Browsing by Author "Muhwezi, Wilson Winstons"

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    Assessment of the relationship between life events with psychosocial competence of students in selected secondary schools in Northern and Central Uganda
    (African Health Sciences, 2020) Muhwezi, Wilson Winstons; Abbo, Catherine; Okello, Elialilia S.; Akello, Grace; Ovuga, Emilio B. L.
    As they grow, young people transit through adolescence; a particularly challenging phase. Many go through without difficulties but some experience maladaptive responses in form of conduct and adjustment problems, pubertal challenges and life stress. Published research from the developed societies demonstrates consistent associations between young people’s exposure to life events, psychosocial competence (PSC) and mental health problems. However, comparable research from income-constrained societies remains scarce. The purpose of this study was to determine the prevalence of life events in secondary school students and describe the relationship between life events and PSC in the same population. Methods: This was a cross-sectional study. Participants were 2,902 randomly selected in Central and Northern Uganda. They responded to self-administered questionnaires on socio-demographics, life events and PSC. Results: Northern Ugandan students were more likely to be susceptible to stress-related illness associated with major life events (p = < 0.01). Among students with a high susceptibility to stress related illness, those with low scores on self-efficacy (p = < 0.001), accurate self-assessment (p = < 0.001) and self-confidence (p = < 0.001) were mostly from the North. Students from Northern Uganda had experienced more negative events. Students with higher scores on empathy, emotional awareness, accurate self- assessment and self-confidence tended to have low distress. Students that had a low susceptibility to stress related illness (AOR = 1.97; 95% CI: 1.57 - 2.48); high scores on self-efficacy (AOR 1.37; 95% CI: 1.09 - 1.74), self-confidence (AOR 1.32; 95% CI: 1.02- 1.72), and accurate self-assessment (AOR 2.19; 95% CI: 1.70 - 2.80) were mostly from northern Uganda. Conclusion: It is important to help students to cope with negative life events since an association exists between negative life events and PSC domains. PSC domains of empathy, emotional awareness, accurate self-assessment and self-confidence seem to be associated with lower distress levels, implying that these should be reinforced.
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    Caregivers’ Experiences With Major Depression Concealed by Physical Illness in Patients Recruited From Central Ugandan Primary Health Care Centers
    (Qualitative Health Research, 2008) Muhwezi, Wilson Winstons; Okello, Elialilia Sarikiaeli; Neema, Stella; Seggane, Musisi
    In this article, we present caregivers’ grapples with major depression seen among their physically ill patients. A thematic analysis of 29 in-depth caregiver interviews identified four themes: (a) caregivers’ perceptions of depression, (b) barriers to caregivers’ focus on depression, (c) resources and opportunities for managing depression, and (d) caregivers’ perspectives on consequences of depression. Patients’ physical illnesses concealed depressive episodes. Caregivers could not apply the label of “depression” but enumerated its indicative features. Stigmatization of depression, common with other mental illnesses and poverty, undermined caregiving. Vital caregiving resources included caregivers’ willingness to meet patients’ basic needs, facilitating patients’ access to health care, informal counseling of patients, and ensuring patients’ spiritual nourishment. Caregivers’ management of depression in physically ill patients was expensive, but they coped; however, caregiving was burdensome. Ongoing support should be given not only to patients but caregivers, as well. To provide appropriate care, caregivers deserve sensitization about depression in the context of physical illness.
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    Community Participation to Improve Health Services for Children: a methodology for a community dialogue intervention in Uganda
    (African Health Sciences, 2019) Muhwezi, Wilson Winstons; Palchik, Elizabeth Allen; Kiwanuka, Dorcus Henriksson; Mpanga, Flavia; Mukundane, Moses; Nanungi, Annet; Bataringaya, Denis; Ssesanga, Patrick; Aryaija-Karemani, Adelaine
    Like other developing countries, Uganda still struggles to meaningfully reduce child mortality. A strategy of giving information to communities to spark interest in improving child survival through inducing responsibility and social sanctioning in the health workforce was postulated. By focusing on diarrhea, pneumonia and malaria, a Community and District Empow- erment for Scale up (CODES) undertaking used “community dialogues” to arm communities with health system performance information. This empowered them to monitor health service provision and demand for quality child-health services. We describe a process of community dialoguing through use of citizen report cards, short-text-messages, media and post-dialogue monitoring. Each community dialogue assembled 70-100 members including health workers and community leaders. After each community dialogue, participants implemented activities outlined in generated community contracts. Radio messages promoted demand for child-health services and elicited support to implement accepted activities. The perception that community dialoging is “a lot of talk” that never advances meaningful action was debunked since participant-initiated actions were conceived and implemented. Potential for use of electronic communication in real-time feedback and stimulating discussion proved viable. Post-dialogue monitoring captured in community contracts facilitated pro- cess evaluation and added plausibility for observed effects. Capacitated organizations during post-dialogue monitoring guaran- teed sustainability.
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    Crafting an Oil Revenue-Sharing Mechanism for Uganda
    (Advocates Coalition for Development and Environment ACODE, 2009) Muhwezi, Wilson Winstons; Bainomugisha, Arthur; Ratemo, Fred; Wainnier, Greg
    The discovery of commercial oil deposits in Uganda makes the country strategically important not only in the Great Lakes Region but also in international affairs. As one of the leading oil producers, Uganda will be expected to join the Organization of the Petroleum Exporting Countries (OPEC) which would makes it a key player in international politics. OPEC members include; Algeria, Angola, Ecuador, Iran, Iraq, Kuwait, Libya, Nigeria, Qatar, Saudi Arabia, United Arab Emirates and Venezuela.2 As Uganda prepares to start drilling and refining petroleum, one looming question is how the country will manage oil revenues and the challenges associated with oil-producing countries in a manner that promotes equity, sustainable development and political stability.
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    Effects of a School‑Based Intervention on Frequency and Quality of Adolescent‑Parent/Caregiver Sexuality Communication:
    (Cross Mark, 2018-08-16) Katahoire, Anne Ruhweza; Banura, Cecily; Muhwezi, Wilson Winstons; Bastien, Sheri; Wubs, Annegreet; Klepp, Knut‑Inge; Edvard, Leif
    In a cluster-randomized trial conducted in 22 government secondary schools in Uganda, effects of a school-based intervention aimed at improving aspects of parent/caregiver-adolescent communication on sexuality were examined. The intervention comprised classroom-based education sessions, take home assignments for students to discuss with parents/caregivers and parenting workshops. Baseline and post intervention questionnaires were completed by students and by parents/caregivers. Effect estimates were significant for both students and parents/caregivers on sexuality communication frequency and quality, and for positive and negative attitudes towards sex-related communication, all in the desired direction with effect sizes ranging from 0.17 to 0.38. Effects on four sum scores related to general parenting proved significant only for parents’/caregivers’ legitimacy with regard to rule setting (parents’/caregivers’ reports only). These results suggest that in Uganda, using schools as gateways, parent/caregiver-adolescent communication can be improved through modification of existing school curricula, training teachers in learner-centred approaches and through mobilization and training of parents/caregivers.
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    Examining the Nexus between Nature, Wealth and Power in the Lake George Fishery: The Case of Major Actors in the Fish Product Chain
    (Advocates Coalition for Development and Environment ACODE, 2006) Keizire, Boaz Blackie; Muhwezi, Wilson Winstons; Natuhwera, Carolyn; Kayiso, Fulgencio
    Lake George is an important fish habitat that supports fish stocks estimated to be worth 4-5 billion shillings per year. Secondly, the economic value of fish to the Ugandan economy reached record levels in 2005 with fish exports reaching US $143 million. Fishing is being viewed as a potential growth sub-sector with potential to contribute significantly to national GDP and ensure eradication of poverty. Fishing also has other multiplier benefits of boosting other sectors of the economy like construction (buildings at most landing sites), manufacturing (foods and beverages e.g. beer, sodas, spirits, wines etc), and the transport. From our research, emerging evidence point to the fact that overemphasis on fish conservation without corresponding emphasis on power (governance), economic relations and behavioral patterns found among the actors largely account for the marginal successes in poverty eradication based planning that has been emphasized for a while.
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    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.
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    Life events and depression in the context of the changing African family The case of Uganda
    (World Cultural Psychiatry Research Review, 2007) Muhwezi, Wilson Winstons; Ågren, Hans; Neema, Stella; Musisi, Seggane; Koma, Albert; Koma Maganda, Albert
    Traditionally, the African extended family gave psychosocial support to all members, which cushioned any illness effects including depression. Recent changes in the African family, notably urbanization and market economies, have changed that structure. Changes, especially roles of the family and its relationship to life events and depression, have not received much research attention. Aim: To compare depressed and non-depressed patients in terms of their demographics, family structure, life events and depression. Methods: We compared quantitative data from 85 DSM-IV depressed patients that sought care at three Primary Health Care (PHC) centres with 170 unmatched non-depressed patients. To each group, we administered three questionnaires covering socio-demographics, family structure and an adapted Interview For Recent Life Events (IRLE). Results: Of the depressed patients, over 70% were females giving a M:F ratio of 2.3:1; 71.8% were aged < 39 years and 50.6% were married; the single were 14.1% and 73.9% belonged to male-headed households. Depressed patients significantly differed from the non-depressed in having less post-primary education (p=0.02), fewer singles (0.04), fewer had regular incomes (p=0.01), more were single parents (p=0.02) and separated (p=0.01). Family structure in the two groups never significantly differed. For life events, depressed patients had more deaths of close family members and poor harvests (p=0.003), deaths of children and funeral rites (p=0.014) and sexual health problems (p=0.002). Positive exciting events were more common among non-depressed patients from extended families (p=0.047) while saddening and bereavement events were more common among depressed patients from extended families. Sexual problems were more common among depressed patients and from nuclear families (p= 0.001 & 0.006 respectively). Being a regular income earner was protective against depression [OR=0.45 (95% CI: 0.23-0.85)]. Conclusion: Depressed patients were often single, separated and had children signifying family break ups. They had less income, lower education and had experienced more negative life events, highlighting the weakened family ties in times of modern adversities. This calls for training of more mental health workers and informal helpers for vigorous family therapy interventions in modern Africa, in the face of the weakening extended family.
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    Life Events Associated With Major Depression in Ugandan Primary Healthcare (PHC) Patients: Issues of Cultural Specificity
    (International Journal of Social Psychiatry, 2008) Muhwezi, Wilson Winstons; Ågren, Hans; Neema, Stella; Koma Maganda, Albert; Musisi, Seggane
    The study compared life events experienced by depressed patients seen at primary healthcare (PHC) centres with those among healthy community controls. Method: Data was collected from 74 depressed patients and 64 unmatched controls from village locales of patients. Interview instruments included the depression module of the Mini International Neuropsychiatric Interview (MINI) and Interview for Recent Life Events (IRLE). Associations between type of respondent and demographic variables were examined. Statistical comparisons were done for the two groups on other variables. Results: Most depressed patients were single by marital status, lacked formal employment and had less post-primary education. They had experienced more life events; job changes, discomforting working hours, unfavourable working conditions, and job losses; personal health problems; loss of valuables; difficulties with intimate partners and family members’ marital problems. Independent life events were more among depressed patients and clustered around work, health, bereavement and marriage. Most events reported by depressed patients had high negative impact ratings compared to controls. Conclusion: Compared to healthy community controls, depressed patients reported more undesirable life events. The relationship between life events and depression implies that in PHC settings of poor countries, deploying mental health-oriented workers to manage life events may lessen escalation of distress.
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    Parents’ Knowledge, Risk Perception and Willingness to Allow Young Males to Receive Human Papillomavirus (HPV) Vaccines in Uganda
    (PLoS ONE, 2014) Muhwezi, Wilson Winstons; Banura, Cecily; Kampikaho Turiho, Andrew; Mirembe, Florence
    The Ministry of Health in Uganda in collaboration with the Program for Appropriate Technology for Health (PATH) supported by Bill and Melinda Gates Foundation in 2008–2009 vaccinated approximately 10,000 girls with the bivalent human papilloma virus (HPV) vaccine. We assessed parent’s knowledge, risk perception and willingness to allow son(s) to receive HPV vaccines in future through a cross-sectional survey of secondary school boys aged 10–23 years in 4 districts. 377 questionnaires were distributed per district and 870 were used in analysis. Parents that had ever heard about cervical cancer and HPV vaccines; those who would allow daughter(s) to be given the vaccine and those who thought that HPV infection was associated with genital warts were more willing to allow son(s) to receive the HPV vaccine. Unwilling parents considered HPV vaccination of boys unimportant (p = 0.003), believed that only females should receive the vaccine (p = 0.006), thought their son(s) couldn’t contract HPV (p = 0.010), didn’t know about HPV sexual transmissibility (p = 0.002), knew that males could not acquire HPV (p = 0.000) and never believed that the HPV vaccines could protect against HPV (p = 0.000). Acceptance of HPV vaccination of daughters and likelihood of recommending HPV vaccines to son(s) of friends and relatives predicted parental willingness to allow sons to receive HPV vaccines. Probable HPV vaccination of boys is a viable complement to that of girls. Successfulness of HPV vaccination relies on parental acceptability and sustained sensitization about usefulness of HPV vaccines even for boys is vital.
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    Perceptions and experiences of adolescents, parents and school administrators regarding adolescent-parent communication on sexual and reproductive health issues in urban and rural Uganda
    (Cross Mark, 2015-11-30) Muhwezi, Wilson Winstons; Katahoire, Anne Ruhweza; Banura, Cecily; Mugooda, Herbert; Kwesiga, Doris; Bastien, Sheri; Klepp, Knut-Inge
    Abstract Background: Evidence suggests that in spite of some adolescents being sexually active, many parents do not discuss sex-related issues with them due to lack of age-appropriate respectful vocabulary and skills. The likelihood of parent-adolescent communication improving sexual and reproductive health outcomes appears plausible. The desire to understand parent-adolescent communication and how to improve it for promotion of healthy sexual behaviours inspired this research. The paper is meant to describe perceptions of adolescents, parents and school administrators about parent-adolescent communication on sexual issues; describe the content of such communication and identify factors that influence this communication. Methods: The study was done among two urban and two rural secondary school students in their second year of education. Data were collected from 11 focus group discussions and 10 key Informants Interviews. Data management, analysis and interpretation followed thematic analysis principles. Illuminating verbatim quotations are used to illustrate findings. Results: Parental warmth and acceptability of children was perceived by parents to be foundational for a healthy adolescent- parent communication. Perceptions of adolescents tended to point to more open and frequent communication with mothers than fathers and to cordial relationships with mothers. Fathers were perceived by adolescents to be strict, intimidating, unapproachable and unavailable. While adolescents tended to generally discuss sexual issues with mothers, male adolescents communicated less with anyone on sex, relationships and condoms. Much of the parent-adolescent communication was perceived to focus on sexually transmitted infections and body changes. Discussions of sex and dating with adolescents were perceived to be rare. Common triggers of sexuality discussions with female adolescents were; onset of menstruation and perceived abortion in the neighbourhood. Discussion with male adolescents, if it occurred was perceived to be triggered by parental suspicion of having female ‘friends’ or coming home late. Peers at school and mass media were perceived to the main source of sexuality information. (Continued on next page