Lira University Institutional Repository

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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.

Through this repository, Lira University strengthens visibility, knowledge sharing, long-term preservation, and worldwide access to its academic contributions.

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Recent Submissions

Three‑dose Completion of R21/matrix‑M Malaria Vaccine among Children Eligible for the Third Dose in Kole and Kwania Districts, Uganda: A Parallel Mixed‑Methods Study.
(BMC, 2026) Puleh, Sean Steven; Ocan, Moses; Siu, Godfrey; Yeka, Adoke; Nankabirwa, Joaniter I.; Idro, Richard; Akech, Stella Immaculate; Acen, Joy David L.; Ejalu, David L.; Nankinga, Ziadah; Afayo, Robert; Kalyango, Joan N.
Background: The R21/Matrix-M malaria vaccine (hereafter “R21”) contains the R21 antigen and Matrix-Madjuvant. Completion of the initial three-dose series is important for protection, but continuation through multi-dose schedules remains a programmed challenge. This study assessed three-dose completion and associated fac-tors among children who had initiated vaccination and were eligible for dose three in Kole and Kwania districts, Uganda, and explored barriers and facilitators of completion. Methods: A convergent mixed-methods was conducted from September to October 2025. A community-based cross-sectional survey included caregivers of 733 children who had received dose one at least 3 months before enrolment. Descriptive analyses and modified Poisson regression with village-clustered robust standard errors were used; adjusted prevalence ratios (aPRs) and 95% confidence intervals were reported. Qualitative data were collected from 55 participants through key informant interviews, caregiver in-depth interviews and caregiver focus group discussions using semi-structured guides. Recordings were transcribed, anonymised and analysed in ATLAS.ti 25. The components were analysed separately and integrated through a convergence matrix. Results: Of the 733 children, 399 (54.4%) were female and 404 (55.1%) were aged ≤12 months. Three-dose completion was 55.7% (village-clustered 95% CI: 48.6–62.7). Among the 408 children who completed three doses, 360 (88.2%) received the third dose within the specified timing window. In the adjusted analysis of 727 children, caregiver-reported vaccine unavailability was associated with lower completion (aPR 0.64, 95% CI: 0.44–0.93). Health-worker reminders were not significantly associated with completion (aPR 1.09), and walking time was not statistically significant overall (p = 0.074). Qualitative analysis involving 55 participants identified two overarch- ing themes: factors supporting completion, including perceived benefits, caregiver motivation, reminders, and community support; and barriers, including missed appointments, vaccine unavailability, transport difficulties, safety concerns, and gender-related responsibilities. Conclusions: Just over half of children completed the initial three-dose R21/Matrix-M series. Caregiver-reported vaccine unavailability was associated with lower completion, while qualitative findings highlighted practical barriers and sources of support. The Ministry of Health should prioritise reliable vaccine availability and evaluate outreach and reminder strategies to support completion.
Stakeholder Experiences of Community-Linked Group Antenatal Care in Rural Northern Uganda: A Qualitative Study
(Journal of Multidisciplinary Healthcare, 2026) Puleh, Sean Steven; Akech, Stella Immaculate; Okunu, Nicholas; Apio, Brenda; Anyinge, Harriet; Kigongo, Eustes; Awio, John Peter; Ojok, Moses; Ocen, Patrick Buchan; Rukundo, Gerald
Background: Group antenatal care (G-ANC) combines shared learning and peer support with antenatal services. Evidence on stakeholder experiences of community-linked models in post-conflict settings remains limited. This study explored the experiences of pregnant women, Village Health Team (VHT) members and facility midwives participating in or implementing G-ANC in Kole District, Northern Uganda. Methods: An exploratory qualitative study conducted in June 2024 included nine key-informant interviews with four VHT members and five facility midwives, and four focus-group discussions with 33 pregnant women. Audio-recorded data were transcribed and analysed using a combined deductive–inductive thematic approach supported by ATLAS.ti version 23. Results: Five themes concerned education and services, acceptability and perceived benefits, implementation and access challenges, cultural and gender influences and conditions for continuation. Participants valued shared discussion, peer reassurance, health information, and encouragement to attend care. VHT members described mobilization, education, and referral support, while midwives described clinical oversight and staffing pressures. Group-specific constraints included insufficient meeting space, materials, and facilitator capacity. Medicine shortages, provider absence, and transport difficulties affected the linked routine antenatal care pathway. Participants identified training, supervision, reliable clinical services, community engagement, and district integration as conditions for continuation. Conclusion: Participants perceived community-linked G-ANC as acceptable and supportive of learning, peer support and motivation to attend care. This study did not measure changes in knowledge, attendance or clinical outcomes, or demonstrate effectiveness or long-term sustainability. Implementation requires support for group facilitation alongside reliable facility-based antenatal services.
Stakeholder Experiences of Community-Linked Group Antenatal Care in Rural Northern Uganda: A Qualitative Study.
(Dove Press: Taylor & Francis Group, 2026) Puleh, Sean Steven; Akech, Stella Immaculate; Okunu, Nicholas; Apio, Brenda; Anyinge, Harriet; Kigongo, Eustes; Awio, John Peter; Ojok, Moses; Ocen, Patrick Buchan; Rukundo, Gerald
Background: Group antenatal care (G-ANC) combines shared learning and peer support with antenatal services. Evidence on stakeholder experiences of community-linked models in post-conflict settings remains limited. This study explored the experiences of pregnant women,Village Health Team (VHT) members and facility midwives participating in or implementing G-ANC in Kole District, Northern Uganda. Methods: An exploratory qualitative study conducted in June 2024 included nine key-informant interviews with four VHT members and five facility midwives, and four focus-group discussions with 33 pregnant women. Audio-recorded data were transcribed and analysed using a combined deductive–inductive thematic approach supported by ATLAS.ti version 23. Results: Five themes concerned education and services, acceptability and perceived benefits, implementation and access challenges, cultural and gender influences and conditions for continuation. Participants valued shared discussion, peer reassurance, health informa tion, and encouragement to attend care. VHT members described mobilization, education, and referral support, while midwives described clinical oversight and staffing pressures. Group-specific constraints included insufficient meeting space, materials, and facilitator capacity. Medicine shortages, provider absence, and transport difficulties affected the linked routine antenatal care pathway. Participants identified training, supervision, reliable clinical services, community engagement, and district integration as conditions for continuation. Conclusion: Participants perceived community-linked G-ANC as acceptable and supportive of learning, peer support and motivation to attend care. This study did not measure changes in knowledge, attendance or clinical outcomes, or demonstrate effectiveness or long-term sustainability. Implementation requires support for group facilitation alongside reliable facility-based antenatal services.
Knowledge, attitudes and practices regarding occupational hazards among grain mill workers in Soroti City, North Eastern Uganda: A cross-sectional study.
(Academic Journal: Journal of Toxicology and Environmental Health Sciences, 2026) Akello, Anne Ruth; Omondi, Oscar Donde; Moturi, Wilkister N.
Grain milling is a hazardous occupation associated with respiratory diseases, musculoskeletal disorders, and noise-induced hearing loss. However, evidence on knowledge, attitudes, and practices (KAP) regarding occupational hazards among grain mill workers in sub-Saharan Africa is limited. This study assessed KAP regarding occupational hazards and factors associated with safety practices among grain mill workers in Soroti City, Uganda. A cross-sectional study was conducted among 384 grain mill workers from August to October 2025. Consecutive sampling was used to recruit eligible workers present during the study period, with data collected across different shifts and days to minimize selection bias. Data were collected using a structured interviewer-administered questionnaire and an observation checklist. Knowledge, attitude, and practice levels were categorized using composite scores. Modified Poisson regression with robust error variance was used to identify factors associated with good safety practices, with adjusted prevalence ratios (aPR), 95% confidence intervals (CI), and p-values reported. Most respondents had good knowledge (59.9%, n=230), while 7.3% (n=28) had poor knowledge. Attitudes were evenly distributed between positive (50.0%, n=192) and negative. Despite relatively good knowledge, 68.3% (n=262) demonstrated poor safety practices. Availability of occupational safety and health (OSH) policies was the only factor significantly associated with good safety practices; workers reporting policy availability were less likely to have good practices (aPR=0.39, 95% CI: 0.25–0.60, p<0.001). This paradoxical finding may reflect the absence of written and displayed policies, with reported availability referring mainly to verbal instructions. Grain mill workers had relatively good knowledge and mixed attitudes, but safety practices remained poor, indicating a critical implementation gap. Written and displayed OSH policies, regular inspections, enforcement of safety measures, and continuous worker training are needed to improve workplace safety.
Beyond the Device: Reforming Higher Education and Teacher Education Curricula from ICT Literacy to AI Pedagogical Readiness in East Africa.
(East African Journal of Education Studies, 2026) Kipleting, Cornelius Rugut
The rapid advancement of artificial intelligence (AI) is transforming teaching, learning, assessment, and educational practice, requiring education systems to rethink how future educators are prepared for AI enabled teaching and learning. The Nairobi Declaration on Artificial Intelligence and Emerging Technologies in Education for Eastern Africa (2024) highlights the need for education systems to strengthen AI capacity, ethical adoption and human-centred innovation. However, despite significant investments in digital infrastructure and ICT literacy across East African higher education institutions, many teacher education curricula remain focused on basic digital skills and technology operation rather than the advanced competencies required for AI-enabled teaching and learning. This creates a growing mismatch between existing teacher preparation approaches and the knowledge, pedagogical skills, and ethical awareness required for responsible AI integration. By adopting a qualitative conceptual research design supported by systematic document analysis published from (2020-2026) of contemporary scholarship and key policy frameworks, including UNESCO's AI Competency Framework for Teachers, the OECD Digital Education Outlook, and the African Union AI Strategy, this conceptual paper aimed to examine how higher education and teacher education curricula can transition from ICT literacy to AI pedagogical readiness. The paper argues that AI readiness requires more than technological proficiency; it requires educators who can critically understand, ethically evaluate, and pedagogically apply AI in teaching, learning, assessment, research, and professional practice. It proposes curriculum reform that positions AI pedagogical readiness as a core graduate attribute within teacher education. The paper concludes that coordinated curriculum reform, institutional support, and responsible AI governance are essential for preparing AI-ready educators capable of advancing equitable, innovative, and sustainable education in East Africa.