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The Lira University Institutional Repository is a digital platform for collecting, preserving, and disseminating the intellectual and scholarly output of the University.

It provides access to theses, dissertations, journal articles, conference papers, learning materials, reports, university publications, and other research outputs produced by the Lira University community.

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Cost-effectiveness Analysis of Adding Tuberculosis Household Contact Investigation on Passive Case-finding Strategy in Southwestern Uganda.
(Plos One, 2023) Odongo, Dickens; Omech, Benard; Acanga, Alfred
Introduction: The standard passive case-finding strategy implemented by most developing countries is inadequate to detect new of Tuberculosis. A household contact investigation is an alternative approach. However, there is limited cost-effectiveness data to support planning and implementation in low and middle-income countries. The study aimed to evaluate the cost-effectiveness of adding household contact investigation (HCI) to the passive case-finding (PCF) strategy in the Tuberculosis control program in Southwestern Uganda. Methods: We conducted an economic evaluation using a retrospective study approach and bottom-up costing (ingredients) techniques. It was a synthesis-based evaluation of existing data extracted from the District Health Information System (DHIS 2), TB registers, and a primary cost survey. The study compared two methods of Tuberculosis (TB) case finding (PCF and HCI) strategies. Regarding PCF, patients either self-reported their signs and symptoms or were prompted by healthcare workers. At the same time, HCI was done by home visiting and screening contacts of TB patients. Patients and household contacts presumed to have Tuberculosis were requested to produce samples for analysis. We applied a static decision- analytic modeling framework to examine both strategies’ costs and effectiveness. The study relied on cost and probability estimates from National Tuberculosis (TB) program data, activity costs, and published literature. It was performed from the societal and provider perspectives over 1.5 years across 12 facilities in Ntungamo, Sheema, and Rwampara Districts. The primary effectiveness measure was the number of TB cases detected (yield) and the number needed to screen (NNS). The TB yield was calculated from the number of patients screened during the period under study. The incremental cost-effectiveness ratio (ICER) was expressed as cost in 2021 US$ per additional TB case detected. We did not apply a discount rate because of the short analytic time horizon. Results: The unit costs of detecting a Tuberculosis case were US$ (United States dollar) 204.22 for PCF and US$ 315.07 for HCI. Patient and caregiver costs are five times more in PCF than in HCI [US$26.37 Vs. US$ 5.42]. The ICER was US$ 3,596.94 per additional TB case detected. The TB screening yields were 0.52% (1496/289140) for passive case finding and 5.8% (197/3414) for household contact investigation. Household contact investigation yield among children 0–14 Vs. 15+ years [6.2% Vs.5.4%] P = 0.04. The Yield among People living with HIV (PLHIV) Vs. HIV-negative [15.8% Vs.5.3%] P = 0.03 in HHCI. The PCF yield in men Vs. Women [1.12% Vs.0.28%] P<0.01. The NNS in PCF was 193 [95% CI: 186–294] and 17 [95% CI: 14–22] in HCI. Conclusion: Our baseline assumptions and the specific implementations of adding HCI to existing PCF programs in the context of rural African settings prove to be not cost-effective, rather than HCI as a strategy. HCI effectively identifies children and PLHIV with TB and should be prioritized. Meanwhile, the Passive case-finding strategy effectively finds men with TB and costs lower than household contact investigation.
Uptake of R21/Matrix-M malaria vaccine and associated factors among children eligible for vaccination in Kole and Kwania districts, Northern Uganda: a cross-sectional study
(BMC Public Health, 2026) Puleh, Sean Steven; Nankabirwa, Joaniter I.; Kalyango, Joan N.; Ocan, Moses; Siu, Godfrey; Idro, Richard; Akech, Stella Immaculate; Acen, Joy; Ejalu, David L; Nankinga, Ziadah; Afayo, Robert; Ocen, Francis; Opio, Bosco; Yeka, Adoke
Background The introduction of R21/Matrix-M (R21) vaccine as a malaria control strategy provides an oppor¬tunity to reduce the disease burden. However, there is limited evidence on its uptake and what affects the uptake, information that is important for the successful implementation of the vaccine. We assessed the level of uptake and associated factors among caregivers of children eligible for malaria vaccination in northern Uganda. Methods Between September and October 2025, a cross-sectional survey was conducted among 557 caregiv¬ers of children eligible for malaria vaccination. Data were collected using pretested structured questionnaires in KoboCollect and exported into Stata version 18 for analysis. Child health cards were used to verify vaccine sta¬tus. Uptake was defined as the proportion of caregivers whose eligible children received at least one dose of the vaccine. Factors associated with vaccine uptake were determined using modified Poisson regression, adjusting for village level clustering and reported as adjusted prevalence ratio (aPR) with their 95% confidence intervals. Results Of the 557 caregivers interviewed, 269 reported that their children had received the first dose of the malaria vaccine, putting uptake at 48.3% (95% confidence interval CI: 44.0% − 52.0%). Vaccine uptake was positively associated with exposure to community-based health campaigns (aPR = 1.32, 95% CI: 1.01–1.72); caregivers’ receiving advice from healthcare workers about the vaccine (aPR = 2.61, 95% CI: 1.55–4.40); per¬ceived increased susceptibility of the child to malaria (aPR = 2.26, 95% CI: 1.67–3.04); ease of accessing the vaccine (aPR = 1.47, 95% CI: 1.25–1.73); and trust in government programs (aPR = 1.80, 95% CI: 1.43–2.25). Negative interaction effects were observed between health-worker advice combined with perceived malaria sus¬ceptibility (aPR = 0.44; 95% CI: 0.29–0.66) and long queues combined with poor information (aPR = 0.12; 95% CI: 0.02–0.89). Conclusion The level of R21 malaria vaccine uptake was sub optimal, with less than half of eligible children receiving their first dose. Multiple factors influenced uptake, including those affecting caregiver knowledge and vaccine access. The Ministry of Health should strengthen factors improving uptake including, caregiver educa¬tion on benefits of the vaccine and expanding access through different channels including campaigns
Association of person-centred maternity care during childbirth and future reproductive and health-seeking intentions among adolescents in Lira, Northern Uganda: a cross-sectional survey.
(Taylor & Francis Group., 2026) Udho, Samson; Clow, Elizabeth Sheila
Background: Person-centred maternity care (PCMC) is essential for delivering respectful, responsive, and high-quality care during childbirth. However, limited evidence exists on the association between PCMC during childbirth and adolescents’ future reproductive and health- seeking intentions. Objective: To examine the association between PCMC during childbirth and future reproductive and health-seeking intentions among adolescents in Lira, Northern Uganda. Methods: We conducted a community-based cross-sectional study among 560 adolescents aged 14–19 years who had given birth in public primary health facilities between March 2023 and July 2024. PCMC was measured using the validated PCMC scale, while future reproductive and health-seeking intentions were assessed using items adapted from the Community Survey Tool. Data were analysed using descriptive statistics and multivariable logistic regression, adjusting for socio-demographic and obstetric factors. Results: The median age of participants was 18 years (IQR: 18–19). Most adolescents intended to have another child (82%), return to the same facility for future childbirth (83%), and recommend the facility to others (85%). Overall, 77.7% reported moderate levels of PCMC. Adolescents reporting moderate and high PCMC were more likely to intend to return to the same facility for future childbirth (AOR = 2.84, 95% CI: 1.61–5.00; AOR = 5.60, 95% CI: 1.19– 26.43, respectively). Adolescents reporting moderate PCMC were also more likely to recommend the facility to others (AOR = 4.31, 95% CI: 2.46–7.54). Conclusions: Higher levels of PCMC were associated with positive future health-seeking intentions among adolescents. Strengthening adolescent-responsive PCMC may enhance future engagement with skilled childbirth services and contribute to improved maternal health outcomes in low-resource settings.
From Access to Impact: Lessons from African Academic Libraries in Driving Digital Transformation and Knowledge Equity
(East African Journal of Interdisciplinary Studies, 2026) Ojulong, Andrew; Namugera, Lydia; Kutyamukama, Alice Gitta
African academic libraries are undergoing a profound structural transformation from traditional repositories of information into digitally enabled knowledge ecosystems that actively support research, innovation, and inclusive development. This paper examines how collaborative library consortia, continental coordination frameworks, and digital infrastructure systems are reshaping scholarly communication and advancing knowledge equity across African higher education institutions. Using a qualitative desk-review methodology, the study synthesises evidence from peer-reviewed literature, institutional reports, policy frameworks, and technical documents published between 2021 and 2026. The analysis focuses on key actors and systems, including the Consortium of Uganda University Libraries, the Kenya Library and Information Services Consortium, the Association of African Universities, Electronic Information for Libraries, Research4Life, and National Research and Education Networks such as the Research and Education Network for Uganda. Findings indicate that African academic library consortia have evolved beyond traditional resource procurement models into complex socio-technical ecosystems integrating digital infrastructure development, capacity building, policy advocacy, open science implementation, and institutional innovation. These transformations are strengthening research visibility, improving access to scholarly resources, and enhancing the resilience of higher education systems. The paper concludes that African academic libraries are increasingly functioning as strategic drivers of epistemic equity and digital transformation, offering a scalable model for Global South institutions seeking to align knowledge systems with sustainable development priorities and the evolving digital knowledge economy.
Harnessing Mothers’ Union Activities as a Means to Enhance Church Marriages
(East African Journal of Traditions, Culture and Religion, 2026) Ayang, James; Mwesigwa, David
Church marriage plays a central role in spiritual, social, and family life, offering moral guidance, relational mentorship, and community support. The Mothers’ Union (MU) emerged in this historical context as a movement to strengthen Christian marriage and family life. While economic factors such as the high cost of church weddings are often cited, deep-rooted cultural beliefs surrounding clan rituals, ancestral approval, and customary obligations continue to shape marital legitimacy, making traditional marriage more socially authoritative in many communities. The Mothers’ Union represents one of the most enduring faith-based women’s movements within Christian institutions, particularly within Anglican traditions, where it functions as both a spiritual fellowship and a structured social support system. Church marriage is a Christian marital union solemnised within a church setting according to established religious rites and formally sanctioned by denominational authority. Counselling wedded couples is the most important and most tricky challenge affecting mothers’ unions in Uganda and possibly beyond because of several factors, namely masterminded by the social media and modernisation. Sensitisation programs should be organised from time to time among members of the mothers’ union on how to cope with modernisation and the robust expansion of the social media among wedded couples.