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A Socio-History of the Media and Participation in Uganda
(Routledge, 2007) Chibita, Monica; Fourie, Peter, J.
This article is based on research done for a doctoral thesis titled Indigenous language programming and citizen participation in Ugandan broadcasting: An exploratory study (Chibita, 2006). The purpose of the thesis was to investigate and show the importance of first-language media for the participation of citizens in democratic processes. The thesis covered a wide range of topics including linguistic perspectives on language and participation, the history, structure and operation of the media in Uganda, the regulatory environment for linguistic diversity in Uganda's broadcast media, debates about indigenous language broadcasting in Uganda, and policy recommenda tions. In this article, the emphasis is on one of the topics dealt with in the thesis, namely key political, economic and cultural factors in Uganda's history and how these factors, including the right to the use of indigenous languages, have had an important impact on citizens' capacity to participate in public debate through the media (especially broadcasting). It is argued that the opportunities for Ugandans to participate in their governance through critiquing and making an input in government policy have been limited by a number of factors. These include bad colonial and postcolonial policies on the media and language, poverty, low levels of education, and lack of basic access to the means of participation. They have also been limited by governments which have proscribed freedom of expression and association by varying means and to different degrees since the early twentieth century.
Quantitative Trait Loci Controlling Cyanogenic Glucoside and Dry Matter Content in Cassava (Manihot esculenta Crantz) Roots
(Wiley Online Lirary, 2007) Balyejusa Kizito, Elizabeth; Rönnberg-Wästljung, Ann-Christin; Egwang, Thomas; Gullberg, Urban; Fregene, Martin; Westerbergh, Anna
Cassava (Manihot esculenta Crantz) is a starchy root crop grown in the tropics mainly by small-scale farmers even though agro-industrial processing is rapidly increasing. For this processing market improved varieties with high dry matter root content (DMC) is required. Potentially toxic cyanogenic glucosides are synthesized in the leaves and translocated to the roots. Selection for varieties with low cyanogenic glucoside potential (CNP) and high DMC is among the principal objectives in cassava breeding programs. However, these traits are highly influenced by the environmental conditions and the genetic control of these traits is not well understood. An S1 population derived from a cross between two bred cassava varieties (MCOL 1684 and Rayong 1) that differ in CNP and DMC was used to study the heritability and genetic basis of these traits. A broad-sense heritability of 0.43 and 0.42 was found for CNP and DMC, respectively. The moderate heritabilities for DMC and CNP indicate that the phenotypic variation of these traits is explained by a genetic component. We found two quantitative trait loci (QTL) on two different linkage groups controlling CNP and six QTL on four different linkage groups controlling DMC. One QTL for CNP and one QTL for DMC mapped near each other, suggesting pleiotrophy and/or linkage of QTL. The two QTL for CNP showed additive effects while the six QTL for DMC showed additive effect, dominance or overdominance. This study is a first step towards developing molecular marker tools for efficient breeding of CNP and DMC in cassava.
The Politics of Broadcasting, Language Policy and Democracy in Uganda
(Intellect Ltd, 2009) Chibita, Monica
This article examines the interweaving between socio-political history, broadcast policy and regulation, and political participation. Although the article primarily discusses the Ugandan situation, it draws conclusions that could be helpful in examining similar situations in Africa and in other parts of the world. The research was conducted in Uganda in three phases over three years (2003–2006) and additional research was conducted between 2007 and 2008.1 The first phase of the research constituted a socio-historical analysis of Uganda’s media and politics. The second phase focused on the language debate in Uganda and the final phase sought to interpret the Ugandan language debate in light of the findings from the socio-historical analysis. The article is conceived within a critical media studies framework and the methodology is inspired by J.B. Thompson’s (1990) depth hermeneutics. The study employed qualitative interviews and an analysis of media, communication and education policy documents and other archival sources to elicit information at various levels on indigenous language broadcasting policy in Uganda. Placing the debate on indigenous language policy in historical context made it possible to critically examine the relationship between language policy and political participation in Uganda. The article concludes that effective future policy and regulation must strike a balance between the priorities of government, media proprietors and audiences. It must also take cognizance of current commercial realities, while being sensitive to the socio-historical factors that determine attitudes towards the use of specific languages in the media.
Understanding Client Satisfaction With a Health Insurance Scheme in Nigeria: Factors and Enrollees Experiences
(Health Research Policy and Systems, 2011) Shafiu Mohammed; Mohammad N Sambo; Hengjin Dong
Background: Health insurance schemes have been widely introduced during this last decade in many African countries, which have strived for improvements in health service provision and the promotion of health care utilization. Client satisfaction with health service provision during the implementation of health insurance schemes has often been neglected since numerous activities take place concurrently. The satisfaction of enrollees and its influencing factors have been providing evidence which have assisted in policy and decision making. Our objective is to determine the enrollee’s satisfaction with health service provision under a health insurance scheme and the factors which influence the satisfaction. Methods: This retrospective, cross-sectional survey took place between May and September 2008. Two hundred and eighty (280) enrollees insured for more than one year in Zaria-Nigeria were recruited using two stage sampling. Enrollee’s satisfaction was categorized into more satisfied and less satisfied based on positive responses obtained. Satisfaction, general knowledge and awareness of contribution were each aggregated and assessed as composite measure. Logistic regression analysis was used to analyze factors that influenced the satisfaction of enrollees. Results: A high satisfaction rate with the health insurance scheme was observed (42.1%). Marital status (p < .05), general knowledge (p < .001) and awareness of contributions (p < .05) positively influenced clients’ satisfaction. Length of employment, salary income, hospital visits and duration of enrolment slightly influenced satisfaction. Conclusions: This study highlighted the potential effects of general health insurance knowledge and awareness of contributions by end-users (beneficiaries) of such new program on client satisfaction which have significant importance. The findings provided evidence which have assisted the amendment and re-prioritization of the medium term strategic plan of operations for the scheme. Future planning efforts could consider the client satisfaction and the factors which influenced it regularly
NREN Network Security: A case study of Uganda Christian University ICT Infrastructure
(2013) Matsiko, Perez; Kiden, Sarah
The long wait for high speed access to the Internet is finally coming to an end. National Research and Education Networks (NRENs) are being connected to the rest of the world through high speed fiber optic cables. This paper focuses on NREN security with Uganda Christian University (UCU) as a case study. It discusses how regional and national reseach and education networks will signifiantly lower bandwidth costs for the member institutions. It goes ahead to discuss the initial UCU ICT infrastructure, security practices and implementation, and then suggest recommendations based on lessons learnt and experiences.
Africa Communicating: Digital Technologies, Repersentation and Power
(Nokoko Institution of African Studies, 2013) Alzouma, Gado; Chibita, Monica; Tettety, Wisdom; Thompson, Allan
Players and Processes Behind the National Health Insurance Scheme: A Case Study of Uganda
(BMC Health Services Research, 2013) Robert K Basaza; Thomas S O’Connell; Ivana Chapčáková
Background: Uganda is the last East African country to adopt a National Health Insurance Scheme (NHIS). To lessen the inequitable burden of healthcare spending, health financing reform has focused on the establishment of national health insurance. The objective of this research is to depict how stakeholders and their power and interests have shaped the process of agenda setting and policy formulation for Uganda’s proposed NHIS. The study provides a contextual analysis of the development of NHIS policy within the context of national policies and processes. Methods: The methodology is a single case study of agenda setting and policy formulation related to the proposed NHIS in Uganda. It involves an analysis of the real-life context, the content of proposals, the process, and a retrospective stakeholder analysis in terms of policy development. Data collection comprised a literature review of published documents, technical reports, policy briefs, and memos obtained from Uganda’s Ministry of Health and other unpublished sources. Formal discussions were held with ministry staff involved in the design of the scheme and some members of the task force to obtain clarification, verify events, and gain additional information. Results: The process of developing the NHIS has been an incremental one, characterised by small-scale, gradual changes and repeated adjustments through various stakeholder engagements during the three phases of development: from 1995 to 1999; 2000 to 2005; and 2006 to 2011. Despite political will in the government, progress with the NHIS has been slow, and it has yet to be implemented. Stakeholders, notably the private sector, played an important role in influencing the pace of the development process and the currently proposed design of the scheme. Conclusions: This study underscores the importance of stakeholder analysis in major health reforms. Early use of stakeholder analysis combined with an ongoing review and revision of NHIS policy proposals during stakeholder discussions would be an effective strategy for avoiding potential pitfalls and obstacles in policy implementation. Given the private sector’s influence on negotiations over health insurance design in Uganda, this paper also reviews the experience of two countries with similar stakeholder dynamics.
A National Framework for Sustainability of Health Knowledge Translation Initiatives in Uganda
(Uganda Country Node of the Regional East African Community Health Policy Initiative, 2014-05-26) Robert Basaza; Alison Annet Kinengyere; Nelson Sewankambo
This report is intended to inform the deliberations of those engaged in developing policies on sustainability of health knowledge translation initiatives policies as well as other stakeholders with an interest in such policy decisions. It summarizes the best available evidence regarding the design and implementation of policies on how to advance sustainability of health knowledge translation initiatives policies in Uganda’s [mainstream] health system. The purpose of the report is not to prescribe or proscribe specific options or implementation strategies. Instead, the report allows stakeholders to consider the available evidence about the likely impacts of the different options systematically and transparently.
Seasonality of Burkitt's lymphoma in Uganda
(Indian Association of Oral and Maxillofacial Pathology, 2014-09) Muwazi, Louis; Rwenyonyi, Charles Mugisha; Kutesa, Annet; Kasangaki, Arabat; Kamulegeya, Adriane
Background/Aims: Burkitt’s lymphoma is the most common childhood oral maxillofacial tumor in Africa and some studies have reported seasonal variation. Materials and Methods: All Burkitt’s cases diagnosed from 1969 to 2006, from all over Uganda, at the Makerere University’s Department of Pathology, were analyzed, to determine seasonal variation. This was done by evaluation of monthly and rainy versus dry season prevalence. Statistical analysis: The Wilcoxon test was used in both cases, to assess the statistical significance of differences in the diagnostic rates of Burkitt’s lymphoma, in comparison to nonspecific chronic inflammation, using the total as the denominator. Yearly variation in prevalence was examined by a Chi‑square test for linear trend. Mann‑Whitney tests were done to compare the climatic regions. Multivariate analysis of variance (MANOVA) was used to test for differences when gender, seasons and climatic regions were factored in. Results: Although monthly frequencies varied considerably over the period, none of the differences were statistically significant (Pearson’s 15.199, degrees of freedom df = 11, P = 0.174). Likewise, there was no statistically significant difference in the total number of Burkitt’s and nonspecific chronic inflammation biopsies handled at the Department during the rainy and dry seasons. Conclusion: Although the 38‑year period gave us sufficient numbers to use the Edward’s method for seasonality, it also meant that a lot of seasonal changes that occurred during the period were not taken into consideration. We hence feel that a review of this data with weather experts, so as to group the biopsies into accurate rainfall and dry patterns, would yield a more authoritative publication.
Prevalence and Factors Associated with Dental Caries Among Children and Adults in Selected Districts in Uganda
(African Health Sciences, 2015-12) Kutesa, Annet; Kasangaki, Arabat; Nkamba, Moses; Muwazi, Louis; Okullo, Isaac; Rwenyonyi, Charles Mugisha
Objective: The aim was to determine the prevalence and factors associated with dental caries among adults and children in seven districts of Uganda. Methods: Participants aged 11-13 (n=1230) and 35-44 years (n=648) were randomly selected from urban and rural areas of Gulu, Soroti, Jinja, Masaka, Kabale, Kabarole and Hoima districts. They were examined by 4 trained and calibrated dentists for dental caries using Decayed, Missing and Filled teeth index as described by World Health Organisation. Results: Overall mean DMFT score was 0.73 for children and 4.71 for adults. Generally, there was a higher mean DMFT score in the rural (2.19) compared to urban areas (1.97). In all the districts, except Hoima, there was a higher mean DMFT score of children in rural compared to urban. In adults, similar trend was mainly registered in Masaka, Hoima and Gulu dis tricts. Most participants (79.9%, n=1309) occasionally ate sugared snacks. Overall, 95% (n=1795) of the participants cleaned their teeth with plastic tooth brushes (71.7%) and chewing sticks (8.3%). Conclusion: Although the severity of dental caries was low, the disease was widespread in the study population. A high proportion of participants reported consumption of sugared snacks and drinks, which calls for oral health education.
Social media and Social Transformation in Uganda‘s families
(African Research and Documentation, 2016) Kaddu, Sarah; Mukasa, Geoffrey
The development and application of social media, has transformed Ugandan social life. Transformations are seen in the way Ugandans are socializing with one another and in the way families utilize their free time. Through a questionnaire survey, and interviews the paper examines the way technology development is transforming the social family cycle in Uganda. It further examines the challenges faced by families as a result of application of social media. Finally the paper proposes strategies of solving the challenges. This paper will benefit Ugandans and the people beyond, the researchers and educational administrators including the proponents of social media.
Oralture on twin rituals among Jopadhola of Uganda
(Academic Journals, 2016-05) Owor, Joseph Jakisa; Naula, Mary
The purpose of this study was to identify and critically analyze the oralture products associated with rituals concerning twins among the Jopadhola of Uganda. The study had the following objectives: to establish the successive stages in the life of twins among the Jopadhola and the rituals which accompany them; establish the nature or categories and functions of the oralture produced around these rituals; and establish the content and the literary features of these oralture products. The study used a qualitative approach, involving observation and verbal interviews with twenty seven respondents. The researchers listened to songs in response to the designed interview schedule. The findings reveal that oralture around rituals concerning twins among the Jopadhola are rich in literary features like imagery, kenning, personification, metaphors, symbols, satire, hyperbole, repetition, similes and structure with numerous functions, categories and features that pertain to them. Songs proved to be more utilized than all other literary products and the least used are the sayings and folktales.
Knowledge, Attitudes and Perceptions of Secondary School Teenagers Towards HIV Transmission and Prevention in Rural and Urban Areas of Central Uganda
(Scientific Research Publishing, 2016-07) Rukundo, Annamaria; Muwonge, Mathias M.; Mugisha, Danny; Aturwanaho, Dickens; Kasangaki, Arabat; Bbosa, Godfrey S.
HIV/AIDS has remained a challenge in Uganda among adolescent despite the ABC strategy used globally to prevent HIV infection. The study assessed the knowledge, attitudes and perceptions of secondary school teenagers towards HIV transmission and prevention in rural and urban schools of central Uganda. A cross sectional study using self-administered questionnaires and structured interviews was used to collect data from adolescents in secondary schools in Kampala and Buikwe districts. Eight schools were randomly selected with 4 schools in each district. A total of 245 students from schools were recruited in the study with 120 and 125 students from urban Kampala and rural Buikwe district schools respectively. Data were analyzed using SPSS version 11. The results were expressed as percentages in a 2 × 2 tables. The mean age of the participants was 15.9 ± 2.5 years. Results showed that 95.1% participants had knowledge on HIV/AIDS in both urban and rural schools and 27.4% knew all the modes of HIV transmission. About 83.7% knew the ABC strategy for HIV prevention and 37.6% would talk about HIV/AIDS mainly with friends. For HIV cure, 62.0% of study participants reported non-cure and 24.9% were not sure. The remaining 13.1% of the study participants in both urban and rural schools reported that HIV can be cured. And the modes of curing HIV that were mentioned by participants included spiritual healing, transmitting it to others through sexual intercourse and that antiretroviral (ARVs) drugs can cure it as well as that it can be cured abroad. About 65.7% of participants reported recognition of one with HIV/ AIDS and by having red lips, being sickly; weight loss, skin rash and being very rich were mentioned. About 39.2% of the study participants mentioned that they cannot get infected with HIV and can’t contract HIV at all and 18.4% believed that chances of getting HIV infection were high. On perception and attitude on condoms and their use, participants reported that it is a sign of mistrust, reduces sexual pleasures and they are embarrassing to buy. Majority of the participants in both urban and rural schools had some knowledge on HIV/AIDS and the ABC strategy for HIV prevention. However, there was a knowledge gap on the various modes of HIV transmission and prevention. There was misconception of the participants on HIV/AIDS cure, condom use and on the chances of contracting HIV. About the source of HIV/AIDS information, majority of the participants were getting information on HIV/AIDS from friends of which some information was misleading. This false information could be the reason for the increased HIV prevalence reported among the adolescents in the schools. Generally, participants had some knowledge on HIV/AIDS though they had knowledge gap on HIV transmission and prevention.
Assessment Uganda Health System Pre-assessment Report 2016
(United States Agency for International Development/Uganda, 2016-08) Sebastian Olikira Baine; Robert Basaza; Beth Ann Pratt
The 2011-2015 USAID/Uganda Country Development Cooperation Strategy (CDCS 1.0) hypothesized that a structurally sound, well-resourced, functioning health system, supporting access to quality service delivery is essential to ensuring effective utilization of health services and subsequently, to improving health outcomes in Uganda (USAID, 2010). Therefore, as USAID/Uganda approaches the end of implementation of CDCS 1.0 and in preparation for the next CDCS, it is important to understand the changes that have occurred in the elements of the system and elements that currently comprise Uganda’s national health system, the relationships and interdependencies between these elements, and the fiscal, political, economic, social, and multi-sectoral factors and stakeholders that influence and impact the system’s functionality. The World Health Organization defines a health system as “all organizations, people and actions whose primary intent is to promote, restore or maintain health,” the purpose of which is to improve access and coverage of responsive, efficient, effective, equitable, and quality-driven health services (WHO, 2000). To this end, a health system is supported by a set of basic building blocks - including human resources, financing, information systems, medical supply chains, governance mechanisms, and ervice delivery structures - linked to quality assurance mechanisms, all of which serve to uphold the health sector’s responsibility and accountability to both patients and their communities (Figure 1). For diagrammatic purposes, health systems frameworks often present these building blocks as parallel, stand-alone pillars. In practice, however, elements of a health system are mutually derivative and reinforcing.
The Relationship Between Parental Mediation of Adolescent Media Use and Ugandan Adolescents' Sexual Attitudes and Behavior
(Routledge, 2017) Miller, Ann Neville; Gabolya, Charles; Mulwanya, Richard; Nabaseke, Grace; Kiva, Joseph; Nalugya, Evangeline; Lagot, Sarah; Chibita, Monica
In sub-Saharan Africa, research about the role of media as an influence on adolescent sexual behavior has focused almost exclusively on the effects of health communication campaigns. Little research has explored the association between parents' attempts to guide their children's entertainment media intake, and adolescents' sexual attitudes and behaviors. The authors surveyed 360 Ugandan high school students regarding their parents' mediation of their media use; their attitudes about stereotypical gender roles in sexual relationships and casual sex; and their sexual behaviors. Co-using media with opposite sex friends was associated with higher endorsement of casual sex. Adolescents who reported their parents limited the amount of time they spent with media were less likely to report having ever had sex. However, both effects were smaller than the effects of relationship and demographic variables.
Identifying and Characterising Health Policy and System-Relevant Documents in Uganda: A Scoping Review to Develop a Framework for the Development of a One-Stop Shop
(Healthy Research Policy and Systems, 2017) Boniface Mutatina; Robert Basaza; Ekwaro Obuku; John N. Lavis; Nelson Sewankambo
Background: Health policymakers in low- and middle-income countries continue to face difficulties in accessing and using research evidence for decision-making. This study aimed to identify and provide a refined categorisation of the policy documents necessary for building the content of a one-stop shop for documents relevant to health policy and systems in Uganda. The on-line resource is to facilitate timely access to well-packaged evidence for decision-making. Methods: We conducted a scoping review of Uganda-specific, health policy, and systems-relevant documents produced between 2000 and 2014. Our methods borrowed heavily from the 2005 Arksey and O’Malley approach for scoping reviews and involved five steps, which that include identification of the research question; identification of relevant documents; screening and selection of the documents; charting of the data; and collating, summarising and reporting results. We searched for the documents from websites of relevant government institutions, non-governmental organisations, health professional councils and associations, religious medical bureaus and research networks. We presented the review findings as numerical analyses of the volume and nature of documents and trends over time in the form of tables and charts. Results: We identified a total of 265 documents including policies, strategies, plans, guidelines, rapid response summaries, evidence briefs for policy, and dialogue reports. The top three clusters of national priority areas addressed in the documents were governance, coordination, monitoring and evaluation (28%); disease prevention, mitigation, and control (23%); and health education, promotion, environmental health and nutrition (15%). The least addressed were curative, palliative care, rehabilitative services and health infrastructure, each addressed in three documents (1%), and early childhood development in one document. The volume of documents increased over the past 15 years; however, the distribution of the different document types over time has not been uniform. Conclusion: The review findings are necessary for mobilising and packaging the local policy-relevant documents in Uganda in a one-stop shop; where policymakers could easily access them to address pressing questions about the health system and interventions. The different types of available documents and the national priority areas covered provide a good basis for building and organising the content in a meaningful way for the resource.
Factors Influencing Cigarette Smoking Among Soldiers and Costs of Soldier Smoking in the Work Place at Kakiri Barracks
(HHS Public Access, 2017-05) Robert Basaza; Emmanuel Otieno; Ambrose Musinguzi; Possy Mugyenyi; Christopher K. Haddock
Background: Although Uganda has a relatively low prevalence of smoking, no data exists on cigarette use among military personnel. Studies in other countries suggests military service is a risk factor for tobacco use. Objectives: To assess prevalence and risk factors for and costs of smoking among military personnel assigned to a large military facility in Uganda. Design: A mixed methods study including focus groups, interviews, and a cross-sectional survey of military personnel. Setting: Kakiri Barracks, Uganda Subjects: Key informants and focus group participants were purposively selected based on the objectives of the study, military rank and job categories. A multi stage sample design was used to survey individuals serving in Uganda People’s Defense Forces (UPDF) from June-November 2014 for the survey (n = 310). Results: Participants in the qualitative portion of the study reported that smoking was harmful to health and the national economy and that its use was increasing among UPDF personnel. Survey results suggested that smoking rates in the military were substantially higher than in the general public (i.e., 34.8% vs. 5.3%). Significant predictors of smoking included lower education, younger age, having close friends who smoked and a history of military deployment. Estimated costs of smoking due to lost productivity was US$576,229 and US$212,400 for excess healthcare costs. Conclusion: Smoking rates are substantially higher in the UPDF compared to the general public and results in significant productivity costs. Interventions designed to reduce smoking among UPDF personnel should be included in the country’s national tobacco control plan.
Task Shifting in Health Service Delivery From a Decision and Policy Makers’ Perspective: a Case of Uganda
(BMC, 2018) Baine, Sebastian Olikira; Kasangaki, Arabat; Baine, Euzobia Margaret Mugisha
Background: Documented evidence shows that task shifting has been practiced in Uganda to bridge the gaps in the health workers’ numbers since 1918. The objectives of this study were to provide a synthesis of the available evidence on task shifting in Uganda; to establish levels of understanding, perceptions on task shifting and acceptability from the decision and policy makers’ perspective; and to provide recommendations on the implications of task shifting for the health of the population in Ugandan and human resource management policy. Methods: This was a qualitative study. Data collection involved review of published and unpublished literature, key informant interviews and group discussion for stakeholders in policy and decision making positions. Data was analyzed by thematic content analysis (ethical clearance number: SS 2444). Results: Task shifting was implemented with minimal compliance to the WHO recommendations and guidelines. Uganda does not have a national policy and guidelines on task shifting. Task shifting was unacceptable to majority of policy and decision makers mainly because less-skilled health workers were perceived to be incompetent due to cases of failed minor surgery, inappropriate medicine use, overwork, and inadequate support supervision. Conclusions: Task shifting has been implemented in Uganda for a long time without policy guidance and regulation. Policy makers were not in support of task shifting because it was perceived to put patients at risk of drug abuse, development of drug resistance, and surgical complications. Evidence showed the presence of unemployed higher-skilled health workers in Uganda. They could not be absorbed into public service because of the low wage bill and lack of political commitment to do so. Less-skilled health workers were remarked to be incompetent and already overworked; yet, the support supervision and continuous medical education systems were not well resourced and effective. Hiring the existing unemployed higher-skilled health workers, fully implementing the human resource motivation and retention strategy, and enforcing the bonding policy for Government-sponsored graduates were recommended.
Etiology and Pattern of Mandibular Fractures Among Patients Attending Oral and Maxillofacial Surgery Unit in Mulago Hospital, Uganda: a Cross–Sectional Study
(SRYAHWA, 2018) Rwenyonyi, Charles Mugisha; Mpiima, Patrick; Kasangaki, Arabat; Nkamba, Eriab
Background: The mandible is one of the most commonly fractured bones of the facial skeleton because of its anatomical prominence. Objective: The objective of the study was to establish the etiological factors and pattern of mandibular fractures among patients (n=73) aged 3 – 55 years attending the Oral and Maxillofacial Surgery Unit of Mulago Hospital. Methods: This was a hospital based cross-sectional study among patients with mandibular fractures who were consecutively recruited after informed consent. The data were collected using a structured questionnaire and clinical oral examination. The collected data were analyzed using Statistical Package for Social Sciences, version 17 for Windows, Chicago, Illinois, USA. Results: There were 73 patients with 107 mandibular fracture sites. Most fractures were caused by road traffic accident (58%) and assault (38%), and especially among pedestrians and passengers. About half of the patients with fractures were aged 21-30 years. The sex ratio of the patients was 7.7 males versus 1 female. About 17% of the patients were under the influence of alcohol during injury. Majority (69.9%) of the injuries occurred in the Kampala Metropolitan area. Single fractures were observed in 55% of the patients and half of them, displaced. About 91% of the patients with multiple fractures were bilateral. Conclusions: The present study indicated that road traffic accidents and assaults were major causes of madibular fractures, particularly among the youths in the studied population. Males were more prone to mandibular fractures.
The Cost of Routine Immunization Services in a Poor Urban Setting in Kampala, Uganda: Findings of a Facility-Based Costing Study
(Journal of Immunological Sciences, 2018-07-03) Isaiah Chebrot; Annet Kisakye; Brendan Kwesiga; Daniel Okello; Diana Kiiza; Eva Kabwongera; Robert Basaza
Background: Reducing infant and under-five mortality by use of cost-effective strategies like immunization continues to be a challenge, particularly in resource limited settings. Strategic planning for immunization requires credible costing information to estimate available funding, allocate funds within the program and avoid funding shortfalls. This study assessed the total and unit costs of providing routine immunization in health facilities in Kampala. Methods: This was a retrospective descriptive cost analysis study that applied a bottom-up, ingredients-based costing methodology which identified costs from the perspective of the health service providers. The cost of providing immunization services in health facilities in Kawempe Division in the financial year 2015/2016 was determined using relevant data which was collected using an Excel questionnaire adapted from the CostIt software of the World Health Organization. The analysis was also based on the same CostIt software. Results: The average total facility immunization costs were USD 14,415.1 with a range of 8,205.3 at private for profit to USD 47,094.9 at public health facilities. Vaccines and supplies were the main cost driver accounting for 63.6% followed by personnel costs at 24.0%. Routine facility based immunization had the highest cost with an average of 47.9% followed by outreach services at 32.3%. The average cost per dose administered was USD 1.4 with a range of USD 1.0 in larger health centres (HCIV) to 1.5 in HCIII (medium-sized HC or dispensary). The average cost per DPT3 immunized child was USD 20.0 with a range of USD 12.6 in HCIV to 22.0 in HCIII. The findings show a great variance between facility ownership and levels. Conclusions: The study found that the recurrent costs were significantly higher than capital costs and this was across all facilities. Vaccines and personnel costs were the two main cost drivers. Routine facility based immunization was the costliest activity followed by outreaches with social mobilization being the least. The cost per dose administered and DPT3 immunized child were dependent on outputs with high output health facilities having less unit costs compared to facilities with less out outputs. Private health facilities had higher unit costs compared to publicly owned health facility.

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