155 research outputs found
Treatment seeking behaviour among poor urban women in Kampala Uganda
This thesis examines women's treatment seeking behaviour for their own illnesses and that of children underfive in Kamwokya . The focus is on the extent to which women's access to money and time use patterns affect treatment seeking. It has been argued that women's treatment seeking behaviour is influenced more by their time use than their access to and availability of money.The findings obtained through the use of case histories and in-depth interviews indicate that though women in Kamwokya have access to their own money, mainly through participation in income generating activities (business), illness management for children under-five and even more for the women themselves, remains problematic. Women are overworked and manage fragile businesses that require their personal attention and presence. Hence, treatment seeking is done in a manner that will ensure minimal disruption of businesses. Consequently children's health, and even more so, that of women , is compromised for the sake of other family needs.This thesis demonstrates that illness management is not context free, and that no one factor can explain the whole process ; it both affects and is affected by other things happening in the family. Due to the multiple roles women have to fulfil, "time use "is found to be the organising and central factor in illness management for both women and children in Kamwokya, whether from rich or poor households.The thesis concludes by suggesting that policy makers, health care providers and professionals ought to take into account the daily routines of family life in their plans and programmes. Strengthening of private sector health providers, health education programmes and increased awareness raising of male responsibilities towards their families are recommended as a way of improving the health of women and children in Uganda
Question de confiance
Ă lâimage de la nouvelle gĂ©nĂ©ration de professionnels de lâinformation, Jane est ouverte, enthousiaste, engagĂ©e, dynamique. Entre deux ateliers du sĂ©minaire CTA sur les organisations paysannes, elle a rĂ©pondu aux questions de Spore sur son travail, son action et ses rĂȘves. Un brin de conversation Ă lâombre dâun arbre.
' Lâinformation, câest le pouvoir. Lâinformation et le savoir vous mettent en confiance et vous permettent de prendre des dĂ©cisions en connaissance de cause. ' Veut-elle dire par lĂ quâune personne accomplie ne doute pas dâelle-mĂȘme et que certaines personnes avec qui elle travaille ne sont pas des agricultrices et agriculteurs accomplis? En un sens, oui. Certains ne sont pas sĂ»rs dâeux, mĂȘme sâils sont issus dâune famille qui cultive la terre depuis des siĂšcles. Ils ont lâinformation pratique, certes, mais ils nâen savent pas assez sur les marchĂ©s. Un producteur qui ignore la demande du marchĂ© nâaura peut-ĂȘtre pas de dĂ©bouchĂ©, mĂȘme sâil produit un excellent maĂŻs. Alors, il risque de se dĂ©sintĂ©resser de son maĂŻs, puisque celui-ci ne lui rapporte rien.
Et le pouvoir, demandons-nous? Notre travail, rĂ©torque Jane, consiste Ă donner aux gens le pouvoir et la confiance en soi en les informant. Beaucoup de gens nâosent pas se lever et prendre la parole, parce quâils ont peur de ne pas dire ' ce quâil faut ', mais sâils sont informĂ©s, sâils sont sĂ»rs dâeux, ils peuvent faire de bons commentaires ou poser la bonne question au bon moment. Cela les aide Ă sâengager.
Moi-mĂȘme, ajoute-t-elle, jâai besoin de confiance pour aller chercher la bonne information, par exemple chez mes collĂšgues â chercheurs, agronomes, vulgarisateurs, commerciaux ou chargĂ©s du crĂ©dit. Jâai besoin quâils apprĂ©cient mieux le rĂŽle de lâinformation et quâils ne considĂšrent pas quâils ont dâautres prioritĂ©s quand je leur demande un article.
Mais, insistons-nous, pense-t-on encore vraiment ainsi au XXIe siĂšcle, en pleine Ăšre de lâinformation ? Pas intentionnellement, nous rassure-t-elle. En fait, la plupart des gens ont du mal Ă estimer une information Ă sa juste valeur, car ils ne peuvent ni la toucher ni la sentir. Un vulgarisateur peut montrer des semences ou des espacements Ă respecter dans la culture du maĂŻs, et les paysans verront et apprĂ©cieront directement. Avec lâinformation, ils ne rĂ©agissent pas aussi vite.
Jane se penche en avant, comme pour marteler son propos sur une note plus positive. ' Certaines personnes apprĂ©cient lâinformation, dâailleurs des agriculteurs Ă©crivent dans notre revue Farmersâ Voice. ' Au passage, nous plaisantons avec elle : quâest-ce qui vaut mieux, publier les lettres de lecteurs en premiĂšre page comme dans FV ou en derniĂšres pages comme dans Spore ? Jane parle dâun agriculteur de la rĂ©gion du centre quâelle a rencontrĂ© pendant un atelier et qui lui a dit : ' Jâai lu un article sur un agriculteur qui produit, dans une autre rĂ©gion, des oranges et des fruits de la passion et je me suis dit, sâil peut le faire, pourquoi pas moi ? ' Les fruits de la passion sont devenus sa principale source de revenus et la plus sĂ»re. Ce quâil a bien fait comprendre Ă ses collĂšgues participant Ă lâatelier, câest quâil faut apprĂ©cier la connaissance et toujours chercher Ă en savoir plus. En fait, le savoir a changĂ© sa vie.
Jâai aussi Ă©crit sur un autre paysan, Jane continue, car il ne connaissait pas lâanglais et nâĂ©tait pas en mesure de lire lâarticle. Il a Ă©tĂ© lu jusquâau Danemark oĂč se trouve le principal bailleur de fonds de lâUNFFE. Une organisation paysanne danoise sâest intĂ©ressĂ©e Ă lui et quand son Ă©quipe de tournage est venue en Ouganda pour un film, elle lui a rendu visite. En fin de compte, il a obtenu une formation spĂ©ciale en vulgarisation, car il Ă©tait douĂ© pour transmettre des connaissances Ă ses collĂšgues paysans. Croyez-moi, il est maintenant trĂšs sĂ»r de lui, il sâest vraiment Ă©panoui et quand il vient au bureau, il demande ceci et cela, car il sait quâil connaĂźt exactement les besoins des autres agriculteurs.
Et tout le monde est comme lui, demandons-nous? Pas tout le monde : certains liront quelque chose, lâapprĂ©cieront et le mettront en pratique ; dâautres nâen feront rien de concret. Lâinformation, suggĂ©rons-nous, serait-elle comme les semences qui tombent ici sur un sol fertile ou lĂ sur les cailloux, comme on le dit dans la Bible ? Jane dĂ©veloppe lâidĂ©e : ce nâest pas une question de terre caillouteuse. La terre peut ĂȘtre trĂšs fertile, mais elle a besoin dâeau. Lâinformation peut tomber sur cette terre fertile, mais manquer de pluie. LâĂ©nergie des gens peut avoir sur lâinformation lâeffet de la pluie sur une semence.
Jane parle avec fiertĂ© des Ă©missions de radio de son organisation et de sa collection de cassettes pour les agriculteurs, en six langues. Elle Ă©voque la façon dont chaque exemplaire de FV est lu par quatre personnes et est diffusĂ© dans les Ă©coles, et son projet dâaugmenter le tirage au-delĂ des 2 000 exemplaires actuels en le finançant par la publicitĂ©.
Quâest-ce qui lâa déçue ? La maigre couverture des thĂšmes agricoles par la presse Ă©crite. Lâattitude des journalistes, qui demandent un ' coup de pouce ', et des rĂ©dacteurs qui dissertent sur la culture du haricot, mais nâabordent pas les grandes questions politiques. Jane sâenflamme et parle dâorganiser un atelier pour les journalistes afin de gagner leurs plumes.
A-t-elle un rĂȘve, un rĂȘve professionnel ? Ses yeux brillent un peu plus, sa main bat lâair fermement. Je veux ĂȘtre dans un rĂ©seau, aider Ă donner la bonne information aux agriculteurs, crĂ©er une boutique oĂč lâon puisse tout trouver, mais elle nâexiste pas encore parce que les investisseurs, les agences dâappui nâapprĂ©cient pas la circulation de lâinformation Ă sa juste valeur.
Ah ! Mais ça, câest parce quâils nâont pas encore rencontrĂ© Jane⊠la confiance personnifiĂ©e.
[caption]
Jane Kyomuhendo Baitwa dirige le service dâinformation de la FĂ©dĂ©ration nationale ougandaise des agriculteurs (UNFFE) â anciennement lâUNFA â Ă Kampala, ainsi que son magazine Farmersâ Voice. Journaliste professionnelle avec une expĂ©rience radio, elle est titulaire dâune maĂźtrise en sciences politiques de lâUniversitĂ© de Makerere.
Les opinions exprimĂ©es dans ce Point de vue sont celles de lâauteur, et ne reflĂštent pas nĂ©cessairement les idĂ©es du CTA.Ă lâimage de la nouvelle gĂ©nĂ©ration de professionnels de lâinformation, Jane est ouverte, enthousiaste, engagĂ©e, dynamique. Entre deux ateliers du sĂ©minaire CTA sur les organisations paysannes, elle a rĂ©pondu aux questions de Spore sur son..
Gender focused methods of research
Meeting: Climate Change and Adaptation Workshop, 25-30 January, 2010, Naivasha, KEResearch methodology should include a range of data collection methods to address the gender dimensions of vulnerability. Gender focused research reduces biases such as: treating sex/gender like any other variable and failing to put it into context; assumptions about gender neutrality and the consequent failure to provide gender sensitive research; failing to disaggregate data based on sex; failing to analyze sex-disaggregated data; failing to report the results of disparities. No single method can cover all of the issues hence it is important to combine quantitative and qualitative methods
High Efficacy of Two Artemisinin-Based Combinations (Artesunate + Amodiaquine and Artemether + Lumefantrine) in Caala, Central Angola.
In April 2004, 137 children 6-59 months of age with uncomplicated Plasmodium falciparum (Pf) malaria (Caala, Central Angola) were randomized to receive either artemether-lumefantrine (Coartem) or artesunate + amodiaquine (ASAQ). After 28 days of follow-up, there were 2/61 (3.2%) recurrent parasitemias in the Coartem group and 4/64 (6.2%) in the ASAQ group (P = 0.72), all classified as re-infections after PCR genotyping (cure rate = 100% [95%CI: 94-100] in both groups). Only one patient (ASAQ group) had gametocytes on day 28 versus five (Coartem) and three (ASAQ) at baseline. Compared with baseline, anemia was significantly improved after 28 days of follow-up in both groups (Coartem: from 54.1% to 13.4%; ASAQ: from 53.1% to 15.9%). Our findings are in favor of a high efficacy of both combinations in Caala. Now that Coartem has been chosen as the new first-line anti-malarial, the challenge is to insure that this drug is available and adequately used
Competitive advantage in SMEs: effect of supply chain management practices, logistics capabilities and logistics integration in a developing country
Purpose â The purpose of this paper is to explore the relationship between supply chain management practices, logistics capabilities, logistics integration and competitive advantage of Small and Medium Enterprises (SMEs) in a developing country. Design/methodology/approach â Using a structured questionnaire survey, cross-sectional data collected from 204 SMEs in Kampala â Uganda were analysed using exploratory and confirmatory factor analysis, and Structural Equation Modelling (SEM) using AMOS version 26 to validate the theorised relationships. Findings â The study findings revealed that both supply chain management practices and logistics integration are positively and significantly associated with competitive advantage. Also, both supply chain management practices and logistics capabilities are positively and significantly associated with logistics integration. Additionally, the authors found that logistics integration partially mediates in the relationships between supply chain management practices and competitive advantage, and logistics capabilities and competitive advantage. Conclusively, the three independent variables collectively account for 11% variance in competitive advantage of SMEs. Originality/value â Given the general observation that SMEs are fundamental to socio-economic development, yet resource constrained, this study uses Resource-based and dynamic capabilities theoretical perspectives to provide an empirical understanding of the supply chain and logistics resources and capabilities necessary for building competitive advantage of SMEs in the context of a developing economy
Supervised versus unsupervised antimalarial treatment with six-dose artemether-lumefantrine: pharmacokinetic and dosage-related findings from a clinical trial in Uganda.
BACKGROUND: A six-dose antimalarial regimen of artemether-lumefantrine (A/L) may soon become one of the most widely used drug combination in Africa, despite possible constraints with adherence and poor absorption due to inadequate nutrition, and a lack of pharmacokinetic and effectiveness data. METHODS: Within a trial of supervised versus unsupervised A/L treatment in a stable Ugandan Plasmodium falciparum transmission setting, plasma lumefantrine concentrations were measured in a subset of patients on day 3 (C [lum]day3) and day 7 (C [lum]day7) post-inclusion. Predictors of lumefantrine concentrations were analysed to show how both C [lum]day7 and the weight-adjusted lumefantrine dose affect 28-day recrudescence and re-infection risks. The implications of these novel findings are discussed in terms of the emergence of lumefantrine-resistant strains in Africa. RESULTS: C [lum]day3 and C [lum]day7 distributions among 241 supervised and 238 unsupervised patients were positively skewed. Unsupervised treatment and decreasing weight-adjusted lumefantrine dose were negatively associated with C [lum]day3. Unsupervised treatment and decreasing age showed strong negative associations with C [lum]day7. Both models were poorly predictive (R-squared < 0.25). There were no recrudescences in either arm, but decreasing lumefantrine dose per Kg resulted in up to 13-fold higher adjusted risks of re-infection. Re-infections occurred only among patients with C [lum]day7 below 400 ng/mL (p < 0.001). CONCLUSION: Maintaining the present six-dose regimen and ensuring high adherence and intake are essential to maximize the public health benefits of this valuable drug combination
Limiting nutrients for bean production on contrasting soil types of Lake Victoria Crescent of Uganda
Common bean (Phaseolus vulgaris L.) is one of the most important grain legumes in East Africa, but its yield has remained below the genetic potential. Declining soil fertility is among the primary constraints to bean production in most East African bean producing regions. Often existing recommendations are generic and inept to guide farm level decision making on nutrient replenishment. A greenhouse nutrient omission study was conducted to determine the limiting nutrients in three soils of Masaka District, commonly cropped to beans: âLiddugavuâ a Phaeozem, âLimyufumyufuâ a Cambisol and âLuyinjayingaâ an Umbrisol soil. Nine treatments; (i) complete nutrient treatment, (ii) N omitted, (iii) P omitted, (iv) K omitted, (v) Mg omitted, (vi) S omitted, (vii) Ca omitted, (viii) Micronutrients omitted and (ix) control without nutrients. Each treatment was randomly assigned to the three soils and replicated three times using a completely randomised design. Nitrogen, phosphorus and potassium were limiting nutrients for bean production in Umbrisol (Luyinjayinja) while in Cambisol (âLimyufumyufu), common bean production was most limited by soil acidity. The performance varied with soil types, with beans grown on the Phaeozem registering greater leaf number and growth, confirming both scientistâs and local farmerâs knowledge that this soil has greater potential than the other two soils
The pathway of obstructed labour as perceived by communities in south-western Uganda: a grounded theory study
BACKGROUND: Obstructed labour is still a major cause of maternal and perinatal morbidity and mortality in Uganda, where many women give birth at home alone or assisted by non-skilled birth attendants. Little is known of how the community view obstructed labour, and what actions they take in cases where this complication occurs. OBJECTIVE: The objective of the study was to explore community members' understanding of and actions taken in cases of obstructed labour in south-western Uganda. DESIGN: Grounded theory (GT) was used to analyse data from 20 focus group discussions (FGDs), 10 with women and 10 with men, which were conducted in eight rural and two urban communities. RESULTS: A conceptual model based on the community members' understanding of obstructed labour and actions taken in response is presented as a pathway initiated by women's desire to 'protecting own integrity' (core category). The pathway consisted of six other categories closely linked to the core category, namely: (1) 'taking control of own birth process'; (2) 'reaching the limit - failing to give birth' (individual level); (3) 'exhausting traditional options'; (4) 'partner taking charge'; (5) 'facing challenging referral conditions' (community level); and finally (6) 'enduring a non-responsive healthcare system' (healthcare system level). CONCLUSIONS: There is a need to understand and acknowledge women's reluctance to involve others during childbirth. However, the healthcare system should provide acceptable care and a functional referral system closer to the community, thus supporting the community's ability to seek timely care as a response to obstructed labour. Easy access to mobile phones may improve referral systems. Upgrading of infrastructure in the region requires a multi-sectoral approach. Testing of the conceptual model through a quantitative questionnaire is recommended
Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies
BACKGROUND: Very few data on anti-malarial efficacy are available from the Democratic Republic of Congo (DRC). DRC changed its anti-malarial treatment policy to amodiaquine (AQ) and artesunate (AS) in 2005. METHODS: The results of two in vivo efficacy studies, which tested AQ and sulphadoxine-pyrimethamine (SP) monotherapies and AS+SP and AS+AQ combinations in Boende (Equatorial province), and AS+SP, AS+AQ and SP in Kabalo (Katanga province), between 2003 and 2004 are presented. The methodology followed the WHO 2003 protocol for assessing the efficacy of anti-malarials in areas of high transmission. RESULTS: Out of 394 included patients in Boende, the failure rates on day 28 after PCR-genotyping adjustment of AS+SP and AS+AQ were estimated as 24.6% [95% CI: 16.6-35.5] and 15.1% [95% CI: 8.6-25.7], respectively. For the monotherapies, failure rates were 35.9% [95% CI: 27.0-46.7] for SP and 18.3% [95% CI: 11.6-28.1] for AQ. Out of 207 patients enrolled in Kabalo, the failure rate on day 28 after PCR-genotyping adjustment was 0 [1-sided 95% CI: 5.8] for AS+SP and AS+AQ [1-sided 95% CI: 6.2]. It was 19.6% [95% CI: 11.4-32.7] for SP monotherapy. CONCLUSION: The finding of varying efficacy of the same combinations at two sites in one country highlights one difficulty of implementing a uniform national treatment policy in a large country. The poor efficacy of AS+AQ in Boende should alert the national programme to foci of resistance and emphasizes the need for systems for the prospective monitoring of treatment efficacy at sentinel sites in the country
Limiting nutrients for bean production on contrasting soil types of Lake Victoria Crescent of Uganda
Common bean (Phaseolus vulgaris L.) is one of the most important grain
legumes in East Africa, but its yield has remained below the genetic
potential. Declining soil fertility is among the primary constraints to
bean production in most East African bean producing regions. Often
existing recommendations are generic and inept to guide farm level
decision making on nutrient replenishment. A greenhouse nutrient
omission study was conducted to determine the limiting nutrients in
three soils of Masaka District, commonly cropped to beans:
\u201cLiddugavu\u201d a Phaeozem, \u201cLimyufumyufu\u201d a
Cambisol and \u201cLuyinjayinga\u201d an Umbrisol soil. Nine
treatments; (i) complete nutrient treatment, (ii) N omitted, (iii) P
omitted, (iv) K omitted, (v) Mg omitted, (vi) S omitted, (vii) Ca
omitted, (viii) Micronutrients omitted and (ix) control without
nutrients. Each treatment was randomly assigned to the three soils and
replicated three times using a completely randomised design. Nitrogen,
phosphorus and potassium were limiting nutrients for bean production in
Umbrisol (Luyinjayinja) while in Cambisol (\u2018Limyufumyufu), common
bean production was most limited by soil acidity. The performance
varied with soil types, with beans grown on the Phaeozem registering
greater leaf number and growth, confirming both scientist\u2019s and
local farmer\u2019s knowledge that this soil has greater potential
than the other two soils.Le haricot commun (Phaseolus vulgaris L.) est un des l\ue9gumes
\ue0 grains les plus importants en Afrique de l\u2019Est, mais son
rendement reste toujours en dessous de son potentiel
g\ue9n\ue9tique. La baisse de la fertilit\ue9 du sol est parmi
les contraintes primaires \ue0 la production du haricot dans la
plupart des r\ue9gions productrices de l\u2019Afrique de
l\u2019Est. Le plus souvent, les recommandations sont
g\ue9n\ue9riques et inad\ue9quates pour guider la prise de
d\ue9cision au niveau champ sur le r\ue9approvisionnement en
nutriment. Une \ue9tude sous serre sur l\u2019omission de nutriment
a \ue9t\ue9 conduite pour d\ue9terminer les nutriments limitants
dans les trois sols du district de Masaka, commun\ue9ment
utilis\ue9s pour produire du haricot\ua0: \u201cLiddugavu\u201d
un sol du Phaeozem, \u201cLimyufumyufu\u201d un sol du Cambisol et
\u201cLuyinjayinga\u201d un sol du Umbrisol. Neuf traitements, (i)
traitement complet de nutriments, (ii) N omis, (iii) P omis, (iv) K
omis, (v) Mg omis, (iv) S omis, (vii) Ca omis, (viii) micronutriments
omis et (ix) control sans nutriments. Chacun des traitements a
\ue9t\ue9 al\ue9atoirement distribu\ue9 aux trois types de sols
et r\ue9pliqu\ue9 trois fois dans un dispositif compl\ue8tement
al\ue9atoire. Azote, phosphore, et potassium ont \ue9t\ue9 les
nutriments limitants pour la production du haricot dans Umbrisol
(Luyinjayinja) tandis que dans Cambisol (\u2018Limyufumyufu), la
production du haricoct commun a \ue9t\ue9 limit\ue9e par
l\u2019acidit\ue9 du sol. Les performances varient en fonction des
types de sols, avec le haricot produit sur le Phaeozem comptant plus de
feuilles et de croissance, confirmant \ue0 la fois les connaissances
des scientifiques et des populations locales qui stipulent que le sol a
un potentiel plus \ue9lev\ue9 que les deux autres sols
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