Journal articles on the topic 'Social trust Uganda'

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.

While SMEs are globally recognised for their importance in the social and economic development of many economies, their survival and competitiveness has remained a cause for concern. More than half of SMEs in Uganda fail during their first year. Analytical and empirical research on appropriate strategies for SMEs' competitiveness in Uganda is limited. The potential outcomes of CSR engagement such as employee satisfaction, business reputation, and customer loyalty have been found to be positively related to the competitiveness of SMEs. The primary objective of this article is to identify and empirically test the factors that influence the competitiveness of SMEs in Uganda. A structured selfadministered questionnaire was distributed to 750 potential SME respondents. The respondents were identified using purposive sampling technique, and the data were collected from 3 83 usable questionnaires. An exploratory factor analysis was conducted, and Cronbach-alpha coefficients calculated to determine the discriminant validity and reliability of the measuring instrument. Correlations were analysed using Structural Equation Modeling. The empirical results of this study indicate that Employee satisfaction, Business reputation, Customer loyalty and Stakeholder trust significantly impact the competitiveness of SMEs.

We assessed how the everyday work challenges that frontline health workers (FRHWs) face in the government health sector in northern Uganda influence their trust in the Ministry of Health (MOH). We employed qualitative research techniques, including interviews and participant observation, over a 9-month period to examine FRHWs’ viewpoints about how the MOH should address these challenges in service delivery. One hundred and sixty-five FRHWs, of whom 48 were recruited for extensive follow-up, participated in our study. Key findings include distrust in the MOH is prevalent among FRHWs, there is a lack of trust in the organization’s coordination role in service delivery and this affects health care delivery to patients, interrelations, and provider cooperation. Therefore, restoring trust in government hospitals will require a truthful non-violent response by the MOH in its contractual agreement with FRHWs. In our analysis, we employ Habermas’s Theory of Communicative Action.

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.

Purpose – The purpose of this paper is to examine the determinants of a household's social capital in the form of community group participation and empirically analyses the roles that social capital plays in helping rural households rebuild productive assets after shocks. Design/methodology/approach – In this paper, social capital is modelled as a household's intensity of group participation measured by the density and active participation in group activities as well as their multiplicative and additive indices. Instrumental variable methods were used to address the problem of endogeneity associated with social capital. Findings – The results indicate that household characteristics such as age, education level, dependence ratio and years of village residence as well as village-level characteristics such as the village population density are critical determinants of social capital. In addition, social capital measured in form of density of participation in group activities and attendance score as well as multiplicative and additive indices of these have significant positive effects on the household ability to rebuild livestock assets. Research limitations/implications – The authors realize that several weakness in the approach could compromise the validity of the findings. These weaknesses include: the cross-sectional nature of the data, the omitted variable bias, the endogeneity concerns of social capital and the identification strategy, sample size and the dimensions the authors chose to measure social capital. Future research should explore the factors that can help households to engage more in-group activities. Practical implications – The findings have important implications for government policy especially in areas of agricultural development and poverty reduction. Specifically, governments should pay close attention to the various social groups as they can serve as important channels to achieve better social economic outcomes, including the accumulation of rural assets, as is the case with livestock assets in rural Uganda. Social implications – Many governments in Sub-Saharan Africa are constrained to provide basic public goods to the people. This is due to a combination of limited budgets and lack of good leadership. In such circumstances, the people have to rely on their collective/social effort to take advantage of market opportunities. Such opportunities can be accessed using the existing social structures whose norms and the trust between members permit cooperation. Originality/value – The study contributes to a small but growing empirical literature on social groups and how they can mediate social economic outcomes especially for rural households. The empirical estimations take into consideration the endogeneity concerns associated with social network capital. The paper will be useful for policy makers and researchers who may have a keen interest in the roles that group activities play in agricultural development and poverty reduction.

Background: The desire for universal health coverage in developing countries has brought attention to communitybased health insurance (CBHI) schemes in developing countries. The government of Uganda is currently debating policy for the national health insurance programme, targeting the integration of existing CBHI schemes into a larger national risk pool. However, while enrolment has been largely studied in other countries, it remains a generally under-covered issue from a Ugandan perspective. Using a large CBHI scheme, this study, therefore, aims at shedding more light on the determinants of households’ decisions to enrol and renew membership in these schemes. Methods: We collected household data from 464 households in 14 villages served by a large CBHI scheme in southwestern Uganda. We then estimated logistic and zero-inflated negative binomial (ZINB) regressions to understand the determinants of enrolment and renewing membership in CBHI, respectively. Results: Results revealed that household’s socioeconomic status, husband’s employment in rural casual work (odds ratio [OR]: 2.581, CI: 1.104-6.032) and knowledge of health insurance premiums (OR: 17.072, CI: 7.027-41.477) were significant predictors of enrolment. Social capital and connectivity, assessed by the number of voluntary groups a household belonged to, was also positively associated with CBHI participation (OR: 5.664, CI: 2.927-10.963). More positive perceptions on insurance (OR: 2.991, CI: 1.273-7.029), access to information were also associated with enrolment and renewing among others. Burial group size and number of burial groups in a village, were all significantly associated with increased the likelihood of renewing CBHI. Conclusion: While socioeconomic factors remain important predictors of participation in insurance, mechanisms to promote inclusion should be devised. Improving the participation of communities can enhance trust in insurance and eventual coverage. Moreover, for households already insured, access to correct information and strengthening their social network information pathways enhances their chances of renewing.

In Uganda, the agricultural sector contributes substantially to gross domestic product. Although the involvement of Ugandan women in this sector is extensive, female farmers face significant obstacles, caused by gendering that impedes their ability to expand their family business and to generate incomes. Gender refers to social or cultural categories by which women–men relationships are conceived. In this study, we aim to investigate how gendering influences the development of business relationships in the Ugandan agricultural sector. To do so, we employed a qualitative–inductive methodology to collect unique data on the rice and cassava sectors. Our findings reveal at first that, in the agricultural sector in Uganda, inter-organization business relationships (i.e., between non-family actors) are mostly developed by and between men, whereas intra-organization business relationships with family members are mostly developed by women. We learn that gendering impedes women from developing inter-organization business relationships. Impediments for female farmers include their restricted mobility, the lack of trust by men, their limited freedom in communication, household duties, and responsibilities for farming activities up until sales. Our findings also reveal that these impediments to developing inter-organization business relationships prevent female farmers from being empowered and from attainting economic benefits for the family business. In this context, the results of our study show that grouping in small-scale cooperatives offers female farmers an opportunity to overcome gender inequality and to become economically emancipated. Thanks to these cooperatives, women can develop inter-organization relationships with men and other women and gain easier access to financial resources. Small-scale cooperatives can alter gendering in the long run, in favor of more gender equality and less marginalization of women. Our study responds to calls for more research on the informal economy in developing countries and brings further understanding to the effect of gendering in the Ugandan agricultural sector. We propose a theoretical framework with eight propositions bridging gendering, business relationship development, and empowerment and economic benefits. Our framework serves as a springboard for policy implications aimed at fostering gender equality in informal sectors in developing countries.

The interdisciplinary nature of conservation science has generated much discussion. Previous scholars have highlighted the lack of mutual understanding between the natural and social sciences in terms of theoretical knowledge and methodological practices. Due to this, the potential for the ‘tragedy of (un)common knowledge’ may hinder interdisciplinary scholarship within conservation science. While others have provided valuable insight on the scholarly and pedagogic challenges associated with interdisciplinary research, there has been little dialogue on the methodological components. Based on an ethnographic study on law enforcement rangers in a protected area in Uganda, this article provides key reflections on entrée, forming trust and rapport, establishing an identity, and data collection. It is argued that such methodological transparency will help foster dialogue between the natural and social sciences, while displaying the central role of qualitative methods in facilitating interdisciplinary research.

A well-designed impact evaluation study in the education sector is relevant in informing decision and policymaking based on high-quality evidence generated from the research. In this paper, we provide a chronology on how we developed and implemented an impact evaluation on school facilities grant (SFG) programme designed to support Government aided primary schools in Uganda – to construct classrooms, sanitation facilities as well as teacher houses. We describe the appropriate methodology, randomization designs implemented and the target groups. Results revealed that selecting a clear intervention with identified observable and unobservable characteristics is important for the robust results. Measuring attribution on outcomes may also require a balance on internal and external validity checks and analysis. The internal validity, in addition to statistical measures also requires stakeholders’ engagement in the impact study process as a way of promoting social audits of public programmes. Finally, a well-planned and designed evaluation often leads to increased public trust in the findings and evidence uptake hence informing policy decision in management of programmes and projects.

Purpose – The purpose of this paper is to investigate how social network capital may facilitate agricultural household market access in Uganda. Specifically, the paper investigates if social network capital has significant positive effects on the ability of households to receive higher prices for coffee. Design/methodology/approach – In this paper, social network capital is modeled using a household utility maximisation problem that is dependent on consumption and social interactions. The authors assume that social network capital mediates economic benefits through its effect on information flow, market intelligence and collective bargaining. The paper uses two-stage least square econometric methods to investigate whether group involvement at the household level helps farmers to access markets with higher prices. Findings – The findings indicate that social network capital, measured in form of density of participation and attendance score, and multiplicative and additive indices of these, have significant positive effects on the ability to receive higher prices for coffee. Research limitations/implications – The authors realise that several weaknesses in the approach could compromise the validity of the findings. These weaknesses include: the cross-sectional nature of the data, the omitted variable bias, the endogeneity concerns of social capital, sample size and the dimensions that the paper choses to capture social network capital. Future research should explore the factors that can help households to engage more in group activities. Practical implications – The findings have important implications for government policy especially in areas of agricultural development and poverty reduction. Specifically, governments should pay close attention to various social groups as they can serve as important channels to achieve better market outcomes, as is the for coffee prices in rural Uganda. Social implications – Many governments in Sub Saharan Africa are constrained to provide basic public goods to the people. This is due to a combination of limited budgets and lack of good leadership. In such circumstances, the people have to rely on their collective/social effort to take advantage of markets opportunities. Such opportunities can be accessed using the existing social structures whose norms and the trust between members permit cooperation. Originality/value – The study contributes to a small but growing empirical literature on social groups and how they can mediate social economic outcomes especially for rural households. The empirical estimations take into consideration the endogeinety concerns associated with social network capital. The paper will be useful for policy makers and researchers who may have a keen interest in the roles that group activities play in agricultural development and poverty reduction.

AbstractVincent McCauley, bishop and missionary, was a great champion of the Second Vatican Council (1962–1965). As Bishop of Fort Portal, Uganda, a new diocese in the Western portion of the country (1961–1971), McCauley was instrumental in the full implementation of the 16 documents of Vatican II, but his principal legacy will be his work in the area of ecumenism. Overcoming significant and long standing hostility between Roman Catholics and Anglicans, McCauley was able to forge ecumenical dialogue and programs on various levels. Beginning simply through prayer services and a vernacular translation of the New Testament, he graduated to be a founder and initial chairman of the Uganda Joint Christian Council (UJCC), an organization which made great strides in removing government opposition to religion and forging dialogue between Christians in areas of sacraments and social justice. Both simultaneously and after his tenure in Fort Portal, McCauley served as chairman and secretary general of the Association of Member Episcopal Conferences of Eastern Africa (AMECEA). These positions allowed him to continue his ecumenical work on a broader scope.He was instrumental in setting up numerous conferences to foster ecumenical dialogue, various pastoral programs and certain educational initiatives, including the Interdisciplinary Urban Seminar, for which McCauley served as a member of the Academic Board. He was also integrally involved as a member of the advisory board of the Christian Organization Research and Advisory Trust (CORAT), an organization that sought to train church members in organization and management.Vincent McCauley stands as a significant example of one who implemented the ecumenical teachings of Vatican II on local and regional levels. His contribution continues to serve the church in Eastern Africa today.

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.

The use of the unified identification system (UIDS) can undoubtedly result in increased effectiveness and efficiency, improvement in the quality of life, reduction of crime, enhanced transparency, and good government. This study examined the dimensions of environmental factors in explaining the adoption of a unified identification system (UIDS). Dynamic capability theory (DCT), technology- organisation-environment (TOE) framework, and diffusion of innovation (DOI) were used as grounding theories. The study opted for a concurrent triangulation research design. The results revealed that government support, competitive pressure, and perceived trust are significant and support the adoption of a unified identification system. However, user readiness was insignificant in explaining the use of UIDS in the Ugandan context. This study recommends that policymakers focus on government support as it is a symbol of leadership in IS innovation adoption.

Abstract With support of the European Union, the Makerere School of Public Health in Uganda developed the SPEED project in collaboration with local (civil society) organisations and research institutes. In the project the partners developed the Roadmap for developing a strategy for Universal Health Coverage in Uganda. Through conferences, workshops, social media, policy briefs the researchers interacted with decision makers. The Ministry of Health Adopted to Roadmap as the guidance for further strategic development of UHC. Most important lesson learned: collaboration between academics, administrators, and activists can have a positive impact on health policy development, if built on trust and mutual understanding.

The study sought to investigate the relationship social networking construct and firm performance. A quantitative research design was employed, whereby data were collected, analyzed and presented using quantitative techniques. Primary data was collected directly from the respondents who are intrapreneurs employed in small and medium bakery and beverage manufacturing firms in Kampala Uganda. The results show a significant and positive relationship between social networks and firm performance (r=.521**, p<.01). This implies that, adhering to and implementing the advice and other information from the professionals, experienced business associates and colleagues will enhance the level of performance of the small scale manufacturing businesses. Further, regression results show that social networks predicted firm performance (Beta = .445, Sig=000). This study posits that social networks can be a cost-effective way of improving small firms’ performance, particularly manufacturing firms. It can therefore be recommended that, small firms support information exchange and resource sharing within and without the business through building blocks that enhance trust amongst its employees. This can be inexpensive method of finding out more efficient ways of operating thus improved firm performance.

Lotte Meinert & Mette Kølner: The Trap of Hope? Enchantment and Universal Education in Uganda and Tanzania This article challenges the apparent global consensus, hope and belief in schooling as a primary tool for making the world a better place. Schooling is enchanting as an idea, because it entails a promise of improvement in the future – at political as well as individual levels. Based on missionary accounts and empirical cases of schooling in Uganda and Tanzania, we attempt to identify the enchantment and seduction that lures people into what appears to be moral traps. Despite endless examples of people who go through schooling without being able to materialise the hope that schooling will lead to a way out of poverty, why do parents keep sending children to school and why do children keep insisting on the importance of education? To answer this question we are inspired by Alfred Gell’s thoughts about enchantment (1992) and traps (1996). We point to the problems and social dynamics that are set in motion when the future cannot fulfill the promise of being the “modern and salaried citizens” which children start believing in as the only proper form of personhood during their school years. An important argument in the article is that the enchantment and entrapment of schooling is dynamic. It is not static and totally blinding, but a continuous and contested social process fluctuating between trust and distrust, enchantment and disenchantment. The hope and belief in education varies over time, during changing political discourses, historical periods and in individuals’ and families’ lives depending on experience, possibilities and structural limitations. We attempt to grasp the ambivalence and apparent contradictions that are inherent in schooling locally, by drawing a nuanced picture of the magical as well as the hopeless sides of schooling in East Africa.Keywords: Schooling, enchantment, hope, trap, Uganda, Tanzania.

Abstract Background Informed consent, whose goal is to assure that participants enter research voluntarily after disclosure of potential risks and benefits, may be impossible or impractical in emergency research. In low resource settings, there is limited information on the experiences of the informed consent process for randomized clinical trials in the emergency care context. The objective of this study was to explore the experiences of the informed consent process and factors that motivated participation in two obstetrics and newborn care randomized clinical trials (RCTs). Methods This was a qualitative study conducted among former participants of RCTs in the emergency obstetric care context, conducted at Kawempe National Referral Hospital, Uganda. It employed 30 in-depth interviews conducted from June 1, 2019 to August 30, 2019. Issues explored included attitudes about research, the purpose of the research in which they participated, motivations to take part in the study, factors that influenced enrolment decisions, and experiences of the informed consent process. Results Respondents felt that research was necessary to investigate the cause, prevention or complications of illness. The decisions to participate were influenced by hope for material or therapeutic benefit, trust in the healthcare system and influence of friends and family members. Many were satisfied with the informed consent process, though they did not understand some aspects of the research. Conclusion Respondents valued participation in RCTs in emergency obstetric and newborn care. Hope for benefit, altruism, desire to further scientific knowledge and trust in the investigators featured prominently in the motivation to participate. Both intrinsic and extrinsic factors were motivators for RCT participation.

Background: The need to equip students with the theoretical knowledge and applied skills is an essential requirement for professional practice; even more in an increasingly competitive job market. The opportunity to travel to Mbale, Eastern Uganda, as part of a field course, identified areas of professional development which were then transferred and extended to students who were not able to make the travel commitment. Description: As part of the ongoing collaboration between the University of South Wales (USW) and the charity Partnerships Overseas Networking Trust (PONT), the nutrition and geography students took part in a range of community development and research projects. Of particular focus here, the nutrition students designed and delivered a training course aimed at volunteer community health workers on nutrition and food combining. The same approach was taken for students who were not able to travel to Africa. In partnership with the Communities First Health Team of Newport West Cluster, a nutrition course was also developed. The students took part in all the stages of the projects and gained a variety of skills; from developing, planning, implementing and evaluating a ‘real’ project to working with an interpreter. Conclusions: The increasing competitive and challenging employment market requires the need to equip students with appropriate skills for their working lives and to play a constructive role in a world that is ‘shrinking’. Increased geographical and social mobility supports multicultural living and working and demands certain cultural competencies. Such learning opportunities bring with them challenges along with opportunities from the perspective of the learner. Therefore, the teacher has a role in supporting the student in this process that enhances the potential of the opportunities while making those challenges enjoyable and fun to manage. Furthermore, collaborations, such as those described, benefit everyone providing a ‘win-win’ experience.

Abstract Background A 12-dose, once-weekly regimen of isoniazid and rifapentine (3HP) is effective in preventing tuberculosis (TB) among people living with HIV (PLHIV). We sought to identify potential barriers to and facilitators of acceptance and completion of 3HP treatment from the perspective of people living with HIV (PLHIV) and health workers in a routine HIV care setting in Kampala, Uganda. Methods We conducted semi-structured interviews with 25 PLHIV and 10 health workers at an HIV/AIDS clinic in Kampala, Uganda. For both groups, we explored their understanding and interpretations of TB and TB preventive therapy (TPT), and perceptions about social and contextual factors that might influence the willingness of PLHIV to initiate and complete 3HP. We analyzed the data using an inductive thematic approach and aligned the emergent themes to the Behavior Change Wheel framework to identify sources of behavior and targeted behavior change interventions. Results Facilitators of acceptance and completion of 3HP treatment among PLHIV were fear of contracting TB, awareness of being at risk of getting TB, willingness to take TPT, trust in health workers, and the perceived benefits of directly observed therapy (DOT) and self-administered therapy (SAT) 3HP delivery strategies. Barriers included inadequate understanding of TPT, fear of potential side effects, concerns about the effectiveness of 3HP, and the perceived challenges of DOT or SAT. Among health workers, perceived facilitators included knowledge that TB is a common cause of mortality for PLHIV, fear of getting TB, and trust in the health workers by PLHIV, the advantages of once-weekly 3HP dosing, and the benefits of DOT and SAT 3HP delivery strategies. Health worker-reported barriers for PLHIV included inadequate understanding of TB and benefits of TPT, TB-associated stigma, potential side effects pill burden, and challenges of DOT and SAT 3HP delivery strategies. Lack of experience in the use of digital technology to monitor patient care was identified as a health worker-specific barrier. Identified intervention functions to address the facilitators or barriers included education, persuasion, environmental restructuring, enablement, and training. Conclusions Using a formative qualitative and comprehensive theoretical approach, we identified key barriers, facilitators, and appropriate interventions, including patient education, enhancing trust, and patient-centered treatment support that could be used to optimize the delivery of 3HP to PLHIV in our setting. These interventions are likely generalizable to other clinical interventions in similar populations in sub-Saharan Africa and other TB high-burden settings.

Purpose The purpose of this paper is to assess the readiness of Ugandans to accept electronic voting under the restrictive conditions of the COVID-19 pandemic. Design/methodology/approach A semi-structured questionnaire, built on a five-point-Likert scale with responses ranging from 1 – strongly disagree to 5 – strongly agree was used to get quantifiable data from four main electoral stakeholders i.e. the policymakers, urban and semi-urban youth, rural voters and government officials. These stakeholders were purposively and conveniently selected because of the influential roles they play in promoting electoral democracy in Uganda. Using a cross-sectional survey design, the authors adopted correlational and quantitative research designs to collect and analyse data. Data was collected from a maximum sample size of 384 as recommended by Krejcie and Morgan (1970) from which 252 useful responses (65.6% response rate) were obtained. Using a statistical package for social scientists version 21.0, the authors performed a Pearson correlation coefficient to determine the relationships between study variables and linear regression analysis to predict the readiness of the stakeholders to accept e-voting more especially under the constraints caused by the COVID-19 pandemic. Findings There was a positive significant relationship between perceived usefulness (PU) and attitude towards adoption, perceived ease of use and attitude towards adoption, attitude and readiness and finally trust propensity and readiness. The regression results show that 65% of the variations in readiness to adopt e-voting can be explained by perceived ease of use, PU, trust propensity and attitude towards adoption. Attitude towards adopting e-voting accounts for the highest variations in the model followed by trust propensity and finally PU. However, perceived ease of use was found to be insignificant. Research limitations/implications The study was limited to only PU, perceived ease of use, trust propensity, attitudes towards using/adoption and readiness to accept e-voting amidst the COVID-19 strict conditions. In Africa, electoral democracy can be influenced by a number of factors such as finances, education levels, sectarianism, voter rigging, perceived risk, political and economic environment. These were not taken into consideration yet they would affect the stakeholders’ attitudes and perceptions which would directly or indirectly affect the adoption of electronic voting. Practical implications Given the low levels of technology infrastructure in the country, there is a general low uptake of technology-oriented systems. The internet reach is low and quality is poor whilst the radio and televisions network is limited to a few urban settings, poor quality technology systems such as the recently acquired voter biometric systems and the constant government actions to switch off the internet and social media whenever there are contentious political issues. These inadequacies together with the restrictive COVID-19 conditions have compromised the participation of stakeholders which dents the stakeholders’ readiness to accept e-voting which consequently compromises electoral democracy in the country. Therefore, government, electoral observers, the international community and civil society organizations need to accelerate the technology infrastructure development in the country, training and development of technical skills and competences, as well as mass mobilization on the use of technology-oriented platforms aimed at promoting electoral democracy. The country should come up with ICT policies and regulations that encourage the use of ICT in areas that promote democracy. These may include; the use of an easy e-voting system such as emails and voting via the post office. Also, Lawmakers, civil society organizations and the international community should make it punitive for anyone who disenfranchises people through internet disconnection, denial of access to broadcast, print and online media. These interventions will restore peoples’ attitudes and perceptions towards electronic voting, consequently increasing their levels of participation in the electioneering process. Originality/value The Ministry of Health, the Uganda Police Force and other security agencies have come out strongly to enforce the COVID-19 standard operating procedures which among others include the banning of political gatherings, processions and meetings of any kind. As a remedy, the Electoral Commission is encouraging political parties, electoral candidates, voters and other stakeholders to use technology-oriented systems such as mobile phones, broadcast and print media, the internet and others to reach out to the electorate. With the government in full control of all these electronic, print and broadcast media, having previously switched them off during the 2011 and 2016 polls consequently disenfranchising many people from their democratic rights, it remains unknown the extent to which the electorate is ready to accept and appreciate scientific voting more so during this time when restrictions against COVID-19 are not making it any better for the voters and other key participants to carry out their political and civil activities.

Abstract Background Whereas many adolescents and young people with HIV require the transfer of care from paediatric/adolescent clinics to adult ART clinics, this transition is beset with a multitude of factors that have the potential to hinder or facilitate the process, thereby raising ethical challenges of the transition process. Decisions made regarding therapy, such as when and how to transition to adult HIV care, should consider ethical benefits and risks. Understanding and addressing ethical challenges in the healthcare transition could ensure a smooth and successful transition. The purpose of this study was to analyze the ethical challenges of transitioning HIV care for adolescents into adult HIV clinics. Methods Data presented were derived from 191 adolescents attending nine different health facilities in Uganda, who constituted 18 focus group discussions. In the discussions, facilitators and barriers regarding adolescents transitioning to adult HIV clinics were explored. Guided by the Silences Framework for data interpretation, thematic data analysis was used to analyze the data. The principles of bioethics and the four-boxes ethics framework for clinical care (patient autonomy, medical indications, the context of care, and quality of life) were used to analyze the ethical issues surrounding the transition from adolescent to adult HIV care. Results The key emerging ethical issues were: reduced patient autonomy; increased risk of harm from stigma and loss of privacy and confidentiality; unfriendly adult clinics induce disengagement and disruption of the care continuum; patient preference to transition as a cohort, and contextual factors are critical to a successful transition. Conclusion The priority outcomes of the healthcare transition for adolescents should address ethical challenges of the healthcare transition such as loss of autonomy, stigma, loss of privacy, and discontinuity of care to ensure retention in HIV care, facilitate long-term self-care, offer ongoing all-inclusive healthcare, promote adolescent health and wellbeing and foster trust in the healthcare system. Identifying and addressing the ethical issues related to what hinders or facilitates successful transitions with targeted interventions for the transition process may ensure adolescents and young people with HIV infection remain healthy across the healthcare transition.

This article explores resilience as it is experienced by refugees in the context of a relational community, visiting the notions of trauma, a thicker description of resilience and the trajectory toward positive growth through community. It calls for going beyond a Western biomedical therapeutic approach of exploration and adopting more of an emic perspective incorporating the worldview of the refugees. The challenge is for service providers working with refugees (who have experienced trauma) to move forward from a ‘harm minimisation’ model of care to recognition of a facilitative, productive community of people who are in a transitional phase between homelands. Contextualising Trauma Prior to the 1980s, the term ‘trauma’ was not widely used in literature on refugees and refugee mental health, hardly existing as a topic of inquiry until the mid-1980’s (Summerfield 422). It first gained prominence in relation to soldiers who had returned from Vietnam and in need of medical attention after being traumatised by war. The term then expanded to include victims of wars and those who had witnessed traumatic events. Seahorn and Seahorn outline that severe trauma “paralyses you with numbness and uses denial, avoidance, isolation as coping mechanisms so you don’t have to deal with your memories”, impacting a person‘s ability to risk being connected to others, detaching and withdrawing; resulting in extreme loneliness, emptiness, sadness, anxiety and depression (6). During the Civil War in the USA the impact of trauma was referred to as Irritable Heart and then World War I and II referred to it as Shell Shock, Neurosis, Combat Fatigue, or Combat Exhaustion (Seahorn & Seahorn 66, 67). During the twenty-five years following the Vietnam War, the medicalisation of trauma intensified and Post Traumatic Stress Disorder (PTSD) became recognised as a medical-psychiatric disorder in 1980 in the American Psychiatric Association international diagnostic tool Diagnostic Statistical Manual (DSM–III). An expanded description and diagnosis of PTSD appears in the DSM-IV, influenced by the writings of Harvard psychologist and scholar, Judith Herman (Scheper-Hughes 38) The Diagnostic and Statistical Manual (DSM-IV) of Mental Disorders (American Psychiatric Association, 2000) outlines that experiencing the threat of death, injury to oneself or another or finding out about an unexpected or violent death, serious harm, or threat of the same kind to a family member or close person are considered traumatic events (Chung 11); including domestic violence, incest and rape (Scheper-Hughes 38). Another significant development in the medicalisation of trauma occurred in 1998 when the Victorian Foundation for Survivors of Torture (VFST) released an influential report titled ‘Rebuilding Shattered Lives’. This then gave clinical practice a clearer direction in helping people who had experienced war, trauma and forced migration by providing a framework for therapeutic work. The emphasis became strongly linked to personal recovery of individuals suffering trauma, using case management as the preferred intervention strategy. A whole industry soon developed around medical intervention treating people suffering from trauma related problems (Eyber). Though there was increased recognition for the medicalised discourse of trauma and post-traumatic stress, there was critique of an over-reliance of psychiatric models of trauma (Bracken, et al. 15, Summerfield 421, 423). There was also expressed concern that an overemphasis on individual recovery overlooked the socio-political aspects that amplify trauma (Bracken et al. 8). The DSM-IV criteria for PTSD model began to be questioned regarding the category of symptoms being culturally defined from a Western perspective. Weiss et al. assert that large numbers of traumatized people also did not meet the DSM-III-R criteria for PTSD (366). To categorize refugees’ experiences into recognizable, generalisable psychological conditions overlooked a more localized culturally specific understanding of trauma. The meanings given to collective experience and the healing strategies vary across different socio-cultural groupings (Eyber). For example, some people interpret suffering as a normal part of life in bringing them closer to God and in helping gain a better understanding of the level of trauma in the lives of others. Scheper-Hughes raise concern that the PTSD model is “based on a conception of human nature and human life as fundamentally vulnerable, frail, and humans as endowed with few and faulty defence mechanisms”, and underestimates the human capacity to not only survive but to thrive during and following adversity (37, 42). As a helping modality, biomedical intervention may have limitations through its lack of focus regarding people’s agency, coping strategies and local cultural understandings of distress (Eyber). The benefits of a Western therapeutic model might be minimal when some may have their own culturally relevant coping strategies that may vary to Western models. Bracken et al. document case studies where the burial rituals in Mozambique, obligations to the dead in Cambodia, shared solidarity in prison and the mending of relationships after rape in Uganda all contributed to the healing process of distress (8). Orosa et al. (1) asserts that belief systems have contributed in helping refugees deal with trauma; Brune et al. (1) points to belief systems being a protective factor against post-traumatic disorders; and Peres et al. highlight that a religious worldview gives hope, purpose and meaning within suffering. Adopting a Thicker Description of Resilience Service providers working with refugees often talk of refugees as ‘vulnerable’ or ‘at risk’ populations and strive for ‘harm minimisation’ among the population within their care. This follows a critical psychological tradition, what (Ungar, Constructionist) refers to as a positivist mode of inquiry that emphasises the predictable relationship between risk and protective factors (risk and coping strategies) being based on a ‘deficient’ outlook rather than a ‘future potential’ viewpoint and lacking reference to notions of resilience or self-empowerment (342). At-risk discourses tend to focus upon antisocial behaviours and appropriate treatment for relieving suffering rather than cultural competencies that may be developing in the midst of challenging circumstances. Mares and Newman document how the lives of many refugee advocates have been changed through the relational contribution asylum seekers have made personally to them in an Australian context (159). Individuals may find meaning in communal obligations, contributing to the lives of others and a heightened solidarity (Wilson 42, 44) in contrast to an individual striving for happiness and self-fulfilment. Early naturalistic accounts of mental health, influenced by the traditions of Western psychology, presented thin descriptions of resilience as a quality innate to individuals that made them invulnerable or strong, despite exposure to substantial risk (Ungar, Thicker 91). The interest then moved towards a non-naturalistic contextually relevant understanding of resilience viewed in the social context of people’s lives. Authors such as Benson, Tricket and Birman (qtd. in Ungar, Thicker) started focusing upon community resilience, community capacity and asset-building communities; looking at areas such as - “spending time with friends, exercising control over aspects of their lives, seeking meaningful involvement in their community, attaching to others and avoiding threats to self-esteem” (91). In so doing far more emphasis was given in developing what Ungar (Thicker) refers to as ‘a thicker description of resilience’ as it relates to the lives of refugees that considers more than an ability to survive and thrive or an internal psychological state of wellbeing (89). Ungar (Thicker) describes a thicker description of resilience as revealing “a seamless set of negotiations between individuals who take initiative, and an environment with crisscrossing resources that impact one on the other in endless and unpredictable combinations” (95). A thicker description of resilience means adopting more of what Eyber proposes as an emic approach, taking on an ‘insider perspective’, incorporating the worldview of the people experiencing the distress; in contrast to an etic perspective using a Western biomedical understanding of distress, examined from a position outside the social or cultural system in which it takes place. Drawing on a more anthropological tradition, intervention is able to be built with local resources and strategies that people can utilize with attention being given to cultural traditions within a socio-cultural understanding. Developing an emic approach is to engage in intercultural dialogue, raise dilemmas, test assumptions, document hopes and beliefs and explore their implications. Under this approach, healing is more about developing intelligibility through one’s own cultural and social matrix (Bracken, qtd. in Westoby and Ingamells 1767). This then moves beyond using a Western therapeutic approach of exploration which may draw on the rhetoric of resilience, but the coping strategies of the vulnerable are often disempowered through adopting a ‘therapy culture’ (Furedi, qtd. in Westoby and Ingamells 1769). Westoby and Ingamells point out that the danger is by using a “therapeutic gaze that interprets emotions through the prism of disease and pathology”, it then “replaces a socio-political interpretation of situations” (1769). This is not to dismiss the importance of restoring individual well-being, but to broaden the approach adopted in contextualising it within a socio-cultural frame. The Relational Aspect of Resilience Previously, the concept of the ‘resilient individual’ has been of interest within the psychological and self-help literature (Garmezy, qtd. in Wilson) giving weight to the aspect of it being an innate trait that individuals possess or harness (258). Yet there is a need to explore the relational aspect of resilience as it is embedded in the network of relationships within social settings. A person’s identity and well-being is better understood in observing their capacity to manage their responses to adverse circumstances in an interpersonal community through the networks of relationships. Brison, highlights the collective strength of individuals in social networks and the importance of social support in the process of recovery from trauma, that the self is vulnerable to be affected by violence but resilient to be reconstructed through the help of others (qtd. in Wilson 125). This calls for what Wilson refers to as a more interdisciplinary perspective drawing on cultural studies and sociology (2). It also acknowledges that although individual traits influence the action of resilience, it can be learned and developed in adverse situations through social interactions. To date, within sociology and cultural studies, there is not a well-developed perspective on the topic of resilience. Resilience involves a complex ongoing interaction between individuals and their social worlds (Wilson 16) that helps them make sense of their world and adjust to the context of resettlement. It includes developing a perspective of people drawing upon negative experiences as productive cultural resources for growth, which involves seeing themselves as agents of their own future rather than suffering from a sense of victimhood (Wilson 46, 258). Wilson further outlines the display of a resilience-related capacity to positively interpret and derive meaning from what might have been otherwise negative migration experiences (Wilson 47). Wu refers to ‘imagineering’ alternative futures, for people to see beyond the current adverse circumstances and to imagine other possibilities. People respond to and navigate their experience of trauma in unique, unexpected and productive ways (Wilson 29). Trauma can cripple individual potential and yet individuals can also learn to turn such an experience into a positive, productive resource for personal growth. Grief, despair and powerlessness can be channelled into hope for improved life opportunities. Social networks can act as protection against adversity and trauma; meaningful interpersonal relationships and a sense of belonging assist individuals in recovering from emotional strain. Wilson asserts that social capabilities assist people in turning what would otherwise be negative experiences into productive cultural resources (13). Graybeal (238) and Saleeby (297) explore resilience as a strength-based practice, where individuals, families and communities are seen in relation to their capacities, talents, competencies, possibilities, visions, values and hopes; rather than through their deficiencies, pathologies or disorders. This does not present an idea of invulnerability to adversity but points to resources for navigating adversity. Resilience is not merely an individual trait or a set of intrinsic behaviours that can be displayed in ‘resilient individuals’. Resilience, rather than being an unchanging attribute, is a complex socio-cultural phenomenon, a relational concept of a dynamic nature that is situated in interpersonal relations (Wilson 258). Positive Growth through a Community Based Approach Through migrating to another country (in the context of refugees), Falicov, points out that people often experience a profound loss of their social network and cultural roots, resulting in a sense of homelessness between two worlds, belonging to neither (qtd. in Walsh 220). In the ideological narratives of refugee movements and diasporas, the exile present may be collectively portrayed as a liminality, outside normal time and place, a passage between past and future (Eastmond 255). The concept of the ‘liminal’ was popularised by Victor Turner, who proposed that different kinds of marginalised people and communities go through phases of separation, ‘liminali’ (state of limbo) and reincorporation (qtd. in Tofighian 101). Difficulties arise when there is no closure of the liminal period (fleeing their former country and yet not being able to integrate in the country of destination). If there is no reincorporation into mainstream society then people become unsettled and feel displaced. This has implications for their sense of identity as they suffer from possible cultural destabilisation, not being able to integrate into the host society. The loss of social supports may be especially severe and long-lasting in the context of displacement. In gaining an understanding of resilience in the context of displacement, it is important to consider social settings and person-environment transactions as displaced people seek to experience a sense of community in alternative ways. Mays proposed that alternative forms of community are central to community survival and resilience. Community is a source of wellbeing for building and strengthening positive relations and networks (Mays 590). Cottrell, uses the concept of ‘community competence’, where a community provides opportunities and conditions that enable groups to navigate their problems and develop capacity and resourcefulness to cope positively with adversity (qtd. in Sonn and Fisher 4, 5). Chaskin, sees community as a resilient entity, countering adversity and promoting the well-being of its members (qtd. in Canavan 6). As a point of departure from the concept of community in the conventional sense, I am interested in what Ahmed and Fortier state as moments or sites of connection between people who would normally not have such connection (254). The participants may come together without any presumptions of ‘being in common’ or ‘being uncommon’ (Ahmed and Fortier 254). This community shows little differentiation between those who are welcome and those who are not in the demarcation of the boundaries of community. The community I refer to presents the idea as ‘common ground’ rather than commonality. Ahmed and Fortier make reference to a ‘moral community’, a “community of care and responsibility, where members readily acknowledge the ‘social obligations’ and willingness to assist the other” (Home office, qtd. in Ahmed and Fortier 253). Ahmed and Fortier note that strong communities produce caring citizens who ensure the future of caring communities (253). Community can also be referred to as the ‘soul’, something that stems out of the struggle that creates a sense of solidarity and cohesion among group members (Keil, qtd. in Sonn and Fisher 17). Often shared experiences of despair can intensify connections between people. These settings modify the impact of oppression through people maintaining positive experiences of belonging and develop a positive sense of identity. This has enabled people to hold onto and reconstruct the sociocultural supplies that have come under threat (Sonn and Fisher 17). People are able to feel valued as human beings, form positive attachments, experience community, a sense of belonging, reconstruct group identities and develop skills to cope with the outside world (Sonn and Fisher, 20). Community networks are significant in contributing to personal transformation. Walsh states that “community networks can be essential resources in trauma recovery when their strengths and potential are mobilised” (208). Walsh also points out that the suffering and struggle to recover after a traumatic experience often results in remarkable transformation and positive growth (208). Studies in post-traumatic growth (Calhoun & Tedeschi) have found positive changes such as: the emergence of new opportunities, the formation of deeper relationships and compassion for others, feelings strengthened to meet future life challenges, reordered priorities, fuller appreciation of life and a deepening spirituality (in Walsh 208). As Walsh explains “The effects of trauma depend greatly on whether those wounded can seek comfort, reassurance and safety with others. Strong connections with trust that others will be there for them when needed, counteract feelings of insecurity, hopelessness, and meaninglessness” (208). Wilson (256) developed a new paradigm in shifting the focus from an individualised approach to trauma recovery, to a community-based approach in his research of young Sudanese refugees. Rutter and Walsh, stress that mental health professionals can best foster trauma recovery by shifting from a predominantly individual pathology focus to other treatment approaches, utilising communities as a capacity for healing and resilience (qtd. in Walsh 208). Walsh highlights that “coming to terms with traumatic loss involves making meaning of the trauma experience, putting it in perspective, and weaving the experience of loss and recovery into the fabric of individual and collective identity and life passage” (210). Landau and Saul, have found that community resilience involves building community and enhancing social connectedness by strengthening the system of social support, coalition building and information and resource sharing, collective storytelling, and re-establishing the rhythms and routines of life (qtd. in Walsh 219). Bracken et al. suggest that one of the fundamental principles in recovery over time is intrinsically linked to reconstruction of social networks (15). This is not expecting resolution in some complete ‘once and for all’ getting over it, getting closure of something, or simply recovering and moving on, but tapping into a collective recovery approach, being a gradual process over time. Conclusion A focus on biomedical intervention using a biomedical understanding of distress may be limiting as a helping modality for refugees. Such an approach can undermine peoples’ agency, coping strategies and local cultural understandings of distress. Drawing on sociology and cultural studies, utilising a more emic approach, brings new insights to understanding resilience and how people respond to trauma in unique, unexpected and productive ways for positive personal growth while navigating the experience. This includes considering social settings and person-environment transactions in gaining an understanding of resilience. Although individual traits influence the action of resilience, it can be learned and developed in adverse situations through social interactions. Social networks and capabilities can act as a protection against adversity and trauma, assisting people to turn what would otherwise be negative experiences into productive cultural resources (Wilson 13) for improved life opportunities. The promotion of social competence is viewed as a preventative intervention to promote resilient outcomes, as social skill facilitates social integration (Nettles and Mason 363). As Wilson (258) asserts that resilience is not merely an individual trait or a set of intrinsic behaviours that ‘resilient individuals’ display; it is a complex, socio-cultural phenomenon that is situated in interpersonal relations within a community setting. References Ahmed, Sara, and Anne-Marie Fortier. “Re-Imagining Communities.” International of Cultural Studies 6.3 (2003): 251-59. Bracken, Patrick. J., Joan E. Giller, and Derek Summerfield. Psychological Response to War and Atrocity: The Limitations of Current Concepts. 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