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Despite the importance of early childhood education in improving academic achievements in subsequent years and also in social development, it remains out of reach for majority of children in developing countries. This leaves informal education as the main preparation children in rural areas receive before entry into primary schools. This paper focuses on contributions of informal early childhood education to pupils learning in lower primary schools. Data was drawn from a three-year longitudinal study of children who had benefitted from the informal early childhood education provided by a nongovernmental organization (LABE), in Uganda. Findings show that attendance of informal home based learning improves pupils' performance in literacy and numeracy by primary three. Children who attend the informal early childhood education performed better than those who start school direct from home. Informal early childhood education also increases children readiness for schools and helps them cope better with school. The paper recommends adaptation of the LABE model in rural areas with inadequate formal ECCE provisions. In addition, for improved supervision, linking HLC and primary schools is critical.

This paper is based on two studies conducted in Colorado Springs, Colorado, in 2008 and in Kampala, Uganda, in 2014. The basic research question addressed in both studies was: "What are the experiences in the lives of upper elementary-aged children that foster an intrinsic motivation to seek information?" The secondary question was: "How do the experiences of students from a collectivist culture (Kampala, Uganda) who are intrinsically motivated to seek information compare and contrast with the experiences of similarly aged students from an individualistic culture (Colorado Springs, Colorado, U.S.A.)?" The focus of this paper is to explore the dispositions of both sets of informants using a theoretical framework consisting of the educative dispositions of an Effective Learner--independence, creativity, self-motivation, and resilience (Bertram and Pascal 2002)--as correlated with the dispositions listed in the American Association of School Librarians' "Standards for the 21st-Century Learner" (2007). The findings were that both sets of informants exhibited an affinity for play and a tendency toward creativity, and that the Ugandan students were more inclined toward competence-building activities than their Colorado Springs counterparts, who generally exhibited noncompetitive dispositions. Furthermore, resilience was a disposition revealed by students in the Ugandan study.

The relationship between education and empowerment has been widely debated in development literature. In recent times, social capital and community-centric learning have been increasingly recognized as important variables in the empowerment process. This paper outlines the development of a "Three-dimensional Empowerment Framework", and looks at the relationship between a community-centric learning process and empowerment in selected villages in Uganda. Based on a study of two villages, the paper evaluates the role of the "Lifelong Learning for Farmers" (L3F) programme, developed and supported by the Commonwealth of Learning (COL), in empowering farming communities. The purpose of the study was to gain a better understanding of empowerment in the selected farming communities and to identify factors that may contribute to empowerment, including the L3F programme. Two sample villages with similar demographics were used for comparison, one L3F village and one non-L3F village, with 62 respondents from the L3F village and 78 from the non-L3F village, selected randomly. A survey, which included demographic questions as well as an empowerment scale, was administered to respondents from both groups. The responses were analysed and a regression model showing the factors that influenced empowerment was developed. The study shows that the integration of human capital (viewed purely from learning, knowledge acquisition, reflective practices, skills and competencies), social capital and financial capital, has a positive impact on development outcomes such as empowerment.

This paper summarises experiences of efforts made by twenty individuals when implementing small-scale ICT development projects in their organizations located in seven developing countries. The main focus of these projects was the use of ICT in educational settings. Challenges encountered and the contributing factors for implementation success of the projects are systematically investigated using interviews and follow up surveys. Results show that the typical limitations of technology and infrastructure were the key obstacles. The commitment of individual project managers in the role of "change agents" and organizational support in the were the strengths behind the success of the projects. Based on the outcome of this study, professional development of the change agents is a key factor for the success of projects. IT and infrastructure limitations contributed to the failure of the majority of the ICT related projects.

Purpose: This paper examines the in-service teacher training needs of secondary school agriculture teachers in Uganda as the country moves towards an "outcome-based" education by removal of subjects and instead, uses learning areas, presenting a need for new pedagogical skills among teachers. Design/methodology/approach: A cross-sectional survey was conducted in Uganda between June and September 2016 to assess the teaching methods and teacher training needs for secondary school agriculture curriculum. Data were collected from 80 agriculture teachers and 57 administrators from 60 secondary schools, randomly drawn from 25 districts in Uganda. The data were analysed with descriptive statistics. Findings: The findings show that there about 10 key competences required by the teachers to thrive in their profession. These range from traditional classroom teaching to community outreach and linkages with agribusinesses which is in tandem with outcomebased education beyond the classroom walls. Respondents highlight lack of practical agriculture skills and exposure to the modern farming practices. Theoretical implications: This paper examines role of formal inservice teacher training based on theory of change and proposes using professional learning communities for school-level improvements. Practical implication: The results were not significant enough to warrant strong recommendations. However, they suffice to highlight a growing need for in-service teacher support mechanism for a dynamic subject like agriculture using communities of practice at school and district levels. Originality/value: In the current context of growing concern for unemployment in Africa, secondary schools will require competent teachers to engage students into transferable learning, given that it is the terminal level of education for majority.

Competent graduates are a critical input in enhancing the university's role in agricultural transformation. How graduates play their role in contributing to development mirrors on how they trained. Low quality graduates are believed to be a product of a more subject-centered and instructive style of teaching. The Makerere University Kampala School of Agricultural Sciences (SAS) made effort to improve and enhance the competence of its lecturers to use a learner centered teaching approach in its programmes through training. This paper presents an assessment of how the training influenced the lecturers to use different teaching practices toward producing quality responsive graduates. Data was collected from 120 students and 20 lectures from the SAS using a semi-structured questionnaire. The findings show that Training lecturers in experiential learning influenced their awareness and use of experiential learning approaches in delivery of the courses they taught. Effective application of experiential learning approaches was constrained by challenges of varied understanding and appreciation of the concept among lecturers, short class periods, large class sizes and financial limitations. In effect, the traditional lecture method remained dominant. Above all, application of experiential learning approaches is not institutionalized at SAS thus limiting the attainment of critical and reflective thinking for the attainment of lifelong learning abilities among students. To strengthen application of experiential learning approaches, training of all lecturers and curriculum review to integrate experiential learning practices as part of the general teaching quality assurance measures is critical.

Assessment in health sciences education has become an extremely critical issue in recent years, given the rapidly changing disease patterns and behavioral changes in communities among diverse cultural and economic contexts of patients. Globally, there is increasing demand for highly qualified contemporary healthcare professionals. Subsequently, learner assessment regimes need to have the capacity to accurately evaluate the competences (i.e. attitudes, skills and know-how) acquired during the training of healthcare professionals. This paper provides an analysis of assessment of and for learning in health sciences education with a focus on clinical laboratory training at MLT in Uganda. This study utilized both quantitative and qualitative research designs. The program evaluation design principles were also utilized to measure the levels of compliance towards attainment of curriculum outcomes. The instruments used during data collection included checklists, questionnaires, in-depth interviews, and focus group discussions (FDGs). The findings of this study showed that learners were achieving the intended curriculum objectives progressively. The assessment tools used were prepared through a rigorous process to ensure that the basic principles of assessment are identified and integrated during curriculum design and implementation. Results of the study also showed that adequate institutional administrative support available enhanced the teaching and learning processes and ensured that appropriate curriculum assessment schedules and strategies were strictly followed as stated in the elements of the curriculum structures. This contributed meaningfully in preparing competent contemporary healthcare professionals (clinical laboratory technicians). It was recommended that all healthcare professional training institutions should take the use of authentic assessment of and for learning very seriously.

This paper presents a "peace with social justice" framework for analysing the role of teachers as agents of sustainable peace, social cohesion and development and applies this to research evidence from Pakistan, Uganda, Myanmar and South Africa. The paper draws on evidence from a recently completed UNICEF and ESRC funded project on education and peacebuilding, and specifically from data gathered around the role of teachers. Drawing on rich fieldwork data collected between 2014-2016 in each of the four countries, the paper will evidence the complex and contradictory role that teachers play in sustainable peace and development and its implications for teacher governance, teacher policy and teacher practice. The paper challenges the overly human capital driven logics of much teacher policy reform agendas and highlights the need and importance for a more holistic approach to teacher governance and management that recognises teachers' multiple potential to contribute to both societal peace and development.

This paper establishes the extent to which attitudinal variables affect the education reforms and subsequently the quality of primary education in Uganda. The paper is based on the views of a wide spectrum of different education stakeholders including: policy analysts, Members of Parliament (MPs), education officers, Headteachers, teaching staff, school directors, parents, and school management committees. The variables under study include: school culture, religion of the school, freedom of expression, parents' attitude toward the school, the learners' attitude toward the school and achievement of expectations. It was realized that the reform of Uganda's Primary Education System is mostly determined by three elements within the attitudinal dynamics. First, majority of the respondents 336 (93.1%) agreed that parents' attitudes toward the school affect quality of primary education; 331 (91.7%) concurred that learners' attitude toward the school affects the quality of primary education and lastly; 320 (88.6%) agreed that achievement of expectations affects the quality of primary education. In addition, all elements of attitudinal dynamics, according to the regression analysis accounted for 19.7% of the variations in the quality of primary education.

Educational research has linked parental participation in children's schooling with a wide range of children's academic outcomes. Parental involvement involves time and resource commitment towards children's academic performance. This paper extracts data from a cross-sectional survey involving 2,669 grade six students attending public and private primary schools serving households located in Iganga-Mayuge health and demographic surveillance system in rural Eastern Uganda. The paper adopts two of the six types of parental involvement detailed in the Epstein parental involvement framework. This paper hypothesises that parental participation through parenting and communication types of involvement will give children an advantage towards academic achievement. Using a regression model and controlling for individual, school and household covariates, the results indicate that a unit increase in parental participation through parenting and communication types of involvement significantly increases students' numeracy scores by 6 and 15 percentage points, respectively. Similarly, a unit increase in parental participation through parenting and communication types of involvement significantly increases students' literacy scores, by 6 and 12 percentage points, respectively. This implies that parental participation plays a pivotal role in motivating children to improve their academic grades. For students to reap maximum benefits in an education system, the learning should not be solely left to the student--teacher relationship but should be extended to include active parental involvement among other education stakeholders.

This paper examines the place of public libraries in supporting distance learners in Makerere University, exploring the factors which affect utilisation of their services. The study adopted a survey design with 300 B.Ed. students, collecting data through focus group discussions, structured questionnaires and individual interviews.

This paper explores the design of a blended learning environment in a transition from face-to-face and seeks to determine whether learner characteristics and background together with blended learning design elements are significant factors for learning outcomes such as intrinsic motivation, satisfaction, knowledge construction and learning performance in blended learning. It is aimed at examining the learner characteristics and backgrounds such as age, gender, self-regulation, attitudes, family and social support as well as the management of workload in blended learning. It is again to find out the levels of use and satisfaction with blended learning design features such as interactions, learning management system tools and resources, face-to-face support and technology quality by learners. Students from three schools and one directorate were involved in a face-to-face set up in the first part of a seventeen week semester and in an online set up in the second part. They finally had a face-to-face at the end to review their work after which they took end of semester examinations. A questionnaire survey was administered to 270 respondents in this group to gather data on student characteristics and background, design features and three of the outcomes. The examination results were used as a measure of the performance variable in the learning outcomes. We applied the online self-regulated learning questionnaire for data on students' self-regulation, the intrinsic motivation inventory for data on motivation and other self-developed instruments to measure the other constructs. Descriptive statistics showed that the identified learner characteristics manifest strength for blended learning design and the learners' involvement with design features was found to be high and satisfactory. ANOVA results showed no significant differences between age groups in performance and t-test results showed no significant differences between male and female students. Regression analysis results showed learner attitudes as predictors of learner satisfaction and motivation while workload management is a significant predictor for learner satisfaction and knowledge construction. Among the design elements, regression results showed only learner interactions as significant predictors of knowledge construction and satisfaction. As a consequence, a number of learner characteristics and design features are seen to be important for blended learning design and the non-significant ones remain a focus for future research.

This paper presents findings from the third stage of a longitudinal, qualitative study involving nine female participants from a class cohort in a secondary school in rural Uganda. Since 2004-05, this study has tracked the progress of these young women's lives, and the present aspect of the study explores the ways in which they have found that post-primary education has impacted their adult lives, particularly with respect to employment-related factors. I draw upon the conceptual construct of Amartya Sen's "capabilities approach" (1999) to interpret and present data. Findings considered in this paper indicate that post-primary education has been crucial to the capabilities development and socioeconomic well-being of the participants' lives.

The purpose of this paper is to compare and contrast characteristics of use and adoption of mobile learning in higher education in developed and developing countries. A comparative case study based on a survey questionnaire was conducted with 189 students (undergraduate and postgraduate) from Makerere University in Uganda and the University of Adelaide in Australia. The Unified Theory of Acceptance and Use of Technology (UTAUT) was employed as the theoretical framework. The results indicated that higher education students in developed and developing countries use a range of technologies for learning, with major differences between Uganda and Australia. The study concludes that mobile learning in higher education in developed and developing country contexts is still at an experimental stage with students using mobile devices in pedagogically limited ways.

Purpose: This paper aims to present findings of a study that was carried out to identify strategies of enabling learners in developing countries to fully exploit the potential of learning management systems (LMSs). The study set out to: identify the services of learning management systems that are most needed and desired by university learners in developing countries; and identify appropriate access strategies that would guide design decisions on how to effectively and satisfactorily deliver such services to the university students in developing countries. Design/Methodology/Approach: A total of 144 students from two African universities participated in the study by responding to an online survey questionnaire. The questionnaire asked students: how often they accessed LMSs to obtain, create and exchange information and knowledge; their preference for the different devices used for accessing the LMS; the LMS services they are most often required to access; and the services they most desire to use. Findings: The findings of the survey indicate that the most desired and most accessed LMS services by the students include: assignments, announcements, resources, course outlines and the chat room. At the same time, mobile phones are rated the least used devices for accessing the LMS services, mainly due to inadequate design of LMSs for mobile interaction. Originality/Value: The paper also presents mobile LMS interface designs and ideas achieved through a participatory design process for enhancing the accessibility of the most needed and desired LMS services on mobile phones. (Contains 4 tables and 15 figures.)

Purpose: This paper aims to identify the differences between African and European students with regard to their entrepreneurial intentions, attitudes towards entrepreneurship, role models and entrepreneurial experience. It also aims to set the scene for future comparative research between developing and developed countries in the area of graduate entrepreneurship. Design/methodology/approach: A quantitative empirical research design was applied, using self-administered questionnaires. Questionnaires were distributed to first-year business students at universities in three African countries that are either developing (Uganda and Kenya) or emerging (South Africa) and four European developed nations (Finland, Germany, Ireland, and Portugal). Findings: The results indicate that students from developing/emerging economies are more likely to envisage future careers as entrepreneurs and are more positive towards entrepreneurship than their industrialised European counterparts, even though motivators for employment/self-employment are similar across the samples. The type of role models used and the extent of entrepreneurial experience varied between individual countries. Research limitations/implications: Limitations include the use of a convenience sample and its restriction on the use of statistics, a single data collection point and a sample across seven countries on two continents. Practical implications: The results lead to universal and country-specific recommendations relating to the improvement of student-oriented entrepreneurship activities within universities. Originality/value: The paper extends research on graduate entrepreneurship by providing an international comparison of entrepreneurship intentions, attitudes and experiences between developing/emerging and developed nations, leading to suggestions on how to foster an entrepreneurial spirit and assist new-venture creations for students. (Contains 2 tables and 4 figures.)

Research on reading has established that reading is a pivotal discipline and early literacy development dictates later reading success. Therefore, the purpose of this study is to investigate challenges encountered with reading pedagogy, teaching materials, and teachers' attitudes towards teaching reading in crowded primary classes in Kampala, Uganda's Central Municipality. This study's scope reached beyond daily functional literacy for reading road signs, recipes, and posters into teaching reading with critical reading methodologies that benefit learners' progress to higher reading levels. The methods used to collect quantitative and qualitative data were surveys, interviews, and questionnaires. Three approaches to data collection that guided the study were determining the effect of the size of the classes on the teaching methods used to teach reading skills in primary classes, the effect of big classes on the teaching materials used to teach reading skills in huge classes, and the effect of enrollment on teachers' attitudes towards teaching reading in big classes. Data were collected from 48 teachers of reading skills in lower primary classes, 16 primary head teachers, and 16 heads of the lower sections in the 16 primary schools selected for the study. Most responders tended to show that the commonest teaching methods used by the teachers of reading in the crowded classes were those that tended to raise chorus reading. Such methods helped the teachers involve every pupil to read. Besides, such methods indirectly enabled the teachers to have better class control. Another finding was that the teachers used mostly the traditional learning materials, including chalkboards and wall charts. No school had any materials that use modern technology. Yet, the markers and manila paper that would be used to design other teaching materials were given out irregularly. Also, the big numbers of pupils handled made the teachers' teaching a burdensome task. It was concluded, therefore, that the teaching-learning process of reading in the lower classes was substantially affected negatively by the large classes. A map of the Kampala District showing Central Division is appended. (Contains 9 tables.)

This paper describes an applied research study conducted to find solutions for the problem of the use of physical punishment in schools in the Kampala District of Uganda. In this study stakeholders were requested to state their actions and feelings towards the use of physical punishment in schools. The objective of the study was to investigate attitudes of stakeholders towards physical punishment in schools, find out circumstances which commonly lead to physical punishment, and explore perceptions of stakeholders on alternative forms of punishment. To achieve these objectives the researcher used survey methods in his research methodology. The sample was composed of 360 respondents/subjects (school administrators, parents, teachers and pupils). These respondents were subjected to interviews and questionnaires. In these aspects the research was carried out under the requirements of both qualitative and quantitative research. Attitudes towards physical punishment as a dependent variable depended on the use of physical punishment as an independent variable; therefore attitudes of stakeholders are influenced by physical punishment. To analyze the data, the researcher coded similar issues and therefore calculated percentages in order to estimate the average of respondents who appreciate or do not appreciate any issue concerning the use of physical punishment in schools. The study revealed that in both international and national schools, pupils acknowledged that physical punishment is helpful; pupils did not agree that a teacher who beats children should be dismissed. Referring to these findings it seems that pupils are driven by external pressures about the matter of the use of physical punishment.

University students in Uganda had been confined to use of traditional educational technologies such as chalkboards, papers and text books. Digital Media Approach recently found its way in the academia at public universities in Uganda. Information and communication technology (ICT) have become popular means of surfing, downloading and obtaining electronic materials among students. The approach has globally facilitated the seeking of academic information at institutions of higher learning in Uganda. However, little research has been conducted in regard to students who are the key users of Digital Media. The purpose of this study was to explore students' attitudes towards Digital Media Approach at a public university in Uganda. The study specifically sought to establish whether university students' attitudes towards digital technology were dependent on computer ownership, field of study and previous computer hands-on experience. A survey research was employed to establish students' attitudes in regard to digital media. Questionnaires and interviews were used as tools for data collection while data was analyzed using a t-test. The findings showed that students who had their own computers as well as previous computer hands-on experience had more positive attitudes towards using the media than their counterparts without previous computer hands-on experience.

This paper reports a survey that sought to establish levels of use of PC (personal computer) software by graduate students in Makerere University and to link the same to organizational characteristics, related to a given respondent's "unit", that is school, faculty or institute, namely its ability to absorb change, its ICT (Information and Communication Technology) culture, size and leader's ICT change management style. The correlational and cross-sectional survey involved 175 students who filled a questionnaire. Data analysis, involving summary statistics (e.g., means and standard deviations) and multiple regression, indicated low levels of use of PC software, and only unit ICT culture was a significantly positive correlate of the same. It was thus recommended that stakeholders, such as the Makerere University directorate of ICT support, encouraged respective units to build and continually enhance their ICT cultures as a possible means of enhancing the use of PC software by graduate students therein. (Contains 6 tables.)

This paper reports on a study which assessed the application of information and communication technologies (ICT) in health information access and dissemination in Uganda. The project focused not only on information obtainable through libraries for research, teaching, learning and practice, but also on ICT applications concerned with the administration and planning of health services in Uganda. A thematic analysis highlighted the current state of ICT applications, the extent of applications, the roles played and problems faced. The paper further explores areas where it is used most, cost of accessing information, user profile, ICT literacy, quality of services and telemedicine in the country. It concludes that a number of challenges must be addressed if the full benefit of the use and application of ICT in health information access and dissemination is to be realized in Uganda, and draws the attention of all the stakeholders in the health sector to the need to support and promote ICT as the most effective tool for health information access and dissemination. (Contains 1 table.)

Most universities are enrolling large numbers of students amidst dwindling budgets. This leads to reduced book- to student ratios. Makerere University started a Book Bank system to ensure availability of basic text books to students. The aim of this paper was to assess whether the Book Bank system was a viable strategy for enhancing access to reading materials in academic libraries with low budgets. Findings revealed that the Book Bank system was appreciated and 92% of the students used Book Banks. Concludes that the Book Bank is a possible strategy for enhancing access to reading materials in academic libraries with low budgets.

Purpose: Concern for the state of architectural education in East Africa was a catalyst for this exploration of socialisation, which sought to understand socialisation and its influence on educational outcomes in the region. Socialisation within architectural education has long been known to influence how students acquire important aspects of the profession, building both values and a cultural ethos in the process. An appreciation of these processes in the context of East Africa adds to the wider understanding of the implicit curriculum in architectural education. The paper aims to discuss these issues. Design/methodology/approach: An ethnographic study was undertaken in five architecture schools across Kenya, Tanzania and Uganda, making use of a mixed method approach incorporating document analysis, a questionnaire study, participant observations and focus group discussions as the data gathering instruments. Focus group discussions, as the primary data gathering method, acknowledged the social context of the study, with data gathered from multiple sites across the region. Findings: As an integral component of architectural education, socialisation was evident at all stages of the educational process. Within the educational realm, contrasting expectations of students and instructors were evident, leading to conflicts that influenced the values acquired by students. This was seen in attitudes towards contemporary architectural issues within architectural education, and suggests that socialisation can at times have pronounced negative consequences. Originality/value: The wider study represents the first comprehensive review of architectural education in the context of East Africa, and contributes to the global appreciation of the influence of socialisation on educational outcomes.

Purpose: The purpose of this paper is to examine relationship between teacher competences and organizational citizenship behavior (OCB) with empowerment as a mediating factor. Design/methodology/approach: The study took a cross-sectional descriptive and analytical design. Using cluster and random sampling procedures, data were obtained from 383 usable questionnaires. Data were analyzed through SPSS and Analysis of Moment Structures. Findings: Results indicated that planning, continuous assessment and initiating as operant teacher competences were significantly and positively related to empowerment. Also, empowerment was significantly and positively related to OCBs. Similarly, empowerment came out as a full mediator of the relationship between the teacher competences and OCBs. Practical implications: The study is relevant in that heads of schools will ensure they set up and implement human resources policies and practices that are favorable to building empowerment and OCB. School heads will be able to closely adhere to planning, initiating and continuous assessment rules in order to promote teacher empowerment and OCB. Government could appraise school heads based on whether they can successfully implement operant competence related rules on the employees Originality/value: The findings theoretically reconceptualize competences from the objectivist to the constructivist perspective. Planning, initiating, continuous assessment and empowerment make significant variations in OCB. The study demonstrates that empowerment translates the inputs of teacher competence into OCB.

Purpose: The purpose of this paper is to examine the various entrepreneurship teaching methods in Uganda and how these methods relate to entrepreneurial self-efficacy (ESE). Design/methodology/approach: A sample of 522 final year students from selected universities and study programs was surveyed using self-reported questionnaires. Findings: There was a statistically significant positive relationship between ESE and lecturers' business experience. Interacting with successful people, personal reading and handout notes, class presentations and imaginary case studies had a statistically significant positive relationship with ESE. There was no statistical significance in the relationship between ESE and some teaching methods. A positively significant correlation was also observed between lectures' business experience and the choice of teaching method(s). Research limitations/implications: Further research should explore how various methods are used to teach different aspects of entrepreneurship as well as the attitudes and perceptions of entrepreneurship educators about entrepreneurial experience and its relevancy in entrepreneurship education. Practical implications: Lecturers should seek opportunities for attaining business experience through practice and business networks. Institutions should orient lecturers through different teaching styles and train them on how to relate learning outcomes to learning environments as well as investing in learning aids. Originality/value: The study provides insights about the most feasible methods of activating ESE in the most practical and efficient ways. It also informs readers about the state of learning technologies from a developing country's perspective.

In this paper, we address findings from a study conducted in a rural, Ugandan secondary school from August 2009 to May 2011 that explored the challenges and possibilities of developing language and literacy across the curriculum, including digital possibilities for the development of multilingual academic literacy. The central questions we address are: (1) in a rural African context, what educational conditions and language policies impact the use of English as a medium of instruction in secondary schools? and (2) how do teachers across the curriculum navigate these conditions and policies to integrate English language and content? Data collection methods included questionnaires, interviews, observations, policy document analysis and researchers' journal reflections. Central findings highlight the difficulties faced by content teachers in addressing their students' language needs in the context of contemporary policy guidelines; issues related to the pre-service preparation of subject area teachers; and possibilities for developing pedagogy for teaching language/s and literacies across the curriculum. From the findings, we argue that language policies, despite best intentions, might, like other "placed resources" become dysfunctional when moved across distinctly different spaces from relatively well-resourced urban areas to poorly resourced rural communities and from elite to grassroots contexts.

This paper examines the relationship between budget planning and the quality of educational services at Kyambogo University in Uganda. We argue that the manner in which the university's budget planning activities are conducted determines in a significant way (by 76.8%) the quality of the services offered by public universities in Uganda. The findings are original and contribute to the body of education quality in developing countries. The results are compared with both local and international findings to suggest policy and managerial implications.

Background: Forcibly displaced populations are highly vulnerable to psychosocial distress and mental disorders, including alcohol misuse. In an ongoing trial that seeks to develop a transdiagnostic intervention addressing psychological distress and alcohol use disorders among conflict-affected populations, we will carry out a cost-effectiveness evaluation using a capability-based Oxford Capabilities Mental Health (OxCAP-MH) measure. The OxCAP-MH is a 16-item questionnaire developed from the Capability Approach, that covers multiple domains of functioning and welfare. The aim of the current paper is to present the results of the translation, cultural adaptation and valuation of the OxCAP-MH into Juba Arabic for South Sudanese refugees living in Uganda. We adhered to the official Translation and Linguistic Validation process of the OxCAP-MH. To carry out the translation, the Concept Elaboration document, official English version of the OxCAP-MH, and the Back-Translation Review Template were used. Four independent translators were used for forward and back translations. The reconciled translated version was then piloted in two focus group discussions (N = 16) in Rhino refugee settlement. A most important to least important valuation of the sixteen capability domains covered in the OxCAP-MH was also done. Results: The Juba Arabic version of the OxCAP-MH was finalized following a systematic iterative process. The content of the Juba Arabic version remained unchanged, but key concepts were adapted to ensure cultural acceptability, feasibility, and comprehension of the measure in the local context of Rhino refugee settlement. Most participants had low levels of literacy and required support with filling in the tool. Participants suggested an additional capability that is currently not reflected in the OxCAP-MH, namely access to food. Furthermore, discussions around the valuation exercise of the sixteen domains led to two separate importance scales, which showed relevant differences. Conclusions: In this context, the OxCAP-MH was considered culturally acceptable. The valuation exercise proved cognitively demanding. Participants voiced confusion over how to answer the questions on the OxCAP-MH instrument due to low levels of literacy. These concerns invite consideration for future research to consider how measures such as the OxCAP-MH can be made more accessible to individuals with low literacy rates in resource poor settings. [ABSTRACT FROM AUTHOR]

The educational culture in most developing countries is lecturer-centred with lecturers as providers of information and students as receivers of information. This approach has impacted on student's ability to seek and create knowledge to support their learning process. A collaborative learning approach that promotes students process of inquiry, critical thinking and skill development thus lacks in the context, yet these aspects are crucial in the knowledge society. If universities in developing countries are to educate students to compete and become active participants in society, the teaching and learning processes underpinned by relevant theories and models should be adopted. This paper proposes an approach to support students' learning in a developing country context--Uganda. Specifically, the authors design and model a peer assignment review process for collaborative e-learning, employing the second stage of development research. The model is based on using student to pedagogically support each other's learning through four process stages: familiarization, assignment, review and feedback. Empirical investigations of the process stages indicated that the peer assignment review process facilitated the students learning. Students indicated that they were able to actively participate in the course, gain experience in critical reading and evaluating peers work, while reflecting on their own work. The empirical investigation further indicated that students were able to adopt and use online technologies in their learning activities. As such the peer assignment review process impacted the students learning both as receivers and providers of reviews creating a level of acceptance to adopt and use the proposed collaborative e-learning approach. (Contains 1 figure and 4 tables.)

Purpose: This paper aims to examine the predictive potential of elder abuse on welfare status of older persons in selected districts in Southwestern Uganda. Design/methodology/approach: The study took a cross-sectional descriptive and analytical design. Using a sample of 285 respondents, data were obtained from 201 usable questionnaires collected from caregivers and officials relating with older persons in this area making it a response rate of 70.5%. Using statistical program for social scientists (SPSS), the researchers tested and analyzed six hypotheses. Findings: Results indicate that physical abuse, emotional abuse, financial abuse and neglect negatively and significantly predicted welfare status. Though negatively related, social abuse and sexual abuse did not significantly predict welfare status. Practical implications: Family members and caregivers must make practices that do not promote physical abuse, emotional abuse, financial abuse and neglect as these negatively affect the welfare status of elderly persons. District officials such as community development officers and other persons handling older persons need to implement policies that promote the welfare status of the elderly. Originality/value: The study demonstrates that the existence of physical abuse, emotional abuse, financial abuse and neglect is a deterrent to older person's welfare status. [ABSTRACT FROM AUTHOR]

Introduction: Trauma registries are a means for improving trauma care in low- and middle-income countries, though a number of challenges for the sustainability of these trauma registries exist. Mobile health applications represent a promising technology for low- and middle-income country trauma registries. The development, implementation and evaluation of a mobile application trauma registry for use at the Mbarara Regional Referral Hospital, Uganda is demonstrated. Methods: A paper-based trauma registry was implemented at the Mbarara Regional Referral Hospital. Based on feedback from local stakeholders, this was developed into an open-source mobile application version of the trauma registry. The mobile application was evaluated by 17 healthcare workers using a modified Unified Theory of Acceptance and Use of Technology questionnaire and qualitative analysis. Results: Unified Theory of Acceptance and Use of Technology scores showed the majority of participants responding positively to the major constructs of Performance Expectancy, Effort Expectancy, Social Influence and Facilitating Conditions, with mean Likert scores (out of 7) of 6.41 (±1.43), 6.25 (±1.41), 5.44 (±1.43) and 5.32 (±1.99), respectively. There was also a young average user age (29.1 years). Qualitative analysis identified response themes of ease of use, efficiency and potential for future research and clinical use; users also suggested expansion of the type of platforms the application was available on. Conclusion: Though a number of challenges exist for sustaining trauma registries in low- and middle-income countries, substantial involvement of local stakeholders and responsiveness to feedback should be used to facilitate the use of these technologies in developing countries. This study demonstrates a potential methodology for developing and evaluating trauma registry technologies for use in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the mediating role of social capital in financial literacy and financial inclusion relationship in rural Uganda. The major aim is to establish the role of social capital in the relationship between financial literacy and financial inclusion. Design/methodology/approach: The paper adopts and uses MedGraph programme (Excel version 3.0), Sobel and Kenny and Baron tests to test the mediation effect of social capital in the relationship between financial literacy and financial inclusion. Findings: The results reveals that social capital is a significant mediator in the relationship between financial literacy and financial inclusion of rural poor in Uganda. Financial literacy did not have a direct effect on financial inclusion, but through full mediation of social capital. Existence of social capital into the relationship boosts the relationship between financial literacy and financial inclusion by 61.6 per cent among rural poor households in Uganda. Thus, the finding suggests that with the absence of social capital, financial literacy may fail to enhance the level of financial inclusion among rural poor households in Uganda. Research limitations/implications: This study adopted only single research approach using a questionnaire. However, future research through interview may be of importance. Besides, for the purpose of triangulation, a study involving financial institutions' staff may be viable. Moreover this study was limited by the fact that it was cross-sectional. Furthermore, a longitudinal study may be useful in future to investigate the mediating impact of social capital spanning over a long period of time. Practical implications: Managers, policymakers and financial inclusion practitioners should advocate and embark on building social capital among rural communities, so as to improve on the level of financial inclusion. Originality/value: While a large body of research has been carried out on financial literacy, this paper is the first to test the mediating role of social capital in the relationship between financial literacy and financial inclusion, especially in rural Uganda. This study generates evidence and contributes to the powerful influence of social capital in enhancing the level of financial inclusion based on financial literacy. [ABSTRACT FROM AUTHOR]

This paper explores the influence of the community-based rehabilitation approach among international development actors in Gulu, Uganda through the lens of policy transfer. Developed by international organizations, this approach has been promoted as a meaningful way to address the needs of persons with disabilities in low-income countries. This qualitative case study consists of a questionnaire completed by representatives from 25 different organizations, in addition to semi-structured follow-up interviews with 8 development professionals. The findings indicate that the community-based rehabilitation approach has had some influence, as respondents appeared cognisant of key principles of the approach in relation to persons with disabilities. However, detailed knowledge of the approach is mainly limited to the field of health, and there were few current examples of the approach being implemented. These results illustrate the challenges of implementing community-based rehabilitation specifically, as well as broader issues related to the transfer of international policy ideas to the Global South. Community-based rehabilitation is a way of helping people with disabilities in low-income countries where services are limited Development organizations in Gulu, Uganda (like the local government and non-governmental organizations) think that this approach is a good way to support people with disabilities Only a few of the people interviewed for this study had a strong understanding of the community-based rehabilitation approach, and these people mostly worked in the health sector There were no examples of community-based rehabilitation programs in Gulu at the time of the study, but some projects (mostly in the health field) used some ideas drawn from the approach Local development organizations find it difficult to apply policy ideas like community-based rehabilitation, especially when they do not have consistent funding [ABSTRACT FROM AUTHOR]

Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of 'The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,' 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale-up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale-up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Health systems in many low‐ to middle‐income countries (LMICs) are heavily underfunded, and staff training opportunities are limited.There is a lack of empirical data on the development and use of sustainable training programmes in aggression management skills in LMICs. What does this paper add to existing knowledge?: After RESPECT, participants showed greater agreement with statements about the role of environmental and relational factors as antecedents of aggression and described favouring the use of non‐physical techniques to manage aggressive behaviour.Attitudes towards management practices of seclusion, medication and restraint remained unchanged after RESPECT training. What are the implications for practice?: Training programmes like RESPECT may be useful to improve attitudes towards causes of aggression and its management in LMIC hospitals. However, further evidence is required to demonstrate whether these results can be sustained over time and whether these attitudinal changes are associated with reduction of workplace violence.Mental health nurses and other mental health professionals can play a key role in establishing hospital‐wide training and sharing skills across geographical boundaries. Introduction: Occupational violence has been demonstrated to impact negatively on the well‐being of nurses and patients. Staff attitudes towards causes and management of patients' aggression influence their practice. Training is likely to influence attitudes towards aggression; however, Uganda's health system lacks adequate resources to provide aggression management training for staff. Aim: To assess the impact of a training programme (RESPECT) on staff attitudes towards causes and management of patient's aggression in a Ugandan hospital. Methods: This study used a mixed‐methods convergent design. A convenience sample of nurses and support staff employed in the psychiatric ward and other services across the hospital (N = 90) completed the Management of Aggression and Violence Attitude Scale (MAVAS) pre‐ and post‐training. The views of a smaller sample (n = 35) were captured via interviews and focus groups and analysed using thematic analysis. Results: Participants reported greater agreement with patients' physical and social environment (external and situational causative models) as factors influencing patient's aggression. Qualitative findings substantiated the results identified in the survey. Attitudes towards seclusion, restraint and medication remained unchanged. Discussion and implications for practice: RESPECT has the potential to change staff attitudes towards aggression in the short term. Further research is needed to investigate long‐term effects and impact on incidents of aggression. [ABSTRACT FROM AUTHOR]

Background: There is growing global concern about poor mental health among adolescents in sub-Saharan Africa. In particular, adolescent girls face multiple challenges in managing menstruation which can impact both their health and wellbeing. In this study we address an evidence gap on the association of a broad range of menstrual-related factors with mental health problems amongst secondary school female adolescents in Uganda. Methods: We used baseline data from a cluster-randomised menstrual health intervention trial conducted in 60 secondary schools in two districts in Uganda. Baseline data were collected between March and July 2022, including socio-demographic characteristics, menstrual knowledge and attitudes, menstrual practices and self-efficacy, and mental health problems measured using the Strengths and Difficulties Questionnaire Total Difficulties score (SDQ-25). We used random-effects linear regression to estimate the adjusted mean difference (aMD) for the association between mental health problems (SDQ Total Difficulties Score) and menstrual-related factors, including the Menstrual Practice Needs Scale (MPNS) and the Self-Efficacy in Addressing Menstrual Needs scale (SAMNS)), accounting for school-level clustering and adjusting for prior confounders. Results: Among the 3841 female participants, there was strong and consistent evidence of associations between mental health problems and menstrual-related factors. Mental health problems were associated with poor knowledge about menstruation (aMD = 1.17, 95%CI 0.50, 1.84 <0.001), using disposable and reusable menstrual products compared to using just disposable products (aMD = 1.42, 95%CI 0.92, 1.92, p <0.001), and experiencing menstrual pain even when using an effective management method at last menstrual period (LMP) compared to those experiencing no pain (aMD = 1.60, 95%CI 1.19, 2.01, p <0.001). Mental health problems were also associated with greater unmet menstrual needs according to the MPNS (aMD = 4.40 95%CI 3.96, 4.84, p <0.001), and with lower menstrual self-efficacy measured by the SAMNS (aMD = 0.94 95% CI 0.51, 1.37, p <0.001). Conclusion: This study shows strong evidence that mental health problems reported by adolescent girls in Uganda are associated with poor menstrual health. The association between menstrual health and mental health provides evidence as to why menstrual health should be a public health priority. Trial registration: Trial registration: ISRCTN 45461276. Registered on 16 September 2021. [ABSTRACT FROM AUTHOR]

Background: Globally, oral diseases remain a major public health problem. However, there is limited information about the oral health status and factors associated with oral disease among children in Uganda. The aim of this study was to examine the oral health status and factors associated with oral health of primary school children in urban and rural areas of the Gulu district of northern Uganda. Methods: A comparative cross-sectional study was conducted among 356 school children aged 11–13 years attending six schools located in urban and rural areas. The children received a clinical oral examination and participated in a questionnaire survey that collected information on sociodemographic and oral health knowledge, attitude, and practices. All data were entered and analysed using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp statistical software. Logistic regression analyses examined factors associated with dental caries and gingival bleeding. Results: Of the 356 children (11–13 years) included, the mean age was 12.2 years, 140 (39.3%) were male and 176 (49.4%) were from urban areas. The proportion of school children with dental caries was 33.6% (n = 119), with the mean decayed, missing due to caries, and filled teeth (DMFT) index of 0.81 (25th percentile = 0; 75th percentile = 1.00). There was no significant difference in caries prevalence between rural and urban children (31.6% versus 35.6%, p = 0.33). Of the children involved in the study, 141(39.8%) had gum bleeding. The mean oral knowledge score was 2.85 ± 1.53 (range, 0–7), while the mean attitude, hygiene practice, frequency of sweets consumption, and oral health related impact scores were 4.25 ± 1.23 (range, 1–6), 5.40 ± 1.81 (range, 0–9), 25.66 ± 4.29 (range 9–54) and 2.1 ± 1.65 (range, 0–6), respectively. Using logistic regression analyses, as oral health knowledge score increased the odds of not having dental caries increased (aOR = 1.19, 95% CI 1.02–1.39). Conclusion: The prevalence of dental caries and gum bleeding of primary school children in Gulu district is high. Children lacked knowledge on causes of oral disease, and behaviour towards oral disease prevention. In addition, oral health knowledge scores were significantly associated with dental caries. Oral health education programs in schools should emphasise providing skills-based education. [ABSTRACT FROM AUTHOR]

Uganda suffered four Ebola and five Marburg virus outbreaks from 2000 to 2012 with significant health worker mortality. This paper describes findings from 41 interviews with health workers from three outbreaks. Interviewees frequently encountered stigma from their communities, sometimes accompanied by mistrust and violence. These difficulties were defined as 'challenges of society.' Health workers also suffered emotional trauma, depressive symptoms, and fear classified as 'challenges of psyche.' As the incidence of such outbreaks will likely increase due to ecological and economic trends, health workers require greater access to personal protective equipment (PPE) and knowledge of viral containment. Such improvements would create an optimal psychosocial climate for managing infectious patients ultimately decreasing the severity of future outbreaks. [ABSTRACT FROM AUTHOR]

Despite its reduction over the last decade, the maternal mortality rate in Uganda remains high, due to in part a lack of access to maternal health care. In an effort to increase access to care, a quasi-experimental trial using vouchers was implemented in Eastern Uganda between 2009 and 2011. Findings from the trial reported a dramatic increase in pregnant women's access to institutional delivery. Sustainability of such interventions, however, is an important challenge. While such interventions are able to successfully address immediate access barriers, such as lack of financial resources and transportation, they are reliant on external resources to sustain them and are not designed to address the underlying causes contributing to women's lack of access, including those related to gender. In an effort to examine ways to sustain the intervention beyond external financial resources, project implementers conducted a follow-up qualitative study to explore the root causes of women's lack of maternal health care access and utilization. Based on emergent findings, a gender analysis of the data was conducted to identify key gender dynamics affecting maternal health and maternal health care. This paper reports the key gender dynamics identified during the analysis, by detailing how gender power relations affect maternal health care access and utilization in relation to: access to resources; division of labour, including women's workload during and after pregnancy and lack of male involvement at health facilities; social norms, including perceptions of women's attitudes and behaviour during pregnancy, men's attitudes towards fatherhood, attitudes towards domestic violence, and health worker attitudes and behaviour; and decision-making. It concludes by discussing the need for integrating gender into maternal health care interventions if they are to address the root causes of barriers to maternal health access and utilization and improve access to and use of maternal health care in the long term. [ABSTRACT FROM AUTHOR]

In the context of the COVID-19 pandemic, we investigated associations between specific COVID-19-related changes and its impact on generalized anxiety disorder (GAD) levels among vulnerable young adults living with HIV (YALHIV) in a low-resource setting in Southern Uganda. This research utilized data from 500 YALHIV aged 19 to 25 from the Suubi+Adherence-R2 COVID-19 Supplement study. Disruptions were assessed using an 8-item modified Coronavirus Impact Scale, while anxiety was measured with the GAD-7 questionnaire. Hierarchical logistic regression analysis and multivariate linear regression were employed, guided by the Social Determinants of Health framework. Key findings highlighted changes in routines, family income, stress from the pandemic, changes in family stress and discord, and reduced access to mental health services heightened levels of probable GAD for YALHIV during the pandemic. Additionally, female young adults showed greater levels than males. These results underscore the urgency to develop tailored support mechanisms for YALHIV, especially during challenging and unprecedented times. [ABSTRACT FROM AUTHOR]

Women living with HIV are at increased risk for psychosocial distress, especially among social and economically disadvantaged women living in rural areas. Little is known about how social support and wealth impacts the mental health of women caring for young children in low- and middle-income countries. The purpose of this paper was to assess demographic, socio-economic, and social support correlates of depression and anxiety in HIV-infected+ female caregivers living in rural Uganda. Depression and anxiety were assessed using the Hopkins Symptom Checklist (HSCL-25), two-domains of social support (family and community) were measured with the adapted Multidimensional Scale for Perceived Social Support, and wealth was measured using a checklist of material possessions and housing quality among 288 women. Multivariable linear regression models assessed the association of depression and anxiety with demographic and social predictors. Sixty-one percent of women reported clinically significant symptoms of depression or anxiety using the standard HSCL-25 cut-off of >1.75. Lower wealth (p = .01) and family support (p = .01) were significantly associated with more depressive symptoms, with greater family support being more protective of depression in the highest wealth group (top 20%) compared to the lowest. More anxiety symptoms were associated with lower wealth (p = .001), lower family support (p = .02), and higher community support (p = .003). Economic and social support factors are important predictors of caregiver mental health in the face of HIV disease in rural Uganda. Findings suggest that interventions should consider ways to increase economic opportunities and strengthen family support for HIV+ caregivers. [ABSTRACT FROM PUBLISHER]

Introduction: Many organizations are developing new contraceptive products and approaches that promote self-care including a microarray patch (MAP) that has the potential for self-administration with appropriate training. We studied women's perceptions of the MAP technology with the primary goal of providing feedback on product attributes to inform early technical design decisions regarding various MAP contraceptive products in development by MAP developers. Methods: Our study consisted of a qualitative phase with in-person In-Depth Interviews (IDIs) with a total of 60 women of reproductive age (WRA) and quantitative surveys, via face-to-face computer-assisted interviews of a total of 927 women in Ghana, Kenya and Uganda. Women's perceptions on 12 attributes of the MAP were assessed through written descriptions, a profile, and visual stimuli such as graphics and images. Results: Overall, the most widely preferred attribute set included: a hand-applied MAP, utilizing one circular patch, with a sticky backing, no larger than 2 cm diameter in size, applied by self, to the arm, offering sensory feedback (clicking sound and/or color change signals) to confirm enough pressure, successful application and removal, lasting 6 months with up to 12 months return to natural state of fertility. There is space to allow for variation in MAP designs (including the use of an applicator or provider administered MAP) if the design promotes and reflects the needs and expectations of users and providers. Discussion: The contraceptive MAP had a high and broad level of appeal amongst all groups of women who participated in the study and has a strong value proposition around important contraceptive needs such as ease of use, convenience, and discretion. [ABSTRACT FROM AUTHOR]

HIV remains a significant public health issue among young adults living in Uganda. There is a need for reliable and valid measures of key psychological and behavioural constructs that are related to important outcomes for this population. We translated, adapted and tested the psychometric properties of questionnaires measuring HIV stigma, HIV disclosure cognitions and affect, antiretroviral therapy (ART) adherence, social support, personal values, and hope, using a multi-step process. This included: translation, back-translation, expert review, cognitive interviewing, readability and assessments of internal consistency with 93 young adults (18–25 years) living with perinatally acquired HIV in Uganda. Preliminary criterion validity was assessed by examining relationships between the adapted measures and wellbeing, HIV disclosure behaviour, HIV disclosure intention and viral load suppression. The measures all showed acceptable reliability and every questionnaire apart from the Agentic and Communal Value Scale was easy to read. Those scales measuring HIV disclosure affect and cognitions, social support, HIV stigma and hope showed relationships with other constructs suggestive of validity. There is preliminary evidence to support the use of these measures in research and clinical contexts for young adults living with perinatally acquired HIV in Uganda. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization recommends the use of donated human milk (HM) as the second-best option for mothers who are temporarily unable to provide sufficient breast milk to meet the needs of their infants. However, HM donation is yet to become an accepted practice in Uganda. We assessed the level of, and factors associated with acceptability to donate HM among postnatal mothers at St. Francis Hospital Nsambya (SFHN). Methods: A cross-sectional sequential explanatory mixed method study was conducted between October 2018 and March 2019. A questionnaire on sociodemography, awareness and likely acceptability to donate HM was administered to 410 postnatal mothers at SFHN. Multivariate logistic regression analysis was undertaken to determine factors associated with acceptance of HM donation. Focus Group Discussions (4) and Key Informants Interviews (4) were used to explore factors influencing behaviours to donate human milk. Qualitative data were analysed using a content thematic approach. Results: Overall acceptance of donating the HM was 77.6%, and the significant factors were: willingness to express the HM (AOR 7.5; 95% CI 3.01, 18.68); wet-nursing knowledge (AOR 2.3; 95% CI 1.1, 5.0) and visit to under-5 years' clinic (AOR 21.3; 95% CI 2.3, 196.9). The major themes in relation to accepting to donate HM were wet nursing experience, and confidence in donating the HM, and its perceived effectiveness. There were concerns about the safety and adequacy of HM and fear of transmitting criminal behaviours and mental illness through human milk. Conclusions: Acceptance to donate HM among postnatal mothers at St. Francis Hospital Nsambya was very high. Willingness to express and store human milk, prior knowledge about wet nursing and a visit to an under-five outpatient clinic were associated with acceptance. Thus, establishing a human milk bank is feasible in the study setting. [ABSTRACT FROM AUTHOR]

Later-life loneliness is becoming an area of great concern in Uganda in light of gradual weakening of extended family as a source of old-age human support. Although information about the effects of feeling lonely exists, little is known about the associated risk factors within the country's social and cultural setting. This paper discusses prevalence and correlates of feeling lonely among older persons. An interviewer-administered questionnaire was used to collect data on 605 older persons in a 2012 cross-sectional study. Respondents were asked to evaluate how they felt in terms of loneliness during the administration of the questionnaire. A total of ten focus group discussions and 12 key informant interviews were also conducted to collect qualitative data. Binary logistic regression was used to predict factors affecting loneliness. Findings indicate that approximately seven in ten older persons felt lonely. Elderly people residing in the urban area were more likely to be lonely than their counterparts staying in the rural environment. In comparison with married older persons, elderly people who were widowed were more likely to be lonely. Absence of a television and pension benefits and prevalence of limb joint ill-health predicted loneliness. The findings have several implications, including developing age-friendly urban centres, encouraging old-age social organisations, decentralising the elderly health-care system and establishing a special old-age fund. [ABSTRACT FROM PUBLISHER]

Background: In Uganda, neonatal mortality rate (NMR) remains high at 27 deaths per 1000 live births. There is paucity of data on factors associated with NMR in rural communities in Uganda. The objective of this study was to determine NMR as well as factors associated with neonatal mortality in the rural communities of three districts from eastern Uganda. Methods: Data from a baseline survey of a maternal and newborn intervention in the districts of Pallisa, Kibuku and Kamuli, Eastern Uganda was analyzed. A total of 2237 women who had delivered in the last 12 months irrespective of birth outcome were interviewed in the survey. The primary outcome for this paper was neonatal mortality. The risk ratio (RR) was used to determine the factors associated with neonatal mortality using log - binomial model. Results: The neonatal mortality was found to be 34 per 1000 live births (95 % CI = 27.1-42.8); Kamuli 31.9, Pallisa 36.5 and Kibuku 30.8. Factors associated with increased neonatal deaths were parity of 5+ (adj. RR =2.53, 95 % CI = 1.14-5.65) relative to parity of 4 and below, newborn low birth weight (adj. RR = 3.10, 95 % CI = 1.47-6.56) and presence of newborn danger signs (adj. RR = 2.42, 95 % CI = 1.04-5.62). Factors associated with lower risk of neonatal death were, home visits by community health workers' (CHW) (adj. RR =0.13, 95 % CI = 0.02-0.91), and attendance of at least 4 antenatal visits (adj. RR = 0.65, 95 % CI = 0.43-0.98). Conclusions: Neonatal mortality in rural communities is higher than the national average. The use of CHW's to mobilize and sensitize households on appropriate maternal and newborn care practices could play a key role in reducing neonatal mortality. [ABSTRACT FROM AUTHOR]