NRU :: Browsing by Author "Muhangi, Denis"

Browsing by Author "Muhangi, Denis"

Now showing 1 - 20 of 34

Anthelmintic Resistance in Gastrointestinal Nematodes in goats and Evaluation of FAMACHA Diagnostic Marker in uganda
(Veterinary parasitology, 2014) Nabukenya, Immaculate; Akiiki, Chris Rubaire; Olila, Deogracious; Muhangi, Denis; Höglund, Johan
Gastrointestinal nematodes (GIN) are a challenge to goat production globally causing reduced growth, morbidity and mortality. We report here results of the first nation-wide anthelmintic resistance (AR) study and validation of assessment of clinical anaemia with FAMACHA eye scores in goats in Uganda. From August to December 2012 the efficacy of albendazole (7.5mg/kg), levamisole (10.5mg/kg) and ivermectin (0.3mg/kg) against strongyle nematodes was tested on 33 goat farms in Soroti, Gulu, Mpigi, Mbarara and Ssembabule districts of Uganda. Altogether 497 goats were subjected to a total of 45 different faecal egg count reduction tests (FECRT), each involving 5–20 goats. On one farm all substances were tested. Faecal and blood samples were collected and FAMACHA eye scores evaluated on the day of treatment and 15 days later. A questionnaire survey was conducted on frequency, type and dose of anthelmintics used, farm size and grazing management system. Examination of infective third stage larvae (L3) from pooled faecal cultures demonstrated Haemonchus to be the predominant genus (>75%). Resistance to at least one anthelmintic group was detected on 61% of the 33 farms and in 49% of the 45 test groups. Prevalence of resistance to ivermectin, levamisole and albendazole was respectively 58%, 52% and 38%. Correlation between pre-treatment packed cell volume determinations and FAMACHA scores (r498=−0.89) was significant. Paddock grazing system (Odds ratio 4.9, 95% CI 1.4–17.3) and large farm size of >40 goats (odds ratio 4.4, 95% CI 1.2–16.1) were significant predictors of AR. In all districts, resistance to all three anthelmintics was higher on large-scale goat farms practising mostly paddock grazing. Interestingly, resistance to albendazole, the most commonly used anthelmintic in Uganda, was lower than that to ivermectin and levamisole. We recommend adaptation of FAMACHA to goats to help restrict anthelmintic treatment to heavily infected individuals. This will limit selection pressure and hence delay development of anthelmintic resistance.
Assessing risk of HIV and hepatitis C among people who inject drugs in East Africa: findings from a rapid assessment
(Journal of Viral Hepatitis,, 2019) Platt, Lucy; Nkurunziza, Menus; Muhangi, Denis; Byansi, Peter; Wandiembe, Symon; Bitira, David
Rapid assessment cross-sectional surveys and qualitative interviews were conducted among people who inject drugs (PWID) in Burundi and Uganda, as well as key informants working with drug users, to assess risk associated with HIV and hepatitis C (HCV). A total of 127 PWID were recruited in Burundi and 125 in Uganda of which the majority were male and aged between 24 and 26 years. Blood samples were collected in Burundi to test for antibodies to HIV, HCV and B Surface Antigen (HBsAg). Heroin was mainly injected in Uganda and Burundi with a small minority injecting crack/cocaine. Half of participants in Burundi, and 86% in Uganda had been HIV tested. The minority had been tested for HCV in any site (5-7%). HIV prevalence from the serological testing in Burundi indicated that 10% tested positive for antibodies to HIV, 6% to HCV and 9% to HBsAg. Qualitative data suggested that structural factors including costs of needle/syringes as well policies prohibiting pharmacies selling injecting equipment to PWID were related to reuse and sharing of needles/syringes among PWID, despite awareness HIV transmission risk. Police arrest was common in Burundi and Uganda and the use of bribes by police compounded existing high levels of poverty. Findings accentuate the need for policy shifts to enable easier access to clean injecting equipment, increased availability of HIV and HCV testing and increased access to affordable drug treatment and introduction of opioid substitution therapy. Specific attention is needed to the potential for sexual transmission of HIV among this population.
Community Dialogues for Child Health: Results from a Qualitative Process Evaluation in Three Countries
(Journal of Health, Population and Nutrition, 2017) Martin, Sandrine; Leitão, Jordana; Muhangi, Denis; Nuwa, Anthony; Magul, Dieterio; Counihan, Helen
Across the developing world, countries are increasingly adopting the integrated community case management of childhood illnesses (iCCM) strategy in efforts to reduce child mortality. This intervention’s effectiveness is dependent on community adoption and changes in care-seeking practices. We assessed the implementation process of a theory-driven community dialogue (CD) intervention specifically designed to strengthen the support and uptake of the newly introduced iCCM services and related behaviours in three African countries.A qualitative process evaluation methodology was chosen and used secondary project data and primary data collected in two districts of each of the three countries, in purposefully sampled communities. The final data set included 67 focus group discussions and 57 key informant interviews, totalling 642 respondents, including caregivers, CD facilitators community leaders, and trainers. Thematic analysis of the data followed the ‘Framework Approach’ utilising both a deduction and induction process. Results show that CDs contribute to triggering community uptake of and support for iCCM services through filling health information gaps and building cooperation within communities. We found it to be an effective approach for addressing social norms around child care practices. This approach was embraced by communities for its flexibility and value in planning individual and collective change.Regular CDs can contribute to the formation of new habits, particularly in relation to seeking timely care in case of child sickness. This study also confirms the value of process evaluation to unwrap the mechanisms of community mobilisation approaches in context and provides key insights for improving the CD approach.
Comparative Studies of Orphans and Non-Orphans in Uganda
(Center for International Health and Development, 2004) Munaaba, Flavia; Owor, Joseph; Baguma, Peter; Musisi, Seggane; Mugisha, Frank; Muhangi, Denis
There are now in Uganda more than two million orphans, i.e. children under 18 years old who have lost one or both of their parents. Roughly one in every five children is an orphan and one in every four households in the country is caring for at least one orphan. As a follow-up to a Situation Analysis of Orphans in Uganda in 2002, this monograph presents six studies carried out by Ugandan researchers in 2003 and 2004 on different aspects of the orphan crisis about which the Situation Analysis found inadequate data. Five studies focused on the following: the comparative psycho-social situation of orphans relative to other children (two studies), the legal issues (such as property grabbing and abuse) which they face, suspected differential care-giving practices, and whether orphans face greater risk for sexually transmitted diseases (including HIV/AIDS). The sixth study conducted a comparative evaluation of an orphan support and intervention effort to determine its impact and to test a particular evaluation approach. The results of these studies have already contributed to the preparatory discussions and formulation of the Uganda National Policy on Orphans as well as to the Uganda National Strategic Program Plan of Interventions for Orphans which were produced in 2004.
Counting that counts: Estimating the number of People Who Inject Drugs in two urban centers in Uganda
(Researchgate, 2019) Baluku, Matayo; Wamala, Twaibu; Muhangi, Denis; Namanya, Bharam
Population size estimates of People Who Inject Drugs (PWIDs) are needed to help policy makers understand the scope of the epidemic and allocate appropriate resources yet little is known about the size estimates of PWIDs in Uganda. We aimed to establish the number of people who inject drugs in Kampala Capital City and Mbale Municipality in Uganda. We integrated three population size estimation methods into a cross-sectional survey of PWIDs in two urban centers. These methods included enumeration, Wisdom of the Crowds and multiplier method. The mean of the three estimates was hypothesized to be the most plausible size estimate with the other results forming the upper and lower plausible bounds. Data were shared with community representatives and stakeholders to finalize ‘best’ point estimates and plausible bounds.We estimate there are approximately 550 PWIDs and 189 PWIDs in Kampala Capital City and Mbale Municipality respectively and plausibly 576-1,695 PWIDs living in these two urban centers.We employed multiple methods and used a wide range of data sources to estimate the size of PWIDs—a hidden population in Kampala Capital City and Mbale Municipality in Uganda. These estimates may be useful to advocate for and to plan, implement and evaluate HIV and Viral Hepatitis response for PWIDs.
COVID-19 Prevention Measures: Impact Stories and Lived Experiences of Uganda-based Refugees
(Vienna Journal of African Studies, 2021) Okot, Betty J.; Malagala, Aloysius Tenywa; Ochen, Eric Awich; Muhangi, Denis; Serwagi, Gloria K.
The COVID-19 pandemic is making new demands on society to become more aware of humanity’s oneness and collective vulnerability. The disease has instigated a catalogue of health communication initiatives focused on prevention and containment. Tentative solutions such as social distancing, face masking, hand-washing, and lockdowns have seemingly become the mantras of safety and prevention. Moreover, staying safe entails going against the everyday normal and nearly doing away with that which, defnes humanity, namely: socialising (even physical contact), thus, leading to compliance dilemmas. Relying on fndings of the mixed methods socio-behavioural study, “Knowledge, adherence and the lived experiences of refugees in COVID-19:A Comparative Assessment of Urban and Rural Refugee Settings in Uganda,” hereafter REFLECT. We show that refugees are in a constant dilemma of choosing either to comply with prevention measures or maintaining the everyday normal. Hence, we refect on how the prevention-related social restrictions might be increasing refugee vulnerabilities by disrupting their everyday normal. We question whether it is appropriate to view non-compliance as a deliberate act of defance on the part of refugees when their current positionality hinders amenability. We conclude that, it is vital to understand how refugees’ lived experiences and socio-economic pressures lead to compliance dilemmas.
COVID-19 Risk Behaviors in Humanitarian Settings: A Crosssectional Study among Conflict Refugees in Uganda
(International Journal of Community Medicine and Public Health, 2021) Lawoko, Stephen; Seruwagi, Gloria; Muhangi, Denis; Ochen, Eric A.; Okot, Betty; Lugada, Eric; Masaba, Andrew; Ddamulira, Dunstan P.; Luswata, Brian; Nakidde, Catherine L.; Kaducu, Felix
Worldwide, behavioral change interventions are at the core of prevention efforts to contain the novelCorona Virus (COVID-19). While the evidence base to inform such interventions in the general population is growing, equivocal research in humanitarian populations is lacking. The current study describes the nature, extent and predictors of COVID-19 risk behaviors among conflict refugees in Uganda in a bid to inform prevention strategies for humanitarian settings. Cross-sectional survey data on COVID-19 risk-behaviors, demographic, socio-economic, behavioral and clinical variables was gathered from 1014 adult refugees drawn from 3 refugee settlements in Uganda, using two-staged cluster sampling. Data was analyzed using t-test, Analysis of Variance (ANOVA) and Multivariable Linear Regression.Many refugees (25-70%) were involved in hygiene, congestion and nutritional/physical activity related risk behaviors likely to contribute to community transmission of COVID-19. Refugees living in rural settlements, of male sex, young age and low socio-economic status were at heightened risk of exposure to COVID-19 risk behaviors.Physical activity and healthy nutritional practices reduced the likelihood of COVID-19 risk behavior. Indulgence in COVID-19 risk behaviors increased the risk of developing COVID-19 symptoms.COVID-19 risk behaviors among conflict refugees in Uganda are multifaceted in nature, widespread in extent and associated with symptom development, signaling for high risk for COVID-19 transmission in humanitarian settings. The data on predictors of COVID-19 risk behaviors have unmasked underlying inequalities, holding promise for development of evidence-based interventions to meet the needs of most vulnerable clusters in the refugee community.
Decision-Making on Intra-Household Allocation of Bed Nets in Uganda: Do Households Prioritize the most Vulnerable Members
(Malaria journal, 2014) Lam, Yukyan; Harvey, Steven A.; Monroe, April; Muhangi, Denis; Loll, Dana; Kabali, Asaph Turinde; Weber, Rachel
Access to insecticide-treated bed nets has increased substantially in recent years, but ownership and use remain well below 100% in many malaria endemic areas. Understanding decision-making around net allocation in households with too few nets is essential to ensuring protection of the most vulnerable. This study explores household net allocation preferences and practices across four districts in Uganda.Data collection consisted of eight focus group discussions, twelve in-depth interviews, and a structured questionnaire to inventory 107 sleeping spaces in 28 households.In focus group discussions and in-depth interviews, participants almost unanimously stated that pregnant women, infants, and young children should be prioritized when allocating nets. However, sleeping space surveys reveal that heads of household sometimes receive priority over children less than five years of age when households have too few nets to cover all members. When asked directly, most net owners highlight the importance of allocating nets to the most biologically vulnerable household members. This is consistent with malaria behaviour change and health education messages. In actual allocation, however, factors other than biological vulnerability may influence who does and does not receive a net.
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.
The first mile: community experience of outbreak control during an Ebola outbreak in Luwero District, Uganda
(BMC public health, 2016) de Vries, Daniel H.; Rwemisisi, Jude T.; Musinguzi, Laban K.; Turinawe, Benoni E.; Muhangi, Denis; de Groot, Marije; Kaawa-Mafigiri, David; Pool, Robert
A major challenge to outbreak control lies in early detection of viral haemorrhagic fevers (VHFs) in local community contexts during the critical initial stages of an epidemic, when risk of spreading is its highest (“the first mile”). In this paper we document how a major Ebola outbreak control effort in central Uganda in 2012 was experienced from the perspective of the community. We ask to what extent thecommunity became a resource for early detection, and identify problems encountered with community health worker and social mobilization strategies. Methods: Analysis is based on first-hand ethnographic data from the center of a small Ebola outbreak in Luwero Country, Uganda, in 2012. Three of this paper’s authors were engaged in an 18 month period of fieldwork on community health resources when the outbreak occurred. In total, 13 respondents from the outbreak site were interviewed, along with 21 key informants and 61 focus group respondents from nearby Kaguugo Parish. All informants were chosen through non-probability sampling sampling. Results: Our data illustrate the lack of credibility, from an emic perspective, of biomedical explanations which ignore local understandings. These explanations were undermined by an insensitivity to local culture, a mismatch between information circulated and the local interpretative framework, and the inability of the emergency response team to take the time needed to listen and empathize with community needs. Stigmatization of the local community – in particular its belief in amayembe spirits – fuelled historical distrust of the external health system and engendered community-level resistance to early detection. Conclusions: Given the available anthropological knowledge of a previous outbreak in Northern Uganda, it is surprising that so little serious effort was made this time round to take local sensibilities and culture into account. The “first mile” problem is not only a question of using local resources for early detection, but also of making use of the contextual cultural knowledge that has already been collected and is readily available. Despite remarkable technological innovations, outbreak control remains contingent upon human interaction and openness to cultural difference.
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.
Healthworker preparedness for COVID-19 management and implementation experiences: a mixed methods study in Uganda’s refugee-hosting district
(Conflict and Health, 2021) Seruwagi, Gloria; Nakidde, Catherine; Otieno, Felix; Kayiwa, Joshua; Luswata, Brian; Lugada, Eric; Ochen, Eric Awich; Muhangi, Denis; Okot, Betty; Ddamulira, Dunstan; Masaba, Andrew; Lawoko, Stephen
The negative impact of COVID-19 on population health outcomes raises critical questions on health system preparedness and resilience, especially in resource-limited settings. This study examined healthworker preparedness for COVID-19 management and implementation experiences in Uganda’s refugee-hosting districts.A cross sectional, mixed-method descriptive study in 17 health facilities in 7 districts from 4 major regions. Total sample size was 485 including > 370 health care workers (HCWs). HCW knowledge, attitude and practices (KAP) was assessed by using a pre-validated questionnaire. The quantitative data was processed and analysed using SPSS 26, and statistical significance assumed at p < 0.05 for all statistical tests. Bloom's cutoff of 80% was used to determine threshold for sufficient knowledge level and practices with scores classified as high (80.0–100.0%), average (60.0–79.0%) and low (≤ 59.0%). HCW implementation experiences and key stakeholder opinions were further explored qualitatively using interviews which were audio-recorded, coded and thematically analysed.On average 71% of HCWs were knowledgeable on the various aspects of COVID-19, although there is a wide variation in knowledge. Awareness of symptoms ranked highest among 95% (p value < 0.0001) of HCWs while awareness of the criteria for intubation for COVID-19 patients ranked lowest with only 35% (p value < 0.0001). Variations were noted on falsehoods about COVID-19 causes, prevention and treatment across Central (p value < 0.0356) and West Nile (p value < 0.0161) regions. Protective practices include adequate ventilation, virtual meetings and HCW training. Deficient practices were around psychosocial and lifestyle support, remote working and contingency plans for HCW safety. The work environment has immensely changed with increased demands on the amount of work, skills and variation in nature of work. HCWs reported moderate control over their work environment but with a high level of support from supervisors (88%) and colleagues (93%).HCWs preparedness is inadequate in some aspects. Implementation of healthcare interventions is constrained by the complexity of Uganda’s health system design, top-down approach of the national response to COVID-19 and longstanding health system bottlenecks. We recommend continuous information sharing on COVID-19, a design review with capacity strengthening at all health facility levels and investing in community-facing strategies.
Healthworker preparedness for COVID‑19 management and implementation experiences: a mixed methods study in Uganda’s refugee‑hosting districts
(Conflict and Health, 2021) Seruwagi, Gloria; Nakidde, Catherine; Otieno, Felix; Kayiwa, Joshua; Luswata, Brian; Lugada, Eric; Awich Ochen, Eric; Muhangi, Denis; Okot, Betty; Ddamulira, Dunstan; Masaba, Andrew; Lawoko, Stephen
The negative impact of COVID-19 on population health outcomes raises critical questions on health system preparedness and resilience, especially in resource-limited settings. This study examined healthworker preparedness for COVID-19 management and implementation experiences in Uganda’s refugee-hosting districts. Methods: A cross sectional, mixed-method descriptive study in 17 health facilities in 7 districts from 4 major regions. Total sample size was 485 including > 370 health care workers (HCWs). HCW knowledge, attitude and practices (KAP) was assessed by using a pre-validated questionnaire. The quantitative data was processed and analysed using SPSS 26, and statistical significance assumed at p < 0.05 for all statistical tests. Bloom’s cutoff of 80% was used to determine threshold for sufficient knowledge level and practices with scores classified as high (80.0–100.0%), average (60.0– 79.0%) and low (≤ 59.0%). HCW implementation experiences and key stakeholder opinions were further explored qualitatively using interviews which were audio-recorded, coded and thematically analysed. Results: On average 71% of HCWs were knowledgeable on the various aspects of COVID-19, although there is a wide variation in knowledge. Awareness of symptoms ranked highest among 95% (p value < 0.0001) of HCWs while awareness of the criteria for intubation for COVID-19 patients ranked lowest with only 35% (p value < 0.0001). Variations were noted on falsehoods about COVID-19 causes, prevention and treatment across Central (p value < 0.0356) and West Nile (p value < 0.0161) regions. Protective practices include adequate ventilation, virtual meetings and HCW training. Deficient practices were around psychosocial and lifestyle support, remote working and contingency plans for HCW safety. The work environment has immensely changed with increased demands on the amount of work, skills and variation in nature of work. HCWs reported moderate control over their work environment but with a high level of support from supervisors (88%) and colleagues (93%). Conclusions: HCWs preparedness is inadequate in some aspects. Implementation of healthcare interventions is constrained by the complexity of Uganda’s health system design, top-down approach of the national response to COVID-19 and longstanding health system bottlenecks. We recommend continuous information sharing on COVID-19, a design review with capacity strengthening at all health facility levels and investing in community-facing strategies.
HIV- and Hepatitis C-Related Risk Behaviors among People who Inject Drugs in Uganda: Implications for Policy and Programming
(Harm Reduction Journal, 2019) Baluku, Matayo; Wamala, Twaibu; Muhangi, Denis
There is a dearth of evidence on injecting drug use and associated HIV and hepatitis C virus (HCV) infections in Uganda. As such, policy and programming for people who inject drugs (PWID) is limited due to scarcity of epidemiological data. We therefore conducted this study to assess the injecting drug and sexual practices among PWID in Kampala Capital City and Mbale Municipality.Using a rapid situation assessment framework, we conducted semi-structured interviews among 125 PWID (102 males and 23 females)—recruited through outreach and snowball sampling. We assessed their injecting drug and sexual practices. We also conducted 12 focus group discussions among PWID and 30 in-depth interviews among key informants.A total of 125 PWID (81.6% males and 18.4% females) were recruited into the study. Approximately three quarters of PWID started injecting before the age of 25. More females (21.7%) compared to males (13.7%) started injecting by the age of 17. Fifty-seven percent of the PWID in Kampala and 50% in Mbale shared injecting equipment in the last 3 months prior to the study. There was an emerging practice of mixing drugs with blood and sharing it among different PWID as a sign of oneness. Heroin was being injected by 72% of the participants. Less than one half of the PWID had used a condom during the last casual sex, and 42.7% did not use a condom the last time they engaged in sex work. Seventy-six percent of the PWID had undertaken an HIV test in the last 12 months, and 9.2% self-reported to be HIV positive.This study highlights the need for introducing harm reduction policies and services including increased access to sterile injecting equipment and education around safer injecting and sexual practices. Programs for PWID should also address the specific needs of female sex workers who inject drugs.
Impact Evaluation of Youth-Friendly Family Planning Services in Uganda
(International initiative for impact evaluation, 2019) Asingwire, Narathius; Muhangi, Denis; Kyomuhendo, Swizen; Leight, Jessica
This final impact evaluation grantee report has been submitted in partial fulfilment of the requirements of grant UPW.06 awarded under the Uganda Policy Window. 3ie is making it available to the public in this final report version as it was received. The encouragement design in the study did not lead to an increased uptake of the programme and therefore the identification strategy failed.
Intra-Household Differences in Health Seeking Behaviour for Orphans and Non-Orphans in an NGO-Supported and Non-Supported Subcounty of Luwero, Uganda
(African Health Sciences, 2009) Muhwezi, Wilson Winstons; Muhangi, Denis; Mugumya, Firminus
Comparing healthcare dynamics among orphans and non-orphans in an NGO supported and a non-supported subcounty so as to identify the level of equity.This was a cross-sectional unmatched case-control research. A sample of 98 orphans and 98 non-orphans in an NGO supported sub-county and a similar number in a control sub-county participated. For each child, a corresponding caregiver participated. Each respondent was interviewed. Analysis was comparative. Relationships between variables were ascertained using a X2.Fevers were the most common health problem. However, 14.3% of children reported an experience of diarrhoea in an NGO-supported sub-county as opposed to 85.7% in the control sub-county (p = 0.014). Twenty percent of children in the NGO supported sub-county reported skin infections compared to 80% in the control sub-county [p= 0.008]. When orphans fell sick, more caregivers in the supported sub-county consulted village clinics compared to self herbal-medication (p = 0.009). Majority of orphan caregivers compared to those for non-orphans in the control sub-county took their children to village clinics as opposed to health centres (p = 0.002). In the control sub-county, fewer caregivers responded to children’s illness by buying medicines from drug-shops as opposed to taking them to village clinics [(p = 0.040).There were some differences between orphans and non-orphans within each sub-county and between orphans in the two sub-counties. NGO support is critical in cultivating equity, compassion and non-discrimination. The extended family system in Africa was managing orphan care although it displayed cracks in support systems.
Linking Communities to Formal Health Care Providers through Village Health Teams in Rural Uganda: Lessons from Linking Social Capital
(Human resources for health, 2017) Musinguzi, Laban Kashaija; Turinawe, Emmanueil Benon; Rwemisisi, Jude T.; Vries, Daniel H. de; Mafigiri, David K.; Muhangi, Denis; Groot, Marije de; Katamba, Achilles; Pool, Robert
Community-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services.Data were collected through ethnographic fieldwork undertaken as part of a larger research program in Luwero District, Uganda, between 2012 and 2014. The main methods of data collection were participant observation in events organised by VHTs. In addition, a total of 91 in-depth interviews and 42 focus group discussions (FGD) were conducted with adult community members as part of the larger project. After preliminary analysis of the data, we conducted an additional six in-depth interviews and three FGD with VHTs and four FGD with community members on the role of VHTs. Key informant interviews were conducted with local government staff, health workers, local leaders, and NGO staff with health programs in Luwero. Thematic analysis was used during data analysis.The ability of VHTs to link communities with formal health care was affected by the stakeholders’ perception of their roles. Community members perceive VHTs as working for and under instructions of “others”, which makes them powerless in the formal health care system. One of the challenges associated with VHTs’ linking roles is support from the government and formal health care providers. Formal health care providers perceived VHTs as interested in special recognition for their services yet they are not “experts”. For some health workers, the introduction of VHTs is seen as a ploy by the government to control people and hide its inability to provide health services. Having received training and initial support from an NGO, VHTs suffered transition failure from NGO to the formal public health care structure. As a result, VHTs are entangled in power relations that affect their role of linking community members with formal health care services. We also found that factors such as lack of money for treatment, poor transport networks, the attitudes of health workers and the existence of multiple health care systems, all factors that hinder access to formal health care, cannot be addressed by the VHTs.As linking social capital framework shows, for VHTs to effectively act as links between the community and formal health care and harness the resources that exist in institutions beyond the community, it is important to take into account the power relationships embedded in vertical relationships and forge a partnership between public health providers and the communities they serve. This will ensure strengthened partnerships and the improved capacity of local people to leverage resources embedded in vertical power networks.
Linking Social Welfare Development with Cash Transfers and Education to Promote Child Wellbeing – What we Know and What We Need to Know
(Vulnerable Children and Youth Studies, 2009) Pinkerton, John; Muhangi, Denis
This review aimed to identify international literature on the triple provision combination of social welfare services (SWS) embedded within programmes where cash transfers are conditional (CCT) on school attendance in order to inform best policy and practice. The review found only one example of such provision, descriptions of which indicated a benefit of the triple combination approach yet did not provide an in-depth evaluation of the link with SWS. More relevant evidence and indications for future research and policy were found within literature concerned with the double combination of SWS and schooling, including extended and full-service schools. However, this has not yet been linked to CCT. This literature reports an overall positive impact of a SWS and school integration for both children and families, while noting several complexities and challenges such as resource availability and management issues. Methodologies are currently diverse. A Theory of Change approach may represent an optimum strategy for future programme evaluations to address the complex synergies of inputs and outcomes. Also, the definition of SWS needs to be refined as appropriate to countries of the global South, where the triple combination is of particular relevance.
A Longitudinal Survey of African Swine Fever in Uganda Reveals High Apparent Disease Incidence Rates in Domestic Pigs, But Absence of Detectable Persistent Virus Infections in Blood and Serum
(BMC veterinary research, 2015) Muhangi, Denis; Masembe, Charles; Emanuelson, Ulf; Boqvist, Sofia; Mayega, Lawrence; Ademun, Rose Okurut; Bishop, Richard P; Ocaido, Michael; Berg, Mikael; Ståh, Karl
African swine fever (ASF) is a fatal, haemorrhagic disease of domestic pigs, that poses a serious threat to pig farmers and is currently endemic in domestic pigs in most of sub-Saharan Africa. To obtain insight into the factors related to ASF outbreaks at the farm-level, a longitudinal study was performed in one of the major pig producing areas in central Uganda. Potential risk factors associated with outbreaks of ASF were investigated including the possible presence of apparently healthy ASF-virus (ASFV) infected pigs, which could act as long-term carriers of the virus. Blood and serum were sampled from 715 pigs (241 farms) and 649 pigs (233 farms) to investigate presence of ASFV and antibodies, during the periods of June-October 2010 and March-June 2011, respectively. To determine the potential contribution of different risks to ASF spread, a questionnaire-based survey was administered to farmers to assess the association between ASF outbreaks during the study period and the risk factors.Fifty-one (21 %) and 13 (5.6 %) farms reported an ASF outbreak on their farms in the previous one to two years and during the study period, respectively. The incidence rate for ASF prior to the study period was estimated at 14.1 per 100 pig farm-years and 5.6 per 100 pig farm-years during the study. Three pigs tested positive for ASFV using real-time PCR, but none tested positive for ASFV specific antibodies using two different commercial ELISA tests.There was no evidence for existence of pigs that were long-term carriers for the virus based on the analysis of blood and serum as there were no seropositive pigs and the only three ASFV DNA positive pigs were acutely infected and were linked to outbreaks reported by farmers during the study. Potential ASF risk factors were present on both small and medium-scale pig farms, although small scale farms exhibited a higher proportion with multiple potential risk factors (like borrowing boars for sows mating, buying replacement from neighboring farms without ascertaining health status, etc) and did not implement any biosecurity measures. However, no risk factors were significantly associated with ASF reports during the study.
Mapping of Civil Society Organizations in Uganda
(UPHOLD CSO, 2004) Muhangi, Denis
This report discusses the results of the Phase I study to map Civil Society Organizations (CSOs) in the 20 districts of Uganda, where UPHOLD is operating. Phase I was based on a review of secondary data both at national and district levels, as well as interviews with selected key informants at national level.The study focused on CSOs involved in the UPHOLD target sectors of Health, education, and HIV/AIDS, as well as the cross-cutting areas of gender, advocacy, capacity building, management, and communication. At national level, documentation of CSOs exists in form of directories and inventories compiled by different organizations. Most such compilations have been made by NGO network organizations including DENIVA, the National NGO Forum, HURRINET, and UNASO. Some NGOs and government programmes have also compiled directories to serve their needs. The NGO Registration Board in the Ministry of Internal Affairs has a listing of all organizations registered with it. The level and quality of documentation of CSOs at district level varies across districts. Some districts such as Pallisa and Gulu, through their Community Development Department or the District NGO Forum have directories of CSOs. Others (Lira, Bushenyi, Bundibugyo, Mbarara and Rukungiri) are in the process of recording CSOs. Yet others do not have any systematic or comprehensive record of their CSOs. The study results indicate that a very big number of CSOs exists in the districts, a listing by this study revealing 3,400 CSOs in the 20 districts. Yet this figure does not represent the actual number of CSOs that exist, but rather, only those captured in the documents that were accessed. The South-Western district of Bushenyi, Rukungiri and Mbarara revealed the biggest number of CSOs, while the Northern and North Eastern districts had the least number. Bushenyi had 1,160 CSOs, being the district with the biggest number of CSOs recorded. Districts that have been registering CBOs through their Community Development Departments reveal a very big number of CBOs. In almost all districts, CBOs were the most dominant type of CSOs that exists. International NGOs were mainly found in districts that have a history of civil war and other forms of conflict (Gulu, Kitgum, Nakapirirpirit, Bundibugyo, Luwero), and those with a history of other calamities such as HIV/AIDS (Rakai). Several of the CSOs could not be classified in terms of their type, due to unavailability of such information.

Browsing by Author "Muhangi, Denis"

Results Per Page

Sort Options