Groups In Uganda Research Articles

Perceptions of yellow fever emergency mass vaccinations among vulnerable groups in Uganda: A qualitative study.

Yellow fever (YF), a mosquito-borne viral hemorrhagic fever, is endemic in Uganda and causes frequent outbreaks. A total of 1.6 million people were vaccinated during emergency mass immunization campaigns in 2011 and 2016. This study explored local perceptions of YF emergency mass immunization among vulnerable groups to inform future vaccination campaigns. In this qualitative study, we conducted 43 semi-structured interviews, 4 focus group discussions, and 10 expert interviews with 76 participants. Data were collected in six affected districts with emergency mass vaccination. We included vulnerable groups (people ≥ 65 years and pregnant women) who are typically excluded from YF vaccination except during mass immunization. Data analysis was conducted using grounded theory. Inductive coding was utilized, progressing through open, axial, and selective coding. Participants relied on community sources for information about the YF mass vaccination. Information was disseminated door-to-door, in community spaces, during religious gatherings, and on the radio. However, most respondents had no knowledge of the vaccine, and it was unclear to them whether a booster dose was required. In addition, the simultaneous presidential election during the mass vaccination campaign led to suspicion and resistance to vaccination. The lack of reliable and trustworthy information and the politicization of vaccination campaigns reinforced mistrust of YF vaccines. People in remote areas affected by YF outbreaks rely on community sources of information. We therefore recommend improving health education, communication, and engagement through respected and trusted community members. Vaccination campaigns can never be seen as detached from political systems and power relations.

Love and Care in the Lord’s Resistance Army (LRA) in Northern Uganda

Abstract Dominant storylines about armed conflicts and rebel groups, such as the Lord’s Resistance Army (LRA) rebel group in Uganda, typically focus on violence, suffering, harm, and abuse. Without a doubt, life within insurgency groups, including in the LRA, is characterized by immense social suffering, typically portrayed to be beyond the pale of humanity. Yet, what of the connections of compassion, joy, love, and care that emerged in the context of cohesion and alongside these aspects and experiences of violence, suffering, and abuse? Over the years, our interlocutors narrated to us what can be understood as meaningful forms of kinship, social connections, or intimacy during and after their time with the group; in the context of conjugal spousal relations, among fellow recruits, or between abductees and their families and communities. This article focuses on these practices of love and care within and in the wake of life in the LRA, and how they are entangled with and sit alongside experiences of violence. The simultaneities of care and suffering constitute a key aspect of this analysis; not intending to negate, downplay, ignore, or trivialize the detrimental impact of violence within rebel groups in general, nor to idealize the relations of compassion, love, or care that emerged within this context. This dual focus, we maintain, is important for unearthing the complexities, intricacies, and nuances of peoples’ lived realities in the context of insurgency movements, and in the context of armed conflict more broadly, holding important analytical and ethical implications.

HIV epidemiologic trends among occupational groups in Rakai, Uganda: A population-based longitudinal study, 1999-2016.

Certain occupations have been associated with heightened risk of HIV acquisition and spread in sub-Saharan Africa, including female bar and restaurant work and male transportation work. However, data on changes in population prevalence of HIV infection and HIV incidence within occupations following mass scale-up of African HIV treatment and prevention programs is very limited. We evaluated prospective data collected between 1999 and 2016 from the Rakai Community Cohort Study, a longitudinal population-based study of 15- to 49-year-old persons in Uganda. Adjusted prevalence risk ratios for overall, treated, and untreated, prevalent HIV infection, and incidence rate ratios for HIV incidence with 95% confidence intervals were estimated using Poisson regression to assess changes in HIV outcomes by occupation. Analyses were stratified by gender. There were 33,866 participants, including 19,113 (56%) women. Overall, HIV seroprevalence declined in most occupational subgroups among men, but increased or remained mostly stable among women. In contrast, prevalence of untreated HIV substantially declined between 1999 and 2016 in most occupations, irrespective of gender, including by 70% among men (12.3 to 4.2%; adjPRR = 0.30; 95%CI:0.23-0.41) and by 78% among women (14.7 to 4.0%; adjPRR = 0.22; 95%CI:0.18-0.27) working in agriculture, the most common self-reported primary occupation. Exceptions included men working in transportation. HIV incidence similarly declined in most occupations, but there were no reductions in incidence among female bar and restaurant workers, women working in local crafts, or men working in transportation. In summary, untreated HIV infection and HIV incidence have declined within most occupational groups in Uganda. However, women working in bars/restaurants and local crafts and men working in transportation continue to have a relatively high burden of untreated HIV and HIV incidence, and as such, should be considered priority populations for HIV programming.

Amplicon sequencing identified a putative pathogen, Macrophomina phaseolina, causing wilt in African eggplant (Solanum aethiopicum) grown in Tanzania and Uganda

African eggplant (Solanum aethiopicum L.) is one of the most common traditional vegetables in Tanzania and Uganda, but its productivity is severely affected by wilt diseases caused by a number of pathogens. Plant stem and root samples were collected in several fields from many neighboring diseased and healthy plants of the Gilo group in Tanzania and from the Shum group in Uganda to identify putative pathogens causing wilt on African eggplants. Through amplicon sequencing of sampled diseased and healthy tissues, we identified putative causal pathogens for the wilt symptoms. Wilting of S. aethiopicum in Uganda is most likely caused by the bacterial pathogen Ralstonia solanacearum whereas, in Tanzania, wilt is most likely caused by the fungal pathogen Macrophomina phaseolina, infecting roots. Infection of stems by Fusarium solani may also contribute to the wilt symptoms in Tanzania. Further artificial inoculation under controlled conditions confirmed that M. phaseolina can cause typical wilting symptoms on S. aethiopcium genotypes. The discovery of different putative causal agents of wilt in the crop demonstrates the need for site specific etiological analysis of wilt before developing and implementing effective control methods. Further research is needed to confirm the results and develop appropriate management measures against specific wilt pathogens.

Spillover Effects and Diffusion of Savings Groups

We estimate the spatial spillover effects of a program to promote savings groups in Uganda and Malawi. We use geolocation data from a cluster-randomized experiment to compare the outcomes of households in areas where a high proportion of nearby villages were randomly assigned to treatment to those in areas where a low proportion of nearby villages were assigned to treatment. We have four key results. First, take-up of the program is highest in villages where promotion by NGO-employed field officers was concentrated — promotion by peers was about half as effective, and ‘organic’ replication was rare. Second, we find evidence of large positive between-village spillover effects on total income, food security, and business outcomes in control villages. Third, we estimate positive direct effects of the program on business outcomes and financial inclusion — these estimates are qualitatively similar to a previous evaluation of the program (Karlan et al., 2017) which did not account for spillovers, though our estimated impacts on business outcomes are larger. Finally, we estimate that 23%–28% of the overall benefits of the program are not captured by an analysis which does not account for spatial spillover effects.

Determinants of Performance in Smallholder Farmer Groups in Uganda

The performance of farmer groups is critical for the success of the farmer-led Agricultural Extension approach currently used in Uganda. This study examines factors affecting performance of farmer groups accessing agricultural extension and advisory services from the National Agricultural Advisory Services in Eastern Uganda. The study collected data 200 members of 19 farmer groups in Eastern Uganda. Performance of farmer groups was the dependent variable, which was perceived to be influenced by individual members’ objectives, participation culture, power distance, structure of task, perceived equity, reward allocation and participation in group activities. Farmer group performance had a statistically significant positive relationship with power distance and perceived equity. Group participation culture and structure of tasks had a statistically negative relationship with group performance. Members tended to deflect group losses to factors beyond the seasonality of group activities, quality of farm inputs, and poor training delivered by advisory service providers. The advisory service providers and farmer group members need to use the political and social capital possessed by the local leadership, groups and community members for enhancing support and collective participation of the community in farmer groups. Since farmer groups are a sub-set of wider community, this empirical study brings into perspective the role of community culture in influencing performance of farmer groups in smallholder farming communities.

We Can Manage: Experimental Evidence From Savings Groups in Uganda

Abstract Village savings and loans associations (VSLAs) are promoted as an important tool for economic and social empowerment, primarily targeting women. However, there is relatively limited evidence on the impact of VSLAs, and no evidence on whether such programs work better for some groups than for others. Using a large-scale field experiment on a VSLA targeting people with disabilities in Uganda, we document positive effects of the program on economic empowerment, social empowerment and general well-being. The effects are overall somewhat stronger for the male participants, and in particular we find no evidence of social empowerment for women. Our findings suggest that VSLAs can be an important tool for improving the situation also for economically active persons with disabilities, but that additional measures need to be implemented to achieve a more comprehensive empowerment of women.

Alternative business finance: insights from selected informal savings groups in Uganda

PurposeThe study examined the nature of the operation of informal savings groups. Emphasis was on their composition, the mode of financial transactions and sharing of financial proceeds, the impact of the savings and members loaning on the members' financial and business growth, and the perception of the members on the benefits of the savings. The study also profiled the significant challenges encountered by the groups.Design/methodology/approachThe study adopted an exploratory research design. The point of saturation was achieved after 15 members of informal savings groups were interviewed. Data were analyzed using content analysis techniques with the aid of NVivo version 10 software, and verbatim tests were used to explain the emergent themes.FindingsThe findings indicate that informal savings groups are accessible, sustainable and inclusive financing alternatives for low-income earners. Group sizes range from 250 to 3 members. As a sign of commitment, a form of identification is required to join the group. Findings also indicate that group leaders are elected, and their term of service could be renewable. It was discovered that members join mainly to save in financial terms, and they have benefited both monetary and socially. The biggest challenge these groups face is that members default.Practical implicationsThe study provides evidence that informal financial service providers are an effective alternative to business financing that leverage existing social structures that are predominant in Uganda.Originality/valueThe study provides a benchmark for understanding the dynamics, capabilities and challenges impeding the survival and growth of informal savings groups as critical components in Uganda's financial system.

RA92A recombinant protein as immunogen to protect cattle against tick challenge in Brazil and Uganda

In this study, the recombinant gut protein rRa92A produced in Pichia pastoris yeast cells was used to immunize cattle in two experiments, one in Brazil and the other in Uganda. In both experiments, the animals were intramuscularly (IM) injected with 200 µg of recombinant protein in Brazil on days 0, 30 and 51 and in Uganda on days 0, 30. Blood samples for sera separation were collected from different days in both experiments. These samples were analyzed by ELISAs. In Brazil, ticks collected from the animals during the experimental period were analyzed for biological parameters. At Uganda, blood was collected to assess blood parameters, clinical signs were recorded and adult tick (Rhipicephalus appendiculatus) counts were performed. All animals of the vaccinated groups were shown to produce antibodies, and it was not possible to detect an effect on Rhipicephalus microplus. All the clinical parameters were considered within the normal ranges for both the experimental and control groups in Uganda. Antibody absorbance was elevated after each immunization and remained high until the end of the experiments, remaining low in the control animals. The results of stall test carried out in Brazil using R. microplus tick showed efficacy of 21.95%. The rRa92A immunization trial experiments in Uganda showing a decrease of 55.2% in the number of engorged adult ticks, which was statistically significant (p<0.05). Assessment of the immunogenicity of Ra92A produced in the P. pastoris expression system in bovines is reported for the first time, and the protein acted as a concealed antigen.

Phylogenetic Networks and Parameters Inferred from HIV Nucleotide Sequences of High-Risk and General Population Groups in Uganda: Implications for Epidemic Control.

Phylogenetic inference is useful in characterising HIV transmission networks and assessing where prevention is likely to have the greatest impact. However, estimating parameters that influence the network structure is still scarce, but important in evaluating determinants of HIV spread. We analyzed 2017 HIV pol sequences (728 Lake Victoria fisherfolk communities (FFCs), 592 female sex workers (FSWs) and 697 general population (GP)) to identify transmission networks on Maximum Likelihood (ML) phylogenetic trees and refined them using time-resolved phylogenies. Network generative models were fitted to the observed degree distributions and network parameters, and corrected Akaike Information Criteria and Bayesian Information Criteria values were estimated. 347 (17.2%) HIV sequences were linked on ML trees (maximum genetic distance ≤4.5%, ≥95% bootstrap support) and, of these, 303 (86.7%) that consisted of pure A1 (n = 168) and D (n = 135) subtypes were analyzed in BEAST v1.8.4. The majority of networks (at least 40%) were found at a time depth of ≤5 years. The waring and yule models fitted best networks of FFCs and FSWs respectively while the negative binomial model fitted best networks in the GP. The network structure in the HIV-hyperendemic FFCs is likely to be scale-free and shaped by preferential attachment, in contrast to the GP. The findings support the targeting of interventions for FFCs in a timely manner for effective epidemic control. Interventions ought to be tailored according to the dynamics of the HIV epidemic in the target population and understanding the network structure is critical in ensuring the success of HIV prevention programs.

Determinants of cohesion in smallholder farmer groups in Uganda

Cohesion is a fundamental determinant of performance in farmer groups in which collective action is pursued for the benefit of the members. The study examined the influence of individual members’ objectives, participation culture, group rewards, structure of tasks and perceived equity on cohesion of farmer groups that can promote access to agricultural extension services. Quantitative data were collected from 180 members of 19 farmer groups using questionnaires selected in a multi-stage process that combined purposive and random sampling. Qualitative data were gathered from 20 key informants in oral interviews and three focus group discussions. Regression analysis indicated that there were statistically significant negative relationships between individual members’ objectives, structure of the tasks, group reward system and cohesion of farmer groups. In contrast, perceived equity had a statistically significant positive relationship with cohesion in farmer groups. We recommend that, for sustainability of group cohesion, group facilitators work with the farmer groups to ensure alignment of group and NAADS institutions and performance indicators. A group dynamics perspective to understanding farmer group cohesion should be a helpful organizing principle.

Determinants of female sterilization method uptake among women of reproductive age group in Uganda

BackgroundDespite its great effectiveness, safety and convenience for women who do not wish to have more children; female sterilization method uptake in Uganda is very low. This study aimed at establishing factors associated with female sterilization uptake in Uganda.MethodsSecondary data were sourced from the 2016 Uganda Demographic and Health Survey (UDHS). We analyzed all (18,506) women aged 15–49 years who were interviewed in the 2016 UDHS. This sample was categorized into women who were sterilized and those using other modern methods. We used a Chi-square test to measure the association between the current uptake of female sterilization by the women and selected independent variables. Multivariate analysis applied the complimentary log-log model to determine the net effect of selected characteristics on female sterilization uptake in Uganda.ResultsThe overall prevalence of female sterilization among modern contraceptive users was 2%. Female sterilization uptake was highly associated with age of 30 years and older (OR = 34.49;, 95%CI:13.33–99.88), middle wealth status (OR = 0.65, 95% CI:0.47–0.92), women who had ever given birth to at least four children (OR = 3.19, 95% CI:1.63–6.22) and decision making by either the husband/partner (OR = 2.42, 95% CI:1.55–3.78) or jointly between a woman and her husband/partner (OR = 1.38, 95% CI:1.02–1.86).ConclusionsThe uptake of female sterilization was very low, and this was associated with; age, household wealth, parity and contraceptive decision-maker. The uptake of Family planning programs needs to focus on male engagement to increase joint decision making on family planning issues especially those relating to fertility limitation. Government and its other implementing partners need to scale-up efforts that increase accessibility to information on female sterilization services for women who have completed their fertility.

Alcohol consumption, hypertension and obesity: Relationship patterns along different age groups in Uganda

The prevalence of non-communicable diseases including hypertension and obesity is rising and alcohol consumption is a predisposing factor. This study explored the effect of alcohol consumption patterns on the hypertension-age group and obesity-age group relationships. The data were extracted from the 2014 National NCD Survey of adults aged 18-69 years. Hypertension was defined as a condition of having systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90mmHg while obesity was defined as having a body mass index ≥30kg/m2. Frequent alcohol consumption was measured as alcohol use ≥3 times a week. Multivariable log binomial regression analysis was used to assess independent relationship between the outcomes and alcohol consumption. The prevalences of hypertension, frequent alcohol consumption and obesity increased across age groups but were divergent towards last age group. Hypertension prevalence ratios were higher with higher age groups among moderate and nondrinkers but not among frequent drinkers. Alcohol drinking pattern modified the age hypertension relationship in a model with ungrouped age. The drinking pattern did not modify obesity-age relationship. Alcohol consumption pattern appeared to modify the hypertension-age group relationship. However, more research is needed to explain why prevalence ratios are higher with higher age groups among moderate drinkers and abstainers while they stagnate among the frequent drinkers. There was no evidence to show the effect of alcohol consumption on obesity-age group relationship.

Singing for Breathing Uganda: Group singing for people with chronic lung disease in Kampala

Group singing for people with chronic lung diseases has become increasingly popular in Europe, North America and Australia, with a growing body of research suggesting biopsychosocial benefits for participants. This article presents notes from the field and includes information about the programme sessions and programme evaluation, on Singing for Breathing (SFB) Uganda, a group singing programme for people with chronic lung diseases in Kampala, Uganda. Sessions were delivered by Ugandan singing leaders who were supported by a British Lung Foundation Singing for Lung Health trained leader. Sessions included physical, vocal and breathing warm-ups, rhythm and pitch games, repertoire and relaxation. Programme evaluation indicates that sessions were greatly enjoyed by participants and facilitators. Lessons learnt will inform the development of resources to support other groups in Uganda and other countries in sub-Saharan Africa.

English

Focusing on the period 1894 to 1995 and drawing on both written and oral sources, this article explores the origin, ethnic identity and settlement of the Nubians since their advent in Uganda. Ugandan Nubians abandoned some aspects of their former African traditional customs and adopted new ones borrowed from the Arabic culture, constituting a unique and distinct ethnic group. Using a historical research design and adopting a qualitative approach, the article articulates the fluidity and formation of the Nubian ethnic identity on one hand, and the strategies that the Nubians have used to define and sustain themselves as a distinct ethnic group in Uganda. The article therefore suggests that the question of the Nubian identity in Uganda, through tracing their origin, ethnic identity and settlement since their advent, goes beyond the primordial understanding of ethnicity that tags ancestral location or settlement pattern, language, family history to a particular group claiming itself ethnic. Key words: Ethnicity, Nubians, Nubis, origin, identity, settlement.

HIV prevalence by ethnic group covaries with prevalence of herpes simplex virus-2 and high-risk sex in Uganda: An ecological study.

BackgroundHIV prevalence varies from 1.7% to 14.8% between ethnic groups in Uganda. Understanding the factors responsible for this heterogeneity in HIV spread may guide prevention efforts.MethodsWe evaluated the relationship between HIV prevalence by ethnic group and a range of risk factors as well as the prevalence of herpes simplex virus-2 (HSV-2), syphilis and symptomatic STIs in the 2004/2005 Uganda HIV/AIDS Sero-Behavioural Survey—a two stage, nationally representative, population based survey of 15–59-year-olds. Spearman’s correlation was used to assess the relationship between HIV prevalence and each variable.ResultsThere was a positive association between HIV prevalence and HSV-2, symptomatic STIs and high-risk sex (sex with a non-cohabiting, non-marital partner) for women. Non-significant positive associations were present between HIV and high-risk sex for men and lifetime number of partners for men and women.ConclusionVariation in sexual behavior may contribute to the variations in HIV, HSV-2 and other STI prevalence by ethnic group in Uganda. Further work is necessary to delineate which combinations of risk factors determine differential STI spread in Uganda.

Agriculture in Shifting Climates: The Configuration and Ripeness of Problem Understandings in Uganda and Senegal.

The international community has advocated the adoption of climate-smart agriculture (CSA) as lower-income countries deal with the negative consequences of climate change. Scaling up such policies, practices, and programs successfully will require support from a variety of local stakeholders. Such support requires alignment between CSA solutions and the problem understandings of stakeholders. However, problem understandings can differ across individuals, stakeholder groups, and geographic areas. Consequently, we examine understandings of climate problems and socioeconomic and infrastructure problems related to agriculture among different stakeholder groups in Uganda and Senegal. We operationalized and measured these problem understandings following the detailed guidance of the political will and public will approach for analyzing social change. Semi-structured interviews elicited stakeholder-generated lists of problems for each group. Limited quantification of problem understandings and their relative importance or "ripeness" demonstrates how contexts might shape opportunities for CSA.

Characteristics of community savings groups in rural Eastern Uganda: opportunities for improving access to maternal health services

ABSTRACTBackground: Rural populations in Uganda have limited access to formal financial Institutions, but a growing majority belong to saving groups. These saving groups could have the potential to improve household income and access to health services.Objective: To understand organizational characteristics, benefits and challenges, of savings groups in rural Uganda.Methods: This was a cross-sectional descriptive study that employed both quantitative and qualitative data collection techniques. Data on the characteristics of community-based savings groups (CBSGs) were collected from 247 CBSG leaders in the districts of Kamuli, Kibukuand Pallisa using self-administered open-ended questionnaires. To triangulate the findings, we conducted in-depth interviews with seven CBSG leaders. Descriptive quantitative and content analysis for qualitative data was undertaken respectively.Results: Almost a quarter of the savings groups had 5–14 members and slightly more than half of the saving groups had 15–30 members. Ninety-three percent of the CBSGs indicated electing their management committees democratically to select the group leaders and held meetings at least once a week. Eighty-nine percent of the CBSGs had used metallic boxes to keep their money, while 10% of the CBSGs kept their money using mobile money and banks,respectively. The main reasons for the formation of CBSGs were to increase household income, developing the community and saving for emergencies. The most common challenges associated with CBSG management included high illiteracy (35%) among the leaders,irregular attendance of meetings (22%), and lack of training on management and leadership(19%). The qualitative findings agreed with the quantitative findings and served to triangulate the main results.Conclusions: Saving groups in Uganda have the basic required structures; however, challenges exist in relation to training and management of the groups and their assets. The government and development partners should work together to provide technical support to the groups.

Urbanization fueling marriage dynamics among the Baganda of central Uganda

This paper examines changes in marriage practices and patterns of the Baganda, the largest ethnic group in Uganda. Primary data that included Focus Group Discussions in the rural districts of Mpigi, Kisoro, Sironko and Arua as well as Kampala city that is 100% urban is complimented with secondary data. The results show that with 18% of Uganda’s population being urban and 5.1% urban growth rate, marriage practices and patterns have not been spared. It is showed that some relevant marriage practices such as: “pulling”; parent involvement in choosing marriage partners; abstinence before marriage; using traditional items in payment of bride price and rare divorce rates are changing partly because of urbanization. The authors recommend that good Baganda marriage practices and patterns should continue and be strengthened, while polygamy, secret marriages and cohabitation should be discouraged.

Factors affecting adherence to national malaria treatment guidelines in management of malaria among public healthcare workers in Kamuli District, Uganda.

BackgroundMalaria remains a major public health threat accounting for 30.4 % of disease morbidity in outpatient clinic visits across all age groups in Uganda. Consequently, malaria control remains a major public health priority in endemic countries such as Uganda. Experiences from other countries in Africa that revised their malaria case management suggest that health workers adherence may be problematic.MethodsA descriptive, cross-sectional design was used and collected information on health system, health workers and patients. Using log-binomial regression model, adjusted prevalence risk ratios (PRRs) and their associated 95 % confidence intervals were determined in line with adherence to new treatment guidelines of parasitological diagnosis and prompt treatment with artemisinin combination therapy (ACT).ResultsNine health centres, 24 health workers and 240 patient consultations were evaluated. Overall adherence to national malaria treatment guidelines (NMTG) was 50.6 % (122/241). It was significantly high at HC III [115 (53 %)] than at HC IV (29 %) [PRR = 0.28 (95 % CI 0.148 0.52), p = 0.000]. Compared to the nursing aide, the adherence level was 1.57 times higher among enrolled nurses (p = 0.004) and 1.68 times higher among nursing officers, p = 0.238, with statistical significance among the former. No attendance of facility malaria-specific continuing medical education (CME) sessions [PRR = 1.9 (95 % CI 1.29 2.78), p = 0.001] and no display of malaria treatment job aides in consultation rooms [PRR = 0.64 (95 % CI 0.4 1.03), p = 0.07] was associated with increased adherence to guidelines with the former showing a statistical significance and the association of the latter borderline statistical significance. The adherence was higher when the laboratory was functional [PRR = 0.47 (95 % CI 0.35 0.63)] when the laboratory was functional in previous 6 months. Age of health worker, duration of employment, supervision, educational level, and age of patient were found not associated with adherence to new treatment guidelines.ConclusionAdherence to malaria treatment guidelines in Uganda is sub-optimal. There is an urgent need for deliberate interventions to improve adherence to these guidelines. Possible interventions to be explored should include: provision of job aides and improved access to laboratory services. There is also a need for continuous medical educational sessions for health workers, especially those at higher-level facilities and higher cadres, on adherence to guidelines in management of fever, including management of other causes of fever.