Egranary as a Digital Resource in Uganda: Preliminary Findings

In this paper, we address preliminary findings from a digital literacy study on the use the portable digital library, eGranary, currently being conducted in a rural Ugandan school. The eGranary system is an intranet that comprises a 750Gb harddrive with specialized browsing software, which can be attached to a PC or a local area network. It contains approximately 10 million educational documents, including Wikipedia, which can be searched like the internet (see www.egranary.org). Drawing on theories of new literacies and identities, the two research questions we are addressing in our current project are as follows: (i) how does eGranary function as a placed resource in Ugandan society? (ii) to what extent do identities shift as teachers learn from and contribute to global knowledge production? These research questions are centrally concerned with the innovative use of educational resources to promote social inclusion in poorly resourced regions of the world.\u

Civil society leadership in the struggle for AIDS treatment in South Africa and Uganda

Includes abstract.Includes bibliographical references.This thesis is an attempt to theorise and operationalise empirically the notion of ‘civil society leadership’ in Sub-Saharan Africa. ‘AIDS leadership,’ which is associated with the intergovernmental institutions charged with coordinating the global response to HIV/AIDS, is both under-theorised and highly context-specific. In this study I therefore opt for an inclusive framework that draws on a range of approaches, including the literature on ‘leadership’, institutions, social movements and the ‘network’ perspective on civil society mobilisation. This framework is employed in rich and detailed empirical descriptions (‘thick description’) of civil society mobilisation around AIDS, including contentious AIDS activism, in the key case studies of South Africa and Uganda. South Africa and Uganda are widely considered key examples of poor and good leadership (from national political leaders) respectively, while the Treatment Action Campaign (TAC) and The AIDS Support Organisation (TASO) are both seen as highly effective civil society movements. These descriptions emphasise ‘transnational networks of influence’ in which civil society leaders participated (and at times actively constructed) in order to mobilise both symbolic and material resources aimed at exerting influence at the transnational, national and local levels

Independent and combined effects of improved water, sanitation, and hygiene, and improved complementary feeding, on child stunting and anaemia in rural Zimbabwe: a cluster-randomised trial.

BACKGROUND: Child stunting reduces survival and impairs neurodevelopment. We tested the independent and combined effects of improved water, sanitation, and hygiene (WASH), and improved infant and young child feeding (IYCF) on stunting and anaemia in in Zimbabwe. METHODS: We did a cluster-randomised, community-based, 2 × 2 factorial trial in two rural districts in Zimbabwe. Clusters were defined as the catchment area of between one and four village health workers employed by the Zimbabwe Ministry of Health and Child Care. Women were eligible for inclusion if they permanently lived in clusters and were confirmed pregnant. Clusters were randomly assigned (1:1:1:1) to standard of care (52 clusters), IYCF (20 g of a small-quantity lipid-based nutrient supplement per day from age 6 to 18 months plus complementary feeding counselling; 53 clusters), WASH (construction of a ventilated improved pit latrine, provision of two handwashing stations, liquid soap, chlorine, and play space plus hygiene counselling; 53 clusters), or IYCF plus WASH (53 clusters). A constrained randomisation technique was used to achieve balance across the groups for 14 variables related to geography, demography, water access, and community-level sanitation coverage. Masking of participants and fieldworkers was not possible. The primary outcomes were infant length-for-age Z score and haemoglobin concentrations at 18 months of age among children born to mothers who were HIV negative during pregnancy. These outcomes were analysed in the intention-to-treat population. We estimated the effects of the interventions by comparing the two IYCF groups with the two non-IYCF groups and the two WASH groups with the two non-WASH groups, except for outcomes that had an important statistical interaction between the interventions. This trial is registered with ClinicalTrials.gov, number NCT01824940. FINDINGS: Between Nov 22, 2012, and March 27, 2015, 5280 pregnant women were enrolled from 211 clusters. 3686 children born to HIV-negative mothers were assessed at age 18 months (884 in the standard of care group from 52 clusters, 893 in the IYCF group from 53 clusters, 918 in the WASH group from 53 clusters, and 991 in the IYCF plus WASH group from 51 clusters). In the IYCF intervention groups, the mean length-for-age Z score was 0·16 (95% CI 0·08-0·23) higher and the mean haemoglobin concentration was 2·03 g/L (1·28-2·79) higher than those in the non-IYCF intervention groups. The IYCF intervention reduced the number of stunted children from 620 (35%) of 1792 to 514 (27%) of 1879, and the number of children with anaemia from 245 (13·9%) of 1759 to 193 (10·5%) of 1845. The WASH intervention had no effect on either primary outcome. Neither intervention reduced the prevalence of diarrhoea at 12 or 18 months. No trial-related serious adverse events, and only three trial-related adverse events, were reported. INTERPRETATION: Household-level elementary WASH interventions implemented in rural areas in low-income countries are unlikely to reduce stunting or anaemia and might not reduce diarrhoea. Implementation of these WASH interventions in combination with IYCF interventions is unlikely to reduce stunting or anaemia more than implementation of IYCF alone. FUNDING: Bill & Melinda Gates Foundation, UK Department for International Development, Wellcome Trust, Swiss Development Cooperation, UNICEF, and US National Institutes of Health.The SHINE trial is funded by the Bill & Melinda Gates Foundation (OPP1021542 and OPP113707); UK Department for International Development; Wellcome Trust, UK (093768/Z/10/Z, 108065/Z/15/Z and 203905/Z/16/Z); Swiss Agency for Development and Cooperation; US National Institutes of Health (2R01HD060338-06); and UNICEF (PCA-2017-0002)

Language education policy and multilingual literacies in Ugandan primary schools

This thesis reports on a study on multilingual language policies conducted in two primary schools in two communities in eastern Uganda, one rural and one urban, from 2005-2006. The study focused on stakeholders' responses to the new Uganda language education policy, which promotes the teaching of local languages in the first four years of schooling. The policy states that the medium of instruction is the relevant local language for Primary 1-4 in rural schools, and thereafter it is English. In the urban schools, English is the medium of instruction in all the classes and a local language is to be taught as a subject. The study was premised within the framework of literacy as a social practice. Accordingly, the context in which multilingual literacy develops is important to the implementation of Uganda's new language education policy. The key stakeholders identified in the implementation process included: the ministry representatives at the district level, the school administration, the teachers, and the community. The study used questionnaires, individual interviews, classroom observations, focus group discussions, and document analysis to collect data from the two communities, each of which was linked to a local primary school. Although the findings show that in both communities the participants were generally aware of the new local language policy, they were ambivalent about its implementation in their schools. While they recognized the importance of local languages in promoting identity and cultural maintenance, a higher priority was their children's upward mobility, and the desire to be part of wider and more international communities. Further, while area languages like Luganda and regional languages like Kiswahili were perceived to have some benefits as languages of wider communication, it was English that received unequivocal support from both communities. The study concludes that parents and communities need to be better informed about the pedagogical advantages of instruction in the local language, and that communities need convincing evidence that the promotion of local languages will not compromise desires for global citizenship. Therefore, drawing in particular on the work of Stein in South Africa, I argue that we need to consider "re-sourcing resources" to create space in which teachers and other stakeholders can enhance children's multilingual literacy development.Education, Faculty ofLanguage and Literacy Education (LLED), Department ofGraduat

Languaging in and about Lunyole: African Storybook materials as a catalyst for re-imagining literacy teaching and learning in two Ugandan primary schools

Throughout sub-Saharan Africa, many children are not learning to read competently in the first 3 years of primary school; thus, both ‘reading to learn’ and ‘reading for pleasure’ in these early years, and in higher grades, are constrained. Two of the many reasons for reading failure are the absence of suitable materials in languages with which learners are familiar and teachers’ limited knowledge of pedagogic practices that support reading development. In this article, we describe the African Storybook (ASb) initiative as one imaginative response to the dearth of interesting and accessible stories in local languages and report findings from the first phase of a professional development project in which teacher-researchers in two Ugandan schools are using ASb materials to ‘language’ in Lunyole at the meetings of their action research group. We argue that their investment in extending their literacy in a language which they speak more fluently than they read or write, and the contestations over written forms of this language that have surfaced in some of the discussions, are likely to be productive for their professional development as teachers and for their participation in ongoing community debates about the orthography of a recently codified and standardised language. By languaging together in Lunyole, with ASb materials as the main object of their conversations and activities, the teacher-researchers have begun to develop capabilities that are likely to benefit the Lunyole/ English biliteracy of the learners whom they teach. They are imagining new possibilities for themselves and for the learners

Patterns of treatment-seeking behaviors among caregivers of febrile young children: a Ugandan multiple case study

Background: The vast majority of malaria deaths in Uganda occur in children five and under and in rural areas. This study’s exploratory case study approach captured unique situations to illustrate special attributes and aspects of treatment-seeking during a malaria episode. Methods During August 2010, a qualitative exploratory study was conducted in seven of Butaleja District’s 12 sub-counties. Multiple case study methodology consisting of loosely-structured interviews were carried out with eight caregivers of children five and under in the local dialect. Caregivers were geographically distant and not known to each other. Interviews were translated into English and transcribed the same day. Data were analyzed using content analysis. Results Of the eight cases, children recovered fully in three instances, survived but with deficits in three, and died in two. Common to all outcomes were (1) triggers to illness recognition, (2) similar treatment sequences and practices, (3) factors which influenced caregivers’ treatment-seeking decisions, (4) challenges encountered while seeking care at public health facilities, (5) cost burdens associated with managing malaria, (6) life burdens resulting from negative outcomes from malaria, (7) variations in caregiver knowledge about artemisinin combination therapy, and (8) varying perspectives how malaria management could be improved. Conclusions Despite the reality that caregivers in Butaleja District generally share similar practices, experiences and challenges, very few children ever receive treatment in accordance with the Uganda’s national guidelines. To bring national practice into conformance with policy, three advances must occur: (1) All key stakeholders (those affiliated with the formal health system - public facilities and licensed private outlets, unlicensed drug vendors, and caregivers of young children) must concur on the need and the means to improve malaria management, (2) all health providers (formal and unlicensed) need to be engaged in training and certification to improve timely access to affordable treatment irrespective of a region’s remoteness or low population density, and (3) future public health interventions need to improve caregivers’ capacity to take the necessary actions to best manage malaria in young children.Medicine, Faculty ofNon UBCPopulation and Public Health (SPPH), School ofReviewedFacult

Caregivers’ treatment-seeking behaviors and predictors of whether a child received an appropriate antimalarial treatment: a household survey in rural Uganda

Background: This study responds to a rural community’s concern that, despite national initiatives, malaria management in young children falls short of national guidelines in their district. This study aimed to: (1) describe caregivers’ treatment-seeking behaviors in the rural district of Butaleja, (2) estimate the percentage of children who received an appropriate antimalarial, and (3) determine factors that maximized the likelihood of receiving an appropriate antimalarial. Appropriate antimalarial in this study is defined as having received only the Uganda’s age-specific first-line malaria treatment for uncomplicated and severe malaria during the course of the febrile illness. Methods A household survey design was used in 2011 to interview 424 caregivers with a child aged five and under who had fever within the two weeks preceding the survey. The survey evaluated factors that included: knowledge about malaria and its treatment, management practices, decision-making, and access to artemisinin combination therapy (ACT) and information sources. Bivariate analysis, followed by logistic regression, was used to determine predictors of the likelihood of receiving an appropriate antimalarial. Results Home management was the most common first action, with most children requiring a subsequent action to manage their fever. Overall, 20.9 % of children received a blood test, 68.4 % received an antimalarial, and 41.0 % received an ACT. But closer inspection showed that only 31.6 % received an appropriate antimalarial. These results confirm that ACT usage and receipt of an appropriate antimalarial in Butaleja remain well below the 2010/2015 target of 85 %. While nine survey items differentiated significantly whether a child had or had not received an appropriate antimalarial, our logistic regression model identified four items as independent predictors of likelihood that a child would receive an appropriate antimalarial: obtaining antimalarials from regulated outlets (OR = 14.99); keeping ACT in the home for future use (OR = 6.36); reporting they would select ACT given the choice (OR = 2.31); and child’s age older than four months (OR = 5.67). Conclusions Few children in Butaleja received malaria treatment in accordance with national guidelines. This study highlighted the importance of engaging the full spectrum of stakeholders in the management of malaria in young children - including licensed and unlicensed providers, caregivers, and family members.Education, Faculty ofMedicine, Faculty ofNon UBCEducational Studies (EDST), Department ofPopulation and Public Health (SPPH), School ofReviewedFacult

Additional file 2: Table S2. of Patterns of treatment-seeking behaviors among caregivers of febrile young children: a Ugandan multiple case study

Caregivers’ experiences with external sourcesa. (PDF 171 kb

Additional file 4: Figure S3. of Caregivers’ treatment-seeking behaviors and predictors of whether a child received an appropriate antimalarial treatment: a household survey in rural Uganda

Select first actions taken by caregivers (n = 424). Abbreviations: artemisinin combination therapy (ACT); antimalarial (AM); malaria (MA); management (Mgmt); trained health professional (HP); within (W/I). (DOCX 64 kb