Mak IR Repository (Makerere University)
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Prevalence and factors associated with failed induction of labor in Kawempe National Referral Hospital
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the award of Master of Medicine in Obstetrics and Gynecology of Makerere University.Background: Induction of labor is the artificial stimulation of uterine contractions before the spontaneous onset of labor to achieve vaginal delivery. Failed induction of labor is associated with poor maternal and neonatal outcomes compared to spontaneous labor. There is limited work done on predictors of failed induction of labor in Uganda and none in the study area. This study was aimed at determining the prevalence and factors associated with failed induction of labor in Kawempe National Referral Hospital.
Method: Institution- based cross-sectional study was conducted among 279 women who were eligible for induction using simple random sampling. The data were collected from 15th March to 30th May 2024 using a structured questionnaire and extraction from maternal files in the electronic medical record. Then data was entered into the excel and analyzed using Statistical Package for the Social Sciences version 24. Descriptive statistics were performed to describe the study population. A chi-square test was adopted for a bivariate analysis with 95% confidence level. Level of significance at < or equal 0.20. In a multivariate analysis a binary logistic regression was adopted with 98% confidence level and level of significance at < or equal 0.20. Results: A total of 279 women were recruited to the study. Of these 142 (51%) were aged 25 to 34 years and 198 (71%) were urban residents. The induction protocol was followed in 259 (93%) of the participants. Ninety-six of the women had a failed induction of labor representing a prevalence of 34%. Women in whom induction protocols were not followed were 9 times more likely to have a failed induction. [AOR 9.2 (95% CI: 2.8-30.2)]. Women of maternal age less than 24 years were 50% less likely to have a failed induction of labor than women older than 34 years [AOR 0.5 (95% CI: 0.3-0.9)].Conclusion: The study revealed that the prevalence of failed induction of labor was 34%. Not following induction protocol was significantly associated with failed induction of labor. Maternal age less than 24 years reduced the rate of failed induction of labor. Following the induction protocol was recommended
Mitigating the socio economic and ecological impacts of genetically modified organisms in Uganda: a legal framework analysis for effective forestalling
No full textA dissertation submitted to the School of Law in fulfilment of the requirements for the award of the Degree of Master of Laws of Makerere UniversityThis study investigated the legal frameworks, socio-economic implications, and ecological impacts of genetically modified organisms in Uganda. It aimed to identify gaps and weaknesses in Uganda’s regulatory mechanisms, draw lessons from comparative frameworks in Kenya, South Africa, and Tanzania, and propose strategies for the effective management of genetically modified organisms. Using desk research, the study evaluated existing policies, legislation, and institutional frameworks governing genetically modified organisms in Uganda. Key findings revealed critical gaps in the country’s legal structure, including unclear risk management guidelines, limited public participation, and weak enforcement mechanisms. The comparative analysis provided insights from Kenya’s emphasis on stakeholder engagement, South Africa’s robust yet contested legal frameworks, and Tanzania’s cautious stance, offering valuable lessons for Uganda. The findings demonstrated both positive and negative impacts of genetically modified organisms. On the positive side, genetically modified organisms have the potential to enhance agricultural productivity, reduce pesticide use, conserve biodiversity, and improve food security. However, significant concerns remain, such as increased dependency on multinational corporations, biodiversity loss, and health risks related to genetic contamination and pesticide resistance. To address these challenges, the study recommends developing a comprehensive regulatory framework for genetically modified organisms, strengthening risk assessment and management processes, and promoting regional cooperation to address transboundary issues. Additionally, periodic reviews of biosafety legislation, enhanced public awareness, and the integration of international best practices are essential to foster sustainable agricultural innovation while safeguarding biodiversity and public health
Assessing the spatial performance of forecasting models for parish population estimates
No full textAccurate population forecasts are critical for regional planning and resource allocation. In Uganda, population forecasts have historically been conducted at district levels, often resulting in coarse projections with limited applicability at finer administrative scales like parishes. This study evaluates the spatial performance of three forecasting models—Curve Fit Forecast, Exponential Smoothing Forecast, and Forest-based Forecast—for predicting parish-level population in Central Uganda. Using gridded population data from 2001 to 2020, trends were analyzed to project population changes by 2030. Results reveal that the Forest-based Forecasting model performed best, covering a majority of parishes with high accuracy. The findings highlight the importance of spatial population projections in enhancing the effectiveness of decentralized planning initiatives such as Uganda’s Parish Development Model. By leveraging high-resolution data and spatial modeling techniques, this study contributes to addressing the challenges of population growth and supporting sustainable development goals.
Keywords:
Population forecasting, Spatial modeling, Curve Fit Forecast, Exponential Smoothing Forecast, Forest-based Forecast, Remote sensing
Proposed residential Villa in Kigo
No full textA project report submitted in partial fulfillment of the requirements for the award of Post Graduate Diploma in Construction Project Management of the College of Engineering, Design, Art & Technology of Makerere University.The construction of the proposed residential villa in Kigo is aimed at providing a comfortable and relaxing living environment with privacy and exclusivity, spacious living areas and bedrooms, amenities like gardens, pools and outdoor areas with customized design and architecture, high end finishes and materials, security and safety features and a sense of prestige and luxury, with an aim to create a dream home to meet the owner’s lifestyle and luxury aspirations. The reporter, being part of the project team explored the project details which included the project name, purpose, stakeholders involved, objectives of the project, cost and project duration among others. Furthermore, identification of key management issues such as project delays, variations, delays, safety issues among others were held, major decisions taken and rationale for the decisions discussed. The key challenges were explored, lessons learned from the key issues, management decisions and challenges are listed. The reporter was able to draw conclusions and make appropriate recommendations from the project challenges. Additionally, relevant project documents such as extracts from the Bill of Quantities, site layout and photographic documentations were considered
Factors associated with awareness of HIV status among HIV positive men 25-39 years of age in Rakai. A mixed methods study
No full textA research dissertation submitted to Makerere University School of Public Health in partial fulfillment of the requirements for the award of a Master's Degree in Health Services ResearchBackground. HIV/AIDS continues to be a significant public health challenge globally, with Sub-Saharan Africa being highly affected. In Uganda, particularly in the Rakai region, efforts to address the HIV epidemic have shown progress. However, men aged 25-39 years remain a group with low awareness of their HIV-positive status, contributing to higher transmission rates. Understanding the factors associated with awareness of HIV-positive status in this demographic group is crucial for achieving the UNAIDS 95-95-95 targets.
Objectives. I aimed to determine the proportion of HIV-positive men aged 25-39 years in Rakai who are unaware of their HIV-positive status, explore the factors associated with awareness of HIV status, and examine their experiences and barriers with HIV testing services.
Methods. A cross-sectional study design was employed, utilizing quantitative data from the Rakai community cohort study (RCCS) round 20 (December 2020 - March 2023) and qualitative data from in-depth interviews with HIV-positive men and key informants. The quantitative analysis included 349 HIV-positive men aged 25-39 years. Factors associated with awareness of HIV status were analysed using multivariate modified Poisson regression. Qualitative data were analysed thematically to explore barriers and facilitators related to HIV testing services.
Results. The study found that 86.4% of HIV-positive men aged 25-39 years in Rakai were aware of their HIV status, while 13.6% remained unaware. Key factors associated with higher awareness included higher education levels 84.62%, urban residence 88.95% and consistent condom use 92.9%. Men engaged in agricultural or home-based work exhibited higher awareness levels 89.04% compared to those in manual 83.93% or professional occupations 80.56%. Qualitative findings highlighted barriers such as societal stigma, masculine norms
affecting health-seeking behaviour, and limited accessibility to male-friendly HIV testing services, which hindered testing and awareness.
Conclusion. Despite considerable progress, a significant proportion of men aged 25-39 years in Rakai remain unaware of their HIV-positive status, highlighting the need for targeted interventions. Improving access to male-friendly health services, addressing stigma, and promoting consistent condom use are critical to enhancing HIV testing and awareness in this population, contributing to the attainment of the UNAIDS 95-95-95 targets.
Recommendations. Strengthening health systems to provide flexible and male-friendly HIV testing services, increasing community-based HIV education, and reducing stigma are essential steps to improve HIV status awareness among men aged 25-39 years in greater Rakai.
Keywords: HIV/AIDS, awareness of HIV status, men aged 25-39, HIV testing services
Utilization of facility-based delivery services among postnatal adolescent mothers aged 10-19 years attending the young child clinic, Namayingo District, Uganda
No full textA research dissertation submitted to Makerere School of Public Health in partial fulfillment of the requirements for the award of a Masters Degree in Health Services Research of Makerere University.Background: Approximately, 13% of adolescent girls give birth before 18 years, with about 12 million of them giving birth every year, and 2 million giving birth before 15 years in low-income countries contributing 11% of all births globally.
Objective: The study aimed at determining the level of utilization, factors associated and facilitators and barriers to utilization of facility-based delivery services among postnatal adolescent mothers, aged 10-19 years attending the young child clinic, Namayingo district.
Methods: A cross-sectional convergent parallel mixed methods study design was used. Both quantitative and qualitative data were collected simultaneously and analyzed separately, and the findings from the parallel quantitative and qualitative data were triangulated at interpretation and discussion.
Result: There was an overall 78.45% prevalence in the utilization of facility-based delivery services among the adolescent mothers aged 10-19 years in Namayingo; this showed an increase in the utilization compared to the 53% reported by UBOS in 2018. A number of explanatory factors were associated with the utilization of facility-based delivery services; and these were, family support, marital status, ANC attendance, risk of complications, and intention to get pregnant.
Conclusion and recommendation: The proportion of utilization of facility-based delivery services among adolescent mothers aged 10-19 years is 78.45% slightly higher than the anticipated of 53%. Factors associated with this prevalence were marital status, family support, ANC attendance, risk of complications and intention to get pregnant. A community-based study focusing on all postnatal adolescent mothers needs to be conducted to produce more quality and representative results
Birth preparedness and complications readiness among pregnant women living with HIV attending antenatal care at Kawempe national referral hospital
No full textA dissertation submitted in partial fulfilment of the requirements for the award of a Master of Medicine Degree in Obstetrics and Gynaecology, Makerere UniversityBackground: Pregnancy in women living with HIV poses unique challenges that necessitate specialized care to ensure favourable maternal and neonatal outcomes. Birth preparedness and complications readiness (BP/CR) is a critical component in optimizing maternal health services utilization. This aims at encouraging all pregnant women and the communities in which they live to effectively plan for births and deal with emergencies that may occur because of the natural progress of pregnancy and birth. This study aimed to assess the levels of BP/CR among pregnant women living with HIV, identify associated factors, and contribute valuable insights to inform targeted interventions.
Methods: A cross-sectional design was employed to collect data from 350 pregnant women living with HIV attending antenatal care clinics in Kawempe National Referral Hospital (KNRH). A structured questionnaire was used to collect the data which was analysed using Stata 13 software. A participant was considered prepared if she had fulfilled 5 out of 7 BPCR parameters at the time of data collection. Logistic regression analysis including bivariate and multivariate analysis was used to assess the factors associated with BPCR. A P-Value <0.05 was considered statistically significant.
Results: More than half (63.4%) of the mothers were prepared for birth of which 100% had identified a place of delivery, 96.3% had identified means of transport, 93.4% had identified an attendant and 71.1% had identified a skilled health care provider. Only 4% had however identified a blood donor. Majority of the participants (96.0%) were aware of danger signs of pregnancy with vaginal bleeding (95.8%) as the most known danger sign of pregnancy. On multivariate analysis, participants who were married were 2 times more likely to be prepared as compared to those who were not married (aOR=1.90 (1.032 - 3.498], P=0.039). Participants who were in their 1st trimester (aOR=0.11 [95% CI 0.034 - 0.375], P=0.0001) or second (aOR=0.30 [95% CI 0.184 - 0.5], p=0.0001) were significantly less likely to be prepared as compared to those in their third trimester.
Conclusion: Practice of BPCR among HIV positive pregnant women was moderate as 6 in 10 mothers were found prepared, practices which were significantly associated with marital status and gestation age of the pregnancy. There is need for community-based support services, counseling, and practical assistance to support HIV positive unmarried women and those without strong social support networks to effectively prepare for birth.Non
Exploring the use of M-Omulimisa phone-based platform in delivering extension services to farmers in Lira District, Northern Uganda
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the award of the Degree of Master of Arts in Journalism and Communication of Makerere UniversityThis study delved into the utilization of the M-Omulimisa phone-based platform for delivering extension services to farmers in Lira district, Northern Uganda. Grounded in the diffusion of innovation theory, the research employed in-depth interviews and focus group discussions to investigate how farmers use M-Omulimisa to access information on agronomy, finance and insurance services. Additionally, the study identified the constraints faced by farmers in using M-Omulimisa for these services.. It examined how the platform integrates phone-based and interpersonal communication to deliver information effectively. The findings reveal that farmers access information on weather, markets, training and other e-extension services through a bidirectional flow of information via the M-Omulimisa platform. However, several constraints impede the platform's effectiveness in delivering finance and agro-insurance services. These constraints include network challenges, electricity issues, low levels of digital literacy, high cost of phones, negative perceptions about mobile technology, and the high costs associated with agro-insurance and agro-inputs. The study also highlighted the dual approach M-Omulimisa employs in integrating its website, mobile application and phone services with the village agent model to deliver extension services and agro-inputs and insurance. This approach combines platform-mediated communication with interpersonal communication. The study recommends that the government should facilitate the increased adoption of digital platforms for extension services by subsidizing the cost of mobile devices and internet access. Reducing internet costs could be achieved by removing taxes and establishing ICT centres at the sub-county or parish level that serve as internet access points and skills development hub
An interrogation into causes of conflicts and the community awareness of environmental laws in Uganda: case of Kampala City Wetlands
No full textA dissertation submitted to the Directorate of Research and Graduate Studies in partial fulfilment of the requirements for the award of Master of Arts Degree In Peace and Conflict Studies of Makerere UniversityNatural resource conflicts have become prevalent across the globe and Uganda is not an
exception. This is further exacerbated by irresponsible and unsustainable human activities.
While there are several laws in Uganda that regulate the human treatment of the non-human
environment; compliance with these laws and enforcement have always been a great challenge.
Conflicts related to natural resources continue to occur in various parts of the country, both
rural and urban; especially between law enforcement agencies/environmental conservation
agencies and environmental degraders; and among members of local communities. This
research was conducted to delve deeper into natural resource conflicts in Kampala City in order
to assess level of compliance with environmental laws and the effectiveness of environmental
law enforcement; with specific focus on wetlands. Three categories of respondents were
involved during primary data collection, namely: members of local communities bordering
wetlands, law enforcement officials and senior government officials from environmental
conservation Ministries, Agencies and Departments. Other sources of information were derived
from secondary data, collected through literature review. The findings of the study reveal that
most of the respondents are quite aware of the existence of environmental laws and regulations.
However, there is impunity within the population, where environmental laws are violated
knowingly. On the other hand, rich individuals and large corporations tend to circumvent
environmental laws using technical terms such as “vanquished” wetlands. Where a project is
approved with some sections of the land falling within wetlands, the terms and conditions
stipulated in the Environmental and Social Impact Assessment (ESIA) certificate are rarely
followed; primarily to avoid the huge financial implications. The study further established that
the high population of Kampala City has driven most of the low-income City residents to seek
accommodation in wetlands, where land is relatively cheap. Several recommendations to
minimize natural resource conflicts in Kampala City are provided. These include massive
sensitization, expansion of specialized courts to expeditiously handle environmental cases,
operationalization of Local Environment Committees at District level, non-selective
enforcement of environmental laws, clear demarcation of wetland boundaries and sustainable
use of wetland resources guided by wetland management plans for each wetland system. It is
also recommended that the two environmental enforcement Units – one under Uganda Police
Force (UPF) and the other under National Environment Management Authority (NEMA) be
merged to form one robust enforcement unit. This will enhance effectiveness, avoid duplication
of duties and streamline command and control. Local communities bordering wetlands also
need to own these resources by deriving direct benefits from them. Such benefits include edge
farming (especially fruits and vegetables), fish farming and sustainable extraction of wetland
resources under a clear wetland management plan
Tense and aspect marking in Rutagwenda
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the award of the Degree of Master of Arts (Linguistics) of Makerere UniversityThis study aimed at documenting tense and aspect marking in Rutagwenda which is a subdialect of both Runyankore and Rutooro. The general objective of the study was to describe the grammatical structure of tense and aspect in Rutagwenda as a sub-dialect of Runyankore and Rutooro, whereas the specific objectives were: to identify the different types of tense and aspect in Rutagwenda, to identify the morphosyntax of the tense and aspect marking in Rutagwenda, and to compare tense and aspect marking in Rutagwenda with its source languages, Runyankore and Rutooro. The study used a descriptive research design, which helped in the observation, description, and documentation of the grammatical structure of tense and aspect in Rutagwenda. The study targeted the speakers of Rutagwenda from Kitagwenda District in Uganda. In terms of theoretical underpinning, the study was anchored on the model of perception of tense and aspect in the mind and then on the model for realization of tense and aspect in the language. The findings of the study show that Rutagwenda has three major tenses, namely; past, present, and future. The past consists of the remote past, recent past, near past, and immediate past. The present does not have any categories and subcategories, unlike the future and past tense. For aspect, it was found out that Rutagwenda has two major aspects; perfective and imperfective aspects. The perfective consists of the following categories: Remote Past Perfective Aspect, Near Past Perfective Aspect, and Immediate Past Perfective Aspect. The imperfective aspect has the categories – habitual, progressive, persistive, and prospective, each of which have other subcategories. The respective markers for each of these and their positions in the verb are portrayed in this study. Finally, the findings show the similarities and differences in tense and aspect marking between Rutangwenda and its source languages. The study will be helpful as a source of literature on the structure of tense and aspect in Rutagwenda as a subdialec