Mid-western Uganda Research Articles

Tracing the Employability Competencies among BSE Graduates in Mid-Western Uganda

This study investigated the influence of competence acquired through the Bachelor of Secondary Education (BSEd) program on the development of employability skills among graduates in Midwestern Uganda. This research begets a core question- what are the relevant competencies for employability skills of graduate teachers in mid-western Uganda? To unveil the socially constructed realities shaping BSEd teachers' perceptions of competence and the development of employability skills, we applied qualitative methodologies particularly case study design with interviews. Hence the study found out that, well-mastered principles of the subject would render a university teacher graduate employable. Communication skill was also an antecedent for greater performance within the teaching trial. Several other skills were found to depict our study employability skills framework and cognizant of the nature of training that empowered the BSEd graduates in various employable skills. Withal, school administrators reported a lack of some of the 21st-century skills from the graduate teachers (for example problem-solving, and critical thinking skills). It’s recommended that universities align BSE programs with the competence-based curriculum to ensure more employable and relevant citizens

Uptake of HIV Testing Services among Refugee Men in Kiryandongo Refugee Settlement Camp, Mid-western Uganda

Aims: HIV testing is a critical checkpoint to late diagnosis and delayed treatment. However, utilization of HIV testing services has not yet reached the desired target, especially for men. This study aimed to determine the level of uptake of HIV testing services and the associated factors among refugee men in the Kiryandongo Refuge Settlement Camp. Study Design: Cross-sectional by mixed methods. Methodology: The study was conducted by mixed methods. A total of 422 men >18 years were selected using systematic random sampling. Interview administered semi-structured - questionnaires and informant interview guides were used to collect quantitative and qualitative data respectively. Results: The level of uptake of HIV testing services was 32%. Key factors negatively associated with the testing included social-cultural status (P=0.006, AOR=3.80) disclosure of positive results and awareness (P=0.002, AOR=0.14 and P=0.000, AOD=0.08) respectively, unemployment (P=0.015, AOR=0.17), religion (P=0.043, AOD=0.37) and multiple sexual partners (P=0.033, AOR=0.23). Conclusion: The level of uptake of HIV testing services among refugee men in the Kiryandongo refugee settlement camp is significantly lower than the national mark. Targeted testing strategies and sensitization are critical to address the negatively associated factors and inform public health policies.

Long-acting injectable antiretroviral treatment: experiences of people with HIV and their healthcare providers in Uganda

IntroductionLong-acting injectable antiretroviral treatment (LAI-ART) has emerged as a novel alternative to the burden of daily oral pills. The bi-monthly intramuscular injectable containing cabotegravir and rilpivirine holds the promise of improving adherence to ART. The perspectives of potential users of LAI-ART, the majority of whom reside in Eastern and Southern Africa, are still largely unexplored. We set out to understand the experiences of people with HIV (PWH) who received LAI-ART at Fort Portal Regional Referral Hospital in mid-Western Uganda for at least 12 months.MethodsThis qualitative study, conducted between July and August 2023, was nested within a larger study. We conducted four focus groups with 32 (out of 69) PWH who received intramuscular injections of cabotegravir and rilpivirine. In-depth interviews were held with six health workers who delivered LAI-ART to PWH. Data were analyzed by thematic approach broadly modeled on the five domains of the Consolidated Framework for Implementation Research (CFIR).ResultsThere was high acceptability of LAI-ART (30 /32 or 94%) participants requested to remain on LAI-ART even after the end of the 12-month trial. Adherence to ART was reportedly improved when compared to daily oral treatment. Participants credited LAI-ART with; superior viral load suppression, redemption from the daily psychological reminder of living with HIV, enhanced privacy in HIV care and treatment, reduced HIV-related stigma associated with taking oral pills and that it absolved them from carrying bulky medication packages. Conversely, nine participants reported pain around the injection site and a transient fever soon after administering the injection as side effects of LAI-ART. Missed appointments for receiving the bi-monthly injection were common. Providers identified health system barriers to the prospective scale-up of LAI-ART which include the perceived high cost of LAI-ART, stringent cold chain requirements, physical space limitations, and workforce skills gaps in LAI-ART delivery as potential drawbacks.ConclusionOverall, PWH strongly preferred LAI-ART and expressed a comparatively higher satisfaction with this treatment alternative. Health system barriers to potential scale-up are essential to consider if a broader population of PWH will benefit from this novel HIV treatment option in Uganda and other resource-limited settings.Trial registrationTrial Registry Number PACTR ID PACTR202104874490818 (registered on 16/04/2021).

Associations between maternal dietary intake and nutritional status with fetal growth at 14 to 26 weeks gestation: a cross- sectional study

BackgroundMaternal undernutrition during pregnancy is currently estimated at 23.5% in Africa, which is worrying given the negative impacts of malnutrition on maternal and fetal birth outcomes. The current study aimed at characterizing the associations of maternal dietary intake and nutritional status with fetal growth at 14–26 weeks gestation. It was hypothesized that maternal dietary intake was positively associated with maternal nutritional status and fetal growth both in early and late pregnancy.MethodsThis was a cross-sectional survey of 870 pregnant women in mid-western Uganda conducted in August 2013. Data were collected on women’s dietary intake (indicated by women’s dietary diversity and the diet quality score) and nutritional status (indicated by hemoglobin level and mid-upper arm circumference) at 14–26 weeks gestation. Fetal growth was determined by symphysis-fundal height Z-scores processed using the INTERGROWTH-21st calculator. Associations between maternal dietary intake and nutritional status with fetal growth were determined using correlations and chi-square tests.ResultsOverall, only 25% had adequate dietary diversity and the most utilized food groups were White tubers, roots and starchy vegetables; Pulses, nuts and seeds; Cereals and grains, Dark green leafy vegetables, and Fats and oils. A larger proportion of younger women (15–29 y) were classified as anemic (20.4% versus 4.4%) and underweight (23.7% versus 5.0%) compared to older women (30–43 y). Additionally, women aged 15 to 24 years had significantly lower mean SFH-for-gestation age Z-scores than women 36–43 years (F4, 783 = 3.129; p = 0.014). Consumption of legumes nuts and seeds was associated with reduced risk of anemia while consumption of dairy products (mostly milk) was positively associated with better fetal growth. Surprisingly, low Hb level was positively associated with normal fetal growth (rP = -0.133; p = 0.016) after 20 weeks gestation, possibly indicating normal fetal growth paralleled with physiologically necessary hemodilution.ConclusionsSub-optimal dietary patterns, characterized by limited dietary diversity and low protein intake, are likely to compromise maternal nutrition and fetal growth in limited resource settings. Improving pregnant women’s access to cheaper but nutrient-dense protein sources such as pulses, nuts and dairy products (mostly milk) has potential to improve women’s nutritional status and enhance fetal growth.

Perception and Adoption of Government Agricultural Technologies among Smallholder Farmers in Western Uganda

Agriculture production and productivity remain key to feeding the growing population with agriculture extension being at the centre of the performance of the agricultural sector in Uganda. Research shows that improved technologies promoted through extension service provision could have an even greater impact on food production and on farmers’ livelihoods in developing countries like Uganda. This study was conducted to investigate the perception and adoption of improved agriculture technologies under the government extension system among smallholder farmers in Kagadi District, mid-western Uganda. Data was collected using a questionnaire from 149 randomly selected households in three sub-counties. Results generated using Excel and SPSS revealed a high positive perception index of +0.63 for government extension services. The level of adoption of improved technology based on generalised partial adoption was 54.3% with farm size and training attendance being the significant factors affecting adoption of improved agricultural technologies in the study area. It is clear from the results that notable differences exist in terms of the perceptions of government extension services and the adoption of improved agricultural technologies. The general observation of farmers’ perception is that government extension service is helpful to farmers and is the major source of agricultural information in the area. Efforts should be made to support access to arable land and intensification of agricultural training sessions coupled with appropriate mobilisation of farmers to attend such training. Further studies should be done to understand these aspects on a wider scope in the country since this study was only conducted in one district. There is also needed to study the factors individually as well as the relationships with other factors to determine the adoption processes of technological advancement

The influence of sugarcane growing by smallholder farmers on household livelihood, food security, and nutrition status of children below five years in mid-western Uganda

The current study aimed at determining the influence of sugarcane production on livelihoods, food security and nutrition status. A cross-sectional study was carried out among 350 smallholder farmers in mid-western Uganda. Food security was assessed by Household Food Insecurity Access Scale (HFIAS) while household livelihood and nutrition status of children below five (5) years were assessed by a semi-structured questionnaire and anthropometry respectively. Results showed that sugarcane growing households (SCG) cultivated more acreage of food, owned more assets, earned more income than the non-sugarcane growing households (NSCG). Ownership of motorcycles was higher (p < 0.05) among SCG than NSCG. Households reported anxiety and uncertainty of having food in the previous four weeks (SCG 38%; NSCG 55.2%); had insufficient food quality (SCG 56.8%; NSCG 70.7%); and had insufficient food quantity (SCG 41.7%; NSCG 49.2%). SCG were more food secure (32.3%) than the NSCG (20.8%) (p < 0.05) with a corresponding mean HFIAS of 6.56 ± 6.69 and 8.41 ± 6.41, respectively. Stunting among children below five years among NSCG was higher (34.6%) than in SCG (21.3%). Among SCG, 7.3% and 5.2% of children were underweight and wasted while 6.06% and 2.7% were underweight and wasted from NSCG. This demonstrated that sugarcane growing had better livelihood outcomes, positively impacted on asset ownership and food security but mixed effect on nutrition indicators among children in sugarcane growing and non-sugarcane growing households. It is recommended that government and development agencies diversify livelihoods among the NSCG and reinforce the existing livelihoods among SCG; provide nutrition education to both SCG and NSCG for improved food security and nutrition outcomes. Authors suggest further studies using a mixed approach to assess the levels of household nutrient intake in sugarcane growing areas.

The impact of donor transition on continuity of maternal and newborn health service delivery in Rwenzori sub-region of Uganda: a qualitative country case study analysis

BackgroundThe transition of donor-supported health programmes to country ownership is gaining increasing attention due to reduced development assistance for health globally. It is further accelerated by the ineligibility of previously Low-Income Countries’ elevation into Middle-income status. Despite the increased attention, little is known about the long-term impact of this transition on the continuity of maternal and child health service provision. Hence, we conducted this study to explore the impact of donor transition on the continuity of maternal and newborn health service provision at the sub-national level in Uganda between 2012 and 2021.MethodsWe conducted a qualitative case study of the Rwenzori sub-region in mid-western Uganda which benefited from a USAID project to reduce maternal and newborn deaths between 2012 and 2016. We purposively sampled three districts. Data were collected between January and May 2022 among subnational key informants (n = 26), national level key informants at the Ministry of Health [3], national level donor representatives [3] and subnational level donor representatives [4] giving a total of 36 respondents. Thematic analysis was deductively conducted with findings structured along the WHO’s health systems building blocks (Governance, Human resources for health, Health financing, Health information systems, medical products, Vaccines and Technologies and service delivery) framework.ResultsOverall, continuity of maternal and newborn health service provision was to a greater extent maintained post-donor support. The process was characterised by a phased implementation approach. The embedded learning offered the opportunity to plough back lessons into intervention modification which reflected contextual adaptation. The availability of successor grants from other donors (such as Belgian ENABEL), counterpart funding from the government to bridge the gaps left behind, absorption of USAID-project salaried workforce (such as midwives) onto the public sector payroll, harmonisation of salary structures, the continued use of infrastructure (such as newborn intensive care units), and support for MCH services under PEPFAR support post-transition contributed to the maintenance of coverage. The demand creation for MCH services pre-transition ensured patient demand post-transition. Challenges to the maintenance of coverage were drug stockouts and sustainability of the private sector component among others.ConclusionA general perception of the continuity of maternal and newborn health service provision post-donor transition was observed with internal (government counterpart funding) and external enablers (successor donor funding) contributing to this performance. Opportunities for the continuity of maternal and newborn service delivery performance post-transition exist when harnessed well within the prevailing context. The ability to learn and adapt, the presence of government counterpart funding and commitment to carry on with implementation were major ingredients signalling a crucial role of government in the continuity of service provision post-transition.

Integrity and Ethical Values, and Financial Performance of Savings and Credit Cooperatives (SACCOs) in Mid-Western Uganda

Purpose: To establish the relationship between control integrity and ethical values, and financial performance of SACCOs in Mid-Western Uganda.&#x0D; Methodology: To collect data was presented using frequency tables and was analyzed using standard regression analysis. Besides, a cross-sectional research design and positivist paradigm were used. Besides, a closed-ended questionnaire was used to collect data.&#x0D; Findings: The study findings indicate a strong positive significant relationship between integrity and ethical values and financial performance of SACCOs in Mid-Western Uganda.&#x0D; Unique Contribution to Practice and Policy: This study provides a detailed understanding of how integrity and ethical values influence financial performance, thus pointing to the fact that integrity and ethical values are predictors of financial performance.&#x0D;

Internal Control Environment and Financial Accountability of Savings and Credit Cooperatives in Mid-Western Uganda

Purpose: To test the association between internal control environment and financial accountability of SACCOs in Mid-Western Uganda.&#x0D; Methodology: The study adopted a cross-sectional research design and positivist paradigm to gather data from 93 SACCOs in Mid-Western Uganda using a closed-ended questionnaire. Data was analyzed using the standard linear regression.&#x0D; Findings: The study depict a strong positive significant association relationship between internal control environment and financial accountability of SACCOs in Mid-Western Uganda.&#x0D; Unique Contribution to Theory, Practice and Policy: The high level of transparency and value for money can be achieved if management puts into place effective internal control environment if SACCOs are to realize a high level of transparence and value for money.&#x0D;

Community-based forest management promotes survival-led livelihood diversification among forest-fringe communities in Uganda

Livelihood diversification is a prominent feature of rural households in developing countries. It is a strategy commonly pursued by households to enhance their resilience to shocks and/or risks that affect their livelihood. While a common characteristic of Uganda’s community-based forest management (CBFM) is the promotion of alternative livelihood activities to reduce household reliance on natural forest resources from gazetted forests, it is unclear how livelihood diversification has been embraced by households engaged in CBFM. We explore livelihood diversification using cross-sectional survey data collected from 423 households in villages adjacent to Collaborative Forest Management (CFM) compartments and non-CFM compartments of Budongo Central Forest Reserve as well as two Community Forests (CF) in mid-western Uganda. We quantified the levels of diversification and fitted a Gini-Simpson Diversity Index as the response variable in two Tobit regression models to examine the determinants of livelihood diversification among forest-fringe communities in CFM and CF sites. Our results reveal high levels of survival-led household livelihood diversification in the area, with an average household engaging in five livelihood activities that were predominantly on-farm or involved the extraction of forest products for subsistence. In the CFM sites, livelihood diversification levels significantly increased with household heads’ duration of residence in the village and membership in other social groups in the village. In villages adjacent to the community forests, only the household dependency ratio positively influenced household livelihood diversification. Membership in forest conservation groups did not significantly predict the level of household livelihood diversification. Given the current survival-led diversification that these communities pursue, we recommended that development and conservation agencies in the area and other similar sites of CBFM deliberately enhance household access to high-return on-farm and non-farm livelihood activities to achieve meaningful transformations in rural livelihoods.

Involving men in cervical cancer prevention; a qualitative enquiry into male perspectives on screening and HPV vaccination in Mid-Western Uganda.

Evidence-based preventive strategies for cervical cancer in low-resource setting have been developed, but implementation is challenged, and uptake remains low. Women and girls experience social and economic barriers to attend screening and human papillomavirus (HPV) vaccination programs. Male support has been proven successful in uptake of other reproductive healthcare services. This qualitative study with focus groups aimed to understand the perspectives of males on cervical cancer screening and HPV vaccination in Western-Uganda This knowledge could be integrated into awareness activities to increase the attendance of cervical cancer screening and HPV vaccination programs. Focus group discussions were conducted with men aged 25 to 60 years, who were married and/or had daughters, in Kagadi district, Mid-Western Uganda. All interviews were transcribed verbatim and thematically analyzed using an inductive approach. Eleven focus group discussions were conducted with 67 men. Men were willing to support their wives for screening and their daughters for HPV vaccination. Misperceptions such as family planning and poor personal hygiene leading to cervical cancer, and misperception of the preventative aspect of screening and vaccination were common. Women with cervical cancer suffer from stigmatization and family problems due to loss of fertility, less marital sexual activity, domestic violence and decreased economic productivity. Ugandan men were willing to support cervical cancer prevention for their wives and daughters after being informed about cervical cancer. Limited knowledge among men about the risk factors and causes of cervical cancer, and about the preventative aspect of HPV vaccination and screening and their respective target groups, can limit uptake of both services. Screening and vaccination programs should actively involve men in creating awareness to increase uptake and acceptance of prevention.

2079. Comparison of Recency Assays to Estimate HIV Incidence in the SIENA (eStimating hIv incidEnce amoNg Agyw) Study in Uganda

Abstract Background HIV-1 recent infection testing algorithms (RITAs) use recency assays to estimate population level HIV incidence rates (IRs), and are currently being employed in PrEP trials to estimate background HIV incidence rates (bHIV-IR). The SIENA study was conducted to determine the HIV incidence rate among young women in and around central and mid-western Uganda, and to assess the suitability of different recency assay platforms for use in determining bHIV-IR in future PrEP trials. Methods Diagnosis of HIV was confirmed by positive results on both the Alere Determine HIV-1/2 and Oraquick HIV-1/2 rapid tests. Positive samples were analyzed for recent infection using the Sedia HIV-1 Limiting Antigen Avidity Enzyme ImmunoAssay (LAg-EIA; Sedia Biosciences, Beaverton, OR) and the Sedia Asante HIV-1 Rapid Recency Assay (Asante; Sedia Biosciences). The Asante assay was performed by electronic reader (Asante-Reader) or visual read (Asante-Visual). VL was determined by COBAS TaqMan HIV-1 Test (LabCorp, Indianapolis, IN). HIV incidence was calculated based on previously determined MDRI and FRRs that were specific for the study population. Results Of 743 women screened, 191 were diagnosed with HIV, of whom 44 (23%) had a viral load of &amp;lt; 75 copies/mL. The 3 recency assays identified between 43 and 57 samples as recent and between 35 and 37 samples when the VL cutoff of &amp;lt; 75 copies/mL was used (Table). When no VL cutoff was used the calculated bHIV-IR was 17.9/100 person-years (PY) for the LAg-EIA, 12.8/100PY for the Asante-Reader and 20.3/100PY for the Asante-Visual. Using the VL cutoff, the calculated bHIV-IR was 11.4/100 PY with the LAg-EIA assay and 10.9/100 PY with the Asante-Reader. No MDRI or FRR for the Asante-Visual with a VL cutoff was available for calculation of the Asante-Visual HIV incidence. Conclusion When the RITA included a VL cutoff of 75 cp/mL, the LAg-EIA and Asante assays classified the number of recent and long-term infections similarly, resulting in comparable bHIV-IR results. Overall, these analyses support the use of these recency assays in the RITA to estimate the bHIV-IR in future PrEP trials. Our results demonstrate extremely high prevalence and incidence of HIV in young women in central and mid-western Uganda, highlighting the need for expanded HIV prevention options in these areas. Disclosures Stephanie Cox, BS, Gilead Sciences: Paid employee|Gilead Sciences: Stocks/Bonds Shelley N. Facente, PhD, MPH, CDC-funded TRACE program: Grant/Research Support|Gilead Sciences: Advisor/Consultant|Sedia Biosciences Corporation: Grant/Research Support Eduard Grebe, PhD, CDC-funded TRACE program: Grant/Research Support|Gilead Sciences: Advisor/Consultant|Sedia Biosciences Corp: Grant/Research Support Ramin Ebrahimi, MS, Gilead Sciences: Paid employee|Gilead Sciences: Stocks/Bonds Christoph C. Carter, MD, PhD, Gilead Sciences: Employee|Gilead Sciences: Employee|Gilead Sciences: Stocks/Bonds|Gilead Sciences: Stocks/Bonds Christian Callebaut, PhD, Gilead Sciences: Paid employee|Gilead Sciences: Stocks/Bonds Jared Baeten, MD, PhD, Gilead Sciences: Employee|Gilead Sciences: Stocks/Bonds Moupali Das, MD, Gilead Sciences: Employee|Gilead Sciences: Employee|Gilead Sciences: Stocks/Bonds|Gilead Sciences: Stocks/Bonds.

Analysis of the quality of local council elections in Hoima city, mid-western Uganda

Purpose: The aim of this study was to discuss the quality of local council elections by exploring factors that influence vote buying and vote selling during electoral seasons in Uganda.&#x0D; Methodology: A cross-sectional study aimed at promoting free, fair and credible local council elections in Hoima city. The study was conducted in one city ward that is part of Hoima City Cohort Study (HCCS). The HCCS is a population-based cohort that was identified for purposes of this study. A total of 28 registered voters, resident in four study areas were enrolled into the study. Data were collected on socio-econ-political related characteristics. A regression model was used to generate voting frequency as a measure of association for factors that were associated with voter bribery.&#x0D; Findings: Results suggest that voter bribery was high; higher in men than in women. Less than half had participated in more than two previous local council elections while slightly more than half were taking part in the second election. After adjusting for potential and suspected confounder, the factors that were negatively associated with voter bribery were: greed, poverty, and expectations; political party/candidate influence and lack of self-control were positively associated with voter bribery. Since political party/candidate influence and lack of self-control were positively associated with voter bribery in the area of study, targeting those having exorbitant resources to tempt voters may help reduce voter bribery in this area.&#x0D; Unique Contribution to Policy and Practice: The results of this study may be useful to policy and practice since they can facilitate managers of electoral management bodies as well as political parties to evolve frameworks that can facilitate credible electoral processes.

Financial Accountability and Financial Performance of Savings and Credit Cooperatives in Mid-Western Uganda

Purpose: To establish the association between financial accountability and Financial Performance of SACCOs in Mid-Western Uganda.&#x0D; Methodology: A cross-sectional research design and positivist paradigm were used to collect data from 93 SACCOs in Mid-Western Uganda using a close-ended questionnaire. Besides, a standard linear regression analysis was conducted. From the target population of 122 SACCOs, a sample of 93 SACCOs was selected using probability sampling technique.&#x0D; Findings: The study established a positive significant association between financial accountability and Financial Performance.&#x0D; Unique Contribution to Practice and Policy: The study confirms the theoretical assertions that financial accountability associates with financial performance. Besides, the study addresses the mixed findings on the link between financial accountability and financial performance. Also, the study suggests a need for management to consider financial accountability as a key driver of financial performance of SACCOs. Still, there is need for government to advocate for effective financial accountability to ensure that SACCOs attain sustainable financial performance.

The Mediating Role of Financial Accountability in the Relationship between Internal Control Environment and Financial Performance of Savings and Credit Cooperatives in Mid-Western Uganda

Purpose: This paper aimed at establish the mediating effect of financial accountability in the relationship between internal control environment and financial performance of savings and credit cooperatives (SACCOs). The purpose of this paper is to establish the mediating role of financial accountability in the association between internal control environment and financial performance.&#x0D; Methodology: A cross-sectional research design and positivist paradigm were used to collect data using a close-ended questionnaire. Also, a standard regression analysis, Medgraph program, and Baron and Kenny approach were adopted to test for the mediation effects. Based on the target population of 122 SACCOs, a sample of 93 SACCOs was selected using probability sampling technique.&#x0D; Findings: It is clearly revealed that the true drivers of financial performance in the SACCO sector are financial accountability and internal control environment. Nevertheless, financial accountability exhibits a partial form of mediation in the association between internal control environment and financial performance.&#x0D; Unique Contribution to Practice and Policy: In the event that financial accountability is established as a conduit in the relationship between internal control environment and financial performance, managers in the SACCO sector should work on reinforcing the agents of financial accountability (i.e., value for money and level of transparency) in an effort to enhance sustainable financial performance.

The correctness and completeness of documentation of parameters on the partographs used by midwives in primary healthcare facilities in midwestern Uganda: A retrospective descriptive study.

This study was conducted to determine the correctness and completeness of documentation of partographs. This was a retrospective descriptive study. We included 365 partographs of deliveries conducted from January 1st to October 31st 2019. Data were collected using a checklist and analysed descriptively. The study based on 13 partograph parameters. About 8-13 parameters were correctly documented in 71.5 % of the partographs. About 38.9%, 24.7%, 99.7%, 22.5% and 16 % of the partographs had no documentation of obstetric risk factors, foetal heart rate, colour of liquor, uterine contractions and cervical dilatation respectively. About 12.1% of the cervicographs crossed the action line and 61.4% of partographs where cervicographs crossed the action line had no documentation of action(s) taken.

How do youth innovate to make agriculture gainful? Challenges and youth entrepreneurs in mid-western Uganda

The global population is expected to increase to 9 billion by 2050, with the youth accounting for 14 per cent of this total. While the world's youth population is expected to grow, employment and entrepreneurial opportunities for youth, particularly those living in low and middle-income countries remain limited, poorly remunerated and of poor quality. The Ugandan population, in particular, is largely comprised of a high youthful population with 78 percent below the age of thirty. Evidence reveals that youth engagement in agriculture is declining, and in recognition of the agricultural sector's potential to serve as a source of livelihood opportunities, this study assesses the factors impeding youth engagement and the drivers of innovation among the youth engaged in agricultural enterprises in Mid-Western Uganda. Anchoring in the Agricultural Innovation System (AIS), cross-sectional survey and case study research designs were employed to establish the innovativeness of youth, and the factors impeding engagement in agricultural enterprises from the youth's perspective. A pairwise ranking of the factors was also independently done. The findings reveal that the significant factors restraining youth engagement in agricultural enterprises as enhancing soil productivity, access to relevant technical knowledge and information, and access to land for production. The major innovations for successful youth engagement in agriculture are irrigation to reduce risks of dependence on rain, mechanization to reduce labour struggle, and market linkages. The case studies' innovation index portrays a high potential of innovativeness of youth to revolutionize and make agriculture gainful and attractive to the youth. Int. J. Agril. Res. Innov. Tech. 12(1): 39-44, June 2022

Costs of treating childhood malaria, diarrhoea and pneumonia in rural Mozambique and Uganda

BackgroundGlobally, nearly half of all deaths among children under the age of 5 years can be attributed to malaria, diarrhoea, and pneumonia. A significant proportion of these deaths occur in sub-Saharan Africa. Despite several programmes implemented in sub-Saharan Africa, the burden of these illnesses remains persistently high. To mobilise resources for such programmes it is necessary to evaluate their costs, costs-effectiveness, and affordability. This study aimed to estimate the provider costs of treating malaria, diarrhoea, and pneumonia among children under the age of 5 years in routine settings at the health facility level in rural Uganda and Mozambique.MethodsService and cost data was collected from health facilities in midwestern Uganda and Inhambane province, Mozambique from private and public health facilities. Financial and economic costs of providing care for childhood illnesses were investigated from the provider perspective by combining a top-down and bottom-up approach to estimate unit costs and annual total costs for different types of visits for these illnesses. All costs were collected in Ugandan shillings and Mozambican meticais. Costs are presented in 2021 US dollars.ResultsIn Uganda, the highest number of outpatient visits were for children with uncomplicated malaria and of inpatient admissions were for respiratory infections, including pneumonia. The highest unit cost for outpatient visits was for pneumonia (and other respiratory infections) and ranged from $0.5 to 2.3, while the highest unit cost for inpatient admissions was for malaria ($19.6). In Mozambique, the highest numbers of outpatient and inpatient admissions visits were for malaria. The highest unit costs were for malaria too, ranging from $2.5 to 4.2 for outpatient visits and $3.8 for inpatient admissions. The greatest contributors to costs in both countries were drugs and diagnostics, followed by staff.ConclusionsThe findings highlighted the intensive resource use in the treatment of malaria and pneumonia for outpatient and inpatient cases, particularly at higher level health facilities. Timely treatment to prevent severe complications associated with these illnesses can also avoid high costs to health providers, and households.Trial registration: ClinicalTrials.gov, identifier: NCT01972321.

Patient experiences of sexual dysfunction after transition to dolutegravir-based HIV treatment in mid-Western Uganda: a qualitative study

BackgroundThe literature on dolutegravir (DTG)-based HIV treatment has focused on assessing therapeutic efficacy particularly with regard to viral load suppression. However, little empirical attention has been devoted to understanding the effects of DTG on quality of life, in particular sexual health and functioning in PLHIV. This study focused on understanding patient experiences of sexual dysfunction, after transition to DTG-based regimens in Rwenzori region in Mid-Western Uganda.MethodsWe adopted a qualitative exploratory research design. Between August and September 2021, we conducted sixteen in-depth interviews and six focus group discussions (48 participants) with patients reporting ‘new’ sexual dysfunction after transition to DTG-based regimens at seven health facilities in mid-Western Uganda. Data were analyzed by thematic approach.ResultsDecreased libido was reported in both sexes of patients within weeks of transition to DTG-based regimens. Diminished interest in sex was more frequently reported among women while men complained of a marked reduction in the frequency of sex. Women reported loss of psycho-social attraction to their long-term male partners. Erectile dysfunction was common among men in this sample of patients. Patients described their experiences of sexual dysfunction as an affront to their socially-constructed gender identities. Patients described tolerating sexual adverse drug reactions (ADRs) as a necessary tradeoff for the extension in life granted through antiretroviral therapy. A number of women reported that they had separated from their spouses as a result of perceived drug-induced sexual dysfunction. Marital strife and conflict arising from frustration with sexual-partner dysfunction was frequently reported by participants in both sexes. Several participants indicated experiencing insecurity in their heterosexual relationships due to difficulties in sexual functioning.ConclusionSexual dysfunction following transition to DTG-based regimens is common in both sexes of PLHIV, who indicated that they had no prior experience of difficulties in sexual health. Our findings demonstrate that sexual ADRs negatively impact self-esteem, overall quality of life and impair gender relations. DTG-related sexual health problems merit increased attention from HIV clinicians. Further research is warranted to assess the prevalence of DTG-associated sexual dysfunction in patients in Uganda.

Can the current youth agricultural groups be sustainable? Experiences from Mid-Western Uganda

Can the current youth agricultural groups be sustainable? Experiences from Mid-Western Uganda