Pressure From Below: The Case of Walukuba?Masese Division in the Municipality of Jinja, Uganda

Uganda has recently embraced a decentralised system of governance with the main goal of approaching citizens to participatory decision?making processes and improving efficiency and effectiveness of service delivery, as well as fighting poverty and exclusion. Despite a number of important government programmes, policies and structures, a significant number of people in Uganda still remain poor and many still live below the poverty line. There is a high degree of powerlessness and voicelessness that negatively influences the level of organisation for collective action. In the districts of Jinja and Lira, the Pressure From Below experience has been led by a grass roots organisation engaging with government and non?government institutions to influence citizens at the local level to voice their concerns and participate in joint community improvement initiatives

Why the increase in under five mortality in Uganda from 1995 to 2000? A retrospective analysis

<p>Abstract</p> <p>Background</p> <p>From 1995-2000 the under five mortality rate in Uganda increased from 147.3 to 151.5 deaths per 1000 live births and reasons for the increase were not clear. This study was undertaken to understand factors influencing the increase in under five mortality rate during 1995-2000 in Uganda with a view of suggesting remedial actions.</p> <p>Methods</p> <p>We performed a comparative retrospective analysis of data derived from the 1995 and the 2000 Uganda demographic and health surveys. We correlated the change of under five mortality rate in Uganda desegregated by region (central, eastern, north and western) with change in major known determinants of under five mortality such social economic circumstances, maternal factors, access to health services, and level of nutrition.</p> <p>Results</p> <p>The increase in under five mortality rate only happened in western Uganda with the other 3 regions of Uganda (eastern, northern and central) showing a decrease. The changes in U5MR could not be explained by changes in poverty, maternal conditions, level of nutrition, or in access to health and other social services and in the prevalence of HIV among women attending for ante-natal care. All these factors did not reach statistical significance (P > 0.05) using Pearson's correlation coefficient.</p> <p>Conclusion</p> <p>In order to explain these findings, there is need to find something that happened in western Uganda (but not other parts of the country) during the period 1995-2000 and has the potential to change the under five mortality by a big margin. We hypothesize that the increase in under five mortality could be explained by the severe malaria epidemic that occurred in western Uganda (but not other regions) in 1997/98.</p

The "aid contract" and its compensation scheme: a case study of the performance of the Ugandan health sector.

Current literature on aid effectiveness describes increasing use of a more contractual approach to the relationship between donor and recipient government in which a system of rewards and penalties for good and bad performance operates. The purpose of this case study of the Ugandan health sector was to understand the extent to which this approach is influencing processes and effectiveness. This qualitative study used a conceptual framework based on agency theory and 'realistic evaluation'. Our results showed that the main official mechanism to assess and reward performance established through the Sector Wide Approach lacked objective criteria and was based on an unstructured system of discussions and agreements among donors. The achievement of a satisfactory performance rating was facilitated by the agreeing to undertakings that were under-demanding, vaguely formulated and lacking quantitative benchmarks against which progress could be measured. However, even when poor performance was readily observable, penalties failed to be applied by donors. This was always the case in relation to health sector performance and mostly so in relation to general governance and accountability. Funds continued to be disbursed despite the lack of progress made in achieving targets and undertakings and other evident performance problems (e.g. in the area of governance). A series of explanations of the failure to penalise were put forward by donor representatives in relation to this behaviour including the need to maintain long-term relationships based on trust and not to undermine health sector performance by withdrawing aid. Thus there are likely to be incentives to disburse funds and report success, irrespective of the realities of aid programmes in the context of large foreign aid volumes associated with increased political visibility of aid in donor countries

The private sector in rural water and sanitation services in Uganda: understanding the context and developing support strategies

This article analyses private sector delivery of water and sanitation services in Uganda. Uganda's policies of decentralization and privatization, combined with enhanced sector funding through debt relief, provide the context for the work described. After a brief description of the attributes of small water sector enterprises, the findings of extensive interviews with all the major stakeholders in eight of Uganda's 56 districts are set out under eight thematic headings (corruption; community participation; role of NGOs; private sector support services; networks and associations; local Government procurement procedures; construction quality; business viability) and two sets of root causes. The paper concludes that a sector strategy requires a limited number of focus areas in order to avoid overwhelming the institutions and local ownership. The strategy should lie between the extremes of prescriptive and process oriented approaches. Monitoring mechanisms should balance quantitative with qualitative data. Finally, a balance is needed between the drive for short-term impact through physical outputs and the long-term sustainability of water and sanitation services so delivered. Copyright © 2003 John Wiley & Sons, Ltd.

Opportunities and pitfalls for researchers to contribute to the design of evidence-based agricultural policies: lessons from Uganda

Agricultural policies in sub-Saharan Africa have paid insufficient attention to sustainable intensification. In Uganda, agricultural productivity has stagnated with aggregate increases in crop production being attributed to expansion of cultivated land area. To enhance sustainable crop intensification, the Ugandan Government collaborated with stakeholders to develop agricultural policies using an evidence-based approach. Previously, evidence-based decision-making tended to focus on the evidence base rather than evidence and its interactions within the broader policy context. We identify opportunities and pitfalls to strengthen science engagement in agricultural policy design by analysing the types of evidence required, and how it was shared and used during policy development. Qualitative tools captured stakeholders' perspectives of agricultural policies and their status in the policy cycle. Subsequent multi-level studies identified crop growth constraints and quantified yield gaps which were used to compute the economic analyses of policy options that subsequently contributed to sub-national program planning. The study identified a need to generate relevant evidence within a short time 'window' to influence policy design, power influence by different stakeholders and quality of stakeholder interaction. Opportunities for evidence integration surfaced at random phases of policy development due to researchers’ ’embededness’ within co-management and coordination structures

Reducing poverty through fisheries co-management: an analysis of design and intentions in Uganda

Reducing poverty is the overarching policy objective in developing countries and so policies in all sectors are required to show how they will contribute to poverty reduction-fisheries included. Fisheries co-management in Uganda has been designed to contribute to poverty reduction through development of an enabling policy framework; improving governance at community and lake wide levels; empowering marginalised stakeholders; and, improving benefits for women and the poor. Challenges for the realisation of poverty-reduction objectives include financing implementation in a donor-dependent environment; changing attitudes and securing commitment of local government officials and communities; and, ensuring that empowerment of the 'marginalised' is effective. Copyright © 2007 John Wiley & Sons, Ltd.

Gender inequity in the lives of women involved in sex work in Kampala, Uganda

BACKGROUND: Gender inequity is manifested in the social and economic burden women carry in relation to men. We investigate women's experiences of gender relations from childhood to adult life and how these may have led to and kept women in sex work. METHODS: Participants were drawn from an ongoing epidemiological cohort study of women working in high HIV/STI risk environments in Kampala. From over 1000 enrolled women, we selected 101 for a qualitative sub-study. This analysis focuses on 58 women who engaged in sex work either as a main job or as a side job. In-depth life history interviews were conducted to capture points of vulnerability that enhance gender inequity throughout their lives. RESULTS: Most participants were young, single parents, poorly educated, who occupied low skilled and poorly paying jobs. All women knew their HIV status and they disclosed this in the interview; 31 were uninfected while 27 said they were infected. Parental neglect in childhood was reported by many. Participants described experiences of violence while growing up sometimes perpetuated by relatives and teachers. Early unwanted pregnancies were common and for many led to leaving school. Some women stated a preference for multiple and short-term money-driven sexual relationships. Needing to earn money for child care was often the main reason for starting and persisting with sex work. Violence perpetrated by clients and the police was commonly reported. Alcohol and drug use was described as a necessary "evil" for courage and warmth, but sometimes this affected clear decision making. Many felt powerless to bargain for and maintain condom use. Leaving sex work was considered but rarely implemented. CONCLUSIONS: Inequities in gender and power relations reduce economic and social opportunities for better lives among women and increase risky sexual behaviour. Interventions focused on these inequities that also target men are crucial in improving safer practices and reducing risk