Journal articles on the topic 'Conflict management – Uganda'

The aims of this study were to establish the feasibility and effectiveness of training Ugandan mental health workers in the management of post-traumatic stress disorder (PTSD) based on guidelines from the UK National Institute of Health and Clinical Excellence (NICE). The Butabika Link is a mental health partnership between the East London Foundation NHS Trust (ELFT) and Butabika National Psychiatric Referral Hospital, Kampala, Uganda, supported by the Tropical Health Education Trust (THET), and based on the recommendations of the Crisp report (Crisp, 2007). The Link has worked on the principle that the most effective partnership between high-income and low- or middle-income countries is through organisations already delivering healthcare, that is, through the support of existing services. Butabika Hospital is a centre of excellence, serving an entire nation of 30 million people, many of them recovering from 20 years of armed conflict that took place mainly in the north of Uganda. In addition, Uganda has received refugees from conflicts in neighbouring states, including Congo, Rwanda, Kenya, Sudan and Burundi. The Ugandan Ministry of Health's Strategic Plan (2000) has prioritised post-conflict mental disorders and domestic violence, which is reflected in the vision of the Link's work.

Purpose – The purpose of this study was to explore the role social entrepreneurship has played in post conflict recovery in Gulu district in northern Uganda. Design/methodology/approach – An exploratory and qualitative research design was used to examine the role of social entrepreneurship in post conflict recovery in the Gulu community located in Uganda. A sample of five social entrepreneurs and 15 beneficiaries were interviewed. Findings – The findings revealed that there is an association between active social entrepreneurship and post conflict recovery. Social entrepreneurship was found to create opportunity recognition, networking and innovation at both an individual and societal level. Research limitations/implications – The generalization of the findings was limited by sample and method. A cross-sectional design that was used does not allow for a long-term impact study and limited empirical published research done. Originality/value – This in-depth richness provides a clearer appreciation of the role social entrepreneurs’ play in post conflict recovery.

“Reconciliation” and “justice” are key concepts used by practitioners as well as authors of conflict-management and peacebuilding textbooks. While it is often recognized that there may be contradictions between the implementation of justice and truth-telling, on the one hand, and an end to organized violence, on the other, the ideal of a seamless fusion of these diverse goals is widely upheld by, among other things, reference to the rather utopianconcept of “positive peace” (Galtung). One difficulty arises from the fact that discourses usually focus on (post-)conflict settings that resemble a victory of one conflict party, whereas peace settlements are often negotiated in a context more similar to a military or political stalemate – a more ambiguous and complicated scenario. This essay discusses these problems against the background of an empirical case study of the peace accord between the government and the rebels in the West Nile region in north-western Uganda.

Uganda, Tanzania, the Sudan, South Sudan, Rwanda, Kenya, Ethiopia, Egypt, DR Congo, and Burundi all make entitlement claims to the ecological system of the Nile Basin. This region is rich in resources, yet prone to interstate conflict, drought, and other vulnerabilities. Water resource conservation systems, alternative purification systems, and rainfall stimulation systems programmed by artificial intelligence can facilitate the establishment of transboundary partnerships that reduce international conflict and serve as a foundation for economic growth and job creation in the Nile Basin region. Water conservation systems using artificial intelligence have been found to increase rainfall capture by an average of 1.5 billion gallons of stormwater per year or enough to provide clean drinking water for 36,000 people per year (O’Neill et. al, 2012). The ecological framework of Nile Basin’s various regions will determine the appropriate artificial intelligence systems that can be implemented to promote the equitable distribution the Nile Basin’s resources. These systems will lessen political conflict that can negatively impact the agricultural practices of Nile Basin farmers and inhabitants who depend on the Nile Basin’s resources for their livelihoods.

PurposeThe purpose of this paper is to shed light on the rising waves of workplace militancy in the public sector and to provide insights into the perceptions that frame justification for industrial action among Ugandan public sector employees.Design/methodology/approachIn-depth interviews and documentary analysis, analysed qualitatively, as well as a review of theoretical and empirical literature.FindingsPublic school teachers and public university lecturers in Uganda who frequently engage in industrial action mainly rationalise their engagement by the absence, or the ineffectiveness of alternative conflict resolution mechanisms. The findings also show that industrial action, even in resource-constrained settings like Uganda, is stimulated more by the desire to achieve equity rather than by the basic desire to improve working conditions. It is also notable that new, often unstructured, forms of workplace militancy continue to emerge in the public sector, and waves of industrial action are shifting from the industrial to the public sector.Practical implicationsWhereas industrial action is a protected labour right, the findings of this research strongly suggest that public employees do not necessarily enjoy their right to engage, but only reluctantly take industrial action as a “last resort”. The findings will, therefore, help public managers and policymakers to appreciate their responsibility in reducing the compulsion for industrial action among public employees.Originality/valueThis paper provides a general explanation for industrial action from the perspective of the people involved, rather than explaining the causality of specific strike actions. At a time when industrial action is generally declining in the developed industrialised states, this paper sheds light on the rise in collective action in developing countries and especially in the public sector.

PURPOSE: In low resource areas, neonatal hypothermia is an important source of neonatal morbidity. Separating newborns from their mothers at birth puts neonates at risk for hypothermia. The Teso Safe Motherhood Project (TSMP) in Soroti, Uganda provides birth center care for women in conflict areas of Northern Uganda. After conducting a needs assessment at TSMP, a continuing education project was developed to facilitate change in clinical practice to enhance prevention and recognition of neonatal hypothermia, including implementation of skin-to-skin practices at birth.STUDY DESIGN: This education project employed multiple learning strategies including pretest and posttest questionnaires, group discussion of cultural beliefs and practices, didactic education, participation in creative informational art, and demonstration, supervision, and return demonstration of skills.MAJOR FINDINGS: At the completion of the program, 100% of participants demonstrated a statistically significant increase in both knowledge and skills in the prevention and management of neonatal hypothermia (p = .011).MAIN CONCLUSION: The participants reported that this continuing education project enhanced their skills in neonatal hypothermia prevention and management. The cost-effective strategies employed in this project can be replicated in low resource settings, contributing to decreased mortality and morbidity from newborn hypothermia.

AbstractWhile rumors predominate in conflict settings, researchers have not identified whether and why they influence the start of organized armed conflict. In this paper, we advance a new conceptualization of initial rebel group formation that aims to do so. We present a simple game-theoretic network model to show why the structure of trusted communication networks among civilians where rebel groups form—which carry credible rumors about the rebels—can influence whether incipient rebels become viable. We argue further that in rural Sub-Saharan Africa, kinship network structures favorable to nascent rebels often underlie ethnically homogeneous localities, but not heterogeneous ones. In doing so, we advance a new explanation for why ethnicity influences conflict onset, and show why ethnic grievances may not be a necessary condition for the emergence of “ethnic rebellion.” We illustrate our arguments using new evidence from Uganda that provides a rare window into rebel group formation.

AbstractThis paper analyses the impact of a community conservation programme (CCP) implemented over a 7-year period around a national park in Uganda. Programme activities included dialogue, conflict reduction, education, community resource access and support for community development. Surveys of attitudes show that communities benefited from the programme were significantly more positive towards the park and wildlife than communities that did not. The community conservation programme built an understanding of conservation objectives amongst communities whose members were more likely to recognize positive aspects of the park and less likely to demand that it be degazetted. Comparison over the 7-year duration of the programme, however, did not show that communities were generally more positive towards conservation. They were more critical of management and demanded more support and resources than they had received. Their behaviour was not greatly changed, and high levels of poaching and illegal grazing continued. Attitudes were influenced by communities receiving development assistance, but improvements were fragile, vulnerable to poor behaviour of park staff and lawenforcement activities. Both were seen as contradicting community approaches. Attitudes were also influenced by land ownership and economic occupation. The CCP was not a panacea for the problems of the park and did not resolve fundamental conflicts of interest between communities and park management. However, it did change the way the protagonists perceive and interact with each other.

Purpose The purpose of this paper is to develop an empirical model for inflation in Uganda, highlighting the role of supply side factors in the domestic agricultural sector. Design/methodology/approach The adopted empirical analysis is based on a single equation model that exploits cointegration techniques and general-to-specific modeling. The analysis controls for historical, seasonal as well as policy factors such as the effects of the global financial crisis, change in monetary policy regime to inflation targeting and monthly seasonal effects. Findings Results indicate that disequilibrium in the money, external and agricultural sectors feed into the Ugandan inflation process in the long run. However, the external and monetary sectors have larger long-run effects on inflation than the agricultural sector. Other factors that influence inflation in the short run include: inflation inertia, real output, money supply, exchange rate movements, foreign prices, monetary policy instruments and seasonal factors. In addition, the paper shows that the inflation-targeting policy has been successful in containing inflationary pressures. Practical implications These findings suggest that in the long-run monetary policy will continue to play an important role in managing Ugandan inflation through money demand management. The inflationary effects of agricultural supply shocks could be mitigated with appropriate domestic actions. In particular, fiscal policy that targets increased productivity and efficiency in agriculture through increased focus on production, irrigation, storage and transportation could reduce the effects of agricultural supply variability on inflation. In addition, policies intended to improve economic growth by expanding total output, control money supply growth and maintaining stability in the foreign exchange markets will help to reduce inflation. Social implications Studies of inflation and its determinants have dominated macroeconomic debates in the past decades because of the importance of price stability in economic growth and household welfare. The major conclusions from those studies are that: high inflation is detrimental to investment and growth; erodes the purchasing power; reduces household welfare; and exacerbates income inequality. Moreover there is a growing strand of literature establishing a causal link between inflation and conflict. Particularly for agricultural households, the effects of inflation are usually felt through the increase in food prices with implications for consumption and food security. These findings indicate the important macro and social implications of inflation. By focusing on the importance of agricultural supply shocks, the paper contributes to a better understanding of the drivers of inflation and how the macro and social effects can be addressed. Originality/value The major contribution of this paper is to try and model an equilibrium relationship in the domestic agricultural sector rather than using proxies such as an output gap measure or rainfall.

AbstractIn 2001 sport hunting was reintroduced in Uganda around Lake Mburo National Park, and in 2008 at Kabwoya and Kaiso-Tonya Game Management Area, to derive economic benefits for communities and thus reduce human–wildlife conflict and change communities’ attitudes towards wildlife. We used the policy arrangement approach to analyse and compare the development of the two sport hunting policy arrangements. Through interviews and document review we learned that the arrangement at Lake Mburo changed considerably over time, whereas that at Kabwoya remained relatively stable. The two policy arrangements started with small constellations of actors but turned out to be complex arenas, mainly involving disagreement regarding the benefits. Land ownership proved to be a crucial factor in explaining the differences between the arrangements. Our results also show that benefits do not change communities’ attitudes towards conservation, thus questioning incentive-based policies for conservation. We argue for a careful analysis of the complex social, cultural and political contexts in which conservation and development policies are implemented, to better understand their outcomes.

Purpose The purpose of this paper is to assess the relationship between five green practices and firm performance. In addition, this paper investigates the influence of each green practice on environmental performance, economic benefits, and economic costs. Design/methodology/approach Data were collected based on a cross-sectional survey of owner/managers of 200 manufacturing SME firms in Uganda, Africa. SPSS was used to find descriptive means and test relationships between green practices and performance outcomes. Structural equation modelling was used to test for the influence of each practice on performance outcomes. The structural equation modelling results were obtained using the Covariance-Based Structural Equation Modelling software. Results were compared with similar studies conducted in developing countries. Findings Different green practices affect different performance dimensions in different ways across different industries. For example, eco-design and internal environmental management practices significantly influence environmental performance; green purchasing and internal environmental management practices significantly influence economic benefits; and internal environmental management practices affect economic costs. Overall internal environmental management is the key to positive outcomes across the three performance criteria. The authors show how the results obtained vary from similar studies conducted in developing countries and explain possible reasons for the difference. Research limitations/implications Africa is a rapidly industrialising nation faced with difficult choices between economic growth and increased pollution. Because SMEs represent the majority of manufacturing firms, they are the main polluters. Hence, better understanding of the costs and benefits, both environmental and economic, is important to encourage green practice adoption for the betterment of community health and prosperity. Originality/value Despite numerous studies on the relationships between green practice adoption and performance outcomes, only a few studies include both economic costs and benefits in addition to environmental performance. The study covers five green supply chain practices, whereas most similar studies are limited in the number of practices examined. The African context is unique and important because industrial development and environmental protection goals are in conflict. Similar studies are predominant in an Asian context which is more developed than Africa. The findings and comparisons raise important questions for further research in relation to the roles of national regulations, geographical markets and industry types in furthering green practices in manufacturing.

Since 1987, the Lord’s Resistance Army has continued systematic human rights violations in the Central African region. Cases of kidnapping, village raids, mass rapes, and murders, have become defining factors to the urgency of resolving the crisis. In an attempt to respond to the conflict, the United Nations Security Council has initiated a number of political and military-based resolutions to control the conflict since 2008, which includes extending UN peacekeeping mandates in Uganda, Democratic Republic of Congo, and South Sudan, as well as coordinate efforts with relevant African Union bodies. However, its success is far-reached, urging the need to contextualize the forms of hindrances that the UN faced in responding to the crisis. Employing Rourke and Bouyer’s (1996) concept of collective security and measures of response success, with a research limitation set to 2008-2012, a qualitative research utilizing secondary data is implemented, concluding the following hindrances that can be categorized into the following; (1) Implementation of the additional mandate of the UN Peace Forces, (2) Application of the AU Regional Task Force, and (3) Implementation of the Disarmament, Demobilization, Repatriation, Resettlement, and Reintegration program. Received: 16 December 2020 / Accepted: 11 March 2021 / Published: 10 May 2021

Background: Human African Trypanosomiasis (HAT) is fatal if untreated; the drugs to treat it are toxic making its management difficult and diagnosis complex. Nwoya district has a long history of sleeping-sickness dating back to pre-colonial times. The civil war of 1986-2008 displaced many who upon return complained of cattle and dogs dying of unknown causes alongside increased tsetse flies infestation hence, the needs for the study. Methods: We enrolled local 3,040 pupils and recorded their social-demographic characteristics and access to different domesticated animals/fowls in their homes. Screening for HAT using the card agglutination test for trypanosomiasis (CATT) was performed; positive individuals had their titres determined, followed by microscopy and loop mediated isothermal amplification analysis (LAMP). R was used for analysis where associations were sought between dependent and independent variables. Any factor with P-value <0.05 was taken as statistically significant. Results: HAT serological prevalence of 1.2% (95% CI 0.8-1.6) was obtained, 58.3% being boys while 41.7% were girls with titres ranging from 1:2 - 1:16. Two schools alone, constituted 47% of the CATT positive cases. Pupils who came from homes with dogs were more likely to be CATT/Trypanosoma brucei gambiense positive; (adjusted odds ratio = 3.12, 95% CI 1.41-6.99 & p=0.005). Conclusions: Though no parasites were detected, with prevalence of CATT positive at 1.2%, active surveillance in the district is still recommended. CATT positive cases needs follow-ups were immune trypanolysis test done to ascertain their exposure.

Purpose Uganda has one of the highest age-standardized incidence rates for breast cancer (38.3/100,000) occurring among women age 35 to 45 years. The disease is associated with increased biomedical and psychological demands on affected women and their families. Clinical and supportive care services are offered to patients with metastatic breast cancer (MBC) to meet their needs and improve survival and quality of life. However, the existence of challenges and barriers to health care access affect the satisfaction of the needs of patients with MBC and imply that available services cannot meet every clinical and psychological need these patients. No previous assessment has been done in Uganda of the clinical and psychological needs of patients with MBC. The aim of the current study was to generate data that can be used to increase awareness of the unmet clinical and psychological needs of patients with MBC and their families to inform advocacy strategies for supportive care services in Uganda. Methods We conducted interviews, in-depth interviews, focus group discussions, and document review. Results Patients with MBC (n = 67), survivors (n = 185), clinical providers (n = 24), family (n = 134), and VHT (n = 12) participated in this work. The patient’s most important needs include physical and daily living needs (relieving pain, 85.69%; nutrition and diet, 83.69%; wound management, 80.69%; help when tired, 74.6%; help with house cores, 73.19%); health system, information, and patient support (treatment with dignity, 86.6%; pleasant environment, 83.6%; sensitivity to feelings, 80.6%; counseling, 79.1%; choice of cancer specialists, 77.6%; treatment plan, 76.1%; respect for a patient’s opinion, 74.6%); and psychological (close family concerns, 79.1%; advice on faith, 79.6%; comforting when sad, 74.6%; positive outlook, 73.3%; how to disclose, 71.6%). Long waiting times, out-of-stock medicines, inadequate hospital amenities, family exclusion during patient review conversations, caregiver burnout, cost of care, limited funding, and spiritual, legal, and human resource shortages were needs and challenges identified by survivors, family caregivers, clinical providers, and policymakers. Polices on supportive care for patients with MBC are also unclear. Conclusion There exists a mismatch between patients with MBC, survivors, and health care providers with regard to knowledge of some of the needs of patients with MBC, particularly clinical-related information needs. Dialogue between patients with MBC, survivors, family caregivers, clinical providers, and VHTs is recommended to harmonize knowledge and perceptions of the needs of patients with MBC. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.

ObjectivesTo critically explore and describe the pathways that women who require emergency obstetrics and newborn care (EmONC) go through and to understand the delays in accessing EmONC after reaching a health facility in a conflict-affected setting.DesignThis was a qualitative study with two units of analysis: (1) critical incident technique (CIT) and (2) key informant interviews with health workers, patients and attendants.SettingThirteen primary healthcare centres, one general private-not-for-profit hospital, one regional referral hospital and one teaching hospital in northern Uganda.ParticipantsForty-nine purposively selected health workers, patients and attendants participated in key informant interviews. CIT mapped the pathways for maternal deaths and near-misses selected based on critical case purposive sampling.ResultsAfter reaching the health facility, a pregnant woman goes through a complex pathway that leads to delays in receiving EmONC. Five reasons were identified for these delays: shortage of medicines and supplies, lack of blood and functionality of operating theatres, gaps in staff coverage, gaps in staff skills, and delays in the interfacility referral system. Shortage of medicines and supplies was central in most of the pathways, characterised by three patterns: delay to treat, back-and-forth movements to buy medicines or supplies, and multiple referrals across facilities. Some women also bypassed facilities they deemed to be non-functional.ConclusionOur findings show that the pathway to EmONC is precarious and takes too long even after making early contact with the health facility. Improvement of skills, better management of the meagre human resource and availing essential medical supplies in health facilities may help to reduce the gaps in a facility’s emergency readiness and thus improve maternal and neonatal outcomes.

AbstractWhy do combatants uproot civilians in wartime? In this paper I identify cross-national variation in three population-displacement strategies—cleansing, depopulation, and forced relocation—and test different explanations for their use by state actors. I advance a new “assortative” theory to explain forced relocation, the most common type. I argue that combatants displace not only to expel undesirable populations, but also to identify the undesirables in the first place by forcing people to send signals of loyalty and affiliation based on whether, and to where, they flee. This makes communities more “legible” and facilitates the extraction of rents and recruits. I test these arguments using a novel Strategic Displacement in Civil Conflict data set (1945–2008). Consistent with my expectations, different displacement strategies occur in different contexts and appear to follow different logics. Cleansing is more likely in conventional wars, where territorial conquest takes primacy, while forced relocation is more likely in irregular wars, where identification problems are most acute. The evidence indicates that cleansing follows a logic of punishment. The results for relocation, however, are consistent with the implications of my assortative logic: it is more likely to be employed by resource-constrained incumbents fighting insurgencies in “illegible” areas—rural, peripheral territories. A case study from Uganda based on in-depth fieldwork provides evidence for the assortative mechanism. As the most comprehensive analysis of wartime displacement strategies to date, this paper challenges some core assumptions about a devastating form of contemporary political violence.

PurposeThe purpose of this paper is to establish the relationship between corporate governance, ethical culture, Internal Controls over Financial Reporting (ICFR) and compliance with International Financial Reporting Standards (IFRS) by microfinance institutions (MFIs).Design/methodology/approachThis is a cross-sectional survey based on a sample of 85 MFIs in Uganda. Hypotheses were tested using partial least squares (PLS) analysis technique. An unweighed IFRS compliance index to capture the level of compliance with IFRS was constructed. Yet to capture corporate governance, ethical culture and ICFR variables, the perceptions of top management of MFIs have been taken into consideration.FindingsCorporate governance, ethical culture and ICFR, each makes a significant contribution to compliance with IFRS. Also both corporate governance and ethical culture are significantly associated with ICFR. However, compliance with IFRS by MFIs is better enhanced by corporate governance and ethical culture through ICFR.Research limitations/implicationsResults support the idea that in terms of agency and virtue ethics theories, the board should support ICFR to minimize egocentric managers and other employees and also inculcate an ethical culture to achieve better compliance with IFRS because corporate governance and ethical culture are associated with sound ICFR which in turn lead to compliance with IFRS.Practical/implicationsBoards of MFIs should encourage investments that improve ICFR. At the same time, regulators should ensure that boards are composed of members with financial expertise, with no conflict of interest and introduce mechanisms that encourage boards to perform their roles.Originality/valueThe study contributes towards a methodological position by showing that the behavioural perspective of corporate governance can be an alternative to the boards’ structural variables in investigating compliance with IFRS. A direct association of ethical culture and compliance with IFRS and an indirect association through ICFR can be envisaged.

Loss of wildlife, encroachment on wild lands and conflicts between protected areas and neighbouring communities continue to threaten the integrity of protected areas (PAs) in Uganda. To increase support from local communities and ensure long-term sustainability for Uganda's PAs, a policy of community-based conservation was introduced in 1988 as a management approach in seven PAs. The effectiveness of the community-based approach for reducing threats was compared to conventional PA management by conducting a threat reduction assessment at 16 PAs, seven with community-based approaches and nine without. Additional data collected using document reviews, interviews with government officials, and surveys of PA wardens were compared with the threat reduction assessments. Twenty-three primary threats were identified at PAs. Local game poaching was the most common threat. The threat reduction assessment indices of community-based PAs (mean=49.0±12) were not significantly different from those of conventional PAs (mean=37.96±21.6). Some specific threats, such as bush burning, logging, encroachment and unclear boundaries, seemed to be better mitigated at community-based PAs. Management approaches at all PAs mitigated fewer than half of the identified threats. Management approaches are needed that directly target PA threats, go beyond PA boundaries by involving additional government departments, link people's livelihoods to conservation efforts and strengthen PA institutions.

PurposeThe purpose of this study is to examine whether contractual completeness is a cornerstone to stakeholder management in Public–Private Partnership (PPP) projects in Uganda.Design/methodology/approachThis study adopted a cross-sectional and quantitative approach. Data were collected by means of a questionnaire survey from a sample of 103 PPP projects in Uganda. Partial Least squares structural equation modeling was used to analyze the data.FindingsThe study found that contractual completeness dimensions (contractual obligatoriness, contingency adaptability, issue inclusiveness, term specificity) are all significantly and positively associated with stakeholder management in PPP projects in Uganda.Originality/valueThis paper is one of the few studies on stakeholder management in PPP projects from a developing country’s perspective, thus contributing to scanty literature on how to manage stakeholders in PPP projects.Research limitations/implicationsThis paper is limited to the relationship between contract completeness dimensions and stakeholder management in PPP projects in Uganda. Future studies should be conducted on other factors that affect stakeholder management in PPP projects in Uganda.Practical implicationsOur results imply that when all the relevant issues are included in the contract, contract terms are explicitly stipulated, all the unanticipated changes are described and when all the parties involved are restrained by a binding force of a contract, conflicts and opportunism reduces and stakeholders concerns are addressed.

Abstract 23 HIV increases the incidence and mortality of cancer; knowledge of HIV status and treatment is essential for management of patients with HIV-associated malignancies (HIVAM). In Uganda, where the prevalence of HIV infection is 7.4%, the incidence of AIDS-defining cancers (ADCs) is high, and non-AIDS defining cancers (NADCs) are increasingly common. We investigated how often cancer providers documented HIV status and clinical parameters of HIV infection among patients at the Uganda Cancer Institute (UCI). Medical records of patients aged ≥18 who registered at the UCI June - September 2015 were abstracted for demographics and cancer and HIV parameters. We calculated binomial proportions and used χ2 tests to evaluate factors associated with HIV. Among 1,130 patients in this analysis, 71% of charts documented HIV status. Of those documenting HIV status, 32% were HIV+, and 58% of HIV+ individuals had an ADC. The documented HIV prevalence in NADCs was 21%. Women were more likely to lack HIV results (RR 1.32, p=0.009); 36% of women lacked results, including 40% with cervical cancer. HIV+ patients were younger than HIV-negative patients (median age 41 vs. 49, p<0.001). 62% of HIV-infected patients had a CD4 count recorded; CD4 counts were lower among persons with ADC (median 270 cells/ml, IQR 80-460) compared with NADC (median 370, IQR 215-564), p=0.006. There was no difference in the proportion of HIV patients with ADCs and NADCs receiving ART (both 86%, p=0.45). HIV prevalence was 4.5 times higher in Ugandan cancer patients with documented status than in the general population. Though the majority of cancer patients had HIV testing performed, gaps remained in documenting HIV status, even among cancers considered AIDS-defining in HIV. This study highlights opportunities to educate cancer clinicians in Africa on the burden of HIV in cancer patients and opportunities to coordinate management of both cancer and HIV. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Matine J. Ghadrshenas No relationship to disclose Rachel A. Bender Ignacio No relationship to disclose Daniel H. Low No relationship to disclose Warren Phipps No relationship to disclose Jackson Orem No relationship to disclose Ann Duerr No relationship to disclose Corey Casper Leadership: Temptime Consulting or Advisory Role: Janssen Pharmaceuticals Research Funding: Janssen Pharmaceuticals Travel, Accommodations, Expenses: Temptime Corporation, GlaxoSmithKline

Over 70% of Uganda is infested by the tsetse fly, which has negative effects on human and livestock health. From colonial to post-independent Uganda, the Government of Uganda has worked to eradicate the tsetse menace. Despite these efforts, recent veterinary reports from the Karamoja sub-region have indicated widespread tsetse invasion. This study investigated the potential impact of tsetse invasion on the socioecological resilience of pastoral communities in the Karamoja sub-region. Results indicated that tsetse invasion is spreading from north to south of Karamoja. The tsetse transmission route emerging from southern Karamoja is perceived to be a continuation of the tsetse belt from West Pokot, Kenya. Cases of livestock deaths, livestock abortions, decreased milk yields, restricted access to prime grazing lands, heightened human-wildlife conflicts and disruption on crop cultivation have been reported. A computed socioecological resilience index in the study area was positive but low. Owing to the transboundary characteristics of tsetse invasions and sources and the associated documented effects, an urgent, strategic and system-wide intervention should be undertaken to control the tsetse invasion in this sub-region.

PurposeThe purpose of this paper is to identify gaps in the structure of organizations that hinder collaboration of organizations involved in the creation of graduate employment opportunities in Uganda.Design/methodology/approachData was collected from staff and leaders of 14 organizations that were purposely selected to represent government, private, and civil society organizations. These organizations were selected based on their mandates, which touch on the employability of university graduates in the country in very direct ways. This was a cross-sectional survey design—based on a self-administered questionnaire, key informant interviews, and documentary analysis.FindingsOrganizations were found to have “Tell”/directive decision-making, high power distance between employees, and jobs were not coded in a way that gives employees freedoms to interact and build collaborative relationships. Finally, rules and regulations were very restrictive, disorienting employee's abilities to collaborate.Research limitations/implicationThis research concentrated on the gaps that exist in the structure of organizations from which the results point to inadequate relational, interactional, inclusive, and democratic space among different stakeholders. It would be useful for future research to examine the extent to which the structure of organizations not only impacts collaboration but also measures the level to which it affects organizational performance.Practical implicationsThe knowledge economy of the twenty-first century demands for collaborative engagements with different stakeholders if they are to survive the competitive business environment. Collaborative engagement helps in the sharing of knowledge, expertise, and resources, development of more coherent services, facilitation of innovation and evaluation, avoiding duplication of work, and minimizing conflicts and competition while creating synergy among partners.Originality/valueUnlike previous studies, which have examined employability of graduates from a supply side perspective, this study investigates organizations from both the supply and demand perspectives and identifies synergy that is as a result of bringing organizations to work together.

This study presents evidence on the organisation of farm work in rice farming areas in Uganda and Tanzania, where farms of different scale co-exist, drawing on the same pool of workers. Here, local labour regimes have been rapidly reorganised following the creation and expansion plans of mega-farms after the global financial crisis of 2007/2008, characterised as land grabs. The synchronic comparison of two rice mega-farms is based on the history of relations of production in rice farming areas in the region. With post-crisis global restructuring, shifting global value relations have driven the reorganisation of control within the labour process in frontiers of capitalist accumulation. This article argues that local labour process and farm labour regimes are important elements in the process of mediation with global value relations in the study areas. Labour control within the labour process and local labour regimes across farm scale are at the core of the additional reasons leading local workers to see employment on mega-farms undesirable, compared to gang work on local farms of different size. Work on mega-farms, alongside its highly exploitative character, is undesirable for workers because of the tight system of disciplining at the basis of labour control, which creates conflicts with the social reproduction system. The devalorisation and exploitation of labour is enabled by disciplining and control over workers in the production process.

Given the diversity of active institutions and stakeholders in a landscape, and the difficulties in ensuring inclusive decision-making, evaluating landscape governance can help surface and address underlying issues. In the context of two protected area landscapes in Uganda, where landscape approaches are being implemented through a wider project on landscape governance, we analyse stakeholder perceptions of inclusive decision-making and then use this evaluation to stimulate dialogue amongst stakeholder groups in each landscape. We ask, how can capturing, analysing, and collaboratively applying people’s perceptions address inclusive decision-making in landscape governance? We collected and analysed perceptions using SenseMaker®, a software package that enables analysis of micronarratives (stories) from the field based on how respondents classify their own stories, using triads, dyads, stones, and multiple-choice questions. This self-categorisation by the respondent reduces bias in the analysis and allows the micronarrative to be cross-examined in a variety of ways when analysed using Sensemaker. This analysis created an integrated view of the stakeholder’s perceptions about inclusive decision-making in landscape governance. The results show large portions of the respondents feel their voices are neglected, and management of the landscape is poor in Mount Elgon, while in Agoro-Agu, it is the opposite trend. During a community feedback process, reasons for these trends were discussed and solutions proposed. Some of the underlying factors include historical relationships with park authorities and displacement during park creation. To more precisely answer our research question, one could have extended stays in the communities studied in these landscapes, using ethnographic methods including interviews and participant observation; nonetheless, our method, including the feedback process, was an innovative and important way to confront our findings with the informants directly and foster collaborative action. We conclude that understanding people’s perceptions, including through participatory feedback, can significantly inform and improve management decisions, help resolve conflicts, and facilitate dialogue between different stakeholders in the landscape.

The East African region in sub-Saharan Africa (SSA) is widely considered as one of the secondary centers of diversity for sweetpotatoes [Ipomoea batatas (L.) Lam.]. Farmers in the region typically grow landraces, but hybridizations occasionally result in new genotypes. Factors such as regional conflicts, natural disasters, disease, and land pressure continually threaten the SSA sweetpotato gene pool. Despite this threat, very little updated information is easily accessible about SSA germplasm collections. Such information is valuable for purposes of management, exploration, and conservation. Using germplasm collection data from Kenya, Tanzania, and Uganda, we demonstrate how publicly available GIS-based tools, e.g., DIVA-GIS, can be used to document current collections as well as make this information easily accessible, searchable, and portable. First, collection data from each country were compiled and known collection sites were georeferenced using available gazetteers. Following data cleaning and verification, georeferenced data were then converted into a GIS-compliant format, primarily as shapefiles. All files were then copied into storage media for exchange among stakeholders. To further demonstrate the portability of the GIS database files, available World Wide Web GIS web viewers enabled real-time access to GIS files uploaded to an experimental web site. This work demonstrates that with very little expense, access to extant SSA germplasm information for sweetpotatoes can be improved using publicly available GIS tools.

Purpose Concern for the state of architectural education in East Africa was a catalyst for this exploration of socialisation, which sought to understand socialisation and its influence on educational outcomes in the region. Socialisation within architectural education has long been known to influence how students acquire important aspects of the profession, building both values and a cultural ethos in the process. An appreciation of these processes in the context of East Africa adds to the wider understanding of the implicit curriculum in architectural education. The paper aims to discuss these issues. Design/methodology/approach An ethnographic study was undertaken in five architecture schools across Kenya, Tanzania and Uganda, making use of a mixed method approach incorporating document analysis, a questionnaire study, participant observations and focus group discussions as the data gathering instruments. Focus group discussions, as the primary data gathering method, acknowledged the social context of the study, with data gathered from multiple sites across the region. Findings As an integral component of architectural education, socialisation was evident at all stages of the educational process. Within the educational realm, contrasting expectations of students and instructors were evident, leading to conflicts that influenced the values acquired by students. This was seen in attitudes towards contemporary architectural issues within architectural education, and suggests that socialisation can at times have pronounced negative consequences. Originality/value The wider study represents the first comprehensive review of architectural education in the context of East Africa, and contributes to the global appreciation of the influence of socialisation on educational outcomes.

Background: Emerging from a 20-year armed conflict, Uganda adopted several laws and policies to protect the rights of people with disabilities, including their sexual and reproductive health (SRH) rights. However, the SRH rights of people with disabilities continue to be infringed in Uganda. We explored policy actors’ perceptions of existing pro-disability legislation and policy implementation, their perceptions of potential barriers experienced by people with disabilities in accessing and using SRH services in post-conflict Northern Uganda, and their recommendations on how to redress these inequities. Methods: Through an intersectionality-informed approach, we conducted and thematically analysed 13 in-depth semi-structured interviews with macro level policy actors (national policy-makers and international and national organisations); seven focus groups (FGs) at meso level with 68 health service providers and representatives of disabled people’s organisations (DPOs); and a two-day participatory workshop on disability-sensitive health service provision for 34 healthcare providers. Results: We identified four main themes: (1) legislation and policy implementation was fraught with numerous technical and financial challenges, coupled with lack of prioritisation of disability issues; (2) people with disabilities experienced multiple physical, attitudinal, communication, and structural barriers to access and use SRH services; (3) the conflict was perceived to have persisting impacts on the access to services; and (4) policy actors recommended concrete solutions to reduce health inequities faced by people with disabilities. Conclusion: This study provides substantial evidence of the multilayered disadvantages people with disabilities face when using SRH services and the difficulty of implementing disability-focused policy in Uganda. Informed by an intersectionality approach, policy actors were able to identify concrete solutions and recommendations beyond the identification of problems. These recommendations can be acted upon in a practical road map to remove different types of barriers in the access to SRH services by people with disabilities, irrespective of their geographic location in Uganda.

Abstract Background Mental health is linked to HIV outcomes, including linkage into care and adherence to medication. Integrated care for mental and physical health is recommended. HIV testing and counselling sessions represent an opportunity to implement interventions to address mental health, however it is first necessary to understand the roles, current practice, knowledge and attitudes of the testing and counselling staff. Methods This qualitative study used semi-structured interviews with HIV testing and counselling staff at four centres of a HIV healthcare provider charity in Uganda. Interviews focused on their current practice, perceptions of mental health and their role in supporting this, challenges of this work, training and support needs, and views of potential greater emphasis on mental health work in their role. Data were audio-recorded, transcribed verbatim, and analysed thematically. Results Data from twenty-one testing and counselling staff revealed five themes. Clients presented to counselling staff with needs spanning bio-psycho-social domains, where psychological health was intertwined with HIV management, medication adherence, and seen as “inseparable” from HIV itself. Mental health was largely thought about as “madness”, identifiable from extreme behaviour. As such, common mental health problems of anxiety and depression were not often seen as part of mental health. Approaches to intervening with mental health were seen as behavioural, with some ideas about changing thinking styles. Participants demonstrated significant practice of common techniques to address mental health. Needs were identified for further training in suicide risk assessment and identification of depression, together with greater clinical supervision. Participants described significant conflict within their roles, particularly balancing time demands and need to achieve testing targets against the need to offer adequate mental health support to clients in need. Conclusions HIV testing and counselling staff described a diverse role that already includes addressing mental health. Mental health is “vital” to their work, however the time needed to address it is at odds with current testing targets. They require more training and resources to effectively address mental health, which is vital to optimising HIV outcomes. Interventions to integrate mental health support into HIV testing and counselling sessions need to be further researched and optimised.

Abstract Health centres and supervision teams in rural/poor settings in developing countries are affected by limited resources, uneasy reporting to higher level of power and unclear proceedings to filling the gaps. Inconsistency in supervising visits lead to mistrust. Supervisees react with resistance or indifference. Supervisors react behaving as policemen. In Uganda, Oyam Health District, february-august 2018, actions were taken in order to solve conflicts, sustain quality, improve interactions. Sharing the concept and the implementing process could inspire colleagues engaged in workplace health promotion. Key points were informed by direct observations, talks with staffs, literature review, ugandan Ministry of Health official directives and tools, NGO’s adaptations. Selected issues were discussed during two workshops held in april ’18 involving all the concerned staff: 100 people. Agreement reached, based on a 3 (gap-act-resp) 5 (0-4 grading) algorithm, re-designed tools were able to reduce aléa during inspections, grade the gaps, guide actions and to address the appropriate level of responsability. User friendly reporting formats, database and unicode for linkage were designed ex novo. Information flow was agreed with the Health District Authorities. After the learning period, staffs felt empowered about resolving gaps and less stressed advocating higher authorities. Conflicts lost harshness. Satisfaction was captured by a self-filled anonymous questionnaire in june 2018 (n = 80, 12 core questions, 0-4 likert scale, mean &gt;3, SD &lt; 1, median= 4, open sentences positives). Quality improvements of health care services were measured by the Ugandan Ministry of Health independently. Unclear targets, shortage of means, ineffective communication flows reduce quality and trigger frustration. Sustaining transparency, organizing communication flows and proceedings, sourcing staff’s experience could enhance success both in reaching targets and promoting relational health at workplace. Key messages Transparency, shared decisions, clear communication, awareness of the aims and mastership are able to reduce conflicts and misunderstandings, sustaining a healthier workplace relational environment. People spend 60 to 80% of their active time at workplace. Well designed tools, policies and information flows, could be effective health enhancer as well. Work style is a lifestyle.

Purpose: This paper presents aspects of a Corporate Social Responsibility (CSR) Implementation Success Model to guide CSR engagements. Design/methodology/approach: A qualitative case methodology is used to investigate two CSR companies in Uganda. Semi-structured interviews with managers and stakeholders are conducted. Data triangulation includes reviewing CSR reports and documents, and visiting communities and CSR activities/projects mentioned in the case companies’ reports. Grounded theory guides the data analysis and aggregation. Findings: The findings culminate into a “CSR Implementation Success Model. ” Key aspects of CSR implementation success are identified as: (i) involvement of stakeholders and management (i.e., co-production) at the start and during every stage of CSR implementation; (ii) management of challenges and conflicts arising within/outside of the company itself; and (iii) feedback management or performance assessment—i.e., accountability via CSR communications and reporting. Stakeholder involvement and feedback management (accountability) are pivotal, though all three must be considered equally. Research limitations: The studied companies were large and well-established mature companies, so it is unclear whether newer companies and small and medium-sized enterprises would produce similar findings. Practical implications: Successful CSR implementation starts with a common but strategic understanding of what CSR means to the company. However, CSR implementation should (i) yield benefits that are tangible, and (ii) have a sustainable development impact because these two aspects form implementation benchmarks. Additionally, top management should be involved in CSR implementation, but with clear reasons and means. Originality/value: This paper unearths a CSR Implementation Success Model that amplifies views of “creating shared value” for sustainable development. It guides organizations towards strategic CSR, as opposed to the responsive CSR (returning profits to society) that largely dominates in developing countries. Additionally, it explains how to add value to the resource envelope lubricating the entire CSR implementation process

Extant literature has explored the effects of foreign aid on armed conflicts and state repression, but not on public demonstrations. This article compares distribution patterns of Chinese and World Bank-funded projects and public demonstrations in Cameroon, receiving predominantly Chinese official finance, and Uganda, receiving predominantly traditional, Western aid. Distributive patterns suggest negative and positive associations between Chinese and traditional official finance on the one hand and public demonstrations on the other. However, with respect to anti-project demonstrations specifically, I find through fieldwork interviews in Cameroon that Chinese-funded projects are more prone to anti-project demonstrations owing to less stringent risk management standards.

Introduction Documentary film has grown significantly in the past decade, with high profile films such as Fahrenheit 9/11, Supersize Me, and An Inconvenient Truth garnering increased attention both at the box office and in the news media. In addition, the rising prominence of web-based media has provided new opportunities for documentary to create social impact. Films are now typically released with websites, Facebook pages, twitter feeds, and web videos to increase both reach and impact. This combination of technology and broader audience appeal has given rise to a current landscape in which documentary films are imbedded within coordinated multi-media campaigns. New media have not only opened up new avenues for communicating with audiences, they have also created new opportunities for data collection and analysis of film impacts. A recent report by McKinsey and Company highlighted this potential, introducing and discussing the implications of increasing consumer information being recorded on the Internet as well as through networked sensors in the physical world. As they found: "Big data—large pools of data that can be captured, communicated, aggregated, stored, and analyzed—is now part of every sector and function of the global economy" (Manyika et al. iv). This data can be mined to learn a great deal about both individual and cultural response to documentary films and the issues they represent. Although film has a rich history in humanities research, this new set of tools enables an empirical approach grounded in the social sciences. However, several researchers across disciplines have noted that limited investigation has been conducted in this area. Although there has always been an emphasis on social impact in film and many filmmakers and scholars have made legitimate (and possibly illegitimate) claims of impact, few have attempted to empirically justify these claims. Over fifteen years ago, noted film scholar Brian Winston commented that "the underlying assumption of most social documentaries—that they shall act as agents of reform and change—is almost never demonstrated" (236). A decade later, Political Scientist David Whiteman repeated this sentiment, arguing that, "despite widespread speculation about the impact of documentaries, the topic has received relatively little systematic attention" ("Evolving"). And earlier this year, the introduction to a special issue of Mass Communication and Society on documentary film stated, "documentary film, despite its growing influence and many impacts, has mostly been overlooked by social scientists studying the media and communication" (Nisbet and Aufderheide 451). Film has been studied extensively as entertainment, as narrative, and as cultural event, but the study of film as an agent of social change is still in its infancy. This paper introduces a systematic approach to measuring the social impact of documentary film aiming to: (1) discuss the context of documentary film and its potential impact; and (2) argue for a social science approach, discussing key issues about conducting such research. Changes in Documentary Practice Documentary film has been used as a tool for promoting social change throughout its history. John Grierson, who coined the term "documentary" in 1926, believed it could be used to influence the ideas and actions of people in ways once reserved for church and school. He presented his thoughts on this emerging genre in his 1932 essay, First Principles of Documentary, saying, "We believe that the cinema's capacity for getting around, for observing and selecting from life itself, can be exploited in a new and vital art form" (97). Richard Barsam further specified the definition of documentary, distinguishing it from non-fiction film, such that all documentaries are non-fiction films but not all non-fiction films are documentaries. He distinguishes documentary from other forms of non-fiction film (i.e. travel films, educational films, newsreels) by its purpose; it is a film with an opinion and a specific message that aims to persuade or influence the audience. And Bill Nichols writes that the definition of documentary may even expand beyond the film itself, defining it as a "filmmaking practice, a cinematic tradition, and mode of audience reception" (12). Documentary film has undergone many significant changes since its inception, from the heavily staged romanticism movement of the 1920s to the propagandist tradition of governments using film to persuade individuals to support national agendas to the introduction of cinéma vérité in the 1960s and historical documentary in the 1980s (cf. Barnouw). However, the recent upsurge in popularity of documentary media, combined with technological advances of internet and computers have opened up a whole new set of opportunities for film to serve as both art and agent for social change. One such opportunity is in the creation of film-based social action campaigns. Over the past decade, filmmakers have taken a more active role in promoting social change by coordinating film releases with action campaigns. Companies such as Participant Media (An Inconvenient Truth, Food Inc., etc.) now create "specific social action campaigns for each film and documentary designed to give a voice to issues that resonate in the films" (Participant Media). In addition, a new sector of "social media" consultants are now offering services, including "consultation, strategic planning for alternative distribution, website and social media development, and complete campaign management services to filmmakers to ensure the content of nonfiction media truly meets the intention for change" (Working Films). The emergence of new forms of media and technology are changing our conceptions of both documentary film and social action. Technologies such as podcasts, video blogs, internet radio, social media and network applications, and collaborative web editing "both unsettle and extend concepts and assumptions at the heart of 'documentary' as a practice and as an idea" (Ellsworth). In the past decade, we have seen new forms of documentary creation, distribution, marketing, and engagement. Likewise, film campaigns are utilizing a broad array of strategies to engage audience members, including "action kits, screening programs, educational curriculums and classes, house parties, seminars, panels" that often turn into "ongoing 'legacy' programs that are updated and revised to continue beyond the film's domestic and international theatrical, DVD and television windows" (Participant Media). This move towards multi-media documentary film is becoming not only commonplace, but expected as a part of filmmaking. NYU film professor and documentary film pioneer George Stoney recently noted, "50 percent of the documentary filmmaker's job is making the movie, and 50 percent is figuring out what its impact can be and how it can move audiences to action" (qtd. in Nisbet, "Gasland"). In his book Convergence Culture, Henry Jenkins, coined the term "transmedia storytelling", which he later defined as "a process where integral elements of a fiction get dispersed systematically across multiple delivery channels for the purpose of creating a unified and coordinated entertainment experience" ("Transmedia"). When applied to documentary film, it is the elements of the "issue" raised by the film that get dispersed across these channels, coordinating, not just an entertainment experience, but a social action campaign. Dimensions of Evaluation It is not unreasonable to assume that such film campaigns, just like any policy or program, have the possibility to influence viewers' knowledge, attitudes, and behavior. Measuring this impact has become increasingly important, as funders of documentary and issue-based films want look to understand the "return on investment" of films in terms of social impact so that they can compare them with other projects, including non-media, direct service projects. Although we "feel" like films make a difference to the individuals who also see them in the broader cultures in which they are embedded, measurement and empirical analysis of this impact are vitally important for both providing feedback to filmmakers and funders as well as informing future efforts attempting to leverage film for social change. This type of systematic assessment, or program evaluation, is often discussed in terms of two primary goals—formative (or process) and summative (or impact) evaluation (cf. Muraskin; Trochim and Donnelly). Formative evaluation studies program materials and activities to strengthen a program, and summative evaluation examines program outcomes. In terms of documentary film, these two goals can be described as follows: Formative Evaluation: Informing the Process As programs (broadly defined as an intentional set of activities with the aim of having some specific impact), the people who interact with them, and the cultures they are situated in are constantly changing, program development and evaluation is an ongoing learning cycle. Film campaigns, which are an intentional set of activities with the aim of impacting individual viewers and broader cultures, fit squarely within this purview. Without formulating hypotheses about the relationships between program activities and goals and then collecting and analyzing data during implementation to test them, it is difficult to learn ways to improve programs (or continue doing what works best in the most efficient manner). Attention to this process enables those involved to learn more about, not only what works, but how and why it works and even gain insights about how program outcomes may be affected by changes to resource availability, potential audiences, or infrastructure. Filmmakers are constantly learning and honing their craft and realizing the impact of their practice can help the artistic process. Often faced with tight budgets and timelines, they are forced to confront tradeoffs all the time, in the writing, production and post-production process. Understanding where they are having impact can improve their decision-making, which can help both the individual project and the overall field. Summative Evaluation: Quantifying Impacts Evaluation is used in many different fields to determine whether programs are achieving their intended goals and objectives. It became popular in the 1960s as a way of understanding the impact of the Great Society programs and has continued to grow since that time (Madaus and Stufflebeam). A recent White House memo stated that "rigorous, independent program evaluations can be a key resource in determining whether government programs are achieving their intended outcomes as well as possible and at the lowest possible cost" and the United States Office of Management and Budget (OMB) launched an initiative to increase the practice of "impact evaluations, or evaluations aimed at determining the causal effects of programs" (Orszag 1). Documentary films, like government programs, generally target a national audience, aim to serve a social purpose, and often do not provide a return on their investment. Participant Media, the most visible and arguably most successful documentary production company in the film industry, made recent headlines for its difficulty in making a profit during its seven-year history (Cieply). Owner and founder Jeff Skoll reported investing hundreds of millions of dollars into the company and CEO James Berk added that the company sometimes measures success, not by profit, but by "whether Mr. Skoll could have exerted more impact simply by spending his money philanthropically" (Cieply). Because of this, documentary projects often rely on grant funding, and are starting to approach funders beyond traditional arts and media sources. "Filmmakers are finding new fiscal and non-fiscal partners, in constituencies that would not traditionally be considered—or consider themselves—media funders or partners" (BRITDOC 6). And funders increasingly expect tangible data about their return on investment. Says Luis Ubiñas, president of Ford Foundation, which recently launched the Just Films Initiative: In these times of global economic uncertainty, with increasing demand for limited philanthropic dollars, assessing our effectiveness is more important than ever. Today, staying on the frontlines of social change means gauging, with thoughtfulness and rigor, the immediate and distant outcomes of our funding. Establishing the need for evaluation is not enough—attention to methodology is also critical. Valid research methodology is a critical component of understanding around the role entertainment can play in impacting social and environmental issues. The following issues are vital to measuring impact. Defining the Project Though this may seem like an obvious step, it is essential to determine the nature of the project so one can create research questions and hypotheses based on a complete understanding of the "treatment". One organization that provides a great example of the integration of documentary film imbedded into a larger campaign or movement is Invisible Children. Founded in 2005, Invisible Children is both a media-based organization as well as an economic development NGO with the goal of raising awareness and meeting the needs of child soldiers and other youth suffering as a result of the ongoing war in northern Uganda. Although Invisible Children began as a documentary film, it has grown into a large non-profit organization with an operating budget of over $8 million and a staff of over a hundred employees and interns throughout the year as well as volunteers in all 50 states and several countries. Invisible Children programming includes films, events, fundraising campaigns, contests, social media platforms, blogs, videos, two national "tours" per year, merchandise, and even a 650-person three-day youth summit in August 2011 called The Fourth Estate. Individually, each of these components might lead to specific outcomes; collectively, they might lead to others. In order to properly assess impacts of the film "project", it is important to take all of these components into consideration and think about who they may impact and how. This informs the research questions, hypotheses, and methods used in evaluation. Film campaigns may even include partnerships with existing social movements and non-profit organizations targeting social change. The American University Center for Social Media concluded in a case study of three issue-based documentary film campaigns: Digital technologies do not replace, but are closely entwined with, longstanding on-the-ground activities of stakeholders and citizens working for social change. Projects like these forge new tools, pipelines, and circuits of circulation in a multiplatform media environment. They help to create sustainable network infrastructures for participatory public media that extend from local communities to transnational circuits and from grassroots communities to policy makers. (Abrash) Expanding the Focus of Impact beyond the Individual A recent focus has shifted the dialogue on film impact. Whiteman ("Theaters") argues that traditional metrics of film "success" tend to focus on studio economic indicators that are far more relevant to large budget films. Current efforts focused on box office receipts and audience size, the author claims, are really measures of successful film marketing or promotion, missing the mark when it comes to understanding social impact. He instead stresses the importance of developing a more comprehensive model. His "coalition model" broadens the range and types of impact of film beyond traditional metrics to include the entire filmmaking process, from production to distribution. Whiteman (“Theaters”) argues that a narrow focus on the size of the audience for a film, its box office receipts, and viewers' attitudes does not incorporate the potential reach of a documentary film. Impacts within the coalition model include both individual and policy levels. Individual impacts (with an emphasis on activist groups) include educating members, mobilizing for action, and raising group status; policy includes altering both agenda for and the substance of policy deliberations. The Fledgling Fund (Barrett and Leddy) expanded on this concept and identified five distinct impacts of documentary film campaigns. These potential impacts expand from individual viewers to groups, movements, and eventually to what they call the "ultimate goal" of social change. Each is introduced briefly below. Quality Film. The film itself can be presented as a quality film or media project, creating enjoyment or evoking emotion in the part of audiences. "By this we mean a film that has a compelling narrative that draws viewers in and can engage them in the issue and illustrate complex problems in ways that statistics cannot" (Barrett and Leddy, 6). Public Awareness. Film can increase public awareness by bringing light to issues and stories that may have otherwise been unknown or not often thought about. This is the level of impact that has received the most attention, as films are often discussed in terms of their "educational" value. "A project's ability to raise awareness around a particular issue, since awareness is a critical building block for both individual change and broader social change" (Barrett and Leddy, 6). Public Engagement. Impact, however, need not stop at simply raising public awareness. Engagement "indicates a shift from simply being aware of an issue to acting on this awareness. Were a film and its outreach campaign able to provide an answer to the question 'What can I do?' and more importantly mobilize that individual to act?" (Barrett and Leddy, 7). This is where an associated film campaign becomes increasingly important, as transmedia outlets such as Facebook, websites, blogs, etc. can build off the interest and awareness developed through watching a film and provide outlets for viewers channel their constructive efforts. Social Movement. In addition to impacts on individuals, films can also serve to mobilize groups focused on a particular problem. The filmmaker can create a campaign around the film to promote its goals and/or work with existing groups focused on a particular issue, so that the film can be used as a tool for mobilization and collaboration. "Moving beyond measures of impact as they relate to individual awareness and engagement, we look at the project's impact as it relates to the broader social movement … if a project can strengthen the work of key advocacy organizations that have strong commitment to the issues raised in the film" (Barrett and Leddy, 7). Social Change. The final level of impact and "ultimate goal" of an issue-based film is long-term and systemic social change. "While we understand that realizing social change is often a long and complex process, we do believe it is possible and that for some projects and issues there are key indicators of success" (Barrett and Leddy, 7). This can take the form of policy or legislative change, passed through film-based lobbying efforts, or shifts in public dialogue and behavior. Legislative change typically takes place beyond the social movement stage, when there is enough support to pressure legislators to change or create policy. Film-inspired activism has been seen in issues ranging from environmental causes such as agriculture (Food Inc.) and toxic products (Blue Vinyl) to social causes such as foreign conflict (Invisible Children) and education (Waiting for Superman). Documentary films can also have a strong influence as media agenda-setters, as films provide dramatic "news pegs" for journalists seeking to either sustain or generation new coverage of an issue (Nisbet "Introduction" 5), such as the media coverage of climate change in conjunction with An Inconvenient Truth. Barrett and Leddy, however, note that not all films target all five impacts and that different films may lead to different impacts. "In some cases we could look to key legislative or policy changes that were driven by, or at least supported by the project... In other cases, we can point to shifts in public dialogue and how issues are framed and discussed" (7). It is possible that specific film and/or campaign characteristics may lead to different impacts; this is a nascent area for research and one with great promise for both practical and theoretical utility. Innovations in Tools and Methods Finally, the selection of tools is a vital component for assessing impact and the new media landscape is enabling innovations in the methods and strategies for program evaluation. Whereas the traditional domain of film impact measurement included box office statistics, focus groups, and exit surveys, innovations in data collection and analysis have expanded the reach of what questions we can ask and how we are able to answer them. For example, press coverage can assist in understanding and measuring the increase in awareness about an issue post-release. Looking directly at web-traffic changes "enables the creation of an information-seeking curve that can define the parameters of a teachable moment" (Hart and Leiserowitz 360). Audience reception can be measured, not only via interviews and focus groups, but also through content and sentiment analysis of web content and online analytics. "Sophisticated analytics can substantially improve decision making, minimize risks, and unearth valuable insights that would otherwise remain hidden" (Manyika et al. 5). These new tools are significantly changing evaluation, expanding what we can learn about the social impacts of film through triangulation of self-report data with measurement of actual behavior in virtual environments. Conclusion The changing media landscape both allows and impels evaluation of film impacts on individual viewers and the broader culture in which they are imbedded. Although such analysis may have previously been limited to box office numbers, critics' reviews, and theater exit surveys, the rise of new media provides both the ability to connect filmmakers, activists, and viewers in new ways and the data in which to study the process. This capability, combined with significant growth in the documentary landscape, suggests a great potential for documentary film to contribute to some of our most pressing social and environmental needs. A social scientific approach, that combines empirical analysis with theory applied from basic science, ensures that impact can be measured and leveraged in a way that is useful for both filmmakers as well as funders. In the end, this attention to impact ensures a continued thriving marketplace for issue-based documentary films in our social landscape. References Abrash, Barbara. "Social Issue Documentary: The Evolution of Public Engagement." American University Center for Social Media 21 Apr. 2010. 26 Sep. 2011 ‹http://www.centerforsocialmedia.org/›. Aufderheide, Patricia. "The Changing Documentary Marketplace." Cineaste 30.3 (2005): 24-28. Barnouw, Eric. Documentary: A History of the Non-Fiction Film. New York: Oxford UP, 1993. Barrett, Diana and Sheila Leddy. 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