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Exposure behaviour to Escherichia coli and user risk perceptions of sanitation options among households in Imvepi Refugee Settlement, Terego District Uganda
No full textBackground: Exposure to Escherichia coli (E. coli) from sanitary facilities remains a significant problem, especially in settings like refugee settlements where the majority of the households use sub-optimal sanitary facilities. Whereas the sanitation coverage in Imvepi refugee settlement is high, diarrhoeal diseases remain prevalent, and yet little is known about the exposure behaviors to E. coli and user risk perceptions of sanitation options.
Objective: To assess exposure behaviour to E. coli and user risk perceptions of sanitation options among households in Imvepi
refugee settlement so as to guide government and non-government organizations in the design of interventions for the control of diarrheal diseases, ultimately benefiting the health and well-being of the household members.
Methodology: Guided by the Sanitation Safety Planning tool and the Health Belief Model, a cross-sectional study utilizing quantitative data collection methods was conducted among 426 households. A structured questionnaire digitized using Kobocollect was administered to women to obtain data on their background characteristics, exposure behaviours and user risk perceptions. An observation checklist was used to inspect sanitation facilities for exposure risk. Additionally, 80 environmental samples were collected from latrine walls, soil, door handles/frames, and floors in 20 sanitary facilities. Each sample was analyzed by culture on Compact Dry plates and incubated at 37°C. Data were downloaded into Microsoft Excel v2016 for cleaning and later imported into STATA v17.0 for analysis. Descriptive statistics were performed to summarize continuous and categorical variables. Modified Poisson was used to establish the factors associated with E. coli exposure behaviour.
Results: The study revealed that the prevalence of E. coli was 61.3% (49/80). Only 53.3% (227/426) had high perceptions regarding exposure to E. coli, and over 59.4% (253/426) exhibited high-risk exposure behaviour. Residing in compound homes (Adjusted Prevalence Ratio (APR) = 0.72, 95% Confidence interval (CI): 0.58-0.90), being aged 35-49 years (Adjusted Prevalence Ratio (APR) = 0.76, 95% Confidence interval (CI): 0.60-0.97), having household heads with post-primary education (APR = 0.54, 95% CI: 0.38-0.77), high knowledge (APR = 0.69, 95% CI: 0.59-0.80), and high-risk perceptions regarding exposure to E. coli (APR = 0.75, 95% CI: 0.64-0.88) were associated with a lower prevalence of high-risk E. coli exposure behaviours. Conversely, having sanitary facilities with excreta overflowing from the squat hole (APR = 1.26, 95% CI: 1.08-1.48) was associated with a higher prevalence of high-risk exposure behaviours.
Conclusion: The study indicates a significant prevalence of E. coli contamination in various environmental samples from the Imvepi Refugee Settlement, with higher levels detected in soil. Furthermore, the study found a substantial prevalence of high-risk E. coli exposure behaviour and low risk perceptions. There's a need to implement interventions targeted at reducing high-risk behaviours, especially among households whose heads have low education attainment, those with young caretakers and those with limited knowledge and low-risk perceptions regarding exposure to E. coli. Additionally, efforts should focus on reducing the prevalence of E. coli in the environment, particularly in soil near sanitary facilities.The IHE Delft Water and Development Partnership Programme, financed by the Dutch Ministry of Foreign Affair
Prevalence and factors associated with smell disorders among patients with Type 2 Diabetes mellitus at Mulago National Referral Hospital
No full textA dissertation submitted in partial fulfilment of the requirements for the award of a Master of Medicine in Ear, Nose and Throat, Makerere University.Background: Diabetes mellitus continues to present a pressing global challenge, affecting an estimated 537 million adults worldwide, a figure expected to increase to 643 million by 2030. Smell disorders like anosmia and hyposmia are among diabetes mellitus complications. These happen secondary to diabetes mellitus affecting an individual's olfactory ability. The reasons why diabetes mellitus patients present with smell disorders are unclear. However, existing theories suggest that smell disorders arise as a sequel of microvascular hyperglycemic injury. This study aimed to examine the prevalence of smell disorders and associated factors among adults attending the diabetes clinic at Mulago National Referral Hospital. Methods: A cross-sectional study was conducted among adults aged 18 years and above, attending the diabetes clinic of MNRH during the study period. Systematic sampling was done among patients confirmed to have T2DM. Data was collected using interviewer-administered questionnaires. Sniffin’s Sticks test kit was used to identify smell disorders. Results: A total of 369 adults were recruited, with the mean age was 52.2 years (sd 11.8 years) with the majority (67.75%) being middle-aged (36 -59 years), male-to-female ratio was 1:2.18 and majority (75.82%) of the participants had lived with Type 2 Diabetes for less than 10 years. The prevalence of smell disorders was found at 47.43% with 7.86% anosmic and 39.57% hyposmic. Abnormal HbA1C levels (aOR: 2.23; 95% CI: 1.34-3.71; p-value:0.002), oral hypoglycemic medication use (aOR: 1.63 95% CI: 1.03-2.59 p-value 0.038), and Hypertension (aOR: 1.98 95% CI: 1.26-3.11; p-value:0.003) were associated with increased odds of presence of a smell disorder.
Conclusion: The prevalence of smell disorders among T2DM patients at Mulago Hospital is high. Higher HbA1c levels, non-insulin hypoglycemic medications and hypertension were significantly associated with smell disorders. Recommendations: Routine screening for smell disorders should be integrated into the clinical care of T2DM patients especially; the hypertensive, those with poor glycemic control, and those taking oral hypoglycemic medications to allow for timely intervention and delay the progression of smell disorders. Further research in the form of Longitudinal studies is recommended to examine the effect of smell disorders over time in T2DM patients, especially those whose kind of work relies on the use of the sense of smell
Time from recognition of symptoms to cancer diagnosis and factors associated with delayed diagnosis among pediatric cancer patients in Mulago National Referral Hospital
No full textA dissertation submitted to the College of Health Sciences, School of Public Health for the award of the degree of Master of Public Health, Makerere universityIntroduction: Late presentation of pediatric cancers is common in sub- Saharan African countries, including Uganda and is largely due to diagnosis delay; a combination of patient/caregiver delay and physician/ health system delays. Diagnosis delay allows for disease progression and ultimately can worsen treatment outcomes. However, there’s limited data on time to diagnosis and factors associated with delayed diagnosis of childhood cancers in Uganda. This study aimed to determine the median time to diagnosis from initial symptom recognition to diagnosis confirmation and associated factors among pediatric cancer patients in Mulago National Referral Hospital. Methods: This was a mixed methods study that utilized both quantitative and qualitative data collection methods. The quantitative study involved data abstraction from all records of children diagnosed with leukemia or lymphoma in the Pediatric Hematology Oncology department of Mulago National Referral Hospital from February 2019 to June 2023. Additionally, six key informant interviews and four focus group discussions were conducted with selected health workers and caregivers of the children diagnosed with cancer respectively. The quantitative data was collected using a data abstraction tool which was designed in open data kit (ODK) while the qualitative data was collected using key informant and focus group discussion interview guides. Quantitative data was downloaded into Microsoft excel and then transferred to STATA version 14 for statistical analysis. Descriptive statistics was performed to summarize data while Cox regression was used to determine the factors associated with delayed diagnosis. Qualitative data was analyzed using thematic analysis. Results: Records of 384 children with cancer were included in the study. Majority, 65.4% (253/387) of the children were male. The median age was 8 years with an interquartile range (IQR) of 4.7 -11.7 years. More than half of the children, 57.4% (222/384) were not in school. More than half of the children, 58.7%, (227/387) were from the central region and resided in rural setting, 60.7%, (235/387). Overall, the median time from symptom onset to diagnosis confirmation was 47 days (IQR: 21.0 – 107.0). Additionally, the median time from symptom onset to diagnosis confirmation for leukemia patients was 31.0 days (IQR:16.0 – 85.0) while that for lymphoma patients was 68.0 days (IQR: 32.3 – 175.8). At any given time, children with lymphoma were 51% less likely to receive a diagnosis confirmation compared to those with leukemia. From the qualitative findings, caregiver related factors influencing the time between symptom recognition and diagnosis were; caregiver knowledge gaps, financial access barriers, caregiver health-seeking behaviors and health beliefs. Health system factors influencing the time between symptom recognition and diagnosis among children were; lack of provider expertise, diagnostic tools, inaccurate diagnosis, and ineffective referral mechanisms. Conclusion: The study found that the average duration from initial symptom recognition to diagnosis confirmation was 47 days. Various factors, including gaps in caregiver knowledge, financial barriers, caregiver health-seeking behaviors and beliefs, as well as health system factors such as lack of expertise among providers, insufficient diagnostic tools, inaccurate diagnoses, and ineffective referral processes, influenced the time between symptom recognition and diagnosis among children. There is need for targeted interventions to address both caregiver and health system barriers so as to promote timely diagnosis and treatment of pediatric hematological cancers
Enhancing students’ knowledge of integration of GeoGebra in learning mathematics in lower secondary schools in Wakiso District, Uganda
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of the Degree of Master of Education (Science Education) of Makerere UniversityThe use of technology in the pedagogical process is growing at a phenomenal rate due to the vast availability of gadgets. As a result, there is an urgent need for integrating technology into students’ mathematical activities. GeoGebra is a technology software that support teaching and learning mathematics, especially in geometry, algebra, and statistics. This study aimed to enhance the students’ knowledge of integration of GeoGebra in learning mathematics in lower secondary schools in Wakiso District, Uganda. Technological Pedagogical Content Knowledge (TPACK) and Technology Acceptance Model (TAM) theories focusing on content knowledge, technological knowledge, technological content knowledge, and perceived ease of use, respectively, guided this study. The study utilized robust quasi-experimental and cross-sectional designs where 85 senior two students from a selected secondary school were randomly selected to make 42 students in the experimental group and 43 in the control group. Data were collected using pre-tests, post-tests, and questionnaires to identify the students’ difficult geometric concepts when learning mathematics, establish the impact of GeoGebra-based training on the students’ learning, and examine the relationship between students’ perceived ease of use of GeoGebra and its integration in learning mathematics. Independent samples t-test, Pearson's Linear Correlation Coefficient, and descriptive statistics such as mean, standard deviation, percentages, and frequencies were employed to analyze the data. The study revealed that reflection on the Cartesian plane was the most students’ difficult geometric concept to learn. The results further revealed using GeoGebra software to learn reflection on the Cartesian plane resulted in higher achievement scores in the experimental group. Furthermore, students exposed to GeoGebra-based training demonstrated positive perceptions of using GeoGebra. Thus, there was a moderately significant positive linear correlation between students’ perceived ease of use of GeoGebra and its integration in learning reflection on the Cartesian plane. Therefore, the study recommends urgently training students to incorporate GeoGebra software into their mathematics learning. Curriculum developers should incorporate GeoGebra into secondary schools mathematics curriculum. This will help students explore mathematics concepts more in detail and help them build and develop their mathematics knowledge
A comparative study of structured and free text CT reporting for patients with traumatic brain injury at Mulago Hospital
No full textBackground: Radiology reports are essential for communicating imaging findings to the referring clinicians and facilitating clinical decision-making. However, the traditional free-text format of radiology reports (FTR) can be inconsistent, incomplete, and unclear, leading to potential errors and misinterpretations. Structured reporting (SR) is a method of creating radiology reports using predefined templates or categories to improve radiology reports' quality, clarity, and consistency. The objective of this study was to compare SR with FTR in reporting CT scans of patients with traumatic brain injury at MNRH.
Methods: This cross-sectional study was conducted at Mulago National Referral Hospital to evaluate the impact of structured reporting versus free-text reporting in the radiological assessment of traumatic brain injury (TBI). The study included a sample of patients already diagnosed with TBI. Radiology reports were generated using both SR templates and FTR methods. Completeness was scored based on major (2 points) and minor (1 point) criteria. Interobserver agreement was assessed using Cohen’s Kappa statistic. Statistical analyses were performed to compare the effectiveness of SR and FTR, with significance set at p<0.05.
Results: This study evaluated the efficacy and interobserver agreement of Structured Reporting (SR) and Free Text Reporting (FTR) against a gold standard in radiological assessments across multiple criteria. SR demonstrated improved completeness over FTR. The overall average SR score (18.5) was higher than that of FTR (14.0) across all participants, indicating more exhaustive reporting in SR. Interobserver agreement among participants was also notably higher with SR in criteria such as Brainstem Major, Cerebral Minor and CSF Spaces Minor with kappa values ranging from 0.45 to 1.0.
Conclusion: This study demonstrates that structured reporting (SR) significantly improves the completeness of radiology reports for traumatic brain injury (TBI) at Mulago National Referral Hospital. The Radiology department at MNRH and the Ministry of Health should consider implementing SR widely, supported by targeted training, IT infrastructure upgrades, and continuous research, to improve radiology services and patient outcomes across Uganda.Brain Healt
Prevalence, associated risk factors, and consequences of medication errors in poultry practice in Wakiso district
No full textDissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the award of the Master of Science in Pharmacology of Makerere University, Kampala-UgandaMedication errors are a serious health challenge in both humans and animals including in poultry practice in Uganda. However, limited information exists on the extent of burden of medication errors, risk factors and its associated consequences in poultry practice in Wakiso district. Aim: The study assessed the prevalence, risk factors, and associated consequences of Medication errors in poultry practice in Wakiso District. Methods: A cross-sectional study was conducted on 492 of 241 poultry farmers, 137 veterinary paraprofessionals and 69 veterinary surgeons who were involved in poultry practice in Wakiso district, Uganda's top poultry producer, where a large market for poultry products drives intensive use of medicines. It involved systematic sampling of poultry farmers, convenient sampling of veterinarians, and cluster sampling of veterinary paraprofessionals. Data was collected through structured researcher-administered interviews, using a designed tool as a guide. Medication error tracking form was used to capture medication errors, associated consequences and risk factors. Data was analyzed using STATA Version 17. Results: Of 492 participants approached, 455 participated in the study with a response rate of 92.0%. Among 455 participants, 83.5% (380/455; CI: 80.0% - 87.0% ) committed MEs, with the most prevalent being administration errors (87.5%, 336/384, CI: 83.8% - 91.2%). Veterinary paraprofessionals (99.2%, 119/120, CI: 97.6 - 100%) and poultry farmers (36.6%, 97/265, CI: 22.4 - 44.4% ) were engaged I n the prescription of poultry medicines. Risk factors to MEs reported included lack of laboratory tests (AOR = 8.4, CI 2.1 - 34.4) and lower education levels (AOR= 2.9, CI 0.7 - 12.5). Significant consequences included increased poultry mortality rates (OR = 9.2, CI 1.3 - 65.9), birds treated for longer time (OR = 8.1, CI 1.2 - 55.0) and economic losses (OR =6.6, CI 1.7 - 26.7). Conclusion: Medication errors are a common problem in poultry practice in the Wakiso district, with a prevalence of 83.5%, with administration errors being the most common encountered. Major risk factors to MEs included lower education levels and absence of laboratory tests. Consequences of MEs reported in poultry practice included high death rates, prolonged treatment durations, and significant economic losses. The findings emphasize the need for enhanced training, better diagnostics, and improved regulatory enforcement to mitigate medication errors and improve poultry health and productivity
Challenges and prospects of implementing inclusive education practice at the College of Education and External Studies, Makerere University
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of the Degree of Master of Education in Educational Policy and Planning (MEPP) of Makerere UniversityMy study focused on examining the challenges and prospects of implementing the inclusive education practices at the College of Education and External Studies (CEES), Makerere University. The study was guided by the following research objectives: to identify the challenges encountered in implementing inclusive education Practices, to explore the coping strategies and mechanisms employed by stakeholders to address these challenges and to assess the prospects and opportunities for enhancing inclusive education practices at the College of Education and External Studies (CEES), Makerere University. The study adapted a qualitative research approach taking a descriptive case study design. This approach was chosen due to its provision of room for collecting extensive first-hand data, which can be given verbally by the study participants. The content and thematic data analysis was based on the values that these participants perceived from their world. The study established that inaccessible infrastructure particular resulting from the design of the buildings in the college, nature of the wash rooms, shortage of the skilled manpower, limited knowledge of inclusive education among the academic staff and administrators and limited instructional materials for teaching students with disabilities were the major challenges to implementation of inclusive education practices. Although some participants reported a number of positive experiences, the coping mechanisms employed by the stakeholders included capacity building for academic staff through seminars and workshops, blended learning was also mentioned as one of the coping mechanisms. It was concluded that the future of inclusive education practices at CEES can be projected to be promising however, more planning for successful implementation of inclusive education practices at CEES is needed. Generally, the college is welcoming to all students though a number of modifications are still being put in place to cater for students with disabilities (SWDs
User-centred design and collaboration engineering integration to reinforce user involvement in requirements elicitation and analysis tasks: a case of EHIS
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment for the award of the Degree of Doctor of Philosophy in Information Systems of Makerere UniversityRequirements elicitation and analysis tasks in User-Centered Design (UCD) are pivotal for assessing digital systems’ quality and costs. However, these tasks often face challenges due to limited user involvement. This stems from unclear guidelines on how to conduct activities and engage users effectively to achieve their goals during the development process. This study explored how the integration of collaboration engineering (CE) principles with UCD approach could address these challenges. The study adopted a pragmatic philosophy aimed at discovering practical solutions to the identified research problem. An abductive approach was utilized to gain new insights by interpreting user needs and experiences, iteratively refining our understanding based on empirical findings. An exploratory survey was conducted to identify the types of users involved in the requirements elicitation and analysis of electronic Health Information Systems (eHIS) and to uncover the challenges they faced during these phases. This survey encompassed both primary and secondary users and assessed their participation through a mix of open-ended and closed-ended questionnaires. A total of 140 respondents were purposively selected from 20 health facilities in northern and central Uganda. The application of CE principles provided essential steps and guidelines for deriving the UCD-CE process requirements. Design Science was employed to develop the study’s artifact (the UCD-CE process), utilizing an Applied Science/Engineering approach to facilitate the integration of CE principles with the UCD process. This integration aimed to enrich the "what" and "how" aspects, enhancing user group involvement during the requirements gathering and analysis phases of eHIS development. To pursue this integration effectively, the Five-ways framework was utilized to delineate the similarities and differences between UCD and CE, addressing the "why," "how," and "what" aspects relevant to their processes. Additionally, we drew on the Six-layer model of Collaboration to illustrate how CE principles address the limitations of UCD and how to derive the work breakdown structure of the UCD-CE process during the eHIS development phase. By applying CE principles and techniques, we designed a structured and collaborative environment that reinforced user involvement in the requirements elicitation and analysis tasks. The collaboration sessions were structured to emulate the first two steps of the UCD process alongside the six steps of the CE approach. Following the design of the UCD-CE process, we implemented this hybrid approach using the Meetingwizard tool to organize and coordinate collaboration sessions across four healthcare facilities in northern and central Uganda: St. Mary's Hospital Lacor, Luwero Hospital, Kisenyi Health Center IV, and the Ugandan Ministry of Health. To ensure participant engagement and alignment with the study goals, we employed a two-pronged sampling strategy. First, purposive sampling targeted specific user categories relevant to the research questions. Second, convenience sampling was used to select participants based on their availability, anticipating that some individuals might not participate due to busy schedules or lack of interest. A total of 57 participants were selected, all possessing adequate knowledge of eHIS and similar backgrounds to foster a shared understanding and provide deeper insights. Their roles included clinicians, doctors, nurses, implementing partners, biostatisticians, counselors, data clerks, lab technicians, quality control officers, IT focal persons, data protection and security specialists, data warehouse architects, health informatics specialists, and monitoring and evaluation officers. The UCD-CE process underwent rigorous Evaluation in three iterations using an action research method, which included both formative and summative evaluations. Data collection tools comprised questionnaires and non-participant observation, supported by techniques such as structured interview guides, user stories, dialogues, ThinkLets, and patterns of collaboration. Both formative and summative evaluations were utilized to validate the UCD-CE process, with data analyzed using SPSS version 25.0 for Likert scale data from the field study. The findings from the exploratory study revealed a predominant use of a top-down approach, favoring the capture of high-level requirements at the Ministry of Health level and among implementing partners. However, less attention was given to gathering and analyzing requirements from facility-level users. Even when collected, primary users reported that their opinions and recommendations were frequently disregarded, leading to eHIS designs with usability-related challenges. Empirical results from evaluating the UCD-CE process highlight its strengths, particularly its efficiency in task completion, reduced cognitive load, and collaborative efforts to achieve common goals (user requirements). The process also demonstrated high user satisfaction, increased creativity and productivity, ease of use, learnability, and completeness of the deliverables in the requirements elicitation and analysis tasks during the development process. This study underscores the critical need for active user involvement in the early stages of eHIS development to ensure alignment with user needs and work practices. Looking ahead, future research should focus on assessing the practicality of the UCD-CE design process in enhancing user involvement during the UCD design phase, as well as exploring the long-term impact of the UCD-CE process on user experiences in developed eHIS systems
Ethical implications of Uganda's education system on graduates
No full textA thesis submitted in fulfilment of the requirements for the award of the Degree of Doctor of Philosophy of Makerere University, Department of Religion and Peace StudiesThis multidisciplinary study integrates religious ethics, theology, and education with other critical disciplines to examine Uganda’s formal education system and its impact on university graduates through the lens of Moral Theology—Judeo-Christian Ethics. It questioned whether the current formal schooling system provides an appropriate education to enable graduates to fulfil their Divine Mandate (DM) in Genesis 1:28: “Be fruitful, multiply, fill, and subdue the earth”—full potential. The study pursued three objectives: (1) exploring the philosophy guiding Uganda’s formal education system since independence and its implications on graduates’ Divine Mandate; (2) examining the system’s general purpose in relation to graduates’ Divine Mandate; and (3) creating a pathway for an appropriate education necessary for graduates’ realisation of their full potential. The study employed a convergent parallel approach under mixed-methods design across Uganda’s four regions: South-west, Eastern, Northern, and Central. Data collection involved diverse stakeholders, including the Ministry of Education (MoES), the National Council for Higher Education (NCHE), the National Curriculum Development Centre (NCDC), Uganda National Examination Board (UNEB) officials, university graduates, employers, human resource personnel and coaches, secondary school leaders and teachers, parents, and educational NGO leaders. The study utilised questionnaires, interviews, and observational methods. Qualitative data underwent thematic, process tracing, documentary, and exegetical analysis, while quantitative data was subjected to univariate analysis. The findings revealed that Uganda’s education system lacks a unified philosophical framework, and stakeholders, including university graduates, expressed uncertainty about the general purpose and definition of education. This philosophical gap significantly impacts graduates’ ability to fulfil their Divine Mandate (DM) as outlined in Genesis 1:28. Based on these findings, the study proposes an innovative model for restructuring Uganda’s educational framework, emphasizing the need for a comprehensive macro-level educational philosophy to accommodate institutional-level philosophies while addressing the three fundamental questions of “Why education?” “Education for what?” and “For whom is it designed for?”This work was sponsored by the Gerda Henkel fellowship /CHUSS scholarship at Makerere University
Factors associated with early identification of developmental delays and disabilities, and linkage to care among children under 5 years in Kabarole District, Western Uganda
No full textA research dissertation submitted to the Directorate of Research and Graduate Training (DRGT) in partial fulfillment of the requirements for the award of the Degree of Master of Public Health of Makerere University KampalaChildren in rural and resource-constrained areas face challenges in accessing early diagnosis and care for developmental delays and disabilities, affecting about 4.3% of children aged 0–4 years. In Kabarole District, despite efforts like UNICEF's IDEC program, an estimated 9,349 children live with developmental delays and disabilities, and limited information exists on early identification and linkage to care for children under 5 years, hindering effective service planning. This study assessed the factors associated with early identification of developmental delays and disabilities, and linkage to care for children under five years with developmental delays and disabilities in Kabarole District, Western Uganda. Methodology: A cross-sectional design was employed, utilizing both quantitative and qualitative methods to meet distinct objectives. Data from 211 caregivers were analyzed using descriptive and modified Poisson regression in STATA 15. Qualitative data from 9 key informants and 12 caregivers were analyzed thematically using Atlas.ti v.8. The response rate was 100%, ensuring comprehensive data collection. The results revealed that 50.2% of caregivers identified and linked their children to care early. The prevalence of reporting of early identification and linkage to care among caregivers with prior knowledge of the disability was nearly twice higher than those who didn’t (aPR=1.98, CI: 1.37-2.87, p<0.001). A very good relationship with healthcare providers increased the prevalence of reporting of early identification and linkage to care (aPR=1.59; 95% CI: 0.97-2.62), though not statistically significant. The prevalence of reporting of early identification and linkage to care among caregivers who benefited from healthcare programs was 1.45 times higher (aPR = 1.45, 95% CI: 0.95-2.20). Qualitative findings emphasized strengthening health and social support systems, including postnatal care, regular checkups, screening tools, community awareness, peer and family support, and family welfare. The study concluded that early identification and intervention for children under 5 with developmental disabilities in Kabarole district are low. The key factors included knowledge, healthcare relationships, and access, highlighting the need for better awareness, training, screenings, access, and organizational collaboration