Luwero District Research Articles

Rice Blast Prevalence in Smallholder Rice Farmlands in Uganda

Rice blast disease remains the most important contributor to low and stagnated rice yields in Uganda. However, the role of the smallholder farming system in shaping the prevalence of the disease in the country is not known. In 2015B and 2016A, we surveyed smallholder rice farmlands in 27 districts of Uganda and recorded blast incidence, severity, and symptoms expression. Infected rice samples taken from the infected plants were sub-cultured on PDA media to confirm the pathogen and obtain isolates for the establishment of a core collection for breeding work. Rice blast prevalence in the districts varied from 50-100% and the national average stood at 72.61%, higher than that recorded five years ago. Mean incidence and severity varied significantly (< 0.001) with the highest incidence (96.8%) recorded in Luwero district and the least (21.3%) was recorded in the Amuru district. However, the eastern region recorded the highest average incidence (74.5%) followed by the central, the northern, and Mid-western regions. In the rice ecologies, the highest blast incidence was recorded in the rain-fed lowland rice (72.18%) followed by irrigated lowland (59.53%) and rain-fed upland rice (47.27%). This is the first report on the prevalence of blast in smallholder rice farmlands in Uganda and showed a higher prevalence of the disease.

Level of disease risk knowledge among abattoir workers in Mukono and neighbouring districts, Uganda

A participatory disease search was conducted among abattoir workers in Lugazi abattoir in Buikwe District, Bombo abattoir in Luwero District, Kame Valley abattoir in Mukono District, and Kyengera cattle abattoir and Nakasozi-Buddo Pig Slaughterhouse in Wakiso District with the aim of assessing the level of disease risk knowledge among abattoir workers. Data collection employed PDS tools, including, key informant interviews, focus group discussions, simple ranking, proportional piling, observations, and transect walk through abattoir facilities. In addition questionnaires were administered to a selected number of abattoir workers. Five abattoirs visited were small to medium size in terms of slaughter capacity: Lugazi abattoir (20 heads of cattle and 5 shoats per day); Bombo abattoir (10 heads of cattle and 6 shoats per day); Kame Valley abattoir (20 heads of cattle and 6 shoats); Kyengera Cattle abattoir (20 heads of cattle and 10 shoats per day and Nakasozi-Buddo pig slaughterhouse (30 pigs per day). Many had poor infrastructure, poor sanitation and poor drainage. Of the 52 abattoir workers interviewed, a substantial proportion (67.3%) was aware of zoonoses. However, a reasonable proportion (32.7%) did not know zoonoses. Awareness was on a wide range of diseases and conditions, including, Brucellosis, Tuberculosis, Tetanus, Cysticercosis, Mange, Foot and Mouth Disease, Swine Influenza, Hepatitis B, Lumpy Skin Disease, African Swine fever, Lice, Tunga penetrans, Anthrax, Rift Valley fever, Fasciolosis, Tick-borne infections and Salmonellosis. A reasonable proportion of abattoir workers (40.4%) were aware of consumption of meat from diseased animals, drinking of raw milk, contact, open cuts, aerosols, skin cuts, and tick bites as the mode of infection for disease. Utilization of personal protective equipment, especially boots (98%) and coveralls (90%) was highly observed and practised in the abattoirs visited. A high proportion of abattoir workers (95%) stated they normally observe hand washing in the abattoirs, with 88% practising hand washing during every task but only 40% of the respondents utilized the soap hand wash. In conclusion, improved abattoir facilities, sanitation, drainage and improved biosafety of workers could be achieved through development support towards facilities and an awareness program for abattoir workers on health hazards, zoonotic diseases and protective clothing.

The role of variety attributes in the uptake of new hybrid bananas among smallholder rural farmers in central Uganda

BackgroundWhile advances in agricultural research and development have led to generation of improved new cooking hybrid banana varieties (HBVs) with enhanced yield potential to restore production levels, these have been received with mixed feelings on production and consumption attributes among the farming communities in Uganda. Some farmers prefer HBVs that are comparable to their local varieties in terms of consumption attributes such as soft food, color when cooked, flavor and taste while others prefer high-yielding HBVs to produce surplus output for sale.MethodsUsing cross-sectional survey data from 242 randomly selected smallholder banana farmers in Nakaseke and Luwero districts in Central Uganda, the study applied a Tobit regression model to analyze the influence of socio-economic factors and variety attributes on the adoption of new hybrid bananas.ResultsThe results on the perception of farmers on banana variety attributes showed that the new HBVs had desirable production-related attributes, while local cultivars were rated superior to hybrids on consumption-related attributes. Evidence further showed that production-related and consumption-related attributes influenced farmers’ decisions in the adoption of HBVs. Further, an assessment of the socio-economic factors that influence the adoption of HBVs showed that education of the farmer, household size, interaction with different banana actors, experience (number of years growing HBVs), and source of planting materials had a significant influence on farmers’ adoption of the new HBVs.ConclusionThe study findings provide insights into the need for agricultural research and development initiatives to target the development of banana varieties with multi-traits that meet end-users’ preferences and needs. Facilitating the establishment of multi-actor platforms that bring together the different actors to share information and learn might be useful in increasing the intensity of HBVs adoption.

Beyond solidarity and mutual aid: Tension and conflict in burial groups in rural Uganda

Drawing from ethnographic data collected between 2012 and 2014 and January and June 2018 in Luwero district, Uganda, this article questions the romanticised depiction of burial groups as a means of enhancing social support, a sense of solidarity and mutual aid. We found that the felt sense of identity and belonging for members is not shared across community members, and that solidary relations between members and non-group members in the community are fraught with tensions and conflicts. Beyond the romanticised view of burial groups, we need to study burial groups as a model of solidarity in disunity and diversity.

Distribution of Pseudocercospora species causing Sigatoka leaf diseases of banana in Uganda and Tanzania.

Sigatoka leaf diseases are a major constraint to banana production. A survey was conducted in Tanzania and Uganda to assess the distribution of Pseudocercospora species and severity of Sigatoka leaf diseases. Pseudocercospora species were identified using species-specific primers. Sigatoka-like leaf diseases were observed in all farms and on all cultivars, but disease severity varied significantly (P < 0.001) between countries, districts/regions within countries, altitudinal ranges and banana cultivars. In all regions except Kilimanjaro, P. fijiensis, the causal agent of black Sigatoka, was the only pathogen associated with Sigatoka disease. Mycosphaerella musae was associated with Sigatoka-like symptoms in Kilimanjaro region. Black Sigatoka disease was more severe in Uganda, with a mean disease severity index (DSI) of 37.5%, than in Tanzania (DSI = 19.9%). In Uganda, black Sigatoka disease was equally severe in Luwero district (mean DSI = 40.4%) and Mbarara district (mean DSI = 37.9%). In Tanzania, black Sigatoka was most severe in Kagera region (mean DSI = 29.2%) and least in Mbeya region (mean DSI = 11.5%). Pseudocercospora fijiensis, the most devastating sigatoka pathogen, was detected at altitudes of up to 1877 m a.s.l. This range expansion of P. fijiensis, previously confined to altitudes lower than 1350 m a.s.l. in East Africa, is of concern, especially for smallholder banana farmers growing the susceptible East African Highland bananas (EAHB). Among the banana varieties sampled, the EAHB, FHIA hybrids and Mchare were the most susceptible. Here, the loss of resistance in Yangambi KM5, a banana variety previously resistant to P. fijiensis, is reported for the first time.

Indigenous traditional knowledge of medicinal plants used by herbalists in treating opportunistic infections among people living with HIV/AIDS in Uganda.

Currently, more than two thirds of the world's 36.9 million people living with HIV/AIDS reside in Sub-Saharan Africa. Opportunistic infections (OI) associated with HIV are the single most important cause of mortality and morbidity among HIV/AIDS patients in poor countries. There is widespread use of medicinal plant species to manage the HIV infection and it's associated OI in Uganda, even by patients already on antiretroviral drugs (ARV). However, much of this information remains undocumented and unverified. The aim of this study was to systematically and comprehensively document the traditional indigenous knowledge and practices associated with the management of HIV/AIDS infections by herbalists in Uganda. Ethnobotanical data were collected using semi-structured interviews and questionnaires. Ninety traditional medicine practitioners (TMP) or herbalists were interviewed in Arua, Dokolo, Mbale, Bushenyi, Iganga, Rakai, Luwero and Kaabong districts to gather information on the plant species used. Data were analysed and presented using descriptive statistics and the Informant Consensus Factor. We documented 236 medicinal plant species from 70 families and 201 genera. Acacia was the most widely represented genus with five species. The most frequently used medicinal plant species for treating various OI were Erythrina abyssinica (45), Warburgia ugandensis (43), Zanthoxylum chalybeum (38), Acacia hockii (37), Mangifera indica (36), Aloe vera (35), Albizia coriaria (34), Azadirachta indica (32), Psorospermum febrifugum (27) Vernonia amygdalina (22) and Gymnosporia senegalensis (21). Some of the plant species were used for treating all the OI mentioned. There is a high degree of consensus among the TMP on which plant species they use for the different OI, even though they are geographically separated. Herbalists contribute to the widespread practice of simultaneously using herbal medicines and ARV. Some TMP are also engaged in dangerous practices like injecting patients with herbs and encouraging simultaneous use of herbs and ARV. Although the TMP relied on biomedical laboratory diagnoses for confirming the patients' HIV sero status, they were familiar with the signs and symptoms of HIV/AIDS. There is wide spread use of a rich diversity of medicinal plants species and practices by TMP to manage OI in HIV/AIDS patients in Uganda.

Determinants of smallholder farmers’ participation in rice value chains in Uganda

This study explored the key determinants of smallholder farmers’ participation in the One Stop Centre Farmer Association (OSCA) rice value chains in Uganda. Data were collected from 98 respondents in Luwero and Bugiri districts using focus group discussions and 20 key informant interviews, and analysed with NVIVO software. The findings indicated that style of leadership, trust, cohesive networks and support services were key determinants of participation. Minimal participation of some members occurred due to unrealistic expectations and incompetent leadership. Further, addressing OSCA objectives can mitigate ensuing expectations. Along with this, strengthening the OSCA leadership to entrench transparency and establishment of business models for integration of value chain interventions into the wider livelihood strategies is important in order to cater for interests of all the members.Key words: Participation, Smallholder farmers, Value chains, Networks.

Reducing Physical Violence Toward Primary School Students With Disabilities

PurposeWe tested whether the Good School Toolkit reduces physical violence from peers and school staff toward students with and without disabilities in Ugandan primary schools. MethodsWe conducted a cluster randomized controlled trial, with data collected via cross-sectional surveys in 2012 and 2014. Forty-two primary schools in Luwero District, Uganda, were randomly assigned to receive the Good School Toolkit for 18 months, or to a waitlisted control group. The primary outcome was past week physical violence from school staff, measured by primary 5, 6, and 7 students' (aged 11–14 years) self-reports using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. Disability was assessed through the six Short Set Washington Group questions on functioning. Analyses were by intention to treat. ResultsAt endline, 53% of control group students with no functional difficulties reported violence from peers or school staff, versus 84% of students with a disability. Prevalence of past week physical violence from school staff was lower in intervention schools than in the control schools after the intervention, in students with no functional difficulties (adjusted odds ratio [aOR] = .41, 95% confidence interval [CI .26–.65]), students with some functional difficulties (aOR = .36, 95% CI .21–.63), and students with disabilities (aOR = .29, 95% CI .14–.59). The intervention also reduced violence from peers in young adolescents, with no evidence of a difference in effect by disability status. ConclusionsThe Good School Toolkit is an effective intervention to reduce violence perpetrated by peers and school staff against young adolescents with disabilities in Ugandan primary schools.

Effect of the good school toolkit on school staff mental health, sense of job satisfaction and perceptions of school climate: Secondary analysis of a cluster randomised trial.

The Good School Toolkit, a complex behavioural intervention delivered in Ugandan primary schools, has been shown to reduce school staff-perpetrated physical violence against students. We aimed to assess the effect of this intervention on staff members' mental health, sense of job satisfaction and perception of school climate. We analysed data from a cluster-randomised trial administered in 42 primary schools in Luwero district, Uganda. The trial was comprised of cross-sectional baseline (June/July 2012) and endline (June/July 2014) surveys among staff and students. Twenty-one schools were randomly selected to receive the Toolkit, whilst 21 schools constituted a wait-listed control group. We generated composite measures to assess staff members' perceptions of the school climate and job satisfaction. The trial is registered at clinicaltrials.gov (NCT01678846). No schools dropped out of the study and all 591 staff members who completed the endline survey were included in the analysis. Staff in schools receiving the Toolkit had more positive perspectives of their school climate compared to staff in control schools (difference in mean scores 2.19, 95% Confidence Interval 0.92, 3.39). We did not find any significant differences for job satisfaction and mental health. In conclusion, interventions like the Good School Toolkit that reduce physical violence by school staff against students can improve staff perceptions of the school climate, and could help to build more positive working and learning environments in Ugandan schools.

Dis-adoption of Household Biogas technologies in Central Uganda

The study analyses dis-adoption of biogas technologies in Central Uganda. Biogas technology makes use of livestock waste, crop material and food waste to produce a flammable gas that can be used for cooking and lighting. Use of biogas technology has multiple benefits for the households since it reduces the need for fuelwood for cooking and also produces bio-slurry which is a valuable fertilizer. Despite efforts by Government and Non-Governmental Organizations to promote the biogas technology, the rate of its adoption of biogas technology was found to be low, estimated at 25.8% of its potential. A review of literature showed that the households that dis-adopted biogas technology, did so within a period of 4years after its installation, yet the lifespan of using it is estimated at 25years. There was need to examine the factors contributing to dis-adoption. Using cross sectional data collected from Luwero and Mpigi districts found in Central Uganda, a probit model was estimated. The findings showed that an increase in the family size, the number of cattle, number of pigs and the age of the household head reduced the likelihood of biogas technology dis-adoption. Other factors that contributed to dis-adoption included the failure to sustain cattle and pig production that are necessary for feedstock supply, reduced availability of family labor the and inability of the households to repair biogas digesters after malfunctioning. Based on the findings, it was concluded that long term use of biogas technology required improved management practices on the farm so as to sustain livestock production. It is also recommended that quality standards and socio-cultural factors be considered in the design of biogas digesters and end use devices.

How did the Good School Toolkit reduce the risk of past week physical violence from teachers to students? Qualitative findings on pathways of change in schools in Luwero, Uganda

Violence against children is a serious violation of children's rights with significant impacts on current and future health and well-being. The Good School Toolkit (GST) is designed to prevent violence against children in primary schools through changing schools' operational cultures. Conducted in the Luwero District in Uganda between 2012 and 2014, findings from previous research indicate that the Toolkit reduced the odds of past week physical violence from school staff (OR = 0.40, 95%CI 0.26–0.64, p < 0.001), corresponding to a 42% reduction in risk of past week physical violence. This nested qualitative study involved 133 interviews with students, teachers, school administration, and parents, and two focus group discussion with teachers. Interviews were conducted using semi-structured tools and analysed using thematic analysis complemented by constant comparison and deviant case analysis techniques. Within a context of normative acceptance of corporal punishment this qualitative paper reports suggestive pathways related to teacher-student relationships through which reductions in violence operated. First, improved student-teacher relationships resulted in improved student voice and less fear of teachers. Second, the intervention helped schools to clarify and encourage desired behaviour amongst students through rewards and praise. Third, many teachers valued positive discipline and alternative discipline methods, including peer-to-peer discipline, as important pathways to reduced use of violence. These shifts were reflected in changes in the views, use, and context of beating. Although the GST is effective for reducing physical violence from teachers to students, violence persisted, though at significantly reduced levels, in all schools with reductions varying across schools and individuals. Much of the success of the Toolkit derives from the support it provides for fostering better student-teacher relationships and alternative discipline options. Such innovation could usefully be incorporated in teacher training syllabi to equip teachers with knowledge and skills to maintain discipline without the use of fear or physical punishment.

Methods to increase reporting of childhood sexual abuse in surveys: the sensitivity and specificity of face-to-face interviews versus a sealed envelope method in Ugandan primary school children

BackgroundUnderreporting of childhood sexual abuse is a major barrier to obtaining reliable prevalence estimates. We tested the sensitivity and specificity of the face-to-face-interview (FTFI) method by comparing the number of disclosures of forced sex against a more confidential mode of data collection, the sealed-envelope method (SEM). We also report on characteristics of individuals associated with non-disclosure in FTFIs.MethodsSecondary analysis of data from a cross-sectional survey conducted in 2014, with n = 3843 children attending primary school in Luwero District, Uganda. Sensitivity and specificity were calculated, and mixed effects logistic regression models tested factors associated with disclosure in one or both modes.ResultsIn the FTFI, 1.1% (n = 42) of children reported ever experiencing forced sex, compared to 7.0% (n = 268) in the SEM. The FTFI method demonstrated low sensitivity (13.1%, 95%CI 9.3–17.7%) and high specificity (99.8%, 95%CI 99.6–99.9%) in detecting cases of forced sex, when compared to the SEM. Boys were less likely than girls to disclose in the FTFI, however there was no difference in prevalence by sex using the SEM (aOR = 0.91, 95%CI 0.7–1.2; P = 0.532). Disclosing experience of other forms of sexual violence was associated with experience of forced sex for both modes of disclosure.ConclusionsThe SEM method was superior to FTFIs in identifying cases of forced sex amongst primary school children, particularly for boys. Reporting of other forms of sexual violence in FTFIs may indicate experience of forced sex. Future survey research, and efforts to estimate prevalence of sexual violence, should make use of more confidential disclosure methods to detect childhood sexual abuse.

Increasing Uptake of HIV, Sexually Transmitted Infection, and Family Planning Services, and Reducing HIV-Related Risk Behaviors Among Youth Living With HIV in Uganda

PurposeTo address barriers to care for youth living with HIV (YLHIV), the Link Up project implemented a peer-led intervention model that provided a comprehensive package of HIV and sexual and reproductive health and rights services through community-based peer support groups for YLHIV. Peer educators delivered targeted counseling and health education, and referred YLHIV to antiretroviral therapy (ART), and reproductive health services that were available at youth-oriented sexual and reproductive health and rights facilities. MethodsAt baseline (October to November 2014), 37 peer support groups for YLHIV were established in Luwero and Nakasongola districts. During this same time period, we recruited a cohort of 473 support group members, aged 15–24 years. After a 9-month intervention period (January to September 2015), we completed the end-line survey with 350 members of the original cohort. Multivariate logistic regression analysis applied to longitudinal data was used to assess changes in key outcomes from baseline to end line. ResultsMultivariate analyses showed significant increases at end line, compared with baseline, in self-efficacy (adjusted odds ratio [AOR]: 1.8 [1.3–2.6]), comprehensive HIV knowledge [AOR: 1.8 [1.3–2.6]), HIV disclosure (AOR: 1.6 [1.01–2.6]), condom use at last sex (AOR: 1.7 [1.2–2.5]), sexually transmitted infection uptake (AOR: 2.1 [1.5–2.9]), ART uptake (AOR: 2.5 [1.6–4.0]), ART adherence (AOR: 2.5 [1.3–4.9]), CD4 testing (AOR: 2.4 [1.5–3.6]), and current use of a modern contraceptive method (AOR: 1.7 [1.1–2.7]). ConclusionsLink Up's intervention strategy likely contributed to observed increases in self-efficacy, knowledge of HIV, condom use, HIV disclosure ART utilization and adherence, CD4 testing, STI testing uptake, and use of modern family planning methods. This model shows promise and should be adapted for use among YLHIV in similar settings and evaluated further.

Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital

BackgroundCommunity-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services.MethodsData were collected through ethnographic fieldwork undertaken as part of a larger research program in Luwero District, Uganda, between 2012 and 2014. The main methods of data collection were participant observation in events organised by VHTs. In addition, a total of 91 in-depth interviews and 42 focus group discussions (FGD) were conducted with adult community members as part of the larger project. After preliminary analysis of the data, we conducted an additional six in-depth interviews and three FGD with VHTs and four FGD with community members on the role of VHTs. Key informant interviews were conducted with local government staff, health workers, local leaders, and NGO staff with health programs in Luwero. Thematic analysis was used during data analysis.ResultsThe ability of VHTs to link communities with formal health care was affected by the stakeholders’ perception of their roles. Community members perceive VHTs as working for and under instructions of “others”, which makes them powerless in the formal health care system. One of the challenges associated with VHTs’ linking roles is support from the government and formal health care providers. Formal health care providers perceived VHTs as interested in special recognition for their services yet they are not “experts”. For some health workers, the introduction of VHTs is seen as a ploy by the government to control people and hide its inability to provide health services. Having received training and initial support from an NGO, VHTs suffered transition failure from NGO to the formal public health care structure. As a result, VHTs are entangled in power relations that affect their role of linking community members with formal health care services. We also found that factors such as lack of money for treatment, poor transport networks, the attitudes of health workers and the existence of multiple health care systems, all factors that hinder access to formal health care, cannot be addressed by the VHTs.ConclusionsAs linking social capital framework shows, for VHTs to effectively act as links between the community and formal health care and harness the resources that exist in institutions beyond the community, it is important to take into account the power relationships embedded in vertical relationships and forge a partnership between public health providers and the communities they serve. This will ensure strengthened partnerships and the improved capacity of local people to leverage resources embedded in vertical power networks.

Information quality, sharing and usage in farmer organizations: The case of rice value chains in Bugiri and Luwero Districts, Uganda

AbstractInformation is the connection of all components of a value chain network, activities and operations. Information transfer depends on the level of trust and interaction in the structure of the chain’s information system. This study was conducted on information quality, sharing and usage by two OSCAs in the rice value chain in Luwero and Bugiri districts, Uganda. The methodology used involved use of semi structured interviews, check lists for focus group discussions and key informant interviews. Seven focus group interviews were conducted, with an average attendance of six members per group (42 members) in Bugiri and 42 members in Luwero district. Interviews were also conducted for 30 key informants. A total of 114 respondents were interviewed in focus group discussions and as key informants. The information was analyzed with NVIVO software. Findings indicate that information sharing, type, quality content and usage of information depended on trust. Trust was a result of regular interactions among t...

Partnership construction and value co-creation to address voids in rice production: The case of rice value chains in Uganda

AbstractSince the establishment of One Stop Center Farmer Associations (OSCAs) in Uganda 13 years ago, no documentation of the work done had been carried out. This study was conducted on the partnership and value co-creation initiatives implemented by two OSCAs in the rice value chain in Luwero and Bugiri districts, Uganda. The methodology used involved use of semi structured interviews and check lists for focus group discussions as well as key informant interviews. Eight focus group interviews were conducted, with an average attendance of six members per group (48 members) in Bugiri and 48 members in Luwero district. Interviews were also conducted for 44 key informants. A total of 140 respondents were interviewed both in the focus group discussions and as key informants. The information was analyzed with NVIVO software. Findings indicate that partnership construction and value co-creation occurred in the OSCA value chains, but have not yet reached the ideal status, although they have advanced through the...

Cattle management practices and milk production on mixed smallholder organic pineapple farms in Central Uganda.

A longitudinal study to assess animal management practices and milk production was conducted for a period of 12months on 30 smallholder farms keeping dairy cattle and certified organic pineapple production in Luwero and Kayunga districts, based on questionnaire and on-farm collected data. Farm sizes were 9.3 ± 6.7acres in tethering system and 4.3 ± 2.6acres in zero-grazing. Fifty-four percent of the zero-grazing herds had animal housing facilities. All farmers in tethering system kept cows on earthen floors and calves without bedding. Hygiene level in existing farms was low. Majority of calves were fed once a day by restricted suckling (77%). Seventy-four percent of tethered cows were only fed on natural grass, while cows under zero-grazing system had a more diversified diet but with 82% feeding mainly Napier grass. Most farms (87%) used bulls for breeding. Milk production was higher (P < 0.05) in zero-grazing (6.5L/cow/day) than tethering system, and higher (P < 0.05) for Holstein-Friesian crossbred cows (5.2L/cow/day) than local breed cows (2.6L/cow/day). Less than 1L of milk per farm per day on average was sold. Disease treatments were exclusively for helminths, East Coast fever, and trypanasomiasis. Spraying of ticks and deworming were important control measures of vector-borne diseases. There is potential to develop alternative feed resources for dairy cattle and biorational pesticides for control and treatment of vector-borne diseases.

Effects of an Educational Program about Reproductive Health Promotion on Knowledge, Attitudes and Behavior

The purpose of this study was to examine the effects of an educational program about reproductive health promotion on knowledge, attitude, and behavior at reproductive age in Luwero district in Uganda. A single-group pretest-posttest design was used to find the effect of education. Subjects were 720 women of reproductive age (15–49 years) who lived in seven sub-counties in Luwero district. First, individuals working as midwifes in the community were trained; subsequently, these individuals administered the education program to community members including the village health team. The results indicate that education affected participants’ knowledge (t = 29.58, p < .001), attitude (t = 25.16, p < .001), and behavior (t = 12.98, p < .001) regarding family planning and reproductive health.

The first mile: community experience of outbreak control during an Ebola outbreak in Luwero District, Uganda.

BackgroundA major challenge to outbreak control lies in early detection of viral haemorrhagic fevers (VHFs) in local community contexts during the critical initial stages of an epidemic, when risk of spreading is its highest (“the first mile”). In this paper we document how a major Ebola outbreak control effort in central Uganda in 2012 was experienced from the perspective of the community. We ask to what extent the community became a resource for early detection, and identify problems encountered with community health worker and social mobilization strategies.MethodsAnalysis is based on first-hand ethnographic data from the center of a small Ebola outbreak in Luwero Country, Uganda, in 2012. Three of this paper’s authors were engaged in an 18 month period of fieldwork on community health resources when the outbreak occurred. In total, 13 respondents from the outbreak site were interviewed, along with 21 key informants and 61 focus group respondents from nearby Kaguugo Parish. All informants were chosen through non-probability sampling sampling.ResultsOur data illustrate the lack of credibility, from an emic perspective, of biomedical explanations which ignore local understandings. These explanations were undermined by an insensitivity to local culture, a mismatch between information circulated and the local interpretative framework, and the inability of the emergency response team to take the time needed to listen and empathize with community needs. Stigmatization of the local community – in particular its belief in amayembe spirits – fuelled historical distrust of the external health system and engendered community-level resistance to early detection.ConclusionsGiven the available anthropological knowledge of a previous outbreak in Northern Uganda, it is surprising that so little serious effort was made this time round to take local sensibilities and culture into account. The “first mile” problem is not only a question of using local resources for early detection, but also of making use of the contextual cultural knowledge that has already been collected and is readily available. Despite remarkable technological innovations, outbreak control remains contingent upon human interaction and openness to cultural difference.

Endemicity of Malaria parasites among Tuberculosis infected HIV patients attending Bombo-Military Hospital, Luwero district, Uganda

Background Malaria parasites, Tuberculosis, and HIV respectively are recognized public health global menace. The prevalence of Tuberculosis and HIV in Malaria endemic regions needs urgent attention to avert catastrophic health consequences. Objective: To evaluate the endemicity of Malaria among Tuberculosis infected HIV patients attending Bombo-Military Hospital. Materials And Methods This was a laboratory-based cross-sectional study in which 100 HIV patients were screened for malaria parasites and Mycobacterium tuberculosis and parasite density determined using standard Microbiological and parasitology methods. Data generated were tested for statistical significance. Results Out of 100 participants (18 females were civilians and 82 males were soldiers), 2.4% of males had malaria, 3.7%) had PTB, 1 (1.2%) had both malaria and PTB. Of the 18 females, only 1 (5.6%) had PTB. Malaria parasites and TB prevalence of 3.3% were among those aged 21-30 years. The highest 16.7% prevalence of PTB and malaria-PTB co-infections was among those aged 51-60 years. Malaria parasites prevalence among soldiers was 2.4%, and 1.2% had malaria and PTB while 3.7% had PTB alone. Participants’ demographic characteristics (p&lt;0.05; r=0.243) influenced malaria endemicity among Tuberculosis infected HIV patients studied. Conclusion Malaria parasites remained endemic even among Tuberculosis infected HIV patients studied Malaria disease surveillance, advocacy on innovative prevention and control strategies, an updated policy that will support effective intervention, are highly recommended.