Burnout Levels among Professional Counselors in Butabika and Mulago National Referral Hospitals in Uganda

Counseling profession places unique demands on care-providers and has negative consequences. This study explored prevalence of burnout and its preventive measures among professional counselors in Butabika and Mulago national referral hospitals in Uganda using the Professional Quality of Life-IV (proQOL-IV) questionnaire to determine levels of burnout. A total of ten research questions were used to determine common strategies employed by counselors in mitigating burnout. A cross sectional descriptive study was adopted and simple random sampling was used to select a sample of 123 respondents. The results showed that70% and 68% of counselors had developed burnout in Butabika and Mulago respectively. It was found out that the most effective strategies for mitigating burnout include; attending workshops, social support, travelling, going on vacations, hobbies, social skills, relaxation, spirituality and supervision. The study recommended that a combination of organizational and individual strategies is necessary to prevent burnout

Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management

Atrioventricular block is classified as congeni- tal if diagnosed in utero, at birth, or within the first month of life. The pathophysiological process is believed to be due to immune-mediated injury of the conduction system, which occurs as a result of transplacental pas- sage of maternal anti-SSA/Ro-SSB/La antibodies. Childhood atrioventricular block is therefore diagnosed between the first month and the 18th year of life. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited progressive car- diac conduction disorders. Indications and techniques of cardiac pacing have also evolved to allow safe perma- nent cardiac pacing in almost all patients, including those with structural heart abnormalities

A Latent Class Analysis of Agricultural Technology Use Behavior in Uganda and Implications for Optimal Targeting

Agricultural productivity is still very low in Africa largely due to low use of improved agricultural technologies. Existing adoption studies are marred by univariate analyses, often focusing on single technologies over a limited scope while assuming uniform effects of the explanatory variables across farm households. In this study, we use a large dataset that covers a wide geographical and agricultural scope to describe use-patterns of improved agro-technology in Uganda. Using latent class analysis, and over 12,500 households collected across the four regions of Uganda, we classify farmers based on the package of improved agro-technologies used. We find that the majority of farmers (61%) do not use any improved agricultural practices ( non-users ) while only 5% of the farmers belong to the class of intensified diversifiers , using most of the commonly available agro-technologies across crop and livestock enterprises. Using multinomial regression analysis, we show that education of the household head, access to extension messages and affiliation to social groups, are the key factors that drive switching from the non-user reference class to the other three preferred classes that use improved agro-technologies to varying levels. Results reveal that different farmer categories with different agro-technology needs, which may have implications for optimal targeting. Acknowledgement : The authors would like to thank the International Institute for Impact Evaluation (3ie) for financial support. This work was undertaken as part of the CGIAR Research Program on Policies, Institutions, and Markets (PIM) led by the International Food Policy Research Institute (IFPRI)

Yield effects of tissue culture bananas in Kenya: accounting for selection bias and the role of complementary inputs

We analyse yield effects of tissue culture (TC) banana technology in the Kenyan small farm sector, using recent survey data and an endogenous switching regression approach. TC banana plantlets, which are free from pests and diseases, have been introduced in East Africa since the late 1990s. Although field experiments show significant yield advantages over traditional banana suckers, a rigorous assessment of impacts in farmers’ fields is still outstanding. A comparison of mean yield levels between TC adopters and non-adopters in our sample shows no significant difference. However, we find evidence of negative selection bias, indicating that farmers with lower than average yields are more likely to adopt TC. Controlling for this bias results in a positive and significant TC net yield gain of 7%. We also find that TC technology is more knowledge intensive and more responsive to irrigation than traditional bananas. Simulations show that improving access to irrigation could lift TC productivity gains to above 20%. The analytical approach developed and applied here and the finding of negative selection bias may also be relevant for the evaluation of other agricultural technologies

Heterogeneous information exposure and technology adoption: the case of tissue culture bananas in Kenya

Published online: 5 July 2012Classical innovation adoption models implicitly assume homogenous information flow across farmers, which is often not realistic. As a result, selection bias in adoption parameters may occur. We focus on tissue culture (TC) banana technology that was introduced in Kenya more than 10 years ago. Up till now, adoption rates have remained relatively low.We employ the average treatment effects approach to account for selection bias and extend it by explicitly differentiating between awareness exposure (having heard of a technology) and knowledge exposure (understanding the attributes of a technology). Using a sample of Kenyan banana farmers, we find that estimated adoption parameters differ little when comparing the classical adoption model with one that corrects for heterogeneous awareness exposure. However, parameters differ considerably when accounting for heterogeneous knowledge exposure. This is plausible: while many farmers have heard about TC technology, its successful use requires notable changes in cultivation practices, and proper understanding is not yet very widespread. These results are also important for other technologies that are knowledge-intensive and require considerable adjustments in traditional practices

TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo

Background: HIV/AIDS and Tuberculosis (TB) are major contributors to the burden of disease in subSaharan Africa. The two diseases have been described as a harmful synergy as they are biologically and epidemiologically linked. Control of TB/HIV co-infection is an integral and most challenging part of both national TB and national HIV control programmes, especially in contexts of instability where health systems are suffering from political and social strife. This study aimed at assessing the provision of HIV/ TB co-infection services in health facilities in the conflict-ridden region of Goma in Democratic Republic of Congo. Methods: A cross-sectional survey of health facilities that provide either HIV or TB services or both was carried out. A semi-structured questionnaire was used to collect the data which was analysed using descriptive statistics. Results: Eighty facilities were identified, of which 64 facilities were publicly owned. TB care was more available than HIV care (in 61% vs. 9% of facilities). Twenty-three facilities (29%) offered services to co-infected patients. TB/HIV co-infection rates among patients were unknown in 82% of the facilities. Only 19 facilities (24%) reported some coordination with and support from concerned diseases’ control programmes. HIV and TB services are largely fragmented, indicating imbalances and poor coordination by disease control programmes. Conclusion: HIV and TB control appear not to be the focus of health interventions in this crisis affected region, despite the high risks of TB and HIV infection in the setting. Comprehensive public health response to this setting calls for reforms that promote joint TB/HIV co-infection control, including improved leadership by the HIV programmes that accuse weaknesses in this conflict-ridden region

Adoption and impact of tissue culture bananas in Burundi: an application of a propensity score matching approach

Pests and diseases are among the main reasons for low banana productivity in smallholder farming systems in the central African highlands, where the crop is an important staple, In parts of Rwanda, Burundi and North and South Kivu provinces of eastern Democratic Republic of Congo, diseases such as banana bunchy top virus and banana Xanthomonas wilt are prevalent, thereby creating a large demand for new planting material and improved varieties that may have higher yield combined with resistance to diseases or nematodes. To improve the productivity of banana (Musa spp), access by farmers to improved pest- and diseasefree planting material is fundamentaL Traditional methods of propagating bananas using suckers serve to perpetuate the problem of pests and diseases, thereby reducing production even further, Banana plantlets obtained from tissue culture (TC) technology are potentially disease-free alternatives but remain largely inaccessible to most smallholder farmers due to the high cost of plantlets, This study employs a propensity score matching technique to examine the adoption and impact of TC banana technology in Burundi using a sample of 313 banana-farming households, In Burundi, TC bananas are subsidized by FAO and non-government organizations (NGOs), thus providing free plantlets to farmers, However, the adoption of TC bananas has not resulted in any significant increment in banana productivity or gross margins compared with traditional propagation using suckers, Improvements in institutional factors related to the delivery of technology and improvement of TC plantlet quality seem to be preconditions for more favourable technology impacts

Tissue culture banana (Musa spp.) for smallholder farmers: lessons learnt from East Africa

The use of tissue culture (TC) banana (Musa spp.) planting material is an effective method of providing pest and disease-free plants. Although there are many added benefits to using TC plants, the adoption of TC technology remains relatively low in East Africa. Currently, adoption is increasing under impetus from the private sector. Adopting TC banana technology, however, is more expensive for the farmer than conventional suckers and may not be economically beneficial across all bananaproducing areas in East Africa. One of the greatest potential dangers for sustainable commercial TC plant production is the limited use of certification for plant quality and health, which is especially important in order to avoid the spread of viruses. Additionally, TC plant nurseries are important components, as they provide essential distribution hubs connecting TC producers with farmers. However, TC nurseries in East Africa face an array of challenges. Organizing banana farmers into groups has long been considered advantageous, as they foster increased buying and selling power, reduce economic and social risk, increase economies of scale, and facilitate access to credit and inputs in the case of formally certified groups. Distribution of superior planting material alone, however, does not ensure improved productivity. Smallholder farmers are constrained by factors such as a lack of: land, capital, access to technology and effective marketing infrastructure. As such, efficient distribution systems need to deliver TC plants as part of a package, including training and access to micro-credit. Despite a booming commercial sector, there is only anecdotal evidence that farmers who have adopted TC bananas have benefitted substantially in terms of higher yields and household incomes. Sound socio-economic analyses are crucial to guide policy strategies, to learn from successes already achieved and to identify important constraints for a wider dissemination of TC banana in the region