up. Home-based follow-up counseling helped to overcome worries resulting from an HIV-positive test result. In addition, the counseling offered an opportunity to address questions on HIV treatment side effects, share experiences of intimate partner violence or threats, and general problems linking to care. The counselling encouraged early linkage to HIV care and use of biomedical medicines, discouraging alternative medicine usage. Home-based follow-up counseling also helped to promote HIV sero-status disclosure, facilitating linkage to, retention in and adherence to HIV care and treatment. This study successfully demonstrated that home-based follow-up counselling increased linkage to care through encouragement to seek care, provision of accurate information about HIV care services and supporting the person living with HIV to disclose and manage stigma.
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Stites, Elizabeth. "'The Only Place to Do This is in Town': Experiences Of Rural–Urban Migration in Northern Karamoja, Uganda." Nomadic Peoples 24, no. 1 (March 1, 2020): 32–55. http://dx.doi.org/10.3197/np.2020.240103.
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Towns in northern Karamoja, Uganda, are growing due to an expanding commercial sector, shifts in livestock-based rural livelihoods, and the economic and social appeal of urban life. This article presents qualitative data from 83 individual migrants to Abim, Kaabong and Kotido, the three largest towns in northern Karamoja. The research aimed to better understand the factors behind migration, the livelihood strategies pursued by those moving to towns and the opportunities and challenges associated with urban life. The data show that the majority of respondents in urban centres retained links to their rural communities: these connections allowed migrants to access key assets such as land, social networks and food, and allowed rural residents to receive remittances and other forms of support. Those who were not able to maintain ties to their rural homes or families were frequently the most vulnerable; most were widowed or abandoned women. Reasons for migration included household-level shocks, such as the loss of livestock or the death of a family member, as well as food insecurity or 'hunger'. Towns are attractive destinations because of their economic opportunities and potential for a better life. However, many respondents struggled with the cost of living in towns and worked multiple ad hoc and low-skilled jobs in order to get by. While rural linkages were important for populations in both areas, most respondents did not envision returning to their rural areas. Urban planning and services have not kept pace with migratory patterns.
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Akullo, Pamella Stella, Patrick Rolex Akena, and David Mwesigwa. "Awareness creation as a strategy to reducing the rate of teenage pregnancy in Lira District." Advances in Social Sciences Research Journal 7, no. 9 (October 4, 2020): 579–88. http://dx.doi.org/10.14738/assrj.79.9005.
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Teenage pregnancy is a serious public health and social problem, with 95%% occurring in developing countries. This study aimed to seek explain how awareness creation can be used to reduce the rate of teenage pregnancies in Lira district. A descriptive survey design was used and the study population was teenage girls. Data was collected using a document review guide since only secondary data was used in this study because of the short time. Secondary data got from plan Uganda Results indicates a drop in teenage pregnancy in five sub-counties in Lira District. It was further found established that the use of mass media and community dialogue helps in reducing the risk of teenage pregnancy by influencing behaviour towards contraceptive use, acquainting teenagers with knowledge of pregnancy prevention, creating a positive social environment. Radio programs and newspapers releases like straight talk and rock point 256 are among the mass media programs used to create awareness about teenage pregnancy. Alternatives of to reducing teenage pregnancy were are birth control, use of modern contraceptives, awareness about birth control, keeping teenagers in school, and positive religious beliefs have also been found as a major factor. Interventions focusing on retaining pregnant and married girls at in school, information on sexual and reproductive health of teenage girls, improving access to and information about contraceptive use among teenage girls, improving socio-economic status of households, and law enforcement on sexual abuse among girls may should be used to improving improve adolescent sexual and health services in Lira District.
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Namukasa, Juliet. "Records management and procurement performance." Records Management Journal 27, no. 3 (November 20, 2017): 256–74. http://dx.doi.org/10.1108/rmj-04-2016-0011.
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Purpose The purpose of this study was to examine the influence procurement records management had on the performance of the procurement function under the National Agricultural Advisory Services (NAADS). Design/methodology/approach The study used both qualitative and quantitative approaches to research. Procurement records management was the independent variable, while procurement performance was the dependent variable. The study also adopted a simple correlation and case study design. An accessible population of 101 respondents was identified, with 93 forming a sample. An 88% response rate was realized. Findings Results indicated that procurement records management had a significant effect on procurement performance. Whereby, there was a positive and statistically significant relationship between records creation and procurement performance; there was a positive relationship between records maintenance, preservation and procurement performance; and, finally, records access and use also had a positive significant influence on procurement performance. Research limitations/implications This research focused on the central region of Uganda, and yet, Uganda has got so many other regions which operate the NAADS programs. This means that research was conducted within a defined scope. Therefore, based on this, the researcher could not generalize the research findings. Practical implications Findings imply that ethical practices should be emphasized and custodians of procurement records be held accountable for their actions, as this will help in the support of proper record-keeping and avoid documents not being on file, misplaced or misfiled, which negatively affects procurement performance. Enabling a more efficient information management system results into effective procurement performance that leads to significant cost reduction in both the private and the government sector, especially when digital records are involved. Social implications As majority of the NAADS staff were found to possess inadequate knowledge in records maintenance and preservation, the government through the NAADS training committees should organize timely workshops to sensitize staff on how best records maintenance and preservation is core to its operations. Originality/value This study contributes to an important area which has not been given attention in the Ugandan context, where there is difficulty of relating the value of effective records maintenance to business management because of the lack of quantifiable evidence. Therefore, the study highlights the influence of records creation, maintenance and use on procurement performance. The review of literature finds that better records management results into better performance of the procurement units in procurement entities.
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Marcus, Hanna P., and Carol M. Runge. "Community-Based Services for Agoraphobics." Families in Society: The Journal of Contemporary Social Services 71, no. 10 (December 1990): 602–6. http://dx.doi.org/10.1177/104438949007101004.
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Okello Candiya Bongomin, George, and Joseph Ntayi. "Trust: mediator between mobile money adoption and usage and financial inclusion." Social Responsibility Journal 16, no. 8 (September 20, 2019): 1215–37. http://dx.doi.org/10.1108/srj-01-2019-0011.
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Purpose Recently, a large body of research has been devoted on the role of trust in shaping different types of transactions, especially in rural financial development. Trust is a set of expectations shared by all those who engage in an exchange. Indeed, the “rule of the game” suggests that no trusting party in a transaction should act opportunistically. Consequently, this study aims to establish the mediating effect of trust in the relationship between mobile money adoption and usage and financial inclusion of MSMEs in developing countries with a specific focus on rural Uganda. Design/methodology/approach A quantitative survey-based study was used and responses obtained from 379 MSMEs located in northern Uganda were analysed using partial least square-PLS version 3.0. A semi-structured questionnaire was developed from scales and items used in previous studies referenced in internationally recognised journals to elicit responses from the MSMEs. Structural equation modelling was used to test the models to arrive at a final empirical model derived from the data. Findings The authors found evidence that trust enhances mobile money adoption and usage to increase the scope of financial inclusion of MSMEs in developing countries. Moreover, when individual effect was determined, trust also had significant and positive effect on financial inclusion. Thus, the study results imply that trust enhances mobile money adoption and usage to improve the level of financial inclusion of MSMEs in developing countries. Research limitations/implications The study used cross-sectional data to document the relationship between mobile money adoption and usage and financial inclusion and to establish the mediating effect of trust in the relationship. Future research could use relevant longitudinal data to verify other benefits of trust. Practical implications The results present trust as a significant factor for FINTECH financial services marketing and growth. Specifically, data privacy and effectiveness of the mobile telephone network is more likely to help consumers to bridge the gap between participation and non-participation on the mobile money platform. Customers’ data sent over the mobile network of providers should be protected from unnecessary access and usage by Mobile Network Operators (MNOs) staff and unauthorised persons and agents. Data protection protocols should be set by the MNOs to avoid unnecessary access and use of customers’ data. Originality/value Globally, Fintech scholars have examined the role of mobile money in promoting financial inclusion. However, there is insufficient evidence on the mediating effect of trust in the relationship between mobile money adoption and usage and financial inclusion, especially among rural MSMEs. This study invents a novel direction on the importance of trust in creating transaction efficiency by eliminating opportunism and fraud with in the Fintech ecosystem.
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Blinkevičiūtė, Vilija. "Social Work and the Development of Community-Based Social Services." Socialinė teorija, empirija, politika ir praktika 1 (October 3, 2015): 7–9. http://dx.doi.org/10.15388/stepp.2001.0.8493.
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The present text is the opening and welcome speech to the 4 international conference “Social work and the development of community services”, which was in 2001, Vilnius, November 23-24. The speaker was Vilija Blinkevčiūtė - the minister of Social security and work ministry of Lithuania Republic. The minister welcomed the participants of conference and presented the goals of the Eleventh Government of the Republic of Lithuania to develop and enhance the social assistance system.
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Spence, Susie A. "The Black Elderly and Community-Based Social Services." Families in Society: The Journal of Contemporary Social Services 72, no. 6 (June 1991): 371–74. http://dx.doi.org/10.1177/104438949107200607.
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Ha, Le Thanh, Dr Nguyen Trung Hai, and Nguyen Thi Lien. "Community-Based Social Services for Elderly in Vietnam." International Journal of Humanities and Social Science 6, no. 5 (September 25, 2019): 58–64. http://dx.doi.org/10.14445/23942703/ijhss-v6i5p108.
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Kiwuwa-Muyingo, S., G. Abongomera, I. Mambule, D. Senjovu, E. Katabira, C. Kityo, D. M. Gibb, D. Ford, and J. Seeley. "Lessons for test and treat in an antiretroviral programme after decentralisation in Uganda: a retrospective analysis of outcomes in public healthcare facilities within the Lablite project." International Health 12, no. 5 (November 15, 2019): 429–43. http://dx.doi.org/10.1093/inthealth/ihz090.
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Abstract Background We describe the decentralisation of antiretroviral therapy (ART) alongside Option B+ roll-out in public healthcare facilities in the Lablite project in Uganda. Lessons learned will inform programmes now implementing universal test and treat (UTT). Methods Routine data were retrospectively extracted from ART registers between October 2012 and March 2015 for all adults and children initiating ART at two primary care facilities (spokes) and their corresponding district hospitals (hubs) in northern and central Uganda. We describe ART initiation over time and retention and use of Cox models to explore risk factors for attrition due to mortality and loss to follow-up. Results from tracing of patients lost to follow-up were used to correct retention estimates. Results Of 2100 ART initiations, 1125 were in the north, including 944 (84%) at the hub and 181 (16%) at the spokes; children comprised 95 (10%) initiations at the hubs and 14 (8%) at the spokes. Corresponding numbers were 642 (66%) at the hub and 333 (34%) at the spokes in the central region (77 [12%] and 22 [7%], respectively, in children). Children <3 y of age comprised the minority of initiations in children at all sites. Twenty-three percent of adult ART initiations at the north hub were Option B+ compared with 45% at the spokes (25% and 65%, respectively, in the central region). Proportions retained in care in the north hub at 6 and 12 mo were 92% (95% CI 90 to 93) and 89% (895% CI 7 to 91), respectively. Corresponding corrected estimates in the north spokes were 87% (95% CI 78 to 93) and 82% (95% CI 72 to 89), respectively. In the central hub, corrected estimates were 84% (95% CI 80 to 87) and 78% (95% CI 74 to 82), and were 89% (95% CI 77.9 to 95.1) and 83% (95% CI 64.1 to 92.9) at the spokes, respectively. Among adults newly initiating ART, being older was independently associated with a lower risk of attrition (adjusted hazard ratio [aHR] 0.93 per 5 y [95% CI 0.88 to 0.97]). Other independent risk factors included initiating with a tenofovir-based regimen vs zidovudine (aHR 0.60 [95% CI 0.46 to 0.77]), year of ART initiation (2013 aHR 1.55 [95% CI 1.21 to 1.97], ≥2014 aHR 1.41 [95% CI 1.06 to 1.87]) vs 2012, hub vs spoke (aHR 0.35 [95% CI 0.29 to 0.43]) and central vs north (aHR 2.28 [95% CI 1.86 to 2.81]). Independently, patient type was associated with retention. Conclusions After ART decentralisation, people living with human immunodeficiency virus (HIV) were willing to initiate ART in rural primary care facilities. Retention on ART was variable across facilities and attrition was higher among some groups, including younger adults and women initiating ART during pregnancy/breastfeeding. Interventions to support these groups are required to optimise benefits of expanded access to HIV services under UTT.
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Lightfoot, Elizabeth. "Community-based rehabilitation." International Social Work 47, no. 4 (October 2004): 455–68. http://dx.doi.org/10.1177/0020872804046253.
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Community-based rehabilitation (CBR) is a fast-growing model of providing services to people with disabilities. This article introduces the underlying philosophy and structure of the CBR model; the strengths and weaknesses of the model; and its implications for social workers in the field of disability services throughout the world.
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Brydges, Colton, and Lauchlan T. Munro. "The policy transfer of community-based rehabilitation in Gulu, Uganda." Disability & Society 35, no. 10 (December 22, 2019): 1596–617. http://dx.doi.org/10.1080/09687599.2019.1702505.
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Saathoff, Amy J., and Elizabeth Ann Stoffel. "Community-Based Domestic Violence Services." Future of Children 9, no. 3 (1999): 97. http://dx.doi.org/10.2307/1602784.
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