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ItemConsistent determinants of delayed initiation of breastfeeding among nursing mothers aged 15-49 years in Uganda(Makerere University, 2025)Delayed initiation of breastfeeding (DIBF), defined as starting breastfeeding one hour or more after birth, remains a major contributor to neonatal morbidity and mortality in Uganda. Although early initiation increased from 32% in 2000–2001 to 67% in 2016, delays persist among certain maternal groups. Using pooled data from 17,357 mothers across four Uganda Demographic and Health Surveys (2000–2016), this study examined determinants of DIBF among mothers aged 15–49 years. Guided by the Social Cognitive Theory (SCT) and Health Belief Model (HBM), a Generalized Structural Equation Model (GSEM) estimated direct and indirect effects of socio-demographic, economic, and health facility related factors, enabling mediation analysis. Results showed no consistent factors directly linked to DIBF across all surveys. Rural residence (β = 0.38, p < 0.05) increased DIBF risk, while delivery from health facilities (β = –0.48, p < 0.001), maternal age 20–34 (β = –0.39, p < 0.05) or 35–49 years (β = –0.88, p < 0.01), and pregnancy desirability (β = –0.30, p < 0.05) reduced it. Mediation analysis revealed rural mothers were less likely to deliver from health facilities (β = –0.69, p < 0.001), indirectly increasing DIBF. Mothers aged 20-34 and 35-49 years and married mothers were more likely to deliver from health facilities, reducing delays. These findings highlight that socio-demographic factors influence breastfeeding both directly and indirectly through healthcare utilization. The study concludes that DIBF in Uganda is shaped by intertwined behavioral and structural determinants. Integrating SCT and HBM within a GSEM framework uncovered pathways linking social context, healthcare access, and breastfeeding behavior. Strengthening rural health infrastructure and enhancing antenatal education for mothers aged 15-19 years and rural mothers are recommended to accelerate progress toward SDG 3 on maternal and newborn health. Future research should use GSEM to capture complex direct and indirect effects in longitudinal or community-based studies.
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ItemCorrelates of intimate partner violence among pregnant women in Uganda(Makerere University, 2025-10)This study examines the prevalence and factors associated with intimate partner violence (IPV) during pregnancy in Uganda. It highlights global and regional patterns, with a focus on sub-Saharan Africa where rates are highest. Findings underscore IPV as a critical public health and human rights issue affecting maternal and child health outcomes. Methods: The study utilized secondary data from the 2016 Uganda Demographic and Health Survey (UDHS) and adopted the complementary log-log regression to analyze the correlates of IPV among pregnant women in Uganda. Results: The prevalence of physical, emotional, and sexual IPV among pregnant women were 20%, 21% and 28%, respectively. In addition, those who had ever experienced any IPV were 41%. Pregnant women who were in the age bracket of 45-49 had higher odds (OR: 6.27, 95% CI: 1.39 28.23) of experiencing sexual IPV compared to those of age group 15-24. Respondents from eastern (OR: 2.04, 95% CI: 1.13-3.67) and western Uganda (OR: 2.25, 95% CI: 1.22-4.14) were more likely to experience sexual IPV compared to those from central Uganda. Pregnant women who were economically empowered were at a lesser risk of experiencing sexual, emotional and any IPV with odds ratio 0.46, 0.24, 0.13, and 0.32 respectively. Also, a pregnant woman whose husband had controlling behaviours, was more likely to experience physical, sexual, emotional and any IPV. Pregnant women’s partners who take alcohol had high odds of experiencing physical, emotional and any (OR: 2.32, 1.92, and 1.56 respectively). Pregnant women with 1-3 children were 1.6 times more likely to experience IPV compared to those with none also to respondents who had cowives were at a high risk (OR: 1.68, 95% CI: 1.27-2.23) of experiencing any IPV compared to the counterparts. Conclusion The study recommends integrating IPV screening into prenatal care, establishing support groups, and empowering women economically to reduce vulnerability. It urges government led sensitization, community engagement, and improved family planning access to address socio cultural drivers of IPV. Targeted interventions for partners with alcohol misuse and stronger law enforcement are also essential. Key words: Intimate Partner Violence, Uganda, Africa, Pregnancy. Subject keywords; Intimate partner violence, Pregnant women, Uganda
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ItemWill the parish development model pillar 1 services interventions promote agricultural production? An ex- ante analysis on groundnut production using the Uganda panel data set.(Makerere University, 2025-11)Using the UNPS 2018/19 and UNPS 2019/20 datasets, this study assesses how the proxies of PDM pillar 1 services interventions are likely to affect groundnut production in Uganda. Descriptive statistics were used to analyze the distribution and characteristics of respondents. At the multivariable level of analysis, the Random Effects Linear Regression Model was fitted to investigate the likely effects of proxies of the PDM pillar one interventions on groundnuts production in Uganda at a 5% level of significance. The study found that twelve of the seventeen proxies of the PDM pillar one services interventions indeed had a statistically significant (p <0.05) effects on groundnut production in Uganda, ceteris paribus. The PDM pillar one service interventions proxies with statistically significant positive effects included: 1-agriculture extension services, 2-use of agricultural inputs such as: i) quantity of groundnuts seeds sown, ii) organic fertilizer usage, iv) pesticides usage, and v) mechanization (use of tractors and ox-plough), 3-household farmland ownership documentation, 4-access to credits, 5-type of crop stand (pure stand/mono-cropping), 6-quality standard of groundnuts seeds, 7-household members’ participation in community crop harvesting activity, 8-access to markets, 9-erosion control methods, 10-water sources used for farming. Conversely, the PDM pillar one service interventions proxies with statistically significant negative effects included: 2-agricultural inputs, such as inorganic fertilizer usage, 11-commodity storage methods, and 12-transport costs. All the four geographical regions of farmers (such as the Central, Eastern, Northern, and Western regions) negatively affected groundnut production in Uganda. Therefore, the study recommended that: First, all PDM Pillar One interventions with potentially positive effects on groundnut production should be scaled up and strengthened by the Government of Uganda to enhance production. These interventions have demonstrated a capacity to improve production and, therefore, warrant continued investment and expansion to other farming communities. Second, in contrast, interventions with potentially negative effects should be critically reviewed and restructured by the Government of Uganda to address underlying challenges and improve their effectiveness in promoting production and farmer welfare. Subject keywords; Agricultural production, Groundnut production, Parish development model pillar 1, Services interventions,
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ItemDimension reduction and regularization approaches in response to multicollinearity problem of the prediction of student performance in the final national examination: case of North-Kivu/Goma-DRC(Makerere University, 2025-11)Multicollinearity among predictors in regression models can inflate variance estimates and undermine the stability and interpretability of parameter estimates. This study conducts a comparative analysis of four widely used approaches: Dimension reduction approaches, Principal Component Regression (PCR), and Partial Least Square Regression (PLSR) on one hand and regularization approaches Ridge and Lasso Regression on the other hand. Through Student’s performances dataset, we assessed these methods in terms of model fit and predictive performance, variable selection capability and interpretability. Model selection criteria were employed, as well as T-paired test to compare residuals (MSE) of competing models, Akaike Information Criterion (AIC), and R-Squared (R2) determined the relative effectiveness and prediction accuracy of each approach. Results report there is no significant difference between residuals of Lasso and Ridge regression (Paired t-test P-value =0.15), this means that Ridge and Lasso regression models have same predictive performance. Lastly the test revealed a significant difference between residuals of Partial Least Square and Principal Component Regression (Paired t-test P-value=0.00), this means that PLS regression model outperformed PC regression model in terms of predictive accuracy. Results indicated that Lasso Regression outperformed the other approaches in terms of model fit with the least AIC= -2229.66, followed by the Ridge Regression with AIC= -2225.38, the Partial Least Square Regression and the Principal Component Regression were also performed respectively with AIC of -1041.05 and -1013.925. The findings also revealed the Lasso regression with the highest R2 value (72.7%) indicating the highest proportion of variance explained in the dependent variable. Through all the approaches, the regression models report that Sex, School of the student and Cohort of study were the most significant covariates predictors of the final national score at the national examination. In Addition, three of the four Principal components (humanities social sciences, science and Mathematics, Creative and Technical skills) are significant Predictors of The final Score. In the Ridge and Lasso Regression approaches, French, Chemistry, Civism, English, Probability, Biology, Philosophy and Algebra as the most important predictors of the Final score. Keywords; Student performance, Final national examination, North-Kivu/Goma-DRC
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ItemCurrent health expenditure and under-five mortality rates in Uganda (2001 to 2021)(Makerere University, 2025)Numerous studies in Sub-Saharan Africa have shown that increased healthcare spending contributes to lower child mortality rates. This study examined whether this relationship holds true for Uganda by assessing the impact of both economic and health system factors on under-five mortality between 2001 and 2021. The main objective was to determine the extent to which current health expenditure per capita influences child survival outcomes, alongside GDP per capita, immunization coverage, and population size. An observational ecological longitudinal (time-series) was used to analyze national-level data from Uganda (2001–2021) on under-five mortality and its one-year lagged predictors, including health expenditure, GDP per capita, immunization coverage, and population size. Data were obtained from UNICEF and World Bank databases. Ridge-adjusted hierarchical regression models were applied to assess associations while controlling for multicollinearity and ensuring model validity. Descriptive analysis revealed substantial variability in under-five mortality (mean = 81.5 deaths per 1,000 live births, standard deviation of 33.14.) and in economic indicators over the 21-year period. Correlation analysis indicated significant negative relationships between under-five mortality and health expenditure per capita, immunization coverage, population size, and GDP per capita. The hierarchical regression model showed that including immunization and population variables increased the explained variance in under-five mortality from 88% to 98%. In the ridge- adjusted model, current health expenditure per capita (β = –0.70, 95% CI -1.40 to -0.01, p = 0.047), immunization coverage (β = –0.97,95% CI -1.52 to -0.41, p = 0.002), and population (β = –2.85, 95% CI -3.86 -1.85, p < 0.001) remained significant predictors, while GDP per capita was not. The study concludes that higher current health expenditure per capita significantly reduces under- five mortality in Uganda, underscoring the importance of targeted health investments in improving child survival. Immunization coverage and population dynamics also play vital roles, whereas general economic growth alone does not ensure better health outcomes. Policy efforts should therefore focus on increasing and efficiently utilizing health spending and sustaining universal immunization programs to accelerate progress toward reducing under-five mortality. Subject Keywords: Health expenditure; Children under-five; mortality rates; Child mortality; Uganda