Mbarara University of Science and Technology Institutional Repository (MUST-IR)

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Faculty of Applied Sciences and Technology 53
Faculty of Business and Management Sciences 93
Faculty of Computing and Informatics 133
Faculty of Interdisciplinary Studies 199
Faculty of Medicine 2102
Faculty of Science 516
Institute of Tropical Forest Conservation 125
Maternal Newborn and Child Health Institute 18
MUST Grants Office 0

Recent Submissions

Early Nephropathy Screening as a Health Seeking Behavior Among Type 2 Diabetes Mellitus Patients: A Phenomenological Study in Southwestern Uganda
(Journal of Multidisciplinary Healthcare, 2025-09-16) Ritah Kiconco; Robert Kalyesubula; Naomi Sanyu; Bosco Bekiita Agaba; Erick Nyakundi Ondari; Deusdedit Tusubira; Gertrude N Kiwanuka
Background: Nephropathy screening is vital in type 2 diabetes mellitus (T2DM) management to prevent complications, yet uptake remains low in resource-limited settings like Southwestern Uganda. This study explored the barriers and facilitators influencing screening among T2DM patients and providers at the diabetic clinic of Mbarara Regional Referral Hospital. Methods: A qualitative cross-sectional study guided by a phenomenological approach to explore lived experiences around nephropathy screening was conducted. Fifteen adult T2DM patients in care for ≥12 months and five healthcare providers (doctors, nurses, and a laboratory technician) were purposively sampled. Semi-structured, in-depth interviews were conducted. Data were analyzed using an inductive approach. Socio-demographics; including age, sex, education, and employment were collected. All interviews were audiorecorded, transcribed verbatim, and thematically analyzed using Dedoose (version 10.0.25). Study reporting adhered to the COREQ 32-item checklist. Results: Patients described diabetes as a burdensome and life-altering condition. Key barriers to nephropathy screening included financial constraints, lack of transport, limited awareness, and dissatisfaction with care. Despite these challenges, facilitators such as proactive provider encouragement, community outreach, and availability of free testing motivated screening uptake. Providers emphasized their critical role in educating patients and detecting nephropathy but reported systemic constraints, including staff shortages, equipment failures, limited knowledge on new disease trends and screening protocols. Both groups highlighted the need for routine integration of nephropathy screening into diabetes care and greater support from the health system. Conclusion: Nephropathy screening behaviors among T2DM patients are influenced by perceived disease severity, provider communication, and systemic barriers such as cost and infrastructure. While both patients and providers recognize the value of early detection, sustained screening is hindered by resource limitations and inconsistent implementation. Strengthening institutional capacity, integrating screening into routine care, and enhancing patient-provider engagement are essential to reducing the burden of diabetic nephropathy in the study setting.
Quality of maternal and newborn care services in Uganda: a scoping review
(Journal of Medicine, Surgery, and Public Health, 2025) Brian Turigye; Edgar Mugema Mulogo; Jonathan Kajjimu; Joseph Ngonzi
Despite significant advancements over the past two decades, mothers and newborns continue to experience preventable deaths, even when they give birth at healthcare facilities both globally and in Uganda. Evidence indicates that the quality of facility-based care may be a major factor contributing to this issue. This review aimed to identify, map, and synthesize all published studies on the quality of maternal and newborn care in Uganda. Following the Arksey and O’Malley five-stage framework for scoping reviews, a search strategy was employed to retrieve articles published over 20 years, from 2004 to 2024, in PubMed, EMBASE, and Web of Science. Two independent reviewers screened the extracted articles, first by title and abstract, and subsequently by full text, utilizing Covidence. Data were mapped according to the World Health Organization (WHO) Quality of Maternal and Newborn Care (QMNC) framework. Of the 2482 studies identified, 36 were included in this review. The majority of the studies focused on human resources and infrastructure, with few addressing the experience of care. Overall, the standards of care were inadequate across the studies, with particularly poor conditions noted in lower-tier government health facilities. Despite the critical importance of quality care in reducing maternal and newborn mortality, levels have remained persistently low in Uganda over the past 20 years, especially in public facilities. There is an urgent need to rethink the health system approach and deliberately enhance the quality of care if Uganda is to meet the 2030 global targets
Landscape-level human disturbance results in loss and contraction of mammalian populations in tropical forests
(PLoS Biology, 2025-02-13) Ilaria Greco; Lydia Beaudrot; Chris Sutherland; Simone Tenan; Chia Hsieh; Daniel Gorczynski; Douglas Sheil; Jedediah Brodie; Mohammad Firoz Ahmed; Robert Bitariho; Jorge Ahumada; Rajan Amin; Megan Baker-Watton; Ramie Husneara Begum; et al
Tropical forests hold most of Earth’s biodiversity and a higher concentration of threatened mammals than other biomes. As a result, some mammal species persist almost exclusively in protected areas, often within extensively transformed and heavily populated landscapes. Other species depend on remaining remote forested areas with sparse human populations. However, it remains unclear how mammalian communities in tropical forests respond to anthropogenic pressures in the broader landscape in which they are embedded. As governments commit to increasing the extent of global protected areas to prevent further biodiversity loss, identifying the landscape-level conditions supporting wildlife has become essential. Here, we assessed the relationship between mammal communities and anthropogenic threats in the broader landscape. We simultaneously modeled species richness and community occupancy as complementary metrics of community structure, using a state-of the-art community model parameterized with a standardized pan-tropical data set of 239 mammal species from 37 forests across 3 continents. Forest loss and fragmentation within a 50-km buffer were associated with reduced occupancy in monitored communities, while species richness was unaffected by them. In contrast, landscape-scale human density was associated with reduced mammal richness but not occupancy, suggesting that sensitive species have been extirpated, while remaining taxa are relatively unaffected. Taken together, these results provide evidence of extinction filtering within tropical forests triggered by anthropogenic pressure occurring in the broader landscape. Therefore, existing and new reserves may not achieve the desired biodiversity outcomes without concurrent investment in addressing landscape-scale threats.
Enablers and challenges of integrating digital health into medical education curricula: a scoping review
(Discover Education, 2025) Wilson Tumuhimbise; Stefanie Theuring; Esther C. Atukunda; Mugyenyi R. Godfrey; Doreen Babirye; Fred Kaggwa; Mwavu Rogers; Kizza Gerald; Rebecca Nuwematsiko; Irene Wanyana; Daniel Atwine; Nelson Twinamasiko; John Paul Bagala; Richard Mugahi; Geoffrey Namara; Joseph Ngonzi; Rhoda Wanyenze; Juliet N. Sekandi; Angella Musiimenta
Background: The global strategy for digital health advocates digital health literacy in formal education and training curricula for all health professionals. However, little is known about the enablers and challenges of integrating digital health into medical training curricula. Methods: Guided by Arksey and O’Malley’s scoping review methodology, we searched the PubMed, Google Scholar, and ScienceDirect scholarly databases for peer-reviewed articles published between 2014 and 2024. Data extraction was guided by the consolidated framework for implementation research. Results: Thirty studies met the inclusion criteria and were analyzed. The enablers identified include the need for healthcare digitalization, reshaping the future daily work of healthcare professionals, decreasing students’ doubts about digital health and increasing the quality of patients’ care. On the other hand, a lack of infrastructure and educational materials, the dense nature of the existing curriculum, and bureaucratic tendencies were identified as challenges. The provision of consolidated funds and the establishment of dedicated digital health infrastructure, starting with elective and audited modular approaches, raising awareness, and educating stakeholders, emerged as implementation strategies for mitigating these challenges. Conclusion: Global progress toward integrating digital health literacy in formal medical training curricula remains slow. There is a need for concerted efforts and political commitment to offer guidance and moral and financial support for this integration.
Do Perceptions Influence the Adoption and Abandonment of Biomass Briquettes for Cooking? An Exploratory Study of Different Energy Source Users in Mbarara City
(Environmental Management and Sustainable Development, 2025-08-28) Justus Asasira; Imelda Kemeza; Ireen Kemigisa; David Kilama Okot
This study investigates the perceptions and experiences of current, former, and non-users of biomass briquettes in Mbarara City, Uganda. Using a qualitative approach, 24 participants were selected through snowball and purposive sampling, ensuring representation from all three user groups and briquette producers. In-depth interviews were conducted to capture their views, behaviours, and attitudes toward biomass briquettes. Briquette producers were interviewed to gain deeper insights into production practices, challenges, and the factors that influence the adoption of briquettes. Compared to charcoal, briquettes last longer on a cookstove, making them ideal for steaming food, which is a common practice. The lack of information about the briquettes and the briquettes taking too long to ignite are highlighted as the main reasons for low adoption and abandonment. Various factors, including food preparation habits, social connections, knowledge about briquettes, and media exposure, do influence adoption. The current briquettes produced and used in Mbarara are mainly made of charcoal residues, which makes them unsustainable and environmentally unfriendly. The frequent breakdown of machines is highlighted as a major challenge for briquette producers. Strategies such as leveraging social networks, conducting physical cooking demonstrations, improving briquette quality, using fire starters, training more producers, and utilizing social media could enhance adoption rates and reduce user attrition. The triple helix model could bridge the knowledge and skills gaps to facilitate institutional collaborations and improve the quality of briquettes. Future research should explore the drivers of briquette adoption in medium and large-scale enterprises, such as poultry farms, schools, restaurants, and manufacturing industries.
Factors associated with relief from acute pain among patients admitted in medical ward of Mbarara Regional Referral Hospital, south western Uganda: A cross-sectional study
(PLOS ONE, 2025-03-03) Silas Ojuk; Robert Tamukong; Tadele MekuriyaYadesa
Acute pain is an understudied subject among patients admitted in medical wards, especially in sub-Saharan Africa. Given that it is one of the commonest causes of hospital admissions, it is necessary to diagnose and adequately treat it in time. Unrelieved acute pain may have negative consequences such as; reduced quality of life, prolonged hospital stays and increased cost of treatment. The purpose of this study was to assess relief of acute pain and factors associated with it in medical ward of Mbarara Regional Referral Hospital, South-Western Uganda. Severity of pain was determined using the Brief Pain Inventory. Adequate drug therapy for acute pain was assessed using the Pain Management Index. Relief from acute pain was considered a change in pain grade from severe to mild or moderate to mild or mild to no pain. This was done by comparing baseline pain grade at enrollment (day one) and follow up pain grade on day two. Multivariate logistic regression was performed to identify associated factors that had statistical significance. Out of 280 patients with acute pain, analgesic drug therapy was adequate for 32 (11.43%) participants while relief from acute pain was achieved among 95 (34%). Multivariate logistic regression showed female gender to be significantly associated with relief from acute pain (adjusted Odds Ratio=1.86; 1.11-3.10 at 95% C.I; p value=0.018). Prevalence of adequacy of analgesic drug therapy for acute pain among patients admitted in medical ward of Mbarara Regional Referral Hospital was low. Proportion of patients with relief from acute pain was also low. Female patients were more likely to experience relief from acute pain compared to their male counterparts.
Job Stress, Job Satisfaction, Self-Efficacy and Turnover Intentions across Socio-Demographic Characteristics of Government Secondary School Teachers in Greater Mbarara
(American Journal of Education and Practice, 2025) Innocent Nkwatsibwe; Aloysius Rukundo; Sudi Balimuttajjo
Purpose: The study examined the levels job stress, job satisfaction, self-efficacy and turnover intentions across socio-demographic characteristics of government secondary school teachers in greater Mbarara. Materials and Methods: The cross-sectional, quantitative study adopted census strategy select schools and simple random sampling to select respondents. Data was collected from 470 teachers using self-administered questionnaires. Data was analyzed using frequencies, means, standard deviations, independent samples t test and one-way ANOVA. Findings: Generally, teachers reported moderate job stress, job satisfaction and turnover intentions while self-efficacy was high. High stress was reported among males (M=2.962), teachers aged 40-49 years (M=2.693), teachers with master’s degree (M=3.17), teachers with an experience of ˂ 1year (M=2.91), arts teachers (M=2.93), teachers on government payroll (M=2.87) and teachers in rural settings (M=2.88). High job satisfaction was reported among females (M=3.657), diploma holders (M=3.653), teachers on government payroll (M=3.596), teachers with an experience of ˂ 1year (M=3.691), science teachers (M=3.681), teachers aged ˂ 30years (M=3.787) and teachers in urban schools (M=3.62). Self-efficacy was high among teachers with ˂ 1year experience (M=3.497), females (M=3.495), teachers in urban schools (M=3.459), teachers with master’s degree (M=3.454), teachers on government payroll (M=3.358), science teachers (M=3.403) and teachers aged ˃ 50 years (M=3.455). Turnover intentions were high among teachers with master’s degree (M=3.004), teachers aged ˃ 50 years (M=2.801), teachers on PTA payroll (M=2.662), females (M=2.6001), teachers with an experience of ˂ 1 year (M=2.609), arts teachers (M=2.701) and teachers in rural schools (M=2.608). Implications to Theory, Practice and Policy: There is need for development of mentorship programs to help early-career teachers navigate professional challenges to reduce stress and build confidence, enhance job satisfaction so as to mitigate turnover intentions.
Internal Facilitation by Health Assistants for the “WHO Lay Health Worker Dementia Care” in Rural Uganda: A Formative Evaluation
(Journal of Multidisciplinary Healthcare, 2025-02-05) Edith K Wakida; Celestino Obua; Godfrey Zari Rukundo; Mary Samantha; Samuel Maling; Christine K Karungi; Zohray M Talib; Jessica Haberer; Stephen J Bartels
Background: Dementia is characterized by cognitive symptoms like memory loss, difficulty with language, and impaired judgment, alongside behavioral and psychological symptoms such as depression, anxiety, and aggression. Early diagnosis and tailored care are essential for managing these symptoms, improving quality of life, and reducing caregiver burden. Dementia affects a substantial portion of older people globally, especially in low- and middle-income countries like Uganda, where rural healthcare systems face challenges in dementia care access. To address these needs, we gathered key stakeholders’ perspectives on a culturally tailored model employing lay health workers, supported by health assistants as internal facilitators, to implement the World Health Organization dementia toolkit in rural communities. Methods: We conducted a formative qualitative study, utilizing one-on-one interviews with health assistants, district health team members, and primary healthcare providers in rural Uganda. We solicited their perspectives on implementing the World Health Organization dementia toolkit at the village level. The integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework guided data collection and analysis, focusing on implementation support, process improvement, and practice sustainment. Results: Strong support was found for health assistants’ roles in facilitating lay health worker-led dementia care at the community level. Health assistants’ familiarity with lay health workers and pre-established structures were considered facilitating factors. Key challenges included knowledge gaps in dementia care and limited resources. Participants emphasized the importance of training, mentorship, and standardized reporting tools to enhance the implementation of dementia care. They recommended providing the health assistants with job guides, updated reporting templates to collect dementia indicators, and orientation on what they should do during internal facilitation with the lay health workers using the dementia toolkit. Conclusion: Health assistants’ internal facilitation provides a promising strategy for scaling dementia care in rural Uganda by leveraging community-based lay health workers. Addressing identified knowledge gaps, communication needs, and resource constraints will be essential to sustaining dementia care interventions in these communities.
Impact of Meteorological Factors on Seasonal and Diurnal Variation of PM2.5 at a Site in Mbarara, Uganda
(Air, 2025-01-02) Shilindion Basemera; Silver Onyango; Jonan Tumwesigyire; Martin Mukama; Data Santorino; Crystal M. North; Beth Parks
Because PM2.5 concentrations are not regularly monitored in Mbarara, Uganda, this study was implemented to test whether correlations exist between weather parameters and PM2.5 concentrations, which could then be used to estimate PM2.5 concentrations. PM2.5 was monitored for 24 h periods once every week for eight months, while weather parameters were monitored every day. The mean dry and wet season PM2.5 concentrations were 70.1 and 39.4 µg/m3 , respectively. Diurnal trends for PM2.5 levels show bimodal peaks in the morning and evening. The univariate regression analysis between PM2.5 and meteorological factors for the 24 h averages yields a significant correlation with air pressure when all data are considered, and when the data are separated by season, there is a significant correlation between PM2.5 concentration and wind speed in the dry season. A strong correlation is seen between diurnal variations in PM2.5 concentration and most weather parameters, but our analysis suggests that in modeling PM2.5 concentration, the importance of these meteorological factors is mainly due to their correlation with underlying causes including diurnal changes in the atmospheric boundary layer height and changes in sources both hourly and seasonally. While additional measurements are needed to confirm the results, this study contributes to the knowledge of short-term and seasonal variation in PM2.5 concentration in Mbarara and forms a basis for modeling short-term variation in PM2.5 concentration and determining the effect of seasonal and diurnal sources on PM2.5 concentration
In-hospital trends of non-communicable disease mortality during the pandemic for patients without COVID-19 at a regional referral hospital in southwestern Uganda
(BMC Global and Public Health, 2025-04-17) Peter K. Olds; Edwin Nuwagira; Paul S. Obwoya; Grace Kansiime; Nicholas Musinguz; Lenus Tumwekwatse; Racheal Ninsiima; Shadia Mwesigwa; Daniel Mujuni; Ronald Awani Okii; Lorna Atimango; Julius Ssempiira; Jessica E. Haberer; Samson Okello
Background: Non-communicable diseases (NCDs) represent a growing health burden in sub-Saharan Africa, especially in Uganda. The COVID-19 pandemic presented significant challenges for the Ugandan healthcare system, though changes in hospital admissions and outcomes for adults with NCDs and without COVID-19 infection remain unknown. We evaluated trends of NCD-related in-hospital mortality among patients without COVID-19 in a large regional referral hospital in Uganda from March 2019 through August 2021. Methods: Between March 1, 2019, and August 31, 2021, we conducted a chart review of Ugandan adults who carried a history of or were admitted for an NCD to Mbarara Regional Referral Hospital. Based on mortality trends, we broke admissions into three periods: Pre-Pandemic (March 1, 2019, to May 31, 2020), Early Pandemic (June 1, 2020, to March 31, 2021), and Late Pandemic (April 1, 2021, to August 31, 2021), and calculated admission and mortality rates for the most common NCD diagnoses. A multivariable logistic regression model was fitted for a primary outcome of in-hospital mortality. Results: Of 3777 total individuals, 1655 were admitted Pre-Pandemic, 1423 in the Early Pandemic, and 699 in the Late Pandemic. We found a five-fold increase in mortality in the Early Pandemic period compared to the Pre-Pandemic and Late Pandemic periods (15.4 vs 2.9 vs 2.4, p < 0.001). Factors associated with increased odds for in-hospital mortality included admission during the Early Pandemic period (odds ratio [OR] 5.59; 95% CI 3.90, 8.02; p < 0.001), admission with hypotension (OR 2.13; 95% CI 1.40, 3.24; p < 0.001), admission diagnosis of malignancy (OR 1.79; 95% CI 1.06, 3.01; p = 0.028) and stroke (OR 1.75; 95% CI 1.06, 2.88; p = 0.028), and each unit increase in SOFA score (OR 1.41; 95% CI 1.30, 1.52; p < 0.001). Length of stay greater than 7 days was associated with decreased odds of in-hospital mortality (OR 0.56; 95%CI 0.40, 0.79; p = 0.001). Conclusions: NCD-associated in-hospital mortality was high in the early COVID-19 pandemic period. Disruptions in longitudinal NCD care that occurred due to the pandemic may have been contributory, though this requires further investigation. Future work should focus on NCD care for hospitalized individuals in resource limited settings and developing more resilient systems of NCD care.
Prevalence of High Titre Anti-A and Anti-B Haemolysins Amongst Blood Group “O” Voluntary Donors at Mbale Regional Blood Bank, Eastern Uganda
(Journal of Blood Medicine, 2025-03-09) Patrick Wabuyi; Enoch Muwanguzi; Benson Okongo; Ahmed Bumba; Robert Wagub; Grace Otekat; Yona Mbalibulha
Background: Blood Group O donors with high antibody IgG anti-A and anti-B titers of 1:256 or higher was considered high antibody titer and generally referred to as dangerous donors because their plasma has the potential to haemolyse or agglutinate red blood cells in non-Group O recipients. Titration for the IgG anti-A and anti-B prior to transfusion is required to prevent transfusion reactions. There is a monthly blood collection of 5000 blood units per-month with ABO RhD distribution of A 27%, B 20%, O 48%, AB 5%, and Rh(D) negative 2%. This study aimed at determining the prevalence of high-titer immune anti-A and anti-B in blood group O donors at Mbale regional blood bank. Methods: A total of 382 blood group “O” donors were randomly selected and recruited after obtaining informed consent during the period of May 2022–January 2023. The titration for the anti-A and anti-B hemagglutinins (IgG class) titers was done by use of the tube titration technique. Data were summarized as means, standard deviations, percentages, and frequencies then presented in the form of pie charts and tables. Results: Of the recruited participants, 270(70.7%) were males. Total number of group O donors with high-titer were 27(7.1%) of which 15(55.5%) were male. The most frequent occurring antibody was Anti-B with 17/27 (62.9%). In male with high titer, anti-B was the most occurring and significantly raised, while anti-A was the most raised in female. Conclusion: There is a high proportion of blood group O donors having high titers of anti-A and anti-B (dangerous group O donors), with the most raised antibody being anti-A, which compromises the quality and safety of the blood products. We recommend screening for high-titer anti-A and anti-B antibodies in all blood group O donated units to make them safe for transfusion to non-group O recipients, especially where large volumes of plasma are required.
Optimizing Clinical Postgraduate Training: Perspectives of Postgraduate Alumni Regarding Their Residency Training at Mbarara University of Science and Technology, Uganda
(Advances in Medical Education and Practice, 2025-01-25) Leevan Tibaijuka; Lorna Atimango; Jonathan Kajjimu; Asiphas Owaraganise; Nixon Kamukama; Paul Kalyebara Kato; Godfrey Rwambuka Mugyenyi; Musa Kayondo; Adeline Adwoa Boatin; Joseph Ngonzi
Background: Understanding alumni satisfaction and the competencies gained during university training can guide improvements in education quality, particularly in higher education institutions. This study at Mbarara University of Science and Technology (MUST) explored the factors influencing alumni decisions, their residency experiences, and their levels of satisfaction. Additionally, it provided recommendations for improving graduate training programs. Methods: We conducted a mixed methods study from June to September 2022, employing an online survey and in-depth interviews (IDIs). The survey was distributed via Email and WhatsApp to MUST residency alumni, with 12 participants selected for IDIs. Descriptive summary statistics and thematic analysis were used to analyze the data. Results: Ninety-five MUST alumni (34.3% response rate) participated, predominantly males (80%), aged 31–40 (69%), and Ugandans (72%). Most graduated after 2018 (83%) in surgical specialties such as obstetrics/gynecology (38%) and general surgery (19%). Factors influencing residency program choice included practice-oriented study programs (61%), fields of specialization (55%), university or departmental reputation (46%), and admission standards (32%). While 80% were satisfied with the learning and teaching, only 50% expressed satisfaction with the infrastructure. IDIs revealed satisfaction due to compassionate faculty and strong university partnerships but criticized limited study facilities, difficult adaptation for international students, insufficient hands-on training, human resource shortages, and limited technology. Recommendations included collaborative mentorship, increased hands-on training exposure, more partnerships, and enhanced infrastructure and technology support. Conclusion: Most alumni were satisfied with their residency training despite infrastructure dissatisfaction, finding it well-aligned with their work and beneficial for their careers. Our study highlights opportunities for implementing proposed improvements to enhance residency training. It suggests that similar universities should conduct post-graduate tracers to evaluate trainee experiences and inform future directions.
MathematicalAnalysis of theRole of Treatment andVaccination in the Management of the HIV/AIDS and Pneumococcal Pneumonia Co-Infection
(Journal of Mathematics, 2025) Michael Byamukama; Martin Karuhanga; Damian Kajunguri
Concomitant infections by two or more pathogens are on upsurge and among these is the interplay between HIV/AIDS and pneumococcal pneumonia infections. A mathematical co-infection models that fronts vaccination and treatment against pneumococcal pneumonia and antiretroviral therapy for HIV/AIDS in the management of the co-infection burden is presented. The model is also extended to include optimal control plans, in line with protection, early detection, and treatment of both HIV/AIDS and pneumococcal pneumonia. Co-infection model analysis manifests that the solutions are positive and bounded, and the disease equilibria stabilities are established in reference to the computed effective reproduction numbers. Sensitivity analysis indicated that infection rate parameters are by far the most influential in the co-infection escalation, whereas treatment and vaccination associated parameters have inhibiting effect towards the co-infection. Numerical simulations reveal that treatment and vaccination interventions are important in co-infection reduction but not sufficient for co-infection elimination. Further analysis indicates that, in addition to treatment and vaccination, adopting all optimal control plans can be a concrete start to co-infection elimination.
Refugee Volunteering and Responses to Displacement in Uganda: Navigating Service-Delivery, Work and Precarity
(Journal of Humanitarian Affairs, 2025) Matt Baillie Smith; Bianca Fadel; Frank Ahimbisibwe; Robert Turyamureeba
This paper critically explores the role of voluntary labour in refugee-led responses to displacement. Despite the wide celebration of volunteering in response to crises and community needs, refugees and displaced populations tend to be depicted as passive beneficiaries of support. This paper engages with critical literatures challenging this assumption and provides an analysis of refugee volunteering experiences in Uganda, interrogating the uneven spaces of articulation between dominant humanitarian thinking and action on displacement, and volunteering by refugees. The analysis draws upon data collected as part of a large mixed methods investigation of volunteering by young refugees in Uganda, exploring its impacts on their skills, employability, and experiences of inequality. We explore narratives of volunteering in relation to service-delivery and self-reliance, and how different understandings of voluntary labour emerge from and against the precarities experienced by refugees navigating employment and livelihood strategies. We conclude by arguing that volunteering connects with responses to displacement in ways that are shaped by refugee subjectivities and livelihoods in particular places, and that its potential to de-stabilise existing systems is ambivalently situated between self-reliance strategies and the perpetuation of dependencies.
Design and simulation of an intelligent irrigation system using fuzzy logic
(Discover Electronics, 2025-01-24) Peter Kibazo; Wanzala Jimmy Nabende; Michael Robson Atim
Farmers in developing countries employ various irrigation methods ranging from traditional techniques such as the use of irrigation cans to modern pressurized systems while irrigating short-seasoned crops that require continuous water supply especially during the dry season. Inspite of being cheap and easy to use, farmers find it challenging to optimize farming costs through the application of the neccessary amount of water onto the crops, leading to crop water logging and hence roting. Due to the growing demand for agricultural products, there was need to develop an irrigation system that considers the amount of moisture in the soil, air temperature and light intensity, which are important parameters in plants’ growth. This dissertation therefore presents the design, simulation and implementation of an intelligent irrigation system, utilizing multiple sensors and a fuzzy logic controller to optimize water usage while ensuring high farming yields. The system design integrates light, temperature, and soil moisture sensors to monitor environmental conditions and soil moisture content in real-time. The operation of the irrigation system is governed by a set of one hundred twenty-five (125) fuzzy rules that process the inputs from these sensors, determining the appropriate irrigation duration based on the prevailing light intensity, ambient temperature, and soil moisture levels. The fuzzy logic controller employs a combination of membership functions and rule-based inference to handle the relationships between the environmental parameters and the irrigation needs of the soil. By continuously analyzing the data from the sensors, the system dynamically adjusts the water output, ensuring optimal soil moisture levels while minimizing water wastage. Additionally, the system is equipped to send notifications in form of calls to a smartphone connected to the GSM network in case of critical conditions or system malfunctions. Experimental results demonstrate the ability of the intelligent irrigation system to dynamically adjust the amount of water being pumped into the garden basing on the prevailing soil moisture, temperature and light intensity.
Self-Reported Quality of Life and Lived Experiences of Adolescent Cancer Survivors Aged 10–19 in Southwestern Uganda: A Mixed-Methods Study in a Resource-Limited Setting
(Cancer Reports, 2025) Doreen Faith Longes; Leevan Tibaijuka; Moses Muwanguzi; Peter Kalubi; Steven Asiimwe; Kevin Schwartz; Howard Weinstein; Elizabeth Najjingo; Barnabas Atwiine
Background: Cancer and its management affect the quality of life (QOL) and lived experiences of adolescent survivors. Aims: We describe the QOL and document the lived experiences of adolescent cancer survivors at a tertiary hospital in south western Uganda. Methods and Results: We conducted a mixed-methods, cross-sectional study using descriptive quantitative interviews using the summarized World Health Organization QOL questionnaire and qualitative in-depth interviews with adolescent cancer survivors at Mbarara Regional Referral Hospital in southwestern Uganda in July and August 2023. We explored participants' perceptions of their health as a percentage of the overall QOL scores and evaluated their lived experiences using an inductive approach. The study obtained ethical approval from the Research and Ethics Committee of the Mbarara University of Science and Technology. A total of 42 adolescents with a mean age of 13.2 (SD±2.9) years participated in the study. Twenty-three (55%) were males, and 24 (57%) had survived hematological malignancies. Participants reported very good (n=12, 28.6%), good (n=29, 69.1%), and poor (n=1, 23%) QOL. Eleven (26.2%) and 30 (71.4%) participants reported they were very satisfied and satisfied with their health, respectively. Participants reported both positive and negative lived experiences. The positive experiences included persistent gratefulness, hope for a cure, and relationship restructuring. The negative experiences included concerns about body appearance, family separation, financial difficulties, and academic challenges. Conclusion: The QOL of adolescent cancer survivors in our setting is generally good and is influenced by support from family and the healthcare system. Their lived experiences are varied. Psychosocial services and peer support could improve perceived negative experiences.
Targeted distribution of long-lasting insecticidal nets by community health workers to sustain household coverage: A pilot feasibility study in Western Uganda
(PLOS Glob Public Health, 2025-01-24) Annika K. Gunderson; Rapheal Mbusa; Emmanuel Baguma; Emmanuel Ayebare; Dana Giandomenico; Raquel Reyes; Moses Ntaro; Edgar M. Mulogo; Ross M. Boyce
Universal coverage is defined by the World Health Organization as 1 long-lasting insecticidal net (LLIN) for 2 people in a household. While Uganda has been a leader in the distribution of LLINs, there are concerns regarding the longevity of LLINs. The main aim of this study was to address the LLIN coverage gap that emerges in the period after mass distribution campaigns through the implementation of a novel LLIN distribution strategy utilizing the existing community healthcare worker (CHW) infrastructure. We conducted a pilot feasibility study in two villages randomized to be the control or intervention. CHWs in both villages carried out their regular duties and calculated household eligibility to receive LLINs, classified as having a child under five positives for malaria and being below universal coverage. Only CHWs in the intervention village distributed LLINs to eligible households to reach universal coverage. Summary statistics were calculated for intervention implementation and malaria outcomes. Structured interviews were conducted with CHWs to assess burden and community acceptability of the intervention. Of the children evaluated by the CHWs, 102 of 169 (60.3%) and 112 of 171 (65.5%) were tested for malaria, of which 62 (60.7%) and 71 (63.3%) tested positive in the intervention and control villages, respectively. Only three households were at universal coverage. There was an increase from 4.0% to 6.5% of households meeting universal coverage in the intervention village, compared to a decrease from 7.8% to 1.8% in the control village after the follow-up period. There was an increase in the number of children under the age of 5 who slept under an LLIN the previous night from 15.7% to 31.6% in the intervention village compared to a decrease in the control village from 29.1% to 10.5%. No CHWs reported an increased burden from the intervention and all reported favorable opinions. Our pilot study demonstrates the feasibility and acceptability of targeted LLIN distributions leveraging the existing structure to supplement national distribution campaigns in Uganda. Overall, this work highlights the critical need for novel approaches to sustain LLIN coverage between distribution campaigns, particularly towards the end of the 3-year cycle.
Religiosity: Mediator of Tax Knowledge and Tax Compliance among Small Business Enterprises (SBEs)
(Technology and Investiment, 2025-02-20) Francis Tamale; Violah Mpangwire; Laura A. Orobia; Benjamin Musiita; Thomas Kisaalita; Brian Ssembatya; Kalimu Ndaazano; Brenda Kabasinguzi; Richard Mwesige
This study uses data from small business enterprises (SBEs) in a developing African economy to investigate the role of mediating religiosity in the link between tax Knowledge and tax compliance. This study used closed-ended questionnaires and a quantitative research design. This study employed a cross-sectional and correlational approach. A total of 283 SBE managers provided usable questionnaires, and SPSS v23 and the MedGraph application (Excel version) were used to analyze the data. Religion acts as a partial mediating factor in the relationship between tax compliance and tax knowledge. The results also indicate a strong relationship between tax compliance, tax awareness, and religiosity. Only one methodological research procedure was used, and triangulation may be attempted in future interviews. Furthermore, the results of this study were cross-sectional. More research should be conducted to assess the mediating effects examined in this study over time. A valid interpretation of the correlations between research variables always requires an analysis of the involvement of a third variable (religiosity) in the connection. This enables specialists and researchers to comprehend and reach valid conclusions and selections that might aid in improving tax compliance. Despite the abundance of research on tax compliance, this study uses SBE findings from Uganda, a developing economy in Africa, to provide the first empirical evidence of the mediating role of religiosity in the relationship between tax awareness and tax compliance.
Health economics of snakebite envenomation: A sub-Saharan African perspective
(Trans R Soc Trop Med Hyg, 2025) Innocent Ayesiga; Jonathan Mawutor Gmanyam; Alex Akaka; Olivier Kubwimana; Joshua Naatey Ternor; Ukasha Musa Hashim; Gertrude Ahenewaa Gyabaah; Justice Kwadwo Turzin; d Ivan Kahwa
Sub-Saharan Africa (SSA) is affected by the high direct and indirect costs of snakebite envenomation. With >30% of global mortality, different economic barriers still exist, and effective strategies must be employed to avert the burden and promote quality of life. With the WHO target of reducing the number of snakebites by one-half by 2030, different aspects concerning snakebite envenomation economics must be evaluated, and potential strategies must be developed. Strategies such as exploring the different snakebite prevention interventions, and the costs associated with these interventions, must be prioritized through extensive research and targeted surveys. Information obtained from these surveys can be used to draft effective policies to minimize snakebite envenomation incidence, reduce the economic burden associated with envenomation and improve the quality of life of people at risk. In this narrative review, we evaluate the different aspects concerning the health economics of snakebite envenomation and explore the financial capacity of SSA countries to mitigate envenomation. Additionally, we propose multiple steps that could be undertaken to mitigate the financial burden of envenomation in SSA. Furthermore, we propose critical research strategies to minimize direct and indirect costs arising from snakebite envenomation in the region.
Identification of training needs in schistosomiasis research to build capacity for schistosomiasis control in Uganda
(Tropical Medicine & International Health, 2025) Damalie Nakanjako; Moses Egesa; Helen Byakwaga; Casim Umba Tolo; Anatol Maranda Byaruhanga; Prudence Beinamaryo; Grace Banturaki; Lydia Nakiyingi; Ponsiano Ocama; Moses R. Kamya; Alison M. Elliott
Background: Schistosomiasis is the leading cause of fatal upper gastrointestinal bleeding among adults in East Africa. The prevalence among school-aged children in villages along the Albert–Nile shoreline in North-Western Uganda is estimated at 85%. Efforts to control schistosomiasis in low- and-middle-income countries remain limited due to an incomplete understanding of the pathogenesis, disease manifestations, transmission mechanisms, preventive measures and interventions. In addition, there is insufficient capacity to analyse, model and predict relevant clinical case management systems, biological interventions and disease control efforts. We conducted a needs assessment for schistosomiasis research training at academic and research institutions in Uganda to inform the development of a structured training programme to build capacity to conduct locally relevant research to control the disease. Methods: Using an online survey, we collected data on training needs, potential trainees, available resources including local and international collaborations, as well as priority areas for schistosomiasis research and training at academic and research institutions in Uganda. Data were analysed and presented in frequency tables and figures. Results: Overall, schistosomiasis had the lowest number of studies conducted, based on the studies approved by research ethics committees at the two leading medical schools in Uganda: Makerere University College of Health Sciences (MakCHS) and Mbarara University of Science and Technology (MUST) between 2016 and 2022. The top ranked schistosomiasis focus areas of interest, by scientists at MakCHS, MUST, the Vector Borne and Neglected Tropical Diseases Division of the Ministry of Health and the Uganda Virus Research Institute (UVRI), were schistosomiasis prevention and transmission, vector biology, diagnostics, treatment and clinical trials, respectively. The top ranked training needs were schistosomiasis prevention and control, research ethics, data analysis, epidemiology and research methods (quantitative and qualitative), malacology, infectious diseases modelling, scientific writing and communication skills. Conclusion: Priority areas for schistosomiasis research and training will be utilised to develop a robust, collaborative, multidisciplinary schistosomiasis research training programme, to increase the critical mass of scientists with the competencies required to design, execute and utilise schistosomiasis biology, clinical, laboratory and epidemiology research to advance disease control interventions and minimise/eliminate schistosomiasis-associated morbidity and mortality in sub-Saharan Africa.