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Factors affecting utilization of health care services in Uganda by 2002/2003.

(Makerere University, 2007) Sserwadda, Ntale Peter

The government of Uganda set up the Health Policy Review Commission (HPRC) in 1987 which culminated in the development of the current health policy, Health Sector Strategic Plan (HSSP), to address the ill health in Uganda. The HSSP addressed ill health mainly from the supply approach (improved provision of equipment and human resource). However the approach has not achieved the desired level of health, Uganda like many developing countries still has poor health indices. The purpose of this study is to look at an alternative approach, demand approach, which can be of significant importance in achieving improved health. The approach has entailed an investigation into “Factors Affecting Utilization of Health Care services (HCS) in Uganda by 2002/2003”. In order to achieve that main objective, the study has investigated on the demographic socio-economic, household and geographical factors to establish whether they have an effect on utilization of HCS. Descriptive and multivariate techniques of analysis were adopted to manipulate UNHS, 2002/2003 data collected by UBOS. The key findings of the study show that the infectious diseases were the major cause of sickness in all the four regions, with malaria in the lead. Though the health centers were on average within a distance of four kilometers and treatment was provided free or subsidized, most people sought treatment from clinics where payment for the services was required. The illness mild, health facilities being costly and too far, were the main reasons advanced for not consulting or utilize the available HCS. In the multivariate techniques of data analysis, a multinomial logit regression model was fixed, and showed that sex and age of an individual, residence and education of the household head were decisive in determining the type of HCS an individual opted to utilize. Based on the above findings, the policy makers need to go a step ahead and find out why individuals in Uganda opt to utilize HCS where payment is required instead of utilizing those provided free. There is need to establish whether such occurrence is due to individual perceived concepts or organizational factors or community factors; or a combination of factors. Whatever cause established, appropriate measures should be taken to rectify the problem. The differences observed in utilization of HCS between males and females, the young and elderly, the urban residents and rural and then the less educated and more educated is a clear indication that health is multi-dimension. Therefore if improved health is to be achieved a wider health reform approach need to be undertaken.
Health care insurance seeking patterns in South Africa in 2005 : a case study of civil servants

(Makerere University, 2007) Sukati, Ernest Sabelo

This study investigated the influence of six background characteristics - age, Gender, marital status, province, race and salary level - on civil servants’ health insurance seeking patterns in South Africa in 2005 i.e. the outcome variable. It was based on institutional data sourced from the Department of Public Service and Administration (DPSA), compiled from 1,0I0,518 civil servants’ Employrnent\payroll records. Regrettably, non-availability of educational data may have compromised the comprehensiveness of the study. Because of the dichotomous nature of the outcome variable; Logistic Regression model was applied to the data. Additionally, frequency tables were used to present civil servants’ distribution. The study adopted a three-level analysis; univariate, bivariate and multivariate. To establish association between civil servants’ health insurance seeking behaviour and their corresponding background characteristics, Pearson’s Chi-square and probabilities were used (at 5% level). Findings of the study revealed that about one in two civil servants (49.63%) had no health insurance. Their profile in the main was; the under 50’s, mostly males, cross-cutting between the single and married, strikingly working in poor Limpopo and rich Gauteng Provinces. Africans and the lowly-paid. Encouragingly, results of the study upheld existing literature to the effect that health cover seeking patterns varied with socio-economic status (SES) - a composite index combining, among others; income, age, Gender, employment status, occupational status, educational status and area of residence. In spite of minor variations, all the background characteristics were found to be significantly associated with health cover seeking behaviour. Thus, to stimulate health cover seeking behaviour; government policies may consider national campaigns targeting employees fitting the profile presented in the preceding paragraph. Further, the state-driven universal health insurance (UHI) being mooted should be non-compulsory. Once in place, a removal of compulsory health insurance from the labour market should follow - it creates rigidity; discouraging the young from joining employers who provide it, while the old do not leave such employers, thereby stifling aggregate employment.
Utilization of obstetric care services: A case study of Soroti Municipality in Uganda

(Makerere University, 2007) Achen, Stella

The study was conducted in Soroti district in Uganda. The main focus of the study was on obstetrics as a component of maternal health. Obstetric complications are the leading cause of death for women in the reproductive age group 15-49 years, as a result of pregnancy and childbirth. The study looked at four major technical interventions useful in improving maternal health outcomes, namely: Emergency obstetric care (EmOC), skilled attendance, antenatal care and family planning. The objective of the study was to assess the level of utilization of obstetric care services in improving maternal and child health in Soroti Municipality. A total of 247 clients were interviewed, and 7 health care providers were given a separate structured questionnaire. A cross-sectional study was conducted, and the criteria for eligibility were those clients attending ANC and those in the maternity section. Exit interviews were used to get the necessary information from the clients. Methods used for data analysis included univariate, and bivariate analyses. The study findings indicated that there was generally low utilization of obstetric care services as a result of low availability of the services. Factors that contributed to low utilization included: waiting time at health facility, distance to the nearest health facility as many (36.4%) of the clients moved for more than 5 kms, cost of services, lack of husband's support and the low staffing levels. Staffing levels can be improved by recruiting more qualified health care providers, providing free timely obstetric services to every mother who is in need of them, build more health facilities that offer obstetric care services and provide health education to women so that they are able to make their own decisions especially about their health, and the health care providers. The health care providers must substantially help to build a more pronounced positive attitude towards the clients.
A KAP (Knowledge, Attitudes, Practices) study on abstinence as an HIV preventive strategy among adolescents in Kampala Secondary Schools.

(Makerere University, 2007) Agiresaasi, Apophia

This study on abstinence as a strategy for HIV prevention among adolescents in Kampala secondary schools set out to investigate the knowledge, attitudes, and practices related to abstinence as a primary HIV prevention strategy. The main objective of this research was to investigate attitudes, knowledge and practices related to abstinence as a strategy for prevention of HIV infection among the adolescents in Kampala secondary schools. A total of 353 adolescents aged between 12 and 21years attending secondary schools in Kampala were interviewed and data analyzed. Using frequency tables, the distribution of respondents according to their characteristics was presented. The chi – square test was used to establish the association between the independent variables and the dependent variable (Practice of abstinence). Abstinence was generally interpreted to mean virginity or avoidance of any coital activity. Some had a more liberal definition and interpreted abstaining to mean being in a relationship but not engaging in any sexual activities. This definition was, however, challenged by some who felt that abstinence meant being in no girl/boy relationship at all. Despite universal awareness and approval of abstinence as an appropriate HIV prevention strategy, myths and misconception still abound. Abstaining was perceived to result into diseases like backache, masturbation and impotence. Respondents’ knowledge of abstinence as an appropriate HIV prevention strategy was explored. Only a few did not have the knowledge while the majority were aware that abstinence was an effective HIV prevention strategy. Since attitudes towards virginity may determine ones practice of abstinence, respondents were asked whether they thought it was possible for one to maintain virginity till marriage and majority thought it was possible while the minority thought it was not possible. The majority of the adolescents reported to be abstaining. Other strategies adopted to prevent HIV were condom use and being faithful to their girl/boy friends. In the cross tabulations, factors that were found to be associated with adolescent decision to abstain were: age, sex, ever had sex, have boy/girlfriend, had sex in last one year, attitude towards virginity, knowledge of abstinence as an effective HIV prevention strategy, exposure to pornography, no of wives adolescents father has and quality of sex education received. According to the model, those likely to abstain were male, young, had received information that abstinence is an effective HIV prevention strategy, had no girl/boy friend, had never had sex, had received value based sex education, had not had sex in the last one year, had a positive attitude towards premarital chastity and were not exposed to pornography. This study recommended that targeted interventions like counseling, Information , Education and Communication materials should be provided to help adolescents fully understand the meaning of abstinence and cope with this period. It was also recommended that adolescents who have already made a decision to abstain should be followed up especially those who are out of school. More research in related areas not yet addressed has also been suggested. Future researchers should investigate the social stigma that those abstaining are confronted with. They should also study the lives of younger adolescents aged 10 –12years.
Factors affecting adolescents' utilization of antenatal services in Western Uganda.

(Makerere University, 2007) Kasabiiti, Jennifer-Asiimwe

The study is an outcome of the analysis of data generated by AYA (2002) that examined ASRH behaviors in 24 districts of AYA operation in Uganda. It reviews information about the relationship between adolescents and their utilization of ANC services in LDCs given the structural, economical and wide spread cultural constraints. In order to achieve the stated objective, the study focused on the socioeconomic and demographic factors affecting ever use and number of visits to ANC centres. Literature was reviewed and pointed out the highly missing information on adolescent utilization of ANC in western Uganda despite the high proportion of adolescents to the whole proportion, the high maternal mortality rates .The study therefore adopted both descriptive and multivariate analysis to accumulate findings for western Uganda, the focus of the study. Out of the total 497 respondents interviewed in western Uganda, the study shows that majority of the respondents were rural dwellers (82.9%) with males being fewer than females (31.5%). By religion, Catholics dominated the study (49.5%) while primary pupils constituted the majority of respondents (61.4%). Rate of ANC use was estimated at 85%, only 43% of adolescents made the recommended 4 ANC visits. About 65% were satisfied with the ANC services, 10.9 % went for ANC for the first time in their third trimesters. There exists a significant relationship between ever use of ANC by sex, more females than males went for ANC, by district, Kyenjojo proved significant in both models). In the main analysis, increase in ANC utilization and number of visits was associated to district of origin, again Kyenjojo was significant in both models. More females than males utilized ANC services. As expected, the higher the levels of education, so was the level of ANC utilisation. The study therefore recommends that enrolment, especially for female adolescents to higher levels of education be vigilantly encouraged, so as to boost healthy uptake and also limit teenager pregnancies. Massive sensitization of the masses especially male spouses on the importance of ANC should be done to improve utilization by the married. There is also need to target key groups within adolescent projects (Young versus old, male versus female, in school versus out-of-school, respondents by residence and expensive but necessary ANC services be made more affordable.
Determinants of child nutrition in Uganda (1992-1999)

(Makerere University, 2007) Rubale, Gerald

Using nationally representative household surveys of 1992/ 93 and 1999/ 2000, the study sought to investigate the determinants of child nutrition in Uganda. Specifically, the study required to investigate whether there have been improvements in child nutrition over time. And whether there have been structural changes in the determinants of child nutrition. Child nutrition was approximated by height-for-age z-scores, a long-term child nutrition indicator. The findings demonstrate with substantial evidence that some household and community characteristics in general, play an important role in determining child nutrition outcome. Household consumption expenditure, maternal education, household size, condition of housing, availability of malaria drugs as well as presence of a trained health worker at the nearest health centre, and type of water source, were particularly singled out as the most important covariates. The results further indicate that children were healthier in 1999 than in 1992 and structural shifts in child nutrition determinants were manifested between 1992 and 1999. Household characteristics such as household consumption expenditure, toilet or sanitation facilities, housing conditions and maternal education were particularly found to change over time. Changes over time were also recognized among community characteristics like distance to me nearest health centre, public health centres, and availability of malaria drugs.
Factors that determine the prevalence of Anaemia among children aged less than 2 years in Uganda

(Makerere University, 2007) Nsubuga, Henry Mubiru

This study was based on the 2000-2001 Uganda Demography and Health Survey (UDHS), which was conducted in all the districts of the country except Bundibugyo, Gulu, Kasese and Kitgum. The main objective of this study was to find out the socioeconomic and demographic factors that have an impact on the anaemia status of a child and to also establish the prevalence rate of anaemia among children below two years. The distribution of the children in this study was such that 51% were males, while the females were 49% of all the children studied. Most of the children were residing in the same households with their mothers (97%). This can be attributed to the fact that these children are still in the infancy stage which requires much attention. It was found that most of the children in the study were in a rural area (75%) and thus residing in the countryside. In addition to this, children in rural areas were found to be more anaemic compared to those in the urban area. The mother’s level of education was found to be a statistically significant factor in determining the anaemia status of a child. The more educated a child’s mother, the less likely it was for a child to be anaemic. The number of children below five years of age in a household was significant in determining the anaemia status of a child. The greater the number of children below five years in a household, the more likely it was that a child below two years in such a household was anaemic. This could be attributed to the fact that there is increased competition for food and thus nutrients in the household. Finally, the prevalence rate of anaemia was found to be 65%, which showed that more than half of the children below two years were anaemic in Uganda. Since anaemia is largely attributed to iron deficiency, there is need for children in this age category to be given food rich in iron as anaemia has far reaching effects like intellectual impairment as well as retarded physical development among children.
Factors affecting decisions regarding child bearing among persons living With HIV/AIDS in Uganda: A study of Kampala and Jinja

(Makerere University, 2007-01) Baryamutuma, Rose

This study examined the factors that affect childbearing decisions by PHAs in Uganda. It was aimed at establishing whether fertility intentions among people living with HIV are influenced by access to ARVs, reproductive history or knowledge of PMTCT. Data used were collected from three organizations dealing with HIV infected people in Kampala and Jinja. Views about childbearing intentions subsequent to diagnosis with HIV were sought from 364 HIV infected individuals aged 19-44. It was established in this study that HIV dampens but does not eliminate childbearing intentions among PHAs. The results indicate that childbearing decisions are strongly associated with age, reproductive history and knowledge of PMTCT. In short, those with intentions of pursuing reproduction are younger, have no children of their own and are knowledgeable about PMTCT services. Further analysis indicates that those aged 19-24 were 2 times more likely to consider bearing children than their counterparts in advanced ages. Also, the findings confirmed that those with children were less likely to have intentions of childbearing compared to their counterparts without children. More so, the results revealed that those with knowledge of PMTCT services were about 2 times more likely to consider childbearing than their counterparts who were ignorant about PMTCT. Based on the findings of this study, it is recommended that reproductive desires and intentions of people living with HIV especially young PHAs are addressed. This is because like any other group in society, PHAs have fertility intentions which if not well understood by service providers in the HIV sector, have implications for the spread of HIV. To help them make informed decisions, therefore, young counselors who are themselves HIV positive and have received training in matters of childbearing among PHAs should be used. Also the use of success stories by HIV positive individuals who have successfully pursued parenthood can yield results. There is also need to increase sensitization about PMTCT services to help PHAs aspiring for parenthood to make informed decisions. This is because national statistics on knowledge and uptake of PMTCT services show a huge contrast between the former and latter. This can be done by conducting PMTCT workshops at the community level to reduce stigma associated with some aspects of PMTCT such as breastfeeding. Similarly, all efforts should be made to improve access to ARVs to help HIV positive people fulfill desires for parenthood without fears of ill health and limited lifespan.
Effects of exchange rate volatility on trade balance of Uganda (1991-2005).

(Makerere University, 2007-08) Wokadala, James

The primary objective of this study was to determine the effect of exchange rate volatility on trade balance of Uganda for the period 1991 – 2005. The specific objectives were to evaluate the effects of exchange rate volatility and other policy variables on trade balance and to analyze the dynamics of adjustment process on trade balance. The study employed Augmented Dickey Fuller test to establish the order of integration of the variables, the Johansen Maximum Likelihood ratio test to establish the cointegrating relationships and the number of cointegrating equations among variables in the trade balance model system. The Vector Autoregressive Correction model was used to examine dynamic relationships among variables. The exchange rate volatility, real exchange rate, terms of trade, direct investment, government expenditure, private consumption and lending interest rate were used as the long run determinants of trade balance. The results revealed that; Trade balance is insensitive to permanent changes in exchange rate volatility and lending interest rate but highly depend on private consumption, government expenditure, direct investment, real exchange rate and terms of trade in the long run. In addition, exchange rate volatility and lending interest rate were found to be contractionary in the short run because residents have high affinity for imports and demand tends to be inelastic. The results also revealed that government expenditure and direct investment were expansionary both in the short run and long run because they increase on the value of trade balance. Finally, real exchange rate depreciation has a contractionary effect on trade balance in the long run, but there is no presence of J-curve effect. It is recommended that there is need to increase the production of tradable and non-tradable goods and services that can sufficiently satisfy local demand and also be exported, encouraging direct investment through creating an enabling environment such as political stability, proper infrastructure and provision of trade incentives to both local and foreign direct investors should be a matter of priority. Besides, there should be affordable micro-finance facilities vis-à-vis lending interest rates to help local investors establish small and medium enterprises.
Effects of taxation on economic growth: (Uganda’s Experience: 1987-2005)

(Makerere University, 2007-11) Musaga, Brian

The development of endogenous growth theory has opened an avenue through which the effects of taxation on economic growth can be explored. Explicit modeling of the individual decisions that contribute to growth allows the analysis of tax incidence and the prediction of growth effects. This dissertation, titled “Effects of Taxation on Economic Growth (Uganda’s Experience: 1987-2005)”, reviews the theoretical and empirical evidence to assess how taxation affects the rate of economic growth in Uganda. The main objective of the study was to establish the effects of taxation on economic growth. Specific objectives included examining the long run effects of direct taxes on the rate of growth of GDP, examining the long run effects of indirect taxes on the rate of growth of GDP and estimating the empirical relationship between distortionary taxation and the rate of growth of the economy. Major tax reforms implemented in Uganda since early 1990s aimed at addressing fiscal challenges facing the country. Reforms were directed towards improving administrative efficiency and to ensure better taxpayer compliance. Studies on taxation and growth may find negative growth effects resulting from taxation, but it is more difficult to measure the potential benefits of the spending financed by the revenue collected. A combined impact of distortionary taxes and beneficial government expenditure can be used to assess the growth effects on an economy. In the methodology for this study, labor, capital, government consumption and revenue from the different tax components were used as the explanatory variables against GDP as the explained variable. Estimates of this study only reflect the cost of a combined tax and expenditure system and ignore effects caused by political decisions, corruption and other redistribution policies. The results show that a 1% change in direct taxes would increase economic growth by 0.86% while a percent change in indirect taxes would negatively impact economic growth by decreasing it by 0.53%. It was also found out that a 1% change in private investment would increase economic growth by 0.63% while the same change in public investment would decrease economic growth by 0.14%; though these results were not statistically significant. A 1% increase in the labor force would lead the economy to a 0.36% growth, holding other factors constant while a 1% change in government consumption decreases economic growth by 0.02% but again both effects were not found to be statistically significant. A regression with both direct and indirect taxes combined however showed that a percentage change in total tax revenue would reduce economic growth by 0.12% but this time the results were statistically insignificant. It is recommended that the government hedges the correlation between budget revenues and commodity prices to combat the negative effect of indirect taxes on economic growth. An improvement in international tax cooperation is also necessary to combat tax evasion and other harmful tax practices. Finally, fiscal relations among central and local governments need to be reformed to bring expenditure responsibilities at each level of government more into line with the financial resources
Wage determination and gender discrimination in Uganda

(Makerere University, 2008) Sebaggala, Richard

This study examines male-female wage determination and gender discrimination in Uganda. The study used the nationally representative household survey 2002/03 collected by Uganda Bureau of Statistics. Wages for both males and females were estimated by implementing a Heckman selection model. Heckman selection model was employed to correct for selectivity at the stage of entrance into the labour market. Estimations from the wage equations both for men and women with sample selection highlight the relevance of human capital, demographic factors and regional labour market segmentation in wage determination. The returns to education are all positive and significant for females and males. However the trend tends to favour females more than males. For instance, the earnings of female individual with secondary education rise more than 80% percent relative to one with primary education while the earnings of male individual with secondary education rise more than 70% relative to one with primary education. The difference is more pronounced when it comes to post secondary. It is noted that the earnings of individual female with post secondary education rise more than 170% compared to that of a male which rise by 136% relative to ones with secondary education. The regional dummies are associated with negative influence for wages, for both males and females. However, the returns seem to be significantly lower in Northern and Western regions relative to Central region for females, while those for males are significantly higher. Demographic characteristics such as being unmarried, age and residence account for varied wages for males and females. It was found out that male-female wage gap is about 39%. The results from the gender wage gap decomposition using Oaxaca (1973) and Neumark decomposition indicate larger wage differential attributed to discrimination and that the largest component of the unexplained wage gap stems from female disadvantage. The study recommends policies that reduce gender inequalities, particularly those policies that have a positive impact on the empowerment of women who suffer from discrimination like access to education, and work environment that encourage equal treatment in labour market.
Evaluation of factors affecting performance in government-aided primary schools in Gulu Municipal Council, Northern Uganda

(Makerere University, 2008-09) Ejang, Mary

The study was conducted on Government-aided primary schools in Gulu Municipal Council that sat for Primary Leaving Examination. This study covered the period of 1997-2006. The selection of the study was based on the fact that Gulu district is located in the northern part of Uganda and suffered the prolonged LRA insurgence that hit the region for over 20 years. Therefore, internal migration coupled with natural increase contributed to swift increase in the enrollment of pupils in the schools within the Municipality. The study was guided by the major objective of evaluating the factors that affected the performance of candidates in PLE in the Universal Primary education system in Gulu Municipal council. The methodologies used in the study were Pearson’s Correlation Coefficient that established the relationships between the performance of the candidates and the independent ratios. Meanwhile, Multiple Linear Regression models were fitted to determine the amount of variations in the performance of the candidates explained by the intervening factors. The major findings of the study were that; School related factors principally the ratio of pupils to a classroom and pupil to textbook ratio strongly positively correlated with the performance of the candidates in PLE. However, the ratio of pupils to a teacher is established not to have had a very strong positive relationship with the performance of the learners in PLE within the period under study. It was established that pupil’s sex did not have an influence on the performance of the pupils in Gulu Municipal primary schools in PLE. Similarly, the study identified teacher qualification to have had a positive correlation with the performance of the pupils in PLE in the period under study. This relationship however varied according to the grades of the teachers. Consequently, it was established that untrained teachers, Grade 4 teachers and Graduate teachers negatively correlated with the performance of the candidates in PLE. Conclusions were drawn that pupils’ ratios to school facilities affected the quality of performance in PLE in Gulu Municipal primary schools over the years studied. Grade Three and Diploma holders in primary Education (DEP) were better of than the other grades of teachers in the teaching of primary school pupils. However, the sex of the pupils did not have any significant effect the academic performance of the pupils. The following were the major recommendations made basing on the findings and directed to the parents, policy makers and implementers. There is need to embark on the improvement of school facilities in order to meet the horrendously high number of pupils. The Municipal Council needs to invest more in the provision of school facilities particular the classrooms and textbooks. This would promote effective use of the instructional materials to facilitate the learning process. Similarly, teacher recruitment should be fortified with emphasis on Grade Three and Diploma holders in primary education (DEP). An improvement in this area would boost up the standards of pupils’ performance in PLE in Gulu Municipal Council primary schools. The District Service Commission should ensure that suitably qualified teachers are recruited to teach in the primary section of education so that the pupils can meaningfully gain from the learning process. Children should be given equal opportunity to access formal education regardless of their sex as it has been verified that the sex of a candidate does not determine his/her academic performance in national examination.
Analysis of the factors that influence outcome of tuberculosis treatment using first line drugs in Uganda - Case study: Mbarara University Teaching Hospital and Mulago Hospital

( 2008-11) Nansamba, Bitiyali

The increase in lack of adherence to tuberculosis treatment has been attributed to patients’ failure to complete treatment whereby they expose themselves to the risk of reactivation of the disease and on the other hand health services have failed to evaluate treatment outcome because they lose contact with the patients before completion of treatment. This study aimed at analyzing the factors that influence treatment outcome after 8 months of short course chemotherapy. Data were summarized using frequency tables, the chi-square test was used to test for independence and binary regression was used to determine the factors that influence treatment outcome after 8 months of treatment. The study involved patients who were treated at Mulago and Mbarara University teaching hospitals under the Directly Observed Treatment short course (DOTS) and followed up for a period of 8 months for the year 2003. Data was obtained from hospital records of patients which included variables like age, sex, category of patient, treatment regimen given, category of disease and outcome of treatment (this was noted as cured, not cured, defaulted, referred and died) at the end of the period. The study involved 1437 patients who were treated for over 8 months with initial therapy of 2 months and a continuation phase of 6 months using different treatment regimens. It comprised of 625 females and 812 males of all ages. Of the patients involved, 69.03% tested positive for pulmonary tuberculosis and 30.97% had extra pulmonary tuberculosis. 29.44% of the patients were cured after 8 months of treatment, 20.11% were not cured though they completed treatment, 47.74% defaulted, 0.35% died and 2.37% transferred. Patients of all ages were treated with the youngest patient being one year old and the oldest was 86 years old and on average, patients were 33 years old. The study established that the only factors that influence treatment outcome were, pretreatment status, hospital visited and treatment regimen used in the first 2 months as observed from the complementary log log model. The age of the patient, treatment regimen used for the continuation phase of 6 months and patient category did not influence outcome. Patients that tested positive for pulmonary tuberculosis had a higher chance of getting cured at the end of the 8 months of treatment. From this study, the following recommendations were made, proper record management to assist in the follow up of patients, sensitization of the public concerning the disease and decentralization of health services to reduce on the transport costs.
Assessment of the effect of orphan-hood on secondary school attendance in Uganda

(Makerere University, 2009) Ankunda, Grace

The study set out to investigate the effect of orphan hood on secondary school attendance in Uganda. It is an outcome of the analysis of data collected by the Uganda Demographic Household Survey (UDHS) and ED data survey (UDES) that was conducted by the Uganda Bureau of Statistics (UBOS). In order to achieve the stated objective, the study adopted both descriptive and multivariate analyses using STATA to accumulate findings. Multivariate analysis measured the net effect of the explanatory factors using the Poisson regression model. The dependant variable was the number of days missed in the last year secondary school attendance which was fitted in the model. Orphan hood plays a big role in the education of children because their school attendance is likely to be negatively affected. Out of 723 children studied in the age group 12-17, about approximately 26.83 % were orphaned. Age, sex, orphan hood status, region of residence (Northern and Western), education level of parent, and place of residence, are significant at multivariate level. The findings show that orphaned children were more likely to miss school compared to non-orphaned children. Religion and distance to school were not significant predictors of the number of days a child missed school. The study recommends that the Government through the Ministry of Education, Local Authorities, Civil Society Organizations, and Non Governmental Organizations should put mechanisms in place to support orphaned children, since they are more vulnerable compared to non-orphans. Research should also be carried out on the causes of orphan hood and the link with education.
An analysis of factors determining voter turnout : a case study of Kampala Central Division

(Makerere University, 2009) Namata, Ssimbwa Gladys

The determinants of voter turnout in Uganda have not been researched on like it has been done in other countries like South Africa, USA and others; yet voting is a crucial exercise in every country. For instance, since South Africa's society is segmented on ethnic lines, ethnicity therefore plays a crucial role in affecting voting patterns and political choices, followed by socio-economic status and age of the voter. In USA, American citizens with more education and income, employed individuals, home owners, those who have stayed longer at current residence, professionals, women, older individuals, married individuals and blacks were more likely to register and vote. In Uganda, there was need to research on the determinants of voter turnout and the magnitude of their contributions. The major aim of the study was to analyse factors determining voter turnout. The data used in the research was mainly primary data, collected by use of questionnaires in Kampala Central Division. However, some secondary data was obtained; like the list of registered voters which was used as the sampling frame. This was provided by the Electoral Commission of Uganda, a body in charge of elections. Systematic sampling procedure was applied at all stages in sample selection. The data was analyzed using logistic regression model which showed the length of time at current residence as the most significant predictor, followed by education, then age, eligibility of household members to vote and lastly not knowing whom to vote. The findings were that; for each additional year a person resides in a particular area, the odds in favour of voting increases by 4.6%, the less educated vote more than the higher educated, the odds in favor of a person to vote increases by 6.2% each additional year of age, the odds of not voting for persons from households where some members are below the voting age are one and a half times more than for those where all members are eligible voters and many voters not know who to vote. The other variables, which are; sex, marital status, region of origin, economic status, lack of interest, elections rigging and other forms of malpractices and being very busy or process is time wasting were not significant. It was therefore concluded that age, length of time at current residence, education, eligibility of household members to vote and not knowing whom to vote affect voting. There is need therefore, for the Electoral Commission to carry out more elaborate sensitization programmes about voting targeting all registered and unregistered voters.
Communication between parents and adolescents: Implications on adolescent sexual and reproductive health awareness among adolescents in Rukungiri District

(Makerere University, 2009) Mutekanga, Esau Nelson

This study was carried out in Rubabo and Rujumbura sub-counties in Rukungiri District with the main objective of investigating the implications of communication between parents and adolescents on sexual and reproductive health awareness. A cross sectional research design where both quantitative and qualitative methods of data collection was adopted. Data was collected using interview schedules from adolescents aged between 10 and 19 and interview guide to solicit information from key informants. Also focus group discussion method was employed to generate more information. Cross tabulations between dependent and independent variables were done and logistic regression was used to determine the significant factors that influence awareness among adolescents regarding sexual and reproductive health. The study found out that there is a communication gap between parents and adolescents regarding adolescent sexual and reproductive health in Rukungiri district. The major source of information was found to be teachers, radios and peers meaning that parents contribute less in educating their children about sexual and reproductive health matters expecting teachers to do it. A big number of adolescents were found to have engaged in sex at early ages ranging from 5 years to 19 years. This is different from the past where sex before marriage was severely punished. The study thus found that there is more room for sex before marriage today than before. The respondents were found to be aware of condoms and their importance as well as how to use them. However, they were not using them during their sexual encounters giving reasons like: - “using a condom is lack of trust and is like chewing a sweet in its jacket”. The study concludes that there is lack of awareness among adolescents regarding their sexual and reproductive health. This leaves them to feed on wrong information especially from their friends or peers thus causing a lot of misconceptions. The study concludes that adolescents in Rukungiri have a lot of misconceptions about sexual and reproductive matters especially got from their friends or peer group members. A study to investigate into the reasons why adolescents do not make proper use of the available adolescent sexual and reproductive health centres since it was not investigated due to the limitedness of time and resources.
Factors influencing mother’s choice of place of delivery in Soroti District, Uganda

(Makerere University, 2009-10) Akinyo, Anne Rita

This study on factors that influence mother’s choice of place of delivery intends to establish reasons why mothers decide to deliver in the different sites. The main objective of the study was to understand factors influencing choice of place of delivery in Soroti. A total of 320 mothers with babies less than three years old were sampled. A logistic model regression was fitted to establish the association between the independent variables and place of delivery. Of the 87.5% of the expectant mothers who had planned to deliver in health unit, less than a half (42.2%) deliver from the health units. Yet only 3.3 % of the home deliveries were attended to by a health worker. Place of residence had a strong influence on place of delivery. A majority of the rural residents delivered at home (90.6%). Four in ten of the respondents reported that the reason for delivering at home was because of labor onset which was sudden and quick. In FGDs, a majority of the respondents reported that labour started at night when it was difficult to access the health units due to lack of transport and security reasons. Mother’s age at first pregnancy had influence on mother’s place of delivery. The results revealed that the majority of the mothers who had their first pregnancy at 12-14 years delivered at home (71.4%) as compared to those who were 25-29 years (17.6%). Parity was seen to have a strong influence on place of delivery (P = 0.000). The majority of mothers with higher birth order delivered at home (78.2%). Educational attainment of these women was low. Educational level of a mother is a very important factor in accessing utilization of health unit during birth. Of the women who delivered from health unit, a majority (78.3%) had post secondary education. Home deliveries were common among women with primary level education (70.3%). the P value was 0.000. It was further established that the majority of the women attended ANC. But attendance of most mothers started in the second trimester (58.1%). During ANC, little was talked about the danger signs of pregnancy hence level of knowledge was quite low. About nine in ten of the women who did not attend antenatal care, delivered at home. At multivariate level of analysis, independent variables that showed a strong influence on place of delivery were residence (β = -2.132), length labour (β = -2.254), health unit charge (β = -1.522), ANC attendance (β = 2.799), distance to health unit (β = -1.232), occupation ( β = 1.640 ) and education attainment ( β = 0.213). The recommendations made were as follows; Girls should be encouraged to finish their education so as to delay the age of conceiving and marriage. Parents, schools, local authorities need to enforce age at marriage and girl child should be kept in school. During antenatal visits mother should be educated about the danger signs of pregnancy and risk of delivering at home. Also health workers need to encourage mothers to have health unit deliveries. Health workers should encourage husbands to attend these visits with their wives. They should provide financial and moral support throughout the pregnancy and during delivery. Since transport was found to be the biggest challenge to most of the mothers during time of delivery, ambulances provided in Health Center III should always be on stand by with enough fuel for emergency cases. Government should improve on the facilities in the health units in the rural areas. Therefore, findings highlight that "choice" is not an inert concept influenced only by women’s preferences. The perception of choice varied among women and was influenced by several factors.
Determinants of export growth in Uganda (1987-2006)

(Makerere University, 2009-11) Agasha, Nimrod

The main objective of the study was to identify the determinants of export growth in Uganda for the period 1987-2006. The study was prompted by the inconsistencies in the findings by various researchers on the determinants of export growth hence the need for a clarification on the plausible determinants of export growth. The study was conducted using data obtained from African Development Indicators; World Bank tables and the United Nations Statistics Division Common Database. An export supply model used by Musinguzi et al (2000) was adopted for the study. Foreign price level and Foreign Direct Investment were added to Gross Domestic Product, Terms of Trade and Real Exchange Rate, the explanatory variables used in the model adopted. Foreign price level and Terms of Trade were found to be statistically significant in explaining export growth for Uganda between 1987 and 2006. Interestingly, Foreign Direct Investment, Real Exchange Rate and Gross Domestic Product as per the findings do not significantly affect export growth. This study recommends that in order to improve export growth, the motive of Foreign Direct Investment should be changed from capturing the domestic market to production for export. There should be diversification of exports preferably to include manufactured good but emphasis should be put on utilizing the export potential of the newly discovered oil which if exported would attract higher prices than the current blend of exports.
A comparative study of patterns of sexual behavior among adolescents in internally displaced people's camps and normal settlements in Lira District

(Makerere University, 2009-11) Okae, Patrick George

This study compared the pattern of sexual behaviour among the adolescents living in internally displaced people’s camps and those living in normal settlements in Lira district. This was examined by the social demographic characteristics of the adolescents such as sex, education, age and religion. By virtue of their large numbers and their particular health risks, the reproductive health practices of young people, most especially the vulnerable adolescents in both IDPCs and normal settlements have an impact on their sexual activity. The study was designed to examine the sexual behaviours of adolescents in IDPCs vis-à-vis those in normal settlements in Lira district as a means of addressing the issue of adolescent camp lifestyle in Northern Uganda as compared with that of an adolescent in a normal settlement. The camps are characterised by lack of privacy, idleness, poverty, early initiation to adult roles, RH services and health education and alcoholism. The investigations were carried out using both quantitative and qualitative methods employing structured questionnaires administered to 384 adolescents on one hand and interview guides for resourceful persons (10 Key Informants) and four focus group discussions on the other hand. The findings indicate that of the 384 adolescents interviewed, 54.9% were found to have indulged in sexual intercourse of which 56% were from camps and 44% were from normal settlements. The adolescents in camps within a small range had more sexual partners, as compared to their counterparts in the normal settlements. The camp environment was found to encourage sexual activities by the adolescents. Information on HIV/AIDS, safe sex and hygiene appeared to be more available to adolescents in camps than in normal settlements. It was further established that the adolescents in normal settlements had a higher percentage of condom use as compared to their counterparts in camps. In conclusion, the camp environment was found to contribute to early sex among adolescents. Although information on HIV/AIDS had reached the adolescents, and they were willing to go for VCT, translating this into practice was not possible for camp adolescents due to lack of means of attaining their material needs. As a result of the above findings the study recommends that there should be restoration of peace in Northern Uganda to allow normal life to prevail. Information on safer sex needs to be passed using appropriate locally based channel like drama whose groups should be given material support. Straight Talk should be contextualised according to the local needs in order for it to be user friendly. In order to provide enough services, more health centres should be constructed in rural areas and adequately staffed with well-motivated health-workers.
Using a social accounting matrix to generate a computable general equilibrium model: the case of Uganda

( 2009-11-11) Musaga, Brian

CGE models were first applied to developing countries in the early 1970s. Work has since then expanded considerably. These models are based on the socio-economic structure of a SAM, with its multi-sectoral and multi-class desegregations put to consideration. Other than being close to multi-market models, in which agents’ decisions are price responsive, CGE models also encompass macro-economic components such as investment, savings, Balance of Payments and the government budget. In this paper, I use the SAM of the Ugandan economy 2002, which was developed recently, to calibrate a simple CGE model. The idea is basically to construct artificial sectors - i.e. households, enterprises, government & the foreign sector – which make the same transactions in the equilibrium model of the economy as do their counterparts in the data. The model is basically calibrated to the SAM. The usefulness of the model is shown by presenting results of simulations that consider the policy changes that may be implemented in the tax system of Uganda.

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