Search results for: Kampala
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 29

Search results for: Kampala

29 Status of Production, Distribution and Determinants of Biomass Briquette Acceptability in Kampala, Uganda

Authors: David B. Kisakye, Paul Mugabi

Abstract:

Biomass briquettes have been identified as a plausible and close alternative to commonly used energy fuels such as charcoal and firewood, whose prices are escalating due to the dwindling natural resource base. However, briquettes do not seem to be as popular as would be expected. This study assessed the production, distribution, and acceptability of the briquettes in the Kampala district. A total of 60 respondents, 50 of whom were briquette users and 10 briquette producers, were sampled from five divisions of Kampala district to evaluate consumer acceptability, preference for briquette type and shape. Households and institutions were identified to be the major consumers of briquettes, while community-based organizations were the major distributors of briquettes. The Chi-square test of independence showed a significant association between briquette acceptability and briquette attributes of substitutability and low cost (p < 0,05). The Kruskal Wallis test showed that low-income class people preferred non-carbonized briquettes. Gender, marital status, and income level also cause variation in preference for spherical, stick, and honeycomb briquettes (p < 0,05). The major challenges faced by briquette users in Kampala were; production of a lot of ash, frequent crushing, and limited access to briquettes. The producers of briquettes were mainly challenged by regular machine breakdown, raw material scarcity, and poor carbonizing units. It was concluded that briquettes have a market and are generally accepted in Kampala. However, user preferences need to be taken into account by briquette produces, suitable cookstoves should be availed to users, and there is a need for standards to ensure the quality of briquettes.

Keywords: consumer acceptability, biomass residues, briquettes, briquette producers, distribution, fuel, marketability, wood fuel

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28 Conformance to Spatial Planning between the Kampala Physical Development Plan of 2012 and the Existing Land Use in 2021

Authors: Brendah Nagula, Omolo Fredrick Okalebo, Ronald Ssengendo, Ivan Bamweyana

Abstract:

The Kampala Physical Development Plan (KPDP) was developed in 2012 and projected both long term and short term developments within the City .The purpose of the plan was to not only shape the city into a spatially planned area but also to control the urban sprawl trends that had expanded with pronounced instances of informal settlements. This plan was approved by the National Physical Planning Board and a signature was appended by the Minister in 2013. Much as the KPDP plan has been implemented using different approaches such as detailed planning, development control, subdivision planning, carrying out construction inspections, greening and beautification, there is still limited knowledge on the level of conformance towards this plan. Therefore, it is yet to be determined whether it has been effective in shaping the City into an ideal spatially planned area. Attaining a clear picture of the level of conformance towards the KPDP 2012 through evaluation between the planned and the existing land use in Kampala City was performed. Methods such as Supervised Classification and Post Classification Change Detection were adopted to perform this evaluation. Scrutiny of findings revealed Central Division registered the lowest level of conformance to the planning standards specified in the KPDP 2012 followed by Nakawa, Rubaga, Kawempe, and Makindye. Furthermore, mixed-use development was identified as the land use with the highest level of non-conformity of 25.11% and institutional land use registered the highest level of conformance of 84.45 %. The results show that the aspect of location was not carefully considered while allocating uses in the KPDP whereby areas located near the Central Business District have higher land rents and hence require uses that ensure profit maximization. Also, the prominence of development towards mixed-use denotes an increased demand for land towards compact development that was not catered for in the plan. Therefore in order to transform Kampala city into a spatially planned area, there is need to carefully develop detailed plans especially for all the Central Division planning precincts indicating considerations for land use densification.

Keywords: spatial plan, post classification change detection, Kampala city, landuse

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27 Energy Scenarios for Greater Kampala Metropolitan Area towards a Sustainable 2050: A TIMES-VEDA Analysis

Authors: Kimuli Ismail, Michael Lubwama, John Baptist Kirabira, Adam Sebbit

Abstract:

This study develops 4 energy scenarios for Greater Kampala Metropolitan Area (GKMA). GKMA is Uganda’s capital with a population of 4.1million and a GDP growth rate of 5.8 with a nonsustainable energy management system. The study uses TIMES-VEDA to examine the energy impacts of business as usual (BAU), Kabejja, Carbon-Tax, and Lutta scenarios in commercial, industrial, transportation, residential, agricultural, and electricity generation activities. BAU is the baseline scenario with limited CO2 emissions restrictions against which Kabejja with 20% CO2 emissions restriction, a carbon tax of $100/ton imposed in 2050 for Carbon-Tax scenario, and Lutta with 95% CO2 emissions restriction is made. The analysis suggests that if the current policy trends continue as BAU, consumption would increase from 139.6PJ to 497.42PJ and CO2 emissions will increase from 4.6mtns to 7mtns. However, consumption would decrease by 2.3% in Kabejja, 3.4% in Carbon-Tax, and 3.3 % in Lutta compared to BAU. The CO2 emissions would decrease by 8.57% in Kabejja, 55.14% in Carbon-Tax, and 60% in Lutta compared to BAU. Sustainability is achievable when low-carbon electricity is increased by 53.68% in the EMS, and setting up an electrified Kampala metro. The study recommends Lutta as the sustainable pathway to a lowcarbon 2050.

Keywords: Sustainability, Scenario Plannnig, Times-Veda Modelling, Energy Policy Development

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26 A Sustainable Energy Portfolio for Greater Kampala Metropolitan Area by the Mid-Century

Authors: Ismail Kimuli

Abstract:

With a steadfast economic development, the Greater Kampala metropolitan area (GKMA) faces increasing pressures to increasetheshare of low-carbon electricity in the energy balance, abate CO2 emissions and also restructure the transportation sector for a sustainable 2050. GKMA, is Uganda’s commercial, political, social, and industrial hub with a population of 4.1 million, contributing 60% tothe nation’s GDP and accounts for 80% of Uganda’s industrial sector.However, with the rampant anthropogenic interference that causes climate change, CO2 emissions in the metropolitan are contributing to global warming. Many economies across the globe are addressing this challengethrough development and analysis of sustainable energy portfolios.A sustainable energy portfolio is a low-carbon scenario. The study reviews the literature to establish the current energy management situation of GKMA and finds it wanting in addressing the immediate challenges associated with energy management of the metropolitan. Then, the study develops and examines a sustainable energy portfolio for GKMA using TIMES-VEDA and then presents it as an investigative low-carbon energy scenario that could propel the metropolitan sustainably towards 2050.Sustainability is plausible by optimizing the total primary energy supply, generating low-carbon electricity from hydropower and PV-solar renewables, improving heating technologies for residential & commercial sectors, and switching 90% of land passengers from road to a Kampala metro for a sustainable mid-century.

Keywords: GKMA, sustainability, TIMES-VEDA, low-carbon scenario

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25 Non-Autonomous Seasonal Variation Model for Vector-Borne Disease Transferral in Kampala of Uganda

Authors: Benjamin Aina Peter, Amos Wale Ogunsola

Abstract:

In this paper, a mathematical model of malaria transmission was presented with the effect of seasonal shift, due to global fluctuation in temperature, on the increase of conveyor of the infectious disease, which probably alters the region transmission potential of malaria. A deterministic compartmental model was proposed and analyzed qualitatively. Both qualitative and quantitative approaches of the model were considered. The next-generation matrix is employed to determine the basic reproduction number of the model. Equilibrium points of the model were determined and analyzed. The numerical simulation is carried out using Excel Micro Software to validate and support the qualitative results. From the analysis of the result, the optimal temperature for the transmission of malaria is between and . The result also shows that an increase in temperature due to seasonal shift gives rise to the development of parasites which consequently leads to an increase in the widespread of malaria transmission in Kampala. It is also seen from the results that an increase in temperature leads to an increase in the number of infectious human hosts and mosquitoes.

Keywords: seasonal variation, indoor residual spray, efficacy of spray, temperature-dependent model

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24 Temporal Delays along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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23 A Pathway to Financial Inclusion: Mobile Money and Individual Savings in Uganda

Authors: Musa Mayanja Lwanga, Annet Adong

Abstract:

This study provides a micro perspective on the impact of mobile money services on individual’s saving behavior using the 2013 Uganda FinScope data. Results show that although saving through the mobile phone is not a common practice in Uganda, being a registered mobile money user increases the likelihood to save with mobile money. Saving using mobile is more prevalent in urban areas and in Kampala and Central region compared to other regions. This can be explained by: first, rural dwellers tend on average to have lower incomes and thus have lower to saving compared to the urban counterpart. Similarly, residents of Kampala tend to have higher incomes and thus high savings compared to residents of other regions. Secondly, poor infrastructure in rural areas in terms of lack of electricity and poor telecommunication network coverage may limit the use of mobile phones and consequently the use of mobile money as a saving mechanism. Overall, the use of mobile money as a saving mechanism is still very low and this could be partly explained by limitations in the legislation that does not incorporate mobile finance services into mobile money. The absence of interest payments on mobile money savings may act as a disincentive to save through this mechanism. Given the emerging mobile banking services, there is a need to create more awareness and the need for enhanced synergies between telecom companies and commercial banks.

Keywords: financial inclusion, mobile money, savings, Uganda

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22 Traumatic Brain Injury Neurosurgical Care Continuum Delays in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury

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21 Risk Mapping of Road Traffic Incidents in Greater Kampala Metropolitan Area for Planning of Emergency Medical Services

Authors: Joseph Kimuli Balikuddembe

Abstract:

Road traffic incidents (RTIs) continue to be a serious public health and development burden around the globe. Compared to high-income countries (HICs), the low and middle-income countries (LMICs) bear the heaviest brunt of RTIs. Like other LMICs, Uganda, a country located in Eastern Africa, has been experiencing a worryingly high burden of RTIs and their associated impacts. Over the years, the highest number of all the total registered RTIs in Uganda has taken place in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected. In this regard, the overall objective of the study was to risk map RTIs in the GKMA so as to help in the better planning of EMS for the victims of RTIs. Other objectives included: (i) identifying the factors affecting the exposure, vulnerability and EMS capacity for the victims of RTIs; (ii) identifying the RTI prone-areas and estimating their associated risk factors; (iii) identifying the weaknesses and capacities which affect the EMS systems for RTIs; and (iv) determining the strategies and priority actions that can help to improve the EMS response for RTI victims in the GKMA. To achieve these objectives, a mixed methodological approach was used in four phrases for approximately 15 months. It employed a systematic review based on the preferred reporting items for systematic reviews and meta-data analysis guidelines; a Delphi panel technique; retrospective data analysis; and a cross-sectional method. With Uganda progressing forward as envisaged in its 'Vision 2040', the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth, urbanization, infrastructure development, rapid motorization and other factors. Unless appropriate actions are taken, these changes are likely to worsen the already alarming rate of RTIs in Uganda, and in turn also to put pressure on the few existing EMS and facilities to render care for those affected. Therefore, road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that contribute to RTIs, particularly in the GKMA and Uganda as a whole.

Keywords: emergency medical services, Kampala, risk mapping, road traffic incidents

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20 The Risk of Hyperglycemia Associated with Use of Dolutegravir among Adults Living with HIV in Kampala, Uganda: A Case Control Study

Authors: Daphine Namara, Jeremy I. Schwartz, Andrew K. Tusubira, Willi McFarland, Caroline Birungi, Fred C. Semitala, Martin Muddu

Abstract:

Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is a need for rigorous studies to validate this association in the face of increasing DTG use and the burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case-control study to assess the risk of hyperglycemia associated with the use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia, while controls had no hyperglycemia, as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. The analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis, patients with prior DTG use had seven times greater odds of subsequent diagnosis of hyperglycemia compared to those who had non-DTG-based regimens (adjusted odds ratio [aOR] 7.01, 95% CI 1.96-25.09). The odds of hyperglycemia also increased with age (56 years and above vs. 18-35, aOR 12.38, 95% CI 3.79-40.50) and hypertension (aOR 5.78, 95% CI 2.53-13.21). Our study demonstrates a strong association between prior DTG exposure and subsequent diagnosis of hyperglycemia. Given the benefits of DTG, wide-scale use, and the growing burden of diabetes mellitus (DM) in SSA, there is a need for systematic screening for hyperglycemia and consideration of alternate regimens for those at risk for DM.

Keywords: HIV, hyperglycemia, doluteravir, diabetes

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19 Effect of Project Control Practices on the Performance of Building Construction Companies in Uganda: A Case Study of Kampala City

Authors: Tukundane Hillary

Abstract:

This research paper analytically evaluates the project control practice levels used by the building construction companies within Kampala, Uganda. The research also assesses the outcome of project control practices on the productivity of the companies. The research was performed to ascertain the current control practices among 160 respondents from various construction companies registered with the Uganda Registration Services Bureau. This research used amalgamation from multiple literature to obtain the variables. The research adopts 34 standard control practices from four vital project control duties: planning, monitoring, analyzing, and reporting. These project control tasks were organized using mean response ratings grounded on their relevance to the construction companies. Results showed that evaluating performance with the use of curves (4.32), timely access to information and encouragement (4.55), report representation using quantitative tools 4.75, and cost value comparison application during analysis (4.76) were rated least among the control practices. On the other hand, the top project control practices included formulation of the project schedule (8.88), Project feasibility validation (8.86), Budgeting for each activity (8.84), Key project route definition (8.81), Team awareness of the budget (8.77), Setting realistic targets for projects (8.50) and Consultation from subcontractors (8.74). From the results obtained by the sample respondents specified, it can be concluded that planning is the most vital project control task practiced in the building construction industry in Uganda. In addition, this research ascertained a substantial relationship between project control practices and the performance of building construction companies. Accordingly, this research recommends that project control practices be effectively observed by both contracting and consulting companies to enhance their overall performance and governance.

Keywords: cost value, project control, cost control, time control, project performance, control practices

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18 Human Resource Management Functions; Employee Performance; Professional Health Workers In Public District Hospitals

Authors: Benjamin Mugisha Bugingo

Abstract:

Healthcare staffhas been considered as asignificant pillar to the health care system. However, the contest of human resources for health in terms of the turnover of health workers in Uganda has been more distinct in the latest years. The objective of the paper, therefore, were to investigate the influence Role Human resource management functions in on employeeperformance of professional health workers in public district hospitals in Kampala. The study objectives were: to establish the effect of performance management function, financialincentives, non-financial incentives, participation, and involvement in the decision-making on the employee performance of professional health workers in public district hospitals in Kampala. The study was devised in the social exchange theory and the equity theory. This study adopted a descriptive research design using quantitative approaches. The study used a cross-sectional research design with a mixed-methods approach. With a population of 402 individuals, the study considered a sample of 252 respondents, including doctors, nurses, midwives, pharmacists, and dentists from 3 district hospitals. The study instruments entailed a questionnaire as a quantitative data collection tool and interviews and focus group discussions as qualitative data gathering tools. To analyze quantitative data, descriptive statistics were used to assess the perceived status of Human resource management functions and the magnitude of intentions to stay, and inferential statistics were used to show the effect of predictors on the outcome variable by plotting a multiple linear regression. Qualitative data were analyzed in themes and reported in narrative and verbatim quotes and were used to complement descriptive findings for a better understanding of the magnitude of the study variables. The findings of this study showed a significant and positive effect of performance management function, financialincentives, non-financial incentives, and participation and involvement in decision-making on employee performance of professional health workers in public district hospitals in Kampala. This study is expected to be a major contributor for the improvement of the health system in the country and other similar settings as it has provided the insights for strategic orientation in the area of human resources for health, especially for enhanced employee performance in relation with the integrated human resource management approach

Keywords: human resource functions, employee performance, employee wellness, profecial workers

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17 Uptake of Cervical Cancer Screening Services and Associated Factors at KISWA HCII, Kampala, Uganda

Authors: Mary Kiviiri Nakawuka, Mary Namugalu, Andrew Otiti

Abstract:

BACKGROUND Cervical cancer is the fourth most common cancer in women and seventh overall among all cancers worldwide. It accounts for about 7.5% of all female-cancer deaths with 85% occurring in low and middle-income countries and the first most common female cancer in women aged 15 to 44 years in Uganda with an annual number of new cases at 3,915 and 2,275 annual number of cervical cancer deaths in 2012 (ICO INFORMATION CENTRE ON HPV AND CANCER, 2017).Despite the available free cervical cancer screening services whose uptake has been documented to improve the chances of successful treatment of pre-cancers and cancers among women of reproductive age, there is a low uptake of these services thus we sought to examine the uptake of cervical cancer services and associated factors among women of reproductive age (25-49) attending the ART clinic of KISWA HCII in Kampala, Uganda METHODS The research was carried out in the ART clinic of KISWA HCII among 385 participants. An analytical, cross-sectional study with quantitative methods of data collection was used. The study adopted a non-probability convenience sampling method to select participants. Quantitative data was collected through structured questionnaires. RESULTS 72.2% of the participants were found to have been screened for cervical cancer. 36 % of the screened women had a positive HPV or VIA result ,59.2% of the screened women had a negative HPV or VIA result and 4.8% had an invalid HPV test result. Only 39.5% of the participants had adequate overall knowledge about cervical cancer, more than a third of the participants (50%) had moderate or low knowledge and minority of them (10.5%) had no knowledge. There was no significant association between the uptake of cervical cancer screening services among participants and their socio-demographic characteristics. CONCLUSIONS Although majority of the women surveyed had been screened for cervical cancer, a comparatively large number of participants had inadequate knowledge about cervical cancer and therefore there is still need to continue teaching about cervical cancer and this may include education campaigns, improvements to the accessibility and convenience of the screening services.

Keywords: cervical cancer uptake, cervical cancer screening, women of reproductive age., cervical cancer knowledge

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16 The Causes and Effects of Poor Household Sanitation: Case Study of Kansanga Parish

Authors: Rosine Angelique Uwacu

Abstract:

Poor household sanitation is rife in Uganda, especially in Kampala. This study was carried out with he goal of establishing the main causes and effects of poor household sanitation in Kansanga parish. The study objectively sought to: To identify various ways through which wastes are generated and disposed of in Kansanga parish, identify different hygiene procedures/behaviors of waste handling in Kansanga parish and assess health effects of poor household sanitation and suggest the recommended appropriate measures of addressing cases of lack of hygiene in Kansanga parish. The study used a survey method where cluster sampling was employed. This is because there is no register of population or sufficient information, or geographic distribution of individuals is widely scattered. Data was collected through the use of interviews accompanied by observation and questionnaires. The study involved a sample of 100 households. The study revealed that; some households use wheeled bin collection, skip hire and roll on/off contained others take their wastes to refuse collection vehicles. Surprisingly, majority of the households submitted that they use polythene bags 'Kavera' and at times plastic sacs to dispose of their wastes which are dumped in drainage patterns or dustbins and other illegal dumping site. The study showed that washing hands with small jerrycans after using the toilet was being adopted by most households as there were no or few other alternatives. The study revealed that the common health effects that come as a result of poor household sanitation in Kansanga Parish are diseases outbreaks such as malaria, typhoid and diarrhea. Finally, the study gave a number of recommendations or suggestions on maintaining and achieving an adequate household sanitation in Kansanga Parish such as sensitization of community members by their leaders like Local Counselors could help to improve the situation, establishment of community sanitation days for people to collectively and voluntarily carry out good sanitation practices like digging trenches, burning garbage and proper waste management and disposal. Authorities like Kampala Capital City Authority should distribute dumping containers or allocate dumping sites where people can dispose of their wastes preferably at a minimum cost for proper management.

Keywords: household sanitation, kansanga parish, Uganda, waste

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15 Dynamics of Bacterial Contamination and Oral Health Risks Associated with Currency Notes and Coins Circulating in Kampala City

Authors: Abdul Walusansa

Abstract:

In this paper, paper notes and coins were collected from general public in Kampala City where ready-to-eat food can be served, in order to survey for bacterial contamination. The total bacterial number and potentially pathogenic organisms loading on currency were tested. All isolated potential pathogens were also tested for antibiotic resistance against four most commonly prescribed antibiotics. 1. The bacterial counts on one hundred paper notes sample were ranging between 6~10918/cm cm-2,the median was 141/ cm-2, according to the data it was much higher than credit cards and Australian notes which were made of polymer. The bacterial counts on sixty coin samples were ranging between 2~380/cm-2, much less than paper notes. 2. Coliform (65.6%), E. coli (45.9%), S. aureus (41.7%), B. cereus (67.7%), Salmonella (19.8%) were isolated on one hundred paper notes. Coliform (22.4%), E. coli (5.2%), S. aureus (24.1%), B. cereus (34.5%), Salmonella (10.3%) were isolated from sixty coin samples. These results suggested a high rate of potential pathogens contamination of paper notes than coins. 3. Antibiotic resistances are commonly in most of the pathogens isolated on currency. Ampicillin resistance was found in 60%of Staphylococcus aureus isolated on currency, as well as 76.6% of E. coil and 40% of Salmonella. Erythromycin resistance was detected in 56.6% of S. aureus and in 80.0% of E. coli. All the pathogens isolated were sensitive to Norfloxacin, Salmonella and S. aureus also sensitive to Cefaclor. In this paper, we also studied the antimicrobial capability of metal coins, coins collected from different countries were tested for the ability to inhibit the growth of E. sakazakii, S. aureus, E. coli, L. monocytogenes and S. typhimurium. 1) E. sakazakii appeared very sensitive to metal coins, the second is S. aureus, but E. coli, L. monocytogenes and S. typhimurium are more resistant to these metal coin samples. 2) Coins made of Nickel-brass alloy and Copper-nickel alloy showed a better effect in anti-microbe than other metal coins, especially the ability to inhibited the growth of E. sakazakii and S. aureus, all the inhibition zones produced on nutrient agar are more than 20.6 mm. Aluminium-bronze alloy revealed weak anti-microbe activity to S. aureus and no effect to kill other pathogens. Coins made of stainless steel also can’t resist bacteria growth. 3) Surprisingly, one cent coins of USA which were made of 97.5% Zinc and 2.5% Cu showed a significant antimicrobial capability, the average inhibition zone of these five pathogens is 45.5 mm.

Keywords: antibiotic sensitivity, bacteria, currency, coins, parasites

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14 Improving Sanitation and Hygiene Using a Behavioral Change Approach in Public and Private Schools in Kampala, Uganda

Authors: G. Senoga, D. Nakimuli, B. Ndagire, B. Lukwago, D. Kyamagwa

Abstract:

Background: The COVID-19 epidemic affected the education sector, with some private schools closing while other children missed schooling for fear contracting COVID-19. Post COVID-19, PSIU in collaborated with Kampala City Council Authority Directorate of Education and Social Science, Water and Sanitation department, and Directorate of Public Health and Environment to improve sanitation and hygiene among pupils and staff in 50 public and private school system in Kampala city. The “Be Clean, Stay Healthy Campaign” used a behavioral change approach in educating, reinforcing and engaging learners on proper hand washing behaviors, proper toilet usage and garbage disposal. In April 2022, 40 Washa lots were constructed, to reduce the pupil - hand wash station ratio; distributed KCCA approved printed materials; oriented 50 teachers, WASH committees to execute and implement hygiene promotion. To ensure sustainability, WASH messages were memorized and practiced through hand washing songs, Pledge, prayer, Poems, Skits, Music, dance and drama, coupled with participatory, practical demonstrations using peer to peer approach, guest speakers at assemblies and in classes. This improved hygiene and sanitation practices. Premised on this, PSI conducted an end line assessment to explore the impact of a hand washing campaign in regards to improvements in hand washing practices and hand hygiene among pupils, accessibility, functionality and usage of the constructed hygiene and sanitation facilities. Method: A cross-sectional post intervention assessment using a mixed methods approach, targeting headteachers, wash committee members and pupils less <17 years was used. Quantitative approaches with a mix of open-ended questions were used in purposively selected respondents in 50 schools. Primary three to primary seven pupils were randomly selected, data was analyzed using the Statistical Package for Social Scientists (SPSS) Outcomes and Findings: 46,989 pupils (51% female), 1,127 and 524 teaching and non-teaching staff were reached by the intervention, respectively. 96% of schools trained on sanitation, sustainable water usage and hygiene constituted 17-man school WASH committees with teacher, parents and pupils representatives. (31%) of the WASH committees developed workplans, (78%) held WASH meetings monthly. This resulted into improved sanitation, water usage, waste management, proper use of toilets, and improved pupils’ health with reduced occurrences of stomach upsets, diarrhoea initially attributed to improper use of latrines and general waste management. Teachers reported reduced number of school absenteeism due to improved hygiene and general waste management at school, especially proper management of sanitary pads. School administrations response rate in purchase of hygiene equipment’s and detergents like soap improved. Regular WASH meetings in classes, teachers and community supervision ensured WASH facilities are used appropriately. Conclusion and Recommendations: Practical behaviour change innovations improves pupil’s knowledge and understanding of hygiene messages and usage. Over 70% of pupils had clear recall of key WASH Messages. There is need for continuous water flow in the Washa lots, harvesting rain water would reduce water bills while complementing National water supply coupled with increasing on Washa lots in densely populated schools.

Keywords: handwashing, hygyiene, sanitation, behaviour change

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13 Loud Silence: A Situation Analysis of Youth Living with Hearing Impairment in Uganda

Authors: Wandera Stephen Ojumbo

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People living with hearing impairment in Uganda are one of the most excluded minority groups in the country. The Uganda National Association of the Deaf estimates that deaf people make up 3.4% of Uganda’s 43 million people. Deaf Children and youth often appear withdrawn because they face social stigma. In 2009, photojournalist Stephen Wandera Ojumbo conducted an exhibition in Kampala titled “Silent Voices with colourful Hearts” showcasing the life of deaf children at Uganda School for the Deaf, Ntinda, in order to create awareness of their plight, raising funds for the construction of a vocational centre for the deaf that didn’t continue their education due to: lack of funds, non-inclusive educational institutions, and for those who cannot read and write. These children, whose lives were exhibited in 2009, are currently youths. In Uganda, there are just five primary schools for the deaf (three of these are located in Kampala, the capital city), and barely five secondary schools for the deaf. At the moment, some deaf children only receive special needs training equivalent to primary seven levels and the majority don’t make it to secondary school education level due to the fact that English is a second language to them. There is a communication gap between speaking parents and deaf children, which leads to the breakage of family bonds. The deaf youth run away from their homes to form a community where they can communicate freely. Likewise, employment opportunities for the deaf are equally very limited. It’s for this reason that a follow-up photo exhibition was conducted to expose more about what the youthful deaf people and their guardians go through in Uganda to get jobs, live and fit in the community, how they communicate and get understood, bonding with families instead of running away to bond with fellow deaf persons. The photo exhibition under the theme “Loud Silence” was significant in showcasing the ability of deaf youths in Uganda and eliciting solutions to make a more inclusive society for the deaf. It is hoped that partners in development will join in for intervention. The methodology used included individual interviews with the deaf youth and their parents and caretakers; photography at household and community levels; document review at organizations working with the deaf; observations; and key informant interviews with relevant personnel working with the deaf. Some of the major findings include: i) Effective sign language communication is key in deaf education, family bonding, and developing a sense of belonging; ii) Love and intimacy can keep the deaf bound together; iii) Education is important; everybody should struggle even if alone; iv) Games and sports are a unifying factor and most loved among the deaf; and v) better communication skills build confidence in deaf youth. In conclusion, concerted efforts are still needed to make Uganda schools more inclusive for deaf persons. This will enable a secure future for deaf youths.

Keywords: deaf, education, excluded, photo exhibition

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12 A Prospective Neurosurgical Registry Evaluating the Clinical Care of Traumatic Brain Injury Patients Presenting to Mulago National Referral Hospital in Uganda

Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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11 Promoting Psychosocial Intervention in Social Work to Manage Intersectional Stigma among Sexual Minorities during COVID-19 Pandemic in Uganda: Implications for Social Work Practice

Authors: Simon Mwima, Kasule Solomon Kibirige, Evans Jennifer Mann, Bosco Mukuba, Edson Chipalo, Agnes Nzomene, Eusebius Small, Moses Okumu

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Introduction: Social workers must create, implement, and evaluate client-centered psychosocial interventions (CCPI) to reduce the impact of intersectional stigma on HIV service utilization among sexual minorities. We contribute to the scarcity of evidence about sexual minorities in Uganda by using social support theory to explore clients' perceptions that shape CCPI. Based on Focused Group Discussion (FGD) with 31 adolescents recruited from Kampala's HIV clinics in 2021, our findings reveal the positive influence of instrumental, informational, esteem, emotional, and social network support as intersectional stigma reduction interventions. Men who have sex with men, lesbians, and bisexual women used such strategies to navigate a heavily criminalized and stigmatizing setting during the COVID-19 pandemic in Uganda. Conclusion: This study provides evidence for the social work profession to develop and implement psychosocial interventions that reduce HIV stigma and discrimination among MSM, lesbians, and bisexual young people living with HIV in Uganda.

Keywords: pyschosocial interventions, social work, intersectional stigma, HIV/AIDS, adolescents, sexual minorities, Uganda

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10 Low Back Pain-Related Absenteeism among Healthcare Workers in Kibuli Muslim Hospital, Kampala Uganda

Authors: Aremu Abdulmujeeb Babatunde

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Background: Low back pain was not only considered to be the most common reason for functional disability worldwide, but also estimated to have affected 90% of the universal population. This study aimed at determining the prevalence, consequences and socio-demographic factors associated with low back pain. Methods; A cross-sectional survey was employed and a total number of 150 self-structured questionnaire was distributed among healthcare workers and this was used to determine the prevalence of low back pain and work related absenteeism. Data was entered using Epi info soft-ware and analyzed using SPSS. Results; An overall response rate of 84% (n = 140) was achieved. The study established that majority (37%) of the respondents were in the age bracket of 20-39 years, 57% female (n=59) and 64% of them were married. the pint prevalence was 84%, 31% of the respondents took leave from work as a result of low back pain. There was high prevalence of sick leave among nursing staff 45.2%, Chi-square test shows that there was a statistically significant association between the respondents occupations and daily time spent during their work (P value 0.011 and 0.042) respectively. Socio-demographic factors like age, marital status and gender were not statistically significant at P<0.05. Conclusions; The medical and socio-professional consequences of low back pain among healthcare workers was as a result of their occupation designations and the daily time spent in carry out this occupations.

Keywords: low back pain, healthcare workers, prevalence, sick leave

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9 Social Influences on HIV Services Engagement among Sexual Minorities Experiencing Intersectional Stigma and Discrimination during COVID-19 Pandemic in Uganda

Authors: Simon Mwima, Evans Jennifer Mann, Agnes Nzomene, Edson Chipalo, Eusebius Small, Moses Okumu, Bosco Mukuba

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Introduction: In Uganda, sexual minorities experience exacerbated intersectional stigma and discrimination that exposes them to elevated HIV infections and impedes access to HIV testing and PrEP with low treatment adherence. We contribute to the lack of information about sexual minorities living with HIV in Uganda by using modified social-ecological theory to explore social influences impacting HIV services engagement. Findings from focused group discussion (FGD) involving 31 sexual minorities, ages 18-25, recruited through urban HIV clinics in Kampala reveal the protective and promotive social influence within the individual and interpersonal relationships (sexual partners and peers). Further, inhibitive social influences were found within family, community, societal, and healthcare settings. During the COVID-19 pandemic, these adolescents strategically used promotive social influences to increase their engagement with HIV care services. Interviews were recorded in English, transcribed verbatim, and analyzed using Dedoose. Conclusions: The findings revealed that young people (identified as sexual minorities) strategically used promotive social influences and supported each other to improve engagement with HIV care in the context of restrictive laws in Uganda during the COVID-19-Pandemic. Future HIV prevention, treatment, and care responses could draw on how peers support each other to navigate the heavily criminalized and stigmatized settings to access healthcare services.

Keywords: HIV/AIDS services, intersectional stigma, discrimination, adolescents, sexual minorities, COVID-19 pandemic Uganda

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8 Deficiencies in Vitamin A and Iron Supply Potential of Selected Indigenous Complementary Foods of Infants in Uganda

Authors: Richard Kajjura, Joyce Kikafunda, Roger Whitehead

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Introduction: Indigenous complementary recipes for children (6-23 months) are bulky and inextricably linked. The potential contribution of indigenous complementary foods to infant’s vitamin A and iron needs is not well investigated in Uganda. Less is known whether children in Uganda are living with or without adequate supply of vitamin A and iron nutrients. In this study, vitamin A and iron contents were assessed in the complementary foods fed to infants aged 6-11 months in a Peri-urban setting in Kampala District in Central Uganda. Objective: Assessment of vitamin A and iron contents of indigenous complementary foods of children as fed and associated demographic factor. Method: In a cross sectional study design, one hundred and three (153) households with children aged 6-11 months were randomly selected to participate in the assessment. Complementary food samples were collected from the children’s mothers/caretakers at the time of feeding the child. The mothers’ socio-demographic characteristics of age, education, marital status, occupation and sex collected a semi-qualitative questionnaire. The Vitamin A and iron contents in the complementary foods were analyzed using a UV/VIS spectrophotometer for vitamin A and Atomic Absorption spectrophotometer for iron samples. The data was analyzed using Gene-stat software program. Results: The mean vitamin A content was 97.0± 72.5 µg while that of iron was 1.5 ± 0.4 mg per 100g of food sample as fed. The contribution of indigenous complementary foods found was 32% for vitamin A and 15% iron of the recommended dietary allowance. Age of children was found to be significantly associated Vitamin A and Iron supply potential. Conclusion: The contribution of indigenous complementary foods to infant’s vitamin A and iron needs was low. Complementary foods in Uganda are more likely to be deficient in vitamin A and iron content. Nutrient dense dietary supplementation should be intervened in to make possible for Ugandan children attain full growth potential.

Keywords: indigenous complementary food, infant, iron, vitamin A

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7 Resolution of Artificial Intelligence Language Translation Technique Alongside Microsoft Office Presentation during Classroom Teaching: A Case of Kampala International University in Tanzania

Authors: Abigaba Sophia

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Artificial intelligence (AI) has transformed the education sector by revolutionizing educational frameworks by providing new opportunities and innovative advanced platforms for language translation during the teaching and learning process. In today's education sector, the primary key to scholarly communication is language; therefore, translation between different languages becomes vital in the process of communication. KIU-T being an International University, admits students from different nations speaking different languages, and English is the official language; some students find it hard to grasp a word during teaching and learning. This paper explores the practical aspect of using artificial intelligence technologies in an advanced language translation manner during teaching and learning. The impact of this technology is reflected in the education strategies to equip students with the necessary knowledge and skills for professional activity in the best way they understand. The researcher evaluated the demand for this practice since students have to apply the knowledge they acquire in their native language to their countries in the best way they understand. The main objective is to improve student's language competence and lay a solid foundation for their future professional development. A descriptive-analytic approach was deemed best for the study to investigate the phenomena of language translation intelligence alongside Microsoft Office during the teaching and learning process. The study analysed the responses of 345 students from different academic programs. Based on the findings, the researcher recommends using the artificial intelligence language translation technique during teaching, and this requires the wisdom of human content designers and educational experts. Lecturers and students will be trained in the basic knowledge of this technique to improve the effectiveness of teaching and learning to meet the student’s needs.

Keywords: artificial intelligence, language translation technique, teaching and learning process, Microsoft Office

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6 Biochar and Food Security in Central Uganda

Authors: Nataliya Apanovich, Mark Wright

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Uganda is among the poorest but fastest growing populations in the world. Its annual population growth of 3% puts additional stress through land fragmentation, agricultural intensification, and deforestation on already highly weathered tropical (Ferralsol) soils. All of these factors lead to decreased agricultural yields and consequently diminished food security. The central region of Uganda, Buganda Kingdom, is especially vulnerable in terms of food security as its high population density coupled with mismanagement of natural resources led to gradual loss of its soil and even changes in microclimate. These changes are negatively affecting livelihoods of smallholder farmers who comprise 80% of all population in Uganda. This research focuses on biochar for soil remediation in Masaka District, Uganda. If produced on a small scale from locally sourced materials, biochar can increase the quality of soil in a cost and time effective manner. To assess biochar potential, 151 smallholder farmers were interviewed on the types of crops grown, agricultural residues produced and their use, as well as on attitudes towards biochar use and its production on a small scale. The interviews were conducted in 7 sub-counties, 32 parishes, and 92 villages. The total farmland covered by the study was 606.2 kilometers. Additional information on the state of agricultural development and environmental degradation in the district was solicited from four local government officials via informal interviews. This project has been conducted in collaboration with the international agricultural research institution, Makerere University in Kampala, Uganda. The results of this research can have implications on the way farmers perceive the value of their agricultural residues and what they decide to do with them. The underlying objective is to help smallholders in degraded soils increase their agricultural yields through the use of biochar without diverting the already established uses of agricultural residues to a new soil management practice.

Keywords: agricultural residues, biochar, central Uganda, food security, soil erosion, soil remediation

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5 Optimization of Waste Plastic to Fuel Oil Plants' Deployment Using Mixed Integer Programming

Authors: David Muyise

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Mixed Integer Programming (MIP) is an approach that involves the optimization of a range of decision variables in order to minimize or maximize a particular objective function. The main objective of this study was to apply the MIP approach to optimize the deployment of waste plastic to fuel oil processing plants in Uganda. The processing plants are meant to reduce plastic pollution by pyrolyzing the waste plastic into a cleaner fuel that can be used to power diesel/paraffin engines, so as (1) to reduce the negative environmental impacts associated with plastic pollution and also (2) to curb down the energy gap by utilizing the fuel oil. A programming model was established and tested in two case study applications that are, small-scale applications in rural towns and large-scale deployment across major cities in the country. In order to design the supply chain, optimal decisions on the types of waste plastic to be processed, size, location and number of plants, and downstream fuel applications were concurrently made based on the payback period, investor requirements for capital cost and production cost of fuel and electricity. The model comprises qualitative data gathered from waste plastic pickers at landfills and potential investors, and quantitative data obtained from primary research. It was found out from the study that a distributed system is suitable for small rural towns, whereas a decentralized system is only suitable for big cities. Small towns of Kalagi, Mukono, Ishaka, and Jinja were found to be the ideal locations for the deployment of distributed processing systems, whereas Kampala, Mbarara, and Gulu cities were found to be the ideal locations initially utilize the decentralized pyrolysis technology system. We conclude that the model findings will be most important to investors, engineers, plant developers, and municipalities interested in waste plastic to fuel processing in Uganda and elsewhere in developing economy.

Keywords: mixed integer programming, fuel oil plants, optimisation of waste plastics, plastic pollution, pyrolyzing

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4 China and the Criminalization of Aggression. The Juxtaposition of Justice and the Maintenance of International Peace and Security

Authors: Elisabetta Baldassini

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Responses to atrocities are always unique and context-dependent. They cannot be foretold nor easily prompted. However, the events of the twentieth century had set the scene for the international community to explore new and more robust systems in response to war atrocities, with the ultimate goal being the restoration and maintenance of peace and security. The outlawry of war and the attribution of individual liability for international crimes were two major landmarks that set the roots for the development of international criminal law. From the London Conference (1945) for the establishment of the first international military tribunal in Nuremberg to Rome at the inauguration of the first permanent international criminal court, the development of international criminal law has shaped in itself a fluctuating degree of tensions between justice and maintenance of international peace and security, the cardinal dichotomy of this article. The adoption of judicial measures to achieve peace indeed set justice as an essential feature at the heart of the new international system. Blackhole of this dichotomy is the crime of aggression. Aggression was at first the key component of a wide body of peace projects prosecuted under the charges of crimes against peace. However, the wide array of controversies around aggression mostly related to its definition, determination and the involvement of the Security Council silenced, partly, a degree of efforts and agreements. Notwithstanding the establishment of the International Criminal Court (ICC), jurisdiction over the crime of aggression was suspended until an agreement over the definition and the conditions for the Court’s exercise of jurisdiction was reached. Compromised over the crime was achieved in Kampala in 2010 and the Court’s jurisdiction over the crime of aggression was eventually activated on 17 July 2018. China has steadily supported the advancement of international criminal justice together with the establishment of a permanent international judicial body to prosecute grave crimes and has proactively participated at the various stages of the codification and development of the crime of aggression. However, China has also expressed systematic reservations and setbacks. With the use of primary and secondary sources, including semi-structured interviews, this research aims at analyzing the role that China has played throughout the substantive historical development of the crime of aggression, demonstrating a sharp inclination in the maintenance of international peace and security. Such state behavior seems to reflect national and international political mechanisms that gravitate around a distinct rationale that involves a share of culture and tradition.

Keywords: maintenance of peace and security, cultural expression of justice, crime of aggression, China

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3 Socioeconomic Burden of a Diagnosis of Cervical Cancer in Women in Rural Uganda: Findings from a Phenomenological Study

Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

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2 Dynamics of Hepatitis B Infection Prevention Practices among Pregnant Women Attending Antenatal Care in Central Uganda Using the Constructs of Information-Motivation-Behavioral Skills Model: A Case of Lubaga Hospital Kampala

Authors: Ismail Bamidele Afolabi, Abdulmujeeb Babatunde Aremu, Lawal Abdurraheem Maidoki, Nnodimele Onuigbo Atulomah

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Background: Hepatitis B virus infection remains a significant global public health challenge with infectivity as well as the potential for transmission more than 50 to 100 times that of HIV. Annually, global HBV-related mortality is linked primarily to cirrhosis and liver carcinoma. The ever-increasing endemicity of HBV among children under-5-years, owing to vertical transmission and its lingering chronicity in developing countries, will hamper the global efforts concertedly endorsed towards eliminating viral hepatitis as a global public health threat by 2030. Objective: This study assessed information motivation behavioral skills model constructs as predictors of HBV infection prevention practices among consenting expectant mothers attending antenatal care in Central Uganda as a focal point of intervention towards breaking materno-foetal transmission of HBV. Methods: A cross-sectional study with a quantitative data collection approach based on the constructs of the IMB model was used to capture data on the study variables among 385 randomly selected pregnant women between September and October 2020. Data derived from the quantitative instrument were transformed into weighted aggregate scores using SPSS version 26. ANOVA and regression analysis were done to ascertain the study hypotheses with a significance level set as (p ≤ 0.05). Results: Relatively 60% of the respondents were aged between 18 and 28. Expectant mothers with secondary education (42.3%) were predominant. Furthermore, an average but inadequate knowledge (X ̅=5.97±6.61; B=0.57; p<.001), incorrect perception (X ̅=17.10±18.31; B=0.97; p=.014), and good behavioral skills (X ̅=12.39±13.37; B=0.56; p<.001) for adopting prevention practices all statistically predicted the unsatisfactory level of prevention practices (X ̅=15.03±16.20) among the study respondents as measured on rating scales of 12, 33, 21 and 30 respectively. Conclusion: Evidence from this study corroborates the imperativeness of IMB constructs in reducing the burden of HBV infection in developing countries. Therefore, the inadequate HBV knowledge and misperception among obstetric populations necessitate personalized health education during antenatal visits and subsequent health campaigns in order to inform better prevention practices and, in turn, reduce the lingering chronicity of HBV infection in developing countries.

Keywords: behavioral skills, HBV infection, knowledge, perception, pregnant women, prevention practices

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1 Land Rights, Policy and Cultural Identity in Uganda: Case of the Basongora Community

Authors: Edith Kamakune

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As much as Indigenous rights are presumed to be part of the broad human rights regime, members of the indigenous communities have continually suffered violations, exclusions, and threat. There are a number of steps taken from the international community in trying to bridge the gap, and this has been through the inclusion of provisions as well as the passing of conventions and declarations with specific reference to the rights of indigenous peoples. Some examples of indigenous people include theSiberian Yupik of St Lawrence Island; the Ute of Utah; the Cree of Alberta, and the Xosa andKhoiKhoi of Southern Africa. Uganda’s wide cultural heritage has played a key role in the failure to pay special attention to the needs of the rights of indigenous peoples. The 1995 Constitution and the Land Act of 1998 provide for abstract land rights without necessarily paying attention to indigenous communities’ special needs. Basongora are a pastoralist community in Western Uganda whose ancestral land is the present Queen Elizabeth National Park of Western Uganda, Virunga National Park of Eastern Democratic Republic of Congo, and the small percentage of the low lands under the Rwenzori Mountains. Their values and livelihood are embedded in their strong attachment to the land, and this has been at stake for the last about 90 Years. This research was aimed atinvestigating the relationship between land rights and the right to cultural identity among indigenous communities, looking at the policy available on land and culture, and whether the policies are sensitive of the specific issues of vulnerable ethnic groups; and largely the effect of land on the right to cultural identity. The research was guided by three objectives: to examine and contextualize the concept of land rights among the Basongora community; to assess the policy frame work available for the protection of the Basongora community; to investigate the forms of vulnerability of the Basongora community. Quantitative and qualitative methods were used. a case of Kaseseand Kampala Districts were purposefully selected .138 people were recruited through random and nonrandom techniques to participate in the study, and these were 70 questionnaire respondents; 20 face to face interviews respondents; 5 key informants, and 43 participants in focus group discussions; The study established that Land is communally held and used and thatit continues to be a central source of livelihood for the Basongora; land rights are important in multiplication of herds; preservation, development, and promotion of culture and language. Research found gaps in the policy framework since the policies are concerned with tenure issues and the general provisions areambiguous. Oftenly, the Basongora are not called upon to participate in decision making processes, even on issues that affect them. The research findings call forauthorities to allow Basongora to access Queen Elizabeth National Park land for pasture during particular seasons of the year, especially during the dry seasons; land use policy; need for a clear alignment of the description of indigenous communitiesunder the constitution (Uganda, 1995) to the international definition.

Keywords: cultural identity, land rights, protection, uganda

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