The integration of community engagement and outreach into teaching and learning, research and service at MUK, UCU and UMU in Uganda

This study was conducted to with the main objective being establishing the integration of CE&O into teaching and Learning, Research and Service at MUK, UCU and UMU universities in Uganda. The objectives of the study were ; to examine the models of CE&O used by Makerere, UCU and UMU universities , to establish how CE&O has been institutionalized by Makerere, UCU and UMU universities, to examine how CE&O has been integrated into research and teaching in Makerere, UCU and UMU universities. A cross sectional design was employed to provide a framework for data collection and analysis. A sequential mixed methods approach was employed, involving a successive application of both qualitative (Key Informant Interviews) and quantitative (questionnaire) data collection methods. Creswell et al (2004) argues that, mixed methods lend themselves to valuable opportunities for data triangulation. The findings clearly show that universities recognize CE&O as part of the university functioning albeit differences in emphasis with Makerere being more established in comparison to the newer universities UCU and Nkozi. Institutionalization of community engagement and outreach seems low among all the universities. The findings have shown that community engagement in research and community engaged service have the potential to improve teachin

Towards Promotion of Community rewards to Volunteer Community Health Workers? Lessons from Experiences of Village Health Teams in Luwero, Uganda

In the debate regarding volunteer Community Health Workers (CHWs) some argue that lack of remuneration is exploitation while others caution that any promise to pay volunteers will decrease the volunteer spirit. In this paper we discuss the possibility of community rewards for CHWs. Ethnographic fieldwork that lasted 18 months utilised methods including participant observation, FGDs, in-depth interviews and key informant interviews to gain insight into the dynamic relationship between volunteer CHWs known as Village Health Teams (VHTs) and the community. Contextual transcription was done and data was thematically analysed. Findings show that community members are willing to reward volunteer CHWs with cash, material and symbolic rewards in appreciation for their help. Factors crucial for this gesture included: care and recognition of the VHTs’ work by medical staff, fulfilment of the promises made to the community by government and exemplary behaviour by CHWs. Therefore, effort should be made to facilitate volunteer CHWs to be seen as helpful to their communities. Especially, there needs to be a smooth operation at the intersection between the VHTs, local government and medical structures. Community rewards could be a more sustainable way of motivating CHWs while a solution to health personnel shortage is sought

Selection and performance of village health teams (VHTs) in Uganda: lessons from the natural helper model of health promotion

Background: Community health worker (CHW) programmes have received much attention since the 1978 Declaration of Alma-Ata, with many initiatives established in developing countries. However, CHW programmes often suffer high attrition once the initial enthusiasm of volunteers wanes. In 2002, Uganda began implementing a national CHW programme called the village health teams (VHTs), but their performance has been poor in many communities. It is argued that poor community involvement in the selection of the CHWs affects their embeddedness in communities and success. The question of how selection can be implemented creatively to sustain CHW programmes has not been sufficiently explored. In this paper, our aim was to examine the process of the introduction of the VHT strategy in one rural community, including the selection of VHT members and how these processes may have influenced their work in relation to the ideals of the natural helper model of health promotion. Methods: As part of a broader research project, an ethnographic study was carried out in Luwero district. Data collection involved participant observation, 12 focus group discussions (FGDs), 14 in-depth interviews with community members and members of the VHTs and four key informant interviews. Interviews and FGD were recorded, transcribed and coded in NVivo. Emerging themes were further explored and developed using text query searches. Interpretations were confirmed by comparison with findings of other team members. Results: The VHT selection process created distrust, damaging the programme’s legitimacy. While the Luwero community initially had high expectations of the programme, local leaders selected VHTs in a way that sidelined the majority of the community’s members. Community members questioned the credentials of those who were selected, not seeing the VHTs as those to whom they would go to for help and support. Resentment grew, and as a result, the ways in which the VHTs operated alienated them further from the community. Without the support of the community, the VHTs soon lost morale and stopped their work. Conclusion: As the natural helper model recommends, in order for CHW programmes to gain and maintain community support, it is necessary to utilize naturally existing informal helping networks by drawing on volunteers already trusted by the people being served. That way, the community will be more inclined to trust the advice of volunteers and offer them support in return, increasing the likelihood of the sustainability of their service in the community

Traditional birth attendants (TBAs) as potential agents in promoting male involvement in maternity preparedness: insights from a rural community in Uganda

BACKGROUND: Since the 1994 International Conference on Population and Development, male involvement in reproductive health issues has been advocated as a means to improve maternal and child health outcomes, but to date, health providers have failed to achieve successful male involvement in pregnancy care especially in rural and remote areas where majority of the underserved populations live. In an effort to enhance community participation in maternity care, TBAs were trained and equipped to ensure better care and quick referral. In 1997, after the advent of the World Health Organization’s Safe Motherhood initiative, the enthusiasm turned away from traditional birth attendants (TBAs). However, in many developing countries, and especially in rural areas, TBAs continue to play a significant role. This study explored the interaction between men and TBAs in shaping maternal healthcare in a rural Ugandan context. METHODS: This study employed ethnographic methods including participant observation, which took place in the process of everyday life activities of the respondents within the community; 12 focus group discussions, and 12 in-depth interviews with community members and key informants. Participants in this study were purposively selected to include TBAs, men, opinion leaders like village chairmen, and other key informants who had knowledge about the configuration of maternity services in the community. Data analysis was done inductively through an iterative process in which transcribed data was read to identify themes and codes were assigned to those themes. RESULTS: Contrary to the thinking that TBA services are utilized by women only, we found that men actively seek the services of TBAs and utilize them for their wives’ healthcare within the community. TBAs in turn sensitize men using both cultural and biomedical health knowledge, and become allies with women in influencing men to provide resources needed for maternity care. CONCLUSION: In this study area, men trust and have confidence in TBAs; closer collaboration with TBAs may provide a suitable platform through which communities can be sensitized and men actively brought on board in promoting maternal health services for women in rural communities

Impact of HIV/AIDS on Households’ Food Production in Bushenyi District, Uganda

AIDS has had a devastating impact on Uganda and has significantly lowered life expectancy, reduced the country‟s labor force, reduced agricultural output and food security.AIDS has had a devastating impact on Uganda and has significantly lowered life expectancy, reduced the country‟s labor force, reduced agricultural output and food security. Although much research has been done on the impact of HIV/AIDS in general, relatively little research has been conducted to establish how HIV/AIDS has affected food production at the household level. The objective of the study was to investigate the extent of the HIV/AIDS impact on households‟ food production in Bushenyi district in the context of their demographic and economic backgrounds. This was a cross-sectional study that used the quantitative research design. The study applied a multi-stage cluster sampling of the administrative units; and a complete coverage of the villages was randomly selected. Results show that age, level of education of the household heads, religion, and the form of income, had a great influence on the impact of HIV/AIDS on households‟ food production

The Accreditation Process and Challenges of Private Religious Based Universities in Uganda

The quantitative growth in Ugandan higher education subsector has created many challenges including a drop in quality in education delivery.The quantitative growth in Ugandan higher education subsector has created many challenges including a drop in quality in education delivery. Today, there are 34 universities in Uganda (up from 26 in 2006) with over 185,000 students (up from 137,190), representing an overall growth rate of more than 15% in the last 5 years. Given this rapid expansion of higher education, some form of regulation is necessary to assure quality. Ugandan government established the National Council for Higher Education (NCHE) as a regulatory agency to set standards and regulations to ensure that all public and private tertiary education institutions in Uganda create, sustain and improve the relevance and quality of higher education for all qualified Ugandans and to meet the local, national and global higher education challenges of the 21st century. In addition to sustaining and improving the relevance and quality of higher education, these religious based universities have a special mission of evangelism and discipleship and view all admissions and appointments as opportunities for ministry and service. This however, may not go well with the peer assessors and the Accrediting Agencies. Currently there are more than six recognised faith based universities in Uganda. Out of the seven fully accredited universities in Uganda, five are faith based and only two are secular. There are different views about the philosophies of these faith-based universities. Some people seem to suggest that they pay more attention to evangelism and discipleship than in provision of higher education. While others view this type of institutions as a very good model to provide good morals and education that can transform the society in a positive way. At the same time, the regulatory framework in the country must provide for an all-inclusive environment for all to participate in higher education which may pose a big challenge to these faith based institutions. This article therefore, discusses the accreditation process in Uganda and challenges of private religious based Universities in Uganda in regards to accreditation

Cholera outbreak caused by drinking contaminated water from a lakeshore water collection site, Kasese District, south-western Uganda, June-July 2015

The study investigated this outbreak to identify the mode of transmission and to recommend control measures of cholera.On 20 June 2015, a cholera outbreak affecting more than 30 people was reported in a fishing village, Katwe, in Kasese District, south-western Uganda. We investigated this outbreak to identify the mode of transmission and to recommend control measures. We defined a suspected case as onset of acute watery diarrhoea between 1 June and 15 July 2015 in a resident of Katwe village; a confirmed case was a suspected case with Vibrio cholera cultured from stool. For case finding, we reviewed medical records and actively searched for cases in the community. In a case-control investigation we compared exposure histories of 32 suspected case-persons and 128 age-matched controls. We also conducted an environmental assessment on how the exposures had occurred. We found 61 suspected cases (attack rate = 4.9/1000) during this outbreak, of which eight were confirmed. The primary case-person had onset on 16 June; afterwards cases sharply increased, peaked on 19 June, and rapidly declined afterwards. After 22 June, eight scattered cases occurred. The case-control investigation showed that 97% (31/32) of cases and 62% (79/128) of controls usually collected water from inside a water-collection site ªXº (ORM-H = 16; 95% CI = 2.4±107). The primary case-person who developed symptoms while fishing, reportedly came ashore in the early morning hours on 17 June, and defecated ªnearº water-collection site X. We concluded that this cholera outbreak was caused by drinking lake water collected from inside the lakeshore water-collection site X. At our recommendations, the village administration provided water chlorination tablets to the villagers, issued water boiling advisory to the villagers, rigorously disinfected all patients' faeces and, three weeks later, fixed the tap-water system

UvA-DARE (Digital Academic Repository) Traditional birth attendants (TBAs) as potential agents in promoting male involvement in maternity preparedness: insights from a rural community in Uganda

Traditional birth attendants (TBAs) as potential agents in promoting male involvement in maternity preparedness Insights from a rural community in Uganda General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Download date: 01 Jul 2019 R E S E A R C H Open Access Traditional birth attendants (TBAs) as potential agents in promoting male involvement in maternity preparedness: insights from a rural community in Uganda Abstract Background: Since the 1994 International Conference on Population and Development, male involvement in reproductive health issues has been advocated as a means to improve maternal and child health outcomes, but to date, health providers have failed to achieve successful male involvement in pregnancy care especially in rural and remote areas where majority of the underserved populations live. In an effort to enhance community participation in maternity care, TBAs were trained and equipped to ensure better care and quick referral. In 1997, after the advent of the World Health Organization's Safe Motherhood initiative, the enthusiasm turned away from traditional birth attendants (TBAs). However, in many developing countries, and especially in rural areas, TBAs continue to play a significant role. This study explored the interaction between men and TBAs in shaping maternal healthcare in a rural Ugandan context

Rhomboids of Mycobacteria: Characterization Using an <em>aarA</em> Mutant of <em>Providencia stuartii</em> and Gene Deletion in <em>Mycobacterium smegmatis</em>

<div><h3>Background</h3><p>Rhomboids are ubiquitous proteins with unknown roles in mycobacteria. However, bioinformatics suggested putative roles in DNA replication pathways and metabolite transport. Here, mycobacterial rhomboid-encoding genes were characterized; first, using the <em>Providencia stuartii</em> null-rhomboid mutant and then deleted from <em>Mycobacterium smegmatis</em> for additional insight in mycobacteria.</p> <h3>Methodology/Principal Findings</h3><p>Using in silico analysis we identified in <em>M. tuberculosis</em> genome the genes encoding two putative rhomboid proteins; Rv0110 (referred to as “rhomboid protease 1”) and Rv1337 (“rhomboid protease 2”). Genes encoding orthologs of these proteins are widely represented in all mycobacterial species. When transformed into <em>P. stuartii</em> null-rhomboid mutant (Δ<em>aarA</em>), genes encoding mycobacterial orthologs of “rhomboid protease 2” fully restored AarA activity (AarA is the rhomboid protein of <em>P. stuartii</em>). However, most genes encoding mycobacterial “rhomboid protease 1” orthologs did not. Furthermore, upon gene deletion in <em>M. smegmatis</em>, the ΔMSMEG_4904 single mutant (which lost the gene encoding MSMEG_4904, orthologous to Rv1337, “rhomboid protease 2”) formed the least biofilms and was also more susceptible to ciprofloxacin and novobiocin, antimicrobials that inhibit DNA gyrase. However, the ΔMSMEG_5036 single mutant (which lost the gene encoding MSMEG_5036, orthologous to Rv0110, “rhomboid protease 1”) was not as susceptible. Surprisingly, the double rhomboid mutant ΔMSMEG_4904–ΔMSMEG_5036 (which lost genes encoding both homologs) was also not as susceptible suggesting compensatory effects following deletion of both rhomboid-encoding genes. Indeed, transforming the double mutant with a plasmid encoding MSMEG_5036 produced phenotypes of the ΔMSMEG_4904 single mutant (i.e. susceptibility to ciprofloxacin and novobiocin).</p> <h3>Conclusions/Significance</h3><p>Mycobacterial rhomboid-encoding genes exhibit differences in complementing <em>aarA</em> whereby it's only genes encoding “rhomboid protease 2” orthologs that fully restore AarA activity. Additionally, gene deletion data suggests inhibition of DNA gyrase by MSMEG_4904; however, the ameliorated effect in the double mutant suggests occurrence of compensatory mechanisms following deletion of genes encoding both rhomboids.</p> </div

Mycobacterial rhomboid-encoding genes display differences in complementing <i>aarA</i>.

<p>This table summarizes phenotype rescue ability in XD37.A by mycobacterial rhomboid-encoding genes. With the exception of <i>MAP2426c</i> and <i>MAP2425c</i>, all genes encoding the orthologs of “rhomboid protease 2” fully restored AarA activity (i.e. the golden yellow pigment of colonies, cell morphology, growth on MacConkey agar and the putative signal). <i>MSMEG_5036</i> was the only “rhomboid protease 1” encoding gene that behaved like genes encoded by “rhomboid protease 2” but comparatively weaker. However, all mycobacterial rhomboid-encoding genes (except those of those of MAP) strongly activated production of the extracellular putative signal. Species/strains from which rhomboids were cloned are indicated in brackets (<i>MTB</i> H₃₇Rv, <i>MTB</i> clinical isolates [BN44], <i>M. bovis</i> BCG, <i>M. bovis</i> cattle strain [JN55], <i>M. avium</i> clinical isolate [SU-36800], MAP and <i>M. smegmatis</i> [SMR5]).</p>a<p><i>P. stuartii</i> wild type strain;</p>b<p><i>P. stuartii</i> rhomboid deficient strain;</p>c<p><i>P. stuartii</i> rhomboid deficient strain complemented with <i>aarA</i> (wild type gene);</p>e<p>Two hypothetical rhomboid gene fragments (encoding MAP2426c and MAP2425c) cloned in-frame;</p><p><b>-</b>, not applicable.</p