Academic publications

Permanent URI for this collectionhttps://hdl.handle.net/20.500.11951/16

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Breastfeeding Practices and Experiences Among Working Mothers: A Case Study of Teachers and Nurses in Uganda
(Chritian Journal for Global Health, 2025-11) Emmanuel Otieno; Stella Asayo; Teopista Agutu; Josephine Namyalo
Background: Uganda’s exclusive breastfeeding rate remains high at 94%, despite significant malnutrition rates with nearly 1 in 4 children under 5 suffering from stunting. Breastfeeding is the optimal source of nutrition for infant growth and development. This study aimed to investigate breastfeeding practices and experiences of primary school teachers and nurses in Uganda. Methods: This qualitative study employed a case study design to collect data from 50 respondents — primary school teachers and nurses working in Mukono Municipality between October 2023 and February 2024. All breastfeeding mothers with infants aged 0-6 months were included. In-depth and key informant interviews were done to collect data. Thematic analysis was used to examine the data. Results: Breast feeding primary school teachers and nurses indicated experiencing heavy workloads, tight work schedules, and minimal institutional support towards practicing breastfeeding. As such, most breastfeeding mothers did not successfully achieve the goal of breastfeeding their infants exclusively. Conclusion: In order to improve infant health outcomes in Uganda, it is essential to address the barriers that hinder exclusive breastfeeding among working mothers. This can be achieved through policy occupational health interventions that protect breastfeeding and promote inclusivity and work life balance for mothers.
Evaluation of Agricultural Waste-Based Briquettes as an Alternative Biomass Fuel for Cooking in Uganda
(East African Nature & Science Organization, 2025-11-13) Omino Joseph Oteu; Sarah Kizza-Nkambwe; Junior Senyonga Kasima; Maxmillan Mpewo; Miria Frances Agunyo
Wood fuel has been adopted as a feasible alternative to cooking energy sources in efforts to replace fossil fuels. However, the exorbitant use of wood fuel has raised concern as it is the major cause of forest cover loss in Uganda. Briquettes have recommended as as sources of cooking energy potential to to substitute wood fuel. Unfortunately, sawdust, a product of deforestation, is the primary material used in making briquettes in Uganda. This instead augments the problem of fuel-induced deforestation. Agricultural wastes could potentially be converted into briquetting materials for generation of cooking energy, although these are studied in in Uganda. Thus, this study study established potential of agricultural wastes as alternative briquetting materials for use in cooking. Four fuel types: charcoal from Mangifera indica, firewood of Eucalyptus grandis, carbonized and non-carbonized briquettes from agricultural wastes, all from within Mukono District were used for the study. Laboratory based experiments were used to determine the physico-chemical characteristics of the fuels. Data were analysed using R software, Ver. 4.2.3. Carbonised briquettes’ mean performance measures were higher than conventional fuels (p≤0.05) and non-carbonised briquettes. The amount of energy required to attain experimental boiling point of water was higher (p≤0.05) in conventional fuels and non-carbonised briquettes than in carbonised briquettes. Duration to boil 5 litres of water was least with the conventional fuel sources. All the fuel sources’ emissions exceeded the maximum range recommended for indoor carbon monoxide levels. However, the particulate matter emission was lower in carbonised briquettes and charcoal than the other fuel sources. Agricultural waste-based carbonised briquettes could effectively be used as an alternative cooking energy source in Uganda. The study recommends conducting cost-benefit analyses on the use of agricultural waste-based briquettes as cooking energy sources.
Soil Physical and Chemical Properties Under Shea Tree (Vitellaria Paradoxa) at Different Stages of Growth
(East African Nature & Science Organization, 2025-11-13) Gertrude Ogwok; Sarah Kizza-Nkambwe; Junior Senyonga Kasima; Maxmillan Mpewo; Peter O. Alele
Shea tree (Vitellaria paradoxa) is one of the dominant agro-forestry species in Otuke district of Northern Uganda. Due to its economic importance and, in line with the numerous threats the tree is faced with, there is an urgent need for measures to to conserve species, for example, through incorporating annual food crops in the Shea tree parkland. This, however, requires a better understanding of tree-soil-food crop interactions. A number of studies of this aspect either considered only the mature Shea tree gardens or did not provide a clear distinction between the physiological states of the Shea tree. This was the motivation for this study where we compare variation in soil properties under mature and young Shea tree gardens with sites not having trees in Okwang sub-county, Otuke district. Five soil samples (up to 15 cm deep for top soil and 15-30 cm for sub-soil) were obtained per treatment using a soil auger. Our results show that in the top soil, only percent sand varied among the treatments, while, in the sub-soil, only percentage nitrogen and average phosphorus varied among the treatments. We also found that percentage top soil organic matter and percentage of sub-soil sand had negative strong correlations with maize and soybean yields, while percentage sub-soil clay had a strong positive correlation with maize and soybean yield. We conclude that variations in soil physical and chemical properties under Mature and Young Shea gardens only occur for those properties that have a direct link to tree residues
A Framework for Managing Water Quality From Hand-dug Well: A Case of Mutukula Town Council, Uganda
(Taylor and Francis Group, 2025-11-13) Sarah Kizza-Nkambwe; Maxmillan Mpewoa; Junior Senyonga Kasima; Kheria Mfuranzima
Effective management of windrow-based composting technology in developing cities is a major challenge, especially for municipal authorities mandated to offer these services. Poorly managed waste composting systems could affect the quality of compost and cause complex environmental impacts. The aim of this study was to assess the quality of compost of a waste composting facility in Mukono municipality, central Uganda. Mature compost samples were collected from windrows in the waste composting facility and the samples analysed for physicochemical parameters (temperature, moisture content, organic matter, total nitrogen, total phosphorus, and potassium) and for heavy metals (lead, cadmium, copper) and metalloids (arsenic). To assess the quality of the compost, the analysed results of the samples were compared with common ranges for compost quality. Concentration of heavy metals ranged between 0.01 mg/l (cadmium) and 0.4 mg/l (copper). Except for alkaline pH (9.1), which was higher than the recommended range for mature compost quality, all physicochemical parameters and heavy metals were within common ranges for compost quality. Moisture content and pH correlated with heavy metals, 0.75 and 0.78, respectively. Mean total nitrogen and phosphorus were 0.8% and 0.4%, respectively, while organic matter was 21.7% and potassium 0.3%. Compost quality did not differ between seasons (P = 0.05). Based on the study results, continuous investigative research is recommended to safeguard the compost quality.
A Framework for Managing Water Quality From Hand-dug Well: A Case of Mutukula Town Council, Uganda
(East African Nature & Science Organization, 2025-11-13) Yosam Tumwebaze; Miria Frances Agunyo; Eleanor Wozei; Sarah Kizza Nkambwe
This research proposed the adoption of a framework as a supporting tool to enhance the management of the quality of water from hand-dug wells in Mutukula Town Council, Uganda. Although water from hand-dug wells is often considered prone to contamination, no such study has been carried out for Mutukula Town Council. Adopting both qualitative and quantitative approaches including the use of surveys, experimentation and tools such as the sanitary inspection package developed by the World Health Organization, the research clearly indicated that not only was the quality of water from the 5 wells considered poor but that the wells also lacked pertinent components such as secure covers, drainage provisions, headwalls among others. Moreover, the absence of regulatory tools/guidelines, and cultural and socioeconomic practices amongst community members further contributed to risks associated with using water from these wells. This research proposes a framework that can be adopted by respective local authorities to enhance management and monitoring of water quality and it incorporates key components of training and capacity building, collective supervision and encouraging regular engagements with the various stakeholders
Heavy Metal and Metalloid Concentrations in Agricultural Communities Aroundsteel and Iron Industries in Uganda: Implications for Future Food Systems
(Taylor and Francis Group, 2025-11-13) Maxmillan Mpewoa; Sarah Kizza-Nkambwe; Junior Senyonga Kasima
Poor management of effluents from steel and iron industries could increase element concentrations in the environment and threaten the health of consumers of food products from these areas. The current study assessed element concentration and physicochemical properties of soils, water, and vegetation from within 200 m around three steel and iron industries. A workable grid-based sampling design guided soil and plant sampling; upstream-downstream water quality comparisons were adapted with upstream as a control sample. Analyses were conducted following procedures by USEPA method 3051A. Element concentration was in the order Mn>As>Zn>Cr>Pb. The concentrations reduced with increase in distance from the industry. There was moderate-to-strong pollution of soils for As, and transfer factor for all elements was >1. In conclusion, industrial activity might have contributed to increased element concentrations in the soils, vegetation, and water sources around the industries. Agrarian activities may only be safely carried out 151m away from the industries
Plant Communities as Indicators of Anthropogenic Disturbance on a Peri-urbantropical Wetland of Lutembe Bay Wetland System, Uganda
(Taylor and Francis Group, 2025-11-13) Nuubu Takuwaa; Eleanor Wozei; Sarah Kizza-Nkambwe; Geoffrey Malingac; George Kilandeb; Joel Kinobe
Wetland degradation linked to peri-urban anthropogenic pressures is a major threat to wetland biodiversity. However, little is known of the response of biodiversity to this disturbance. Biotic indicator species are useful for assessing the health and ecological integrity of wetlands. This study evaluated patterns of plant species richness and composition and determined species character-icing each of three differently disturbed wetland sites of Lutembe Bay Wetland, a peri-urban Ramsar Wetland of International Importance and an Important Bird Area in Uganda. The study revealed that total nitrogen decreased following wetland degradation, but total phosphorous was not affected; pH values were <5.5, while OM content was low in the lightly and heavily (2.5–4.4%) degraded sites. While plant species richness did not differ among the sites, total species richness was higher in heavily disturbed, compared to lightly disturbed and relatively intact sites. Community composition differed significantly among the three sites. Indicator plant species were then identified which could be employed as a rapid assessment tool to infer the level of degradation in the sustainable management of Afrotropical wetlands by practitioners. Results show that continued unsustainable use of wetlands results in changes in soil properties and plant species composition, highlighting the need to restore anthropogenically disturbed parts of wet-lands and to prevent further degradation of less degraded areas
HIV/AIDS Stigma: Discussions from Black Female College Students on the Role of Family, Religious Organizations, and Health Institutions in Promoting Dialogue and Dissipating Shame
(University of Nebraska Press, 2025-11-12) James Kiwanuka-Tondo; Fay Cobb Payton; Keon Pettiway
The research used focus groups to analyse the perceptions of Black female college students about HIV/AIDS stigma and prevention efforts. Our findings indicate that study participants perceived family, religious organizations and health care institutions as significantly impacting the promotion or dissipation of HIV/AIDS stigma. Awareness and understanding of students’ opinions and perceptions about stigma can assist health care personnel and religious leaders in developing prevention programs and services for individuals and their families within this particular group. This research is funded by National Science Foundation grant.
Online HIV Prevention Information How Black Female College Students Are Seeking and Perceiving
(Emerald Group Publishing Limited, 2025-11-12) Fay Cobb Payton; Lynette Kvasny; James Kiwanuka-Tondo
Purpose – Two research questions are addressed: what are black female college students’ perceptions of current messages present on web sites about HIV/AIDS awareness and prevention?; and what messages do black female college students find culturally relevant to them, and why? Results indicate that these women perceive several communication barriers including lack of trust and unfamiliarity with information sources, stigma ascribed to HIV, as well as misconceptions and traditional values held by some in the black community and health institutions. HIV prevention messages are perceived as relevant if they exhibit qualities including interactive features. The paper aims to discuss these issues. Design/methodology/approach – To understand black collegiate women as health information seekers, it is important to engage paradigms that allow researchers to make sense of how group members construct their content needs, what helps shape this construction, and the meaning derived from the consumption of the information, focus groups are an effective qualitative method for enabling collective discussion and interaction between research participants that facilitates the exploration of under-researched topics like HIV prevention as well as the language commonly used by respondents to describe HIV from a socio-cultural perspective. The research team conducted three focus groups to appraise current black female college students’ attitudes and perceptions of messages presented on HIV/AIDS prevention and awareness web sites Findings – HIV prevention messages are perceived as relevant if they exhibit qualities including interactive features, practical advice using non-technical vocabulary, content authored and disseminated by familiar and trustworthy individuals and institutions, and risk related to individual behaviors rather than the demographic group. Implications of the findings and suggestions for future research on the design of health information systems are provided. Research limitations/implications – This research is based on a small sample size based on one region of the USA. Practical implications – Health communication materials should also provide strategies for dispelling myths, and combating feelings of stigma, and mistrust. In addition, practical advice such as questions to ask physicians may help to produce positive and desirable outcomes as black women seek services from the healthcare system. The message itself must take into account a number of factors include short and simple messages, clean web pages, navigation structures that make information easy to find, comprehensive information all found in a single web site, and interactive features to facilitate discussion and sharing. In particular, with social media, women can also play a role in the creation and dissemination of health messages in multiple modalities including text, spoken word, still and moving images, and music. Social implications – “A major component of preventive health practice is the availability and provision of information regarding risks to health and promotional measures for enhancing the health status among this population” (Gollop, 1997, p. 142). However, as Dervin (2005) cautions, while information is necessary, it is insufficient to encourage behavior change. To combat the health disparities that differentially impact African-American women requires expertize and understanding from multiple perspectives. By providing insight into how black collegiate women perceive HIV prevention information needs, the women in the focus groups lend a necessary voice in the effort toward healthy equity through the creation of effective health interventions that will appeal to them. Originality/value – The author seeks to create an online and socially connected experience characteristic of ongoing user input and active engagement in content development which targets the population. From a human-computer interaction viewpoint, the authors are seeking to avoid design divorced from context and meaning. In developing such an experience, the authors will need to triangulate the roles of culture, context, and design to reduce the content divide, yet amplify the notion of participatory web. Participatory web embodies a social justice movement to build web content from voices typically dampened in the discourse. It (re)shapes meaning, identity, and ecologies in the process of foci on particular social, health, and political causes (e.g. HIV/AIDS). Giving black women ownership over the creation of health information on the internet may improve the ability to provide targeted HIV prevention content that is culturally salient and more effective in reducing HIV infections in this community.
Constructs of Postcolonial Space and Identity in Women’s Fiction
(East African Journal of Arts and Social Sciences, 2025) Johnson Ocan, Sharon Namara, Gad Kwizera, & Norah Ainemababazi
This study examines women fictionists’ engagement with the interwoven themes of conflict trauma, the pursuit of education, and duplicity in Beatrice Lamwaka’s Butterfly Dreams and Monica Arac de Nyeko’s Jambula Tree. It argues that these authors construct narrative spaces which reflect contemporary realities where their heroines assert autonomy, reconstruct identities, inscribe painful memories, and confront postcolonial tensions in northern Uganda during the Lord’s Resistance Army (LRA) insurgency. Using textual analysis, the research interrogates the weight of postcolonial governance through critical concerns such as gender, post-traumatic stress disorder, armed conflict, educational aspiration, and sexuality—particularly in Uganda’s sociopolitical context, where same-sex relationships are criminalised. Findings indicate that women fiction writers employ the postcolonial framework to anchor their narratives in historical tragedy, advocate for sociopolitical transformation, affirm individuality, and pursue emancipation through the written word.
Five Poems about Youth
(The Journal of African Youth Literature, 2020-07-02) Alice Jossy Kyobutungi
Five poems about youth Song of a Teenager Blessed Curse Let it not Hold You Back The Young Adult Character A Letter to my Mind
A Critical Analysis of Legal and Institutional Framework of Natural Resource Conservation in Kabale, Uganda
(International Journal For Multidisciplinary Research, 2024-09-15) Patience Najuna
Natural resource conservation in Kabale, Uganda, presents a critical challenge given the district's ecological significance and socio-economic dynamics. This article provides a comprehensive analysis of the legal and institutional frameworks governing natural resource management in Kabale. It examines the effectiveness and limitations of existing policies, regulations, and institutional structures in achieving conservation goals amidst growing pressures from population growth and economic activities. While there are notable legislative efforts and institutional commitments to resource conservation, issues such as inadequate enforcement, limited institutional capacity, and conflicts between conservation and local economic interests undermine the effectiveness of these measures. The analysis highlights the need for a more integrated approach that enhances legal enforcement, strengthens institutional capacities, and addresses socio-economic challenges. Recommendations are provided for policy improvements and strategic interventions aimed at fostering more effective natural resource conservation practices in Kabale. This study contributes to the broader discourse on sustainable development by offering actionable insights into optimizing legal and institutional mechanisms for resource management in similar contexts.
Young Adult Vulnerabilities in the Fiction of a Ugandan
(Global Research in Higher Education, 2022-03-08) Alice Jossy Kyobutungi Tumwesigye
Questions of identity, power, autonomy and vulnerability carry a particular weight in cultures that have emerged from colonialism. Although few writers of fiction focus on the conflicts between African and European characters, a focus on power and marginalisation remains. One category in which this focus may be plainly seen is writing for and about young people. The study’s aim was to analyse young adult fiction written by a Ugandan female author, Barbara Kimenye to investigate this writing to find out how young adult vulnerability is depicted in literature. Although literature targeting young people in Uganda has flourished and though issues of limited representation have been scrutinised in literary studies, like gender discrimination, very limited attention has been accorded young adult representation in literature. This research analyses fiction written by a female author Barbara Kimenye to expand knowledge about the criticism of young adult representation in literature with particular focus on young adult vulnerability in an adult dominated world. The methodology was mainly qualitative research design, where a document analysis method was used to aid analysis and make critical appreciation of the fictional works. The study investigated the state of young adult characters in literature with special focus on their vulnerability.
Negotiating Young Adulthood in Ugandan Literature: Identity in Kimenye’s Moses Series and Namukasa’s Stories
(East African Journal of Arts and Social Sciences, 2025-09-17) Alice Jossy Kyobutungi
This article examines the negotiation of young adulthood and identity formation in Ugandan literature through a close reading of Barbara Kimenye’s Moses series and Glaydah Namukasa’s short stories The Pact and Girlie. The study situates these works within broader African literary discourses on adolescence, transition, and socio-cultural belonging, with specific attention to the Ugandan postcolonial context. Drawing from postcolonial theory, youth studies, and identity construction frameworks, it interrogates how young protagonists navigate shifting roles, expectations, and self-concepts amidst the intersecting pressures of family, peers, education, and socio-economic change. Kimenye’s Moses series, set primarily in a Ugandan boarding school, portrays adolescence as a space of playful rebellion, communal bonding, and gradual moral negotiation. The protagonist, Moses, becomes a focal point for exploring the tensions between institutional authority and youthful agency, revealing how humour and camaraderie serve as tools for self-assertion and social learning. In contrast, Namukasa’s stories, set against contemporary urban and peri-urban backdrops, confront the challenges of girlhood and young womanhood, including issues of friendship, sexuality, betrayal, and socio-economic vulnerability. Through The Pact and Girlie, Namukasa foregrounds the gendered dimensions of young adulthood, showing how female protagonists navigate restrictive cultural scripts while asserting individual desires. By juxtaposing Kimenye’s light-hearted, male-centred narratives with Namukasa’s more intimate and gender-conscious portrayals, this article reveals how Ugandan children’s and young adult literature collectively engages with themes of resilience, negotiation, and identity-making. It argues that these works challenge linear, Western-centric models of adolescence by depicting it as a socially embedded, culturally mediated, and at times precarious process. The analysis highlights how language, narrative voice, and character agency reflect both continuity and change in Ugandan youth experiences. Ultimately, the study demonstrates that Kimenye and Namukasa contribute significantly to African literary representations of young adulthood, offering nuanced portraits that resist reductive categorisations. Their works not only document the lived realities of Ugandan youth but also invite critical reflection on how identity is actively shaped within complex socio-cultural and historical landscapes. This intersectional reading underscores the role of Ugandan literature in expanding global understandings of adolescence and identity beyond dominant Euro-American frameworks.
For the Young Adult, Autonomy is a Dream: Tracing the Power Dynamics in Ugandan Literature
(Sryahwa Publications, 2020-11-05) Alice Jossy Kyobutungi Tumwesigye
Age stereotype and its impact on literature is a factor that has not been sufficiently researched especially in Uganda. This article uses the postcolonial theory to reveal that the young adult demographic category is pushed to the periphery in literature as it is in life. It is part of a research done on representations of the young adult in the fiction of selected Ugandan women writers; where the third objective in the bigger study investigates the power dynamic in literature. The article is a projection of a documentary study that uses critical analysis to explore how young adult characters are denied power in literature. It proposes that since literature has had a positive effect on society by reducing marginality in other aspects, it can do the same in the aspect of young adult power. The study confirms that writers (who target the young adult audience) by portraying young adult characters positively are likely to eventually influence such readers by making them aware of their peripheral positions and subsequently contributing towards redressing the problem of age stereotype. The novel Voice of a Dream by Glydah Namukasa (2006) is the core of the analysis.
Rethinking Identity and Crisis: Representations of Young Adult Subjectivities in the Fiction of Selected Ugandan Women Writers
(International Journal of English Literature and Social Sciences., 2025-10-11) Alice Jossy Kyobutungi
This study, Rethinking Identity and Crisis: Representations of Young Adult Subjectivities in the Fiction of Selected Ugandan Women Writers, explores how Ugandan female authors negotiate identity, crisis, and selfhood through the lens of youth experience. Focusing on the works of Barbara Kimenye and Mary Karooro Okurut, this examination explores how these writers depict the evolving subjectivities of young adults within shifting sociocultural, political, and gendered contexts. The purpose is to investigate how young protagonists embody and contest tensions between tradition and modernity, individual freedom and communal obligation, and patriarchy and self-determination. Using textual and thematic analysis and drawing on postcolonial feminist and identity theories, the research interprets narrative strategies, character development, and themes of crisis and transformation. Close reading of selected novels reveals how gender, class, and cultural displacement intersect in the shaping of the perceptions of young adult characters. The findings show that both Kimenye and Okurut reimagine youth identity as a site of negotiation and resilience. Their narratives challenge colonial and patriarchal prescriptions of femininity and adulthood, portraying young adult characters who navigate inequality through resistance, self-assertion, and moral renewal. The study argues that crisis, rather than being destructive, becomes a generative force for redefining belonging, agency, and cultural continuity. Although limited to two authors, the research offers new insights into the symbolic economies of youth and gender in Ugandan literature. It contributes to African feminist criticism, Ugandan cultural studies, and youth identity scholarship by highlighting how women writers envision new forms of selfhood amid crisis and change.
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.
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.
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.

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