Effects of Improved Access to Transportation on Emergency obstetric Care Outcomes in Uganda

Reduction in maternal mortality has not been appreciable in most  low-income countries. Improved access to transport for mothers is one way to improve maternal health. This study evaluated a free-of-charge 24-hour ambulance and communication services intervention in Oyam district using ‘Caesarean section rate’ (CSR) and compared with the neighbouring  non-intervention district. Ecological data were collected retrospectively from maternity/theatre registers in October 2010 for 3 years pre and 3 years  intervention period. The average CSR in the intervention district increased from 0.57% before the intervention to 1.21% (p=0.022) during the  intervention, while there was no change in the neighbouring district (0.51% to 0.58%, p=0.512). Hospital deliveries increased by over 50% per year with a slight reduction in the average hospital stillbirths per 1000 hospital births in the intervention district (46.6 to 37.5, p=0.253). Reliable  communication and transport services increased access to and utilization of maternal health services, particularly caesarean delivery services. (Afr J Reprod Health 2014; 18[3]: 87-94)Keywords: caesarean section, emergency obstetric care, ambulance services, accessibility, referral and communication syste

Nutritional value of selected wild edible plants in Teso-Karamoja Region, Uganda

The use of wild plants for food in the rural communities of Uganda is widespread. This is attributed to food scarcity, perceived nutritional value,  medicinal and health benefits and cultural preservation. However, the claims on the nutritional value of some wild edible plant species have not  been fully validated. In cognizance of this, the macroelement, beta-carotene and ascorbic acid profile of five wild plants commonly used for food in and around eight forest reserves of Teso-Karamoja region, Uganda, were analysed. The plants prioritized for analysis were Vigna kirkii (Baker) J.B. Gillett, Maerua angolensis D.C., Leptadenia hastata (Schumach. & Thonn.) Decne, Senna obtusifolia (L.) H.S. Irwin & Barneby and Dioscorea sp.). The  macro-element, ascorbic acid and beta-carotene composition of these plants was analyzed in triplicate. The variance in parameter means was  analysed using one-way Analysis of Variance in SPSS ver. 16.0. The results showed that all the means of species were significantly different at the p=0.05 level. The highest macro-nutrient means were 80.74±0.34 %/100 g moisture content in V. kirkii, 3.95±0.23 g/100 g ash content in M.  angolensis, 19.04±0.37 Kcal gross energy in M. angolensis, 27.93±0.85 g/100 g dietary fibre in L. hastata, 3.40±0.13 g/100 g crude fat in L. hastata, 65.43±2.91 g/100 g carbohydrate in Dioscorea sp., 36.37±0.42 g/100 g crude protein in M. angolensis. The highest ascorbic acid mean was 14.71±3.56 mg/100 g in M. angolensis while beta-carotene was 1082.1±0.08 μg/100 g in S. obtusifolia. These results show that these wild edible plants have a significantly variable nutritional value. Some of the macro elements can sufficiently meet the Recommended Daily Allowance (RDA) and Adequate Intakes (AI) for certain life stages and groups if consumed in ideal quantities. This information is vital in enhancing food and nutrition security awareness in the community and uplifting the social appeal and acceptability of these plants. This can be enhanced by investigating the micro-nutrients of public health significance, anti-nutrient factors, and toxic compounds in these plants. Key words: Nutritional value, wild edible plants, macro-nutrient, ascorbic acid, betacarotene,Teso-Karamoja, Ugand

Structural Changes are More Important than Compositional Changes in Driving Biomass Loss in Ugandan Forest Fragments

Aboveground biomass (AGB) contained in privately-owned forests is less frequently measured than in forest reserves despite their greater likelihood of degradation. We demonstrate how density changes in contrast to species compositional changes have driven AGB changes in privately-owned fragments in Uganda over two decades. Data on tree assemblages in fragments were obtained by re-sampling a 1990 dataset in 2010 and AGB estimated using generalised allometric equation that incorporates diameter at breast height (DBH) and species-specific wood density. AGB were highly variable between fragments and over time. Structural changes contributed a higher proportion of change in AGB than species compositional changes in all forests. Non-pioneer species constituted over 50% of AGB in reserve forest, in contrast to private forests where pioneer species dominated. Our study demonstrates the potential of private forests to hold comparable AGB to plantation. Reduction in exploitation pressure is required if fragments are to mitigate carbon emissions

The Effects of Ash and Black Carbon (Biochar) on Germination of Different Tree Species

Forest fires generate large amounts of ash and biochar, or black carbon (BC), that cover the soil surface, interacting with the soil’s constituents and its seedbank. This study concerns reproductive ecology assessments supported by molecular characterisation to improve our understanding of the effects of fire and fire residues on the germination behaviour of 12 arboreal species with a wide geographic distribution. For this purpose, we analysed the effects of three ash and one BC concentration on the germination of Acacia dealbata Link, A. longifolia (Andrews) Willd., A. mearnsii De Wild., A. melanoxylon R. Br., Pinus nigra Arnold, P. pinaster Aiton, P. radiata D. Don, P. sylvestris L., Quercus ilex L., Q. pyrenaica Willd., Q. robur L., and Q. rubra L. Each tree species was exposed to ash and BC created from its foliage or twigs (except for Q. rubra, which was exposed to ash and BC of Ulex europaeus L.). We monitored germination percentage, the T50 parameter, and tracked the development of germination over time (up to 1 yr). The BC of A. dealbata, P. pinaster, and Q. robur was analysed by pyrolysis-gas chromatography-mass spectrometry (PY-GC-MS) to assess the molecular composition. In six species, ash inhibited the germination, while in another five species, germination was not affected by ash or by BC. In Q. rubra, ash and BC stimulated its germination. This stimulating effect of the BC on Q. rubra is likely to be related to the chemical composition of the ash and BC obtained from Ulex feedstock. The BC of U. europaeus has a very different molecular composition than the other BC samples analysed, which, together with other factors, probably allowed for its germination stimulating effects.This study was carried out within the Project 10MDS200007PR, financed by the Xunta de Galicia; the Project AGL2013-48189-C2-2-R, financed by the Ministerio de Economía y Competitividad, Spain; and FEDERS

Reflecting strategic and conforming gendered experiences of community health workers using photovoice in rural Wakiso district, Uganda

BACKGROUND: Community health workers (CHWs) are an important human resource in Uganda as they are the first contact of the population with the health system. Understanding gendered roles of CHWs is important in establishing how they influence their performance and relationships in communities. This paper explores the differential roles of male and female CHWs in rural Wakiso district, Uganda, using photovoice, an innovative community-based participatory research approach. METHODS: We trained ten CHWs (five males and five females) on key concepts about gender and photovoice. The CHWs took photographs for 5 months on their gender-related roles which were discussed in monthly meetings. The discussions from the meetings were recorded, transcribed, and translated to English, and emerging data were analysed using content analysis in Atlas ti version 6.0.15. RESULTS: Although responsibilities were the same for both male and female CHWs, they reported that in practice, CHWs were predominantly involved in different types of work depending on their gender. Social norms led to men being more comfortable seeking care from male CHWs and females turning to female CHWs. Due to their privileged ownership and access to motorcycles, male CHWs were noted to be able to assist patients faster with referrals to facilities during health emergencies, cover larger geographic distances during community mobilization activities, and take up supervisory responsibilities. Due to the gendered division of labour in communities, male CHWs were also observed to be more involved in manual work such as cleaning wells. The gendered division of labour also reinforced female caregiving roles related to child care, and also made female CHWs more available to address local problems. CONCLUSIONS: CHWs reflected both strategic and conformist gendered implications of their community work. The differing roles and perspectives about the nature of male and female CHWs while performing their roles should be considered while designing and implementing CHW programmes, without further retrenching gender inequalities or norms