Districts In Uganda Research Articles

Collaborative Efforts by a University, Government and Agricultural Cooperatives (ACS) to Develop a Credit Facilitation Tool: Evidence from Kamwenge and Sheema Districts in Uganda

Financial performance of Agricultural Cooperatives in Uganda has constrained their ability to attract financiers and thus can’t extend timely and optimal credit facilities to Small Scale Farmers in Uganda despite their huge contribution to the country’ GDP. This situation is attributed to constrained decision making mechanisms in Agricultural Cooperatives s’ credit facilitation process. This article addresses how the University collaborated with the Government and the Agricultural Cooperatives to develop a credit facilitation tool to mitigate credit facilitation decision challenges. With a collaborative perspective, the study worked with 116 agricultural cooperatives decision makers in 6 agricultural cooperatives in Kamwenge and Sheema districts in Uganda. The study confirmed that for the financial years 2018 to 2020, Agricultural Cooperatives were not able to return on assets and on equity. Equally confirmed was that the Agricultural Cooperatives’ credit facilitation decision processes, undermined the involvement of technical officers, lacked structured means of recording credit data which delayed decisions on setting optimal lending rate, lending duration and lending limit. Confirmed too was limited credit tracking which was a hindrance to timely reporting. As a result, these confirmed credit facilitation decision challenges were utilized to develop a collaborative credit facilitation decision tool. Its design is presented using user case scenarios showing how the challenges were solved and an output of these scenarios was a six suited model called the Decision Enhancement Credit Facilitation Approach (DECFA). This tool once implemented by Agricultural Cooperatives will enhance the credit process thus quickening decision making in sourcing and availing credit to Small Scale Farmers. All this new knowledge created was done in the confines of a collaboration between the University, Government and the Agricultural Cooperatives

Mapping the Expertise and Understanding of Menarche, Menstrual Hygiene, and Menstrual Health among Adolescent Ladies in Low- and Center-Profit Nations

Mapping the Expertise and Understanding of Menarche, Menstrual Hygiene, and Menstrual Health among Adolescent Ladies in Low- and Center-Profit Nations

Teachers’ Capacity Building Strategies and Pupils’ Academic Performance in Muslim Public Primary Schools in Namutumba District of Uganda

The study examined the effect of teachers’ capacity building strategies on the pupils’ academic performance in muslim public primary schools in Namutumba district, Uganda. The specific objectives were to: establish the effect of in service training strategies on pupils’ academic performance; find out the influence of teachers’ collaboration on pupils’; and ascertain the influence of teacher’s mentoring on pupils’ academic performance in muslim funded public primary schools in Namutumba District. The study employed a descriptive survey design. Cluster sampling method was employed to select one hundred and thirty four (134) teachers from the schools for the study, while census was used to select the DEO and the ten (10) Head teachers. The study used questionnaire and structured interview guide to collect the data. The value of CVI obtained was 0.78 while the values of reliability obtained were 0.767, 0.755 and 0.787 for in- service training, collaboration and mentoring respectively, which indicates that the questionnaire items were relevant and suitable. One hundred and thirty four (134) questionnaires were administered while a total of ninety eight (98) teachers returned giving a return rate of 73.1%. The data was analyzed using both quantitative and qualitative analysis approaches. The quantitative data were descriptively and inferentially analyzed. Frequencies and percentages were used and Pearson Product Moment correlation statistics was used to establish the level of the relationship. On the other hand, the qualitative data were thematically analyzed using data collected from interviewing the head teachers and DEO. Majority 54.1% of the teachers were males, majority 57.1% of the teachers were below 38 years, and overwhelming majority 92.8% of the teachers did not hold University degree. The study concluded that teachers’ in-service training, teachers’ collaboration in teaching and teachers’ coaching strategy improves the pupils’ academic performance in Muslim primary schools in Namutumba district. Finally, the study recommended that government should hold in-service training to include themes on professional skills and subject matter to enable all teachers benefit and be able to help learners improve in their performance; school administration should setup academic committees in schools where teachers discuss learners’ challenges and ways of helping learners improve; and school management should identify the teachers’ competencies in their teaching areas and assign them responsibilities of coaching other teachers.

Nutritional composition of least-cost staple food sources of nutrients in Eastern Uganda

Food cost and seasonal availability are important determinants of food choice and ultimately nutrient intake. This study aimed at establishing the nutritional composition of least-cost staple food sources of nutrients in Kamuli, Buyende and Pallisa districts in eastern Uganda across the cropping seasons. The World Food Programme (WFP) Vulnerability Analysis and Mapping (VAM) Market Analysis Tool guidelines were used to conduct a mini-survey to determine seasonal prices and availability of foods. Retailers (n= 268) from six markets in Kamuli, three in Buyende and six in Pallisa were interviewed. The least-cost sources of energy, protein, iron and zinc were determined using nutrient-cost values. The nutrient composition of the least-cost foods were determined using standard methods. For the first dry season, the least cost sources of energy, protein, iron and zinc were maize (0.052 $/1000kcal), soybeans (0.016 $/10g), maize (0.070 $/10mg) and maize (0.086 $/10mg), respectively. For the second dry season, the least cost sources of energy, protein, iron and zinc were maize (0.052 $/1000kcal), soybeans (0.015 $/10g), maize (0.070 $/10mg) and maize (0.086 $/10mg). For the first rainy season, the least cost source of energy was sorghum (0.074 $/1000kcal), protein was groundnuts (0.019 $/10g), iron was sesame (0.100 $/10mg) and zinc was sweet potatoes (0.123 $/10mg), respectively. For the second rainy season, the least cost sources of energy, protein, iron and zinc were sorghum (0.049 $/1000kcal), groundnuts (0.016 $/10g), sesame (0.067 $/10mg) and sweet potatoes (0.082 $/10mg), respectively. The richest sources of energy, sugars and starch, protein, fat, fibre and iron were sesame (797.2 ± 116.84 Kcal/100g), sweet potatoes (11.5 ± 1.22 and 86.8 ± 10.75 g/100g), soybeans (40.7 ± 4.58 g/100g), sesame (52.9 ± 3.82 g/100g), soybeans (7.0 ± 0.32 g/100g), groundnuts (7.0 ± 0.82 mg/g). The nutrition composition of least-cost foods in the dry seasons and rainy seasons indicates that they can be used to formulate low-cost nutrient-dense mixtures for the respective seasons. Key words: Uganda, cropping seasons, least-cost, energy, protein, iron, zinc

The legal perspective on unlawful possession of firearms, and cattle rustling in Karamoja sub-region

Karamoja is located in the northeastern part of Uganda. It is a 27,200 square kilometer area of semi-arid savannah. It is bordered by the Turkana (Kenya) in the east, Sudan in the north and to the west and south it is bordered by Ugandan districts occupied mostly by the Acholis, Itesots and Sabiny people. The area being semi-arid, the Karamajong focus majorly on livestock–principally cattle. This explains their persistent nomadic life in pursuit for water and pasture. Their love for cattle bred a culture of raiding and warfare which has kept them at loggerheads with their neighbours. In the past, raids were mild but the situation worsened because of the proliferation of small weapons. Following the collapse of Amin’s regime in 1979, Moroto barracks was abandoned thereby leaving weapons in the hands of the clueless civilians and violence as a result reached unprecedented levels. Having assumed power in 1986, the government of Uganda under Y K Museveni, launched disarmament campaigns in 2001 and 2006. This led to the recovery of thousands of guns and by 2010, relative peace was restored. Later people illegally acquired through black-market and the situation worsened because little had been done to rehabilitate the young men who had given up their guns. In the words of Jino Meri, the LCV chairman of Kaabong District, ‘they didn’t have post-disarmament programmes to disarm the mind.’ The government has since embarked on a more appealing disarmament programme whereby, whoever hands over his gun is appreciated with a number goats as a wealth creation mechanism. This is intended dislodging the absurd culture of cattle rustling that not only breeds insecurity but also causes under developed.

Cholera and COVID-19 pandemic prevention in multiple hotspot districts of Uganda: vaccine coverage, adverse events following immunization and WASH conditions survey

BackgroundBetween March, 2020 and December, 2021 due to cholera and coronavirus disease 2019 (COVID-19) pandemics, there were 1,534 cholera cases with 14 deaths and 136,065 COVID-19 cases with 3,285 deaths reported respectively in Uganda. This study investigated mass vaccination campaigns for the prevention of the two pandemics namely: oral cholera vaccine (OCV) and COVID-19 vaccine coverage; adverse events following immunization (AEFI); barriers and enablers for the vaccine uptake and assessed water, sanitation and hygiene (WASH) conditions in the six cholera and COVID-19 hotspot districts of Uganda.MethodsA household survey was conducted between January and February, 2022 in the six cholera hotspot districts of Uganda which had recently conducted OCV mass vaccination campaigns and had ongoing COVID-19 mass vaccination campaigns. The survey randomly enrolled 900 households with 4,315 persons of whom 2,085 were above 18 years. Data were collected using a data entry application designed in KoBoToolbox and analysed using STATA version 14. Frequencies, percentages, odds ratios, means, confidence intervals and maps were generated and interpreted.ResultsThe OCV coverage for dose one and two were 85% (95% CI: 84.2—86.4) and 67% (95% CI: 65.6—68.4) respectively. Among the 4,315 OCV recipients, 2% reported mild AEFI, 0.16% reported moderate AEFI and none reported severe AEFI. The COVID-19 vaccination coverage for dose one and two were 69.8% (95% CI: 67.8–71.8) and 18.8% (95% CI: 17.1–20.5) respectively. Approximately, 23% (478/2,085) of COVID-19 vaccine recipient reported AEFI; most 94% were mild, 0.6% were moderate and 2 cases were severe. The commonest reason for missing COVID-19 vaccine was fear of the side effects. For most districts (5/6), sanitation (latrine/toilet) coverage were low at 7.4%—37.4%.ConclusionThere is high OCV coverage but low COVID-19 vaccine and sanitation coverage with high number of moderate cases of AEFI recorded due to COVID-19 vaccines. The low COVID-19 vaccine coverage could indicate vaccine hesitancy for COVID-19 vaccines. Furthermore, incorporation of WASH conditions assessment in the OCV coverage surveys is recommended for similar settings to generate data for better planning. However, more studies are required on COVID-19 vaccine hesitancy.

The meaning of caring for patients with cancer among traditional medicine practitioners in Uganda: A grounded theory approach.

Traditional medicine practitioners (TMPs) are a critical part of healthcare systems in many sub-Saharan African countries and play vital roles in caring for patients with cancer. Despite some progress in describing TMPs' caring experiences in abstract terms, literature about practice models in Africa remains limited. This study aimed to develop a substantive theory to clarify the care provided by TMPs to patients with cancer in Uganda. This study adhered to the principal features of the modified Straussian grounded theory design. Participants were 18 TMPs caring for patients with cancer from 10 districts in Uganda, selected by purposive and theoretical sampling methods. Researcher-administered in-depth interviews were conducted, along with three focus group discussions. Data were analyzed using constant comparative analysis. The core category that represented TMPs' meaning of caring for patients with cancer was "Restoring patients' hope in life through individualizing care." TMPs restored patients' hope through five main processes: 1) ensuring continuity in the predecessors' role; 2) having full knowledge of a patient's cancer disease; 3) restoring hope in life; 4) customizing or individualizing care, and 5) improving the patient's condition/health. Despite practice challenges, the substantive theory suggests that TMPs restore hope for patients with cancer in a culturally sensitive manner, which may partly explain why patients with cancer continue to seek their services. The findings of this study may guide research, education, and public health policy to advance traditional medicine in sub-Saharan Africa.

Assessment of Safe Motherhood Health Service Coverage, Birth Defects Detection and Child Disability Prevention Using Lot Quality Assurance Sampling in Central Uganda.

It is crucial to have satisfactory coverage of safe motherhood services in order to prevent birth defects and child disabilities. Mildmay Uganda Institute of Health Sciences (MIHS) implemented a safe motherhood project aimed at preventing birth defects and child disabilities. Three years after the project's implementation, a rapid cross-sectional health facility survey was conducted in 4 districts of central Uganda to assess the coverage of key safe motherhood and early childhood services. The Lot Quality Assurance Sampling approach was used to assess coverage of 16 indicators in the areas of ANC, skilled birth attendance, early childhood care, postnatal care, and knowledge about child disability prevention. A Decision Rule was set at 80% upper threshold to classify the performance of health facilities at the district level. The survey found that there was variation in performance across indicators and districts. All districts achieved the 80% coverage target in ANC first visit, mothers who received at least two doses of Fansidar for intermittent preventive treatment of malaria in pregnancy, and mothers with knowledge of the action to take in case they suspect childhood disability. Folic acid supplementation during pregnancy and screening for birth defects using the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score had overall coverage above the target, but one district each had coverage below target in each of these 2 indicators. The coverage target was not reached in the rest of the survey indicators in each of the districts. Well-performing districts, especially in indicators with inconsistent performance, offer valuable insights for learning and adapting interventions in districts that do not meet the desired coverage of those particular indicators. Considering the disparities in performance among different indicators and districts, project planners should adopt, modify and implement successful strategies in districts and indicators that perform well. By doing so, they can enhance the performance of under performing districts or indicators.

The meanings of resilience in climate justice: women smallholder farmers’ responses to agricultural shocks in Uganda under the spotlight

abstract Climate crisis has become a global concern resulting in increased frequency of climate hazards and agricultural shocks. Women who dominate agricultural production in Africa are considered the most vulnerable to these shocks due to their reliance on the natural ecosystem for production, compounded by the persistent gender inequalities that make up the social ecology in which they live. Climate activism as a strategy for promoting social change has a potential for strengthening resilience, especially fostering change in the systems that limit women farmer’s resilience to climate change shocks. With multiple initiatives to support households to adapt to the various agricultural shocks, the question needs to be asked, to what extent do initiatives aim at changing the systems/structures and the social ecology that limit women’s resilience to climate change shocks? The article draws on a baseline survey conducted in two districts in Uganda in 2022 that employed a mixed methods approach. The article interrogates the existing initiatives’ potential to strengthen women’s resilience to climate related agricultural shocks in the context of climate justice. With reference to a social-ecological model of resilience, the article illuminates the extent to which these efforts have contributed to transforming the social ecologies that limit women’s resilience. The findings suggest the need for women’s climate activism and organising to effectively address the underlying social and gender norms that continue to limit women’s empowerment and resilience to climate related agricultural shocks in Uganda.

Impact-Based Flood Early Warning for Rural Livelihoods in Uganda

Abstract Anticipatory actions are increasingly being taken before an extreme flood event to reduce the impacts on lives and livelihoods. Local contextualized information is required to support real-time local decisions on where and when to act and what anticipatory actions to take. This study defines an impact-based, early-warning trigger system that integrates flood forecasts with livelihood information, such as crop calendars, to target anticipatory actions better. We demonstrate the application of this trigger system using a flood case study from the Katakwi District in Uganda. First, we integrate information on the local crop cycles with the flood forecasts to define the impact-based trigger system. Second, we verify the impact-based system using historical flood impact information and then compare it with the existing hazard-based system in the context of humanitarian decisions. Study findings show that the impact-based trigger system has an improved probability of flood detection compared with the hazard-based system. There are fewer missed events in the impact-based system, while the trigger dates are similar in both systems. In a humanitarian context, the two systems trigger anticipatory actions at the same time. However, the impact-based trigger system can be further investigated in a different context (e.g., for livelihood protection) to assess the value of the local information. The impact-based system could also be a valuable tool to validate the existing hazard-based system, which builds more confidence in its use in informing anticipatory actions. The study findings, therefore, should open avenues for further dialogue on what the impact-based trigger system could mean within the broader forecast-based action landscape toward building the resilience of at-risk communities.

Prevalence of gastrointestinal parasites and molecular identification of beta-tubulin mutations associated with benzimidazole resistance in Haemonchus contortus in goats from selected districts of Uganda.

Gastrointestinal parasites are among the most economically important pathogens of small ruminants causing serious economic losses and animal welfare problems for the livestock industry worldwide. The emergence of anthelmintic resistant H. contortus in small ruminants is a serious problem because it undermines effective helminth control and results in reduced productivity. Little is known about resistance to benzimidazoles (BZ) in Haemonchus in goats and sheep in Uganda. The objective of this study was to determine the prevalence of gastrointestinal parasites and to identify the presence of benzimidazole resistance associated mutations in the β-tubulin isotype 1 gene of Haemonchus contortus in goats from selected districts of Uganda. A total of 200 goats from 10 districts of Uganda slaughtered at Kalerwe abattoir in Kampala were sampled for H. contortus adult worms. Faecal samples were also collected to detect other intestinal parasites. Faecal microscopy and analysis were performed using flotation and sedimentation techniques. DNA was extracted from adult worms and PCR and sequencing of the ITS- 2 region and β-tubulin isotype 1 gene performed to identify H. contortus species and to determine the presence of mutations associated with anthelmintic resistance respectively. Faecal microscopy showed that the most prevalent intestinal parasites were coccidia (98%), strongyles (97.5%), Strongyloides (82%), Paramphistomum (74.5%), Moniezia (46%), Fasciola (1.5%) and Trichuris (1%). Most goats had a high intestinal burden of coccidia (≥ 5000 oocyst per gram) and strongyles (≥ 1000 egg per gram), 65% and 67.5%, respectively. The prevalence of H. contortus adult worms was 63% (126/200). Sequencing of the partial β-tubulin isotype 1 gene of 54 Haemonchus contortus adult male isolates revealed the presence of mutations associated with anthelmintic resistance. The F200Y mutation was the most common mutation (13% of samples with good beta-tubulin sequences) followed by the E198A and E198K mutations, both found in 9% of sequenced samples. Mutation F167Y was not identified in any of the samples and there were no heterozygous individuals for any of the SNPS associated with BZ resistance that were identified in this study. These findings highlight the need for controlled use of anthelmintics especially benzimidazoles, to enable sustainable control of H. contortus in Uganda, and a need for further investigation to understand the resistance of other parasites identified in this study.

Evaluating households’ willingness to pay for private water supply services in Wakiso District, Uganda

Accessing water supply services remains a serious challenge in Wakiso District in Uganda, where most households travel long distances to collect water – a process that threatens their health, productivity and economic wellbeing. Although addressing this challenge requires huge financial investment, the value households attach to accessing private water supply services at their premises is not clear. This study used data from 243 households to determine their willingness to pay (WTP) for private water supply services. The analysis applied the Heckman model to check for sample selection bias, and the contingent valuation method (CVM) to estimate the WTP. The mean WTP was estimated at UGX 203.07 (USD 0.06) per 20 litre jerry can. Socioeconomic and demographic factors that influence WTP were also determined. These findings could guide the design of policies on sustainable water supply and cost recovery in the long run.

Influence of poverty on digital education in Uganda’s rural secondary schools: reference to covid-19 lockdown: a case study of Kayunga District in Uganda

This study explored the impact of poverty on digital learning, examined the role of parents’ income in the success of digital education in rural schools, and provided suggestions to improve teaching and learning using digital facilities in times of pandemic in rural schools. Uganda’s rural schools lack enough facilities to support the online school system. And there is a lack of in-depth analysis of poverty's influence on digital education. This study used cross-sectional survey data utilizing quantitative and qualitative research approaches. The findings revealed that rural schools in Uganda do not receive efficient digital education where parents and guardians of the school-going children cannot afford the financial costs of the digital devices that could support children’s home digital learning. Parents' income plays an influential role in the digital education of their children. 38.7% of the parents are farmers, and 6.3% of parents are not employed at all. Over 22% of students revealed that their parents supported more than four school-going children. There is a need for governments, institutions and local communities to develop a technological infrastructure for digital learning and develop new curriculums which can support virtual classrooms. Areas that emerged for further research.

Records Management Practices and Service Delivery in Ntungamo District in Western Uganda

This emprical research study assessed the association between Records Management practices and Service Delivery in Ntungamo District in western Uganda. The research study utilised a cross sectional and descriptive research design with both quantitative and qualitative approaches. A sample of 338 respondents were carefully chosen from 2890 people using table developed by Morgan & Krejcie (1970). Facts were gathered using questionnaires and interview schedules and analyzed by means of frequencies, percentages, Pearson linear correlation coefficient (PLCC) for quantitative data and thematic analysis was used for organising qualitative evidence. The study discoveries established a significant association between Records Management practices and Service Delivery in Ntungamo District in Western Uganda. The study resolved that Records Management practices are important for service delivery because they deal with issues to do with evidence based adminstration which has a bearing to good governance in schools in Ntungamo District in Uganda. From the study outcomes, the scholar recommended that secondary school administrators should put systems in place to manage records scientifically for empirical based management science. This can help in the delivery of services since school managers may have proof of whatever they do in terms of accountability. The government of Uganda through Ministry of Education and Sports should enhance the budget meant to improve on the development of secondary schools in Ntungamo distirict in Western Uganda, East Africa.

Demographic dynamics of waterborne disease and perceived associated WASH factors in Bushenyi and Sheema districts of South-Western Uganda

Water remains a significant player in spreading pathogens, including those associated with neglected tropical diseases. The implications of socio-demographic delineations of water quality, sanitation, and hygiene (“WASH”) interventions are on the downswing. This study assessed waterborne diseases and perceived associated WASH factors in the Bushenyi and Sheema districts of South-Western Uganda. This study examines the linear relationship between WASH and identifies the association of specific demographic factors as well as their contributions/correlations to waterborne disease in the study area. A structured qualitative and quantitative data collection approach was adopted in face-to-face questionnaire-guided interviews of 200 respondents on eight surface water usage. Most participants, 65.5%, were females and had a higher score of knowledge of WASH (71%), 68% score on the improper practice of WASH, and 64% score on unsafe water quality. Low score for basic economic status was (57%), report of common diarrhoea was (47%), and a low incidence of waterborne disease outbreaks (27%). The principal component analysis (PCA) depicts the knowledge and practice of WASH to have a strong positive correlation (r = 0.84, p < 0.001; r = 0.82, p < 0.001); also economic status positively correlated with grade of water source, knowledge, and practice of WASH (correlation coefficient = 0.72; 0.99; 0.76 and p-values = 0.001; < 0.001; < 0.001 respectively). Occupation (p = 0.0001, OR = 6.798) was significantly associated with knowledge and practice of WASH, while age (r = −0.21, p < 0.001) was negatively associated with knowledge and practice of WASH. The basic economic status explains why “low economic population groups” in the remote villages may not effectively implement WASH, and diarrhoea was common among the population. Diarrhoea associated with unsafe water quality and improper practice of WASH is common among the study population, and there is a low incidence of waterborne disease outbreaks. Therefore, government, stakeholders, and non-governmental organisations should work together to promote proper practice of WASH conditions to limit the occurrence of diarrhoea and prevent potential waterborne disease outbreaks.

Risk perception of Ebola virus disease and COVID-19 among transport drivers living in Ugandan border districts.

Cross-border movements between districts bordering Uganda and the Democratic Republic of Congo (DRC) are common due to the interdependence between populations on either side, though this increases the risk of the international spread of infectious diseases. Due to the nature of their work, boda boda drivers (motorcycle taxis), taxis and truck drivers continue to cross the border during epidemics. However, perceived risk of contracting and spreading communicable diseases may be influenced by several factors such as the level of education, packaging and perception of health care messages, limited interaction with local socio-cultural dynamics or personal experiences. This study aims to explore differences in movement patterns and risk perceptions as factors for transmission among transport drivers in Ugandan border districts during the 2018-2020 Ebola Virus Disease (EVD) epidemic and the current COVID-19 pandemic. Between May and June 2021, in-depth interviews and focus group discussions were conducted with transport drivers in three Ugandan districts bordering DRC (Kasese, Kisoro and Hoima). Participants were asked about their knowledge and beliefs about EVD and COVID-19, perceived risk during epidemics, reasons for, and travel patterns during the EVD epidemic and COVID- 19 pandemic. A thematic content analysis was applied. Participants' awareness of EVD was higher than that of COVID-19 however, the risk of transmission of Ebola virus was perceived as a remote threat. Measures restricting mobility during the COVID-19 pandemic had a greater impact on transport drivers compared to those implemented during the EVD epidemic, and were perceived as prohibitive rather than protective, largely due to fear of reprisals by security officers. Despite this, drivers were unlikely to be able to comply with the restrictions as they relied on their work as a source of income. The vulnerabilities of transport drivers should be considered in the context of epidemics such EVD and COVID-19 in Uganda. Policy makers should address these particularities and assess the impact of public health measures on transport drivers' mobility and involve them in designing of mobility-relatedpolicies.

Village health team-delivered oral HIV self-testing increases linkage-to-care and antiretroviral-therapy initiation among men in Uganda

ABSTRACT Targeted strategies are central to increasing HIV-status awareness and progress on the care cascade among men. We implemented Village-Health-Team (VHT)-delivered HIV self-testing (HIVST) among men in a peri-urban Ugandan district and assessed linkage to confirmatory-testing, antiretroviral-therapy (ART) initiation and HIV-status disclosure following HIVST. We conducted a prospective cohort study from November 2018 to June 2019 and enrolled 1628 men from 30-villages of Mpigi district. VHTs offered each participant one HIVST-kit and a linkage-to-care information leaflet. At baseline, we collected data on demographics, testing history and risk behavior. At one-month, we measured linkage to confirmatory-testing and HIV-status disclosure, and at three months ART-initiation if tested HIV-positive. We used Poisson regression generalized estimating equations to evaluate predictors of confirmatory-testing. We found that 19.8% had never tested for HIV and 43% had not tested in the last 12-months. After receiving HIVST-kits, 98.5% self-reported HIVST-uptake in 10-days, 78.8% obtained facility-based confirmation in 30-days of HIVST with 3.9% tested HIV-positive. Of the positives, 78.8% were newly diagnosed, 88% initiated ART and 57% disclosed their HIV-status to significant others. Confirmatory testing was associated with having a higher level of education and knowing a partner’s HIV-status. VHT-delivered HIVST may be effective for boosting testing, ART-initiation and HIV-status disclosure among men.

Uptake and perceptions of oral HIV self-testing delivered by village health teams among men in Central Uganda: A concurrent parallel mixed methods analysis.

The World Health Organization (WHO) recommends HIV self-testing (HIVST) to increase access to and utilization of HIV services among underserved populations. We assessed the uptake and perceptions of oral HIVST delivered by Village Health Teams (VHTs) among men in a peri-urban district in Central Uganda. We used a concurrent parallel mixed methods study design and analyzed data from 1628 men enrolled in a prospective cohort in Mpigi district, Central Uganda between October 2018 and June 2019. VHTs distributed HIVST kits and linkage-to-care information leaflets to participants in 30 study villages allowing up-to 10 days each to self-test. At baseline, we collected data on participant socio-demographics, testing history and risk behavior for HIV. During follow-up, we measured HIVST uptake (using self-reports and proof of a used kit) and conducted in-depth interviews to explore participants' perceptions of using HIVST. We used descriptive statistics to analyze the quantitative data and a hybrid inductive, and deductive thematic analysis for the qualitative data and integrated the results at interpretation. The median age of men was 28 years, HIVST uptake was 96% (1564/1628), HIV positivity yield was 4% (63/1564) and reported disclosure of HIVST results to sexual partners and significant others was 75.6% (1183/1564). Men perceived HIVST as a quick, flexible, convenient, and more private form of testing; allowing disclosure of HIV test results to sexual partners, friends and family, and receiving social support. Others perceived it as an opportunity for knowing or re-confirming their sero-status and subsequent linkage or re-linkage to care and prevention. Utilizing VHT networks for community-based delivery of HIVST is effective in reaching men with HIV testing services. Men perceived HIVST as highly beneficial but needed more training on performing the test and the integrating post-test counseling support to optimize use of the test for diagnosing HIV.

Examining the effect of elder abuse on welfare status: the case of selected districts in Southwestern Uganda

PurposeThis paper aims to examine the predictive potential of elder abuse on welfare status of older persons in selected districts in Southwestern Uganda.Design/methodology/approachThe study took a cross-sectional descriptive and analytical design. Using a sample of 285 respondents, data were obtained from 201 usable questionnaires collected from caregivers and officials relating with older persons in this area making it a response rate of 70.5%. Using statistical program for social scientists (SPSS), the researchers tested and analyzed six hypotheses.FindingsResults indicate that physical abuse, emotional abuse, financial abuse and neglect negatively and significantly predicted welfare status. Though negatively related, social abuse and sexual abuse did not significantly predict welfare status.Practical implicationsFamily members and caregivers must make practices that do not promote physical abuse, emotional abuse, financial abuse and neglect as these negatively affect the welfare status of elderly persons. District officials such as community development officers and other persons handling older persons need to implement policies that promote the welfare status of the elderly.Originality/valueThe study demonstrates that the existence of physical abuse, emotional abuse, financial abuse and neglect is a deterrent to older person’s welfare status.

Spatial prediction of Crimean Congo hemorrhagic fever virus seroprevalence among livestock in Uganda

Crimean-Congo Hemorrhagic Fever (CCHF) is a viral disease that can infect humans via contact with tick vectors or livestock reservoirs and can cause moderate to severe disease. The first human case of CCHF in Uganda was identified in 2013. To determine the geographic distribution of the CCHF virus (CCHFV), serosampling among herds of livestock was conducted in 28 Uganda districts in 2017. A geostatistical model of CCHF seroprevalence among livestock was developed to incorporate environmental and anthropogenic variables associated with elevated CCHF seroprevalence to predict CCHF seroprevalence on a map of Uganda and estimate the probability that CCHF seroprevalence exceeded 30% at each prediction location. Environmental and anthropogenic variables were also analyzed in separate models to determine the spatially varying drivers of prediction and determine which covariate class resulted in best prediction certainty. Covariates used in the full model included distance to the nearest croplands, average annual change in night-time light index, percent sand soil content, land surface temperature, and enhanced vegetation index. Elevated CCHF seroprevalence occurred in patches throughout the country, being highest in northern Uganda. Environmental covariates drove predicted seroprevalence in the full model more than anthropogenic covariates. Combination of environmental and anthropogenic variables resulted in the best prediction certainty. An understanding of the spatial distribution of CCHF across Uganda and the variables that drove predictions can be used to prioritize specific locations and activities to reduce the risk of future CCHF transmission.