Browsing by Author "Richard Sebaggala"

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Gender Differences in Paying Bribes: The Role of Perceived Descriptive Norms of Corruption in Uganda
(Spinger Nature Link, 2023-10-23) Richard Sebaggala; Clare Cheromoi
Although a significant number of studies have reported that gender is associated with less corruption, the underlying mechanism is still unclear. Using 2017 Afrobarometer individual-level survey data for Uganda, this chapter examines gender differences in paying bribes and the mediating effect of perceived descriptive norms. We estimated a multivariate logistic model to examine the effects of gender on bribe-paying while controlling for individual and household factors, and then implemented the Karlsson-Breen-Holm method to determine the mediating effect of perceived descriptive norms of corruption on the relationship between gender and paying bribes. We observed significant gender differences in paying bribes for obtaining government documents and police assistance. Results further revealed that perceived descriptive norms significantly mediated the relationship between gender and paying bribes. The results suggest that gender differences in paying bribes can be sizably reduced by appropriate interventions that deal with social norms of corruption in society.
Has Strategic Purchasing Led to Improvements in Health Systems? A Narrative Review of Literature on Strategic Purchasing
(Health Systems & Reform, 2022-12-23) Fred Matovu; Agnes Gatome-Munyua; Richard Sebaggala
Strategic purchasing is noted in the literature as an approach that can improve the efficiency of health spending, increase equity in access to health care services, improve the quality of health care delivery, and advance progress toward universal health coverage. However, the evidence on how strategic purchasing can achieve these improvements is sparse. This narrative review sought to address this evidence gap and provide decision makers with lessons and policy recommendations. The authors conducted a systematic review based on two research questions: 1) What is the evidence on how purchasing functions affect purchasers’ leverage to improve: resource allocation, incentives, and accountability; intermediate results (allocative and technical efficiency); and health system outcomes (improvements in equity, access, quality, and financial protection)? and 2) What conditions are needed for a country to make progress on strategic purchasing and achieve health system outcomes? We used database searches to identify published literature relevant to these research questions, and we coded the themes that emerged, in line with the purchasing functions—benefits specification, contracting arrangements, provider payment, and performance monitoring—and the outcomes of interest. The extent to which strategic purchasing affects the outcomes of interest in different settings is partly influenced by how the purchasing functions are designed and implemented, the enabling environment (both economic and political), and the level of development of the country’s health system and infrastructure. For strategic purchasing to provide more value, sufficient public funding and pooling to reduce fragmentation of schemes is important.
Heterogeneity in the Adoption of Covid-19 Preventive Measures Among Adults in Ethiopia: A Cluster Analysis Approach
(Texila International Journal of Public Health, 2023-12-29) Liliane Lwanga; Richard Sebaggala; Susan Nyawade; Sisay Derso Mengesha; Isaac Okullo
This study investigates the extent of heterogeneity in the adoption of preventive measures among adult individuals in Ethiopia. Utilizing a nationally representative cross-sectional survey conducted by the World Health Organization in 2021, encompassing 895 participants, we explore the varying patterns of preventive measure adoption. Hierarchical cluster analysis is employed to discern potential subgroups within the respondents based on their adoption of preventive measures. Subsequently, logistic regression analysis is applied to ascertain the factors associated with the identified group divisions. We identify two distinct groups characterized by their responses to nine preventive measures. Group 1 comprises the majority of respondents (87%) who exhibit lower frequencies of adopting preventive measures. In contrast, Group 2 consists of 13% of respondents who demonstrate a higher frequency of adopting preventive measures. The amalgamation of cluster analysis and logistic regression outcomes yields insightful implications for the profile of preventive measure adoption. Our logistic regression analysis delves into the determinants influencing membership in the identified subgroups. Notably, it uncovers that individuals with a higher educational attainment exhibit a 2.33-fold greater likelihood of belonging to Group 1, signifying their relatively lesser adoption of preventive measures. In conclusion, this study not only sheds light on the heterogeneity within the adoption of preventive measures among Ethiopian adults but also underscores the influence of education on the propensity to adopt such measures. The findings contribute to better understanding of the dynamics surrounding public health behavior in the context of a pandemic.
Predicting the Adoption of Covid-19 Public Health Preventive Measures in Ethiopia: Application of Health Belief Model
(Texila International Journal of Public Health, 2023-09-29) Luwaga Liliane; Isaac Okullo; Richard Sebaggala; Denis Mubiru; Sisay Derso Mengesha
In the face of coronavirus disease pandemic, adherence to public health measures largely influences their effectiveness in containing the spread. Four specific objectives guided this study: (i) Assess whether individuals are adhering to the COVID-19 preventive measures promoted by Ethiopian government; (ii) Examine the heterogeneity in adoption of preventive measures in Ethiopia; (iii) Identify the factors affecting adherence to preventive measures-based health belief model; and (iv) Examine the moderating effects of socio-economic factors on the relationship between adherence to preventive measures and HBM factors. The study relied on a nationally representative cross-sectional survey commissioned by the World Health Organization in 2021 for Ethiopia. Data was collected from 895 individuals aged 18 years of age or older. Analysis applied several methods including the Multiple Correspondence Analysis, Univariate analysis, hierarchical cluster analysis, cluster analysis and multiple regression analysis. Using face masks and washing hands were the most frequently practiced preventive measures. The regression analysis indicated that perceived severity, perceived barriers, and cues to action showed a significant association with adherence at p >0.05. Furthermore, socio-economic factors have a moderating role on adherence to preventive measures and HBM factors. Effective promotion and adoption of preventive measures require addressing individuals' perceptions of severity and benefits while minimizing barriers and providing clear cues to action. Additionally, specific preventive measures that require ongoing effort and habit development may face challenges in adoption. Tailoring interventions can help overcome these challenges and encourage the widespread adoption of preventive measures to curtail the spread.