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THE RELATIONSHIP BETWEEN PEER INFLUENCE AND ALCOHOL USE AMONG SCHOOL-GOING ADOLESCENTS IN KASESE MUNICIPALITY, UGANDA
(Journal of Advanced Research and Multidisciplinary Studies, 2023) Musomboli, Priscilla; Nyemara, Novatus; Nzamuhiki, Stephen
Peer influence is a major contributing factor to the upsurge in risky alcohol behaviors among school-going adolescents. This trend has become a public health concern in many parts of the world. Debate continues as to whether peer influence, age, gender, and religion predict alcohol use in this adolescent group. The purpose of the study was to establish the relationship between peer influence and alcohol use among school-going adolescents in Kasese Municipality. Two -structured questionnaires; the Peer Inventory Tool (PPI) and the Alcohol Use Disorders Identification Test (AUDIT) were used to obtain information from 233 adolescents. Adolescents aged 12-19 years, were randomly sampled from 10 secondary schools. Results indicated that 35.6% were hazardous drinkers, 10.7% were harmful drinkers, and 5.2% were dependent drinkers. Pearson correlation analysis confirmed a weak positive correlation (r=0.18) between age and alcohol use among school-going adolescents. A positive peer influence was established between adolescents and their peers and friends (PPI score of 12.18, on a scaled range of -66 to +66). The Chi-square test confirmed that there was no association between religion (p>0.05) or gender (p>0.05), and alcohol use among school-going adolescents. The results provide outcomes that can be used to promote positive peer relationships among school-going adolescents and policy regulation of alcohol use and abuse in schools
Social Capital and Quality of Life among the Refugees residing in Mbarara City Southwestern Ugand
(Research square, 2023) Kakai, Brenda; Bahati, Ronald; Otwine, Anne; Nzamuhiki, Steven; Ainamani, Herbert
Introduction: Globally, social capital is considered a significant resource in improving quality of life among human beings. In this study, we aimed at assessing the proportions of forms of social capital and their association with the quality of life among the refugees living in Mbarara City southwestern Uganda. Methods This cross-sectional study used consecutive sampling method to select 344 refugees that were living in Mbarara city at the time of data collection. Refugees were assessed on their social capital using the World bank Social Capital Integrated Questionnaire. Quality of life was assessed using the World Health Organization questionnaire of quality of life. Data were analyzed using STATA. Descriptive statistics determined the occurrence of social capital while linear regression model determined the association between social capital and quality of life. Results Almost all participants endorsed one form of social capital, with majority of the participants [251(73%)] endorsing sociability, followed by trust and solidarity 186(54%), groups and networks were the least endorsed [170(49%)] within our sample. Our findings further showed that having high levels of trust and solidarity, positively correlated with quality of life (b = 0.80; 95% CI, 0.09 to 1.51; p = 0.027). Conclusions High social capital is likely to be associated with quality of life among refugees. Interventions aimed at building strong social capital are encouraged.
UTILIZATION OF ANTENATAL CARE SERVICES AMONG REFUGEE TEENAGE MOTHERS AT NAKIVALE REFUGEE SETTLEMENT IN WESTERN UGANDA. A PHENOMENOLOGICAL STUDY
(Student’s Journal of Health Research Africa, 2023) Ecodu, Simon Peter; Muhumuza, Benon; Rukundo, Lydia; Kazibwe, Francis
Introduction: Antenatal careis crucialforpositivepregnancyoutcomesandisdependentonthetimingandquality of care. It promotes health education and helps identify and manage maternal complications and risk factors.InSub-SaharanAfrica, pregnancy complications andchildbirthare the leading causeofdeath for women aged 10-19. This study examined teenage mothers’ experiences and perceptions of accessing and utilizing antenatal care services in the Nakivale refugee settlement, Isingiro district. Methodology: A phenomenological study was conducted on teenage mothers in Nakivale, using a snowball sampling method. Key informant interviews were conducted, lasting 45 minutes -1 hour. Ethical clearance was obtained from Bishop Stuart University REC and informed consent was obtained from participants. Data was analyzed thematically using Nvivo version 12. Results:Teenage mothers face challenges utilizing antenatal care services including negative treat ment from family and community members. However, positive feelings of responsibility alleviate stress, making early mothers more resilient. Conclusions: Access toANCservices is closely linkedto itsutilization, but societal discriminationagainstteenage mothers affects ANC utilization. Teenage-friendly spaces in Nakivale significantly influenced access and utilization of ANC services. Recommendations: The study suggests establishing customized ANC services for teenage mothers in the Nakivale refugee settlement, Isingiro district, to enhance access and utilization of ANC.
Community Participation and Sustainability of Community Based Water Projects in Mbarara City North Division
(American Research Journal of Humanities & Social Science (ARJHSS), 2023) Mpora, Vicent; Turyamureba, Robert; Mpairwe, Anthony
The study was about the influence of community participation on sustainability of communitybased water projects in Mbarara City North Division in Mbarara City. The study was aimed at assessing thedifferent ways of community involvement in community based water projects in Mbarara City North Division,examining the level of sustainability of community based water projects in Mbarara City North Division anddetermining the extent to which community participation influences sustainability of community based waterprojects in Mbarara City North Division in Mbarara City. The study used a descriptive survey design for qualitative data and cross-sectional research design forquantitative data. The study employed simple random and purposive sampling techniques. The study used asample size of 70 of the total of 73 populations. Data was collected from primary and secondary data sources.Questionnaire, interview guide and documentary review guide were used as data collection instruments.Analysis was done quantitatively whereby descriptive statistics and inferential statistics were determined usingSPSS. Thematic content analysis was used for qualitative analysis. From the findings, correlationco efficientshowsthatCommunityparticipationinimplementationstageofthecommunity basedwaterprojectshasinfluenceonSustainabilityofCommunity BasedWaterProjectsbecausethePvaluewas.000orP<0.05whichmeansCommunityparticipationinimplementationstageofthecommunity based waterprojecthasasignificant influenceonSustainabilityofCommunityBasedWaterProjects. Furthermore, correlation co efficient shows that Community participationinmaintenancestageofthecommunity based waterprojectonSustainabilityofCommunityBasedWater Projects hasno influence on sustainability of Community Based Water Projects because the P value was .006or P> 0.05which means that Community participation inmaintenance stage of the community based water project has nosignificant influence on SustainabilityofCommunityBased Waterprojects. Also correlation co-efficient showsthat Community participation in evaluationstage of the community based water projects has influence onSustainability of Community Based WaterProjects because the P value was .002or P< 0.05, which means thatCommunity participation inevaluation stage of the community based water projects, has a significant influenceon Sustainability ofCommunityBased WaterProjects. The study concludes that, since communityparticipation inplanning stage of the community water project has a significant influence onSustainability of Community BasedWater Projects. It implies that the water committees,donorsandthegovernmentofficialsintheministryofwaterholdpriorconsultationswiththecommunity members beforethe water projects are deliberated, more so community members areinvolved in decision making when designingthe project structure,location of water standpoints,determiningthe sourceof water amongotherkeyissues. Thestudy recommended that the community water projects should hold capacity building sessionsfor the membersand the committee members so as to equip them with appropriate knowledgeconcerning the designing anddevelopment of community water projects. This will enable themembersto makesuitablecontributions to theproject design.
Cognitive impairment and the associated factors among women with a history of pregnancy complications in rural southwestern Uganda
(PLOS ONE, 2023-10-30) Kihumuro, Raymond Bernard; Peace, Kellen; Chun, Sarah; Wakida, Edith K.; Obua, Celestino; Ainamani, Herbert E
Background Worldwide, there is a growing concern about the rising number of people with declining cog nitive functioning. However, findings on this phenomenon are inconclusive. Our study aimed to assess the prevalence of cognitive impairment and the associated factors in women with a history of pregnancy complications in rural southwestern Uganda. Methods This was a cross-sectional study carried out among women above 40 years of age in the greater Kabale district of southwestern Uganda between March and April 2022. Study par ticipants were identified using a consecutive sampling method. Predictor variables included pregnancy complications and other social demographic factors that were assessed by semi structured interviews while cognitive functioning as an outcome variable was assessed by Montreal Cognitive Assessment (MoCA-B) tool. Data were analyzed using STATA at a 95% Confidence level. Logistic regression 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, 75% (212/280) of participants had some form of cognitive impairment, with 45% (123/280) falling into mild CI, 31% (86/280) moderate CI and 4% (10/280) severe CI. Twenty-three percent (68/280) of participants fell into category of normal cognitive function ing. Participants with >65 years of age had higher odds of developing cognitive impairment (OR = 2.94; 95%CI: 0.96–9.04, p = 0.06) than those with < 65 years of age. Protective factors to cognitive impairment include delivering from a health facility (OR = 0.31,95% CI:0.16–0.60, p = < .001), primary and post primary levels of education (OR = 0.05; 95% CI: 0.02–0.13, p<0.001, OR = 0.04; 95%CI: 0.02–0.23, p<0.001) respectively. Conclusion Results from this study show a high prevalence of cognitive impairment among women with a history of pregnancy complications in rural southwestern Uganda. Interventions geared toward preventing cognitive impairment among females with a history of pregnancy compli cations should be emphasized.
THE EFFECT OF APPRAISAL STANDARDS SETTING ON EMPLOYEE PERFORMANCE IN PRIVATE UNIVERSITIES IN UGANDA
(Bishop Stuart University, 2023) Emily, Ankunda; Dorcus, Mureebe
The study aimed at establishing the relationship between the appraisal standards and performance of employees in selected private universities in Uganda. It was carried out in two universities which were Kampala International University Bushenyi Campus and University of St. Joseph Mbarara. The study was carried out using a self-administered questionnaire and interview guide. It involved the administrative staff of the universities. The study was hence carried out amongst 60 staff members. The results were analysed using the descriptive statistics including frequencies and percentages, the mean distribution and regression analysis was used to analyse the relationship amongst the variable. The study generally revealed that there was a significant relationship between appraisal standards and employee performance. The standards the appraisal focused on were mainly the employee behaviours, competences and achievements. The results indicated that the main behavioural targets were the employees’ relations with colleagues, relations with clients, relations with supervisors and the extent to which employees observed the code of conduct including the disciple. The competences assessed related to relevance of the staff qualifications are assessed, staff members ability to counsel students, the ability to communicate with clients, he staff skills to do the work is assessed and the staff skills to do the work is assessed. On achievement, the study examined the application of appraisal on determining participation and ability to contribute in meetings, the staff performance, the research output, the clients attracted to the organization, the level of attendance to duties and participation in training activities. On the whole the study recommended the need to enhance appraisal standards and ensure that all staff members are aware of the standards that are usually assessed so that they work towards achieving them.
Income Levels and Gender based Violence among the Civil Servants in Kamukuzi Division, Mbarara Municipality
(International Journal of Research and Innovation in Social Science (IJRISS), 2019) Mary, Nomugisha; Peter, Turyamuhaki; Allen, Nuwamanya
The study was about income levels and gender-based violence in Kamukuzi Division, Mbarara Municipality, Mbarara District Uganda; the study focused on the following objectives; to determine income levels of civil servants in relation to gender based violence, to document the experiences of civil servants on gender-based violence (nature, magnitude etc.) in Mbarara Municipality and to ascertain the relationship between income levels and the rate of gender-based violence. A case study design was adopted in this study; it involved both qualitative and quantitative methods of data collection and analysis. The study targeted civil servants in kamukuzi division where samples of 150 respondents were selected from teachers, social workers, administrators and health workers. The study employed questionnaire and interview method for investigation. Basing on the study findings there is no significant relationship between income levels and gender-based violence. The study explored the different income levels basing on the salary scale for Uganda and the respondents studied ranged from U8-U3 as per the government of Uganda. The findings established similarly conditions, nature and perceptions towards gender-based violence. The study further established that civil servants have a negative attitude towards gender-based violence. It was also established that gender-based violence affects staff performance; it causes depression, stress and anger that undermine work performance. Leaders especially the cultural, religious and human rights activist should clearly come to an understanding on the gender roles, positions and participation in family, government agency should always organize a come together sensitization campaign to discuss and explore domestic issues in general and NGOs and other private sectors should intervene to curb down the gender based violence among the working class, life planning.
Coronavirus Disease-2019
(Nigerian Journal of Peace, Development & Humanitarian Affairs (NJPDHA), 2021) RUKUNI, Tinashe; KANSIIME, Noel; ASANI, Collin; Oyinloye, O.B.A
The outbreak of the “Coronavirus Disease 2019” on a worldwide basis has brought about an unprecedented threat to the already fragile global peace and security position. The epidemic has had catastrophic social, economic, and political consequences on a global scale. The global pandemic which originated in the Chinese city of Wuhan in December 2019 has become a source of serious international debate, a humanitarian crisis of fearsome proportions, and sparked conflict among the world's major powers. It is against this background and perturbing development that this paper interrogates the implications of Coronavirus disease 2019 as a threat to global peace and security. Thus, the fulcrum of the ensuing discourse is anchored on the examination of the post-Covid-19 outbreak humanitarian crisis, surge in domestic violence in lockdown periods the world over, the imminent world economic recession, food insecurity, revival of xenophobia related violence and the ignition of geopolitical conflict mainly among the world's major economic and political powers. The paper is based on the qualitative research paradigm, as it sought to probe deep into contemporary issues around the novel Covid-19 pandemic. The paper found out that Covid-19 is a serious threat to global peace and security and has also perpetuated a global humanitarian crisis, gender-based, economic recession violence, and xenophobia. Based on the salient findings and major conclusions reached the paper ends by proffering recommendations tailored to promote global peace and security in the aftermath of the Covid-19 outbreak
A Reflection on how Peacebuiding skills can Mitigate Gender Based Violence in Kenyan Universities.
(American Research Journal of Humanities & Social Science (ARJHSS), 2020) Kansiime, Kiiza Noel; Milimu, Shanyisa Wilkister
Gender based violence (GBV) is a cross-cutting issue that continues to attract prominent attention as a serious violation of human rights. It is deeply rooted in unequal gendered social norms and power imbalance. It is one of the major topical issues in Kenya’s daily media mainstream. Attempts to mitigate the effects of GBV have remained futile both at local and international levels even after launching different frameworks and interventions. This research was part of the bigger research which sought to explore how peacebuilding skills could be used to mitigate GBV with a focus on female university peer counsellors.The study employed Participatory Action Research (PAR). It also adopted a transformative worldview with a focus on mixed methods design. Surveys, Interviews, and Focus Group Discussions (FGDs), were used during data collection.Data was analysed using SPSS and thematic content analysis. Findings revealed that GBV was prevalent in the institutions of higher learning and mechanisms to mitigate it remain superficial. It was also revealed that when youth are equipped with peacebuilding skills like peer counseling, they have the potential to transform and create a culture of peace where they can enjoy the right to education and uphold human rights
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 response to war related trauma and posttraumatic stress disorder – a study among the Congolese refugees in Uganda
(BMC Psychariatry, 2020) Ainamani E., Herbert; Thomas, Elbert; Kani Olema, David; Hecker, Tobias
Background: The wars in the Democratic Republic of Congo have left indelible marks on the mental health and functioning of the Congolese civilians that sought refuge in Uganda. Even though it is clear that civilians who are exposed to potentially traumatizing events in war and conflict areas develop trauma-related mental health problems, scholarly information on gender differences on exposure to different war-related traumatic events, their conditional risks to developing PTSD and whether the cumulative exposure to traumatic events affects men and women differently is still scanty. Methods: In total, 325 (n = 143 males, n = 182 females) Congolese refugees who lived in Nakivale, a refugee settlement in the Southwestern part of Uganda were interviewed within a year after their arrival. Assessment included exposure to war-related traumatic events, and DSM-IV PTSD symptom severity. Results: Our main findings were that refugees were highly exposed to war-related traumatic events with experiencing dangerous flight as the most common event for both men (97%) and women (97%). The overall high prevalence of PTSD differed among women (94%) and men (84%). The highest conditional prevalence of PTSD in women was associated with experiencing rape. The dose-response effect differed significantly between men and women with women showing higher PTSD symptom severity when experiencing low and moderate levels of potentially traumatizing event types. Conclusion: In conflict areas, civilians are highly exposed to different types of war-related traumatic events that expose them to high levels of PTSD symptoms, particularly women. Interventions focused at reducing mental health problems resulting from war should take the context of gender into consideration
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.
Social Capital and Livelihood among The Congolese Urban Refugees
(American Research Journal of Humanities Social Science (ARJHSS), 2023) Asiimwe, Enock; Gershom, Atukunda; A Ivan, Kimpanga Mukibi
ABSTRACT:- In this article, the authors review literature related to Social Capital and Livelihood among urban refugees using a narrative literature review methodology. The literature reviewed forms a vital part of the data available on how social capital has contributed to the welfare of refugees living in urban settings. The purpose of reviewing literature related to Social Capital and Livelihood among urban refugees is to provoke thought and controversy among scholarly writings and assumptions in order to stimulate scholarly discourse. The article specifically seeks for literature related to: Networking, Bonding, Bridging, and Linking, Social Capital formation. This narrative review methodology, proceeded by evaluating and integrating the results of several studies to address gaps and recommend useful ideas among them. By reviewing the literature, we critically analyze how Social Capital is formed and theoretical assumptions underlying it. We also examine the applicability of Social Capital on the Urban Congolese livelihoods
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.
Efficacy of career guidance and counselling among secondary schools in Uganda
(OASIS, 2022-09-22) Anne, T. Otwine; Leonsio, Matagi; John, M. Kiweewa; Herbert, E. Ainamaani
Background: In Uganda, students face difficulty during career transition between different levels of education and employment despite government policies about implementation of career guidance and counselling services. Little has been documented about students’ levels of awareness, utilisation and extent of implementation of career guidance and counselling services within secondary schools in Uganda. Objective: This study aims at documenting students’ level of awareness and utilisation career guidance and counselling services, and how these services were being implemented in secondary schools in Uganda. Method: Cross-sectional survey was conducted using mixed methods in secondary schools in South Western Uganda. A total of 161 students in final year of secondary education (senior six) and 35 teachers across four schools met inclusion criteria and consented to participate in the study. Standardised questionnaires as primary tools of data collection were used. Quantitative data were analysed using SPSS (Version 23) and content analysis for qualitative data. Results: Majority of students (98.8%) revealed high awareness about existence of career guidance and counselling services, while 87.0% reported utilising the services. Implementation of career guidance and counselling in schools was demonstrated by type of programmes, information sources, models, timing and information structure by class level. However, challenges to implementation were sited, namely student, teachers, administrators, parents and policy factors. Conclusion and recommendation: Career guidance and counselling services were available and used in secondary schools. However, implementation was affected by functional and structural challenges that affected the quality of career counselling information and required alignment to national development goals. Contribution: The efficacy of career guidance and counselling in secondary schools in Uganda was documented in this article.
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.
Caring for people with dementia in rural Uganda
(Journal of Global Health Reports, 2020) Herbert E, Ainaman; Paul E, Alele; Godfrey Z, Rukundo; Samuel, Maling; Edith K, Wakida; Celestino, Obua; Alexander, C Tsai
Back Background ground The rising incidence of Alzheimer’s disease among older-age adults worldwide has been accompanied by an increase in caregiving burden. Limited work has examined the lived experiences of both formal and informal caregivers of people living with dementia in low-income countries. Methods We conducted one-on-one, in-depth qualitative interviews with a purposive sample of 10 informal caregivers and 5 formal caregivers of people living with dementia in Mbarara, Uganda. They were interviewed about their experiences caring for people with dementia until thematic saturation was reached. All interviews were audio recorded, transcribed into English, and thematically analysed. RResults esults Two primary themes emerged from the data: patient factors influencing caregiving burden (problematic behaviours, such as wandering and aggression) and patient physical health and cognitive deterioration (namely, loss of memory and incontinence). Psychosocial and economic aspects of caregiving burden included financial costs, family conflicts, anxiety, stigma, and substance misuse. CConclusions onclusions Both formal and informal caregivers of people living with dementia experience physical, financial, and psychological stressors. Interventions aimed at reducing these stressors would benefit caregivers as well as improve quality of care for people living with dementia.
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.
Motivation and Retention of Workers in Faith-based Organisations
(East African Journal of Traditions, Culture and Religion, 2022) Gershom, Atukunda; Johnson, Atwine; Kusasira, Serinah Tinka
The study was about motivation and retention of workers in faith-based organisations: a case study of child development centre projects of Ankole Diocese. It was guided by the following objectives; to establish the influence of promotion on employee retention in faith-based organizations of Ankole Diocese Child Development Centre Projects, to examine the influence of Salary increment on employee retention in faith-based organizations of Ankole Diocese Child Development Centre Projects in reducing employee turnover and to establish the effect of recognition on employee retention in faith-based organizations in Ankole Diocese Child Development Centre Projects. A cross-section design was adopted for this study to determine the frequency of occurrences of the phenomenon and discover whether or not if there is a relationship that exists between the variables. The target population of this study comprised Child development officers, Project directors, Project overseers, Partnership facilitators, LDP graduates, and Centre guides of Ankole Diocese. The study employed questionnaire and interviewing. The study findings revealed that there is a positive strong relationship between promotions on employee retention; there is a positive strong relationship between salary increment influences employee retention; a positive relationship between recognition and employee retention in faith-based organisations. Therefore; the study recommended that employee promotion does play a very significant role in retaining employees at work places; the human resource management department should carry out its career management policy and make relevant changes so as to take into considerations the many factors that individuals may require at the Ankole Diocese Child Development Centre Project. Finally; there should be good management in faith-based organizations with the human resource department so as to ensure that the working conditions specifically in line with working hours, cleanliness of environment and work instruments are put in place
Exploring the Potential Distinction Between Continuous Traumatic Stress and Posttraumatic Stress in an East African Refugee Sample
(SAGE, 2017) Herbert E., Ainamani; Tobias, Hecker; Katharin, Hermenau; Eva, Haefele; Thomas, Elbert
Posttraumatic stress (PTS) indicates a continuous stress response that persists though threats to life had been experienced in the past. However, threats to life are frequently ongoing. For these contexts, the concept of continuous traumatic stress (CTS) has been put forward. Based on structured clinical interviews with Congolese refugees (N = 226), this study investigated the CTS concept and whether it can be distinguished from PTS. We found that current exposure to violence correlated positively with concerns about its recurrence in the CTS group (r = .46). An ANCOVA indicated that higher intrusion symptom severity in the PTS group (no symptom reduction under safe conditions) was explained by higher lifetime trauma exposure (η2 = .125). In contexts of continuous trauma exposure, symptom-like responses may be regarded as appropriate responses to realistic danger. In these contexts, the possibility that symptom changes are a response to real threats should be considered to avoid overestimation of PTSD prevalences

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