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Recent Submissions

Suicidal ideation among adolescents and young adults with cancer in Uganda
(BMC Cancer, 2026) Mukiibi, Nicholas; Abaatyo, Joan; Nanziri, Angella; Ntukunda, Faith; Kaggwa, Mark Mohan; Rukundo, Godfrey Zari
Background Adolescents and young adults (AYAs) living with cancer face unique psychosocial challenges that may heighten vulnerability to suicidality and other mental health challenges. However, evidence from low- and middle-income countries, including Uganda, remains scarce. This study examined the prevalence and factors associated with suicidal ideation among AYAs with cancer in Uganda. Methods A cross-sectional analytical survey was conducted among 271 AYAs aged 10–24 years attending oncology clinics at the Uganda Cancer Institute and Mbarara Regional Referral Hospital, between March and May 2024. Sociodemographic and clinical characteristics were collected using a structured questionnaire. Suicidal ideation was assessed using four suicide-related items rated on a four-point Likert scale. Because depression and anxiety are established risk factors for suicidal ideation, depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and anxiety symptoms using the Generalized Anxiety Disorder-7 (GAD-7) scale as potential explanatory variables. Descriptive statistics summarized participant characteristics, while multivariable logistic regression identified factors independently associated with suicidal ideation. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported, and a sensitivity analysis using a stricter suicidal ideation threshold was performed. Results The overall prevalence of suicidal ideation was 63.5%. Probable anxiety showed the strongest association with suicidal ideation (aOR=15.37, 95% CI: 1.88–125.65), followed by a history of cancer recurrence (aOR=5.56, 95% CI: 1.84–16.77), duration of cancer diagnosis more than two years (aOR=4.17, 95% CI: 1.38–12.57), and probable depression (aOR=3.70, 95% CI: 1.03–13.29). Receiving a combination of treatment modalities was associated with reduced odds of suicidal ideation (aOR=0.27, 95% CI: ad. Conclusions Suicidal ideation is highly common among AYAs with cancer in Uganda, especially those with chronic, or recurrent disease, probable depression and anxiety symptoms, and those receiving a single modality of cancer treatment. Incorporating routine mental health screening and psychosocial support into oncology care can facilitate early identification, timely referral, and appropriate management of AYAs at risk, thereby potentially reducing suicide risk
Induction failure and early death in paediatric acute myeloid leukaemia in Uganda: a developing country experience
(BMC Cancer, 2026) Nyeko, Richard; Kruger, Mariana; Niyonzima, Nixon; Atwiine, Barnabas; Balagadde Kambugu, Joyce; Verhulst, Stijn; Heerden, Jaques van
Abstract Introduction Dose-intensive therapy for paediatric acute myeloid leukaemia (AML) has improved outcomes in high-income countries (HICs); however, outcomes remain poor in resource-limited settings, where induction failure and early death continue to pose significant challenges. This study aimed to determine the frequency of induction failure and early death and identify associated risk factors among children treated for AML in Uganda. Methods This retrospective study examined induction failure and early death among children with AML. Data collected included demographic information, clinical characteristics, and induction outcomes for children under 18 years who were diagnosed with AML between 2016 and 2022 at three Ugandan institutions. Induction failure was defined as failure to achieve microscopic remission after induction chemotherapy, including deaths during induction. Early death was defined as death before or within 42 days of initiating induction therapy. Variables included sex, age, initial white cell count, and nutritional status, among others. Nutritional status was assessed using the World Health Organization weight-for-height, body mass index (BMI)-for-age, and mid-upper-arm circumference (MUAC) z-scores. Descriptive statistics and logistic regression analyses were performed using IBM SPSS version 27 to investigate variables associated with induction failure and early death. Results There were 159 children with AML, of whom 87 (54.7%) were males, with a median age of 9.0 years (IQR 3.0–12.0). Nearly half (n=62; 39.0%) were malnourished, and over a third (n=59; 37.1%) had a peripheral white blood cell count (WBC) at diagnosis of ≥50,000/uL. Of the 149 (93.7%) patients who received induction chemotherapy, 39 (26.2%) experienced induction failure and 27.7% early death (44/159). The main causes of death were sepsis (35%), bleeding (25%), organ failure (15%), severe anaemia (13%), and severe pneumonia with respiratory failure (12%). Induction failure was significantly associated with malnutrition (p=0.031), presumed fungal infection (p=0.043), and absence of CNS involvement assessment at diagnosis (p=0.005). Early death was associated with malnutrition (p=0.007), suspected fungal infection (p=0.008), and pneumonia (p=0.024). Conclusion In this Ugandan cohort of children with AML, induction failure and early death rates remained high and were strongly associated with infections and treatment-related complications, underscoring the challenges in AML management. Malnutrition, suspected fungal infections, and pneumonia were significantly associated with poor outcomes, highlighting the need for improved supportive care and early management of complications in resource-limited settings.
Harnessing digital–relational synergies for sustainable SME performance: exploring the interplay between digital marketing and network capital in resource-constrained settings
(Journal of Sustainable Business, 2026) Bindeeba, Dedrix Stephenson; Bakashaba, Rennie; Tukamushaba, Eddy Kurobuza
This study examines how Digital Marketing (DM) and Network Capital (NC) jointly influence the economic and social performance of small and medium-sized enterprises (SMEs) in Uganda. Drawing on the Resource-Based View, the Technology–Organization–Environment framework, and Network Theory, an explanatory mixed-methods design was employed. In the quantitative phase, survey data from 272 SMEs were analyzed using Hayes’ PROCESS macro (Model 1) with mean-centered predictors and bootstrapped standard errors. The results show that DM and NC independently enhance both economic and social performance; however, NC negatively moderates the DM–performance relationship, indicating a substitution rather than a complementary effect. Conditional effects reveal that DM significantly improves performance at low and moderate levels of NC but becomes non-significant at high NC levels. The qualitative phase, based on 15 interviews, explains this pattern through managerial attention constraints, trust substitution, and digital cost frictions. Together, the findings advance a contextual threshold perspective, showing that digital strategies are most effective where relational capital is limited, while dense networks dampen the marginal returns to digital investment in resource-constrained settings. Practically, the results suggest that SMEs should calibrate digital marketing investments to their relational context, prioritizing digital tools where network resources are weak and avoiding overinvestment where strong relational ties
Opuntia ficus-indica (L.) as a natural coagulant and alum aid for surface water clarification in tropical Uganda
(Water Practice & Technology, 2026) Mutanda, Hosea Eridadi; Ndyabijuka, Pathias; Mbabazi, James; Tibot, Paul; Kusiima, Vian; Najjobyo, Josephine; Kalyankolo, Zaina; Bbosa, Denis
Plant-based coagulants could reduce reliance on traditional chemicals for water clarification; however, their performance requires validation using actual, very turbid waters. This study assessed the efficacy of Opuntia ficus-indica (L.) extract, alu minium sulphate (alum), and a 1:1 Opuntia–alum formulation for the clarity of raw water in Uganda through jar tests, varying coagulant concentrations from 10 to 60 mg/L and specific pH conditions. Untreated water had a turbidity of 135 ± 5 NTU and a colour measurement of 884 ± 8 Pt–Co units. Opuntia eliminated 54–82% of turbidity and 56–76% of colour, while alum removed 78–83% and 76–89%, respectively. The hybrid formulation had the highest observed removals, attaining 96% for turbidity at 30 mg/L and 95% for colour at 60 mg/L. Nonetheless, trends in pH, alkalinity, and conductivity indicated that treatment chemistry was responsive to dosage and the alkaline extraction method. The findings offer region-specific evidence that Opuntia can serve as a coagulant aid for heavily contaminated tropical surface water. The study did not assess post-treat ment microbial elimination, sludge characteristics, lifecycle effects, or full-scale expenses; hence, findings are restricted to clarifying efficacy and laboratory-scale operational behaviour
Lake Mburo National Park Water quality and hydrological monitoring (April 2024–April 2025)
(2026) Ayesiga, Patience; Lodi, Giulia; Tinkasimire, Rogers; Twinamatsiko, Medard; Twongyirwe, Ronald; Ogwang, Tom; Yatuha, Jane; Cools, Jan; Schoelynck, Jonas
The one year monitoring campaign of water quality in the Lake Mburo – River Rwizi system shows clear signs of high turbidity and eutrophication. Persistent low oxygen levels and recurring nitrogen and phosphorus spikes are found at specific lake sites. Water levels in the lake are shallow (1 – 3.5m). Flow in downstream rivers is close to zero in the dry season. The wetlands at the inflow zones play an important role in ecosystem functioning of the Lake Mburo – River Rwizi system. Restoration efforts should hence target wetland areas around in- and outflow zones. A long-term monitoring campaign is necessary to track trends over time, detect changes in both water quality and hydrology, and evaluate the effectiveness of management interventions. The monitoring campaign was conducted by the Universities of Mbarara (MUST, Uganda) and Antwerp (UA, Belgium) under the UCoBS programma, financed by VLIRUOS in Flanders, Belgium. Monthly water quality assessments were done at 11 key sites in Lake Mburo National Park and the southern Isingiro region, covering the Rwizi and Nyarutengura rivers and Lake Mburo (Fig. 1). This document presents the main findings from the first year of monitoring, with the purpose of disseminating results to Lake Mburo Park Authorities (UWA), regional water managers, and other stakeholders. More information is provided in the report by Lodi et al. (2025).
A Student-Led Mentorship Intervention to Enhance Podoconiosis Management Among Healthcare Workers and Village Health Teams in Western Uganda
(Cureus, 2025-12-25) Mwesigye, Vicent; Tebulwa, Joanita Berytah; Ngabirano, Joseph; Muhwezi, Trevor James; Ngasha, Racheal; Najjingo, Daurice Patrice; Lubwama, Hayidar; Kawungezi, Peter Chris; Kitunzi Mulyowa, Grace; Mulogo, Edgar
Podoconiosis is a neglected tropical, nonfilarial lymphedema resulting from prolonged barefoot exposure to irritant volcanic soils. Uganda is among the affected countries, with Kamwenge District documented as endemic. Persistent gaps in knowledge, prevention practices, and access to care contribute to a sustained disease burden. A multidisciplinary team from Mbarara University of Science and Technology conducted a three-day community-based situation analysis and mentorship program in Kamwenge District from October 3 to October 7, 2022. The team included undergraduate and postgraduate trainees in medical laboratory sciences, medicine, nursing, public health, and dermatology under faculty supervision. Following approval from district authorities, 50 community participants were engaged: 30 podoconiosis patients, 12 Village Health Team (VHT) members, five local council leaders, and seven patient caretakers. Activities included free clinical consultations, structured health education, psychosocial counseling, and hands-on demonstrations of limb hygiene, bandaging, appropriate footwear use, and the application of topical antibacterial or antifungal creams. Substantial knowledge gaps related to podoconiosis causation, prevention, and long-term management were identified among both patients and VHTs. Patients described significant stigma, chronic pain, and functional disability, which were also directly observed during mentorship interactions. Practical demonstrations of limb hygiene and bandaging techniques were positively received, and VHTs expressed strong willingness to integrate these practices into routine community follow-up. However, resource limitations, particularly inadequate footwear and medical supplies, emerged as major barriers to sustained self-care. Podoconiosis remains preventable through proper foot hygiene, sustained health education, use of protective footwear, and community empowerment. However, significant knowledge gaps and misconceptions persist in endemic areas of Kamwenge District. The use of multidisciplinary, community-engaged mentorship models can enhance capacity for early detection, self-care, and stigma reduction. Larger district-wide studies are warranted to better characterize the epidemiology and guide sustainable interventions.
Global Preventive and Management Strategies and Their Effectiveness in Patients With Secondary Lymphedema: A Scoping Review
(Cureus, 2025-05-07) Mwesigye, Vicent; Atwine, Daniel; Munguciada, Esther Faith; Tillema, Alice; Tebulwa, Joanita Berytah; Agaba, Bosco Bekita; Bazira, Joel; Bajunirwe, Francis; Itabangi, Herbaert; Byarugaba, Frederick; Mulogo, Edgar
Secondary lymphedema arises from lymphatic damage, often due to infections, inflammatory conditions, cancer treatments, or trauma, leading to fluid retention, swelling, and mobility issues that impact the quality of life. This scoping review examined global preventive and management strategies for secondary lymphedema, assessing their effectiveness and feasibility, particularly in low-resource settings. Additionally, it explored causative agents and knowledge gaps among patients and healthcare workers in endemic communities. This review followed the Joanna Briggs Institute (JBI) methodology and reported findings using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. The search strategy targeted four databases, including PubMed, Embase, Web of Science, and African Index Medicus. The inclusion criteria included all studies that focused on lower or upper limb secondary lymphedema, and reported on either preventive or management interventions or strategies globally, and were published between 2014 and 2024 in English. Data extraction involved two reviewers, with discrepancies resolved through discussion. A descriptive and narrative synthesis was performed to highlight preventive and management strategies and their effectiveness. A total of 3192 published articles were retrieved from searches of the selected databases, that is, PubMed (n=1467), Embase conference (n=386), Embase articles (n=550), Web of Science (n=713), and Africa Index Medicus (n=76). After the elimination of duplicate and ineligible articles, 45 articles were included in the final qualitative synthesis. Microsurgical techniques are more effective than conservative treatments. Self-care and hygiene-based strategies were more widely used for filarial lymphedema and podoconiosis in endemic areas, whereas the Mass Drug Administration (MDA) and Morbidity Management and Disability Prevention (MMDP) programs had limited success in halting disease progression. Adjunct therapies, including low-level laser therapy, cryotherapy, and kinesio taping, have shown potential in enhancing limb function and quality of life. The primary causes of secondary lymphedema vary geographically, with lymphatic filariasis dominant in tropical regions, podoconiosis in volcanic highlands, and cancer-related lymphedema in high-income areas. Knowledge gaps and misconceptions among patients, healthcare workers, and communities hinder effective disease management, with stigma and misinformation remaining key barriers despite educational efforts. While microsurgical interventions offer quick, effective clinical outcomes, hygiene-based interventions and self-care practices are the most scalable strategies for the treatment and management of filarial and podoconiosis-related lymphedema in low-resource settings.
Region-specific forest structure pathways reveal climate effects on old-growth tropical forest biomass
(Scientific Reports, 2026) Depoortere, Pauline; Bauman, David; Fayolle, Adeline; Bialic-Murphy, Lalasia; Zohner, Constantin M.; Linden, ArthurVander; Plumacker, Antoine; Lame, Hugo de; Liang, Jingjing; Bassama, Patrick; Beeckman, Hans; Benu, Nithanel Mikael Hendrik; Bihiya, Hervé; Birnbaum, Philippe; Bitariho, Robert; Boeckx, Pascal; Boekee, Kelly; Bogaert, Jan; Böhning-Gease, Katrin
Old-growth tropical forests store vast amounts of carbon in their aboveground biomass (AGB), yet the relative roles of abiotic factors such as climate, soil, and topography in governing its spatial distribution remain poorly understood. In particular, the degree to which climate acts on AGB through forest structure is still poorly quantified at the pantropical scale. Using a pantropical dataset of more than 2,000 old-growth forest plots and a structure-explicit framework, we assess how climate influences AGB through its effects on four structural attributes: basal area, mean diameter, stem density, and basal area-weighted wood density. We find that climate shapes AGB primarily through its effects on forest structure. However, structural attributes respond to climate in opposite directions, so climate’s net effect on AGB largely cancels out, and no clear climate-AGB relationship emerges across tropical regions. Moreover, only wood density responds consistently, decreasing with annual precipitation and increasing with precipitation seasonality, whereas all other attributes respond to climate differently from one region to another. This geographical variation further obscures any global climatic signal on AGB and points to the role of biogeographic history in shaping forest structure. Our findings highlight the central role of the climate-structure nexus in explaining AGB variation, and call for structure-explicit models to improve carbon stock predictions and inform climate adaptation strategies.
Farmer-reported biometeorological hazards and their implications for banana production in Kyabugimbi subcounty, Bushenyi district, southwestern Uganda
(Discover Agriculture, 2026) Muruhara, Dickson; Byaruhanga, Ronald; Kagoro-Rugunda, Grace; Bitariho, Robert; Nkurunungi, John Bosco
Banana production in Uganda is increasingly exposed to environmental and biological stressors that affect productivity and livelihood stability among smallholder farmers. Despite growing attention to climate-sensitive agriculture, there remains limited localized evidence on how farmers experience and interpret environmental hazards within banana-based production systems. This study examined farmer reported biometeorological hazards and their perceived implications for banana production in Kyabugimbi subcounty, Bushenyi district, southwestern Uganda. A cross-sectional mixed-methods design was employed, combining household surveys with key informant interviews and contextual climate observations. Data were collected from 172 banana farmers and six key informants and analyzed using descriptive statistics and thematic analysis to characterize reported hazards, perceived impacts, and local response patterns. The findings indicate that drought was the most frequently reported hazard, followed by rainfall irregularities, wind related disturbances, pests, and diseases. Farmers associated these stressors with reduced plantation vigor, irregular yields, moisture stress, crop damage, and increased production uncertainty. Spatial differences in hazard reporting suggest that local environmental conditions and management practices influence how production risks are experienced across the study area. The study demonstrates the value of farmer reported knowledge in understanding environmental stress within smallholder banana systems and highlights the importance of integrating localized experiences into agricultural risk management. The findings provide contextually grounded evidence that may inform extension services and support future research combining household observations with environmental monitoring to strengthen understanding of agricultural vulnerability under variable environmental conditions
Work Team Stability and Quality of Health Care in Uganda; Evidence from Health Centre IVs in South Western Uganda
(East African Journal of Business and Economics, 2026-08-04) Bangirana, Sephas; Mulogo, Edgar Mugema; Mucunguzi, Charles; Musiita, Benjamin; Bakashaba, Rennie
Purpose: Given the critical role of quality of health care in promoting a healthy population, this study examined the relationship between work team stability and quality of health care in Health Centre IVs in South Western Uganda. Design/methodology/approach: A cross-sectional design using a mixed-methods approach was adopted. Data were collected from health care workers in selected Health Centre IVs using questionnaires, key informant interviews, and document review. Quantitative data were analysed using descriptive statistics, Pearson correlation, and regression analysis, while qualitative data were analysed thematically. Findings: The findings revealed a positive and statistically significant relationship between work team stability and quality of health care (r = 0.440, p < 0.01). Consistent with this, regression results showed that work team stability significantly predicted quality of health care (β = 0.352, p = 0.003), with the model explaining 19.4% of the variation in quality of health care (R² = 0.194). Originality/value: This study provides empirical evidence on the role of work team stability in influencing quality of health care in public health facilities in Uganda, highlighting workforce stability as a critical factor in improving service delivery
When policy meets practice: enacting WHO global standards for adolescent reproductive health services in Uganda
(Reproductive Health, 2026-07-08) Asiimwe, Susan; Michielsen, Kristien; Nyakato, Viola Nilah
Background: Adolescent pregnancy remains a major public health concern in sub-Saharan Africa. In Uganda, about one in four girls becomes pregnant before age 19, a rate unchanged for more than a decade. Although national adolescent reproductive health policies broadly align with the World Health Organization Global Standards for Quality Health Care Services for Adolescents, important implementation gaps persist. This study examined how these standards are enacted in routine health facility and school settings. Methods: A qualitative study was conducted in eight public health facilities and eight secondary schools in south-western Uganda. Data were collected through structured observations and exit interviews with 80 adolescent girls aged 15-19 years and 20 accompanying caregivers. Health facility findings were organised using the eight World Health Organization Global Standards, while school observations were assessed against national school health and teenage pregnancy guidelines and interpreted alongside the World Health Organization framework. Data were analysed thematically in NVivo using Braun and Clarke’s framework, with Street-Level Bureaucracy theory informing interpretation of how standards were enacted in practice. Results: Implementation was partial and uneven across both settings. Some facilities provided respectful and confidential care, while others had stock-outs of essential commodities, reported out-of-pocket purchases, limited adolescent-friendly spaces, and judgemental or dismissive treatment, particularly toward unmarried adolescents. School-based reproductive health activities were largely abstinence-oriented and often donor-dependent, with weak curriculum integration, referral systems, monitoring, and evaluation. Community engagement and adolescent participation were limited in both settings. Several donor-supported activities became inactive after funding ended because they had not been absorbed into routine institutional systems. The findings indicated alignment in policy intent but weak embedding of adolescent-responsive components in routine institutional systems. Conclusion: Uganda’s adolescent reproductive health policy framework is broadly aligned with World Health Organization Global Standards, but implementation remains uneven because adolescent-responsive components are not sufficiently institutionalised within routine financing, supervision, school programming, data use, and accountability systems. Closing this gap requires embedding adolescent-responsive services in routine institutional systems and strengthening adolescent-specific supervision and accountability.
The Moderating Role of Government Regulations Compliance in the Relationship between Capacity Building, Firm Capabilities and Local Content Consumption in Uganda's Oil and Gas Sector
(East African Journal of Business and Economics, 2026-07-16) Mugisa, Samuel; Bagira, Vincent; Tumuhimbise, Manasseh; Twinematsiko, Ivan
Purpose: This study examined the moderating role of government regulations compliance in the relationship between capacity building, firm capabilities, and local content consumption among firms operating in Uganda’s oil and gas sector. The study adopted a mixed methods cross-sectional research design. Data was collected from 280 firms registered on the National Supplier Database of the Petroleum Authority of Uganda. Data was obtained from Procurement Officers, Accountants, and National Content Officers using questionnaires. Data were analysed using descriptive statistics, Pearson correlation, hierarchical regression, and Structural Equation Modelling (SEM). The findings revealed that capacity building (β = 0.444, p < 0.001) and firm capabilities (β = 0.343, p < 0.001) have positive and statistically significant effects on local content consumption. Hierarchical regression results indicated that capacity building and firm capabilities jointly explained 36.1% of the variation in local content consumption (Adjusted R² = 0.361). The findings further revealed that government regulations compliance positively and significantly moderates the relationship between capacity building and local content consumption (β = 0.273, p < 0.001), while negatively and significantly moderating the relationship between firm capabilities and local content consumption (β = -0.128, p = 0.008). The study recommends strengthening capacity-building programmes through training, knowledge transfer, supplier development initiatives, and improved access to finance for local firms. Regulatory institutions should also enhance monitoring and enforcement of local content requirements to increase the participation of Ugandan firms in oil and gas supply chains. The findings highlight the importance of investing in capacity building, strengthening firm capabilities, and ensuring compliance with local content regulations to enhance the participation of domestic firms in oil and gas procurement activities and increase local content consumption.
Quality of informed consent for research participation obtained during labor versus mid-pregnancy in Uganda
(BMC Medical Ethics, 2026-07-23) Kihumuro, Raymond Bernard; Zhang, Cindy; Zaigham, Mehreen; Haberer, Jessica E.; Byamukama, Anacret; Tindimwebwa, Edna; Asiimwe, Stephen; Gelaye, Bizu; Bajunirwe, Francis; Boatin, Adeline A.; Ngonzi, Joseph; Bebell, Lisa M.
Background: Obtaining high-quality informed consent for research is an ethical imperative and crucial for protecting participants’ rights. For vulnerable populations, including pregnant women, this concern becomes even more paramount. We evaluated the quality of informed consent for research participation obtained at different times during pregnancy in Uganda. Methods: This study was a nested prospective observational birth cohort study within the Placentas, Antibodies, and Child Outcomes (PACO) birth cohort. A total of 216 pregnant women were enrolled either during the second trimester (gestational weeks 16-24) or during labor at Mbarara Regional Referral Hospital and Kabwohe Clinical Research Centre in Uganda. The primary outcomes were objective (Quality of Informed Consent [QuIC]-A) and subjective (QuIC-B) informed consent scores. At the time of consent, we also assessed anxiety (Spielberger State-Trait Anxiety Inventory), pain (Wong-Baker Faces scale), and trust in medical researchers (Medical Researcher Trust scale, see Appendices for tools). We performed multivariable linear regression analyses to examine the association between consent timing and objective and subjective quality of informed consent for research participation. Results: Of 216 participants, 134 (62%) were enrolled during mid-pregnancy and 82 (38%) during early active labor. Consent obtained during labor was associated with significantly lower objective (mean difference -12.9; 95% CI -18.3 to -7.4; Both pain and trust in medical researchers were not associated with subjective or objective consent quality. Conclusions: The quality of informed consent obtained during labor was significantly lower than consent obtained during mid-pregnancy, highlighting the need for strategies to optimize informed consent timing and processes.
Land, informal employment, and fertility preferences in rural southwestern Uganda: A qualitative study
(Global Public Health, 2026) Atahigwa, Catherine; Coene, Gily; Murembe, Clementia Neema; Dirk, Lafaut
Land and informal work remain central to rural livelihoods in Uganda, yet their role in shaping fertility preferences is not well understood. This qualitative study examined how land ownership and informal livelihoods influence men’s and women’s fertility decision-making in rural southwestern Uganda. We conducted 15 focus group discussions and 30 in-depth interviews with women (18–49) and men (18–54) of reproductive age in Rubirizi district. Interviews were conducted in the local language, audio recorded, transcribed, translated into English, and thematically analyzed. Findings show that participants often linked land ownership to men’s preferences for large families, grounded in lineage continuity, provision, and social standing, even as land availability declined. Women described limited land rights under customary tenure as constraining their economic security and bargaining space in fertility-related decisions. Informal livelihoods were portrayed as enabling household survival, but were financially unstable, shaping many women’s preferences for smaller families, while limiting their ability to act on these preferences. This study highlights how participants described land relations and livelihood insecurity as gendered influences on the formation and negotiation of fertility preferences in agrarian settings.
Health facility capacities for providing adolescent sexual and reproductive health services in Southwestern Uganda
(BMC Health Services Research, 2026-07-21) Atwine, Daniel; Nyakato, Viola Nilah; Birungi, Caroline; Namatovu, Shakirah; Munguciada, Esther Faith; Arinaitwe, Rinah; Ivanova, Olena; Kemigisha, Elizabeth
Background: Provision of adolescent-friendly Health services (AFHS) at lower primary health care centres (PHCs) is a core strategy for improving access and health outcomes of adolescents. In this study we assessed the health facility-based prevalence of repeat adolescent pregnancies and the capacity of PHCs (Health centres (HC) level III and IV) to provide AFHS in Uganda. Methods: We conducted a cross-sectional study between April and May 2023 involving 43 healthcare facilities (33 HC III and 10 HC IV) across 4 districts in Southwestern Uganda. Using pretested structured questionnaires, we interviewed the health facility in-charges or their delegates. We extracted the 6-month information from registers on: number of repeat adolescent pregnancies, post-abortion, and post-natal adolescents attending each facility. With a checklist, we assessed the availability of family planning materials/services and other medical equipment. Descriptive statistics were generated. Results: Adolescent contributed 4.9%, 16.3% and 14.8% of all repeat pregnancy, post-abortion and postnatal consultations documented at all PHCs. We noted a low perinatal care staffing with the majority of HC IIIs lacking adolescent peer educators (n=34; 79%), and counsellors (n=26; 60.5%). The need for training in the provision of adolescent-friendly services, post-natal or post-abortion care in adolescents (>90%) was high. PHCs were inadequately supplied with equipment for post-abortion care and IUD insertion. Female and male sterilization and emergency contraception were less offered. Health workers were willing to give family planning to previously pregnant adolescents (90.7%), without parental consent (65.2%), but did not support contraceptive administration to adolescents who had formerly been pregnant in fear of promoting sexual promiscuity (41.9%). A quarter of the PHCs had a dedicated clinic for adolescents and had a day in the week for adolescent services. Conclusions: This study reveals major gaps in adolescent perinatal care in Southwestern Uganda, including limited peer educators, inadequate post-abortion care, and poor healthcare worker training. Strengthening services requires interactive, peer-based training and addressing staffing shortages through peer educators and community health workers. Equipping Health Centre IIIs to deliver comprehensive, adolescent-friendly care is essential to improving access and closing these critical service gaps
Community-Based Tourism Enterprises Performance and Community Attitudes Amidst Changing Demographics: Implications for Community Conservation Outcomes of Bwindi Impenetrable National Park
(African Journal of Tourism and Hospitality Management, 2026) Kyarikunda, Monica; Kagoro-Rugunda, Grace; Ogwang, Tom
The study examined the influence of Community-Based Tourism Enterprises (CBTEs) performance on community attitudes towards community conservation outcomes like reduced illegal resource use, reduced poaching, protection of gorillas and collaborative wildlife management around Bwindi Impenetrable National Park (BINP). A mixed-methods research design was adopted, combining quantitative and qualitative approaches. Data were collected using semi-structured questionnaires, key informant interviews and Focus Group Discussions involving CBTE owners, CBTE members, Uganda Wildlife Authority Staff and local leaders. Quantitative data were analysed using descriptive statistics, correlation and multiple regression, while qualitative data were analysed thematically. Results revealed that CBTEs positively influence community attitudes towards conservation, when communities receive tangible benefits such as income, employment, infrastructure development and social services, they are likely to support conservation efforts. Community involvement in decision-making and equitable benefit sharing were found to significantly enhance positive conservation attitudes, but unequal distribution of tourism benefits and persistent human-wildlife conflicts contributed to negative attitudes among residents. The study concludes that community conservation depends on the good performance of CBTEs through providing socio-economic and environmental benefits, which strengthens positive conservation attitudes. There is a need to strengthen CBTE performance through capacity building, access to conservation benefits, community participation and conservation education to achieve sustainable conservation outcomes.
Assessing the Recognition, Documentation, and Promotion of Local Community Rights Around Bwindi Impenetrable National Park, Uganda
(East African Journal of Interdisciplinary Studies, 2026) Ainomujuni, Junior; Twinamatsiko, Medard; Smis, Stefaan; Muchunguzi, Charles
Recognition and respect for community rights are essential for equitable conservation, particularly for those living near protected areas. However, despite their critical role in natural resource management, indigenous communities continue to face persistent exclusion, which remains a significant challenge. This study investigated how community rights are recognised, defined, documented, and promoted around Bwindi Impenetrable National Park (BINP), Uganda. A mixed methods approach was employed, combining surveys of 120 households with interviews, workshops, documentary reviews, and observations involving 30 key informants across the districts of Kisoro, Rubanda, and Kanungu. Data were analysed using SPSS and NVivo. Findings show that economic and cultural rights, including revenue sharing, cultural practices, and access to medicinal plants, are the most widely acknowledged. However, participatory rights such as access to information, employment opportunities, and involvement in park protection remain limited. Rights are primarily defined through Memoranda of Understanding, strategic plans, and Uganda’s Constitution, though community awareness of these instruments is limited and uneven. Efforts to promote rights, such as sensitisation, human-wildlife conflict mitigation, NGO support, and the Community Conservation Department (UWA), have had some impact, but challenges of transparency, inclusivity, and fair compensation persist. The study recommends equitable governance frameworks that emphasise fair benefit-sharing, inclusive participation, and transparent enforcement to strengthen trust, community engagement, and sustainable conservation outcomes in Bwindi and beyond.
Beyond Borders: Migration Patterns and Surveillance Gaps at the West Nile Uganda-Democratic Republic of the Congo Border Entry Points
(East African Journal of Interdisciplinary Studies, 2026-06-04) Birungi, Spencer; Mulogo, Edgar Migema; Muchunguzi, Charles
Transboundary migration across the Uganda–Democratic Republic of the Congo (DRC) border remains a defining feature of population mobility and border governance in Uganda’s West Nile region. Daily cross-border movements support trade and social ties, and are predominantly circular and repetitive rather than permanent. Such high-frequency mobility places sustained pressure on surveillance systems that are often designed for occasional travellers, creating gaps in routine monitoring at border entry points. This study examined transboundary migration patterns in terms of volume, direction, frequency, and demographic profiles, and assessed how existing migration surveillance controls at West Nile, Uganda–DRC points of entry aligned with and responded to these movements. A cross-sectional mixed-methods study was conducted across six West Nile border districts. Quantitative data were collected through structured interviews with 292 adult cross border travellers at gazetted and porous entry points. Qualitative 03 FGDs, 02 community in-depth individual interviews, 05 policy level executive interviews, and 05 field observations at both gazetted and porous border points of entry. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed thematically. Findings indicated that cross-border mobility was characterised by frequent and repetitive movement: 45.9% of respondents crossed the border 2–10 times in the previous three months, and 39.0% crossed more than 10 times. Although 75.7% used gazetted points of entry during their most recent crossing, 23.3% used ungazetted routes. Surveillance controls were inconsistently experienced, and only 40.4% reported observing migration-related checks. Perceived effectiveness of infectious disease monitoring was significantly associated with experiencing health checks and the presence of cross-border monitoring mechanisms, but not with general awareness of infectious diseases. In conclusion, frequent circular mobility and uneven enforcement of surveillance controls remain central challenges to effective border migration surveillance in the West Nile. Aligning migration surveillance systems with the realities of high frequency movement is critical to strengthening routine infectious disease monitoring at both formal and informal border crossings.
Adolescent mothers’ second chance education: A systematic review of school re-entry and continuation policies in sub-Saharan Africa
(South African Journal of Education, 2026) Nyakato, Viola Nilah; Kemigisha, Elizabeth; Kools, Susan
School re-entry and continuation policies are widely promoted in sub-Saharan Africa (SSA) as a means of safeguarding adolescent mothers’ educational participation, yet their practical effects remain inconsistently documented. With this systematic review we synthesised evidence on national policy and programme responses governing re-entry and continuation for adolescent mothers in SSA, drawing on academic and grey literature published between 2000 and March 2022. Following multi-database searching and screening, 63 sources were included and analysed thematically, guided by African feminism, agency theory, and the positive youth development framework. Across contexts, policy commitments commonly articulate educational rights but fall short at the level of operationalisation: guidance on implementation is often vague, resourcing limited, and accountability mechanisms weak. The evidence shows that re-entry decisions and persistence in school are shaped by intersecting constraints: stigma and moral surveillance, gendered expectations of motherhood, inflexible schooling arrangements, inadequate childcare, and household poverty, alongside uneven school-level interpretation of policy. However, promising practice is visible in alternative and second chance initiatives that combine flexible learning pathways with psychosocial support and childcare or caregiving accommodations, enabling re-engagement and completion where mainstream systems remain exclusionary. Overall, the review indicates that policy expansion has outpaced implementation capacity and social norm change. Advancing adolescent mothers’ educational inclusion requires gender-responsive implementation strategies that translate policy into enforceable procedures, strengthen school and community support structures, and institutionalise cross-sector collaboration to address childcare, stigma, and economic barriers.
Digital Financial Innovation Adoption and SME Financial Performance: The Mediating Role of Financial Inclusion in Developing Economies
(International Journal of Finance, 2026) Aliija, Ronald; Nsambu, Kijjambu Frederick; Kule, John Baguma; Rwakihembo, John; Bakashaba, Rennie; Tumuhimbise, Manasseh
Purpose: This paper develops a theory-driven conceptual framework that explains this relationship by positioning financial inclusion as a mediating mechanism. Methodology: The study employs a structured review of relevant literature and integrates insights from the Resource-Based View (RBV), the Unified Theory of Acceptance and Use of Technology (UTAUT), and Financial Intermediation Theory. DFI adoption is conceptualized as a multidimensional construct comprising the decision to adopt, integration into business operations, and diversity of digital financial innovations utilized. Findings: The review suggests that DFI adoption improves operational efficiency, liquidity management, and business growth. These benefits are largely achieved through enhanced financial inclusion, which strengthens SMEs' access to, usage of, affordability of, and quality engagement with formal financial services, thereby improving financial performance. Unique Contribution to Theory, Policy and Practice: The study contributes to theory by integrating RBV, UTAUT, and Financial Intermediation Theory in to a unified conceptual framework explaining how DFI adoption influences SME financial performance through financial inclusion. It further advances knowledge by proposing a multidimensional conceptualization of DFI adoption and identifying financial inclusion as the key transmission mechanism. The framework offers practical guidance for policymakers, financial institutions, and SME managers seeking to promote financial inclusion and sustainable SME growth through digital financial innovations.