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Recent Submissions
Community health system capacities and capabilities within an evolving community health policy framework: mixed methods study of stakeholders in central Uganda
(BMJ Journals, 2025-01-11) Kabanda, Richard; Ocaatre, Miria Ronald; Atwine, Diana; Kim, Bounggui; Waiswa, Erisa Simon; Kavuma, Denzel Prichard; Lee, Yeni; Mutoni, Loretah; Kim, Solyi; Park, Yein; Okuga, Monica; Tweheyo, Raymond
Empowering communities through identifying and unlocking community capacities and capabilities is vital for improving community health systems. This study assessed the community health system’s status quo and readiness for implementing a government-led, partner-supported community health worker project.
A mixed methods cross-sectional study.
Two districts and one city in central Uganda.
21 key informants (KIIs) with district leaders, 4 focus group discussions (FGDs) with community health workers (CHWs) termed as village health teams in the Ugandan setting and a survey of 487 CHWs and 419 pregnant women who had childbirth 12 months before.
KIIs and FGDs explored community health system resources using the WHO health systems building blocks and the UNICEF health system strengthening maturation model. However, the surveys explored the work-related attributes and services delivered by the CHWs and to the community, respectively.
A framework analysis was used for qualitative data in NVivo 14. While descriptive and stratified analyses were conducted for quantitative data in Stata I/C 15.0: proportions for the varied geographical entities were compared using the t-test with p values <0.05 considered significant, one-way ANOVA was used to compare means.
Overall, all sites had relatively strong governance of community health only challenged by multiple implementing partners that were weakly coordinated. There was an exclusive paper-based information management system that linked to the national DHIS-2 software. Community reporting rates varied between 20% and 80%. Community health financing was weak, similarly to commodities availability. The mean age of the community health workforce was high at 50.9 (SD 11.9); the majority reported adequate skills in service delivery except for community first aid, Kangaroo mother care and noncommunicable diseases. Households’ most received CHW services included home visits, treatment for sick under-five children and child immunisation.
The existing CHW system has governance and reporting strengths but could be enhanced through revitalization, enhanced coordination of stakeholders, providing appropriate training, work tools, supervision and engaging the community for accountability of results.
Mental health in low-income countries: a call to improve mental health in Uganda
(PLOS, 2025-04-30) Omona, Kizito; Bashabire, Barungi Mponye Nice; Bulamu, Ritah; Mugabe, Bernadine; Balamaga, Ssanyu Samuel; Akurut, Enyipu Betty
The World Health Organization defines mental health as a state of mental wellbeing
that enables people to cope with the stresses of life, realize their abilities, learn
well and work well, and contribute to their community [1]. It is an integral component
of our general health that underpins our individual and collective abilities to make
decisions, build relationships and shape the world we live in –and yet it remains a
low priority in many low-income countries. Uganda, like many sub-Saharan African
countries, faces significant challenges in addressing mental health concerns. The
burden of mental illness is exacerbated by poverty, conflict, and a lack of awareness.
Supporting and managing the wellbeing of people is faced with numerous challenges,
especially for those who already face a variety of hurdles or difficulties. For example,
Mugisha, Bantu & Nakalema [2] explored the mental health impact on parents raising
children with Autism Spectrum Disorder (ASD) in Uganda. They highlighted stigma,
economic hardship, and lack of mental health support services as key factors exacerbating
mental health struggles. The results revealed very high levels of stress and
stigma among parents and experiences of financial difficulties, marital conflicts, and
psychological strain resulting from societal discrimination were common. Parents
reported experiencing feelings of shame, embarrassment, and hopelessness, exacerbated
by societal misconceptions and the lack of support systems. The prevalence of
anxiety symptoms among parents (45.9%) surpassed previous estimates, indicating
a significant mental health burden within this population. Another study examined
the intersection of mental health and HIV/AIDS in Uganda and emphasized again,
how financial stress, social stigma, and lack of resources all hinder mental well-being
within this community [3]. This echoes findings in many other similar studies [4,5].
In this Opinion, we aim to provide an overview of the state of mental health in
Uganda, assess existing policies and challenges, and offer possible solutions.
Management practices of primary postpartum hemorrhage among traditional birth attendants: a qualitative survey, Iganga, Uganda
(National Institutes of Health, 2025-12) Namasambi, Sharon; Omona, Kizito
Postpartum hemorrhage is a significant barrier to the achievement of Sustainable development goal 3.1, given that
it is associated with more than a quarter of all maternal mortality cases. Traditional birth attendants (TBAs), who are outlawed in
many countries, including Uganda inclusive, attend to about 33% of all births globally. The objective of this study was to explore
the management practices of primary postpartum hemorrhage among traditional birth attendants in Iganga district.
The study used a case phenomenological qualitative exploratory design, targeting traditional birth attendants. Snow
balling was used to select participants and engage them in-depth interviews. Data collected was analyzed thematically, with the
induction approach.
It was found that TBAs carried out PPH assessment using three methods; quantification of blood lost using household
cups, vital assessment and visual assessment. Visual assessment was the most dominant. Postpartum hemorrhage resuscitation
practices mainly rotated around the use of warm water. They did not carry resuscitation. The treatment interventions used were:
use of herbal medicine and referral of severe cases to hospital.
TBAs in Iganga district visually assess postpartum hemorrhage but they do not conduct resuscitation procedures.
They use herbal uterotonics in the treatment of postpartum hemorrhage alongside with referral to hospital.
Perceived stress variations in relation to gender, year of study, and employment status of teacher-trainees in selected universities in Central Region, Uganda
(East African Nature & Science Organization, 2025-12-04) Atwikirize, Agrace
Transition from high school to university comes with challenges and opportunities that are stressful to the teacher-trainees. The study aimed to establish whether variations of stress existed between gender, year of study, and employment status of teacher-trainees in universities in the Central Region, Uganda. This cross-sectional quantitative study adopted a stratified sampling strategy to select programmes and simple random sampling to select participants using random numbers. Data were collected from 554teacher-trainees using a self-administered questionnaire and analysed using means, t-tests, and ANOVA. The findings revealed that although both male and female teacher-trainees experienced stress, females (mean=2.31) presented a slightly higher level thanmales (mean=2.30). The findings further revealed that stress increased as one moved to years two and three. The year two mean scores were slightly higher (mean=2.39), followed by those in year three (mean = 2.38) and lastly by year one (mean=2.17), and the observed F=11.57 had a highly significant level of (p=0.000<0.05). Additionally, working teacher-trainees experienced higher stress levels as indicated by a slightly higher (mean = 2.80) compared to their non-working peers (mean =2.31). The findings further revealed a negative students’ t-test (-0.524) and the level of significance (p=0.875 >0.05). Thus, university managers should provide an enabling environment, create awareness regularly about mental health through counselling. Universities should also create a supportive environment and activities that can help student to achieve their academic goals. A work-study scheme can be adopted to help needy students work and study from the same institution.
Assessment of learning environment and its impact on teaching and learning process of students in secondary schools in Mpigi District, Uganda
(African Journals Online (AJOL), 2025-10-28) Kibirige, Raymond; Lutalo, Bernard
The purpose of the study was to examine the assessment of the learning environment and its impact on the teaching and learning process of students in secondary schools in the Mpigi district of central Uganda. Based on systems theory, the study adopted a cross-sectional survey research design. The study involved 15 secondary schools in the Mpigi district, whereby5 secondary schools were purposively sampled to participate in the study because the schools had a better learning environment; however, stakeholders complain about their teaching and learning process. The study used a purposive sampling technique to choose 5 headteachers, 5directors of studies, 44 teachers, and 64 students to participate in the study. Interviews, focused group discussions, and observation guides were used for data collection. Qualitative data was analyzed thematically. The study concluded that learning environment resources are inadequate in Mpigi secondary schools; however, the few available resources are effectively used by teachers and students. The teaching and learning process of students in secondary schools of the Mpigi district is below the expectations of the stakeholders. Learning environments positively impact the teaching and learning process of students in Mpigi district secondary schools. The study recommended that the government of Uganda should aid secondary schools with adequate learning environment resources to improve on the teaching and learning process of students. School administrators should organize training sessions and workshops for the teachers to equip them with skills and knowledge required to use the available learning environment resources in order to elevate the teaching and learning process of students in schools.