Kampala Research Articles

Citizens’ Political Knowledge and Participation in Monitoring Local Government Programs in Two Districts of Uganda

Broad political knowledge better equips citizens to discharge the responsibilities of good citizenship, such as monitoring local government programs. Empirical studies show a connection between citizens’ political knowledge and their participation in monitoring activities in contexts other than a decentralized local government system in a developing country. Thus, in this paper, we set out to provide new empirical evidence by assessing the link between citizens’ political knowledge and their participation in monitoring local government programs in Buliisa and Kampala districts of Uganda. We employed a convergent parallel research design. We gathered data using survey questionnaire, key informant interviews, and focus group discussions. We analyzed quantitative data using STATA and performed thematic analysis for the qualitative data. Generally, results showed that the level of political participation of citizens in monitoring local government programs was significantly and positively associated with their level of knowledge of local political affairs. This was especially marked in Kampala compared to Buliisa district. Conclusively, the nature of the association between the aforesaid variables could differ depending on the form of local political knowledge and/or the nature of political participation being measured.

Analysis of groundwater and surface water quality using modelled water index and multivariate statistics in Kampala and Mbarara Districts, Uganda

The demand for domestic, public and industrial use of water increases with population growth. However, activities from humans and natural environment have resulted into decline in water quality. The aim of this study was to evaluate the quality of groundwater and surface water collected from Kampala and Mbarara districts of Uganda using water quality index and multivariate statistics. A total of 10 physicochemical parameters (pH, water temperature, chloride, sulphate, nitrate, electrical conductivity, total dissolved solids, total suspended solids, total solids, and phosphate) were measured monthly to evaluate the quality of water in the study districts. Results showed that sulphate, electrical conductivity and total dissolved solids were observed with significantly high values in surface water than the groundwater for both seasons. Among all the parameters measured, electrical conductivity was observed with the highest value (2129.67 ± 1.41 µS/cm) while nitrate concentration (0.57 ± 0.02 mg/L) was observed with the lowest during the wet season in surface water. In addition, the mean values of nitrate, electrical conductivity, total dissolved solids and sulphate detected in the groundwater and surface water were within the recommended limits, while phosphate and chloride were observed with mean concentrations above the regulatory limits in 50% of the samples. The correlation analysis revealed strong and positive association between electrical conductivity and total dissolved solids in groundwater and surface water for both seasons. Also, the chemical make-up of groundwater and surface water within the study districts revealed that the determination of water quality rests on two major indices (conductivity and anthropogenic-pollutants) based on the factor analysis. The two indices accounted for 0.619% in groundwater and over 0.70% in surface water, indicating more pollution in surface water. Moreover, the water quality index (WQI) values obtained ranged from 14.81 to 115.73 in dry season and 7.77 to 108.24 during the wet season. According to WQI classification, 42% of the samples collected fell within the “excellent” and “good” categories while others fell within “poor” and “unfit” categories (58%) during the dry season. Based on these findings, appropriate treatment methods, proper sanitation and waste management should be implemented in locations with critical water conditions. Also, frequent monitoring of groundwater and surface water quality by environmental protection agency is highly recommended.

Distance Learning and Challenges of Technologies by Students in Uganda

This study was conducted to examine the challenges students face in Uganda when it comes to distance learning. Uganda is a developing country and this has put a strain on the resources available to students in terms of access to technology. Therefore, this study looks to understand the challenges that students in Uganda have experienced in the shift to distance learning and the strategies that students have used to cope. A non-probability sampling technique of snowball was used to identify initial participants who meet the research criteria. In all, thirty (30) students across all levels of education in Kampala district were selected. The results showed that the majority of students reported experiencing some form of challenges related to distance learning. The most commonly reported challenges were technical problems with the learning platform and lack of access to the internet. The results of this study can inform policy decisions to better equip students and teachers for effective teaching-learning program across various educational institutions.

The Vital Role of Special Stains in Immunocompromised Cases: A Focus on Histoplasmosis Screenings for Enhanced Kaposi`s Sarcoma Diagnosis Beyond H&E Morphology

Abstract Introduction/Objective This case report emphasizes the critical importance of thorough pathology-based investigation before making a definitive diagnosis of Kaposi’s Sarcoma (KS). In particular, we demonstrate the importance of using special stains in addition to H&E staining to determine if the lesion is KS or a fungal infection, specifically cutaneous Histoplasmosis. This highlights the necessity of comprehensive diagnostics to ensure accurate and timely identification of underlying conditions, guiding appropriate treatment strategies. Methods/Case Report In Kampala Uganda, a 56-year-old male with a history of HIV/AIDS presented with skin lesions on the lower extremities. The lesions were initially suspected to be Kaposi’s Sarcoma due to their appearance and the patient’s immunocompromised status. Skin biopsy results supported the initial suspicion, showing spindle cell proliferation in the dermis, a common feature of KS. Given his compromised immune system, it was imperative to conduct a thorough investigation to rule out potential etiologies, including opportunistic infections. Additional tests, including a Grocott Methenamine-Silver Nitrate stain, revealed the presence of Histoplasmosis. The patient did not exhibit typical symptoms of Disseminated Histoplasmosis, such as respiratory distress or fever. Resource constraints hindered comprehensive follow-up, impacting long-term outcome assessment. Results (if a Case Study enter NA) NA Conclusion Histoplasmosis is widespread in Africa, accounting for 61% of global cases, with 87% concentrated in Western and Central Africa. The coexistence of KS and Histoplasmosis poses diagnostic challenges due to overlapping clinical manifestations. KS primarily affects the skin, while Histoplasmosis causes invasive vascular and pulmonary infections. However, in Africa, notably in immunocompromised individuals, histoplasmosis can cause cutaneous infections. Failure to recognize and address fungal infections may result in delayed or inappropriate treatment, exacerbating the patient’s condition. This case report underscores the importance of maintaining a high index of suspicion for opportunistic infections in this population for timely intervention.

Perceptions of Beneficiaries of Informal Social Protection Initiatives in Uganda: An Exploratory Factor Analysis Approach

ABSTRACTInformal social protection interventions are instrumental in improving people's welfare through fostering income growth and enabling self‐sufficiency. Whereas the success of some informal social protection initiatives has been acknowledged and documented, there is limited knowledge of the factors influencing the performance of informal social protection initiatives, especially in developing countries like Uganda. In this study, we identify and isolate the perceived factors influencing the performance of informal social protection initiatives. We use exploratory factor analysis on a sample of 130 beneficiaries of two informal social protection interventions in the Alebtong and Kampala districts of Uganda. Findings reveal that the performance of informal social protection interventions is perceived to be influenced by three categories of factors, collectively accounting for 62.4% of the total dataset variance which is more than the threshold of 50%. The factors are beneficiary empowerment, welfare enhancement and coverage and equality. Each factor encompasses a cluster of variables that collectively capture the essential dimensions of individual perceptions concerning the effect of informal social protection initiatives. This research offers valuable insights into how the beneficiaries perceive informal social protection initiatives, shedding light on the nuanced factors contributing to their effectiveness in Uganda.

Asthma symptoms, severity, and control with and without a clinical diagnosis of asthma in early adolescence in sub-Saharan Africa: a multi-country, school-based, cross-sectional study.

Rapid urbanisation and population growth in sub-Saharan Africa has increased the incidence of asthma in children and adolescents. One major barrier to achieving good asthma control in these adolescents is obtaining a clinical diagnosis. To date, there are scant data on prevalence and severity of asthma in undiagnosed yet symptomatic adolescents. We therefore aimed to assess symptom prevalence and severity, the effect of symptoms on daily life, and objective evidence of asthma in young adolescents from sub-Saharan Africa with and without a clinical diagnosis of asthma by spirometry and fractional exhaled nitric oxide (FeNO). We designed a two-phase, multi-country, school-based, cross-sectional study to assess symptom prevalence and severity in sub-Saharan African adolescents. In phase 1 we surveyed young adolescents aged 12-14 years who were attending selected primary and secondary schools in Blantyre in Malawi, Durban in South Africa, Harare in Zimbabwe, Kampala in Uganda, Kumasi in Ghana, and Lagos in Nigeria. The adolescents were screened for asthma symptoms using the International Study of Asthma and Allergies in Children (ISAAC) questionnaire. Then, after opt-in consent, symptomatic adolescents were invited to complete a detailed survey on asthma severity, treatment, and exposure to environmental risk factors for phase 2. Adolescents performed the European Respiratory Society's diagnostic tests for childhood asthma. A positive asthma test was classified as a forced expiratory volume in 1 sec (FEV1) predicted under 80%, a FEV1 under the lower limits of normal, or FEV1 divided by forced vital capacity (FEV1/FVC) under the lower limits of normal; positive bronchodilator responsiveness or reversibility was defined as either an increase in absolute FEV1 of 12% or more, or an increase of 200 mL or more, or both, after 400 μg of salbutamol (shortacting β2 agonist) administered via a metered-dose inhaler and spacer, or FeNO of 25 parts per billion or higher, or any combination of these. The study was registered with ClinicalTrials.gov (NCT03990402) and is complete. Between Nov 1, 2018, and Nov 1, 2021, we recruited 149 schools from six regions in six sub-Saharan countries to participate in the study. We administered phase 1 asthma questionnaires from Jan 20, 2019 to Nov 11, 2021, and from 27 407 adolescents who were screened, we obtained data for 27 272 (99·5%). Overall, 14 918 (54·7%) adolescents were female and 12 354 (45·3%) adolescents were male, and the mean age was 13 years (IQR 12-13); nearly all recruited adolescents were of black African ethnicity (26 821 [98·3%] of 27 272). In phase 1, a total of 3236 (11·9% [95% CI 11·5-12·3]) reported wheeze in the past 12 months, and 644 (19·9%) of 3236 had a formal clinical diagnosis of asthma. The prevalence of adolescents with asthma symptoms ranged from 23·8% in Durban, South Africa to 4·2% Blantyre, Malawi. Using ISAAC criteria, severe asthma symptoms were reported by 2146 (66·3%) of 3236 adolescents, the majority of whom (1672 [77·9%] of 2146) had no diagnosis of asthma by a clinician. Between July 16, 2019, and Nov 26, 2021, we administered the phase 2 questionnaire to the 1654 adolescents who had asthma symptoms in phase 1 and consented to proceed to the second phase. In the phase 2 cohort, 959 (58·0%) were female and 695 (42·0%) were male, and the mean age was 13 years (IQR 12-14). One or more diagnostic tests for asthma were obtained in 1546 (93·5%) of 1654 participants. One or more positive asthma tests were found in 374 (48·8%) of 767 undiagnosed adolescents with severe symptoms, and 176 (42·4%) of 415 of undiagnosed adolescents with mild-to-moderate symptoms. Of the 392 adolescents in phase 2 with clinician-diagnosed asthma, 294 (75·0%) reported severe asthma symptoms, with 94 (32·0%) of those with severe symptoms not using any asthma medication. In general, findings in both phases 1 and 2 were consistent across sub-Saharan African countries. A large proportion of adolescents in sub-Saharan Africa with symptoms of severe asthma do not have a formal diagnosis of asthma and are therefore not receiving appropriate asthma therapy. To improve the poor state of asthma control in sub-Saharan Africa, potential solutions such as educational programmes, better diagnosis, and treatment and screening in schools should be considered. UK National Institute for Health and Care Research and UK Medical Research Council.

Current out of pocket care costs among HIV and hypertension co-morbid patients in urban and peri-urban Uganda.

Despite improvements to the cascade of HIV care in East Africa, access to care for non-communicable disease co-morbidities like hypertension (HTN) remains a persistent problem. The integration of care for these conditions presents an opportunity to achieve efficiencies in delivery as well as decrease overall costs for patients. This study aims to build evidence on the burden of current out-of-pocket costs of care among HIV-HTN co-morbid patients. We administered a pre-tested, cross-sectional, out-of-pocket cost survey to 94 co-morbid patients receiving HIV care from 10 clinics in the Wakiso and Kampala districts of Uganda from June to November 2021. The survey assessed socio-demographic characteristics, direct medical costs (e.g., medications, consultations), indirect costs (e.g., transport, food, caregiving), and economic costs (i.e., foregone income) associated with seeking HIV and HTN care, as well as possible predictors of monthly care costs. Patients were sampled both during a government-imposed nation-wide full COVID-19 lockdown (n = 30) and after it was partially lifted (n = 64). Median HIV care costs constitute between 2.7 and 4.0% of median monthly household income, while HTN care costs are between 7.1 to 7.9%. For just under half of our sample, the median monthly cost of HTN care is more than 10% of household income, and more than a quarter of patients report borrowing money or selling assets to cover costs. We observe uniformly lower reported costs of care for both conditions under full COVID-19 lockdown, suggesting that access to care was limited. The main predictors of monthly HIV and HTN care costs varied by disease and costing perspective. Patient out of pocket costs of care for HIV and HTN were substantial, but significantly lower during the 2021 full COVID-19 lockdown in Uganda. New strategies such as service integration need to be explored to reduce these costs.

Performance Appraisal Practices and Staff Performance in Universal Secondary Schools in Rubaga Division, Kampala District

This study explored the relationship between performance appraisal practices and staff performance in Universal Secondary Schools in Rubaga Division, Kampala District. The study was guided by the following specific objectives; i) To examine the relationship between performance planning and staff performance, ii) To analyse the relationship between performance monitoring and staff performance, and iii) To examine the relationship between performance evaluation and staff performance in Universal Secondary Schools in Rubaga Division, Kampala District. The study employed a correlational research design with a mixed research approach. A sample size of 76 respondents was considered constituting of head teachers and teachers from the three selected universal secondary schools in Rubaga division. Both descriptive analysis and inferential analysis were employed to provide answers to the study phenomenon. The study revealed that performance planning has a strong positive and statistically significant relationship with staff performance in universal secondary schools in Rubaga division, Kampala district. The study also revealed that performance monitoring has a strong positive and significant relationship with staff performance in universal secondary schools in Rubaga division, Kampala district. Further, the study revealed that performance evaluation has a strong positive and statistically significant relationship with staff performance in universal secondary schools in Rubaga division, Kampala district. Therefore, the study concludes that performance appraisal practices in terms of performance planning, performance monitoring, and performance evaluation have a statistically significant association with staff performance in universal secondary schools in Rubaga division, Kampala district. Therefore, a significant increase in the different aspects of performance appraisal practices resultantly leads to an improvement in staff performance in universal secondary schools in Rubaga division, Kampala district. The study recommends that the school administrators should develop clear and quantifiable performance metrics to assess staff performance where possible as well as provide opportunities for staff members to develop the skills necessary to meet their performance goals such as formal training, mentoring, or on-the-job learning which could contribute to an improvement in staff performance in universal secondary schools in Rubaga division, Kampala district.

Metabolic Syndrome and Its Component Factors Among Corporate Company Employees in Kampala Uganda.

Metabolic syndrome (MetS), a cluster of metabolic dysregulations indicative of increased cardiometabolic risk is on the rise in Sub-Saharan Africa. The study aimed to determine the prevalence of MetS and its components, among corporate employees in Kampala, Uganda. A cross-sectional survey was undertaken among 408 adults who were employees from seven corporate companies in Kampala, using the WHO STEPwise NCD screening approach. Metabolic syndrome was measured using the National Cholesterol Education Program Adult Treatment Panel (ATPIII) and the International Diabetes Federation (IDF) criteria with the waist circumference (WC) cut-off points adapted for Sub-Saharan African populations. The mean population age (standard deviation [SD]) of the respondents was 34years (± 8.87) years and 52% of them were females. The prevalence of MetS was 22.8% (NCEP ATPIII) and 28.4% (IDF). Of the respondents who did not have MetS, 75% had at least one metabolic dysregulation. Of those respondents with MetS, only 31% perceived that they were at risk of this cluster of metabolic dysregulations. In this analysis, we observed that the systolic blood pressure (BP) and the body mass index (BMI) correlated strongly (r = 0.81 and r = 0.71) with the diastolic BP and waist circumference (WC), respectively. Age on the other hand correlated fairly with the WC and BMI (both r values = 0.46). Principal component analysis showed that the greatest loadings in principle factors one, two and three were from central obesity, with low HDL-C explaining 60.8% variance in the population. Age, BMI, family history of having cardiometabolic disorders, and perceived cardiometabolic disease risk (CMR) were associated with an increased risk of MetS by 5, 8.86, 1.55, and 2.73 (all P values were < 0.05) respectively in this group of respondents. These risks remained for age, BMI and perceived CMR after removing the confounding effects of education status, marital status and family history of cardiometabolic disease. Being single on the other hand, was associated with a reduced risk of MetS (0.23, p < 0.009). While the primary contributors to the high prevalence of MetS among corporate employees in Kampala, Uganda were the high BP, high WC and high fasting blood sugar (FBS); age, BMI and perceived CMR were the key determinants of MetS. Future MetS interventions should aim to control and monitor obesity indicators in this population. Additionally, the findings inform targeted screening parameters for cardiometabolic risk assessment and suggest the need for further research into a weighted algorithm for MetS in this population.

Total Quality Management Practices and Customer Satisfaction in Hotel Industry: A Case Study of Selected Hotels in Makindye Division, Kampala District

Total Quality Management Practices and Customer Satisfaction in Hotel Industry: A Case Study of Selected Hotels in Makindye Division, Kampala District

Generational persona and entrepreneurial behavior among millennial entrepreneurs: the mediating role of adaptability tendencies

PurposeThe purpose of this study is to examine the relationship between generational persona, adaptability tendencies and entrepreneurial behavior. The paper also aims at testing the mediating role of adaptability tendencies in the relationship between generational persona and entrepreneurial behavior among millennial entrepreneurs in an African setting.Design/methodology/approachThe study adopts a quantitative methodological approach with a cross-sectional, questionnaire survey and correlational design where hypotheses were statistically tested using Structural Equation Modelling based on survey data (n = 382) from millennial entrepreneurs in Kampala Uganda.FindingsDrawing on the sample of 382 millennial entrepreneurs in Kampala, findings show that both generational persona and adaptability tendencies are positively and significantly associated with entrepreneurial behavior. Results further indicate that adaptability tendencies partially mediates the relationship between generational persona and entrepreneurial behavior among millennial entrepreneurs.Research limitations/implicationsThis study focused only on millennial entrepreneurs in Kampala Uganda ignoring other equally important groups of entrepreneurs like the baby boomers, generation Xers, generation Y and others. As such, the findings of this research do not entirely apply to all entrepreneurs in the country and this may have affected the generalizability of the results. Therefore, future studies can be done on the entrepreneurial behavior focusing on all entrepreneurs from all generations. Also, the study used a quantitative approach, future studies should consider a mixed methodology, which may give a more holistic understanding of entrepreneurial behavior.Practical implicationsIn practice, millennial entrepreneurs may use the results of the study to see how they can improve their performance for their businesses to benefit. Specifically, they ought to focus on adaptability, and generational persona to exhibit those entrepreneurial behaviors which will generally lead to the improvement of their businesses.Originality/valueTo the authors’ knowledge, this study provides a shred of initial empirical evidence on the relationship between generational persona, adaptability tendencies and entrepreneurial behavior using evidence from a low developed African country Uganda. Mostly, this study provides initial evidence of the mediating role of adaptability tendencies in the relationship between generational persona and entrepreneurial behavior. This study incorporates the Generational Cohort Theory and the Complex Adaptive Systems Theory into an applied theoretical framework that explains entrepreneurial behavior. More still, this study answers the call for more empirical studies on entrepreneurial behavior.

KNOWLEDGE, ATTITUDE, AND PRACTICE ON NUTRITIONAL REQUIREMENTS OF CHILDREN UNDER FIVE YEARS AMONG MOTHERS ATTENDING MAKINDYE MILITARY POLICE HEALTH CENTRE III, KAMPALA DISTRICT. A CROSS-SECTIONAL STUDY.

Background This study aimed to assess the knowledge, attitude, and practices of nutritional requirements of children under five years among mothers attending Makindye Military Police Health Center lll, Kampala district. Methodology The study employed a cross-sectional study to address the specific objectives where quantitative and qualitative approach was used to collect data in a short period at Makindye Military Police Health Centre III, Kampala district. Results This study documented that (92%) of the respondents had ever heard about nutritional requirements, (55%) obtained information about it from healthy facility,(93%) reported to know the meaning of exclusive breast feeding, (52%) knew breast feeding on demand,(70%) knew the stopping breast feeding at one year and above,(57%) reported feeding a child three times a day, (83%) knew the relevancy of adding fruits and vegetables on meals, (57%) knew that complementary feeds are introduced after 6 months (57%) preferring diet diversity, (77%) felt its right to exclusively breast feed a child for first 6 months (85%) with good attitude towards balanced diet (58%) feeling bad upon seeing a malnourished child (68%) stopping breastfeeding at 2 years, (70%) think fruits and vegetables are a must daily, (45%) would introduce complementary feeds at (4-6) months ,(65%) exclusively breast fed their children for first 6 months of life,(35%) had breast fed their children for 1 years and (60%) feeding child 3 times a day. Conclusion Women had good knowledge and attitude with poor practices towards nutritional requirements of children under five years even though fair practices. Recommendation MOH, NGOs, and other stakeholders should train an adequate number of service providers and health extension workers on health educating the community about the nutritional requirements of children under five years.

Infrastructure Development and Student Performance in Vocational Institutions in Makindye Division, Kampala District

Infrastructure Development and Student Performance in Vocational Institutions in Makindye Division, Kampala District

Teacher Motivation and Job Satisfaction in Private Primary Schools of Kampala District, Uganda

Teacher Motivation and Job Satisfaction in Private Primary Schools of Kampala District, Uganda

Diagnostic pattern of mental, neurological and substance use disorders at primary health care facilities in Uganda

Integration of diagnosis and treatment for mental, neurological, and substance use (MNS) disorders into primary health care is a recommended strategy to improve access to services in low-and middle-income countries. Despite numerous initiatives for integration of mental health care in Uganda, there has not been an evaluation of health management information system (HMIS) records to determine whether MNS disorders are routinely diagnosed. We sought to determine diagnostic pattern of MNS disorders at primary health facilities in Wakiso and Kampala districts, the most populous regions of Uganda. Lower-level primary health facilities were visited to obtain records from HMIS registers, to document diagnoses of MNS disorders. Secondary data analysis was conducted and descriptive statistics reported. A total of 40 primary health care facilities were visited representing 58.6% of the health facilities in the study districts. More than half (54.8%) and almost all (87.5%) of the lower-level health facilities in Wakiso district and Kampala district respectively were visited. The proportion of MNS disorders diagnosed at lower-level primary health facilities in Uganda is very low with Epilepsy the most common MNS diagnosis recorded. Reasons for such low numbers of diagnoses at primary health facilities are discussed as are possible solutions.

Modelling and Optimization of Residential Electricity Load under Stochastic Demand

The paper considers a modelling framework for a set of households in residential areas; using electricity as a form of energy for domestic consumption. Considering the demand and availability of units for electricity consumption, optimal decisions for electricity load allocation are paramount to sustain energy management. We formulate this problem as a stochastic decision-making process model where electricity demand is characterized by Markovian demand. The loading and operational framework is governed by the demand and supply phenomena; where shortage costs are realized when demand exceeds supply. Empirical data for electricity consumption was collected from fifty households in two residential areas within the suburbs of Kampala in Uganda. Data collection was made at hourly intervals over a period of four months. The major problem focussed on determining an optimal electricity loading decision in order to minimize consumption costs as demand changes from one state to another. Considering a multi-period planning horizon, an optimal decision was determined for loading or not loading additional electricity units using Markov decision process approach. The model was tested; whose results demonstrated the existence of an optimal state-dependent decision and consumption costs considering the case study used in this study. The proposed model can be cost-effective for managers in the electricity industry. Improved efficiency and utilization of resources for the distribution systems of electricity to residential areas was realised; with subsequent enhanced reliability of service to essential customers of the energy market.

Exploring Affordances of Online and Offline Strategies for Continuity of Learning in Secondary Schools during Pandemics: Lessons from Uganda's Response to the COVID-19 Pandemic

The COVID-19 pandemic led to widespread school closures, disrupting learning in institutions worldwide. This study examined the online and offline strategies implemented in Uganda's secondary schools during the pandemic and draws lessons from the country's response. This study was conducted in two schools in Kampala District, the research employed a qualitative multiple case study approach, gathering data through interviews, observations, and focus group discussions. The findings revealed that both online and offline strategies played significant roles in facilitating home-based learning. Printed learning materials, such as textbooks and workbooks, were valued by teachers and students for providing a sense of continuity in their studies. However, limitations such as the lack of immediate clarification and two-way communication were identified. Logistical challenges in distributing the materials also posed difficulties, particularly for students in remote areas. Radio broadcasts emerged as a pivotal offline strategy for reaching students without internet access. Parents and students appreciated the insightful educational content delivered through radio programs, even in remote areas. However, accessibility concerns and the lack of interactivity were highlighted as limitations. These findings are not only pertinent for Uganda but also contribute to the global conversation on resilient educational systems in times of unforeseen disruptions. It is crucial to address the limitations of online and offline strategies to ensure equitable access and effective learning experiences for all students, especially those in remote areas

Cancer survival in sub-Saharan Africa (SURVCAN-3): a population-based study

The Cancer Survival in Africa, Asia, and South America project (SURVCAN-3) of the International Agency for Research on Cancer aims to fill gaps in the availability of population-level cancer survival estimates from countries in these regions. Here, we analysed survival for 18 cancers using data from member registries of the African Cancer Registry Network across 11 countries in sub-Saharan Africa. We included data on patients diagnosed with 18 cancer types between Jan 1, 2005, and Dec 31, 2014, from 13 population-based cancer registries in Cotonou (Benin), Abidjan (CÔte d'Ivoire), Addis Ababa (Ethiopia), Eldoret and Nairobi (Kenya), Bamako (Mali), Mauritius, Namibia, Seychelles, Eastern Cape (South Africa), Kampala (Uganda), and Bulawayo and Harare (Zimbabwe). Patients were followed up until Dec 31, 2018. Patient-level data including cancer topography and morphology, age and date at diagnosis, vital status, and date of death (if applicable) were collected. The follow-up (survival) time was measured from the date of incidence until the date of last contact, the date of death, or until the end of the study, whichever occurred first. We estimated the 1-year, 3-year, and 5-year survival (observed, net, and age-standardised net survival) by sex, cancer type, registry, country, and human development index (HDI). 1-year and 3-year survival data were available for all registries and all cancer sites, whereas availability of 5-year survival data was slightly more variable; thus to provide medium-term survival prospects, we have focused on 3-year survival in the Results section. 10 500 individuals from 13 population-based cancer registries in 11 countries were included in the survival analyses. 9177 (87·4%) of 10 500 cases were morphologically verified. Survival from cancers with a high burden and amenable to prevention was poor: the 3-year age-standardised net survival was 52·3% (95% CI 49·4-55·0) for cervical cancer, 18·1% (11·5-25·9) for liver cancer, and 32·4% (27·5-37·3) for lung cancer. Less than half of the included patients were alive 3 years after a cancer diagnosis for eight cancer types (oral cavity, oesophagus, stomach, larynx, lung, liver, non-Hodgkin lymphoma, and leukaemia). There were differences in survival for some cancers by sex: survival was longer for females with stomach or lung cancer than males with stomach or lung cancer, and longer for males with non-Hodgkin lymphomas than females with non-Hodgkin lymphomas. Survival did not differ by country-level HDI for cancers of the oral cavity, oesophagus, liver, thyroid, and for Hodgkin lymphoma. For cancers for which population-level prevention strategies exist, and with relatively poor prognosis, these estimates highlight the urgent need to upscale population-level prevention activities in sub-Saharan Africa. These data are vital for providing the knowledge base for advocacy to improve access to prevention, diagnosis, and care for patients with cancers in sub-Saharan Africa. Vital Strategies, the Martin-Luther-University Halle-Wittenberg, and the International Agency for Research on Cancer. For the French and Portuguese translations of the abstract see Supplementary Materials section.

Heavy metals pollution, distribution and associated human health risks in groundwater and surface water: a case of Kampala and Mbarara districts, Uganda

Groundwater and surface water quality is of great significance for humanity as they serve as the primary drinking water sources globally. Due to population growth and the need to provide people with necessities that depend on water as an essential resource, these bodies of water are becoming more polluted. The present study involved the collection of groundwater and surface water samples from Kampala and Mbarara districts in Uganda during the dry and wet seasons. Also, concentrations of lead (Pb), manganese (Mn), cadmium (Cd), copper (Cu), and iron (Fe) were analyzed in order to evaluate the toxicity of metals, identify potential sources, and determine the health risk associated with their presence in water. Results showed that metals were observed with higher concentration during the wet season than the dry season. The concentrations of Fe (8.646 ± 0.00 mg/L), Mn (2.691 ± 0.01 mg/L) and Cd (0.090 ± 0.41 mg/L) measured in groundwater were significantly higher than those measured in surface water. However, only Cu was observed with higher concentration (0.322 ± 0.06 mg/L) in surface water during the wet season. Furthermore, the degree of contamination (Cd) and the heavy metal pollution index (HPI) were evaluated for both the wet and dry seasons. Results showed that few samples were found in the category of portable drinking water while majority are within the “poor” and “very poor” classes which require proper treatment before consumption. The oral hazard index (HIoral) results showed that none of the samples are suitable for consumption; therefore, cause potential non-carcinogenic health issues to the consumer (HIoral > 1). Moreover, children are more at risk than adults in the study districts (higher HI values in both seasons). This study recommends frequent monitoring of quality of water and also effluent waste treatment by the major source of pollution.

Barriers and benefits of mHealth for community health workers in integrated community case management of childhood diseases in Banda Parish, Kampala, Uganda: a cross-sectional study

BackgroundLow-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to record and submit data electronically. However, the barriers and benefits of mHealth usage among CHWs in informal urban settlements remain poorly understood. This study sought to determine the barriers and benefits of mHealth among CHWs in Banda parish, Kampala.MethodsThis qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model.ResultsThree themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology.ConclusionDespite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs’ demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts.