Browsing by Author "Bukuluki, Paul"

Now showing 1 - 7 of 7
  • Thumbnail Image
    Item
    Changing from the “Pull” to the “Push” System of Distributing Essential Medicines and Health Supplies in Uganda: Implications for Efficient Allocation of Medicines and Meeting the Localized Needs of Health Facilities
    (Global Health Governance, 2013) Bukuluki, Paul; Byansi, Peter K.; Sengendo, John; Ddumba, Nyanzi I.; Banoba, Paul; Kaawa-Mafigiri, David
    Uganda has undergone several reforms in governance of the health sector. One of the profound reforms has been the radical shift in management of medicines from the “pull” approach—health facility staff participated in determining the medicines needed, to the “push” approach—the distribution of a standardized kit of essential medicine to health facilities irrespective of the disease burden and patient population. This paper is based on multi-site, mixed method cross-sectional study on governance in the health sector commissioned by Transparency International. It revealed that this shift affected delivery of essential medicines for rural and hard-to-reach frontline health facilities. Although there were indications that centralization had minimized inefficiency due to over invoicing, abuse of medicine funds and re-allocating funds meant for medicines to other recurrent items, it led to the supplying of large quantities of medicines that are not aligned to the disease burden and needs of some health facilities.
  • Thumbnail Image
    Item
    The Effectiveness of Educational Support to Orphans and Vulnerable Children in Tanzania and Uganda
    (International Scholarly Research Notices, 2013) Shann, Mary H.; Bryant, Malcolm H.; Brooks, Mohamad I.; Bukuluki, Paul; Muhangi, Denis; Lugalla, Joe; Kwesigabo, Gideon
    Little evidence is available to assist policy makers and donors in deciding what kinds of programs in developing countries are more likely to be effective in supporting the entry and continuation of OVC in secondary schools. This is particularly important for females whose education has direct bearing on child mortality in the next generation. This study gathered four kinds of educational outcome measures in two East African countries ravaged by the AIDS/HIV pandemic. e goal was to determine whether direct scholarship aid to individual students versus various forms of block grants would be more effective in promoting lower rates ofabsenteeism, lower dropout rates, higher national examination scores, and higher pass rates for OVC of both genders. Insufficient evidence was available for recipients of scholarships, but OVC with block grant support performed as well or better than their non-OVC counterparts, and significantly better than OVC without support. Contrary to popular belief, girls had lower rates of absenteeism. There were no gender differences in dropout. However, boys consistently outperformed girls on academic tests. Insufficient data systems continue to impede more detailed analysis.
  • Thumbnail Image
    Item
    The Female Genital Mutilation Economy and the Rights of the Girl Child in Northeastern Uganda
    (Springer, Cham, 2017) Ochen, Eric A.; Musinguzi, Laban K.; Nanfuka Kalule, Esther; Ssemakula, Eugene G.; Kukundakwe, Rebecca; Opesen, Chris C.; Bukuluki, Paul
  • Thumbnail Image
    Item
    Gender Analysis of Educational Support Programs for OVC in Uganda and Tanzania: Are they Helping Girls in Secondary School?
    (Vulnerable Children and Youth Studies, 2014) Brooks, Mohamad; Bryant, Malcolm; Shann, Mary; Bukuluki, Paul; Muhangi, Denis; Lugalla, Joe; Kwesigabo, Gideon
    Gender plays an important role in education as most traditional societies give preference to boys over girls when it comes to educational opportunity. Increasing access to education for girls is important to the health and well-being of the individual, their future children, families, and communities. The objective of this paper is to understand the gender differences in educational outcomes for orphans and vulnerable children (OVC) attending secondary schools in Uganda and Tanzania. The study employed a four-year, retrospective record review utilizing both qualitative and quantitative methodologies. A total of 5738 student records were collected as part of the study. Students were grouped as “ever supported” OVC (receiving educational support from either a block grant or scholarship program during their secondary school education), “never supported OVC” (OVC students who did not receive any educational support), and “nonOVC students” (students identified by the school as neither orphaned nor vulnerable). Results of the study indicate that investment in secondary school education for OVC in Uganda and Tanzania can make a difference in educational outcomes, both for boys and girls. Although there was no gender difference in absenteeism or dropout rate among students those who received educational support, stark differences were found in secondary school Year IV national examination pass rates with girls significantly less likely to pass compared to boys. The disparity in secondary school learning achievement between male and female students is of concern and warrants further investigation.
  • Thumbnail Image
    Item
    Gender Dimensions, Food Security, and HIV and AIDS in Internally Displaced People’s (IDPs) Camps in Uganda: Implications for HIV-Responsive Policy and Programming
    (Social Work and Social Administration, 2008) Bukuluki, Paul; Mugumya, Firminus; Neema, Stella; Awich Ochen, Eric
    This study set out to investigate in specific terms how gender relations influence the interaction between food insecurity and HIV/AIDS in two armed conflict-affected districts, Gulu, in northern Uganda and Katakwi. The study largely embraced qualitative and ethnographic approaches of investigation supplemented by quantitative approaches. An exploratory and descriptive study design largely applying an ethnographic approach was employed. This facilitated the research team to gain a clear understanding of the local meanings and contextual issues that influence interactions between gender, food insecurity, and risky sexual behavior in situations of internal displacement. Quantitative variables were also generated from the ethnographic phase of the study. The ethnographic phase helped to clarify the key variables and indicators, such as the extent of food insecurity, risky sexual behavior, perceived and actual risk to HIV infection, that were followed up and measured using quantitative research instruments. Since the whole philosophy underlying this research is to improve policy and programming, the approach employed was a collaborative one that involved deliberate consultation with relevant government departments as well as local and international agencies involved in activities related to food security and HIV/AIDS in internally displaced peoples (IDPs) camps.
  • Thumbnail Image
    Item
    Informed consent practices for surgical care at university teaching hospitals: a case in a low resource setting
    (BMC research notes, 2015) Ochieng, Joseph; Ibingira, Charles; Buwembo, William; Munabi, Ian; Kiryowa, Haruna; Kitara, David; Bukuluki, Paul; Nzarubara, Gabriel; Mwaka, Erisa
    Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting.
  • Thumbnail Image
    Item
    Nodding Syndrome in Post Conflict Northern Uganda: A Human Security Perspective
    (Global Health Governance, 2012) Bukuluki, Paul; Ddumba-Nyanzi, Ismail; David Kisuule, John; Ovuga, Emilio; Lien, Lars; Kaawa-Mafigiri, David
    An increasing concern of public health is the relationship between health and human security in conflict and post-conflict settings.1 Environments where conflicts have taken place are associated with the breakdown of public health infrastructure, massive displacement of people and disruption of livelihoods.2,3,4 Thus the processes and outcomes of violent conflict have implications for health and well-being, including recovery processes in post-conflict settings. Violent conflict is also closely related to “structural violence”, which broadly includes “violence of poverty, social and political marginalization, and other forms of structured inequalities and their effects on people’s lives, health and agency.”5 This underscores the need to understand how the health and wellbeing of people in post-conflict settings is influenced by violent conflict, antecedents to the conflict, or the complex intersection of both.6 This complex relationship raises questions about the challenges of ensuring human security in post-conflict settings especially in developing countries where public service delivery systems, including health and health care delivery, are already constrained.