Journal Articles (Science)

Permanent URI for this collectionhttp://hdl.handle.net/20.500.12280/240

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Palliative Care in Uganda: Quantitative Descriptive Study of Key Palliative Care Indicators 2018-2020
(BMC - Springer Nature, 2022-04-22) Kagarmanova, Ainur; Mwesiga, Mark Donald; Sisk, Matthew L.; Kabagambe, Cynthia; Nyakaisiki, Sheba; Marentette, Tom; Ahern, Lacey N.
The frst and most recent nationwide audit of palliative care services in Uganda was conducted in 2009. Since then, Uganda has made great strides in palliative care development, including policy, education, and services implementation. This study provides an overview of the availability of palliative care services in the country and the challenges and gaps in Uganda prior to the global COVID-19 pandemic. This lays the foundation for better understanding the challenges and changes needed to support palliative care development and access in the wake of the pandemic. We conducted a descriptive quantitative study of secondary data on nationwide morphine distribution, collated a list of accredited facilities, and analyzed key palliative care indicators collected through the mHealth surveillance project present at a subset of accredited facilities. Descriptive statistical analysis involved non-parametric tests using SPSS, mapping geographical distribution of available palliative care services using Geographic Information Systems software, and identifcation of challenges from the subset of accredited facilities. Results: There were 226 accredited palliative care facilities across Uganda’s 135 districts in 2020. Thirty districts lacked any accredited palliative care facility. The estimated population coverage was 88.5%. The majority (68.1%) of accredited facilities were public, and private facilities received slightly more pain-relieving morphine. There was an alternating trend in the volumes of morphine delivered to public and private facilities. More than a third of the patients were diagnosed with non-communicable diseases, highlighting their signifcance alongside cancer and HIV/AIDS as conditions requiring palliative care. Palliative care accredited facilities ofered six types of services: outreach, home visits, psychosocial, legal, bereavement, and spiritual support, but only for an average of 7 months a year due to lack of facilitation and transportation. Palliative care in Uganda developed in quality, volume, and geographic coverage since 2009. The shift in palliative care patients’ primary diagnosis from HIV/AIDS to non-communicable diseases marks an important epidemiologic transition. Although accredited facilities are present in most administrative districts, more research is needed to evaluate the actual accessibility of these services. The existing services, both private and public, are limited by the amount of pain-relieving morphine, fnancial and transport resources. More quality data collected on key palliative
Changing Income Portfolios and Household Welfare in Rural Uganda
(Routledge Taylor and Francis, 2021-06-17) Kakungulu, Moses; Isabirye, Moses; Akoyi, Kevin Teopista; Hoyweghen, Kaat Van; Vranken, Liesbet; Maertens, Miet
This paper provides evidence on the heterogeneous welfare implications of rural income portfolios in eastern Uganda. We use household survey data from two-panel rounds, and fixed and random effects estimation and quantile regressions to estimate average and heterogeneous effects. While the literature mostly focuses on either income diversification or participation in non-farm activities, we distinguish between income diversification, using the Simpson Index, and off-farm income generation. We use ex-post income and poverty measures as well as an ex-ante vulnerability measure to analyse welfare effects. We find that income diversification and non-farm income generation improve household income, and reduce poverty and vulnerability. We find that it is most beneficial for poorer households with less land assets to diversify their income portfolio, while moving out of agriculture is equally beneficial at all income levels and most beneficial for households with more human capital. We find that income diversification reduces vulnerability most strongly at high levels of diversification and low levels of income while non-farm income generation reduces vulnerability at lower levels of non-farm income and increases vulnerability at higher levels of non-farm income. Our results lead to nuanced findings that bring additional insights in the literature on structural transformation and rural development.
Improving Financial Service Delivery to Communities Through Micro-finance Institutions in Uganda :
(Journal of Science & Sustainable Development, 2017-06-01) Wamema, Joseph; Othieno, Joseph
This study examined the design of a target Enterprise Architecture (EA) that can enable Micro-finance Institutions (MFIs) in Uganda improve financial service delivery to communities through use of Information and Communication Technologies (ICTs). Pride Micro-finance Limited (PML) was investigated with specific focus on their mission and goals, business processes, information/data, applications, actors, and technological infrastructure. Data was collected from two branches of PML using questionnaires, observation and document reviews. This data was analysed qualitatively and the results of the analysis indicated that PML faces a number of challenges in financial service delivery; like inability to reach out to its customers in a cost effective manner, inefficient ways of processing customer information, and data/information security risks. Based on findings from this study, a target EA capable of enabling PML reach out to its customers in a more sustainable, efficient, and effective manner was designed and recommendations for its implementation made.
Identifying patterns in urban housing density in developing countries using convolutional networks and satellite imagery
(Elsevier Ltd., 2020) Sanya, Rahman; Mwebaze, Ernest
The use of Deep Neural Networks for remote sensing scene image analysis is growing fast. Despite this, data sets on developing countries are conspicuously absent in the public domain for benchmarking machine learning algorithms, rendering existing data sets unrepresentative. Secondly, current literature uses low-level semantic scene image class definitions, which may not have many relevant applications in certain domains. To examine these problems, we applied Convolutional Neural Networks (CNN) to high-level scene image classification for identifying patterns in urban housing density in a developing country setting. An end-to-end model training workflow is proposed for this purpose. A method for quantifying spatial extent of urban housing classes which gives insight into settlement patterns is also proposed. The method consists of computing the ratio between area covered by a given housing class and total area occupied by all classes. In the current work this method is implemented based on grid count, whereby the number of predicted grids for one housing class is divided by the total grid count for all classes. Results from the proposed method were validated against building density data computed on Open- StreetMap data. Our results for scene image classification are comparable to current state-of-the-art, despite focusing only on most difficult classes in those works. We also contribute a new satellite scene image data set that captures some general characteristics of urban housing in developing countries. The data set has similar but also some distinct attributes to existing data sets.
Temporal relationship between attitude toward mathematics and mathematics achievement
(Taylor & Francis Group, 2020-11-13) Kiwanuka, Henry Nsubuga; Damme, Jan Van; Noortgate, Wim Van den; Reynolds, Chandra
This study examined the temporal relationship between attitude toward mathematics and mathematics achievement among first year secondary (i.e. middle) school students (grade 7, about 14–15 years) with a focus on sex differences in Central Uganda. Random intercept cross lagged panel models, based on structural equation modeling, were used to analyze data which were collected through students’ questionnaires and mathematics tests at three measurement points. The proportion of variance at the class and school level was larger for the achievement measures than for the attitude measures. At these two levels, also the correlation coefficients between the two constructs were higher for boys than for girls. The study found evidence in support of the reciprocal-effects model as the best-fitting structural model within and across both sexes. Between the first and second measurement points, there was evidence for the self-enhancement model (attitude influencing achievement), while between the second and third points, the skill-development model (achievement influencing attitude) was supported.
Factors that Influence Potential Success of eHealth Standards Adoption in a Low- and Middle-Income Country: a review
(Journal of Health Informatics in Africa, 2020) Alunyu Egwar, Andrew; Wamema, Joseph; Kiwanuka, Achilles; Bagyendera, Moses
Assessing the potential success of adopted technology, innovation, or standard in a Low and Middle-Income Country like Uganda continues to focus on outcomes of adoption. This study aimed to investigate the potential success of eHealth standards adoption that may arise from the adoption process as well as outcomes of such adoption. PubMed and Google Scholar were searched using alternate terms for “eHealth”, “standards”, “adoption” “success” and “theory”. On screening and assessing the quality of publications, only nineteen peer-reviewed publications were included in the review. Both quantitative and qualitative analysis was used to synthesize evidence from the included literature. Thematic analysis was used to develop themes regarding the success of standards/technology adoption. Results: Constructs from the theories of Diffusion of Innovation Theory (DOI), Unified Theory of Acceptance and Use of Technology (UTAUT), and Internet Standards Adoption (ISA) were used to extend the Success Model of Innovation Adoption. The Success Model for Innovation contributed to the foundational concepts aligned to categorical factors of the adoption process, organizational, environment, and user context that influence the potential success of eHealth standards adoption in healthcare systems. The study identified 13 factors that contribute to the successful adoption of standards for eHealth. Since the review showed that success of standards adoption starts with assessing readiness to adopt the standards, followed by the standards adoption process and assessment of the lasting outcomes, the study proposes a model for assessing the potential success of eHealth standards adoption. The model has pre-adoption, actual adoption, and post-adoption phases. The proposed model and identified factors have not been evaluated and therefore may not in the current form support eHealth standards adoption processes. Future work is needed to evaluate/validate the model and factors of eHealth standards adoption success. Notwithstanding, the study believes any assessment of the success of standards adoption that uses the identified factors over all three phases of the model is comprehensive to present a true picture of any potential success of standards adoption.
Household determinants of food security in rural Central Uganda
(Academic Journals, 2020-09) Semazzi, John Baptist; Kakungulu, Moses
Food security is at the center stage in the world’s economic development debate. This concern is due to the fact that the world’s population is increasing very fast and is expected to reach 9.8 billion by the year 2050 (DESA, 2017). This will increase pressures on the environment, global food supplies and energy resources. In her article, “Food Insecurity and Food Stamp Program”, Jensen (2002) reports that, in the face of abundant supplies of food worldwide, nearly 800 million people suffered from malnutrition and undernourishment. Most of these undernourished live in low income countries. According to 2014 national population and housing census (UNHS) results, annual population growth rate between 2002 and 2014 censuses was 3.03% (UBOS, 2018). This rapid population growth will lead to acute land constraints and accelerated land degradation if not controlled. Land degradation due to deforestation, and the rapid conversion of natural vegetation into arable lands, exposing big areas to sheet erosion and reducing their productivity happens to be a threat. This problem is partly attributed to the poorly defined land ownership rights (National Environment Management Authority - NEMA, 2016). Declining soil fertility means farmers are experiencing less yields with lower value and less nutrient intensive crops. In addition, land use affects the land available for food production. For example, mining, urbanization and industrialization affect land available for food production leading to food insecurity. Use of land for cash crops also reduces land available for food production. Rural – Urban migration reduces labor available for cultivation hence decreasing food production. The overall goal of the Uganda food and nutrition Policy
A Mathematical Model Approach for Prevention and Intervention Measures of the COVID–19 Pandemic in Uganda
(Cold Spring Habour Laboratory, 2020-05-11) Mbabazi, Fulgensia Kamugisha; Gavamukulya, Yahaya; Awichi, Richard; Olupot–Olupot, Peter; Rwahwire, Samson; Biira, Saphina; Luboobi, Livingstone S.
The human–infecting corona virus disease (COVID–19) caused by the novel severe acute respiratory syndrome corona virus 2 (SARS–CoV–2) was declared a global pandemic on March 11th, 2020. Current human deaths due to the infection have raised the threat globally with only 1 African country free of Virus (Lesotho) as of May 6th, 2020. Different countries have adopted different interventions at different stages of the outbreak, with social distancing being the first option while lock down the preferred option for flattening the curve at the peak of the pandemic. Lock down is aimed at adherence to social distancing, preserve the health system and improve survival. We propose a Susceptible–Exposed–Infected–Expected recoveries (SEIR) mathematical model to study the impact of a variety of prevention and control strategies Uganda has applied since the eruption of the pandemic in the country. We analyze the model using available data to find the infection–free, endemic/infection steady states and the basic reproduction number. In addition, a sensitivity analysis done shows that the transmission rate and the rate at which persons acquire the virus, have a positive influence on the basic reproduction number. On other hand the rate of evacuation by rescue ambulance greatly reduces the reproduction number. The results have potential to inform the impact and effect of early strict interventions including lock down in resource limited settings and social distancing.
A content analysis of the Ghana national health insurance scheme
(Uganda Martyrs University Press, 2009-04) Lem, Robert Bella Kuganab
Several African countries are contemplating the introduction of national health insurance and a few have already started implementing. It is a popular understanding among these countries that by moving away from fee-for-service to a system like national health insurance, the poor and marginalised who are most often the sickest will be protected. The issue of National Health Insurance (NHI) as an alternative health financing system was a popular option in Ghana. However, the desire for NHI and its popularity was not determined by a critical look at the technicalities involved in setting up such a system. Attention was not paid to the fact that the implementation of national health insurance is constrained by a country's economic, social and political context and the inherent technical limitations of health insurance. To determine feasibility in the context of existing constraints, detailed work ought to have been done on the administrative capacity available to technically design the scheme, manage the process and thereafter manage the schemes. Earnings especially of the informal sector, the collection of contributions and the existing health care infrastructure and the commitment and incentives for health providers to make such a complex system work needed equal attention. Careful assessment is critical in producing a policy that is not only desirable but also feasible. It is apparent that the reasoning behind the Ghana Scheme was more towards a general look at risk pooling and providing access by reducing the individual financial burden than a close look at cost containment, efficiency and sustainability.
Conceptual modeling of nodding syndrome: A system dynamics and sequence approaches
(Journal of African Interdisciplinary Studies, 2018) Ongaya, Kizito; Ssemaluulu, Paul Mukasa; Oyo, Benedict; Bongomin, Pido
Conceptual modelling of nodding syndrome (NS) has hardly been considered in most scientific literature although symptoms of the disease have been widely studied. A conceptual model is a representation of hypothesis about a system under investigation and enables a comparison between hypothesis and data. Since nodding syndrome is an unexplained neurological illness that mainly affects children aged between 5 to 15 years, without specific diagnosis and treatment, the aetiology remains unknown and under investigation, conceptual modelling may be a crucial ingredient in understanding the disease. The purpose of the study is therefore, to represent nodding syndrome occurrence and immune-pathogenic pathways in the causation of nodding syndrome using system dynamics approaches. We have used systematic review method to filter literature on nodding syndrome from the year. We also used Systems Dynamic Approach and we emphasized confirmed scientific investigation to enable the relationships conform to reality. Vensim software was preferred for implementation of the casual-loop diagrams. Microsoft Office Visio 2007 was identified as suitable for implementation of the sequence conceptual model of nodding syndrome for its ability to show interactions between electrolytes and other actors. Our findings were that system dynamics approach has not been used research of nodding syndrome. More so, conceptual modeling was not considered by most articles.
Development and validation of a model for tracking administration of malaria drugs in Uganda
(Global Journal of Engineering Science and Researches, 2019-06) Ssegawa E. James, E. James; Ssemaluulu, Paul Mukasa; Gonzales, Vicente; Businge, Phelix Mbabazi; Kareyo, Margret; Kimwise, Alone
The aim of this study was to develop and validate a model for Integration of ICT in Tracking Administration of Malaria Drugs in Uganda for both health workers and health units. A descriptive and correlational research design were used. Descriptive statistics was used during data analysis, analytical approach was used for model development, and model validation employed experts’ knowledge technique. Findings: Model variables revealed strong and positive relationships, Controls, Intention and Actual use of ICT was weak. The controls strongly impacted ICT Integration, Intension and Actual Use of ICTs. Conclusion: model is communicative, relevant to the operations, understandable, adequate for tracking issues, improves rates of execution of malaria drugs information needs, cheap, accurate, reduces operational costs, worth adoption, and model positively support clinical activities.
Modeling the within-host co-infection of influenza A virus and pneumococcus
(Elsevier, 2018-08-15) Kamugisha Mbabazi, Fulgensia; Mugisha, J.Y.T.; Kimathi, M.
In this paper a nonlinear mathematical model for a within-host co-infection of influenza A virus and pneumococcus is investigated. Conditions that explain the relations amid RIP and its relationship to the global asymptotic stability of the infection-free steady state are discussed. A graph-theoretic method shows that, the unique endemic steady state is globally asymptotically stable. The sensitivity analysis show that, the pathogen fitness for pneumococcus and influenza A virus are most sensitive to maximum number of bacteria an alveolar macrophage can catch, phagocytosis rate, number of infectious IAV and pneumococcus particles liberated from lysis of infected cells and infection rates of influenza A virus and pneumococcal. Numerical results of the model show that, there exists a biologically important steady state where the two infectious pathogens of unequal strength co-exist and replace each other in the epithelial cell population (with pneumococcus leading) when the pathogen fitness for each infection exceeds unity, and we find that this endemic steady state is globally asymptotically stable. Further, the impact of influenza A virus on pneumococcus and vice-visa leads to a bifurcation state.
Hopf-Bifurcation Analysis of Pneumococcal Pneumonia with Time Delays
(Hindawi, 2019-02-03) Kamugisha Mbabazi, Fulgensia; Mugisha, Joseph Y. T.; Kimathi, Mark
In this paper, a mathematical model of pneumococcal pneumonia with time delays is proposed. The stability theory of delay differential equations is used to analyze the model. The results show that the disease-free equilibrium is asymptotically stable if the control reproduction ratio Ro is less than unity and unstable otherwise. The stability of equilibria with delays shows that the endemic equilibrium is locally stable without delays and stable if the delays are under conditions. The existence of Hopf-bifurcation is investigated and transversality conditions are proved. The model results suggest that, as the respective delays exceed some critical value past the endemic equilibrium, the system loses stability through the process of local birth or death of oscillations. Further, a decrease or an increase in the delays leads to asymptotic stability or instability of the endemic equilibrium, respectively. The analytical results are supported by numerical simulations.
On Spatial Dependence in Multivariate Singular Spectrum Analysis
(2016) Awichi, Richard
In this paper, I present a method for utilizing the usually intrinsic spatial information in spatial data sets to improve the quality of temporal predictions within the framework of singular spectrum analysis (SSA) techniques. The SSA-based techniques constitute a model free approach to time series analysis and ordinarily, SSA can be applied to any time series with a notable structure. Indeed, it has a wide area of application including social sciences, medical sciences, finance, environmental sciences, mathematics, dynamical systems and economics. SSA has two broad aims: i) To make a decomposition of the original series into a sum of a small number of independent and interpretable components such as a slowly varying trend, oscillatory components and a structure-less noise. ii) To reconstruct the decomposed series for further analysis in the absence of the noise component. Multivariate singular spectrum analysis (MSSA) is an extension of SSA to multivariate statistics and takes advantage of the delay procedure to obtain a similar formulation as SSA though with larger matrices for multivariate data. In situations where spatial data is an important focus of investigation, it is not uncommon to have attributes whose values change with space and time and an accurate prediction is thus important. The usual question asked is whether the intrinsic location parameters in spatial data can improve data analysis of such data sets. The proposed method is based on the inverse distance technique and is exemplified on climate data from Upper Austria for the period Jan 1994 to Dec 2009. Results show that the proposed technique of incorporating spatial dependence into MSSA analysis leads to improved quality of statistical inference.
Conceptual Modeling of Nodding Syndrome: A System Dynamics and Sequence Approaches
(2017) Ssemalulu, Paul; Oyo, Benedict; Bongomin, Pido; Ongaya, Kizito
Conceptual modelling of nodding syndrome (NS) has hardly been considered in most scientific literature although symptoms of the disease has been widely studied. A conceptual model is a representation of hypothesis about a system under investigation and enables a comparison between hypothesis and data. Since nodding syndrome is an unexplained neurological illness that mainly affects children aged between 5 to 15 years, without specific diagnosis and treatment, the aetiology remains unknown and under investigation, conceptual modelling may be a crucial ingredient in understanding the disease. The purpose of the study is therefore, to represent nodding syndrome occurrence and immune-pathogenic pathways in the causation of nodding syndrome using system dynamics approaches. We have used systematic review method to filter literature on nodding syndrome from the year. We also used Systems Dynamic Approach and we emphasized confirmed scientific investigation to enable the relationships conform to reality. Vensim software was preferred for implementation of the casual-loop diagrams. Microsoft Office Visio 2007 was identified as suitable for implementation of the sequence conceptual model of nodding syndrome for its ability to show interactions between electrolytes and other actors. Findings: Our findings were that system dynamics approach has not been used research of nodding syndrome. More so, conceptual modeling were not considered by most articles.
Diversity in Security Environments: The Why and the Wherefore
(Uganda Martyrs University, 2014) Ssembatya, Richard; Kayem, Anne V. D. M.; Burke, Mark-John
Information security is generally discussed in terms of preventing adversarial access to applications and to the data these applications handle. The authors note, however, that increasingly, creating information security solutions that are based on the difficulty of discovering the solution is no longer a truly viable approach. Some of the reasons for this include the increasing availability of faster processing power, high-performance computing systems, and big data availability. On the opposite end, issues such as frequent power outages in resource-constrained environments make applying standard security schemes challenging. In this chapter, the authors discuss examples that highlight the challenges of applying conventional security solutions to constrained resource environments. They postulate that effective security solutions for these environments require rather unconventional approaches to security-solution design. Such solutions would need to take into consideration environmental and behavioral factors in addition to drawing inspiration in certain cases from natural or biological processes.
The STOF model and a development-oriented mobile innovation
(International Conference on Mobile Business, 2012) Nyakaisiki, Sheba
Service innovations in modern economies are driven by the need to gain competitive advantage, technology advancements, market demand and organizational innovation. Uniquely, the need for social development presents opportunities for service innovations in developing nations, particularly in the delivery of social services. The thriving mobile industry in the continent provides new possibilities for development practitioners to design services that might fill gaps in social service delivery for poor communities. The challenge facing development-oriented innovations is sustainability. Sustainability is attained through continuous value generation for users and service owner(s). Proposals to developers of these innovations have therefore focused on business model application and evaluations to ascertain their ability to generate value. The complexity however of service innovation in the modern mobile industry requires a unique perspective of service design and evaluation. This paper introduces the STOF model, a business model framework for mobile service innovations in modern economies to an existing development-oriented service innovation in Uganda. The framework uses the model’s four domains (Service, Technology, Organization and Finance) and their relational Critical Success Factors (CSF), to define and evaluate the innovation. These CSF were defined from web publications on the innovation. The evaluation discovered that some of the CSF, due to poor design and strategic decisions, where poorly defined and formulated, which in turn caused an imbalance in the overall business model and therefore value generation. Keywords: STOF model, Service Innovation, Sustainability
Improving Financial Service Delivery to Communities through Micro-finance Institutions in Uganda; the case of Pride Micro-finance Limited (PML)
(African Journals Online, 2017) Wamema, Joseph; Othieno, Joseph
Security Analysis of Remote Tower Control
(University of Trento, 2015) Musanje Kasozi, Joseph Brian; Male, Henry Kenneth
The main target of the analysis is the Remote Tower control center. This will provide Air traffic control services for more than one airport by a single operator in a remote location therefore eliminating an individual control tower located on the individual airport premises. The Remote tower is expected to offer a full range of air traffic services such that the airspace users are not negatively impacted compared to the traditional local control tower. Furthermore, the analysis focuses on the Identity & access management, web application & database, networking and infrastructure. In order to analyse the threats and risks of the remote tower control center, the following assumptions were considered. ● All the already existing features ,services and systems etc are secured ● All the new features, services and systems need to be secured ● There is also some channel of communication between the Remote tower and the airport ● The new features are compatible with the current airport system In identity and access management, some of the main identified assets included, domain naming service, directory service, information server and out of the window system. these assets can be affected by the unauthorised access to data by employees and denial of service attack launched by an attacker or malicious employee. The proposed controls to these threats include installation of intrusion detection systems and segregation of duties For web application and database security, system identification information, encryption and decryption service and the network configurations were considered to be the main assets. These assets face crosssite scripting and SQL injections as some of the main threats. These threats could be mitigated or eliminated by integration of the database server into the security gateway and eliminating flaws Routers and switches, remote tower control communication and operating systems were the main assets identified in the networking and infrastructure. All these assets are faced by a risk, loss and destruction of infrastructure which can be brought about by malicious employees or hackers manipulating management parameters, however these threats can be controlled by installation of firewalls, setting up security policies and installation of electronic access control systems.
Privacy and Digital Technologies: E-Dossier
(Università degli Studi di Trento, 2014-06) Musanje Kasozi, Joseph Brian
Privacy has been a key issue that needs to be addressed in the digital era. With development of digital technologies now information is shared so easily and fast. The rise of online giants like Google who collect personal information has also affected the privacy even more. This paper shows how privacy was conceived before the digital technology and how its conceived today in the digital era where every online user has a clone of him or her stored on a server. This clone will be referred to as an Electronic dossier throughout this paper. Privacy laws were put in place to see that privacy can be maintained even when using digital technologies but this hasn’t been enough and therefore the paper suggests some more alternatives than can be done by user in order to keep their privacy right.

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