Barriers and facilitators to women’s leadership in savings associations in Uganda

The Village Savings and Loan Association (VSLA) model is currently being employed in Uganda for deepening financial inclusion and poverty reduction. Despite its focus on women’s empowerment, concerns have arisen of an under-representation of women on VSLA leadership committees. Human rights-based, economic, and social justice arguments support active participation of women on VSLA leadership committees. The study sought to identify, explicate and characterise the barriers and facilitators to women in VSLA leadership. An exploratory study design using qualitative methods was selected to address the research objectives. Forty-nine focus group discussions were undertaken, featuring both VSLA members and non-members. VSLAs for inclusion in the study were randomly selected from within four regions of Uganda, stratified by: mature (>2 years old) versus new (<2 years old). The study exposed a diverse array of barriers and facilitators to women in VSLA leadership positions, revealing the influence of individual, material, institutional and social factors, in addition to social norms and gender characteristics, on women in VSLA leadership. The findings revealed that the design of interventions to achieve fair representation of women in leadership positions should be informed by an understanding of the different types, relative strengths, support for/against, and intersectionality of the factors impacting women in VSLA leadership

User-centered design of a gamified mental health app for adolescents in sub-Saharan Africa: multicycle usability testing study

Background: There is an urgent need for scalable psychological treatments to address adolescent depression in low-resource settings. Digital mental health interventions have many potential advantages, but few have been specifically designed for or rigorously evaluated with adolescents in sub-Saharan Africa. Objective: This study had 2 main objectives. The first was to describe the user-centered development of a smartphone app that delivers behavioral activation (BA) to treat depression among adolescents in rural South Africa and Uganda. The second was to summarize the findings from multicycle usability testing. Methods: An iterative user-centered agile design approach was used to co-design the app to ensure that it was engaging, culturally relevant, and usable for the target populations. An array of qualitative methods, including focus group discussions, in-depth individual interviews, participatory workshops, usability testing, and extensive expert consultation, was used to iteratively refine the app throughout each phase of development. Results: A total of 160 adolescents from rural South Africa and Uganda were involved in the development process. The app was built to be consistent with the principles of BA and supported by brief weekly phone calls from peer mentors who would help users overcome barriers to engagement. Drawing on the findings of the formative work, we applied a narrative game format to develop the Kuamsha app. This approach taught the principles of BA using storytelling techniques and game design elements. The stories were developed collaboratively with adolescents from the study sites and included decision points that allowed users to shape the narrative, character personalization, in-app points, and notifications. Each story consists of 6 modules (“episodes”) played in sequential order, and each covers different BA skills. Between modules, users were encouraged to work on weekly activities and report on their progress and mood as they completed these activities. The results of the multicycle usability testing showed that the Kuamsha app was acceptable in terms of usability and engagement. Conclusions: The Kuamsha app uniquely delivered BA for adolescent depression via an interactive narrative game format tailored to the South African and Ugandan contexts. Further studies are currently underway to examine the intervention’s feasibility, acceptability, and efficacy in reducing depressive symptoms