Browsing by Author "Ronald, Bahati"

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ART Uptake Among HIV Positive Adolescents
(Research Square, 2020) Sandra, Akankunda; Sandra, Tayebwa; Benjamen, Byamugisha; Sabastian, Ariho; Ronald, Bahati; Josephine, Najjuma
Background: Globally about 1.7 million adolescents between the ages of 10 and 19 were living with HIV in 2019, of these, about 1.5 million were living in sub-Saharan Africa and approximately above 127,000 were living in Uganda. However uptake of ART is still low among adolescents especially in low income countries due to lack of information they need to understand HIV and its management.
Association between stigma and depression among urban refugees in Mbarara Municipality, Southwestern Uganda
(Research Square, 2018) Ronald, Bahati; Herbert Elvis, Ainamani; Cathy Denise, Sigmund; Godfrey Zari, Rukundo
Background: More than half of the world’s refugees reside in non-camp settings, including urban areas. Refugees in urban areas often face acculturation challenges, stigma, overcoming stereotypes, and living in fear of being repatriated. Depression is one of the most frequent mental disorders experienced by refugee populations as a result of such challenges. In Uganda, the prevalence of mental disorders among urban refugees in general remains unknown and there is little epidemiological data to inform practice and policy in relation to the refugees’ mental health needs in urban areas. The aim of the present study was to examine the association between stigma and depression among urban refugees. Methods: Using snowball sampling method, we conducted a descriptive cross-sectional study among 343 refugees residing in Mbarara Municipality, Southwestern Uganda. The Discrimination and Stigma Scale and the Patient Health Questionnaire were used to assess stigma and depression respectively. Using SPSS, means, standard deviations and ranges were calculated to determine the prevalence of stigma and depression. Multiple regression analysis was used to examine the associations between stigma and depression. Results: Participants in our study experienced high levels of enacted stigma (n=293, 85%) and internalized stigma (n=239, 70%). Most of the participants experienced both internalized and enacted stigma (n=288, 84%). The overall prevalence of depression was 96% (n=329) of which 16% (n=53) was mild, 17% (n=59) was moderate, 41% (n=141) was moderately severe and 22% (n=76) was severe depression. There was a significant positive correlation between stigma and depression (β= 0.37, p<.001). Conclusions: Urban refugees experience high levels of both enacted and internalized stigma. There is a strong association between stigma and depression. Interventions aimed at reducing stigma could subsequently reduce depression among refugees living in urban areas. Background There is an increasing number of refugees who are choosing to settle in urban centers rather than refugee settlements, even when this leaves them without access to UNHCR support (1). The urban 2 refugees are a largely ‘hidden’ population, and little is known about their numbers, profiles, status, location and livelihoods (2). The main factors pushing refugees from camps include security threats, limited livelihood opportunities, harsh climatic conditions and violence in the camps, often related to tensions between different clans, ethnic and political groups (Pavanello, Elhawary, & Pantuliano, 2018). In Uganda, the refugee policy gives them (refugees) ‘freedom of movement’, ‘gainful employment’, and ‘treatment without discrimination nor stigmatization (4). This policy makes it easy for refugees to quit camps and settle in any part of the country including towns. Refugees in urban areas often face challenges of insufficient disposable income, housing, feeding and daily utilities. In addition, they face acculturation challenges, stigma, overcoming stereotypes, and living in fear of being repatriated (5). Furthermore, they commonly experience migration stress and trauma, loss of homes and livelihoods, violence, torture, and family separation (6). As such, it is no surprise that the prevalence of stigma, depression and post-traumatic stress disorder (PTSD), continue to be high among refugee populations (Baranik, Hurst, & Eby, 2018, Close et al., 2016). Stigma has been associated with poor health outcomes of refugees (9). It is characterized by cognitive, emotional, and behavioral components often conceptualized as internalized or enacted stigma affecting a particular trait, among individuals (10). Enacted stigma is the negative attitudes held by members of the public about devalued people whereas self-stigma occurs when people internalize those public attitudes and suffer numerous negative consequences as a result (11). Refugee status is a highly stigmatized driver which affects the health seeking behaviour of forcibly displaced populations (12). Lindert, Ehrenstein, Priebe, Mielck, & Brähler, (2009) reported stigma to be associated with higher levels of depression 44% in first generation Iraqi refugees in Canada compared to estimates of prevalence in the general population reported to be between 8 and 12% (8). Depression is a mood disorder that involves a persistent feeling of sadness and loss of interest. It is one of the most frequent mental disorders experienced by refugee populations as a result of war and living difficulties after migration (14). Negative mental health consequences are more common among refugees as a result of war and living difficulties after migration; however, there is a small body of research that has investigated the 3 stigma of being a refugee as an essential risk factor for the development of mental health problems in post-conflict societies, especially depression (15). Our study aimed to determine the prevalence of stigma and depression among urban refugees and to examine the association between stigma and depression among urban refugees in Mbarara municipality, Southwestern Uganda. We hypothesized that there would be high prevalence of stigma and depression and that stigma would positively correlate with depression among urban refugees in Southwestern Uganda. Methods Study Design, Population and Measures We conducted a descriptive cross-sectional study among 343 refugees residing in Mbarara Municipality, Southwestern Uganda using snowball sampling method between the months of May and November 2019. Our study participants were only those who had lived in Mbarara municipality for at least 12 months prior to the study and were aged 14 years and above. Would be participants with severe psychological disorders and identifiable symptoms of alcohol intoxication during the time of data collection were excluded. To determine our sample size, we adopted a 31% prevalence of stigma found by a study of Baranik et al., (2018) in a mixed methods study about the stigma of being a refugee, among Afghanistan refugees living in the US. The Discrimination and Stigma Scale (DISC-12) was used to measure stigma. To suit our sample, the scale was modified and the words “mental health problems” were substituted with words “refugee status”. The scale measures unfair treatment of people because they are seen to be different from others for any reason (16). Therefore, the substitution of words did not affect the validity of the scale. The scale consists of 34 items, four subscales and scores on a 4-point scale from 0 (not at all), 1 (a little), 2 (moderately) and 3 (a lot). For the current study we considered the first two sub scales of the DISC-12. Subscale 1 measured enacted stigma (Item 1–22) and subscale 2 measured internalized stigma (Item 23–26). A higher score indicated greater experience of stigmatization tendencies reported by a participant. The DISC -12 is reported consistent with a Cronbach’s alpha of 0.78 (17). In the present study the DISC-12 had 0.93 Cronbach’s alpha. The Patient Health Questionnaire (PHQ-9) was used to measure depression. The PHQ-9 is a brief, 4 easily administered and scored screening questionnaire that can be used to improve the recognition rate of major depression and facilitate treatment (18). An advantage of the questionnaire is its exclusive focus on the nine diagnostic criteria for the newly revised DSM-5 depressive disorders (19). The scale is up to a score of 27 with each item with options of not all (0), several days (1), more than half the days (2) and nearly every day (3). A score of 1 – 4 is interpreted as minimal depression, 5 – 9 mild depression, 10 – 14 moderate depression, and 15 – 19 moderately severe depression and 20 – 27 severe depression. Since its development, the PHQ-9 has established itself as a practical tool for use in assisting with “depression diagnoses, depression severity, and depression outcome”. The PHQ-9 is reported as “excellent” with a Cronbach’s alpha of 0.89 and 0.86 in the primary care and obstetrical clinical studies respectively (20). The PHQ-9 possessed a 0.91 Cronbach’s alpha in the present study. All instruments were directly administered to the participants in their own residence or places considered by both the research team and the selected participant as being safe and confidential.
Enhancing Stakeholder Collaboration for Educational Inclusion of Children in Street Situations in Kampala District, Uganda
(The Educator, 2023) Annah, Atuhaire; Ronald, Bahati; Atukunda, Gershom; Jonah, Nyaga Kindiki; Namubiru, Proscovia; Kyohairwe, Stella; sekamatte, David
The United Nations Sustainable Development Goal number four target five seeks to eliminate all forms of discrimination in education for marginalized groups and vulnerable groups like street children. However, their inclusion in mainstream education has not been explored. Literature acknowledges collaboration among stakeholders as vital for reflection of practices and knowledge exchange and also used as a strategy to foster creativity and innovation necessary for effective implementation of inclusive education. This study explored perceptions of selected stakeholders towards collaboration as a strategy for enabling inclusion of children in street situations in mainstream education and how such collaboration can be enhanced. A qualitative approach was adopted selecting Kampala as a case. Five officials from government and Non- governmental organizations were selected purposively to participate in this study. The data was generated using semi-structured interviews and analyzed thematically. Respondents perceived collaboration as key to effectively include children in street situations in education. However, there were less meaningful relationships amongst stakeholders and majority of them were not performing their roles regarding the education of a child. The participants’ experiences of collaborative practices revealed barriers that hindered their partnership regarding the educational inclusion of children in street situations. The study thus concluded that collaboration can be enhanced through a multi-sectorial approach that brings all actors on board in planning and implementation of education inclusion of children in street situations. The study, therefore, recommended that the government should strengthen collaborative practices amongst stakeholders through policy formulation, sensitization and allocation of funds to implement a well-designed educational program based on the learning needs of children in street situations. These findings are of great importance to the Ministry of Education, Head teachers, teachers, Non-Governmental Organizations and other government bodies responsible for the welfare of children in street situations in planning and policy formulation, guidance for including children in street situations in mainstream education so that they gain from the efforts of inclusive and equitable quality education for all.
Gender differences in substance use and associated factors among urban refugees in Uganda
(Informa UK Limited, trading as Taylor & Francis Group, 2023) Ronald, Bahati; Scholastic, Ashaba; Cathy Denise, Sigmund; Godfrey Zari, Rukundo; Herbert Elvis, Ainamani
Background: Alcohol and other substances use related problems among refugees is a global public health concern. Although there is substantial research on the use of alcohol and other substances among the refugees, little is known about gender and other factors that might be associated with the use of alcohol and other substances. Our study aimed to assess the prevalence of alcohol and substance use across gender and other specific associated factors among urban refugees living in Mbarara city, Southwestern Uganda. Methods: In a cross-sectional study, 343 refugees were interviewed on the use of alcohol and other substances using the Alcohol Use Disorder Identification Test and the Drug Abuse Screening Test. The associated factors included, age, marital status, occupation, duration (length of stay) in Uganda, educational levels, stigma and depression. Linear regression analysis was used to examine the associations between the predictor and outcome variables. Results: No significant gender difference in alcohol use was found, and the overall prevalence of hazardous, harmful or dependent alcohol use among our sample of refugees living in Mbarara city was 43%. There were however, statistically significant gender differences in the use of other substances, with a significantly higher percentage of men than women reporting intermediate, substantial, or severe substance use (45% among men, 37% among women). Higher levels of depression and being separated from one’s spouse were associated with higher levels of alcohol and substance use. In addition, higher age and being male were associated with the use of substances other than alcohol. Conclusions: Our findings indicate a high prevalence of problematic alcohol and substance use among both male and female refugees. Clinical interventions focused on the treatment and prevention of alcohol and substance use among the refugee communities may benefit from focusing on depressive symptoms as well
Gender differences in substance use and associated factors among urban refugees in Uganda
(European Journal of Psychotraumatology, 2023) Ronald, Bahati; Scholastic, Ashaba; Cathy Denise, Sigmund; Godfrey, Zari; Herbert Elvis, Ainamani
Background: Alcohol and other substances use related problems among refugees is a global public health concern. Although there is substantial research on the use of alcohol and other substances among the refugees, little is known about gender and other factors that might be associated with the use of alcohol and other substances. Our study aimed to assess the prevalence of alcohol and substance use across gender and other specific associated factors among urban refugees living in Mbarara city, Southwestern Uganda. Methods: In a cross-sectional study, 343 refugees were interviewed on the use of alcohol and other substances using the Alcohol Use Disorder Identification Test and the Drug Abuse Screening Test. The associated factors included, age, marital status, occupation, duration (length of stay) in Uganda, educational levels, stigma and depression. Linear regression analysis was used to examine the associations between the predictor and outcome variables. Results: No significant gender difference in alcohol use was found, and the overall prevalence of hazardous, harmful or dependent alcohol use among our sample of refugees living in Mbarara city was 43%. There were however, statistically significant gender differences in the use of other substances, with a significantly higher percentage of men than women reporting intermediate, substantial, or severe substance use (45% among men, 37% among women). Higher levels of depression and being separated from one’s spouse were associated with higher levels of alcohol and substance use. In addition, higher age and being male were associated with the use of substances other than alcohol. Conclusions: Our findings indicate a high prevalence of problematic alcohol and substance use among both male and female refugees. Clinical interventions focused on the treatment and prevention of alcohol and substance use among the refugee communities may benefit from focusing on depressive symptoms as well.
THE INFLUENCE OF COVID 19 ON THE SOCIAL ECONOMIC WELFARE OF REFUGES
(American Research Journal of Humanities & Social Science, 2023) Noel Kiiza, Kansiime; Ronald, Bahati; Prossy, Kobusingye
ABSTRACT : The study investigated the influence of COVID 19 on the social economic welfare of refugees in Nakivale refugee settlement. Specifically, the study sought to establish the influence of COVID 19 on the education welfare of refugees, influence of COVID 19 on the health services and influence of COVID 19 on the incomes of refugees living in Nakivale refugee settlements. The study used a case study research design encompassing qualitative approaches in data collection on refugees, refugee leaders, project officers of WFP, USAID, UNHCR and FRC, Refugee welfare Committees members, OPM staff and commandant of Nakivale Refugee settlement. Data were collected using an interview method and analysed using NVIVO. The study revealed that lockdown posed a serious threat in education sector whereby refugees lost hope in education because they lacked guidance from their fellow colleagues and teachers. It was also found out that Covid19 pandemic strained healthy systems and disrupted essential health services at the hospital. Some of the measures totally disrupted the supply chain and health care service delivery system as all efforts were focused on covid19 patients. Refugee patients who were infected with other diseases were rarely attended to. Refugees who couldn’t afford medication from private hospitals were forced to go back and get treatment from their homes which caused increased deaths among refugees due to lack of income. Also, refugee patients with diseases like AIDS, sickle cell as well as mental health, maternal and childhood conditions faced an increased risk of complications and death due to inability to access health care because of transport restrictions, lack of energy and fear of contracting with covid19 virus from the healthy centers. Lastly, it was revealed that lockdown caused lack of income and loss of employment among refugees. Findings of study pointed out that refugees whose businesses were not closed like those that worked in markets faced a problem of reduction in their income and salary.
Post-traumatic stress disorder, depression and the associated factors among children and adolescents with a history of maltreatment in Uganda
(EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY, 2022) Herbert, E. Ainamani; Roland, Weierstall-Pust; Ronald, Bahati; Anne, Otwine; Sam, Tumwesigire; Godfrey, Z. Rukundo
Worldwide, children who grow up under adverse conditions risk the development of mental health problems. However, reliable data on the estimated magnitude of mental disorders of PTSD, depression and their associated factors among maltreated children and adolescents in low- and middle-income-countries (LMICs) is still lacking. This study estimated the magnitude of PTSD, depression and the associated factors among the children and adolescents with ahistory of maltreatment in Southwestern Uganda. Methods: In this cross-sectional study, we assessed 232 children and adolescents on the prevalence of PTSD using Child PTSD Symptoms Scale for DSM-5 – Self-Report (CPSS-VSR) and Depression using the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Predictor variables were taken from the Maltreatment and Abuse Chronology of Exposure- Paediatric Version (Pedi MACE). Logistic regressions analyses were selected for statistical modelling while odds-ratios were calculated to assess the strength of associations between the predictor and outcome variables. Results: In total, 140 (60%) participants fulfiled diagnostic criteria for PTSD and 91 (39%) for depression respectively. Predictor variables of PTSD were witnessing intimate partner violence (OR = 1.48, 95% CI: 1.19–1.83, p = <0.001), having lived in more than two homes (OR = 2.69, 95%CI: 1.34–5.41, p = .005), and being cared for by non-relatives (OR = 2.25; 95%CI: 2.26–223.9, p = .008). Variables predicting depression were witnessing intimate partner violence (OR = 1.30; 95%CI: 108–1.57, p = .006); being cared for by non-relatives (OR = 5.62, 95%CI: 1.36–23.1, p = .001) and being female (OR = .054, 95% CI: 0.30–1.00, p = .005). Conclusion: Children living under adverse conditions are at a higher risk of developing PTSD and depression. We recommend interventions that aim at reducing adverse psychosocial stressors so as to improve or restore the children’s mental health. Abbreviations: PTSD: Post traumatic stress disorder; LMICs: Low- and middle-income coun tries; IPV: Intimate partner violence; OVC: Orphans and vulnerable children
Refugee Stigma and Its Association with Depression Symptom Severity
(Scientific Research publishing, 2022-09-16) Ronald, Bahati; Herbert Elvis, Ainamani; Scholastic, Ashaba; Cathy Denise, Sigmund; Godfrey Zari, Rukundo
Introduction: Refugees in urban areas often face acculturation challenges, stigma, and stereotypes that impact their mental well-being. The aim of the present study was to examine the prevalence of stigma and its association with depressive symptoms among urban refugees living in Mbarara city, southwestern Uganda. Methods: This cross-sectional study used snowball sampling and interviewed 343 refugees residing in Mbarara city, southwes tern Uganda. The Discrimination and Stigma Scale was used to assess stigma, whereas the Patient Health Questionnaire (PHQ-9) was used to screen for depression symptoms severity. Linear regression models determined the as sociations between stigma and depression symptoms severity. Data were col lected between June 2019 and March 2020. Findings: Of the 343 participants, 198 were males and 145 were females; their mean age was 28.8 years (SD = 11.0). Most of the participants (95.3%) had attained formal education. Our findings show that 84% (n = 288) of the participants had symptoms of stigma. Stigma had a statistically significant positive association with depressive symptoms severity (b = 0.11; 95% CI, 0.08 to 0.15). Age had statistically sig nificant positive association with depression symptoms severity (b = 0.08; 95% CI, 0.02 to 0.14). Education level had a statistically significant negative association with depressive symptoms severity (b = −0.53; 95% CI, −0.97 to −0.09). Conclusions: Urban refugees experience high levels of both stigma and depression. Interventions aimed at reducing stigma could subsequently reduce depression among refugees living in urban areas.
The Relationship between ICT Utilization and Records Management in Secondary Schools of Sheema District.
(American Research Journal of Humanities & Social Science (ARJHSS), 2023) Patience, Kyoshabire; Ronald, Bahati; Denis, Kintu
The study was designed to establish the relationship between information communication technology utilization and records management in secondary schools in Sheema District,southwestern Uganda. It was guided by the following objectives: to establish the level of utilization of ICTs, to determine the extent to which records are managed in secondary schools, and to determine the relationship between ICTs utilization and records management in secondary schools. A total sample of 10 schools (5 private secondary schools and 5 government aided secondary schools), 10 head teachers, 10 ICT administrators was selected using purposive sampling. Twenty (20) records officialsand 100 teachers were selected using simple random sampling. The researcher used questionnaire survey and interview methods of data collection. Quantitative data from the field was processed and analyzed using Statistical Package for Social Scientists (SPSS v21). Qualitative data from interviews was analyzed descriptively and information presented in the narrative form. The study findings found out that the level of utilization of ICTs in secondary schools of Sheema District was high at an overall mean score of 3.77. The study findings found out that the extent to which records are managed in secondary schools of Sheema District was high, with an overall mean score of 3.80. The study findings found out that the correlation coefficient was 0.290 which indicates that there is a slight positive relationship between ICTs utilization and records management in secondary schools of Sheema District. The p value 0.001 shows that there is a statistically significant relationship between ICTs utilization and records management in secondary schools of Sheema District. It was concluded that there was a high level of utilization of ICTs in secondary schools of Sheema District. It was also concluded that there was a high extent to which records are managed in secondary schools of Sheema District. It was further concluded that there was a statistically significant relationship between ICTs utilization and records management in secondary schools of Sheema District. Therefore changes in ICTs utilization were associated with changes in records management. It was recommended that the school administrators should be trained in basic ICTs utilization skills and especially in their applications in managing records and information by the Government of Uganda. This will enhance the adoption of the technology systems for proper management of records and information of schools.