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Adult patients with cancer in Uganda: validation of the tool, health-related quality of life, and patient experiences
No full textBackground: This study aimed to assess the validity and reliability of the Luganda version of the tool used to measure health-related quality of life (HRQoL), specifically the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). The study sought to investigate the prevalence of poor HRQoL concerning clinical and sociodemographic characteristics and to describe the experiences of adult cancer patients undergoing treatment at a specialized cancer facility in Uganda. Methods: A sequential explanatory multi-method study was conducted at the Uganda Cancer Institute among adult patients with various types and stages of cancer. Clinical and sociodemographic information was collected using study-specific items and patients' medical records. Sub-study 1: Tool validation evaluated the reliability and validity (including construct, known group, and criterion validity) of the Luganda and English versions of the EORTC QLQ-C30 instrument. Sub-study 2: This sub-study investigated the prevalence of and factors associated with poor health-related quality of life (HRQoL). It used predetermined validated clinical thresholds to identify patients with poor HRQoL and conducted multivariable logistic regression analysis to determine the associated
factors. Sub-study 3: This sub-study described the experiences of adult men and women receiving treatment at a specialized cancer facility, utilizing reflexive thematic analysis. Main results: Sub-study 1. Construct validity, CFA yielded good fit indices (RMSEA = 0.08, SRMR = 0.05, and CFI = 0.93). Known-groups validity was supported by statistically significant better HRQoL among patients with early-stage compared to those in late-stage. Criterion validity: positive correlations between the Karnofsky Performance Scale and the Physical Function (0.75 - 0.76) and Global quality of life (0.59 - 0.72) for Luganda and English versions, respectively. Cognitive function did not reach acceptable Cronbach’s alpha values (Luganda α =0.66, English α = 0.50). Sub-study 2: (68%−87%) reported functional impairment and symptoms of pain (80%) and fatigue (63%). Increasing age, no formal education, unemployment, being an inpatient, diagnosed with cervical cancer or leukemia were factors associated with poor HRQoL. Sub-study 3: Organisation of care, personal challenges, mental suffering, and satisfaction with care were the themes generated. Conclusion: The validated Luganda and English versions of the EORTC QLQ-C30 appear to be a valid and reliable instrument recommended for assessing
HRQOL in adult Ugandans with cancer. Most patients reported poor functioning and a significant burden of symptoms, including pain and fatigue, that warrant concern. The prevalence of poor health-related quality of life (HRQoL) is especially noticeable among older adults, those without formal education, and those who are unemployed. Furthermore, being an inpatient and having a cancer diagnosis are both linked to a lower quality of life related to health. Patients also described their penurious experiences of care, including inadequate infrastructure and resources (food, staff, and drugs), delays in accessing care, the poor health system, and high treatment costs as well as stigma, abandonment, isolation, and emotional distress. This situation calls for policymakers'’ interventions including a need to adapt and adopt the cancer pain management clinical guidelines in the Ugandan context, development of a psychosocial oncology center, and training of health professionals Policymakers are urged to update the budget for cancer care to improve the infrastructural challenges and ensure adequate resources, decentralize cancer care for easier access, and create awareness about cancer and its treatment to reduce stigma.Uganda Cancer Institute/The African Development Bank (AfDB
The effect of financial development on economic growth in East Africa: empirical evidence from pooled mean group estimation technique
No full textA research report submitted to the Directorate of Research for the award of the Degree of Master of Arts in Economic Policy and Management of Makerere UniversityThis study examines the effect of financial development on economic growth in East Africa using the Pooled Mean Group (PMG) Estimator from 1991 to 2023. The findings revealed that financial development had a strong positive and significant short-run and long-run effect on economic growth. Furthermore, findings indicated that capital formation and labour force have a strong positive and significant effect on economic growth while external debt stock exhibits a negative and significant effect on economic growth in East Africa. Based on the aforementioned findings, policies that are oriented toward the development of the financial sector by supporting individual businesses and setting up an enabling environment that encourages investments both public and private which is envisaged as one way of enhancing economic growth. In addition, policies to establish significant investments in infrastructural development to enhance business growth, job creation, and economic growth are highly recommended
Frequency, course, outcomes and factors associated with delirium among adult patients admitted to Uganda Cancer Institute
No full textA dissertation submitted in partial fulfilment of the requirement for the award of the degree of Master of Medicine (Psychiatry) of Makerere University.Background: Delirium is a neurocognitive disorder that commonly affects patients with cancer. Among patients with cancer admitted to oncology units, the prevalence varies from 18% to 33% and the incidence varies from 3.5% to 16.5%. The overall incidence of cancer has gradually increased not only worldwide but also in Uganda. Few studies on delirium in patients with cancer have been conducted in our setting. Objectives: This study aimed to investigate the frequency, course and outcome of delirium during a 1-week period after diagnosis, and factors associated with delirium among adult patients admitted to Uganda Cancer Institute (UCI). Methods: This longitudinal study was carried out among adult patients (≥18 years) admitted to UCI with cancer. A socio-demographic questionnaire to document the patient characteristics, the Confusion Assessment Method (CAM) to diagnose delirium, and the Delirium Rating Scale-Revised 98 (DRS-R98) to define the course of delirium were used. Bivariate and Multivariate analyses were done to describe associations between dependent and independent variables. Results: On admission, 26 out of 237 (11%) patients were diagnosed with delirium. On day 3, 10 out of 211 (5%) patients had developed delirium and on day 7, 1 out 131 (1%) patients had developed delirium. The most common type of delirium was hypoactive delirium. The mortality was significantly higher among patients with delirium (32.1%) than those without delirium (2.6%) (p=<0.001). Of the patients who completed the 7-day follow up period; the mean severity of delirium decreased with time and majority achieved resolution (57.1%) – majority of them had mixed delirium. The risk of developing delirium was associated with: a low functional status (Eastern Cooperative Oncological Group Performance Status (ECOG PS) 3 and 4) (RR= 1.99, p=0.002), hypertension (RR=2.08, p=0.033), use of corticosteroids (RR=2.70, p=0.019), and liquid cancer (RR= 2.09, p= 0.023). Conclusion: The prevalence of delirium in this study was clinically significant and higher than that observed in patients on general medical wards. However, it was lower than the prevalence reported among patients with cancer in other studies, which included older patients with more advanced stages of the disease. Patients with delirium have increased mortality and low discharge rates. Delirium is associated with a low functional status (ECOG PS 3 and 4), hypertension, use of corticosteroids and liquid cancer. Our findings highlight the importance of early detection and management of delirium among patients with cancer.Ruggles Scholarship - NUVANCE Health,
Muljibhai Madhvani Foundation Scholarshi
Development of an Azolla-Vermiculite Composite fertilizer for enhancing nutrient use efficiency and soil productivity in Uganda
No full textThesis submitted to the Directorate of Research and Graduate Training in fulfillment of the requirements for the award of the Degree of Doctor of Philosophy of Makerere UniversityUtilization of slow-release fertilizers is a sustainable agricultural strategy which steadily and
consistently supplies nutrients throughout a plant’s life, thereby reducing fertilizer application
rates. Such fertilizers also promote effective nutrient utilization by crops minimizing nutrient
leaching and runoff to non-targeted areas, thereby maintaining a healthy environment. This study
developed a slow-release fertilizer named Azolla-Vermiculite Composite fertilizer, which is an
innovation from a blend of Azolla cristata powder as the mineral nutrient source, and exfoliated
vermiculite as the carrier material. Azolla is an aquatic fern symbiotically associated with the
nitrogen fixing cyanobacteria (Anabaena azollae). The cyanobacteria absorb atmospheric nitrogen
and avail it to Azolla in form of ammonium ions. This makes Azolla a rich source of nitrogen, a
characteristic that was manipulated in this study for developing the Azolla-Vermiculite Composite
fertilizer.
In this study, four species of Azolla were identified in Uganda through molecular characterization.
These species had sequence identities of 100, 93.36, 99.22 and 99.39% to the reference database
sequences namely; Azolla mexicana, Azolla microphylla, Azolla filiculoides and Azolla cristata,
respectively. The four species were found distributed in four out of the ten agro-ecological zones
of Uganda situated in close vicinity to large water masses of L.Victoria, L. Albert, and L. Kyoga.
Principal Component Analysis results revealed that maximum rainfall and altitude significantly
accounted for the variations in the distribution of Azolla in Uganda with factor loadings of 0.921
and 0.922, respectively.
Following experiments of domestication and cultivation of the four Azolla species in the small
ponds under uniform conditions, Azolla cristata was observed to have a significantly higher
nutrient bio-accumulation of nitrogen, phosphorus and potassium as the primary mineral nutrients
for plant growth (p<0.0001) in comparison with the other three species. It was on the basis of this
superiority that it was selected out for massive cultivation in a larger pond in preparation for
development of the slow-release Azolla-Vermiculite Composite fertilizer. These experiments
were conducted at Bukobero village, Masuliita sub-county Wakiso district.
Vermiculite is laminar hydrated clay like mineral with capacity to expand on heating and
treatment with some chemicals like hydrogen peroxide. It is non-reactive, has an alkaline pH and
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a high water holding capacity. In this innovation, exfoliated vermiculite was used because
exfoliation enhances the above properties. Laboratory analysis of both raw and exfoliated
vermiculite indicated a significant difference in water holding capacity, bulk density, and electro conductivity with p-values of 0.0002, 0.0033, and 0.0002 respectively. Furthermore, analysis of
vermiculite microstructure under the Scanning Electron Microscope exhibited a pure and asbestos
free form of vermiculite that was used in the experiment. X-ray Fluorescence exhibited the
richness of vermiculite in various minerals including; silica which contributed (>40%) and
phosphorus (<1%) among other minerals. Therefore, it was on the basis of these unique properties
exhibited by vermiculite after exfoliation, that it was selected for use as a carrier of Azolla powder
in developing the slow-release composite fertilizer.
When the Azolla-Vermiculite Composite (AVC) fertilizer was tested for growth performance,
yield and nutritional composition of Zea maize (maize), the change in height and yield varied
significantly between the composite fertilizer treated and control plants, with p values of <0.003
and ≤0.001 respectively. Proximate nutrient analysis of starch, reducing sugars, total
carbohydrates and pro-vitamin A carotenoids all varied significantly between AVC fertilizer
treated and control plants with p-values of <0.002. This significant variation was attributed to the
availability of sufficient concentrations of mineral nutrients in the fertilizer that enhanced these
nutritional components. In addition, all the fertilizer treated plants benefited from the water
retention property of exfoliated vermiculite in AVC fertilizer. Since yield is a factor of various
components with water as one of the major requirements, the water retention of AVC supported
effective progression of various physiological processes including photosynthesis, cell turgor,
nutrient uptake, among others. The result was enhanced accumulation of photoasssimilates in the
sink tissues resulting into a boost in yield and nutritional composition. Therefore, AVC fertilizer
is a promising Climate Smart Agricultural fertilizer technology for enhancing soil productivity
translating into better food production and improved environmental health. As a sustainability
measure, there is a need to improve this product so as to achieve its maximum potential in
agricultural production. This will serve as a contribution in support of the FAO strategic
framework 2021-2030 in the context of Agenda 2030 for sustainable development and Uganda’s
vision 2040.1. WORLD BANK THROUGH MAPRONANO ACE
2. MAKERERE UNIVERSITY DIRECTORATE OF RESEARCH AND GRADUATE TRAININ
Legal trigger: demystifying the gun in Uganda
No full textA BookIn a nation where the echoes of gunfire have shaped its political landscape, Legal Trigger: Demystifying the Gun in Uganda offers an incisive exploration of the firearm's complex role in law, society, and governance. This intellectually rigorous work probes beyond the mechanics of weapons to reveal their symbolic and pragmatic influence on Uganda’s historical, cultural, and legal fabric. The book opens with a penetrating analysis of the firearm as a dual symbol of authority and violence, tracing its roots from colonial conquest to its pervasive presence in postindependence political struggles. With vivid historical narratives, the authors unravel how firearms became entwined with power dynamics, from colonial disarmament strategies to their utilization by authoritarian regimes in shaping Uganda's socio-political evolution. Grounded in legal scholarship, the middle chapters dissect Uganda’s contemporary firearm legislation, illuminating the regulatory frameworks that govern gun ownership and use. The authors juxtapose these statutes with international conventions, exposing loopholes and enforcement challenges that perpetuate a cycle of violence. Through compelling case studies and critical analysis, they explore the intersection of firearms with human rights violations, extrajudicial killings, and systemic abuses by state security apparatus. With deep cultural insight, Legal Trigger examines the psychological imprint of guns on the Ugandan psyche. It delves into societal perceptions that equate firearms with masculinity, authority, and rebellion, questioning how these narratives influence both lawful and unlawful gun use. The authors challenge readers to consider how popular culture, folklore, and historical memory shape collective attitudes toward arms. Moving beyond critique, the book presents visionary policy recommendations for redefining Uganda’s approach to gun control. The authors advocate for legal reforms that balance individual rights with public safety, emphasizing disarmament, regulatory enforcement, and educational initiatives to foster a culture of peace. They propose innovative frameworks for civilian oversight, stronger legal accountability for misuse by security forces, and strategies for integrating human rights into firearm policies. n its profound conclusion, Legal Trigger calls for a nuanced understanding of the gun as a force that both protects and destroys. It asserts that only through comprehensive legal, societal, and cultural reforms can Uganda transcend its history of militarization and build a future where the law, not the gun, reigns supreme. This book is an essential read for legal scholars, policymakers, security professionals, and citizens seeking to understand and reform the intricate relationship between firearms, law, and society in Uganda. It masterfully blends legal analysis, historical depth, and social commentary, making a bold, timely contribution to the global discourse on arms control and human rights
Enteric bacterial isolates and antimicrobial susceptibility patterns in captive non-human primates at Lwiro, Democratic Republic of Congo
No full textA dissertation submitted to the Directorate of Research and Graduate Training for the award of the Degree of Master of Science of Wildlife Management of Makerere UniversityLwiro Primates Rehabilitation Center (LPRC) is a home in Democratic Republic of Congo (DRC) for more than 85 chimpanzees and 105 monkeys of 11 different species, and who are victims (orphans) of pouching, illegal primate trading, agricultural expansion, road construction, logging among other Non-Human Primates (NHPs) population decreasing factors. The NHPs at LPRC regularly suffer from bacterial infections and are treated with various antibiotics. However, it was observed that the infections were persistent, and this suggested the possible emergence of antibiotic resistance at LPRC requiring further comprehensive investigation. The objective of the study was to characterize the enteric bacterial isolates and their antimicrobial susceptibility pattern in captive non-human primates in Lwiro, Democratic Republic of Congo. This was a cross-sectional study conducted in the sanctuary. Fresh fecal samples were collected, one sample from each primate during the study period between June and August of 2019. The collected samples were placed into sterile containers using sterile spatulas, with care to collect from the top of the samples to avoid ground contamination and they were immediately placed into enrichment medium at LPRC Laboratory and then transported chilled from LPRC to the Institute for Superior Medical Techniques (ISTM) laboratory for analysis. Bacteriological culture was performed, and isolates identified to species level morphologically and biochemically. Ten bacterial species associated with enteric bacterial infections in captive non-human primates (NHP) at Lwiro sanctuary were identified. Antimicrobial susceptibility of the bacterial isolates was tested against 14 commonly used antimicrobial agents in the sanctuary including amoxicillin, amoxicillin/clavulanic acid, imipenem, gentamycin, doxycycline, levofloxacin, meropenem, norfloxacin, oxacillin, tetracycline, ceftazidime, cefotaxime, amikacin, and ampicillin. In order of decreasing mean prevalence, the pathogens found in more than one NHP were: E. coli (33.8%), Enterobacter sp (22.3%), Staphylococcus sp. (18.9%), Staphylococcus aureus (17.3%), Klebsiella sp (13.7%), Citrobacter sp (4.1%), Serratia sp (2.0%), Enterobacter (1.8%), and Salmonella sp (1.4%). The bacterium Proteus sp. was only found in C. Ascanius at a prevalence of 4.3%. Most of the bacterial isolates were resistant to Amoxicillin, Imipenem, and Amoxicillin/Clavulanic Acid. Notably, Enterobacter sp and Proteus sp were 100% resistant to amoxicillin, gentamycin, and ceftazidime. Moderate resistance was observed against levofloxacin, ampicillin, doxycycline, norfloxacin and amikacin. The most effective drug was tetracycline. In conclusion, these results show that there are a number of enteric bacteria species in the primates within the sanctuary with widespread antimicrobial resistance against most of the tested antimicrobials. Most isolated bacteria have the potential to cause gastrointestinal diseases (mainly diarrhea and enteritis) in non-human primates and among caretakers in the sanctuary. Hence, it is recommended routine hygiene measures of the facilities and handwashing among the caretakers. Further, it is recommended conducting culture and sensitivity test for isolates from suspected gastrointestinal infections before any treatment is administered to NHP in the sanctuary
Spatial patterns and determinants of malaria risk among children under five years in Uganda
No full textA research dissertation submitted to the Directorate of Research and Graduate Training for the award of the Degree of Master of Science in Disaster Risk Management of Makerere UniversityMalaria is one of the risk factor diseases which can result into an epidemiological disaster if not handled holistically and effectively in Uganda. However, little is known about the risk factors for this disease at national level. The specific objectives of this study were to:1) analyze the spatial-temporal patterns of malaria prevalence; 2) examine the spatial factors associated with malaria prevalence and 3) assess the household and individual leveldeterminants of malaria infections among children under five years in Uganda.From the 2018-19 Uganda Malaria Indicator Survey (UMIS), 7304 children under five years were included. Socio-economic characteristics of households and the spatial covariates were extracted. Hotspot and spatial percentages were used to determine malaria prevalence. Descriptive statistics were used to provide the frequencies. Chi-square test was used to analyze the association between the dependent and independent variables. Multivariable logistic regression analysis was used to determine the magnitude of the association using Odds ratio. A 95% confidence interval was use and the significance levels were put, p<0.001, p<0.01, p<0.05. All analyses were performed in STATA version 18 and ArcGIS 10.8.The Eastern and Northern regions of Uganda had very high malaria prevalence percentages compared to Karamoja and southwestern regions from 2000 to 2015. The odds of contracting malaria infections were 360% higher (aOR= 4.6,95% CI =3.1-6.9) in children who had been given malaria medication in past two weeks compared to the counterparts who had not received malaria medication the past two weeks. The odds of contracting malaria were higher in households whose children were aged 25-36 months with 240% (aOR = 3.4, 95% CI: 2.3-5.1) followed by children aged 37-48 months with 220% (aOR= 3.2, 95% CI: 2.2-4.5) and above 49 months with 210% (aOR = 3.1, 95% CI: 2.1–4.5). However, households with educated mothers had lower chances of acquiring malaria infectionsthat is 30% lower (aOR = 0.0, 95% CI: 0.0-0.2) primary, 80% lower (aOR = 0.7, 95% CI: 0.5-0.9) secondary and 100% lower (aOR = 0.0, 95% CI: 0.0-0.2) higher level compared to households with uneducated mothers.There was a spatial and temporal variability of malaria occurrences, with the Eastern and Northwestern regions registering the highest prevalences. The Karamoja and South western regions had the lowest prevalences. The major individual based factors influencing malaria prevalence were; child’s age, child having a bed, malaria medication, lack of maternal formal education, while the household level factors were; household wealth status, household size, household main wall, floor and roof materials, ownership and sleeping under mosquito bed nets. More emphasis should be put on children whose mothers have never attended school and children between the ages of 24 and 59 months when designing malaria control programs in Uganda. The Eastern and northern regions need special consideration due to their higher prevalence of malaria
Paternalistic leadership, organizational commitment, and turnover intention among teaching staff in Kyambogo University
No full textA dissertation submitted to the School of Psychology for the award of a Master’s Degree in Organizational Psychology of Makerere UniversityEmployee organizational commitment in public universities has diminished in recent years, resulting in high turnover intention. Kyambogo University's personnel have a high percentage of resignations, tardiness, and absences. This appears to stem from a lack of effective leadership qualities. Therefore, this study sought to examine the relationship between paternalistic leadership, organizational commitment and turnover intention among the teaching staff of Kyambogo University. The study used 234 respondents selected using a cross- sectional study design was used to examine the association between the variables. Data was collected using standardized questionnaires and analyzed using a Pearson Product Moment Correlation Coefficient and Multiple Regression analysis in process macro (SPSS v.27). The findings show that there exists a significant positive relationship between paternalistic leadership and organizational commitment (r=.284, p≤.01); organizational commitment has a non-statistically significant relationship with turnover intention (r=.100, p≥.05); a non-significant relationship between paternalistic leadership and turnover intention (r=-.009, p≥.05); and organizational commitment does mediate the relationship between paternalistic leadership and turnover intention (β=.262, Boot 95% CI [.059, .543]). In conclusion, it is therefore recommended that much emphasis should be placed on advocating for leaders with authoritarian traits as a means to ensure submission by employees and reduce turnover intention. Additionally, higher learning institutions should introduce avenues such as celebrating Employee of the Month and providing exciting offers to employees as a way of increasing their organizational commitment, in so doing this reduces any intention to leave
Modelling factors associated with covid-19 mortality among patients admitted to Dr. Sumait Hospital in Mogadishu Somalia : implementing parametric AFT models
No full textA dissertation report submitted to School of Public Health, Department of Epidemiology and Biostatistics as partial fulfillment for Masters of Biostatistics, College of Health Science, Makerere University.Background: The coronavirus disease of 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first case of COVID-19 in Somalia was confirmed on March 16, 2020. The World Health Organization declared COVID-19 a pandemic on March 11, 2020. From March 2020 to September 2021, WHO reported 27,207 confirmed cases and 1,361 deaths in Somalia, resulting in a case fatality rate (CFR) of 5%. However, there is limited data on factors associated with COVID-19 related mortality among 293 admitted patients and time-to-death of in-patients in DR. Sumait Hospital in Mogadishu, Somalia. Therefore this study aimed to assess individual and clinical factors of COVID-19 mortality and determining time-to-death among patients admitted to DR. Sumait Hospital in Mogadishu Somalia. Methods: This retrospective cohort study examined 293 COVID-19 patients admitted to Dr. Sumait Hospital in Mogadishu from March 16, 2020, to November 16, 2021. Descriptive analysis of inpatient socio-demographic characteristics was conducted using mean and standard deviation for continuous variables and frequency and percentage for categorical variables. Accelerated Failure Time (AFT) models, rather than Cox proportional hazards models, were used to assess factors associated with survival time. Time Ratios (TR) with 95% confidence intervals (CI) were determined as measures of association for AFT models. Model goodness of fit was assessed using Cox-Snell residuals, Deviance residuals, AIC, and BIC. The proportional hazards (PH) assumption was tested with categorical variables. Data analysis was performed using Stata 14. Results: Among the 293 COVID-19 patients admitted to Dr. Sumait Hospital, 93 (32.1%) died, and 199 (67.9%) were discharged. The incidence rate of deaths was 14.05 deaths per 100,000 person-days, while discharge incidence was 0.84 or 84%. Of the patients, 137 (46.9%) were females, including 6 (4%) pregnant, and 155 (53.1%) were males. Most patients, 265 (90.8%), did not have hypertension, while 27 (9.2%) had hypertension. Diabetes was present in 218 patients (74.7%), and 74 (25.3%) were non-diabetic. Severe COVID-19 occurred in 77% of patients, with 23% having mild cases. Survival time increased by 1% for each additional year of age (adjusted.TR = 1.01; 95% CI: 1.00–1.01). Male patients had 6% lower survival time than females (adjusted.TR = 0.94; 95% CI: 0.88–0.99). Patients with hypertension had 33% lower survival time (adjusted.TR = 0.67; 95% CI: 0.63–0.71). Severe cases reduced survival time by 11% (adjusted.TR = 0.89; 95% CI: 0.81–0.90), while diabetes lowered survival by 1% (adjusted.TR = 0.99; 95% CI: 0.91–1.07). Conclusion: The study findings reveals that incidence rate of Covid-19 death in Dr. Sumait was 14.05 deaths per 100,000 person also indicated that individual factors such as age and urban residence significantly influenced survival while clinical factors like hypertension and severe disease status were associated with lower survival times and male patients’ also demonstrated reduced survival compared to females
Servant leadership where faith lit the way
No full textA bookThis book is a collaborative masterpiece by two visionary young leaders from King’s College Budo, a prestigious institution renowned for cultivating intellectual excellence and servant leaders. Kato, the Head Prefect, and Israel Y.K. Lubogo, an innovative Senior Four student, merge their leadership experiences to craft a deeply reflective and practical guide on leading with humility, purpose, and faith. Drawing from their leadership journeys and the timeless wisdom of faith, the authors provide insights that resonate with leaders across generations and contexts. Enriched by the culture of King’s College Budo and the timeless values of faith, this book is a roadmap for those aspiring to lead with purpose and integrit