Mpigi District Research Articles

Prevalence of postpartum complications and associated factors among postpartum women in Uganda, a cross-sectional study

BackgroundPostnatal care exhibits the lowest coverage levels in the obstetric continuum of care. The highest rates of maternal and newborn morbidity and mortality occur within 24 h of birth. Assessment of women in this time period could improve the detection of postpartum complications and maternal outcomes. This study determined the patterns of maternal assessment and the factors associated with postpartum complications.MethodsThis was a cross-sectional study involving observations of immediate postpartum care provided to women following uncomplicated vaginal births at three health facilities in Mpigi and Butambala districts (Uganda) from November 2020 to January 2021. Data were collected using an observation checklist and a data abstraction form for maternal and newborn social demographic data. The collected data were analyzed using Stata version 14.0. Maternal assessment patterns were summarized as frequencies, and the prevalence of postpartum complications was calculated. Logistic regression analysis was performed at both bivariate and multivariate levels to identify factors associated with developing postpartum complications among these women.ResultsWe observed 263 women receiving care at three health facilities in the immediate postpartum period. The level of maternal assessments was very low at 9/263 (3.4%), 29/263(11%) and 10(3.8%) within the first two hours, at three hours and at the fourth hour, respectively. The prevalence of postpartum complications was 37/263 (14.1%), with 67.6% experiencing postpartum hemorrhage (PPH), 13.5% having perineal tears, and 10.8% having cervical tears. Mothers who did not undergo a postpartum check in the first three hours (p = 0.001), those who were discharged after 24 h (p = 0.038), and those who were transferred to the postpartum ward after two hours (p = 0.001) were more likely to have developed postpartum complications.ConclusionThe maternal assessment patterns observed in the population were suboptimal. Women who were not assessed at the third hour and those transferred after two hours to the postnatal ward were more likely to have developed postpartum complications.

Practices of disease diagnosis and patient monitoring by traditional herbalists in Mpigi district, Uganda: Implications for integration into the conventional health care system

BackgroundThe use of herbs by traditional healers plays a vital role in primary health care in rural Uganda, where most patients still prefer and use herbal medicines. However, specific literature on the traditional healing practices of herbalists is lacking. This study documented the methods traditional herbalists in Mpigi District, Uganda, employ to diagnose disease, monitor patients and handle cases of treatment failure. Materials and methodsAn exploratory study was carried out from June to November 2019 in the rural district of Mpigi in Uganda. In-depth interviews were conducted with 20 herbalists. The interviews were audiotaped, transcribed verbatim, and themes were generated using qualitative content analysis. ResultsThe methods used to diagnose disease included; prior conventional diagnosis, the patient’s description of their experience with the disease condition (including signs, symptoms, and history of disease), physical examination for signs of disease, referral for conventional diagnosis, or to another herbalist, and use of conventional tools. Herbalists use phone calls, patients’ visits, and set review dates to monitor response to therapy. Patient monitoring during therapy emphasizes the improvement or resolution of signs and symptoms of disease and does not consider adverse drug reactions to therapy. Disease conditions that do not respond to therapy are referred to conventional health centres and other traditional health practitioners. ConclusionsDiagnosis of disease and monitoring of patients depends on presenting symptomatology as observed by the herbalist or described by the patient. There is considerable dependence on the conventional health system through referral for diagnosis and management of non-responsive conditions.

THE RELATIONSHIP BETWEEN ADVERTISING TEACHING VACANCIES AND STUDENTS' ACADEMIC PERFORMANCE IN MPIGI TOWN COUNCIL PRIVATE SECONDARY SCHOOLS IN MPIGI DISTRICT, UGANDA. A CROSS-SECTIONAL SURVEY

Background The study aimed to determine the relationship between advertising teaching vacancies and students' academic performance in Mpigi Town Council private secondary schools in Mpigi District, Uganda. Methodology A cross-sectional survey was conducted in Mpigi Town Council private secondary schools in Mpigi district, Uganda in Central Uganda along Kampala Masaka road. A population of 130 respondents that is 70 students, 50 teachers, 5 head teachers, and five directors of selected private secondary schools Results From the study findings, 60 (85.8 %) of the student respondents agreed at different levels qualified teachers get to know teaching opportunities from the adverts but 8 (11.4 %) respondents disagreed at different levels and 2 (2.9%) did not know. From the study findings, 53 (75.8 %) of respondents agreed at different levels that advertising helps the schools attract talented teachers who will enable students to perform well but 14 (20% %) respondents disagreed at different levels and 2 (2.9%) did not know. Conclusion The study concluded that advertising vacant teaching positions, lead to good academic performance in private schools if the recruitment process is strictly followed. It can be concluded that recruitment has a significant impact on students’ academic performance. Recommendation Effective teacher recruitment should align with the overall school culture and leadership style to create a cohesive educational community. The private schools and their teachers’ recruitment agencies should adopt some criteria during the recruitment of teachers in Uganda.

The certified sweet potato seed system evolution process: A case of Omoro and Mpigi districts in Uganda

Opportunities for Ugandan farmers to undertake the production of sweet potato have resulted in certified sweet potato seed (CSS) innovations being pursued in recent times. The CSS and farmer-saved vine sources co-exist with the latter still predominant despite the formers’ on-farm superior performance as regards yields, disease reduction and promotions. Information on the evolution process is missing, leading to ambiguous interpretations of its impact on uptake. This study described the evolution stages, emerging delivery structure and actor interactions during the CSS development process in Uganda. A case study design was employed, and data were collected through focus group discussions (FGDs) and key informant interviews (KIIs), and anchored into actor-network theory (ANT) to generate actor actions and interrelationships. Transcripts were analyzed using the thematic analysis approach by Braun and Clarke. Network analysis was done using UCINET6 V6.759 and a Network visualizer (Net Draw 2.179). Results depicted a six-stage evolution process with most actors having multiple roles, business actors involved at utilization stage only and each stage being triggered by an event. During the process, an integrated CSS system emerged with only 35.6% of the potential direct links between actors being present. The major central actors that had closer interactions with farmers and seed growers were largely public sector, with private sector coming in late. Actors were location-specific with those of Mpigi being many, more interactive (average degree of 7.8) compared to Omoro (average degree of 4.5), and high average path lengths (1.7) implying actors are remotely connected with farmers and vine multipliers being most influential. It is envisaged that the involvement of business actors in product innovation stages and imparting entrepreneurial skills to key farmer groups and vine multipliers will spur the CSS system. Future research into CSS systems should focus on building business ecosystems. Key words: Certified sweet potato seed, Evolution process, Delivery structure, Actor interactions

Farmers’ purchase intention and willingness to pay for certified sweetpotato seed under different disease pressure zones in Uganda

AbstractThe use of certified sweetpotato (Ipomoea batatas) seed (CSS) was reported to unlock the yield potential of the crop leading to an over 80% yield increase. Despite the availability of elements of a formal CSS system, uptake in Uganda has remained dismal. Interdependence between farmer knowledge, perceptions, and purchase behaviors (PBs) is not well understood in a way that could allow the design of meaningful policies and interventions. This study aimed at unveiling factors underlying PB through purchase intention (PI) and willingness to pay (WTP) by interviewing 289 farmers from Omoro and Mpigi districts in Uganda, representing the low and high virus disease pressure zones, respectively. A modified theory of planned behavior (TPB) incorporating awareness as independent and farmer innovativeness as mediating variables expounded the relationships. Data were collected on perceptions, knowledge, innovativeness, and PI using a five‐point Likert scale plus WTP as a price, subjected to descriptive and structural equation modeling analysis. Results indicated significant locational differences in most socioeconomic characteristics. Middle income, CSS information access, and farming experience of 7–30 years conferred more likelihood of high PI. Conversely, high PI, group membership, and being female and middle‐aged increased the likelihood of high WTP. The effects of attitude, perceived behavioral control, and awareness were significant in high disease zone, while subjective norm was significant across disease zones. PI significantly affects WTP in high disease zone (p = 0.000) but its effect is insignificant in low disease zone (p = 0.569). An interplay of socioeconomic, perception, and knowledge attributes influences CSS PB calling for social marketing strategies with location‐specific interventions.

Examining archives management practices and service delivery in Mpigi district local government in Uganda

Archives are the memory of an institution giving its employees an awareness of the true history and knowledge of their rights and obligations from past operations. Archives are important resources for local governments as vehicles of communication and interaction. When archives are poorly managed, local governments such as counties and cities will find it difficult to account for past operations, raising the challenge of effective record-keeping. Thus, through the use of a case study research design, this paper reports findings of a study that examined the practices involved in managing archives in Mpigi District Local Government (MDLG) in Uganda. Its population was comprised of MDLG staff, of whom 17 were purposively sampled. Data was collected through face-to-face interviews, observation and document analysis. Data was analysed using interpretative methods and aimed at understanding the respondents’ subjective experiences and their interpretation of the archives management practices around them. The study found that MDLG created and kept archives in both paper and digital formats but lacked an archives management policy; was hampered by an inadequate budgetary allocation to support archival activities; and suffered from a shortage of archivists to guide archives management practices. The study recommended the development of an archives policy to enable the district to manage the archives according to archives management practices; the recruitment of professional archivist personnel to improve the practices; the training of all district staff in handling archives as end users; and that the district to digitise the archives. This study builds on the knowledge of archives management practices in general, and in particular in MDLG.

Amelioration of Soil Acidity in Ferralsols of Central Uganda

Soil acidity is one of the major constraints limiting crop productivity in Central Uganda. Thus, the ideal soil pH for crop production ranges from 5.5 to 6.8, but in Central Uganda, crops are believed to be cultivated in soils with pH below these ranges. Given the adverse effects of soil acidity to agricultural production, appropriate measures such as the use of lime could be an option to improve the productive capacity. Henceforward, soils were sampled from farmers’ fields in Mpigi, Mubende and Wakiso Districts representing Central Uganda to evaluate rates of CaCO3 and corncob biochar in a greenhouse incubation study. Afterwards, 2 kg of soil was weighed, placed in a plastic container and thoroughly mixed with 0, 1, 3 and 5 g equivalent to 0, 1, 3 and 5 tons/ha CaCO3 and corncob biochar. Soils were arranged in a Complete Randomized Design (CRD) and moistened with 500 ml of water to bring it to about field capacity and pH determination done for a period of three (3) months until equilibration. The analysis of variance (ANOVA) showed significant effect (P<0.001) on soil pH when CaCO3 and corncob biochar were applied with the three districts recording a near neutral pH of 6.7.
 After pH equilibration in the greenhouse, rates of CaCO3 and corncob biochar that raised the soil pH in each medium were used to calculate the lime rates i.e., 0, 120, 360 and 600 g applied in the fields. In a Complete Randomized Design (CRD) consisting of four replications, soybean varieties were applied as the main plots while rates of CaCO3 and corncob biochar were applied as the sub plots. The analysis of variance (ANOVA) showed that CaCO3 had significant effect (p<0.001) on soil pH with Mpigi recording the highest soil pH (6.7) followed by Mubende (pH 6.6). Rates of CaCO3 and corncob biochar also showed significant effect (p<0.001) on soybean grain yield compared to 0 g CaCO3 and corncob biochar. Application of 600 g of corncob biochar showed significant effect (p<0.001) on soil pH in the different study locations. Besides, increased in CaCO3 rate to 600 g recorded the highest (7137.5 kg ha-1) soybean grain yield in Wakiso District while 600 g of corncob biochar recorded the highest (5637.5 kg ha-1) soybean grain yield in Mpigi District thus signifying the potential effect of CaCO3 and corncob biochar in Acid Ferralsols.

Linkages between Soil Acidity, Soil Plant Nutrients and Land Use on Ferralsols in Central Uganda

A study to examine the linkages between soil acidity, soil plant nutrients and land use on Ferralsols was carried out on smallholder farms in Central Uganda. The objective of the study was to assess the effect of soil pH on soil plant nutrient availability under the current land use. The study was carried out in Mpigi, Masaka, Wakiso, Mukono and Mubende districts representing Central Uganda. Soil samples were randomly collected from Coffee, Banana, soybean, common bean, maize and virgin fields in the five districts and the pH and plant nutrient analyzed accordingly. The analysis of variance (ANOVA) showed significant difference (p<0.01) on soil nitrogen, Calcium (p< 0.05) and Magnesium (p< 0.05). When treatment was assessed, the study showed significant difference (p< 0.01) on potassium. Besides, the study also showed high concentrations of Manganese (Mn) and Iron (Fe) in addition to very high sand and low silt and clay contents. The current land use for coffee production in Masaka district recorded the lowest soil pH (4.4) followed by annual fields (pH 4.60) in Mpigi. The highest soil pH (5.7) was recorded in banana fields in Mubende. The study also recorded very low to low N, P and K. Generally, the study observed rapid soil fertility decline in smallholder farms in the region.

Village health team-delivered oral HIV self-testing increases linkage-to-care and antiretroviral-therapy initiation among men in Uganda

ABSTRACT Targeted strategies are central to increasing HIV-status awareness and progress on the care cascade among men. We implemented Village-Health-Team (VHT)-delivered HIV self-testing (HIVST) among men in a peri-urban Ugandan district and assessed linkage to confirmatory-testing, antiretroviral-therapy (ART) initiation and HIV-status disclosure following HIVST. We conducted a prospective cohort study from November 2018 to June 2019 and enrolled 1628 men from 30-villages of Mpigi district. VHTs offered each participant one HIVST-kit and a linkage-to-care information leaflet. At baseline, we collected data on demographics, testing history and risk behavior. At one-month, we measured linkage to confirmatory-testing and HIV-status disclosure, and at three months ART-initiation if tested HIV-positive. We used Poisson regression generalized estimating equations to evaluate predictors of confirmatory-testing. We found that 19.8% had never tested for HIV and 43% had not tested in the last 12-months. After receiving HIVST-kits, 98.5% self-reported HIVST-uptake in 10-days, 78.8% obtained facility-based confirmation in 30-days of HIVST with 3.9% tested HIV-positive. Of the positives, 78.8% were newly diagnosed, 88% initiated ART and 57% disclosed their HIV-status to significant others. Confirmatory testing was associated with having a higher level of education and knowing a partner’s HIV-status. VHT-delivered HIVST may be effective for boosting testing, ART-initiation and HIV-status disclosure among men.

Uptake and perceptions of oral HIV self-testing delivered by village health teams among men in Central Uganda: A concurrent parallel mixed methods analysis.

The World Health Organization (WHO) recommends HIV self-testing (HIVST) to increase access to and utilization of HIV services among underserved populations. We assessed the uptake and perceptions of oral HIVST delivered by Village Health Teams (VHTs) among men in a peri-urban district in Central Uganda. We used a concurrent parallel mixed methods study design and analyzed data from 1628 men enrolled in a prospective cohort in Mpigi district, Central Uganda between October 2018 and June 2019. VHTs distributed HIVST kits and linkage-to-care information leaflets to participants in 30 study villages allowing up-to 10 days each to self-test. At baseline, we collected data on participant socio-demographics, testing history and risk behavior for HIV. During follow-up, we measured HIVST uptake (using self-reports and proof of a used kit) and conducted in-depth interviews to explore participants' perceptions of using HIVST. We used descriptive statistics to analyze the quantitative data and a hybrid inductive, and deductive thematic analysis for the qualitative data and integrated the results at interpretation. The median age of men was 28 years, HIVST uptake was 96% (1564/1628), HIV positivity yield was 4% (63/1564) and reported disclosure of HIVST results to sexual partners and significant others was 75.6% (1183/1564). Men perceived HIVST as a quick, flexible, convenient, and more private form of testing; allowing disclosure of HIV test results to sexual partners, friends and family, and receiving social support. Others perceived it as an opportunity for knowing or re-confirming their sero-status and subsequent linkage or re-linkage to care and prevention. Utilizing VHT networks for community-based delivery of HIVST is effective in reaching men with HIV testing services. Men perceived HIVST as highly beneficial but needed more training on performing the test and the integrating post-test counseling support to optimize use of the test for diagnosing HIV.

Access to provisioning services by local communities from Mpanga central forest reserve in central Uganda

IntroductionForest resources are an important source of products on which rural communities depend for survival. Mpanga Central Forest Reserve (CFR) is a valuable resource to adjacent communities through provision of different goods and serves for subsistence and income generation. It also serves as an important eco-tourist site. However, there is scanty information regarding the products obtained from Mpanga CFR and their contribution to livelihoods of adjacent communities.MethodsThe study explored the provisioning services obtained from the CFR, assessed the contribution of the CFR to the surrounding communities and explored the challenges faced while obtaining these services from the forest reserve. Provisioning services are the material benefits supplied by the ecosystem. A total of 118 respondents were randomly selected from 11 villages in Kamengo sub-county Mpigi District and interviewed using semi-structured questionnaires.Results and discussionThe residents obtained wild foods, medicinal herbs, fuelwood, construction and carving materials. Most of the respondents used obtained products for subsistence (51%) while the rest sold them. Regression analysis revealed that 76.5% of the variability in cash income from the CFR is significantly explained by age of respondents, period of stay and education level. Increase in age and educational level of respondents reduced ability to obtain cash income from the forest by (β = −0.19) and (β = −0.625), respectively but increase in period of stay acted in the reverse (β = 0.22). Despite the importance of provisioning services in improving the livelihood of communities adjacent the forest, some challenges in accessing the forest were reported. The quantities of some extracted species had declined over a 5-year period resulting in reduction of household income. This negatively impacts on the livelihoods of the young and uneducated that depend on forest activities for income generation. It is pertinent that alternative livelihood options are sought to address this trend. Also, forest management strategies should provide a win-win situation to forest managers and communities adjacent to the forest. This will not only preserve the forest resource but will also ensure a sustainable livelihood to forest dependent communities.

An Information System Model for Integrating Knowledge of Uganda Herbal Medicine

With health being a priority to all, knowledge on different varieties of herbal medicine is important. This study examines indigenous herbal medicine in Uganda to facilitate the development of a web-based information system model through which knowledge can shared. The research design involved an experimental approach to design and test the information system model and a descriptive qualitative design to collect qualitative data about herbal medicine and the diseases they cure. The study was conducted in the Buwama sub-county, Mpigi district, Uganda, where traditional medicine is widely used in primary health care. The target population was fifty (50) practicing traditional medicine trainees, and purposive sampling was used to select respondents. Data were collected through semi-structured interviews and reviewed existing documents about different kinds of herbal medicine. An architectural framework for the web-based information system model was designed using entity-relationship diagrams that represent data flows, inputs, and outputs of the system. The findings of this study show that integration of traditional medicine into modern healthcare systems in Uganda is possible and is appreciated by most health care practitioner. The developed information system model can contribute to improving the accessibility and use of indigenous herbal medicine, promoting their recognition and validation, and ensuring their safe and effective use. The study findings show that a web-based information system model is a promising approach to support the documentation, sharing, and management of indigenous herbal medicine in Uganda. Keywords: Herbal Medicine, System Model, Traditional Medicine, Indigenous Medicine, Web-Based System DOI: 10.7176/JHMN/108-02 Publication date: May 31 st 2023

Midwives’ perceptions towards the ministry of health guidelines for the provision of immediate postpartum care in rural health facilities in Uganda

BackgroundGuidelines for clinical practice have been part of the Ministry of health’s efforts to improve the quality of care for over two decades. Their benefits have been documented in Uganda. However, having practice guidelines may not always result in their use in care provision. We explored the midwives’ perceptions towards the ministry of health guidelines for providing immediate postpartum care.MethodsAn exploratory descriptive qualitative study was conducted in three districts in Uganda from September 2020 to January 2021. In-depth interviews with 50 midwives from 35 health centers and 2 hospitals in Mpigi, Butambala, and Gomba districts were done. Thematic analysis of data was done.ResultsThree themes emerged; awareness and use of the guidelines, perceived drivers, and perceived barriers to the provision of immediate postpartum care. The subthemes for theme I included; awareness of the guidelines, variations in the postpartum care practices, variations in preparedness to manage women with complications, and varied access to continuing midwifery education. Fear of complications and litigation were the perceived drivers of guideline use. On the other hand, lack of knowledge, busy maternity units, organization of the care, and the midwives’ perceptions about their clients were the barriers to guideline use. Midwives felt that new guidelines and policies regarding immediate postpartum care should be disseminated widely.ConclusionThe midwives felt that the guidelines were good for the prevention of postpartum complications but their knowledge of the guidelines for the provision of immediate postpartum care was suboptimal. They desired on-job training and mentorship to help them bridge the knowledge gaps. Variations in patient assessment, monitoring, and pre-discharge care were acknowledged and said to be due to a poor reading culture and health facility factors like patient-midwife ratios, unit setup, and prioritization of labor.

A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for Policy.

Depression is the fourth leading cause of the global disease burden and worsens the outcome of comorbidities including HIV/AIDS. Depression is particularly problematic among persons living with HIV in sub-Saharan Africa where scarcity of cost-effective interventions is compounded by inadequate understanding of the disease. We examine risk factors for depression among persons living with HIV undergoing antiretroviral treatment in Uganda and discuss policy implications. A qualitative study using a narrative approach was conducted, the formative phase of a large study to develop a model for integrating depression management into routine HIV care in Uganda. Participants were purposively sampled at four public health facilities in Mpigi District. In-depth interviews were conducted with four clinicians, three supervisors, and 11 persons living with HIV and suffering from depression, as were three focus group discussions with lay health workers. Exit interviews were conducted with 17 persons living with HIV who completed/interrupted depression treatment but had not been interviewed. Only data collected from persons living with HIV and lay health workers were analysed for the purpose of this paper. A narrative thematic approach was used in data analysis. Findings. There were several pathways through which lack of family social support reportedly led to depression: worries about disclosure in discordant relationships, false perceptions of social support, stigmatisation and discrimination, and domestic violence. Economic/poverty and other causes were identified, but their role was less significant or moderated by family social support. Family social support plays a dominant role-both directly and indirectly-in influencing depression risk. We propose the mainstreaming of formal psychosocial support and a shift from individual to family-focused counselling that targets both persons living with HIV and their family.

Diversity of Basidiomycetous Macrofungi from Mpanga Forest in Mpigi District, Central Uganda

The present study was conducted at Mpanga Research Forest located in Mpigi District, Uganda, during the months of March, April, May and Jun 2020 (for the first rainy season) then in September, October, November, and December 2020 (for the second rainy season) to determine the diversity and distribution of macrofungi as well as their influence by seasonality, and physicochemical properties of the soil. An inventory was carried out through plot sampling and survey which consists of installing three permanent plots of 30 m x 30 m in each of the four selected sites, the soil was also measured in the sample plots. To measure distribution and diversity, abundance, species richness, density, and Simpson's and Shannon's indices were calculated. SPSS version 20 software was used for the significance tests of the diversity parameters between the two rainy seasons and for those of the correlation between the soil factors and the abundance of macrofungi species. A total of 120 species of basidiomycetous macrofungi distributed in 53 genera and 22 families were recorded. The dominant genus was Psathyrella followed by Marasmius belonging to the most dominant families (Coprinaceae and Marasmiaceae), and the most dominant orders (Agaricales and Tricholomatales). During the two rainy seasons, the majority of the species that have been collected belong to the group of saprophytes. Macrofungi species collected during the second rainy season were more abundant and diverse than those collected during the first rainy season. Among the physicochemical properties of the soil, pH, calcium, potassium, nitrogen, organic carbon, phosphorus, clay, sand and organic matter were significantly correlated with the abundance of macrofungal species. The results of this study provided basic information on the diversity of macrofungi in Mpanga forest, it can be a point of reference for further research to study the evolution of macrofungal biodiversity in this forest.

Ethnomycological Study of Macrofungi from Mpanga Forest in Mpigi District, Central Uganda

This study focused on the documentation of wild macrofungi species used by village communities living around Mpanga Forest in Mpigi District, Central Uganda. In order to determine the variability of knowledge and the modes of use of macrofungi by the local communities, a total of 100 people, distributed in 4 villages (Kalagala, Nakigudde, Mpambire, and Lwanga) including 25 people in each, were interviewed following a semi-structured survey. The information focused on vernacular names, different species of macrofungi used, different categories of uses (food, medicinal, commercial, mythical, and traditional beliefs), Seasonality, habitat, preservation, and preparation methods. The diversity of macrofungi was assessed by combining visits in Mpanga forest and ethnomycological surveys. Ethnomycological indices such as Total Use Value (TUV), Diversity Index (DI), Pielou Regularity Index (EI), and Sorensen's K test were calculated to analyze the use differences between the 4 village communities. To determine the influence of age, gender and literacy level on the mycological knowledge held by village communities, one-way ANOVA and t-tests were used. The field collections associated with the ethnomycological surveys made it possible to identify a total of 35 species useful for the local communities among which, 29 are edible, 14 are medicinal, 5 are used for income and 4 are used for mythical and traditional beliefs. Due to their higher total use value (TUV>1), species such as Leucoagaricus rubrotinctus (Ggudu), Termitomyces sp.1 (Bubbala) and Termitomyces sp.2 (Nakyebowa) are the most exploited by local communities. The study revealed that ethnomycological knowledge is held by a minority of respondents (IE<0.5) within each village community, a consistency homogeneity of this knowledge within this minority (DI<DImax/2), but high variability in the use of macrofungi between village communities as indicated by TUV values ​​and Sorensen's K test. The study also shown that the distribution of mycological knowledge of local communities was significantly (P < 0.05) influenced by gender, age and level of education. The results of this study provided information that could, in the future, be used in the domestication of wild macrofungi species and in mycomedecine to contribute to food security and improve public health care.

Money, a Drain of Educational Opportunity: A Microregional Study of School Dropouts in Mpigi, Uganda

This paper sheds light on the causes of school dropouts, a major challenge facing UPE attainment in public primary schools of Uganda. We offer microregional analysis of school dropout patterns in the Mpigi district, and show a number of distinct patterns of school dropouts in Mpigi that can be differentiated from studies based on national data. While the Universal Primary Education program covered tuition fees, additional costs for education, such as meals, school transport, and uniforms, function as hurdles for longer school years. This is an obstacle regardless of parental awareness about education’s importance and how wealthy the parents think they are. Such findings directly conflict with existing knowledge that higher household income results in longer school years. The previous understanding of girl dropouts in Sub-Saharan Africa and its patriarchal context offer little explanations on the dropout pattern of Mpigi, as it is more related to the economic cost of education and the high demand for male agricultural labor. For a multicultural society such as Uganda, we highlight the importance of microlevel regional study in educational research.

Rethinking Human-Centredness and Eco-Sustainability in an African Setting: Insights from Luganda Folktales

ABSTRACT This article reflects on an alternative mode of anthropocentrism emergent from representations of human–nonhuman relations in a selection of Ganda folktales. In particular, it addresses some major claims against anthropocentrism: the failure to recognise the importance of holism; the overlooking of the intrinsic value of nonhuman elements; and the undue emphasis on the ontological divide between humans and other entities. The article is based on a descriptive qualitative study utilising data from folktales as repositories of both the ancient and experiential wisdom of the Baganda. It focuses on five carefully selected stories, recorded during live performances in Mpigi District of Uganda in 2019, on the theme of human–nonhuman relations. The article argues that while the Ganda folktales selected in this study would generally be considered as advancing anthropocentrism, they exhibit a commitment to environmental sustainability in ways that interrogate the anthropocentrism–ecocentrism dichotomy. Through a blend of thematic and structural narrative analysis of the folktales, the study reveals that a communitarian social setup could promote a balanced stance in human relations with the nonhuman. This study, thus, challenges the blanket disparagement of anthropocentrism in contemporary environmental scholarship.

POSC98 A Model to Evaluate the Cost-Effectiveness of a Highly-Sensitive Rapid Diagnostic Test for Malaria in a Community Setting in Uganda

Malaria remains a major cause of morbidity in Uganda, despite the presence of effective and low-cost interventions such as artemisinin-based combination therapy (ACT) and sulfadoxine/pyrimethamine (SP). This is largely attributed to the prevalence of asymptomatic low-density infections that often go undetected and hence untreated. A new generation of highly-sensitive rapid diagnostic tests (HS-RDTs) has been shown to detect asymptomatic low-density infections, offering a potential tool to help move Uganda towards Malaria elimination. A pragmatic literature review informed the conceptualisation and structuring of a cost-effectiveness model to evaluate use of the HS-RDT compared with conventional diagnostic tests (c-RDT) in three patient cohorts – febrile patients presenting at community health facilities, pregnant women attending ante-natal clinics, and asymptomatic household members of febrile children aged <5. A decision tree model will be used for the analysis to compare clinical (DALY) and cost outcomes, with patients entering the model at diagnosis stage. Clinical inputs, direct and indirect costs (including testing, treatment, disease management and mortality) are sourced from local publications. Prevalence, rapid diagnostic test (RDT) sensitivity and false positive rates will be based on data from a community based observational study in Mpigi District, Uganda. Results from the observational study and model outputs, will be used to test the hypothesis that the higher detection rate using HS-RDT translates into a larger number of asymptomatic malaria cases detected in all three patient cohorts, leading to clinical and cost benefits. Targeting and treating asymptomatic infections is also anticipated to help reduce the asymptomatic Malaria reservoir, thereby contributing towards the goal of Malaria elimination. One way sensitivity analysis will be conducted to test model sensitivity to key inputs. A limitation of this approach is that the model is not a dynamic transmission model and does not therefore model long-term consequences and seasonal effects.

Health system factors influencing traditional herbal medicine use during pregnancy amongst women in Mpigi District, Central Uganda.

An estimated 80% of the population in developing countries is dependent on traditional medicine for their health needs, including use during pregnancy despite limited knowledge of potential side effects including teratogenicity. Controlling use of traditional medicines during pregnancy requires understanding the driving factors. This study aimed at determining the health system factors that influence traditional herbal medicine use during pregnancy in a Ugandan setting. A cross-sectional study was conducted among 315 post-partum women obtained by random sampling from post-natal clinics of health facilities in Mpigi District after informed consent. We carried out concurrent triangulation by conducting two focused group discussions of 10 post-natal mothers each, and four Key informant interviews. Quantitative Data analysis involved descriptive statistics and logistic regression analysis. Qualitative data was analyzed by thematic content analysis and presented as narratives. Prevalence of herbal medicine use during pregnancy was 79% (95% Confidence Interval (CI) 68.1% - 86.9%), mainly consumed through oral route (96%). Costly health care adjusted Prevalence Ratio (aPR) 1.61 (95% CI 1.02-2.53), p-value 0.042, and presence and influence of Traditional Birth Attendants aPR 1.21(95% CI 1.05-1.41), p-value 0.011 were significantly associated with use of traditional herbal medicines during pregnancy. Use of traditional herbal medicines is driven by the high costs of quality health care and influence from Traditional Birth Attendants. Innovations in health financing should be promoted and Traditional Birth Attendants should be sensitized and incorporated in the mainstream health care system as community referral agents.