Living with AIDS in Uganda Impacts on banana-farming households in two districts Monica Karuhanga Beraho Living with AIDS in Uganda Impacts on banana-farming households in two districts Monica Karuhanga Beraho binnenwerk AWLAE6 officieel.indd1 1 18-12-2007 16:40:34 Promotor Prof. Dr. A. Niehof Hoogleraar Sociologie van Consumenten en Huishoudens Co-promotor Dr. P. Hebinck Universitair hoofddocent, leerstoelgroep Rurale Ontwikkelingssociologie Promotiecommissie Prof. Dr. J.D. Van der Ploeg Wageningen Universiteit Prof. Dr. P.L. Geschiere Universiteit van Amsterdam Dr. T.R. Müller University of Manchester, UK Prof. Dr. G.E. Frerks Wageningen Universiteit Dit onderzoek is uitgevoerd binnen de onderzoeksschool Mansholt Graduate School of Social Sciences Living with AIDS in Uganda Impacts on banana-farming households in two districts Monica Karuhanga Beraho Proefschrift ter verkrijging van de graad van doctor op gezag van de rector magnificus van Wageningen Universiteit Prof. Dr. M.J. Kropff in het openbaar te verdedigen op vrijdag 18 januari 2008 des morgens om 11.00 uur in de Aula Living with AIDS in Uganda: Impacts on banana-farming households in two districts Monica Karuhanga Beraho Ph.D. Thesis, Wageningen University (2008) With references – With summaries in English and Dutch ISBN 978-90-8504-817-6 ISBN 978-90-8686-064-7 Acknowledgements I am highly indebted to several individuals and organizations without whose support it would not have been possible to accomplish my PhD studies. This PhD study was funded by the Netherlands government through AWLAE (African Women Leaders in Agriculture and Environment), a program of Winrock International, for which am deeply thankful. I am also grateful to the study leave granted to me by Makerere University and to my colleagues in the Department of Agriculture Extension Education who took over my teaching and administrative duties. Special thanks go to other friends in the Faculty of Agriculture for their friendship and the words of encouragement that they always had for me: Peter Ebanyat, Margaret Najjingo Mangheni, Christopher Bukenya, Florence Kyazze, Edward Semakula, Frank Matsiko, Paul Kibwika, Joyce Kikafunda and Robina Sonko. To Peter, Margaret and Pastor Jooga thanks for standing with me in prayers during those many times that I needed your support. My profound gratitude is due to the management and support staff of the AWLAE Scholars PhD program who were key in facilitating administrative aspects of my PhD work: Anke Niehof, Lisa Price, Antine Hardon, the late Julia Gitobu, Margaret Lubale, Norah Muthike, Riet van de Westeringh, and Hedy Munro. To Anke and Lisa am sincerely grateful for your tireless effort in starting such a novel program that I could benefit from. Special thanks to Anke for your wisdom, patience and commitment to ensuring successful implementation of the AWLAE program. All financial and other support was always received on time. Assistance, warmth and friendship from other staff of the Sociology of Consumers and Household Group is also gratefully acknowledged. Special thanks to Juanwen Yuan and Hom Gartaula with whom I shared offices. To Marian Koster, thanks so much for the friendship and warmth we shared and for taking time to comment on all my chapters despite your own busy schedule. I benefited very much from your critical input. Dinie Verbeek thanks for organizing my work and have it ready for submission in time. To my friends and colleagues in the first cohort of AWLAE scholars, Doris Kakuru, Faith Nguthi, Lydia Ndirangu, and Caroline Nombo and those in the pipeline, Gaynor Paradza, Hirut Bekele, Kidist Gebreselassie, and Susana Akrofi, I am grateful for the friendship, laughter, care and support that we shared. To the other AWLAE scholars that I interacted with, Corrie Du Preez, Joyce Challe, and Mariame Maiga, thanks for the encouragement and friendship. All this support helped me to keep focused on the goal to work hard and finish my PhD program. To the WUR Ugandan friends during my last year in Wageningen: Enoch Kikulwe, Richard Mugambe, Judith Tukahirwa, Ruth Mubeezi, Meshach Katusimeh, Christine Ampumuza, and Racheal Namuli, thanks for creating such a supportive and enjoyable environment away from home. I thank you for the many ways in which you blessed my stay in Living with AIDS in Uganda Wageningen. Special thanks go to Richard Mugambe, Robert Kyakanda and Farai and Busi Maphosa for the spiritual support and special friendship. I would like to express my sincere appreciation to all those who assisted me in my research process. Special thanks go to Steven Yiga and Saul Kusemererwa for the tireless effort they put into organizing the data collection process. I would like to thank the respondents for their time and willingness to share their experiences with me. I thank Jairus Muhere and Basil Mugonola for the data management process. I am very grateful to Enoch Kikulwe, Edward Kato and Kidist Gebreselassie for their technical assistance with the statistical analysis, Moses Musinguzi for drawing the maps of the study area and Andrew Akrofi and Ed Hall for editorial assistance. My gratitude also goes to Mike Jacobs of Wageningen Academic Publishers for the work put into production of this book. To my dear mother-in-law, Joyce Kobuyonjo, while am greatly indebted to your support, I have no words that can describe how grateful I am. For more than two years, you left your home to take care of my children and home during the time I was in Wageningen pursuing my PhD studies. Thanks for the care and comfort that you gave to the children and my husband; it gave me the peace and strength to complete my studies. Thanks for the words of wisdom and encouragement at those times when I would have given up. Without you I know I wouldn’t have finished my program in time. I will forever be grateful to your support. To my other relatives and in-laws thanks for the different ways in which you supported my family during the period of my studies abroad. Special thanks to Steven and Patience Mugarura, Sam and Grace Tayebwa, Simon Nuwagaba, Ruth Kenyangi and Pamela Asiimwe. I am highly indebted to my promoter Prof. dr. Anke Niehof for the technical guidance, tireless review and re-reading of my work because you wanted it to be excellent. I also thank you for your understanding and patience despite some of my shortcomings, without you, this project would have been impossible to accomplish. To my co-promotor Dr. Paul Hebinck, I am very grateful to the valuable critical input that you always brought into our discussions. Your contributions have enriched many of the ideas presented in this book. I also thank you and Anke for believing in me and always making me feel that I could do even better. I am proud to have been one of your students. To my darling husband and friend Emmanuel Beraho, no words can express my sincere gratitude for the love, understanding and support that you have continued to give me throughout this PhD process and for shouldering all the parental responsibilities. Thanks for all the sacrifices you made for your own studies and work and for being there for the children and for me. To my dear children Namara, Ainomugisha, Ninsiima, Kamukama and Kansiime-Ruhanga, thanks for the many Living with AIDS in Uganda ways in which you continued to express your love for me. I also thank you for the patience despite missing me so much. The thought of you was a great source of motivation and strength to complete my studies. In honour, I dedicate this book to you, your Daddy and Nywokwenkuru. Finally, and most important, I thank the Almighty God who gave me the wisdom, good health and strength to successfully complete my studies. All glory and honour be given to Him, for indeed He is a good and faithful God. Living with AIDS in Uganda Table of contents Acknowledgements 7 List of figures 15 Acronyms 17 Glossary 21 Chapter 1 - Introduction and background 23 1.1 Justification and rationale for the research 23 1.2 Research problem and objectives 27 1.3 Country profile: background 29 1.3.1 Geography, climate and population 29 1.3.2 Socio-economic conditions 30 1.3.3 The HIV/AIDS epidemic in Uganda 32 1.3.4 The policy context 40 1.3.5 The role of the agricultural sector 41 1.4 Rationale for selection of banana farming area 44 1.5 Thesis outline 46 Chapter 2 - Rural livelihoods: concepts and research framework 47 2.1 The concept of livelihood 47 2.2 Household 48 2.3 Components of the livelihood framework 52 2.3.1 Assets and resources 53 2.3.2 Human agency 58 2.3.3 Access to resources 59 2.3.4 Policies, institutions and processes (PIP) and the vulnerability context 61 2.3.5 Livelihood activities and strategies 64 2.3.6 Livelihood outcomes 68 2.3.7 Vulnerability 69 2.4 Applying the livelihood approach 71 2.4.1 Food security 72 2.4.2 Social differentiation 75 2.4.3 A gender perspective 76 2.5 HIV/AIDS, rural livelihoods and gender 78 2.6 The research framework 82 Chapter 3 - Research design and methodology 87 3.1 Methodological considerations and research design 87 3.2 Description of the study area 89 3.3 Phases of the field work 93 Living with AIDS in Uganda 11 3.4 Methods and techniques for data collection 93 3.4.1 Secondary data 95 3.4.2 Primary data 95 3.5 Data analysis 103 3.5.1 Quantitative data analysis 104 3.5.2 Qualitative data analysis 106 3.6 Ethical considerations and problems encountered during data collection 106 Chapter 4 - Farming households and farming in the study areas 109 4.1 Demographic and household characteristics 109 4.1.1 Demographic characteristics