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The Uganda Martyrs University Institutional Repository (UMU-IR) preserves research output from the Uganda Martyrs University community
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Recent Submissions
Effect of rural trauma team development on the outcomes of motorcycle accident-related injuries (motor registry project): protocol for a multicenter cluster randomized controlled trial
(PubMed, National Library of Medicine, 2024) Lule, Herman; Mugerwa, Micheal; Ssebuufu, Robinson; Kyamanywa, Patrick; Bärnighausen, Till; Posti, Jussi P; Lowery Wilson, Michael
Background: Injury is a global health concern, and injury-related mortality disproportionately impacts low- and middle-income countries (LMICs). Compelling evidence from observational studies in high-income countries shows that trauma education programs, such as the Rural Trauma Team Development Course (RTTDC), increase clinician knowledge of injury care. There is a dearth of such evidence from controlled clinical trials to demonstrate the effect of the RTTDC on process and patient outcomes in LMICs.
Objective: This multicenter cluster randomized controlled clinical trial aims to examine the impact of the RTTDC on process and patient outcomes associated with motorcycle accident-related injuries in an African low-resource setting.
Methods: This is a 2-arm, parallel, multi-period, cluster randomized, controlled, clinical trial in Uganda, where rural trauma team development training is not routinely conducted. We will recruit regional referral hospitals and include patients with motorcycle accident-related injuries, interns, medical trainees, and road traffic law enforcement professionals. The intervention group (RTTDC) and control group (standard care) will include 3 hospitals each. The primary outcomes will be the interval from the accident to hospital admission and the interval from the referral decision to hospital discharge. The secondary outcomes will be all-cause mortality and morbidity associated with neurological and orthopedic injuries at 90 days after injury. All outcomes will be measured as final values. We will compare baseline characteristics and outcomes at both individual and cluster levels between the intervention and control groups. We will use mixed effects regression models to report any absolute or relative differences along with 95% CIs. We will perform subgroup analyses to evaluate and control confounding due to injury mechanisms and injury severity. We will establish a motorcycle trauma outcome (MOTOR) registry in consultation with community traffic police.
Results: The trial was approved on August 27, 2019. The actual recruitment of the first patient participant began on September 01, 2019. The last follow-up was on August 27, 2023. Posttrial care, including linkage to clinical, social support, and referral services, is to be completed by November 27, 2023. Data analyses will be performed in Spring 2024, and the results are expected to be published in Autumn 2024.
Conclusions: This trial will unveil how a locally contextualized rural trauma team development program impacts organizational efficiency in a continent challenged with limited infrastructure and human resources. Moreover, this trial will uncover how rural trauma team coordination impacts clinical outcomes, such as mortality and morbidity associated with neurological and orthopedic injuries, which are the key targets for strengthening trauma systems in LMICs where prehospital care is in the early stage. Our results could inform the design, implementation, and scalability of future rural trauma teams and trauma education programs in LMICs.
503 Trainee-led rural trauma teams impact clinical process and outcomes of neurological injuries: new insights from the motor cluster randomized trial
(BMJ Publishing Group Ltd, 2024) Lule, H; Mugerwa, M; Ssebuufu, R; Kyamanywa, P; Bärnighausen, T; Posti, JP; Wilson, ML
Background Strengthening capacity for rural trauma education is critical for sustainability of competent trauma care systems.
Objective To examine the effect of rural trauma development course (RTTDC) training and coordination on clinical process and outcomes of motorcycle-attributable neurological injuries in low-income Uganda. Methods Multi-center, two-armed parallel, multiperiod, cluster randomized motorcycle trauma outcome registry (MOTOR) trial. Six trauma centers were randomized to intervention (RTTDC plus standard care n=3) and control (standard care alone, n=3) in equal allocation, using permuted block sequence codes. Patients and outcome assessors were blinded. A motorcycle trauma outcome registry was executed in parallel in collaboration with community traffic police. Rural trauma care frontliners including traffic law enforcement professionals, surgery residents and medical trainees received the intervention. Prehospital and referral-discharge time intervals were primary outcomes whereas all cause 90-day mortality and morbidity of neurological injuries were secondary, all measured as final values. Mixed effects regression models and two-sample Wilcoxon rank-sum test were performed in Stata 15.0 to document differences in outcomes at 95% CI, regarding p<.05 as statistically significant. Pan African Clinical Trial Registry (PACTR202308851460352): Ethical approval from Uganda National Council for Science and Technology (Ref: SS 5082). Results For the 1003 trial participants, both prehospital and referral-discharge intervals were shorter in the intervention group by 1.13hrs (95% CI: 0.96–1.39) and 1.39hrs (95% CI: 1.23–1.55), respectively (p < .0001). Of the 887 participants whose follow-up was complete, 85.5% (758) had a favourable outcome with Glasgow outcome scale of (4–5). The proportions of participants with favourable outcome were higher in the intervention group 90.8% (415/457) compared to controls 79.8% (343/430), p < .0001. The 90-day mortality was 9.2% (82/887). The mortality was lower in the intervention 5.2% (24/457) compared to the control group 13.5% (58/430), p < .0001.
Conclusions Empowering rural health professionals through capacity training and coordinated trauma teams improved clinical process effectiveness and outcomes of time-dependent neurological injuries. These results could inform the design of future trauma teams in similar vulnerable rural environments.
Analysis of push and pull factors influencing the migration of Ugandan domestic workers to Saudi Arabia
(ERRCDF, Rethinking Education for Inclusive Development, 2024-02-21) Munyonyo Asiimwe, Florence; Musinguzi, Denis
The study explored the push and pull factors driving Ugandan domestic workers to migrate to Saudi Arabia. The research paradigm employed was social constructivism, where individuals seek to understand their world and develop meanings based on their experiences. A qualitative approach
using a phenomenological research design was utilised. Data was collected from a sample of eighteen (18) respondents through unstructured interviews to identify the factors contributing to the migration of Ugandan domestic workers to Saudi Arabia. Thematic analysis was conducted during data analysis. The migration factors were presented in concept maps created using Nvivo 10.0. The study uncovered that push factors varied from person to person, but major ones included poverty, unemployment, school dropout, family obligations, marital neglect, domestic violence, personal development goals, poor working conditions, work-related challenges, peer influence, and single parenting. Pull factors include the influence of Arabian family culture that promotes the demand for maids, bilateral labour agreements, adventure, attractive job prospects, free travel documents, cost-effective job processes, and an easy migration process. The study concluded that without effectively addressing push factors to provide long-term solutions, the migration of Ugandan domestic workers to Saudi Arabia will persist. It is recommended that the Government of Uganda take steps to create a conducive environment with satisfying employment opportunities for these young individuals to reduce the number of people seeking jobs outside Uganda. This involves generating employment opportunities to regulate internal domestic work and make it highly profitable, thereby encouraging young people to remain in Uganda.
Teamwork and employee performance in micro deposit institutions: a case of Finca Uganda Limited
(Academic Inn International, 2024-08-02) Wamani, Robinson Fabulous; Okello, Apollo; Kaggwa, Charles Richard
The purpose of the study was to determine the effect of teamwork on employee performance of FINCA in Kampala Uganda. The study was guided by the following specific objectives; i) to determine the effect of team spirit on employee performance in FINCA Uganda ii) to evaluate the effect of team trust on employee performance in FINCA Uganda and iii) to evaluate the effect of team leadership on employee performance in FINCA Uganda. With 45 respondents, the study used a cross-sectional design and included qualitative and quantitative methods. The results indicated that Team spirit has a positive significant association with Employee performance (r = 0.631; p<0.01). Whereas team trust exhibits a positive significant association with employee performance indicated by a correlation index of r =0.453; p<0.01 and team leadership has a positive significant association with Employee performance given a correlation index of r = 0.749; p<0.01 Similarly, results indicate Team spirit, team trust as well as team leadership exhibit positive contributions on employee performance of 14.7%, 10.1% and 60.8% respectively. On the overall, teamwork predicts 57.7% of positive variation on employee performance. According to the research's findings, when teams with clearly defined responsibilities are permitted to function, employees perform effectively, which is reflected in the effectiveness of the company as a whole. Additional results include
the fact that team spirit, team trust, and team leadership have all significantly improved employee performance. This indicates that each of these factors is a reliable indicator of worker performance. The following suggestions are made by the researcher; a condition when a group of people collectively depend on one another is called team spirit. The staff at FINCA Microfinance must put in place methods to build trust among team members; doing so will increase their operational capabilities, which will boost employee performance.
Fuelwood collection: does it matter for rural households’ labour force participation in the labour market
(Elsevier, 2024-04-25) Kaddu, Milly; Sseruyange, John; Senyonga, Livingstone; Musekese Wabukala, Benard; Watundu, Susan; Turyareebama, Muhammed
The study explores the effect of time spent collecting fuelwood on rural labour force participation in the labour market. We use the Uganda National Household Survey data (2019/20) and employee the instrumental variable profit model to address the potential selection bias associated with fuelwood collection and the joint decision making for fuelwood collection and labour market participation. We observe that rural labour force participation rate in paid activities is 25.34%, and a minute increase in time spent gathering fuelwood for home use reduces the odds of rural labour force participation in the labour market by 0.8%. However, fuelwood collection for market in Northern, Eastern and Western Uganda significantly increases the odds of labour force participation in the labour market. In addition, household income, sickness from inhaling fumes, cooking technology and marital status significantly increases the odds of rural labour force participation in the labour market. We recommend upscaling agro-forestry practices and improved cookstoves to facilitate rural livelihood sustenance in the short run. For the long- and medium-term employment sustainability, the government should plan for alternative income options for rural dwellers to augment their productivity and enroll them to the global sustainable supply chains.