A linguistic analysis of Rukiga personal names

The goal of the paper is to provide a linguistic description of the structure of personal names in a lesser studied Bantu language of Uganda, Rukiga (JE14). Data show that Rukiga personal names are presented as lexical entities but with underlying elaborate grammatical structures derived from the syntax, morphology, phonology and the lexicon of the language. Personal names in Rukiga form a special category of nouns derived from nouns, adjectives, verbs, phrases, clauses and full sentences. This study establishes that truncation, affixal derivation, lexicalization of phrases, clauses and sentences are employed in name-formation. The study further reveals that the socio-cultural context influences the semantics and structure of names in Rukiga. Data for this study were collected in Kabale district in western Uganda through interviewing older persons, reviewing religious documents and tax collection registers. The study mirrors personal names as a part of the grammar of Rukiga reflecting the general complex linguistic system of the language. Data from this study is envisaged to contribute to typological and theoretical analyses of personal names which have internal morphosyntactic properties

The Drive to Take an HIV Test in Rural Uganda: A Risk to Prevention for Young People?

A key component of current global HIV prevention efforts is widespread HIV testing. This strategy in part reflects the focus on the broader global targets to eliminate AIDS by achieving high rates of viral suppression. In this chapter we look at young people’s engagement with HIV prevention options in South-West Uganda. Taking a qualitative approach, using repeat in-depth interviews and participatory workshops with 50 young people aged 16–24 years old, we reflect on their accounts of how they navigate risks and opportunities within their daily lives. These risks include HIV-acquisition, but also the harms of economic precarity. Within a context in which using HIV prevention methods, such as condoms or abstinence, were for various reasons severely compromised by their contextual realities, some young people reported relying on irregular HIV testing as their singular method. The young people’s accounts demonstrate that an unintended consequence of the ‘push’ for HIV testing may be the justification of its replacement of other behavioural prevention strategies. This case study illustrates what impact such biomedical interventions may have if implemented as a priority and in isolation from the structural drivers of vulnerability: the social context of young people’s lives

Dealing with disclosure: Perspectives from HIV-positive children and their older carers living in rural south-western Uganda.

There are limited data on the challenges faced by carers, in particular older carers, in managing the difficult task of status disclosure for HIV-positive children. We report findings from qualitative interviews with 18 care dyads of older people and HIV-positive children living in rural south-western Uganda. Our data provide insights into perceptions and norms influencing communication during and following disclosure among both carers and children, including those shaped by gendered expectations of girls' and boys' sexual behaviour. Young participants reported several advantages of knowing their status and showed considerable resilience in the face of HIV disclosure. Better and more support is needed to help health workers and carers (particularly older carers) manage cross-generational communication around HIV disclosure and other related aspects of sexual and reproductive health as critical aspects of children's psychosocial development and well-being

Gendered risks: access to and utilization of sexual and reproductive health services among young migrants in Southwestern Uganda: the role of the ‘lending a hand’ intervention

Young migrants may engage in risky behaviours due to social, economic, and psychological challenges as they try to “get by” in their new host communities. This can result in unintended pregnancies, sexually transmitted infections including HIV, and poor mental health outcomes. During a study to test the feasibility and acceptability of an early intervention to reduce the harm of patterns of risk associated with migration, we assessed access to and utilization of sexual and reproductive health services (SRH) among recent migrants (14–24 years) in south-western Uganda. The intervention conducted in 2022/23 involved training peer supporters to provide referral advice and support to young people. Between March–November 2022, 20 young migrants (11 males and 9 females) were purposively selected to participate in two in-depth interviews each to explore their experiences during the intervention. Data were analysed thematically. Women engaged in transactional sex to supplement their low pay while men got involved in risky behaviour once they had earned some money. Many suffered from sexually transmitted infections-related symptoms, were at risk for HIV infection and some women had fears of unwanted pregnancy. While some tried to seek for SRH services from public facilities, poor health service delivery such as long queues and shortages of drugs, discouraged them from going there. Young people tried to access treatment from private facilities but could not afford the costs. The intervention increased knowledge about SRH and supported young people to access services from the public health facilities at no cost thus increasing utilization. Sexual health risks were experienced differently by women and men. The women were likely to experience symptoms related to sexually transmitted infections (including HIV) much earlier than men and this could increase their likelihood to engage with SRH services. The intervention served to increase men's readiness to access SRH services by providing them at a time and place that is convenient. Recognizing the different risk profiles of young people is important in tailoring appropriate interventions to promote equitable access and utilization of SRH services for both genders in this vulnerable population

`I now have so many friends!’ how young migrants describe their quest to belong in a town in southern Uganda

For many young people in Uganda, labour migration has become a part of growing up. They may not move far, but it is still a move away from a place they belong. For young migrants, the route to economic independence may be precarious, even for those who have people they know nearby. We trace the experience of 12 young male and female migrants (aged 17–24 years) over their first year as a migrant in southern Uganda. Finding friends who could help find jobs, lend them money and be around to relax with, fulfiled an expressed need to belong. That friendship was often based on a shared interest in sport or through their place of work. In a setting where all the young people had at some point experienced hunger, insecurity and a fear of failing to make it, those friendships were a marker of beginning to feel they belonged

Youth migration and access to health services in a trading centre in southern Uganda: A qualitative exploration.

Impeded access to health services is a major factor influencing migrant health. In Uganda, previous research has shown lower utilisation of health services for young rural-urban migrants compared to their non-migrant counterparts. However, access to health services does not start at utilisation, but can be hampered by being able to identify a need for care. Using qualitative methods, we aimed to explore young rural-urban migrants' perceptions of health and patterns of engagement with health services. We analysed, using thematic analysis, a purposive sample of 18 in-depth interviews with 10 young people who had recently migrated within Uganda. Our results are presented through a framework conceptualising access at the intersection between abilities of people and characteristics of services. Participants perceived a need for care mostly through serious crises. Their ability to obtain care was hindered by a lack of resources, as well as the relative social isolation brought by migration. Our study highlights other barriers to accessing care such as the role of social norms and HIV-related stigma in health issues prioritisation, and healthcare workers' attitudes. This knowledge can inform approaches to ensure that community-based services are able to support healthcare access and improved health outcomes for this vulnerable group

Bantu word order between discourse and syntactic relations

Discourse function has often been noticed to be a strong factor in conditioning Bantu word order. The importance of discourse function for determining the word order of Bantu languages is visible for example in locative inversion and dedicated focus positions. As a result of such phenomena, it has been proposed that Bantu word order is best captured by reference to discourse roles, e.g. Topic-Verb-Nontopic. Nevertheless, we typically see statements describing Bantu word order in relation to grammatical roles (e.g. “SVO”), and the notions “subject” and “object” remain core in analyses of Bantu. In this paper we present the result of a study reconsidering Bantu word order from a discourse-configurational perspective, asking how far we can get without reference to grammatical roles. We use a parametric approach to investigate this syntactic variation, presenting new discourse-oriented field data collected on 9 Bantu languages. We show how these parameters highlight variation within the family, with each language sitting at a different point on a continuum between grammatical role-oriented and discourse role-oriented. We therefore argue against a one-size-fits-all account of Bantu word order and advocate for approaches that include both grammatical and discourse roles.La fonction discursive a souvent été identifiée comme un facteur important dans le conditionnement de l’ordre des mots en bantou. L’importance de la fonction discursive dans la détermination de l’ordre des mots des langues bantoues est visible par exemple dans l’inversion locative et les positions du focus. À la suite de tels phénomènes, il a été proposé que l’ordre des mots en bantou est mieux représenté par les rôles discursifs, par ex. Topique-Verbe-Non-topique. Néanmoins, nous observons généralement des déclarations décrivant l’ordre des mots bantou par rapport aux rôles grammaticaux (par exemple « SVO »), et les notions de « sujet » et « objet » restent au cœur des analyses du bantou. Dans cet article, nous présentons les résultats d’une étude reconsidérant l’ordre des mots bantou dans une perspective des configurations discursives, en nous demandant jusqu’où nous pouvons aller sans référence aux rôles grammaticaux. Nous utilisons une approche paramétrique pour étudier cette variation syntaxique, en présentant de nouvelles données de terrain, axées sur le discours, recueillies sur 9 langues bantoues. Nous montrons comment ces paramètres mettent en évidence la variation au sein de la famille, chaque langue se situant à un point différent sur un continuum entre les rôles grammaticaux et les rôles discursifs. Nous nous opposons donc à une description unique de l’ordre des mots bantou et préconisons des approches qui incluent à la fois les rôles grammaticaux et discursifs

Preface

1. The issue The present special issue is developed from a workshop entitled Bantu Universals and Variation at the 10th World Congress of African Linguistics (WOCAL10) held online at Leiden University in June 2021. It includes a selection of papers presented at the workshop, as well as papers submitted in response to an open call for papers. The resultant special issue brings together new perspectives on universals and variation in the Bantu language family, with regards to morphosyntax, sema..

A “Bundle of Care” to Improve Anticoagulation Control in Patients Receiving Warfarin in Uganda and South Africa: Protocol for an Implementation Study

Background: The quality of warfarin anticoagulation among Sub-Saharan African patients is suboptimal. This is due to several factors, including a lack of standardized dosing algorithms, difficulty in providing timely international normalized ratio (INR) results, a lack of patient feedback on their experiences with treatment, a lack of education on adherence, and inadequate knowledge and training of health care workers. Low quality of warfarin anticoagulation, expressed as time in therapeutic range (TTR), is associated with higher adverse event rates, including bleeding and thrombosis, and ultimately, increased morbidity and mortality. Processes and interventions that improve this situation are urgently needed. Objective: This study aims to evaluate the implementation of the “warfarin bundle,” a package of interventions to improve the quality of anticoagulation and thereby clinical outcomes. The primary outcome for this study is TTR over the initial 3 months of warfarin therapy. Methods: Patients aged 18 years or older who are newly initiated on warfarin for venous thromboembolism, atrial fibrillation, or valvular heart disease will be enrolled and followed up for 3 months at clinics in Cape Town, South Africa, and Kampala, Uganda, where the warfarin bundle is implemented. A retrospective review of the clinical records of patients on warfarin treatment before implementation (controls) will be used for comparison. This study uses a mixed methods approach of the implementation of patient- and process-centered activities to improve the quality of anticoagulation. Patient-centered activities include the use of clinical dosing algorithms, adherence support, and root cause analysis, whereas process-centered activities include point-of-care INR testing, staff training, and patient education and training. We will assess the impact of these interventions by comparing the TTR and safety outcomes across the 2 groups, as well as the cost-effectiveness and acceptability of the package. Results We started recruitment in June 2021 and stopped in August 2022, having recruited 167 participants. We obtained ethics approval from the University of Cape Town Faculty of Health Sciences Human Research Ethics Committee, the Provincial Health Research Committees in South Africa, the Joint Clinical Research Centre Institutional Review Board, Kampala, and the University of Liverpool Research Ethics Committee. As of February 2023, data cleaning and formal analysis are underway. We expect to publish the full results by December 2023. Conclusions We anticipate that the “bundle of care,” which includes a clinical algorithm to guide individualized dosing of warfarin, will improve INR control and TTR of patients in Uganda and South Africa. We will use these findings to design a larger, multisite clinical trial across several Sub-Saharan African countries. International Registered Report Identifier (IRRID) DERR1-10.2196/4671