Isingiro District Research Articles

Mapping Meteorological Drought-vulnerability Extent for Isingiro District (1982-2022)

Background: Climate change and associated prolonged meteorological drought have affected crop productivity and food security for decades across the world. Most developing counties including Uganda are majorly affected due to their limited social, economic and technical capacity in climate change mitigation. Isingiro district for instance, is located in the Ugandan dry cattle corridor and has been affected by prolonged meteorological drought resulting in limited crop productivity and food insecurity for the last four decades. The extent to which meteorological drought has affected Isingiro district is not well documented hence the need for this study. The study aimed at mapping meteorological drought-vulnerable extent for the selected six sub-counties of Isingiro District, South Western Uganda. Methods: Precipitation datasets from 1982-2022 were downloaded from NASA powers website. SPI calculator, QGIS 3.4 and ArcGIS10 software were used to calculate SPI values and map the extent of meteorological drought in the selected sub counties. Result: Results show increasing average annual negative and extreme meteorological vulnerability following the order: Masha -2.57 greater than Mbaare -2.40 greater than Kikagate -2.28 greater than Isingiro Town Council -2.26 = Rushasha -2.26 greater than Kashumba -2.05 indicating extremely high vulnerability of the study sub counties to meteorological drought. Results are discussed, conclusions and recommendations are provided in the manuscript.

The Factors Affecting the Adoption of Ecological-Based Adaptation (EbA) Practices Among Smallholder Farmers Adjacent to Lake Nakivale Isingiro District, Southwestern Uganda.

The Factors Affecting the Adoption of Ecological-Based Adaptation (EbA) Practices Among Smallholder Farmers Adjacent to Lake Nakivale Isingiro District, Southwestern Uganda.

Determinants of Maize Production: Intercropping Maize and Beans in South Western Uganda

Background: Intercropping is the practice of growing two or more crops nearby: in the same row or bed, or rows or strips near enough to allow biological interactions. Advantages of inter cropping include: improving soil’s nutrients to better support crops' growth and development thus improving yields; it improves soil-water retention and diversifies the farmers' incomes in case of failure for one crop. It is one of the natural methods for management of crop pests and diseases. Inter cropping maize and beans is one of the climate-smart agricultural approaches used to boost crop production across the globe. However, some smallholder farmers have a negative attitude toward it due to limited knowledge regarding its benefits. The study aimed at establishment of the effect of intercropping maize and beans on the maize yields in Isingiro District, South Western Uganda. Methods: The experiment was conducted in two seasons (March-May 2020 and August- November 2021). Standard agronomical practices were followed from planting to harvesting, after which the dry weight of maize was measured and recorded. Data analysis was done using ONEWAY ANOVA in R Software Version 4.2.2. Result: Results show that intercropping maize and beans in season one significantly increased maize yields (p less than 0.001) more than it did in season two (p=0.0211). The main effect of Season is statistically significant and large (p less than .001). The main effect of Treatment is statistically significant and large (p less than .001). The study concluded that reduced rainfall negatively affects maize yields and intercropping Longe5 with NABE16 increases maize yields. Early planting and good agronomic practices were recommended to improve maize productivity.

Lived experiences of refugee women with vaginal fistula in Nakivale and Oruchinga refugee settlements, Isingiro District, Uganda

BackgroundVaginal fistula (VF) affects 2–3 million women globally, with the majority in Africa. In Uganda, it’s 2%, with western Uganda having the highest prevalence. Major predisposing factors for refugee women include health system breakdowns and sexual violence during conflict. VF has severe consequences for women, relatives, and communities. There’s limited information on lived experiences among refugee women with VF, and there’s a need for quality prevention, treatment, and social reintegration strategies. This study aimed to understand the physical, psychosocial, and economic impacts of VF on refugee women in Nakivale and Oruchinga settlements and their coping mechanisms.MethodsTen refugee women with VF were interviewed using qualitative study design, utilizing Social-Ecological and Transactional Models for data collection, analysis, and discussion.ResultsTen refugee women aged 24–50 years with or who had experienced VF participated in the study. They lived with VF for at least 2–15 years and had multiple stillbirths. Obstetric Fistula (OF) was the leading cause, followed by rape and cancer. Post-fistula, they faced social discrimination, emotional disturbances, survival difficulties, poverty, and lack of support. They struggled with stigma, social isolation, and marital sexual challenges.ConclusionRefugee women experience physical, emotional, financial, social, and sexual trauma due to VF. Discrimination and stigmatization from loved ones and society lead to isolation, depression, and suicidal thoughts. Despite successful repair, their social and emotional healing remains a burden for their lives. There is a need to provide a supportive environment for VF survivors.

Assessing the benefits of agroforestry beyond food security among households in Isingiro district, South-western Uganda

Globally, agroforestry and its capacity to offer a high yielding system are well known as a pathway for providing multiple benefits of Sustainable Development Goals (SDGs) to the households. In Uganda, household farmers adopt on-farm trees for various benefits such as soil erosion prevention, maintaining soil fertility, provision of shade, windbreaks, and climate regulation among others beyond food security. The study aimed at assessing the benefits of agroforestry beyond food security in Isingiro District. The study used a cross-sectional survey design to obtain qualitative and quantitative data. The number of household participants was 284. Multiple Linear Regression to analyse the association between dependent variable and numerous independent variables were employed. The study used Chi-Square tests to find out the statistical value of variables and their effect on agroforestry adoption. The study also used Multiple Regression Model to determine the degree to which selected variables were accountable for influencing agroforestry benefits beyond food security. The results indicated that 41% households in Kabaare, 37.0% in Kikokwa, and 22.0% in Kigyendwa practiced agroforestry. These percentages mean that agroforestry adoption is below the average (50%). The low adoption is attributed to factors such as land shortage, limited financial capacity, poor attitudes and perceptions. Of all the agroforestry adopters, only 21% of the households indicated that they had benefited from on-farm trees. This implies that majority 79% of those who did not practice agroforestry realized no benefits. The socio-economic factors that were positive and insignificant with a positive influence on household agroforestry benefits were the main occupation and income (0.001) while the family size and land size (0.288), land acreage used for food production and household size (0.553), land acreage and marital status (0.182) were insignificant. The study recommends intensive studies on household attitude, and perceptions about agroforestry practice in relation to other factors. The local government needs to review land policy, and strengthen its support to households in utilising their resources productively through on-farm tree adoption to attain diversified benefits. Key words: Agroforestry, Benefits, Food security, Governance, Livelihood, Policy review, Household

Diversity of the On-Farm Crop Dry Spell Adaptation Technologies in Isingiro Town Council, Isingiro District, Uganda

Isingiro Town Council is located within Uganda’s diagonal eco-region referred to as the “cattle corridor” and is synonymous with extreme climatic conditions, particularly dry spells, and intermittent floods (Egeru, 2016). Dry spells create a crisis among the highly rain-fed dependent farming Households (HH) in the study area. Some farming practices among HH are believed to contribute to Crop Dry Spell Adaptation (DSA). An exploratory survey was conducted to collect data from 125 crop farmers. The selection of respondents was through purposive and referral sampling methods in this study that were aimed at determining the diversity and extent of implementation of on-farm crop-specific Dry Spell Adaptation Technologies (DSATs) for major crops grown at the HH level. These include Bananas (98.4%), Beans (69.6%), Maize (43.2%) plus Fruits (4.0%) as per results from generated summary tables from Stata 14 analysis. 99.2% of the farmers who can define DSA are aware that some of their farming practices contribute to its attainment. DSATs for bananas include; up-rooting underground corms (75.2%), pruning (72.0%), de-suckering and pruning (70.4%), weeding before seeding (68.8%), mulching (67.2%) and staking with nylon strings or poles (64.0%) among others. DSAT for beans includes; strip/row planting with hoe weeding (68.8%), hoe weeding (68%), and beans-banana inter-cropping (16.8%) among others. strip/row planting with hoe weeding (44.8%), hand weeding (42.4%), and maize-banana inter-cropping (5.6%) among others. DSATs among fruits include; pruning and weeding and mulching each is implemented by 4.8% of the fruit farmers while spraying against flower abortion is done by 4%. planting with manure, watering/irrigation, and using water catchment basins each is implemented by 2.4% of the fruit farming HH among others. Farmers tend to implement diverse DSATs on crops where there they expected more Returns on Investment

Effect of Stakeholder Engagement on the Adoption of Agricultural Technologies by Farmers in Uganda

This study assessed how stakeholder engagement strategies used by SNV-TIDE project in planning, capacity building and resource mobilisation influenced the adoption of improved forages in Isingiro District, Southwestern Uganda. A cross sectional survey design was adopted for the study, which covered five purposively selected SNV-TIDE project cooperatives. The data were collected from 50 active cattle farmers and three field supervisors using both a semi-structured questionnaire and an interview guide. Descriptive and inferential analysis including multiple regression techniques were employed to analyse the data. The findings revealed that stakeholder engagement in planning and capacity building contributed 35 and 14.3 percent change respectively, in the adoption of improved forages. Stakeholder engagement in planning and capacity building had a positive significant (p<0.05) influence on the adoption of improved forages among the SNV-TIDE project members. But stakeholder engagement in resource mobilisation had no influence (p>0.05) on the adoption of improved forages. Thus based on the study, it was concluded that engaging stakeholders in planning and in capacity building contributes to the adoption of improved forages. To achieve better results, therefore, stakeholder engagement strategies should put more emphasis on involving stakeholders in the project planning activities and capacity building.

Contribution of Dry Spell Adaptation Technologies to Crop Productivity in Isingiro Town Council, Isingiro District, Uganda

Extended Dry Spell Adaptation Technologies (EDSATs) can improve crop resilience to Extended Dry Spells (EDS). This study was aimed at determining the contribution of EDSATs to crop productivity in the Isingiro Town Council. An exploratory survey was conducted to collect data from 125 farmers. The selection of respondents was made through purposive and referral sampling methods. Key informant interviews were conducted with 05 Production Department staff. Data was analysed using Stata 14 to generate summary tables. Results revealed that the farmers’ priority crops are Bananas, beans and maize grown by 98.4%, 69.6% and 43.2% of the farmers, respectively. 99.2% of the farmers are aware that their technologies contribute to Extended Dry Spells Adaptation (EDSA). Weeding is done by 68.8%, 68.4% and 43% of Bananas, Beans and Maize farmers, respectively. Inter-crops of beans-bananas, maize-bananas and maize-beans are implemented by 16.8%, 5.6% and 3.2% of the farmers, respectively. Application of manure is implemented by 60%, 5.6% and 4.8% of the farmers for all crops. Mulching is done by 67.2% and 7.2% of the banana and beans farmers. Contributions of weeding bananas, beans and maize contribute 65.2%, 94% and 88.6%, respectively to productivity. Inter-crops of beans-bananas, maize-banana and maize-beans contribute 122%, 57.1% and 35% to improved beans, maize, and beans productivity, respectively. Factors challenging the implementation of the crop EDSATs include; farmers’ economic status, availability of extension services, farmer exposure and availability of inputs, among others. The sustainability of EDSATs is hindered by a lack of investment funds and lack of consistent technical support, among others. Therefore, there is a need for the formulation of policy provisions that favour the availability of credit facilities to all farmers to enable them to manage all the limiting factors to the implementation and sustainability of EDSATs.

Prevalence of prediabetes and associated factors among community members in rural Isingiro district

BackgroundIn rural Uganda a significant number of persons afflicted with pre-diabetes are unaware of the condition. This is likely to lead to diabetic complications resulting in catastrophic health expendirure.The burden of prediabetes in rural Isingiro has not previously been determined. This study examined the prevalence of prediabetes and the associated factors among rural community members.MethodsWe conducted a cross-sectional survey and enrolled 370 participants aged between 18 and 70 years in the Kabuyanda sub-county, rural Isingiro district in march 2021. Multistage sampling and systematic random sampling were conducted to select eligible households. Data was collected using a pretested WHO STEP-wise protocol questionnaire. The primary outcome was prediabetes (FBG = 6.1mmol/l to 6.9mmol/l), calculated as a proportion. Participants known to be diabetic or on medication were excluded. Chi-square tests and multivariate logistic regression model were performed for data analysis using STATA.ResultsThe prevalence of prediabetes was 9.19% (95% CI 6.23–12.14). Independent factors significantly associated with pre-diabetes were; advancing age [AOR = 5.7, 95% CI:1.03–32.30], moderate-intensity work [AOR = 2.6,95% CI:1.23–5.63], high level of consumption of a healthy diet [AOR = 5.7, 95% CI:1.67–19.05] and body mass index [AOR = 3.7, 95% CI:1.41–9.20].ConclusionPrediabetes is prevalent among adult community members in rural Isingiro, southwestern Uganda. Age and lifestyle factors predict prediabetes in this rural population, suggesting a need for targeted health promotion interventions.

Smallholder Farmers’ Coping Strategies to Perceived Climate Change and Variability in Isingiro District, South Western Uganda

Climate change and variability pose a major challenge facing the agricultural sector around the world and trends are feared to intensify by 2050. This is likely to complicate agricultural decisions affecting local communities who depend on the sector for their livelihood. Seasonal changes in weather patterns are projected to reduce food production due to the reduction in average yields of common food crops. With the majority of smallholder farmers in Uganda depending on agriculture for survival, building their adaptive capacity to climate change is vital to ensure household food and income security. This study aimed at establishing the smallholder farmers’ perceptions of climate change and their initiatives to cope with and manage the associated risks. A sample of 126 farming households were randomly selected from three Sub counties in Isingiro District and studied using field observations and questionnaires. Key informant interviews were also conducted with three extension workers. The collected data was analysed using Stata 14 and Excel. The findings revealed that there was increasing awareness of the climate change and variability challenge among smallholder farmers with the increasing need to take on adaptation strategies. The results showed that the major perceived changes were, increased intensity and frequency of droughts (98%), increase in daytime temperatures (92.7%), decrease in rainfall intensity (92.1%) and changes in rainfall distribution patterns (90%). It also showed that different initiatives had been taken by farmers to cope with the changes like changing planting dates (92.1%), growing crop variety mixtures (73.8%) and practising soil and water conservation (62.7%). Based on the findings of this study, smallholder farmers greatly perceived climate change and variability with negative impacts imposed on their farming operations. Although farmers have tried to adapt, there is still a need to support their coping strategies through appropriate policies. This will facilitate increased adoption of adaptation measures, thereby reducing the negative consequences of climate change in future

Effects of Dietary Supplementation with Yellow Meal Worm Larvae (Tenebrio molitor) on Performance of Broiler Chicken

Climate Smart Agriculture (CSA) can sustainably increase productivity, improve resilience, and reduce emissions of greenhouse gases from agricultural systems. The current study aimed to establish the existing knowledge, attitude, and practice of CSA among smallholder farmers in the Isingiro District. An exploratory survey was conducted to collect data from 126 farmers randomly selected from three Sub counties. Key informant interviews were conducted with three extension workers for more information. Data was analysed using Stata 14 to generate summary tables and the Chi-square test of independence. The results revealed a high level of knowledge about CSA among the farmers, with intercropping and crop rotation as the most popular (99%) whereas rainwater harvesting was least known (71.4%). Farmers’ knowledge about CSA was significantly related to different sources of information and knowledge (P<0.05). Farmers showed a positive attitude towards the use of CSA practices except for inorganic fertilisers with 45%. The dominantly used CSA practices were Intercropping (85.7%), mulching (75.4%) and the use of contour bunds (74.6%). Several limitations that hindered the adoption of CSA practices included limited finances, extension services, availability of CSA inputs, high prices of CSA inputs, price fluctuations and land scarcity, among others. The farmers’ awareness, attitude and practice of CSA were mainly shaped by their local knowledge with limited influence of technical knowledge. Furthermore, the practice of CSA among smallholder farmers is hampered by many limitations. Therefore, there is a need for policymakers to prioritise and enact pro-CSA-relevant policies that address the barriers hampering its adoption

Knowledge, Attitude and the Practice of Climate-Smart Agriculture among Smallholder Farmers in Isingiro District, South Western Uganda

Climate Smart Agriculture (CSA) can sustainably increase productivity, improve resilience, and reduce emissions of greenhouse gases from agricultural systems. The current study aimed to establish the existing knowledge, attitude, and practice of CSA among smallholder farmers in the Isingiro District. An exploratory survey was conducted to collect data from 126 farmers randomly selected from three Sub counties. Key informant interviews were conducted with three extension workers for more information. Data was analysed using Stata 14 to generate summary tables and the Chi-square test of independence. The results revealed a high level of knowledge about CSA among the farmers, with intercropping and crop rotation as the most popular (99%) whereas rainwater harvesting was least known (71.4%). Farmers’ knowledge about CSA was significantly related to different sources of information and knowledge (P<0.05). Farmers showed a positive attitude towards the use of CSA practices except for inorganic fertilisers with 45%. The dominantly used CSA practices were Intercropping (85.7%), mulching (75.4%) and the use of contour bunds (74.6%). Several limitations that hindered the adoption of CSA practices included limited finances, extension services, availability of CSA inputs, high prices of CSA inputs, price fluctuations and land scarcity, among others. The farmers’ awareness, attitude and practice of CSA were mainly shaped by their local knowledge with limited influence of technical knowledge. Furthermore, the practice of CSA among smallholder farmers is hampered by many limitations. Therefore, there is a need for policymakers to prioritise and enact pro-CSA-relevant policies that address the barriers hampering its adoption

Effect of Population Growth on Food Security Situation among Refugees in Nakivale Refugee Settlement, Isingiro District

The study was about the effect of population growth on food security situation among the Refugees in Nakivale Refugee Settlement, Isingiro District. The study objectives were; to determine the main population changes taking place in Nakivale Refugee Settlement, and also to establish the effects of age composition on food availability among the Refugees.
 The researcher used a cross-sectional research design. The study used a sample size of 133 respondents.
 Qualitative data was analyzed using content analysis while quantitateive data was analyzed using SPSS. Basing on the field findings, there was a significant relationship between Population Growth and Food Security situation among the Refugees of Nakivale Refugee Settlement. This was due to the fact that when the population fertility and refugee influx is high, food becomes insufficient to the refugees and when the mortality is highly, the population reduces as most of the people become sick and weak and food is highly consumed by the weak people. 
 Based on the age composition, it was evident that working age bracket increases food security the fact that most households involved in work and their consumption rate is reserved compared to the younger population who are dependants as well as existing mothers who produce more young kids. The researcher recommends that the government and NGOs institute more technical personnel in the camp to help refugees by training them on better farming skills, helping them to create employment. It is also recommended that the refugees need to be trained with income generating activities both entrepreneurial and life skills. Further recommendation to the government and NGOs is that there should be addition of various food types that refugees prefer to eat, also, different seedlings should be given to refugees for them to grow more crops and improve on yielding. NGOs should intervene towards empowering mothers specifically those who have children below 12 years.

The Role of Teachers in Building Resilience of Refugee Learners: A Case Study of Primary Schools in Nakivale Settlement, Isingiro District- Western Uganda

The Role of Teachers in Building Resilience of Refugee Learners: A Case Study of Primary Schools in Nakivale Settlement, Isingiro District- Western Uganda

The Role of Teachers in Building Resilience of Refugee Learners: A Case Study of Primary Schools in Nakivale Settlement, Isingiro District- Western Uganda

The Role of Teachers in Building Resilience of Refugee Learners: A Case Study of Primary Schools in Nakivale Settlement, Isingiro District- Western Uganda

Assessing the potential of Rainwater Harvesting (RWH) for sustaining small-scale irrigated coffee farming in the Bigasha watershed, Uganda

A study was carried out during 2022 to assess the potential of rainwater harvesting for sustaining small-scale irrigated coffee farming in the Bigasha watershed of Isingiro District, south-western Uganda. In this study, remote sensing, Geographical Information System (GIS), the Quantum GIS Soil and Water Assessment Tool (QSWAT+) and Crop Water and Irrigation Requirements Program (CROPWAT) models were utilised to assess the potential of rainwater harvesting (RWH) that can be used for irrigation. The criteria used to identify suitable RWH sites were based on four factors namely; topography, soils, land use land cover and rainfall. It was found out that seventy per cent of the watershed is hilly with slopes greater than 10 per cent and half of the area is covered by Leptosols. Three temporal land use land cover (LULC) maps (of 1999, 2010 and 2022), were derived using the K-nearest neighbor (KNN) algorithm. These LULC databases were used to assess the impacts of land use land cover changes on the runoff hence potential for RWH. The annual average rainfall received in the study area over the 21-year period studied (2000 – 2020) was 954 mm which is adequate for irrigation if harvested. The QSWAT+ model simulated runoff depths from 62, 125 and 114 Hydrologic Response Units (HRUs) of the 1999, 2010 and 2022 LULC maps respectively, were used to estimate potential RWH sites. The 114 HRUs from the 2022 LULC map could generate an annual average surface runoff volume of 1.39 million cubic meters (MCM) which could potentially irrigate 101.8 per cent of the current coffee production areas in the Bigasha watershed. The prediction accuracy of the Kagera river basin model was very good with NSE (R2) of 0.81(0.82) for calibration and 0.87(0.88) for validation. The Kagera watershed model fitted parameters were further used to calibrate the Bigasha watershed model. This was done because the Bigasha is a sub-basin of Kagera and it does not have its own gauged outlet.

Effect of Intercropping Maize and Beans on the Maize Yields in Isingiro Town Council, Isingiro District, South Western Uganda

The study aimed at determination of the effect of intercropping maize and beans on the maize yields Isingiro Town Council, Isingiro District, South Western Uganda. The study used a randomized complete block (RCBD) experiment in which 8 treatments in 4 replicas of each to make a total of 32 sub-plots. Two rows of maize spaced at 4.5cm within rows and 90cm between rows were intercropped with two rows of velvet beans spaced at 30cm with rows and 90cm between rows. Two rows of NABE16 spaced at 4.5cm within rows and 75cm between rows were intercropped with maize a pacing of 5.5cm within rows and 75cm between rows. Rows of beans were separated from those of maize by 75cm in a 10m by 8m sub-plot. The experiment was conducted in two seasons (March to May 2020 and August to November 2021). Standard agronomical practices were followed from planting to harvesting, after which dry maize grain weight was taken and recorded. Data analysis was done using ONE WAY ANOVA in STATA version 13. Results show that the significant statistical difference in season one (p = 0.0000)** was higher than that in season two (p = 0.0211)*. The study concluded that unpredictable (too much or too little) rainfall negatively affects maize productivity. Early planting and application of organic fertilizers were recommended to improve maize productivity.

Thinness among children aged 5–17 years living in Nakivale refugee settlement, South Western Uganda: a cross-sectional study

BackgroundHunger and malnutrition are rampant among refugees and displaced populations, many of whom are infants and children. We sought to determine the prevalence and factors associated with thinness among children aged 5–17 years living in Nakivale refugee settlement, Isingiro district, southwestern Uganda.MethodsThis was a cross sectional study that enrolled 420 children aged 5 to 17 years. The World Health Organization cluster sampling was used to select 30 villages from which 14 households were selected by consecutive sampling and participants were then chosen per household by simple random sampling. Data were collected on the participant socio-demographic, family, dietary, medical, hygiene and refugee status factors. Thinness was defined as having a z-score < -2 standard deviations of Body Mass Index-for-age from the median WHO growth standards. The prevalence of thinness was determined by ascertaining the total number of children with thinness over the total number of children studied. Multivariable logistic regression model was used to determine the factors independently associated with thinness with p < 0.05 level of significance.ResultsA total of 420 children aged 5–17 years were enrolled into the study. The median age (IQR) was 8.6 (6.8–11.8) and majority 248 (59.1%) were female. The prevalence of thinness was 5.5% (95% CI: 3.7-8.1%). The factors independently associated with thinness were; living with a chronic disease (aOR 6.47, 95%CI; 1.63–24.64, p = 0.008), use of water from natural sources (aOR 3.32, 95%CI; 1.27–8.71, p = 0.015), and duration of stay in the settlement of less or equal to 10 years (aOR 3.19, 95%CI; 1.15–8.83, p = 0.025).ConclusionFive in every 100 children aged 5–17 years in Nakivale refugee settlement have thinness. Thinness was more likely among children who are living with a chronic disease, used water from natural sources and those whose families had stayed shorter in the settlement. Our findings suggest that children with chronic disease should receive extra food supplementation and have routine growth monitoring as part of their chronic care. The study reiterates a need to have clean and safe water supply and close nutrition assessment and monitoring, especially for newly registered refugee children.

Determining household and farm level governance factors affecting the transition to household food security in Isingiro district, south-western Uganda

Governance, in particular, decision-making plays a significant role in influencing the transition to households’ food security. It helps in addressing causative factors responsible for undermining household sustainable food security. This study aimed at determining household and farm level governance factors affecting the transition to household food security. Respondents who participated in the study were 284. The study employed a cross-sectional survey design to obtain qualitative and quantitative data on household food security. Household interviews, focus group discussions, key informants’ interviews, and observations were used to collect data. Qualitative data were analyzed by categorizing them into themes to find out respondents’ experiences and opinions. Quantitative data were coded, entered, cleaned, and summarized using descriptive statistics, frequencies, and chi-square. The study used Multiple Regression Model to establish the extent to which selected variables were responsible for the transition to household food security. Results on maize production showed that the association of occupation of coefficient (0.006) and income (-0.54) had a significant and positive value P=0.000 (P˂0.05) and was related to food security, while the association between family size (0.006) and land size (0.055), marital status (0.092), and land acreage (-0.108) had no significant relationship. Regarding beans, results indicated that the relationship between occupation (coefficient -0.059 and income (0.059) had a significant value P= 0.000, while the association between family size (0.096) and land size (0.055, marital status (0.092) and land acreage (-0.108) had no significant association. In the case of bananas, the association of occupation (0.038) and income (0.142) had a significant value of P=0.000, while the relationship between family size (0.010) and land size (-0.026), marital status (0.014), and land acreage (0.184) had no significant relationship. The study recommends increased government support in establishing effective decisions on household food security and strengthening them through a participatory and bottom-up approach. The study also recommends that the government and related stakeholders invest in household capacity building for inclusive gender participation in decision-making pertaining to food security; establish resilient household food production and increase support for strengthening it further. There is also a need for supporting climate change mitigation, environmental conservation, and farm-level landscape restoration. Key words: household, governance, transition, food security, participatory, sustainable, policy, livelihood

Health Care Workers’ Experiences, Challenges of Obstetric Referral Processes and Self-Reported Solutions in South Western Uganda: Mixed Methods Study

IntroductionIn resource limited settings, the highest burden of adverse maternal-fetal outcomes at referral hospitals is registered from emergency obstetric referrals from lower health facilities. Implementation of referral protocols has not been optimally successful possibly attributed to lack of understanding of profile of obstetric referrals and local challenges faced during implementation process.ObjectiveThis study described the profile of emergency obstetric referrals, challenges faced in implementation of obstetric referral processes and explored self-reported solutions by health workers.MethodsThis was a mixed methods study done at Mbarara Regional Referral Hospital (MRRH) and health centre IVs in South-Western Uganda. We consecutively recruited emergency obstetric referrals from Isingiro district for delivery at MRRH. Using a pre-tested questionnaire, we collected demographics, obstetric and referral characteristics. We described the profile of referrals using frequencies and proportions based on demographics, obstetric and referral characteristics. We conducted focus group discussions and in-depth interviews with health workers using discussion/interview guides. Using thematic analysis, we ascertained the challenges and health worker self-reported solutions.ResultsWe recruited 161 referrals: 104(65%) were below 26 years, 16(10%) had no formal education, 11(7%) reported no income, 151(94%) had no professional-escort, 137(85%) used taxis, 151(96%) were referred by midwives. Common diagnoses were previous cesarean scar (24% [n=39]) and prolonged labour (21% [n=33]). There was no communication prior to referral and no feedback from MRRH to lower health facilities. Other challenges included inconsistencies of ambulance and anesthesia services, electric power, medical supplies, support supervision, and harassment by colleagues. Self-reported solutions included the use of phone call technology for communication, audit meetings, support supervision and increasing staffing level.ConclusionMost referrals are of poor social-economic status, use taxis, and lack professional-escort. Health workers suffer harassment, lack of communication and shortage of supplies. We need to experiment whether mobile phone technology could solve the communication gap.