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

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Central Administration 133
This community will contain collections from the general Administrative staff
Faculty of Agriculture, Enviroment and Veterinary Sciences 2
Faculty of Applied Sciences and Technology 69
Faculty of Business and Management Sciences 127
Faculty of Computing and Informatics 150
Faculty of Interdisciplinary Studies 224
Faculty of Medicine 2447
Faculty of Science 575
Institute of Tropical Forest Conservation 124
Maternal Newborn and Child Health Institute 18
MUST Research Institute 3

Recent Submissions

Dam breach analysis of Kibimba Dam in Uganda using HEC‑RAS and HEC‑GeoRAS
(Environmental Systems Research, 2023) Kiwanuka, Moses; Chelangat, Cyrus; Mubialiwo, Ambrose; Lay, Francis Joel; Mugisha, Ayubu; Mbujje, Webster Joel; Mutanda, Hosea Eridadi
Dam failures have severe consequences on human life and property. In the case of an earth filled Kibimba Dam located in Eastern Uganda, the occurrence of a flood equal to or larger than the probable maximum food (PMF) could result in catastrophic economic losses including loss of human life. This study utilized the USACE Hydrologic Engineering Center’s River Analysis System (HEC-RAS) and Hydrologic Engineering Center’s Geographic River Analysis System (HEC-GeoRAS) to analyze the potential dam break of Kibimba Dam, considering overtopping and piping failure scenarios. The results of the analysis revealed that the spillway of Kibimba Dam possesses sufficient capacity to safely discharge a flood resulting from a probable maximum flood peak of 400 m3/s. Therefore, the dam is not susceptible to breach under the overtopping failure mode. However, the dam failed under the piping failure mode. To assess the downstream impact of the dam break, the breach hydrographs resulting from piping failure were examined. Consequently, the study investigated the effects of flood propagation downstream of the dam. This resulted in varying inundation depths of up to 6 m and velocities ranging from 1.2 to 10 m/s. These findings highlight the devastating consequences of Kibimba Dam’s failure, particularly affecting rice field plantations, infrastructure, and other economic activities in the downstream area. Therefore, the outcomes of this study are crucial for the development of Emergency Action Plans that incorporate dam breach and flood routing analyses specific to the affected downstream regions.
Modeling and simulation of human lung mechanics using single to multi-compartment electrical circuit models
(Discover Applied Sciences, 2026) Wanzala, Jimmy Nabende; Atim, Michael Robson
This study focuses on the development, simulation, and comparative analysis of electrical analog models for representing human respiratory mechanics. The respiratory system was modeled using lumped parameter elec¬trical circuits, where physiological variables such as pressure, airflow, lung compliance, airway resistance, and airway inertance were represented by voltage, current, capacitance, resistance, and inductance, respectively. Four distinct models: single-compartment, two-compartment, three-compartment, and multi-compartment were developed and implemented using MATLAB/Simulink and to investigate their predictive accuracy and com¬putational efficiency under both normal and diseased lung conditions, including asthma, COPD, and ARDS. Performance was evaluated using Root Mean Square Error (RMSE), Mean Absolute Error (MAE), and correla¬tion coefficients by comparing the single-, two-, and three-compartment model outputs against a high-fidelity ten-compartment (𝑁𝑁 𝑁 𝑁𝑁) reference model, rather than against patient or clinical ventilator data. Results indi¬cated that predictive error decreased, and correlation with the reference model increased, monotonically with compartment count (from a correlation coefficient of 0.9990 for the single-compartment model to 1.0000 for the 𝑁𝑁 𝑁 𝑁𝑁 reference model itself); the multi-compartment model’s computational complexity makes it more suitable for offline analysis. A weighted decision matrix was used to compare the single-, two-, and three-compartment models on predictive accuracy, computational speed, clinical applicability, ease of parameter estimation, and model stability. A sensitivity analysis showed that the top-ranked model depends materially on how the qualitative criteria (clinical applicability, parameter estimation ease, stability) are scored: under an illustrative expert-judgment scoring the three-compartment model scored highest, while under a fully formula-derived scoring the two-compartment model scored highest instead, and the single-compartment model became competitive with both under weight assumptions with no built-in preference. The study therefore identifies the two- and three-compartment models as the strongest real-time candidates, with the specific choice between them depending on which criteria a given clinical deployment prioritizes, rather than concluding that a single configuration is unconditionally optimal.
The Moderating Role of Health Centre Characteristics in the Relationship between Psychosocial Work Environment and Quality of Health Care in Health Centre IVs in South Western Uganda
(Journal of Economics and Behavioral Studies, 2026) Bangirana, Sephas; Mulogo, Edgar Mugema; Musiita, Benjamin; Bakashaba, Rennie; Mucunguzi, Charlse; Twinematsiko, Ivan
Abstract: This study examined the moderating role of health centre characteristics in the relationship between psychosocial work environment and quality of health care in Health Centre IVs in South Western Uganda. The study adopted a mixed-methods cross-sectional design grounded in a critical realist philosophical orientation. Data were collected from 35 Health Centre IVs in Southwestern Uganda, involving 238 healthcare workers, 172 health service recipients, and six District Health Officers. Quantitative data were analyzed using descriptive statistics, Pearson correlation analysis, hierarchical regression, and Structural Equation Modelling (SEM), while qualitative data were analyzed using thematic content analysis. Pearson correlation analysis revealed a positive and statistically significant relationship between psychosocial work environment and quality of health care (r = .496**, p < .01). SEM results indicated that psychosocial work environment was positively and significantly associated with quality of health care (β = .507, p < .001), while health centre characteristics were also positively and significantly associated with quality of health care (β = .161, p < .001). More importantly, the interaction between psychosocial work environment and health centre characteristics was positive and statistically significant (β = .235, p < .001), indicating that favorable health centre characteristics strengthened the positive relationship between psychosocial work environment and quality of health care. These findings suggest that improving workplace conditions alone may not achieve optimal service quality unless supported by favorable organizational and structural conditions within Health Centre IVs. This study extends the literature by demonstrating that health centre characteristics significantly moderate the relationship between psychosocial work environment and quality of health care
Bridging programmatic gap in post-TB treatment prevention: applying the COM-B model and Behavior Change Wheel to improve the uptake of TB preventive therapy
(Open Forum Infectious Diseases, 2026-09) Izudi, Jonathan; Sekaggya-Wiltshire, Christine; Kerkhoff, Andrew D.; Cattamanchi, Adithya
Tuberculosis preventive therapy (TPT) is a core component of the global tuberculosis (TB) control strategies and aims to reduce progression from Mycobacterium tuberculosis (MTB) infection to TB disease (hereafter, TB), including preventing recurrent TB.1, 2 The World Health Organization recommends TPT policies should be developed for other populations at risk, including those most likely to be exposed to TB and those at high risk of progression from infection to the disease.3 The Uganda Ministry of Health, through the National Tuberculosis and Leprosy Program (NTP), recommends the initiation of TPT immediately after completion of TB treatment (hereafter, post-TB treatment TPT or PTT-TPT).4 Immediate PTT-TPT targets people with retreatment TB (i.e., people previously treated for TB) who remain at elevated risk for future TB. Among others, the NTLP guideline states, "TPT should also be given to those who have previously been treated for TB immediately after completing TB treatment.".
Alcohol use and its association with dementia among older persons in northern and southwestern Uganda: a case-control study
(BMC Geriatrics, 2026) Benyumiza, Deo; Kakongi, Nathan; Nimusiima, Evas; Kintu, Timothy Mwanje; Wakida, Edith K; Obua, Celestino; Maling, Samuel
Background Alcohol use is a major modifiable risk factor for dementia. However, there is a paucity of literature on alcohol use and the development of dementia in sub-Saharan Africa, especially in Uganda. This study investi¬gated alcohol use and the development of dementia among older persons in rural Uganda. Methods A community-based case-control study among 588 older persons aged 60 years and above in Northern and Southwestern Uganda. Using the IDEA cognitive screening tool (294 Cases and 294 controls) older persons were enrolled. Interview data were collected using a questionnaire. Data were entered in EpiData version 3.0, cleaned, and transferred to SPSS version 26.0 for statistical analysis. Logistic regression was used to determine the risk of development of dementia at a 95% confidence interval. Results In this study, the proportion of participants reporting alcohol use was at 82.0% (482/588) among older persons aged 60 years and above in rural Uganda. Specifically, alcohol exposure was higher among cases at 85.7% (252/294), compared to 78.2% (230/294) among controls. Alcohol exposure was significantly associ¬ated with 1.67-fold increase in the odds of possible dementia among older persons in rural Uganda [cOR:1.67, CI:1.08–2.56, p = 0.018]. Furthermore, alcohol use for more than 10 years [cOR:2.15, CI:1.27,3.64, p = 0.005], no formal education [aOR:2.03, CI:1.37,3.01, p < 0.001], and physical inactivity [aOR:1.84, CI:1.30,2.61, p = 0.001] were significantly associated with increased odds of being a case among older persons 60 years and above. Conclusion and recommendation In this study, alcohol exposure between cases and controls is substantially high and is significantly associated with increased odds for being a case among older persons in rural Uganda. Furthermore, alcohol use for more than ten years, lack of formal education, and physical inactivity were signifi¬cantly associated with increased odds for being a case among older persons. These findings highlight the need for community-based interventions that reduce harmful alcohol use, promote lifelong learning, and encourage physical activity among older adults.
Artificial neuro-fuzzy intelligence for dynamic tracking and prediction of HIV prevalence and new infections among individuals aged 15 to 49 years in Uganda
(Medicine, 2026) Abdalla, Elnazeer Ali Hamid; Elsadig, Muna; Omar, Umi; Eze, Val Hyginus Udoka; Mergani, Adil; Salhi, Amina; Dafalla, Abuagla M.; Alkhalig, Yasreen Gasm; Sahla, Mohammed Ahmed; Mumbere, Bienfait Vahwere
Human immunodeficiency virus (HIV) infection remains a major global health burden, and Uganda continues to experience rising new HIV incidence, making prevention and management increasingly challenging. Accurate estimation of HIV prevalence (PHIVP) and tracking new HIV incidence (PHIVN) require robust computational models to effectively inform public health interventions. This study aims to develop a computational tracking model based on a 2-level intelligent framework to dynamically monitor PHIVP and PHIVN in Uganda and to identify influential factors that contribute to HIV trends among individuals aged 15 to 49. Six datasets from 146 Ugandan districts for 2023: sex rate, antiretroviral therapy coverage, awareness, education, personal income, and historical HIV indicators (prevalence and new incidence) were analyzed. A 2-level intelligent technique was employed: level I, an upgraded clustering algorithm was used to identify optimal parameters influencing PHIVP and PHIVN and level II, a neuro-fuzzy model was trained on these parameters to construct the computational tracking model. Data were partitioned into 85% for model training and 15% for testing and validation. Model accuracy was evaluated using regression performance, error metrics, and statistical significance. The model predicted a decline in PHIVP from 5.1% to 4.92%, and accurately tracked 37,996 PHIVN cases out of 38,132 actual incidences. The computational framework demonstrated strong predictive performance, yielding high regression values of R = 0.832 to 0.987 for PHIVP and PHIVN across 3 scenarios. Statistical analysis confirmed model reliability with P < .001 and P = .001. The 2-level intelligent approach exhibits strong potential for dynamically monitoring HIV prevalence and new incidence in Uganda. The 6 analyzed datasets represent significant determinants of PHIVP reduction and PHIVN tracking among adults aged 15 to 49. These findings support the feasibility of computational modeling as a tool for enhancing HIV surveillance, guiding prevention strategies, and strengthening evidence-based public health decision-making in Uganda.
Pharmacy students’ perspectives and training needs on simulation-based interprofessional education at a University in Southwestern Uganda: a qualitative study
(BMC Medical Education, 2026) Kyomya, Julius; Najjuma, Josephine Nambi; Atwiine, Fredrick; Lukyamuzi, Edward John; Musinguzi, Pius; Maleka, Emmanuel; Maling, Samuel; Muhindo, Rose; Wonde, Shewatatek Gedamu
Background Pharmacy graduates are expected to collaborate effectively within interprofessional healthcare teams. However, current training lacks structured opportunities for interprofessional learning. Simulation-based interprofessional education (sim-IPE) offers a promising approach to address this gap. This study explored the training needs and perceptions of pharmacy students regarding sim-IPE at Mbarara University of Science and Technology (MUST). Methods We conducted a formative qualitative study among pharmacy students and faculty at MUST in October 2025. In-depth interviews were conducted with 14 fourth-year pharmacy students, and key informant interviews with three purposively selected faculty members involved in curriculum design. Data was collected using interview guides developed based on the Theoretical Domains Framework. Audio-recorded data were transcribed verbatim, cleaned and analyzed in NVivo version 14 using framework analysis. Results Four themes emerged. First, the current clinical training was constrained by limited clinical training exposure, preceptor shortages, and siloed learning. Second, barriers to IPE included professional hierarchy, low student confidence, scheduling conflicts, and limited simulation capacity. Third, the enablers for successful implementation included skilled facilitation, curriculum integration, institutional support, and simulation’s safe learning environment. Fourth, effective communication skills, pharmaceutical care, and interprofessional collaboration competencies were identified as essential needs for effective participation. Participants anticipated benefits for professional development and patient care from interprofessional learning. Conclusion Pharmacy students and faculty perceived sim-IPE as a valuable approach for addressing gaps in current clinical training and strengthening readiness for collaborative practice. The main training needs identified were communication skills, role clarity, teamwork, pharmaceutical care competencies, and confidence to contribute within interprofessional teams. Implementation will require attention to professional hierarchy, faculty preparation, curriculum integration, scheduling, and simulation resources. These findings provide practical guidance for the design of a contextually appropriate sim-IPE module for undergraduate pharmacy students in Uganda and similar resource-constrained health professions education settings.
Caregivers’ and healthcare providers’ perceptions of blood availability, safety, and acceptability for patients with cancer in southwestern Uganda
(PLOS Global Public Health, 2026) Taremwa, Ivan Mugisha; Niyonzima, Nixon; Ashaba, Scholastic; Akatukwasa, Cecilia; Kemigisha, Elizabeth; Tusubira, Deusdedit; Ayebazibwe, Carlrona; Atuhaire, Shiller; Choi, May Y.; Marle, Guido van; Heather, Hume A.; Natukunda, Bernard
However, in poor-resource settings, blood and blood components remain scarce, and their perceived health risks may hinder their use. This study explored the percep¬tions of blood availability, safety, and acceptability among caregivers and healthcare providers of patients with cancer at Mbarara Regional Referral Hospital in southwest¬ern Uganda. This study employed a qualitative design involving in-depth interviews and key informant interviews with caregivers of patients with cancer and healthcare providers, between September and December 2024. The interviews were audio-recorded, transcribed, translated, and analyzed using thematic content analysis. Of the 30 participants enrolled, 16 were caregivers of patients with cancer (mean age: 36; standard deviation, SD: 10.65 years) and 14 were healthcare providers (mean: 6.5; SD: 5.77 years of practice). Blood availability relied mostly on volunteer donors in educational institutions, and blood shortages were common during school recesses. Other highlighted additional constraints included donor complacency, limited availability of some blood groups, and disruptions during disease outbreaks. While most caregivers trusted that transfused blood was safe, some expressed con¬cerns regarding adverse events and infection risks. Caregivers highly accepted blood transfusion as a life-saving intervention, but concerns relating it to end-of-life care, as well as cultural and religious beliefs were documented, and these were reported to influence transfusion acceptance. These findings reveal persistent blood shortages, with transfusion acceptance influenced by system-level and sociocultural constraints. Since patients with cancer require frequent transfusions, addressing challenges of blood supply and transfusion uptake through coordinated interventions is essential to support cancer care.
Histological placental abnormalities and associated factors among malaria smear-positive women delivering at two tertiary hospitals in Uganda: a comprehensive multicenter cross-sectional study
(Scientific Reports, 2026) Lutula, Yumbi; Baruti, Petrus; Ishimwe, Marie Pascaline Sabine; Atwiine, Raymond; Nteziyaremye, Theodore; Anyanwu, Godson Emeka; Hakizimana, Theoneste
Malaria in pregnancy may disrupt placental structure and function, but evidence describing placental abnormal¬ities among malaria-positive women in Uganda remains limited. This study determined the prevalence and pat¬terns of gross and histological placental abnormalities and examined associated factors among malaria smear-positive women delivering at two Ugandan referral hospitals. A multicenter hospital-based cross-sectional study was conducted among 124 malaria smear-positive women delivering at Jinja and Hoima Regional Referral Hospitals between 1st May and 1st September 2023. Placentas underwent standardized gross examination, tis¬sue sampling and haematoxylin-and-eosin histology. The primary outcome was the presence of any recorded histological placental abnormality. Multivariable logistic regression was used to identify independently asso¬ciated factors. Histological placental abnormalities were identified in 79 of 124 placentas (63.7%; 95% CI 55.0–71.6). Placental weight below 500 g occurred in 93 (75.0%) placentas, while 98 (79.0%) had central umbilical-cord insertion and 84 (67.8%) had a diameter of 15–20 cm. Histological lesions were not mutually exclusive. Infarction was the most frequent lesion (62, 50.0%), followed by inflammation (43, 34.7%), fibrin deposition (39, 31.5%), increased syncytial knotting (38, 30.6%), thrombosis (35, 28.2%) and fibrinoid deposi¬tion (33, 26.6%). Maternal age < 20 years was associated with higher odds of histological abnormalities than age ≥ 20 years (aOR 14.54; 95% CI 3.64–58.05; p < 0.001). BMI ≥ 30 kg/m² was associated with lower odds than BMI < 25 kg/m² (aOR 0.19; 95% CI 0.04–0.83; p = 0.027). Histological placental abnormalities were com¬mon among malaria smear-positive women. Placental weight < 500 g was the predominant gross finding, while infarction was the most frequent histological lesion. Maternal age < 20 years and BMI ≥ 30 kg/m² were inde¬pendently associated with the outcome. Malaria prevention and antenatal assessment should be strengthened, particularly for pregnant adolescents, alongside prospective studies with malaria-negative comparison groups
Prevalence, anatomic-pathologic findings, and associated factors of nontraumatic ileal perforations among patients with gut perforation: a multicenter cross-sectional study
(BMC gastroenterology, 2026) Waziri, Musa Abbas; Akello, Vivian; Atwine, Raymond; Amagara, Lauben Kyomukama; Wandabwa, Joel; Musinguzi, Edwin; Awio, John Peter; Nyenke, Godfrey Basara; Kiyaka, Sonye; Molle, Fabrice; Sikakulya, Franck Katembo; Muhumuza, Joshua; Kithinji, Stephen Mbae; ByaMungu, Pahari Kagenderezo; Mumbere, Bienfait Vahwere
Background Nontraumatic ileal perforation is a cause of obscure peritonitis characterized by severe toxicity and high mortality. This burden is disproportionately greater in LMICs due to poor hygiene practices, burden of HIV infection, and other comorbidities. This study aimed at determining the prevalence, anatomic-pathologic findings, and factors associated with nontraumatic ileal perforation a multicenter cross sectional study at 3 selected hospitals in Uganda. Methods This was a cross-sectional study of 149 consecutive sample participants that used a structured checklist. We conducted logistic regression analyses using SPSS v21.0 (IBM), Variables with p < 0.20 in the bivariate analysis were entered into the multivariable logistic regression model, and p < 0.05 was considered statistically significant. Results Nontraumaticileal perforation was more prevalent among males (20.1%; 149) and peasants/farmers (41.6%; 149) of rural residence (22.1%; 149). The majority of the study participants had typhoid perforations (79.1%; 149). Most ileal perforations occurred 20-39 cm from the ileocecal junction (76.4%; 149), a perforation size/diameter of 0.5-1cm was more common (58.1%; 149), and a single isolated perforation was more common (74.4%; 149). However, all perforations mainly occurred at the ante mesenteric border. Being an HIV-positive person was associated with greater odds of developing NTIP than was being a non-HIV-positive person. AOR 8.344, p = 0.015 (p<0.05). Additionally, patients treated with open and closed pit latrines were more likely to develop nontraumatic perforation than were those treated with water flash latrines. AOR 12.971, p = 0.004 (p < 0.05). Conclusion This study established that nontraumaticileal perforation is more prevalent among male peasants living in rural areas and with typhoid fever and most of ileal perforations were due to typhoid fever
Consumer Behavior in the Functional Beverage Sector: A Systematic Review of Influencer Marketing, Brand Awareness and Perceived Homophily
(Journal of Entrepreneurship & Project Management, 2026) Kabasinguzi, Brenda; Kamukama, Nixon; Nabachwa, Sarah
The functional beverage products such as kombucha have gained prominence within the trends of consumption owing to their health benefits and natural production processes. However, the foundations of consumer behavior are still scattered in the academic literature, especially regarding influencer marketing, brand awareness, and perceived homophily. The structured review was conducted according to the PRISMA framework, and 34 peer-reviewed articles were identified and reviewed across major academic databases such as ScienceDirect, Emerald Insight, and SpringerLink. The findings reveal that influencer marketing impacts customer behavior through credibility, authenticity, trust and engagement. Brand awareness increases recognition, reduces ambiguity and facilitates informed consumption choices. Perceived homophily strengthens persuasion through relatability and social identification between the influencer and the consumer. The review reveals the interactive effects of these aspects via communicative, cognitive and social mechanisms on consumer behavior. The report also highlights the absence of comprehensive research in the context of growing kombucha market in Uganda. This study provides a consistent synthesis of dispersed findings and advances an integrated perspective on consumer behavior. It also offers useful insights for marketers looking to promote consumption through credible influencer campaigns, solid brand positioning and socially relevant communication.
Clinicopathological features, management, and treatment outcome of prostate cancer in West and Central Africa: a systematic review
(African Journal of Urology, 2026) Malisaba, Charles Posite; Wabinga, Henry; Atwine, Raymond; Idania, Leo,; Tumwesigire, Samuel; Legesse, Biruk; Santos, Mirna Batista; Essa, Suleman Ahmed; Usman, Ibe Michael
Background Prostate cancer represents a significant and growing global health disparity, with men of African descent experiencing the highest incidence and poorest survival outcomes worldwide. This systematic review aims to comprehensively synthesize the fragmented literature to determine the specific clinicopathological features, prevailing management strategies, and treatment outcomes of prostate cancer across the 25 nations of West and Central Africa (WCA). Method A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, encompassing primary research articles published between January 2010 and July 2025. Comprehensive searches were performed across Scopus, PubMed, and Web of Science, targeting country-specific data from WCA. Studies reporting on clinicopathological features, treatment modalities, or survival outcomes were included. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Result A total of 25 studies (16 case series, 7 cohorts, 2 quasi-experimental) were included, with the majority originating from Nigeria, Senegal, and Ghana. Clinicopathological features consistently demonstrated a late-stage presentation: mean/median Prostate-Specific Antigen levels frequently exceeded 100 ng/mL, and a significant proportion of cases were categorized as highly aggressive disease (Gleason Grade Group 4 and 5). Consequently, the predominant management strategy was palliative systemic therapy, primarily Androgen Deprivation Therapy, with curative local therapies (surgery/radiation) being infrequently reported. Conclusion Prostate cancer in WCA is characterized by a worsening phenotype associated with a diagnosis at an advanced stage, leading to a management paradigm dominated by palliative care. Urgent, regionally-tailored public health interventions are required to establish effective early detection programs and bolster local oncology capacity to transition from palliative to curative intent treatment and improve survival outcomes
Pathways of resilience: a fuzzy-set qualitative comparative analysis of healthcare systems resilience to extreme weather events
(BMC Health Services Research, 2026) Sylvester, Ruth E; Abwe, Furaha G; Bartram, Jamie; Brainard, Julii; Geere, Jo-Anne; Hanh, Tran Thi Tuyet; Hoyos, Natalia; Hunter, Paul; Kabakama, Severin; Kuchelekana, Kondwani; Mekala, Snehalatha; Longwe, Wezzie; Lukaaya, Dennis; Arroyo, Hugo Andres Macareno; Mapemba, Daniel; Mcconochie, Megan; Pachongo, Carolina Montoya; Muula, Adamson S.; Mulogo, Edgar Mugema; Mwebembezi, Fred; Simkonda, Mwizapanyuma; Ngonzi, Joseph; Nikolaos, Nikitas; Ntaro, Moses; Simbewe, Patrick; Sambala, Evanson; Sunday, Patrick; Sedekia, Yovitha M
Increasing frequency and intensity of extreme weather events (EWEs) threaten healthcare services globally, with particularly acute risks in low-resource settings. While health system resilience is widely discussed, there is limited empirical evidence on how it is enacted in practice across complex, real-world systems, particularly beyond infectious disease contexts. Methods We analysed 18 case studies from diverse global contexts, examining how EWEs affected four interrelated system levels: healthcare facilities, local health systems, communities, and interconnected infrastructures. We applied fuzzy-set Qualitative Comparative Analysis (fsQCA) to identify configurations of vulnerability, adaptive capacity, and external support associated with two outcomes: service continuity and healthcare facility recovery. Results Four distinct resilience pathways were identified. These demonstrate that resilience emerges from cross-scale configurations rather than individual system components, with local adaptive capacity playing a key role in maintaining service continuity. Where high vulnerability across multiple system levels exceeded local capacity, resilience depended on external support, which was associated with eventual recovery but not with continuity of services. Across cases, workforce factors—including staff wellbeing, safety, and morale—were critical in shaping system response. Conclusion This study provides empirical evidence that health system resilience to EWEs is a multi-scalar process. The identified pathways offer practice-based insights for strengthening resilience, highlighting the importance of cross-system coordination, planning for capacity limits and phased operational response escalation, and investing in the health workforce as a central component of effective response and recovery
Understanding Consumer Behavior in Emerging Functional Beverages: Influencer Marketing, Brand Awareness and Kombucha Consumption in Uganda
(Open Journal of Business and Management, 2026) Kabasinguzi, Brenda; Kamukama, Nixon; Nabachwa, Sarah
This study examined the association between influencer marketing and consumer behavior towards kombucha drinks in Southwestern Uganda, with particular emphasis on the mediating role of brand awareness. A cross-sectional quantitative research design was employed. Data were collected from 346 kombucha consumers using a structured questionnaire and analyzed using SPSS and Partial Least Squares Structural Equation Modelling (PLS-SEM). The findings revealed that influencer marketing was positively associated with both brand awareness and consumer behavior. Brand awareness was found to partially mediate the association between influencer marketing and consumer behavior, suggesting that consumers exposed to influencer marketing tend to exhibit more favorable consumer behavior through higher levels of brand awareness. The cross-sectional design and the study’s focus on one geographical region limit the generalizability of the findings. Future research should employ longitudinal and cross-cultural designs to provide further evidence regarding these relationships. From a practical perspective, marketers should develop influencer marketing strategies that strengthen brand awareness through consistent messaging, enhanced brand visibility and meaningful consumer engagement, particularly for emerging functional beverages such as kombucha. The study contributes to the literature by demonstrating the mediating role of brand awareness in the association between influencer marketing and consumer behavior within a developing market context, thereby extending understanding of the cognitive mechanisms underlying influencer marketing effectiveness
From Tourism to Agro-processing: Wekesa the Hustler
(Emerging Economies Cases Journal, 2026) Agasha, Ester; Rono, Lucy Jepchoge; Nabachwa, Sarah
As Great Lakes Safaris, a Ugandan tour and travel company, expanded, so did the needs of its clients. This prompted the company’s proprietor, Amos Masaba Wekesa, to diversify to closely related fields to accommodate this demand. He spotted opportunities in the Ugandan National Parks, where he built several eco-friendly lodges. Relatedly, he took advantage of the blue waters of Lake Victoria to branch into marine tourism and co-patterned with his friends to buy their first water bus—MV Kazinga. However, the advent of the COVID-19 pandemic devastated the tourism industry, pushing Wekesa into the unrelated agro-processing business. The birth of his new venture, PELA Commodities Limited (PCL), was circumstantial and a survival backup plan due to the COVID-19 disruptions. As life returns to normal, Wekesa has to think critically about his diversification strategy and ensure he is well-positioned for success in his tourism and agro-processing businesses. He is worried that his new PLC business could become a distraction to his core Tourism business. He wonders if this will not stretch his current resources or devalue the quality of his services.
Primary health care providers’ readiness to implement the WHO mental health Gap Action Programme Intervention Guide (mhGAP-IG) for alcohol use disorder in rural Uganda: a qualitative study using CFIR
(BMC Health Services Research, 2026) Samantha, Mary; Mlahagwa, Wendo; Maling, Samuel; Bartels, Stephen; Obua, Celestino; Wakida, Edith K.
Background Alcohol Use Disorder (AUD) is a major public health concern in Uganda, yet detection and man¬agement at the primary health care (PHC) remain limited. The World Health Organization Mental Health Gap Action Program Intervention Guide (mhGAP-IG) provides evidence-based recommendations for managing AUD in non-specialist settings. However, little is known about the multilevel determinant influencing PHC providers’ readiness to implement these recommendations in routine practice. This study examined determinants influenc¬ing readiness to implement mhGAP-IG recommendations for AUD management in rural Uganda. Methods We conducted a qualitative exploratory study involving PHC providers and district health team mem¬bers in a predominantly rural district in southwestern Uganda. Participants were purposively selected to capture variation across professional cadres and health system roles. Individual in-depth interviews were conducted using a semi-structured guide informed by the Consolidated Framework for Implementation Research (CFIR). Data were analyzed using a deductive–inductive thematic approach to examine determinants across intervention char-acteristics, outer setting, inner setting, individual characteristics, and implementation process domains. Results Eighteen participants were interviewed including 15 PHC providers and 3 district health team members. Readiness to implement mhGAP-IG recommendations for AUD was shaped by interacting determinants across CFIR domains. Providers generally perceived the recommendations as useful and feasible for non-specialist practice and expressed strong willingness to improve AUD care. However, limited familiarity with mhGAP-IG and gaps in clinical competencies interacted with organizational constraints, including high workloads, limited medicines and educational materials, weak documentation and referral systems, and inconsistent supervision. Community normalization of alcohol use, stigma, geographical barriers, weak alcohol policy enforcement, and limited financing further constrained readiness. Participants emphasized that implementation would require more than provider training, highlighting the need for practical decision-support tools, integration into routine work¬flows and documentation systems, stakeholder engagement, and ongoing monitoring and supportive supervision. Conclusion Provider willingness and favorable perceptions of mhGAP-IG provide an important foundation for implementation but are insufficient to establish implementation readiness. Readiness depends on alignment between intervention usability, provider capability, organizational capacity, and the broader community and health system context. Implementation strategies should therefore combine competency-based training with practical implementation tools, strengthened documentation and referral systems, integration into existing PHC workflows, district and community engagement, and ongoing supportive supervision.
Service Marketing and Intentions to Access Sexual and Reproductive Health Among Young Adults in Nakivale Refugee Settlement: A Qualitative Perspective
(Journal of Community Medicine and Primary Health Care, 2025) Oseku, J; Nabachwa, Sarah
Background: Access to sexual and reproductive health (SRH) products is vital for enhancing individual well-being and socio-economic outcomes. However, marginalized populations, particularly refugees in Uganda, face significant barriers that limit their ability to seek and utilize these essential health services. Understanding these barriers is crucial for addressing the needs of these vulnerable groups. Methodology: This qualitative study explores factors influencing young adults’ intentions to access SRH products within the Nakivale Refugee Settlement. Data were collected through in-depth interviews, and thematic analysis was used to identify how various components of the service marketing mix—such as price, place, promotion, products, process, physical evidence, and personnel—interact with cultural beliefs, economic realities, and social norms, influencing attitudes and behaviours toward SRH services. Results: The findings reveal significant barriers, including a lack of essential SRH products, high costs necessitating informal payment methods, and infrastructural challenges that impede service access. Cultural stigmas and privacy concerns further complicate service uptake, often overshadowing promotional efforts. While some participants reported positive healthcare interactions, many expressed dissatisfactions due to substandard care and unwelcoming environments. Conclusion: This study underscores that social pressures and traditional values significantly influence SRH health-seeking behaviours, diminishing the effectiveness of basic marketing strategies. There is an urgent need for culturally sensitive and trust-building approaches to address these issues. By integrating marketing principles with community engagement, stakeholders can develop more effective interventions, ultimately improving sexual and reproductive health outcomes in refugee settlements.
Diagnosis and Management of Pheochromocytoma in Pregnancy: A Multidisciplinary Approach to Treatment and Outcomes at Mbarara Regional Referral Hospital: A Case Report
(International Medical Case Reports Journal, 2026) Bashir, Mohamed; Begumana, Daniel; Anyit, Moses; Byamukama, Onesmus; Ngonzi, Joseph; Kayondo, Musa; Kyoyagala, Stella; Muhindo, Rose; Ttendo, Stephen; Fajardo, Yarine Tornes; Tibaijuka, Leevan
Introduction: Pheochromocytoma in pregnancy is extremely rare but can be life-threatening for both mother and fetus. Its clinical manifestations often mimic common obstetric complications, such as preeclampsia, resulting in delayed or missed diagnosis with potentially catastrophic consequences. Prompt recognition and careful management are critical to improving maternal and neonatal outcomes. Case Presentation: We report a 27-year-old Black African multiparous refugee woman at 26 weeks of gestation who presented with palpitations, shortness of breath, headaches, and markedly fluctuating blood pressure. Ultrasonography revealed a large right adrenal mass, and 24-hour urinary metanephrines confirmed catecholamine excess. Despite antihypertensive therapy, she continued to experience alternating hypertensive and hypotensive crises, necessitating an emergency cesarean delivery at 31 weeks of gestation. A live preterm neonate weighing 1.8 kg was delivered in good condition. Ten weeks postpartum, she underwent laparoscopic adrenalectomy. Histopathological examination and immunohistochemistry evaluation confirmed the diagnosis of pheochromocytoma. Conclusion: This case highlights the diagnostic challenge of pheochromocytoma in pregnancy, which can masquerade as preeclampsia and other hypertensive disorders. It underscores the importance of considering pheochromocytoma in the differential diagnosis of labile blood pressure during pregnancy. Multidisciplinary coordination, vigilant hemodynamic stabilization, and timely postpartum surgery can achieve excellent maternal and neonatal outcomes
Müllerian adenosarcoma in a young adult: A case report and literature review of diagnostic and management challenges
(Gynecologic Oncology Reports, 2026) Malisaba, Charles Posite; Legesse, Biruk; Etienne, Ndungo; Musubao, Justine; Tumwesigire, Samuel; Birungi, Abraham; Batista, Mirna Santos; Essa, Suleman Ahmed; Wabinga, Henry; Atwine, Raymond
Background: Müllerian adenosarcoma is a rare biphasic uterine malignancy typically affecting postmenopausal women. Its occurrence in young, nulliparous women is extremely uncommon, presenting diagnostic challenges, especially in cases of presumed recurrences. Case Presentation: A 22-year-old nulliparous woman presented with a presumed recurrent, enlarging prolapsing uterine mass and post-coital bleeding. Her history was notable for two prior excisions of a similar mass without histopathological review. Examination revealed a 6 cm friable mass protruding through the cervical os. Given the recurrence and risk of hemorrhage in a resource-limited setting, a total abdominal hysterectomy was performed. Gross examination identified a 9x6x4 cm polypoid mass confined to the fundus. Histopathology confirmed high- grade endometrial adenosarcoma, characterized by classic biphasic features, significant spindle-cell atypia, and a brisk mitotic rate (>10 mitoses/10 HPFs). Immunohistochemistry showed stromal positivity for CD10 and PR. No myometrial invasion or lymphovascular space invasion was observed. The patient remains asymptomatic under a rigorous three-month surveillance protocol. Conclusion: This case highlights a rare high-grade presentation in a young adult. Despite aggressive histological features, the absence of myometrial invasion supports definitive surgery followed by intensive long-term sur veillance. This report underscores the necessity of a high index of suspicion for malignancy in recurrent polypoid masses within the reproductive age group and addresses critical gaps regarding fertility preservation and age- specific management protocols.
Voices and lived experiences of perinatal women recovering from mental illness and informal caregivers regarding quality of maternal mental health care in south western Uganda
(Discover Mental Health, 2026) Nakidde, Gladys; Kamoga, Ronald; Mugisha, John F.; Kumakech, Edward
Background Maternal mental illness (MMI) contributes significantly to maternal morbidity, particularly in low-resource settings. Although policies support integrating maternal mental health into routine maternity care, assessments of care quality have largely focused on health workers’ perspectives rather than women’s lived experiences. This study explored the quality of maternal mental health care as experienced by women recovering from MMI and family caregivers. Methods A phenomenological qualitative study was conducted between November 2022 and February 2023. Nineteen participants were purposively recruited from two regional referral hospitals in southwestern Uganda. We included women who had recovered from MMI and family caregivers. Following REC and hospital approvals, participants were contacted by telephone and after consent, appointments for the interviews were scheduled. Data were collected using in-depth interview guide until saturation was reached and manual thematic analysis done, guided by a hybrid coding approach. Results Most participants were female with male caregivers being husbands, rural residents, and self-employed. Women were aged 23–37 and caregivers 28–65 years. Five interrelated themes emerged: perceived causes of MMI; clinical presentation and healthcare experiences; challenges, recommendations, and future hopes; community perceptions and stigma; and social support and family dynamics. These inform that sociocultural beliefs, health-system responsiveness, and family support shape perceptions of care quality. Recovery and satisfaction were mainly attributed to hospital-based mental health services, often accessed through self-referral after maternity discharge. Despite some positive experiences, maternal mental health care quality remained limited by experienced challenges. Interventions should focus on community education, integrating mental health screening and management into maternity services, improving medicine availability and addressing stigma through culturally appropriate approaches.