Policy In Uganda Research Articles

Environmental Systems and Local Actors: Decentralizing Environmental Policy in Uganda

In Uganda, environmental and natural resource management is decentralized and has been the responsibility of local districts since 1996. This environmental management arrangement was part of a broader decentralization process and was intended to increase local ownership and improve environmental policy; however, its implementation has encountered several major challenges over the last decade. This article reviews some of the key structural problems facing decentralized environmental policy in this central African country and examines these issues within the wider framework of political decentralization. Tensions have arisen between technical staff and politicians, between various levels of governance, and between environmental and other policy domains. This review offers a critical reflection on the perspectives and limitations of decentralized environmental governance in Uganda. Our conclusions focus on the need to balance administrative staff and local politicians, the mainstreaming of local environmental policy, and the role of international donors.

The politics of broadcasting, language policy and democracy in Uganda

This article examines the interweaving between socio-political history, broadcast policy and regulation, and political participation. Although the article primarily discusses the Ugandan situation, it draws conclusions that could be helpful in examining similar situations in Africa and in other parts of the world. The research was conducted in Uganda in three phases over three years (20032006) and additional research was conducted between 2007 and 2008.1 The first phase of the research constituted a socio-historical analysis of Uganda's media and politics. The second phase focused on the language debate in Uganda and the final phase sought to interpret the Ugandan language debate in light of the findings from the socio-historical analysis. The article is conceived within a critical media studies framework and the methodology is inspired by J.B. Thompson's (1990) depth hermeneutics. The study employed qualitative interviews and an analysis of media, communication and education policy documents and other archival sources to elicit information at various levels on indigenous language broadcasting policy in Uganda. Placing the debate on indigenous language policy in historical context made it possible to critically examine the relationship between language policy and political participation in Uganda. The article concludes that effective future policy and regulation must strike a balance between the priorities of government, media proprietors and audiences. It must also take cognizance of current commercial realities, while being sensitive to the socio-historical factors that determine attitudes towards the use of specific languages in the media.

Malaria misdiagnosis in Uganda – implications for policy change

BackgroundIn Uganda, like in many other countries traditionally viewed as harbouring very high malaria transmission, the norm has been to recommend that febrile episodes are diagnosed as malaria. In this study, the policy implications of such recommendations are revisited.MethodsA cross-sectional survey was undertaken at outpatient departments of all health facilities in four Ugandan districts. The routine diagnostic practices were assessed for all patients during exit interviews and a research slide was obtained for later reading. Primary outcome measures were the accuracy of national recommendations and routine malaria diagnosis in comparison with the study definition of malaria (any parasitaemia on expert slide examination in patient with fever) stratified by age and intensity of malaria transmission. Secondary outcome measures were the use, interpretation and accuracy of routine malaria microscopy.Results1,763 consultations undertaken by 233 health workers at 188 facilities were evaluated. The prevalence of malaria was 24.2% and ranged between 13.9% in patients ≥5 years in medium-to-high transmission areas to 50.5% for children <5 years in very high transmission areas. Overall, the sensitivity and negative predictive value (NPV) of routine malaria diagnosis were high (89.7% and 91.6% respectively) while the specificity and positive predictive value (PPV) were low (35.6% and 30.8% respectively). However, malaria was under-diagnosed in 39.9% of children less than five years of age in the very high transmission area. At 48 facilities with functional microscopy, the use of malaria slide examination was low (34.5%) without significant differences between age groups, or between patients for whom microscopy is recommended or not. 96.2% of patients with a routine positive slide result were treated for malaria but also 47.6% with a negative result.ConclusionCurrent recommendations and associated clinical practices result in massive laria over-diagnosis across all age groups and transmission areas in Uganda. Yet, under-diagnosis is also common in children <5 years. The potential benefits of malaria microscopy are not realized. To address malaria misdiagnosis, Uganda's policy shift from presumptive to parasitological diagnosis should encompass introduction of malaria rapid diagnostic tests and substantial strengthening of malaria microscopy.

Malaria case-management under artemether-lumefantrine treatment policy in Uganda

BackgroundCase-management with artemether-lumefantrine (AL) is one of the key strategies to control malaria in many African countries. Yet, the reports on translation of AL implementation activities into clinical practice are scarce. Here the quality of AL case-management is reported from Uganda; approximately one year after AL replaced combination of chloroquine and sulphadoxine-pyrimethamine (CQ+SP) as recommended first line treatment for uncomplicated malaria.MethodsA cross-sectional survey, using a range of quality of care assessment tools, was undertaken at all government and private-not-for-profit facilities in four Ugandan districts. Main outcome measures were AL prescribing, dispensing and counseling practices in comparison with national guidelines, and factors influencing health workers decision to 1) treat for malaria, and 2) prescribe AL.Results195 facilities, 232 health workers and 1,763 outpatient consultations were evaluated. Of 1,200 patients who needed treatment with AL according to guidelines, AL was prescribed for 60%, CQ+SP for 14%, quinine for 4%, CQ for 3%, other antimalarials for 3%, and 16% of patients had no antimalarial drug prescribed. AL was prescribed in the correct dose for 95% of patients. Only three out of seven AL counseling and dispensing tasks were performed for more than 50% of patients. Patients were more likely to be treated for malaria if they presented with main complaint of fever (OR = 5.22; 95% CI: 3.61–7.54) and if they were seen by supervised health workers (OR = 1.63; 95% CI: 1.06–2.50); however less likely if they were treated by more qualified health workers (OR = 0.61; 95% CI: 0.40–0.93) and presented with skin problem (OR = 0.29; 95% CI: 0.15–0.55). AL was more likely prescribed if the appropriate weight-specific AL pack was in stock (OR = 6.15; 95% CI: 3.43–11.05) and when CQ was absent (OR = 2.16; 95% CI: 1.09–4.28). Routine AL implementation activities were not associated with better performance.ConclusionAlthough the use of AL was predominant over non-recommended therapies, the quality of AL case-management at the point of care is not yet optimal. There is an urgent need for innovative quality improvement interventions, which should be rigorously tested. Adequate availability of ACTs at the point of care will, however, ultimately determine the success of any performance interventions and ACT policy transitions.

Transforming Microfinance Institutions: Providing Full Financial Services to the Poor

DOI: 10.1355/ae24-2g Transforming Microfinance Institutions: Providing Full Financial Services to the Poor. By Joanna Ledgerwood and Victoria White. Washington, D.C.: World Bank, 2006. Pp. 517. volume's fifteen chapters, written by the coauthors, each of whom is an experienced development professional, and six other highly qualified development scholars and practitioners begins with a statement and two related questions that are at the core of the study: The microfinance industry (MFI) has seen impressive growth for longer than a decade and yet still reaches only a small percentage of its potential market worldwide. How do we reach those still unbanked? What steps can we take to make microfinance available to more people and do so on a lasting basis and, as well, provide them with the financial services they need other than just credit? (p. xv). book's four parts combine to provide thoughtful responses to the questions posed by the co-authors. Part one examines the basic principles underlying the generation of savings and their mobilization into investments. examination is conducted from three analytical and policy perspectives: institutional, regulatory and macroeconomic. Part two delves further into issues associated with the regulatory and general institutional framework within which deposittaking (savings generation) takes place. third part focuses on transforming MFIs where, for the purposes of the book, transformation is defined as the process of a credit-focused MFI ... creating or becoming a regulated deposit-taking financial intermediary. An intermediary is an institution that mobilizes deposits and then on-lends these deposits to its borrowing (p. xxviii). fourth part contains two case studies summarizing Uganda's experience in developing laws, regulations and licensing agreements that oversee deposit-taking microfinance institutions. They (a) chronicle the development of Uganda's policies towards improving microfinance regulation and supervision; (b) review the key success factors upon which improvement is based; and (c) identify the remaining challenges that impede further improvement in the way that the country's microfinance sector functions. case studies are followed by an interesting and useful appendix that offers fifteen steps in the institutional processes of mobilizing savings and generating of investments. steps begin with studying savings demand to investing excess liquidity, and appropriate sequencing is crucial to achieving success in the process of deposit-taking and on-lending. Ugandan cases are interesting and useful, but for readers who focus their attention on Asia it would have been useful to supplement the volume by examining a case study closer to home. Examining the history, structure, and activities of the Vietnam Bank for Social Policies (VBSP) as an MFI, for example, would be an appropriate supplementary study. It was initially called Vietnam Bank for the Poor (VBP) when the government created it in January of 1996. VBP was designed to provide relief to poorer and underserved depositors and borrowers (who often had no choice but to borrow from local money lenders). result often was huge debts due to exorbitant interest rates because the poor could not obtain loans on a commercial basis from regular microfinance institutions. As an MFI, the Bank stepped in by operating more than 500 branches, mainly in rural areas, as well as 1,500 smaller outlets belonging to the country's Bank for Agriculture. Their deposit-taking and on-lending clients were mainly Vietnam's rural poor. When the VBSP came into being in 2003 it expanded upon its predecessor institution's focus by extending its activities to include providing preferential credit to poor households, poor students, rural and urban job-creating activities, needy migrant workers and both households and business ventures. VBSP has worked reasonably well but similar to virtually every MFI it continues to face the challenge of maintaining profit levels necessary to ensure survival. …

Intermittent preventive treatment of malaria in pregnancy: the effect of new delivery approaches on access and compliance rates in Uganda

To assess whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilizers can administer intermittent preventive treatment (IPT) with sulfadoxine-pyremethamine to pregnant women, and reach those most at risk of malaria and increase access and compliance to it. The study was designed to assess new approaches of delivering IPT through these groups and compare it with IPT at health units. The primary outcome measures were: the proportion of adolescents and primigravidae accessed; gestational age at recruitment and the proportion of women who completed two doses of sulfadoxine-pyremethamine. Two thousand seven hundred and eighty-five pregnant women (78% of those in the study area) participated. With new approaches, 92.4% of the women received IPT during the second trimester as recommended by the policy, vs. 76.1% at health units, P < 0.0001. Of the women who received two doses of sulfadoxine-pyremethamine, 39.9% were at health units (control) vs. 67.5% through new approaches (P < 0.0001). Women using the new approaches also accessed IPT early: the mean gestational age when receiving the first dose of sulfadoxine-pyremethamine was 21.0 weeks vs. 23.1 weeks at health units (P < 0.0001). However, the health units were used by a higher proportion of primigravidae (23.6% vs. 20.0%, P < 0.04), and this was also the case for adolescents (28.4% vs. 25.0%, P < 0.03). This intervention was acceptable with 89.1% of the women at the new approaches intending to use IPT in future. The new approaches increased access to and compliance with IPT. We recommend a review of the policy to allow the provision of IPT through the new approaches.

To Be or Not To Be: Urban Refugees in Kampala

In Uganda, refugee policy and programming is focused almost exclusively on providing protection and assistance to refugees residing in rural settlements. While international law allows refugees the right to freedom of movement and choice of residence, Ugandan legislation restricts refugees’ residency to rural settlements, subjecting those who wish to live outside of settlements and in urban centres to severe restrictions. This study sheds light on the reasons refugees choose to reside in Kampala as opposed to rural settlements and the challenges they endure while attempting to sustain and support themselves. Research findings indicate that at all stages of exile, refugees in Uganda are put under pressure, either implicitly or explicitly, to relocate to settlements. The lack of progressive thinking and hence over-reliance on settlements as the mainstay of refugee protection and assistance has hampered reforms of refugee policy and hindered the broader involvement of municipal authorities in responding to protection and assistance needs of refugees in urban areas. Research findings suggest that many refugees have talents, skills, and abilities which would enable self-sufficiency in Kampala and other urban areas. However, these capabilities are currently undermined by a refugee regime which only promotes self-reliance in rural settlements. In an effort to enhance refugees’ overall human security and to support their own efforts to become independent and self-reliant, this paper asserts that refugee policy in Uganda should be reformed to support refugees’ decisions to choose their own places of residence, instead of restricting them to rural settlements.

Impacts of the universal primary education policy on educational attainment and private costs in rural Uganda

While some governments in Sub-Saharan Africa have abolished tuition to achieve universal primary education (UPE), few studies have examined the impacts of the UPE policy beyond school enrolment. This study estimates the impact of the UPE policy in Uganda on overall primary education attainments by using data including 940 rural households. We find that UPE has decreased delayed enrolments and increased grade completion rates up to the fifth grade and its effects are especially large among girls in poor households. Yet, schools in Uganda still face further challenges in terms of low internal efficiency and the unequal quality of education.

Community referral in home management of malaria in western Uganda: A case series study

BackgroundHome Based Management of fever (HBM) was introduced as a national policy in Uganda to increase access to prompt presumptive treatment of malaria. Pre-packed Chloroquine/Fansidar combination is distributed free of charge to febrile children <5 years. Persisting fever or danger signs are referred to the health centre. We assessed overall referral rate, causes of referral, referral completion and reasons for non-completion under the HBM strategy.MethodsA case-series study was performed during 20 weeks in a West-Ugandan sub-county with an under-five population of 3,600. Community drug distributors (DDs) were visited fortnightly and recording forms collected. Referred children were located and primary caretaker interviewed in the household. Referral health facility records were studied for those stating having completed referral.ResultsOverall referral rate was 8% (117/1454). Fever was the main reason for mothers to seek DD care and for DDs to refer. Twenty-six of the 28 (93%) "urgent referrals" accessed referral care but 8 (31%) delayed >24 hours. Waiting for antimalarial drugs to finish caused most delays. Of 32 possible pneumonias only 16 (50%) were urgently referred; most delayed ≥ 2 days before accessing referral care.ConclusionThe HBM has high referral compliance and extends primary health care to the communities by maintaining linkages with formal health services. Referral non-completion was not a major issue but failure to recognise pneumonia symptoms and delays in referral care access for respiratory illnesses may pose hazards for children with acute respiratory infections. Extending HBM to also include pneumonia may increase prompt and effective care of the sick child in sub-Saharan Africa.

National ownership in the implementation of global climate policy in Uganda

This article explores the history, from a developing country perspective, of how external interventions to implement global policies on the Climate Convention and the Clean Development Mechanism (CDM) have been integrated into national development policy frameworks in the period 1990–2005. The main question asked is to what extent external interventions have formed part of a country-driven approach in Uganda. The conflicting national and global priorities concerning the need for adaptation to the impacts of climate change versus the need for global mitigation of greenhouse gases (GHGs) are explored first. Against this background, Uganda's policy response to climate change is reviewed. National climate policies are found not to exist, and the implementation of global policies is not integrated into national policy frameworks, partly due to conflicting national and global priorities. Given limited national awareness and the fact that climate policy is marginal compared to other national interests in Uganda, the experiences with donor support for the implementation of global climate policy nationally are analysed. This article demonstrates that neither national policies nor national management of donor support have secured a country-driven approach to external interventions in Uganda.

Dying for economic growth? Evidence of a flawed economic policy in Uganda

Uganda is now regarded as a success for having achieved remarkable economic progress. Nevertheless no substantial improvement in social welfare is apparent. The World Bank the International Monetary Fund and latter-day free-market converts including welfare-state donor countries and Uganda’s own finance ministry love to describe the country as an economic star but shy away from explaining in a convincing way why for such a brilliant economic performance the country has a miserable social-welfare situation as epitomised by persistently high maternal and infant mortality. The reason for this paradox is that the economic policy has succeeded specifically at the expense of social welfare. This policy extols export-oriented private-sector investment which is expected to lead to economic growth and increased household incomes. Better incomes are said to be the only way to ensure social welfare. But to create the necessary macroeconomic environment for investment and the private sector public expenditure particularly for social services must be highly restricted and any social-welfare targets such as the Millennium Development Goals that cannot be achieved within these constrained social spending limits must be abandoned. According to the government’s policy welfare should therefore be postponed until economic growth has reached some arbitrary optimum. (excerpt)

Uganda's policy reforms, industry competitiveness and regional integration: a comparison with Kenya

The paper reviews, first, Uganda's economic policies affecting the industrial sector and analyses the international competitiveness of Uganda's manufacturing industries, using a sample of 21 firms in 12 industries. It computes indices of comparative advantage, export and domestic competitiveness and compares the Ugandan indicators with those of Kenyan firms. It also identifies the main sources and obstacles to competitiveness using a decomposition method, which breaks the unit cost indices down into their main components. The study is timely as Uganda is re-establishing a free trade zone with Kenya and Tanzania, and also faces liberalized trade with the rest of the world. The numerical results of the study suggest that Ugandan firms, although not generally cost-competitive with Kenyan and other international firms, due to the country's land-locked geography and its de-industrialization under the preceding political regimes, have benefited from a recently established business-friendly environment and are more competitive in several industries than is generally assumed. This means that they may not be able to export internationally, but they are likely to hold their ground against Kenyan imports under regional free trade.

Pro‐poor politics and the new political economy of stabilisation

Pro‐poor politics and the new political economy of stabilisation

The private sector in rural water and sanitation services in Uganda: understanding the context and developing support strategies

AbstractThis article analyses private sector delivery of water and sanitation services in Uganda. Uganda's policies of decentralization and privatization, combined with enhanced sector funding through debt relief, provide the context for the work described. After a brief description of the attributes of small water sector enterprises, the findings of extensive interviews with all the major stakeholders in eight of Uganda's 56 districts are set out under eight thematic headings (corruption; community participation; role of NGOs; private sector support services; networks and associations; local Government procurement procedures; construction quality; business viability) and two sets of root causes. The paper concludes that a sector strategy requires a limited number of focus areas in order to avoid overwhelming the institutions and local ownership. The strategy should lie between the extremes of prescriptive and process oriented approaches. Monitoring mechanisms should balance quantitative with qualitative data. Finally, a balance is needed between the drive for short‐term impact through physical outputs and the long‐term sustainability of water and sanitation services so delivered. Copyright © 2003 John Wiley &amp; Sons, Ltd.

Increasing antimalarial drug resistance in Uganda and revision of the national drug policy.

Chloroquine (CQ) resistance was first documented in Uganda in 1988. Subsequent surveillance of antimalarial drug resistance, conducted by the Ugandan Ministry of Health and several research organizations, suggests that resistance to CQ is now widespread, reaching critical levels in many areas of the country. In June 2000, the Ministry of Health held a National Consensus Meeting to evaluate the available drug efficacy data and review the national antimalarial drug policy. After extensive debate, the combination of CQ + sulfadoxine-pyrimethamine (SP) was chosen to replace CQ as the first-line treatment of uncomplicated malaria as an interim policy. This review evaluates the in vivo drug efficacy studies conducted in Uganda since 1988 and issues confronted in revision of the drug policy. The Ugandan experience illustrates the challenges faced by sub-Saharan African countries confronted with rising CQ resistance but limited data on potential alternative options. The choice of CQ + SP as a provisional policy in the absence of prerequisite efficacy, safety and cost-effectiveness data reflects the urgency of the malaria treatment problem, and growing pressure to adopt combination therapies. Surveillance of CQ + SP treatment efficacy, collection of additional data on alternative regimens and active consensus building among key partners in the malaria community will be necessary to develop a rational long-term antimalarial treatment policy in Uganda.

How Research Can Assist Policy: The Case of Economic Reforms in Uganda

Research has had a powerful impact on policy in Uganda, affecting the climate of opinion, improving the quality of the policy debate, and helping focus public policy and intervention on poverty reduction. Uganda’s successful use of knowledge and research to help set public policy priorities demonstrates that even a poor post conflict country can, in a relatively short period of time, create an effective information base and feedback mechanisms for decision making.

Implementing Educational Policies in Uganda

Implementing Educational Policies in Uganda

Participation in Schooling: Determinants and Learning Outcomes in Nepal

This paper examines the determinants of adult cognitive competencies and of child school participation in the Terai region of Nepal. Data on three generations from 795 rural farm households were analyzed. The results of the analysis are: 1) First generation (grandparent) landholdings, literacy and caste status were significant determinants of second generation "innate ability" as measured by the "Ravens Progressive Matrices" (RPM) test. 2) RPM was a significant determinant of second generation schooling. 3) Second generation schooling was a significant determinant of second generation literacy, numeracy, reading comprehension and attitudinal modernity. 4) Attitudinal modernity was a significant determinant of attitude toward school for all households, but not for the subset of households in villages for which school availability data had been obtained. 5) In these latter villages, there was no relationship between school availability and a positive attitude toward school. 6) Third generation child school participation was determined jointly by second generation landholdings, caste, schooling and numeracy, and attitudinal modernity, and the child's sex. 7) Girls were significantly less likely to have completed at least one year of school than were boys. 8) The presence of small children in the household only slightly decreased girls' chances to participate in school. 9) School availability had no tffect on child school participation.

Colonial Economic Policy in Uganda after World War I: A Reassessment

Colonial Economic Policy in Uganda after World War I: A Reassessment

LANGUAGE POLICY IN UGANDA: AN INVESTIGATION INTO COSTS AND POLITICS

Journal Article LANGUAGE POLICY IN UGANDA: AN INVESTIGATION INTO COSTS AND POLITICS Get access APOLO NSIBAMBI APOLO NSIBAMBI Makerere University Search for other works by this author on: Oxford Academic Google Scholar African Affairs, Volume 70, Issue 278, January 1971, Pages 62–71, https://doi.org/10.1093/oxfordjournals.afraf.a096085 Published: 01 January 1971