"Food System Mapping in Kanyanya (Kampala)" - Workshop Report.

Food value chains are part of the systemic drivers of urban food and nutrition security. An important part of these value chains are the various informal small actors. These include producers, transporters, processors and retailers. One of the main objectives of the NOURICITY project is to initiate and to implement partnership agreements between different local, national and international stakeholders to improve the urban food system. Therefore, we conducted a workshop as indicated by Work Package 1 of the NOURICITY project. This workshop aims to map the stakeholders of the food system in Kampala and to map the food flows in one of the parishes in Kampala. The parish selected was Kanyanya (Kawempe division). The workshop consisted of two days with two groups of people: the first day for parish representatives and the second day for Kampala and national representatives

Where Have All The Young Men Gone? Evidences and Explanations of Changing Age: Sex Ratios in Kampala

In the second half of the twentieth century the population of Kampala grew substantially and the long-remarked surplus of men over women began to level out. These general trends are equally evident in other African cities, but important differences show up when the balance of age cohorts within the male and female populations is considered. Thus in Kampala, along with population growth and a declining overall sex ratio, censuses show a growing excess of girls/young women over boys/young men. The article reviews these population data and two levels of (unenumerated) explanation for them. The first is extrapolated from Uganda's recent history; the second from observation and narrative in one densely populated parish. The argument is that changes in the age–sex ratio follow from change in the map of work options in Kampala. The disappearance of young males stems from the collapse of the formal economy, once the employer of men, and the developments in the informal economy which favour young women. This conclusion is supported by census data from Nairobi, where the formal employment structure remains relatively buoyant, and the comparable age–sex ratios are less extreme. The health policy relevance of the Kampala trend is underlined by official calculations of increasing HIV/AIDS incidence among teenage women. As long as sex work remains dominant among their options in the informal economy, one effect of their economic advantage is extra vulnerability to fatal disease

HOUSEHOLD PERCEPTIONS OF THE QUALITY OF DRINKING WATER IN UGANDA

This paper analyzed self-reported household water quality opinions and avoidance measures used by households in Kampala, Uganda to manage health risks. The paper is based on survey data collected from four Divisions in Kampala district and analyzed using a simultaneous probit equation system. Probit results confirm the existence of strong relationships between household characteristics, opinions on water quality and the use of avoidance measures.Food Consumption/Nutrition/Food Safety,

Home-based tuberculosis contact investigation in Uganda: a household randomised trial.

IntroductionThe World Health Organization (WHO) recommends household tuberculosis (TB) contact investigation in low-income countries, but most contacts do not complete a full clinical and laboratory evaluation.MethodsWe performed a randomised trial of home-based, SMS-facilitated, household TB contact investigation in Kampala, Uganda. Community health workers (CHWs) visited homes of index patients with pulmonary TB to screen household contacts for TB. Entire households were randomly allocated to clinic (standard-of-care) or home (intervention) evaluation. In the intervention arm, CHWs offered HIV testing to adults; collected sputum from symptomatic contacts and persons living with HIV (PLWHs) if ≥5 years; and transported sputum for microbiologic testing. CHWs referred PLWHs, children <5 years, and anyone unable to complete sputum testing to clinic. Sputum testing results and/or follow-up instructions were returned by automated SMS texts. The primary outcome was completion of a full TB evaluation within 14 days; secondary outcomes were TB and HIV diagnoses and treatments among screened contacts.ResultsThere were 471 contacts of 190 index patients allocated to the intervention and 448 contacts of 182 index patients allocated to the standard-of-care. CHWs identified 190/471 (40%) intervention and 213/448 (48%) standard-of-care contacts requiring TB evaluation. In the intervention arm, CHWs obtained sputum from 35/91 (39%) of sputum-eligible contacts and SMSs were sent to 95/190 (50%). Completion of TB evaluation in the intervention and standard-of-care arms at 14 days (14% versus 15%; difference -1%, 95% CI -9% to 7%, p=0.81) and yields of confirmed TB (1.5% versus 1.1%, p=0.62) and new HIV (2.0% versus 1.8%, p=0.90) diagnoses were similar.ConclusionsHome-based, SMS-facilitated evaluation did not improve completion or yield of household TB contact investigation, likely due to challenges delivering the intervention components

Planning and development regulation amid rapid urban growth:explaining divergent trajectories in Africa

Why are urban plans, land use regulations and construction codes implemented effectively in some African states but not others? This constitutes an increasingly urgent development concern with major implications for the environment and the urban poor. Rather than being explained by economic factors, bureaucratic capacity or the nature of the urban policies and regulations in place, this paper argues that divergent outcomes are largely rooted in differing political bargaining environments. Comparing Uganda and Rwanda, it presents an empirical study that analyses contrasting planning and regulation trajectories in contexts of similarly low levels of socioeconomic development and soaring rates of urban growth. It argues that the divergent outcomes can be explained in relation to the political resources and incentives confronted by governing elites, which in Rwanda impel state actors to implement plans and regulations while in Uganda incentivize overriding them in the interests of political or economic gain. In highlighting political bargaining contexts and how these change over time, the paper illustrates the critical importance of historically informed city-level political economy analysis for understanding divergent urban development outcomes

Outbreak of Marburg hemorrhagic fever among miners in Kamwenge and Ibanda Districts, Uganda, 2007

Marburg hemorrhagic fever was detected among 4 miners in Ibanda District, Uganda, from June through September, 2007. Infection was likely acquired through exposure to bats or bat secretions in a mine in Kamwenge District, Uganda, and possibly human-to-human transmission between some patients. We describe the epidemiologic investigation and the health education response

Good adherence to HAART and improved survival in a community HIV/AIDS treatment and care programme: the experience of The AIDS Support Organization (TASO), Kampala, Uganda.

BACKGROUND: Poor adherence to highly active antiretroviral therapy (HAART) may result in treatment failure and death. Most reports of the effect of adherence to HAART on mortality come from studies where special efforts are made to provide HAART under ideal conditions. However, there are few reports of the impact of non-adherence to HAART on mortality from community HIV/AIDS treatment and care programmes in developing countries. We therefore conducted a study to assess the effect of adherence to HAART on survival in The AIDS Support Organization (TASO) community HAART programme in Kampala, Uganda. METHODS: The study was a retrospective cohort of 897 patients who initiated HAART at TASO clinic, Kampala, between May 2004 and December 2006. A total of 7,856 adherence assessments were performed on the data. Adherence was assessed using a combination of self-report and pill count methods. Patients who took 95%. The crude death rate was 12.2 deaths per 100 patient-years, with a rate of 42.5 deaths per 100 patient-years for non-adherent patients and 6.1 deaths per 100 patient-years for adherent patients. Non-adherence to ART was significantly associated with mortality. Patients with a CD4 count of less than 50 cells/mm3 had a higher mortality (HR = 4.3; 95% CI: 2.22-5.56) compared to patients with a CD4 count equal to or greater than 50 cells/mm3 (HR = 2.4; 95% CI: 1.79-2.38). CONCLUSION: Our study showed that good adherence and improved survival are feasible in community HIV/AIDS programmes such as that of TASO, Uganda. However, there is need to support community HAART programmes to overcome the challenges of funding to provide sustainable supplies particularly of antiretroviral drugs; provision of high quality clinical and laboratory support; and achieving a balance between expansion and quality of services. Measures for the early identification and treatment of HIV infected people including home-based VCT and HAART should be strengthened

The Law Development Centre, its Library and Law Librarianship in Uganda: a presentation to the IALS Library staff

The author explains the role of the Law Development Centre, Kampala in legal education in Uganda - illustrating the changes and challenges that the LDC has faced and describing the circumstances in which the profession of Law Librarianship operates in Uganda