DOCSLIB.ORG

A Tale of Two Regions in Rural Eastern Uganda Jonathan Izudi* , Imelda

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Tale of Two Regions in Rural Eastern Uganda Jonathan Izudi* , Imelda Izudi et al. BMC Health Services Research (2019) 19:979 https://doi.org/10.1186/s12913-019-4834-2 RESEARCH ARTICLE Open Access Explaining the successes and failures of tuberculosis treatment programs; a tale of two regions in rural eastern Uganda Jonathan Izudi* , Imelda. K. Tamwesigire and Francis Bajunirwe Abstract Background: Optimally performing tuberculosis (TB) programs are characterized by treatment success rate (TSR) of at least 90%. In rural eastern Uganda, and elsewhere in sub Saharan Africa, TSR varies considerably across district TB programs and the reasons for the differences are unclear. This study explored factors associated with the low and high TSR across four districts in rural eastern Uganda. Methods: We interviewed District TB and Leprosy Supervisors, Laboratory focal persons, and health facility TB focal persons from four districts in eastern Uganda as key informants. Interviews were audio recorded, transcribed verbatim, and imported into ATLAs.ti where thematic content analysis was performed and results were summarized into themes. Results: The emerging themes were categorized as either facilitators of or barriers to treatment success. The emerging facilitators prevailing in the districts with high rates of treatment success were using data to make decisions and design interventions, continuous quality improvement, capacity building, and prioritization of better management of people with TB. The barriers common in districts with low rates of treatment success included lack of motivated and dedicated TB focal persons, scarce or no funding for implementing TB activities, and a poor implementation of community-based directly observed therapy short course. Conclusion: This study shows that several factors are associated with the differing rates of treatment success in rural eastern Uganda. These factors should be the focus for TB control programs in Uganda and similar settings in order to improve rates of treatment success. Keywords: Barriers, Facilitators, Health systems strengthening, Treatment success, Tuberculosis, Uganda Background centralized and prioritized system of TB monitoring, re- The overall goal of a tuberculosis (TB) control program cording and training; access to quality-assured sputum is to ensure people with TB who are enrolled in the pro- microscopy; standardized short-course chemotherapy for gram complete treatment and become cured, endpoints all cases of TB under proper case management condi- collectively referred to as treatment success. Directly ob- tions, including direct observation of treatment by a served therapy short course (DOTS) is a global strategy healthcare worker or community health worker for at for effective control of TB and its wider application has least the first 2 months; uninterrupted or sustained sup- resulted into better treatment outcomes in several coun- ply of quality-assured drugs; and standardized recording tries [1]. For instance, countries which have imple- and reporting system that allows assessment of treat- mented all the five components of DOTS namely ment have reported high rates of cure and treatment sustained political or government commitment, includ- completion [2]. In particular, the observation of people ing political will at all levels, and establishment of a with TB as they take medication in real time by a treat- ment supporter or a healthcare provider ensures good * Correspondence: [email protected] adherence to and completion of treatment [3]. Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Izudi et al. BMC Health Services Research (2019) 19:979 Page 2 of 10 Although DOTS has been adopted and implemented respectively. The districts were purposively selected to widely, the achievement of the WHO desired treatment provide a framework for comparison of a well versus success rate (TSR) of at least 90% remains a challenge for poorly performing district TB control program. The most TB programs globally. Recent statistics suggest that variation in performance for these TB control programs the global TSR for newly diagnosed bacteriologically con- provides a basis and natural setting for our study. firmed pulmonary TB (BC-PTB) has declined from 86% in Altogether, the population in the four districts, located 2014 to 83% in 2017 [4]. This decline presents an unpre- about 300 km from Kampala Capital City, is close to one cedented concern for TB programs because of exacerba- million people. We enrolled participants from TB units tions in TB morbidity and mortality [5]. In addition, there with the highest patient loads in the selected districts. is significant variation in TSR across sub Saharan Africa, The estimated number of new people with TB in the both between and within countries. The between country study districts were 191 in Serere, 340 in Soroti, 313 in variation is seen from TSR of 83.4% in Cameroon [6], Kumi, and 121 in Ngora for the period July 2017 to June 90.1% in Ethiopia [7], and 75.7% in Nigeria [8]. 2018 [13]. In Soroti district, the units included Soroti Uganda is an example of a country with significant vari- Regional Referral Hospital, Princess Diana Memorial ation in TSR. Overall, the country has a cure rate of 48% Health Center (HC) IV, and Tiriri HC IV. A health cen- and a TSR of 80% [9], which are far below the desired ter IV is a county level health facility in the structure of WHO targets of 85% for cure rate and at least 90% TSR. Uganda’s health system. The study sites in Kumi district In rural eastern Uganda, two districts of Serere and Ngora included Kumi Hospital, Atutur Hospital, and Kumi HC have higher TSR surpassing the WHO desired target of IV. Kumi Hospital is a private not for profit health facil- over 90% while the other two districts of Soroti and Kumi ity. The study sites in Ngora district were Ngora Hos- have at most 70% TSR, falling below the target. To date, pital and Ngora HC IV and in Serere district, Serere and information on factors shaping the variation in TSR across Apapai HC IVs were selected. these districts in the same region is limited. The purpose Each health facility has a TB diagnostic and treatment of this study was therefore to explore factors associated unit which provides TB services according to the WHO with high and low TSR across districts in rural eastern TB treatment guidelines [3]. At each TB unit, there is a Uganda. Exploring these factors is important for designing TB focal person who is either a nursing, clinical, or medical strategies and interventions that may be used to tackle officer to coordinate and provide TB services. However, hindrances to achieving high TSR while the good practices technical leadership for TB management in the entire district identified may be scaled up to improve TSR. is provided by the District TB and Leprosy Supervisor (DTLS), and each district has one. With respect to TB diag- Methods nostic services, each district also has a District Laboratory Study design and participants focal person (DLFP) to provide technical oversight. We conducted a qualitative study and interviewed key in- formants to explore the successes and failures of the TB Data collection and quality control control program in rural eastern Uganda. The study par- Data were collected through audio-recording of key ticipants consisted of health facility TB focal persons informant interviews which were conducted in English (TBFPs), District TB and Leprosy Supervisors (DTLS), language in June 2019 at the selected health facilities. JI (a and District Laboratory focal persons (DLFPs) from both male public health specialist with experience in mixed- settings, districts with low and high TSR. These partici- methods research) introduced the topics for the interview pants were purposively sampled as key informants because to the key informants and conducted the interviews, but they had rich-knowledge and experience in TB program- was assisted by BK (a female social and public health spe- ing and the functioning of the district healthcare system cialist with 10 years of experience in qualitative research) to and hence were expected to provide reliable and credible allow sufficient probing. The interview questions were information [10]. We interviewed these participants until asked in a non-sequential manner as the participant’sre- emerging ideas or responses were not any different from sponses determined the next question to be asked, provided the ones earlier reported, suggesting saturation of ideas all the required topics were responded to at the end of the hence sufficient qualitative data as recommended [11]. interview. All the key informant interviews were conducted in a quiet room and each lasted on average between 30 to Study setting 45 min. The key informant interview guide (Additional file 1) This study was conducted in four predominantly rural was specifically developed for this interview but was districts in eastern Uganda, namely Soroti, Kumi, Ngora, reviewed and approved by relevant research ethics commit- and Serere. Soroti and Kumi districts have recently re- tees, and pre-tested in the neighboring district of Katakwi ported low TSR of 70 and 66.7% [12], while Ngora and to assess its suitability. All participants’ responses were Serere districts have high TSR of 90.9 and 95.3% [12], transcribed within 48 h of completing data collection. Izudi et al. BMC Health Services Research (2019) 19:979 Page 3 of 10 Measurements number: 03/11–18) and the Uganda National Council for We asked the key informants questions on the following: Science and Technology (Reference number: HS 2531).
Load more

Recommended publications
  • HIV/AIDS Treatment and Care in a Long-Term Conflict Setting: Observations from the AIDS Support Organization (TASO) in the Teso Region Emma Smith SIT Study Abroad
    SIT Graduate Institute/SIT Study Abroad SIT Digital Collections Independent Study Project (ISP) Collection SIT Study Abroad Spring 2008 HIV/AIDS Treatment and Care in a Long-Term Conflict Setting: Observations From The AIDS Support Organization (TASO) in the Teso Region Emma Smith SIT Study Abroad Follow this and additional works at: https://digitalcollections.sit.edu/isp_collection Recommended Citation Smith, Emma, "HIV/AIDS Treatment and Care in a Long-Term Conflict Setting: Observations From The AIDS Support Organization (TASO) in the Teso Region" (2008). Independent Study Project (ISP) Collection. 99. https://digitalcollections.sit.edu/isp_collection/99 This Unpublished Paper is brought to you for free and open access by the SIT Study Abroad at SIT Digital Collections. It has been accepted for inclusion in Independent Study Project (ISP) Collection by an authorized administrator of SIT Digital Collections. For more information, please contact [email protected]. HIV/AIDS Treatment and Care in a Long-Term Conflict Setting: Observations from The AIDS Support Organization (TASO) in the Teso Region Emma Smith Advisor: Alutia Samuel Academic Directors: Charlotte Mafumbo and Martha Wandera Location: TASO Soroti SIT Uganda Spring 2008 Dedication To all the people living with HIV/AIDS in Teso, who continue to live strongly despite decades of suffering from continuous war, displacement and neglect. May the world come to recognize the struggles that you live with. Acknowledgements There are so many people to whom thanks is owed, it would not be possible to acknowledge them all even if time and space allowed. Primarily, I would like to thank the clients of TASO Soroti, who so willingly welcomed a stranger into their communities and allowed so many questions to be asked of them.
    [Show full text]
  • Uganda Floods – 2 October 2007
    SITUATION REPORT Nº 5 – UGANDA FLOODS – 2 OCTOBER 2007 HIGHLIGHTS FLOODS SPREAD TO ADDITIONAL DISTRICTS IN CENTRAL UGANDA BLOODY DIARRHOEA IN KATAKWI DISTRICT INCREASES CONCERN OVER HEALTH AND WATER AND SANITATION SITUATION IN FLOOD-AFFECTED AREAS The information contained in this report has been gathered by the Office for the Coordination of Humanitarian Affairs (OCHA) from sources including the Government of Uganda, UN agencies, non-governmental organizations and the International Federation of Red Cross and Red Crescent Societies (IFRC). 4. On 19 September, Ugandan President Yoweri Museveni declared a state of emergency in the areas flood-affected areas of Eastern Uganda, which was endorsed by Parliament on 25 September. 5. Planning for the humanitarian response to the disaster is based on some 50,000 households, or approximately 300,000 people, being affected by the rainfall and associated flooding. This planning figure may be expected to change as additional assessments come in and/or depending on whether the intensified rainfall continues. 6. The Uganda Department of Meteorology, in its seasonal rainfall forecast for September to December, predicts high chances for normal to above normal rains to continue over most parts of the eastern region of Uganda. 7. The flooding has had a severe impact on water and sanitation in the affected areas, which damage increases the risk of outbreak of waterborne diseases such as cholera as the floodwaters recede. Concerns have been elevated in recent days as reports of Situation Overview several cases of bloody diarrhoea have been received from Katakwi district. Cholera response contingency planning is being conducted in regional 1.
    [Show full text]
  • Rcdf Projects in Ngora District, Uganda
    Rural Communications Development Fund (RCDF) RCDF PROJECTS IN NGORA DISTRICT, UGANDA MA P O F N G O R A D IS T R IC T S H O W IN G S U B C O U N TIE S N Kap ir M ukur a Ngor a Kob w in 20 0 20 40 Km s UCC Support through the RCDF Programme Uganda Communications Commission Plot 42 -44, Spring road, Bugolobi P.O. Box 7376 Kampala, Uganda Tel: + 256 414 339000/ 312 339000 Fax: + 256 414 348832 E-mail: [email protected] Website: www.ucc.co.ug 11 Table of Contents 1- Foreword……………………………………………………………….……….………..…..…....….…3 2- Background…………………………………….………………………..…………..….….……..….…4 3- Introduction………………….……………………………………..…….…………….….……….…..4 4- Project profiles……………………………………………………………………….…..…….……...5 5- Stakeholders’ responsibilities………………………………………………….….…........…12 6- Contacts………………..…………………………………………….…………………..…….……….13 List of tables and maps 1- Table showing number of RCDF projects in Ngora district……………….……….5 2- Map of Uganda showing Ngora district………..………………….……………...…….14 10- Map of Ngora district showing sub counties………..……………………..……….15 11- Table showing the population of Ngora district by sub counties……..…...15 12- List of RCDF Projects in Ngora district…………………………………….……..….…16 Abbreviations/Acronyms UCC Uganda Communications Commission RCDF Rural Communications Development Fund USF Universal Service Fund MCT Multipurpose Community Tele-centre PPDA Public Procurement and Disposal Act of 2003 POP Internet Points of Presence ICT Information and Communications Technology UA Universal Access MoES Ministry of Education and Sports MoH Ministry of Health DHO District Health Officer CAO Chief Administrative Officer RDC Resident District Commissioner 12 1. Foreword ICTs are a key factor for socio-economic development. It is therefore vital that ICTs are made accessible to all people so as to make those people have an opportunity to contribute and benefit from the socio-economic development that ICTs create.
    [Show full text]
  • WHO UGANDA BULLETIN February 2016 Ehealth MONTHLY BULLETIN
    WHO UGANDA BULLETIN February 2016 eHEALTH MONTHLY BULLETIN Welcome to this 1st issue of the eHealth Bulletin, a production 2015 of the WHO Country Office. Disease October November December This monthly bulletin is intended to bridge the gap between the Cholera existing weekly and quarterly bulletins; focus on a one or two disease/event that featured prominently in a given month; pro- Typhoid fever mote data utilization and information sharing. Malaria This issue focuses on cholera, typhoid and malaria during the Source: Health Facility Outpatient Monthly Reports, Month of December 2015. Completeness of monthly reporting DHIS2, MoH for December 2015 was above 90% across all the four regions. Typhoid fever Distribution of Typhoid Fever During the month of December 2015, typhoid cases were reported by nearly all districts. Central region reported the highest number, with Kampala, Wakiso, Mubende and Luweero contributing to the bulk of these numbers. In the north, high numbers were reported by Gulu, Arua and Koti- do. Cholera Outbreaks of cholera were also reported by several districts, across the country. 1 Visit our website www.whouganda.org and follow us on World Health Organization, Uganda @WHOUganda WHO UGANDA eHEALTH BULLETIN February 2016 Typhoid District Cholera Kisoro District 12 Fever Kitgum District 4 169 Abim District 43 Koboko District 26 Adjumani District 5 Kole District Agago District 26 85 Kotido District 347 Alebtong District 1 Kumi District 6 502 Amolatar District 58 Kween District 45 Amudat District 11 Kyankwanzi District
    [Show full text]
  • A Case Study of the Teso Sub-Region, Eastern Uganda
    Indian Journal of Traditional Knowledge Vol. 11 (2), April 2012, pp. 217-224 Role of Indigenous Knowledge in Climate Change Adaptation: A case study of the Teso Sub-Region, Eastern Uganda Anthony Egeru School of Forestry, Environment and Geographical Sciences, Department of Environmental Management, Makerere University, PO Box 7062 Kampala, Uganda Emails: [email protected]/[email protected] Received 20.10.2011, revised 21.12.2011 This study examined the role of indigenous knowledge in climate change adaptation in Uganda with specific focus on the Teso sub-region. Specifically, the study identified indigenous knowledge practices used in climate change adaptation, documented indigenous knowledge in climate observation, and identified constraints to indigenous knowledge use for climate change adaptation. Data was collected using semi-structured questionnaires, individual interviews, focused group discussions and observation of local traditional rites. Local observations confirmed altered climate patterns noticeable from the changes in the planting, weeding and harvesting periods in agriculture, in tree growth, and in wind directions. Farmers still observe the intensity of East-West blowing winds, colour of the clouds in the East, and plant traits for rainfall prediction. In addition, they also rely on the meteorological information disseminated through the local radio stations. Low mastery of indigenous knowledge practices by younger community members and persistently changing weather patterns have challenged community reliance on indigenous knowledge for climate change adaptation. There is need to strengthen dissemination of indigenous knowledge and to integrate modern approaches that strengthen indigenous knowledge in climate change adaptation and resilience. Keywords: Adaptation, Climate change, Indigenous knowledge, Teso Uganda IPC Int.
    [Show full text]
  • Tuesday, 20Th November 2018 – Time of Commencement 2:00 P.M
    7TH SITTING OF THE 2ND MEETING OF THE 3RD SESSION OF THE 10TH PARLIAMENT OF UGANDA: TUESDAY, 20TH NOVEMBER 2018 – TIME OF COMMENCEMENT 2:00 P.M. 1. PRAYERS 2. COMMUNICATION FROM THE CHAIR 3. PRESENTATION OF PAPERS: (20 MINUTES) A) EDUCATION SERVICE COMMISSION ANNUAL REPORT FOR FINANCIAL YEAR 2017/18 (Parliamentary Commissioner) B) ANNUAL REPORT ON THE STATE OF EQUAL OPPORTUNITIES IN UGANDA FOR FY 2017/2018 (Parliamentary Commissioner) C) PUBLIC SERVICE COMMISSION ANNUAL REPORT, FY 2017/2018 (Parliamentary Commissioner) D) REPORTS OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF THE FOLLOWING LOCAL GOVERNMENTS FOR THE YEAR ENDED 30TH JUNE 2017: Parliamentary Commissioner) I) KIRUHURA TOWN COUNCIL II) KANUNGU TOWN COUNCIL III) WOBULENZI TOWN COUNCIL IV) MUKONO MUNICIPAL COUNCIL V) KAKIRI TOWN COUNCIL VI) ENTEBBE DIVISION B COUNCIL VII) NKOKONJERU TOWN COUNCIL VIII) BUGONGI TOWN COUNCIL IX) NAKASEKE DISTRICT LOCAL GOVERNMENT X) NAKASONGOLA TOWN COUNCIL XI) KIRA MUNICIPAL COUNCIL XII) BUIKWE TOWN COUNCIL XIII) KABALE DISTRICT LOCAL GOVERNMENT XIV) KITWE TOWN COUNCIL XV) KANUNGU DISTRICT LOCAL GOVERNMENT XVI) BUVUMA DISTRICT LOCAL GOVERNMENT 1 XVII) MPIGI DISTRICT LOCAL GOVERNMENT XVIII) KAKINDO TOWN COUNCIL XIX) KAMBUGA TOWN COUNCIL XX) BUTAMBALA DISTRICT LOCAL GOVERNMENT XXI) WAKISO DISTRICT LOCAL GOVERNMENT XXII) MITOOMA TOWN COUNCIL XXIII) RYAKARIMIRA TOWN COUNCIL XXIV) BUVUMA TOWN COUNCIL XXV) KIRA DIVISION COUNCIL XXVI) SEMUTO TOWN COUNCIL XXVII) RWASHAMAIRE TOWN COUNCIL XXVIII) ENDIINZI TOWN COUNCIL XXIX) GOMBE TOWN COUNCIL XXX)
    [Show full text]
  • Funding Going To
    % Funding going to Funding Country Name KP‐led Timeline Partner Name Sub‐awardees SNU1 PSNU MER Structural Interventions Allocated Organizations HTS_TST Quarterly stigma & discrimination HTS_TST_NEG meetings; free mental services to HTS_TST_POS KP clients; access to legal services PrEP_CURR for KP PLHIV PrEP_ELIGIBLE Centro de Orientacion e PrEP_NEW Dominican Republic $ 1,000,000.00 88.4% MOSCTHA, Esperanza y Caridad, MODEMU Region 0 Distrito Nacional Investigacion Integral (COIN) PrEP_SCREEN TX_CURR TX_NEW TX_PVLS (D) TX_PVLS (N) TX_RTT Gonaives HTS_TST KP sensitization focusing on Artibonite Saint‐Marc HTS_TST_NEG stigma & discrimination, Nord Cap‐Haitien HTS_TST_POS understanding sexual orientation Croix‐des‐Bouquets KP_PREV & gender identity, and building Leogane PrEP_CURR clinical providers' competency to PrEP_CURR_VERIFY serve KP FY19Q4‐ KOURAJ, ACESH, AJCCDS, ANAPFEH, APLCH, CHAAPES, PrEP_ELIGIBLE Haiti $ 1,000,000.00 83.2% FOSREF FY21Q2 HERITAGE, ORAH, UPLCDS PrEP_NEW Ouest PrEP_NEW_VERIFY Port‐au‐Prince PrEP_SCREEN TX_CURR TX_CURR_VERIFY TX_NEW TX_NEW_VERIFY Bomu Hospital Affiliated Sites Mombasa County Mombasa County not specified HTS_TST Kitui County Kitui County HTS_TST_NEG CHS Naishi Machakos County Machakos County HTS_TST_POS Makueni County Makueni County KP_PREV CHS Tegemeza Plus Muranga County Muranga County PrEP_CURR EGPAF Timiza Homa Bay County Homa Bay County PrEP_CURR_VERIFY Embu County Embu County PrEP_ELIGIBLE Kirinyaga County Kirinyaga County HWWK Nairobi Eastern PrEP_NEW Tharaka Nithi County Tharaka Nithi County
    [Show full text]
  • Youth Realities, Aspirations, Transitions to Adulthood and Opportunity Structures in Uganda’S Dryland Areas
    Youth Realities, Aspirations, Transitions to Adulthood and Opportunity Structures in Uganda’s Dryland Areas Brenda Boonabaana, Peace Musiimenta, Margaret Najjingo Mangheni, and Jasper Bakeiha Ankunda Grain Legumes and Alliance Dryland Cereals Table of contents List of tables ................................................................................................................................................ iv List of figures ............................................................................................................................................... iv List of photos ............................................................................................................................................... iv List of boxes ................................................................................................................................................. iv Acknowledgements ..................................................................................................................................... v Acronyms .................................................................................................................................................... vi Summary ..................................................................................................................................................... 1 1. Introduction .............................................................................................................................................. 3 2. Method ...................................................................................................................................................
    [Show full text]
  • Pneumococcal Carriage and Antibiotic Susceptibility
    F1000Research 2020, 9:1156 Last updated: 22 JUL 2021 RESEARCH ARTICLE Pneumococcal carriage and antibiotic susceptibility patterns in mother-baby pairs in a rural community in Eastern Uganda: a cross-sectional study [version 1; peer review: 1 approved, 1 not approved] Gabriel Madut Akech1, Mercy Naloli 1, Paul Sebwami1, Patrick Kazibwe1, Maureen Atwikiriize1, Julius Onyait2, Paul Oboth1, Julius Nteziyaremye 3, Rebecca Nekaka1, Jacob Stanley Iramiot 4 1Community and Public Health, Busitema University, Mbale, Uganda 2Ngora Health Center IV, Ngora District Local Government, Ngora, Uganda 3Obstetrics and Gynaecology, Busitema University, Mbale, Uganda 4Microbiology and Immunology, Busitema University, Mbale, Uganda v1 First published: 21 Sep 2020, 9:1156 Open Peer Review https://doi.org/10.12688/f1000research.22238.1 Latest published: 21 Sep 2020, 9:1156 https://doi.org/10.12688/f1000research.22238.1 Reviewer Status Invited Reviewers Abstract Background: Pneumonia poses a significant threat to the lives of 1 2 children below five years old worldwide, contributing to a high number of hospitalizations and death. Morbidity and morbidity are version 1 especially common in children under five and the elderly, although 21 Sep 2020 report report any age group can be affected. This study aimed to estimate pneumococcal carriage and determine antibiotic susceptibility 1. Wilber Sabiti , University of St Andrews, St patterns of the pneumococci isolated from mother-baby pairs in Ngora district after the rollout of the pneumococcal vaccine. We Andrews, UK hypothesized that high carriage of Streptococcus pneumoniae in 2. Adnan Al-Lahham, School of Applied Medical mothers leads to carriage in their babies and hence a greater chance of contracting pneumonia.
    [Show full text]
  • Rethinking Peace and Conflict Studies
    Rethinking Peace and Conflict Studies Series Editor: Oliver P. Richmond, Professor, School of International Relations, University of St Andrews Editorial Board: Roland Bleiker, University of Queensland, Australia; Henry F. Carey, Georgia State University, USA; Costas Constantinou, University of Keele, UK; A.J.R. Groom, University of Kent, UK; Vivienne Jabri, King’s College London, UK; Edward Newman, University of Birmingham, UK; Sorpong Peou, Sophia University, Japan; Caroline Kennedy-Pipe, University of Sheffield, UK; Professor Michael Pugh, University of Bradford, UK; Chandra Sriram, University of East London, UK; Ian Taylor, University of St Andrews, UK; Alison Watson, University of St Andrews, UK; R.B.J. Walker, University of Victoria, Canada; Andrew Williams, University of St Andrews, UK. Titles include: Susanne Buckley-Zistel CONFLICT TRANSFORMATION AND SOCIAL CHANGE IN UGANDA Remembering after Violence Jason Franks RETHINKING THE ROOTS OF TERRORISM Vivienne Jabri WAR AND THE TRANSFORMATION OF GLOBAL POLITICS James Ker-Lindsay EU ACCESSION AND UN PEACEKEEPING IN CYPRUS Roger MacGinty NO WAR, NO PEACE The Rejuvenation of Stalled Peace Processes and Peace Accords Carol McQueen HUMANITARIAN INTERVENTION AND SAFETY ZONES Iraq, Bosnia and Rwanda Sorpong Peou INTERNATIONAL DEMOCRACY ASSISTANCE FOR PEACEBUILDING The Cambodian Experience Sergei Prozorov UNDERSTANDING CONFLICT BETWEEN RUSSIA AND THE EU The Limits of Integration Oliver P. Richmond THE TRANSFORMATION OF PEACE Bahar Rumelili CONSTRUCTING REGIONAL AND GLOBAL ORDER Europe and Southeast Asia Chandra Lekha Sriram PEACE AS GOVERNANCE Stephan Stetter WORLD SOCIETY AND THE MIDDLE EAST Reconstructions in Regional Politics Rethinking Peace and Conflict Studies Series Standing Order ISBN 978--1--4039--9575--9 (hardback) & 978--1--4039--9576--6 (paperback) You can receive future titles in this series as they are published by placing a standing order.
    [Show full text]
  • Forests, Livelihoods and Poverty Alleviation: the Case of Uganda Forests, Livelihoods and Poverty Alleviation: the Case of Uganda
    Forests, livelihoods and poverty alleviation: the case of Uganda Forests, livelihoods and poverty alleviation: the case of Uganda G. Shepherd and C. Kazoora with D. Mueller Food and Agriculture Organization of the United Nations Rome, 2013 The Forestry Policy and InstitutionsWorking Papers report on issues in the work programme of Fao. These working papers do not reflect any official position of FAO. Please refer to the FAO Web site (www.fao.org/forestry) for official information. The purpose of these papers is to provide early information on ongoing activities and programmes, to facilitate dialogue and to stimulate discussion. The Forest Economics, Policy and Products Division works in the broad areas of strenghthening national institutional capacities, including research, education and extension; forest policies and governance; support to national forest programmes; forests, poverty alleviation and food security; participatory forestry and sustainable livelihoods. For further information, please contact: Fred Kafeero Forestry Officer Forest Economics, Policy and Products Division Forestry Department, FAO Viale Delle terme di Caracalla 00153 Rome, Italy Email: [email protected] Website: www.fao.org/forestry Comments and feedback are welcome. For quotation: FAO.2013. Forests, Livelihoods and Poverty alleviation: the case of Uganda, by, G. Shepherd, C. Kazoora and D. Mueller. Forestry Policy and Institutions Working Paper No. 32. Rome. Cover photo: Ankole Cattle of Uganda The designations employed and the presentation of material in this information product do not imply the expression af any opinion whatsoever on the part of the Food and Agriculture Organization of the United Nations concerning the legal or development status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
    [Show full text]
  • Heifer International Uganda Covid-19 Impact Study Report
    HEIFER INTERNATIONAL UGANDA COVID-19 IMPACT STUDY REPORT PREPARED BY: Paul Muliika | Planning, Monitoring, Learning and Evaluation Manager Abby Bwogi | Regional Monitoring, Learning and Evaluation Manager EAYIP John Ssenyonga | Heifer International Senior Programs Manager MAY–JUNE 2020 TABLE OF CONTENTS EXECUTIVE SUMMARY 3 INTRODUCTION 5 SURVEY PURPOSE 5 METHODOLOGY AND TOOLS 6 RESPONDENT DEMOGRAPHIC CHARACTERISTICS 6 QUANTITATIVE FINDINGS 8 1. EFFECT OF COVID-19 ON FARMER INCOMES 8 2. EFFECT OF COVID-19 ON INFORMAL SAVINGS AND LENDING 12 ASSOCIATION (ISLA) ACTIVITIES 3. EFFECT OF COVID-19 ON FARM AND OFF-FARM PRODUCTION 14 4. EFFECT OF COVID-19 ON ACCESS TO FOOD 16 5. EFFECT OF COVID-19 ON FAMILY DECISION-MAKING 17 6. EFFECT OF COVID-19 ON FAMILY RELATIONSHIPS 19 7. EFFECT OF COVID-19 ON NATURAL RESOURCES 20 8. EFFECT OF COVID-19 ON FAMILY HYGIENE, SANITATION AND 21 HEALTH QUALITATIVE RESULTS 23 9. EFFECT OF COVID-19 ON AGRI-HUB OPERATIONS 23 10. EFFECT OF COVID-19 ON PRIVATE SECTOR OPERATIONS 29 11. EFFECT OF COVID-19 ON PUBLIC SECTOR OPERATIONS 32 12. STRATEGIES ADOPTED BY PROJECTS IN RESPONSE TO COVID-19 34 13. CONCLUSIONS AND RECOMMENDATIONS 36 ANNEX 1: List of People Interviewed 39 ANNEX 2: Key Informant Interview Guide for Private and Public Sector Partners 40 ANNEX 3: Key Informant Interview Guide for Agri-Hubs/Producer Organizations 41 ANNEX 4: Questionnaire for Smallholder Farmers 42 2 HEIFER INTERNATIONAL UGANDA COVID-19 IMPACT STUDY REPORT EXECUTIVE SUMMARY INTRODUCTION On March 25, 2020, Heifer Uganda suspended all office-based work and staff were requested to work from home following the country’s lockdown to combat the spread of COVID-19.
    [Show full text]