Department of Psychiatry

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Promoting Psychiatry in the medical school: "The case of Uganda"
(Psychiatry Bulletin, 2002) Ovuga, E; Buga, J; Oboke, Henry; Boardman, J
Uganda has a rich history of medical education Odonga, 1989) that was severely harmed by the rise of Idi Amin and the years of internal strife. It is only over recent years that the country has begun to rebuild itself Boardman & Ovuga, 1997). A central problem for psychiatry in Uganda …
War related sexual violence and it's medical and psychological consequences as seen in Kitgum, Northern Uganda: A cross-sectional study
(BMC International Health and Human Rights, 2009) Eugene, Kinyanda; Musisi, Seggane; Biryabarema, Christine; Ezati, Isaac; Oboke, Henry; Ojiambo-Ochieng, Ruth; Were-Oguttu, Juliet; Levin, Jonathan; Grosskurth, Heiner; Walugembe, James
Background: Despite the recent adoption of the UN resolution 1820 (2008) which calls for the cessation of war related sexual violence against civilians in conflict zones, Africa continues to see some of the worst cases of war related sexual violence including the mass sexual abuse of entire rural communities particularly in the Great Lakes region. In addition to calling for a complete halt to this abuse, there is a need for the systematic study of the reproductive, surgical and psychological effects of war related sexual violence in the African socio-cultural setting. This paper examines the specific long term health consequences of war related sexual violence among rural women living in two internally displaced person's camps in Kitgum district in war affected Northern Uganda who accessed the services of an Isis-Women's International Cross Cultural Exchange (Isis-WICCE) medical intervention. Methods: The study employed a purposive cross-sectional study design where 813 respondents were subjected to a structured interview as part of a screening procedure for an emergency medical intervention to identify respondents who required psychological, gynaecological and surgical treatment. Results: Over a quarter (28.6%) of the women (n= 573) reported having suffered at least one form of war related sexual violence. About three quarters of the respondents had 'at least one gynaecological complaint' (72.4%) and 'at least one surgical complaint' (75.6%), while 69.4% had significant psychological distress scores (scores greater than or equal to 6 on the WHO SRQ-20). The factors that were significantly associated with war related sexual violence were the age group of less than or equal to 44 years, being Catholic, having suffered other war related physical trauma, and having 'at least one gynaecological complaint'. The specific gynaecological complaints significantly associated with war related sexual violence were infertility, chronic lower abdominal pain, abnormal vaginal bleeding, and sexual dysfunction. In a multivariable analysis the age group of less than or equal to 44 years, being Catholic and having 'at least one gynaecological complaint' remained significantly associated with war related sexual violence. Conclusion: The results from this study demonstrate that war related sexual violence is independently associated with the later development of specific gynaecological complaints.
Work stress and coping strategies among social workers: A case of Northern Uganda
(International Journal of Liberal Arts and Social Science, 2014) Kabunga, Amir; Muya, Francis Kihoro
Social workers are exposed to potent stressors due to the nature of their work. The study examined work stress and coping strategies among social workers in Northern Uganda. The target population consisted of 353 social workers in Northern Uganda. Simple random sampling was employed to select 188 respondents. Descriptive cross-sectional survey design was adopted. The Perceived Stress Scale (PSS) was used to assess the level of stress while researcher developed questionnaires captured both the contributing and mitigating factors. The findings established that majority of the respondents (91%) had high stress levels. Significant factors contributing to stress included finances, work demand, safety concerns, family and violence from the rebels. The most effective mitigating strategies for job stress included spirituality, planning, goal setting, time-management and positive thinking. It was recommended that stress reduction programs and strategies be implemented to mitigate work stress.
Secondary Traumatic Stress Among Mental Health Practitioners in Butabika and Mulago Referral Hospitals in Uganda
(International Journal of Liberal Arts and Social Science, 2014) Kabunga, Amir; Muya, Francis Kihoro; Gitau, Emily W.; Njuguna, Jane M.
Secondary Traumatic Stress (STS) leaves the care-givers feeling anxious, confused, depressed and depleted. This research aimed at establishing the prevalence of secondary traumatic stress among Mental Health Practitioners (MHPs) in Butabika and Mulago referral hospitals in Uganda. Simple random sampling was used to select a sample of 123 respondents, 61 from Butabika and 62 Mulago hospitals. The study used a retrospective cohort study design. Categorical variables were summarized as frequencies and corresponding percentages while continuous variables were summarized as frequencies, means and standard deviations. Chi- square tests were used to check association between variables in the two cohorts (P-value =0.05). The study revealed that 27.9 % of the MHPs from Butabika hospital and 32.3% from Mulago hospital had STS. The study showed that some MHPs in both hospitals were fatigued and recommended psychological care services for them.
Therapists’ Past Traumatic Experiences, Compassion Fatigue and the Consequent Work Performance: A Case of Professional Therapists in Eldoret, Kenya
(International Journal of Sciences: Basic and Applied Research (IJSBAR), 2015) Kabunga, Amir; Adinab, Japheth O.; Margret, Disiye; Shikanga, Mwirotsi E.; Amapesa, Shikanga T.
This study aimed at establishing the impact of past traumatic experiences on the performance of professional therapists drawn from a group of professional therapists (N=84) working in Eldoret, Kenya. A simple random sampling procedure was used to select a sample of 61 professional therapists. The study adopted a cross-sectional descriptive survey design. The proQOL scale was the primary instrument used to collect data. Analysis of data involved descriptive and inferential statistics using STATA version 12 SE. The findings of the study indicated that 70% of the professional therapists presented with compassion fatigue. The study found that 31% of those who had experienced traumatic events had their performance affected while 69% did not have their performance affected. The study also showed that professional therapists with high levels of compassion fatigue had almost four times increased risk of having their performance affected compared to their counterparts with average compassion fatigue. The study recommended that professional therapists handling trauma victims should seek regular supervision in order to overcome the effects of both primary and secondary traumatisation, and also to remain high functional and effective in their careers.
ICD-11 Trauma Questionnaires for PTSD and Complex PTSD: Validation among Civilians and Former Abducted Children in Northern Uganda
(Journal of Psychiatry, 2015) Dokkedahl, Sarah; Oboke, Henry; Ovuga, Emilio; Elklit, Ask
Abstract Objectives: ICD-11 is expected to introduce a new diagnosis of C-PTSD, along with a revision of the current PTSD diagnosis. Are the suggested diagnostic tools for PTSD and C-PTSD valid in a developing country? Method: The tools have been tested on former abducted and regular civilians in northern Uganda (n=314), who have been influenced by the civil war that lasted for more than two decades. Results: The prevalence of either PTSD or C-PTSD was 36.6% and PTSD and C-PTSD was further found to correlate with symptoms of depression, anxiety and somatic complaints. Conclusion: Based on its findings the study concludes that the ICD-11 tools for PTSD and C-PTSD both appear to be valid as suggested by both discriminant and convergent validation of the tools. However, future research can benefit from studying cultural aspects of these diagnoses.
Burnout Levels among Professional Counselors in Butabika and Mulago National Referral Hospitals in Uganda
(American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS), 2015) Kabunga, Amir; Muya, Francis Kihoro; Njuguna, Jane M; Njuguna, Christina N.; Nginya, Mary W; Nguvi, Mary Muindi
Counseling profession places unique demands on care-providers and has negative consequences. This study explored prevalence of burnout and its preventive measures among professional counselors in Butabika and Mulago national referral hospitals in Uganda using the Professional Quality of Life-IV (proQOL-IV) questionnaire to determine levels of burnout. A total of ten research questions were used to determine common strategies employed by counselors in mitigating burnout. A cross sectional descriptive study was adopted and simple random sampling was used to select a sample of 123 respondents. The results showed that70% and 68% of counselors had developed burnout in Butabika and Mulago respectively. It was found out that the most effective strategies for mitigating burnout include; attending workshops, social support, travelling, going on vacations, hobbies, social skills, relaxation, spirituality and supervision. The study recommended that a combination of organizational and individual strategies is necessary to prevent burnout.
The Psychological Impact of War and Abduction on Children in Northern Uganda: A Review
(International Journal of Mental Health and Psychiatry, 2015) Dokkedahl, Sarah Bøgelund; Oboke, Henry; Ovuga, Emilio; Elklit, Ask
In more than two decades northern Uganda was affected by the war between the government and the LRA. Children were abducted and affected during the war, but what is the psychological and social impact of war on the children? Methods: In this study we reviewed 40 epidemiological trauma studies conducted in Uganda from 2004-2014 using databases. Results: The psychological impact was found in many different domains ranging from mental health problems like PTSD, depression, anxiety, and psychosis to suicidal ideation, alcohol abuse, partner violence, child abuse, and feelings of guilt and revenge, furthermore, many experienced problems when returning to their home communities. Uganda only has few mental health workers, few clinical facilities and lack medication to treat mental health problems. Conclusion: We therefore conclude that the prevalence of mental health problems continue to be high to this day, despite the war ending in 2007.
A Study on Emotional Intelligence among Psychotherapists in Northern Uganda
(International Journal of Academic Research in Psychology, 2016) Kabunga, Amir; Jesse, Murithi J.
A growing number of studies have suggested that emotional intelligence could have an impact on several individual domains. However, few studies have been done on emotional intelligence among psychotherapists in Africa in general and Uganda in particular. The study was to determine the levels of emotional intelligence among psychotherapists in northern Uganda. Data collection occurred with surveys incorporating the Emotional Competency Inventory 2.0. Psychotherapists from northern Uganda participated with 207 respondents returning completed surveys. Data analysis was done using descriptive statistics including percentages, median, minimum and maximum. Results indicates that 60.0% possessed high levels of self-awareness, 60.3% reported high levels of social awareness, 55.6% scored high in self-management domain and 70.1% scored highly in social skills. On the basis of these findings, suggestions and recommendations were made to include emotional intelligence as an integral component of training and incorporate emotional intelligence intervention techniques to benefit psychotherapists in managing work related stress.
Class Size And Learning Outcomes: Perceptions Of In-Service Teachers
(Researchjournali’s Journal of Education, 2016) Muya, Francis Kihoro; Kabunga, Amir
Achieving quality learning outcomes within the education system in Kenya remains an elusive goal for educationists. Many strategic plans have been drafted and action plans implemented, but the aspiration remains a mirage. It appears the policy makers require more input from the stakeholders. The purpose of this study was to find out the perceptions of in-service teachers on class size and learner achievement. Fifteen in-service teachers attending the April 2015 school-based session at Mount Kenya University, Nairobi Campus were randomly selected and requested to participate in a Focus Group Discussion (FGD) organized by the researchers. The FGD revealed that class size in isolation cannot have an impact on learners’ achievement. It should be complemented by quality teacher preparation, more individualization, provision of resources and improving the quality of interaction in the classroom. The study recommended hiring of more Early Childhood Education Teachers to reduce class sizes and therefore improve learning outcomes.
Compassion Fatigue: A Study of Psychotherapists’ Demographics in Northern Uganda
(International Journal of Academic Research in Psychology, 2016) Kabunga, Amir; Mbugua, Stephen; Makori, George
Psychotherapists are often required to provide a high degree of care to clients which can result in physical and psychological complaints often referred to as compassion fatigue. The aim of this cross sectional study was to determine the relationships between demographic characteristics and compassion fatigue among psychotherapists. The Professional Quality of Life 5 and a Demographic Data sheet were completed by 207 psychotherapists. Data analysis was done using Pearson’s Chi Square test and Fisher’s exact test. The statistical hypotheses were tested at the significance level of p ≤ .05. The results of this study revealed that there was no sufficient evidence from the data to link gender and age to high or low level of compassion fatigue. The results further revealed that there were progression trends in which compassion fatigue decreased with increase in the psychotherapists’ years of practice. The study concluded that all psychotherapists regardless of gender and age may be similarly capable of handling the stressors that a career as a psychotherapist entails. However, the results showed that working experience may be a starting point for explaining compassion fatigue among psychotherapists.
Compassion Fatigue In Combat Trauma-Related Work Settings: Does It Matter?
(International Journal of Innovative Research and Advanced Studies (IJIRAS), 2016) Kabunga, Amir; Makori, George; Mbugua, Stephen
Abstract: This study investigated the levels of compassion fatigue among psychotherapists working in a war zone region in northern Uganda. A cross sectional design was used. Psychotherapists (n = 207) from northern Uganda participated in the study. Data analysis was done using descriptive statistics. The results of this study revealed that up to 60.4% of the respondents were experiencing high level of compassion fatigue, 23.7% were experiencing average level of fatigue and 15% had low level of fatigue. The results suggest that working with victims of war has profound impact on psychotherapists. The high levels of compassion fatigue evident among psychotherapists indicate that intervention should be considered a matter of priority. Collaborative organizational efforts to minimize compassion fatigue among all areas of psychotherapy is essential in creating awareness and building resiliency.
Undergraduate students’ contributions to health service delivery through communitybased education: A qualitative study by the MESAU Consortium in Uganda
(BMC Medical Education, 2016) Atuyambe, Lynn M.; Baingana, Rhona K.; Kibira, Simon P. S.; Katahoire, Anne; Okello, Elialilia; Mafigiri, David K.; Ayebare, Florence; Oboke, Henry; Acio, Christine; Muggaga, Kintu; Mbalinda, Scovia; Nabaggala, Ruth; Ruzaaza, Gad; Arubaku, Wilfred; Mary, Samantha; Akera, Peter; Tumwine, James K.; Peters, David H.; Sewankambo, Nelson K.
Background: It has been realised that there is need to have medical training closer to communities where the majority of the population lives in order to orient the trainees’ attitudes towards future practice in such communities. Although community based education (CBE) has increasingly been integrated into health professions curricula since the 1990s, the contribution students make to service delivery during CBE remains largely undocumented. In this study, we examined undergraduate health professions students’ contribution to primary health care during their CBE placements. Methods: This was a qualitative study involving the Medical Education for Equitable Services to All Ugandans consortium (MESAU). Overall, we conducted 36 Focus Group Discussions (FGDs): one each with youth, men and women at each of 12 CBE sites. Additionally, we interviewed 64 community key-informants. All data were audio-recorded, transcribed and analysed using qualitative data analysis software Atlas.ti Ver7. Results: Two themes emerged: students’ contribution at health facility level and students’ contribution at community level. Under theme one, we established that students were not only learning; they also contributed to delivery of health services at the facilities. Their contribution was highly appreciated especially by community members. Students were described as caring and compassionate, available on time and anytime, and as participating in patient care. They were willing to share their knowledge and skills, and stimulated discussion on work ethics. Under the second theme, students were reported to have participated in water, sanitation, and hygiene education in the community. Students contributed to maintenance of safe water sources, educated communities on drinking safe water and on good sanitation practices (hand washing and proper waste disposal). Hygiene promotion was done at household level (food hygiene, hand washing, cleanliness) and to the public. Public health education was extended to institutions. School pupils were sensitised on various health-related issues including sexuality and sexual health. Conclusion: Health professions students at the MESAU institutions contribute meaningfully to primary health care delivery. We recommend CBE to all health training programs in sub-Saharan Africa.
Equitable Access to Health Professional Training in Uganda: A Cross Sectional Study
(Annals of global health, 2018) Galukande, M.; Maling, S.; Kabakyenga, J.; Nshaho, J.; Oboke, Henry; Oonge, B.; Muyenje, H.; Katumba-Sentongo, G.; Mayanja-Kizza, H.; Sewankambo, N.K.
Objective: We set out to assess inequalities to access health professional education, and the impact of an education improvement program supported by MEPI (Medical Education Partnership Initiative). Inequalities in the higher education system in sub-Saharan Africa remain despite some transformative policies and affirmative action. Methods: We reviewed enrollment data from four universities for the period 2001–2014 for various health professional training programs, and conducted group discussions through an iterative process with selected stakeholders, and including a group of education experts. Two time periods, 2001–2010 and 2011–2014, were considered. In 2010–11, the MEPI education program began. Gender ratios, regional representation, secondary schools, and the number of admissions by university and year were analysed. We used SPSS version 17 software to analyse these data with level of significance p < 0.05. We collated qualitative data along predetermined and emerging themes. Results: The overall male-to-female ratio among the student population was 2.3:1. In total, there were 7,023 admissions, 4,403 between 2001–2010 (440 per annum) and 2,620 between 2011–2014 (655 per annum) with p = 0.018. There were no significant increases in admissions in the central and western regions over the two time periods, 1,708 to 849 and 1,113 to 867 respectively, both p = 0.713 and p = 0.253. We propose improving the university admission criteria and increasing enrollment to health professions training schools. Conclusion: There were significant inequalities for higher education training in Uganda by gender, regional representation and school attended. Modifying the admission criteria and increasing enrollment may reduce these inequalities.
Learners’ Attitudes and Performance in Science Subjects in A-Level in Secondary Schools, in Mbarara, Uganda
(Journal Of Educational Research, 2018) Kabunga, Amir; Habiba, C. Mohamed; Mnjokava, Christina E.
This research study aimed at investigating the learners’ attitudes and performance in science. The main objective of the study was to establish the relationship between learner’s attitudes and performance in science subjects based on age and gender. Cross-sectional research design was adopted for the study. Schools were randomly drawn from Mbarara district in Uganda. This gave a sample size of 300 form five and six secondary students. A questionnaire was used in collecting data for the study. The data was analyzed using SPSS to generate Pearson’s Chi Square test, Spearman Rank Correlation and bivariate to test the hypotheses of the study. The findings of the study revealed that attitude, age and gender had significant relationship with students’ performance in science subjects. Therefore, students’ attitudes should be very central to teachers, because affective dispositions are powerful predictors of students’ performance
Impact of Mental Health Training on Mental Well-being of Lay Counselors in Northern Uganda
(Jacobs Journal of Community Medicine, 2018) Oboke, Henry; Abio, A; Kaducu, Ocaka F; Sodemann, M; Elklit, A; Ovuga, E
Data on the impact of mental health first aid training on the mental well-being of lay counselors is limited despite a wealth of research on the training of lay counselors. We tested the hypothesis that mental health first aid training improves the mental well-being of trainees. We trained 60 community representatives selected based on desired qualities in Gulu district using an experiential training method. We assessed pre- and immediate post training mental well-being of trainees with the 32-item Response Inventory for Stressful Events (RISLE) in terms of the prevalence of suicidal ideation using. Just under 78 percent (77.8%) of the trainees were male while 22.2% were female. The age of participants ranged from 22 to 62 years (media = 32). Each of the trainees had received a level education but 57.9% of the trainees were peasant farmers. Pre-test prevalence of suicide ideation was 9.3% while post-test prevalence was 11.1%. However, immediate post-training assessment with the RISLE indicated improved mental well-being. Qualitative assessment after three months indicated that trainees were less suicidal and they had improved psychosocial functioning. Experiential training appears to have improved the mental wellness of trainees.
Emotional Intelligence as Predictor of Compassion Fatigue among Mental Health Practitioners
(Open Access Library Journal, 2019) Kabunga, Amir; Apio, Betty; Anyolitho, Maxson Kenneth2
More than half of the professionals working with vulnerable population in high-income countries suffer from compassion fatigue, which has detrimental effects on mental health practitioners’ wellbeing. This study was aimed at investigating the role of emotional intelligence in predicting compassion fatigue among mental health practitioners. Data collection was undertaken using surveys incorporating the Professional Quality of Life-5 and the Emotional Competency Inventory 2.0. Mental health practitioners from Northern Uganda participated with 207 respondents returning completed surveys. Data analysis procedures were undertaken using Fisher’s exact test and logistical regression. The statistical hypotheses were tested at a significance level of p ≤ 0.05. The results revealed that self-management (p = 0.003) and social awareness (p = 0.039) had a statistically significant effect on the prediction of compassion fatigue in mental health practitioners. The results equally indicated that respondents who recorded low levels of self-management were 4 times more likely to report compassion fatigue than those who had registered high levels of self-management. It was also found that a relative increase in social awareness was associated with a lower rating of compassion fatigue (OR = 1.24). Based on these findings, recommendations were made to include emotional intelligence as an integral component of training and incorporate emotional intelligence intervention techniques to benefit mental health practitioners in managing compassion fatigue.
Anger and Bitter Hearts: The Spread of Suicide in Northern Ugandan Families
(Journal of Anthropology, 2019) Oboke, Henry; Whyte, Susan Reynolds
In many societies, the phenomenon of suicide provides a particularly powerful example of how something sinister might ‘run in the family’. In the Acholi sub-region of northern Uganda, concerns about its capacity to spread increased during and after the Lord’s Resistance Army war. Based on interviews with bereaved families in 2016 and historical material on suicide, we offer an analysis of suicide as an approach to the contagious connections of kin. Successful and attempted suicides were often preceded by affective contamination of family relations through feelings of neglect, humiliation, abuse, indignation and resentment that made hearts bitter. Anger finally moved people to take their lives, often leaving behind questions of liability. Suicide requires that we consider these questions together with notions of personhood and mutuality of being. The concept of affective contamination contributes to the understanding of both suicide and contagious kinship connections.
Emotional intelligence and compassion fatigue among psychotherapists in selected districts of Northern Uganda
(South African Journal of Psychology, 2020) Kabunga, Amir; Anyolitho, Maxson Kenneth; Apio, Betty
Globally, close to 50% of the professionals working with traumatised individuals have issues related to compassion fatigue. In Uganda, although compassion fatigue is prevalent among psychotherapists, there is limited evidence of relationship between emotional intelligence and compassion fatigue. This study set out to fill this gap. Data were collected from a random sample of 207 psychotherapists working in Northern Uganda, who completed Emotional Competency Inventory version-2.0 and Professional Quality of Life version-5 questionnaires. Chi-square and Fischer’s exact tests were used to analyse the data. Findings revealed that all the four elements of emotional intelligence (social awareness, self-awareness, self-management, and social skills) were inversely related to levels of compassion fatigue and were statistically significant at p < .0001. The study recommended that organisations offering psychotherapy services could focus on building emotional intelligence of their psychotherapists. Increasing emotional intelligence of psychotherapists is necessary to enable them deal more effectively, with their feelings and thus directly decrease the level of compassion fatigue thereby protecting their mental and physical health.
Depressive Disorders in Refugees in Uganda; A Case of Nakivale Refugee Camp
(Journal of Psychology and Neuroscience, 2020) Kabunga, Amir
Globally, there are studies on refugees regarding different aspects. That notwithstanding, there are limitations in the available literature which makes it difficult to build on such studies as a basis for interventions especially in Africa. Exposure to the traumatic events like violence, persecution, armed conflicts, murder, mass rape and other threats may lead to the development of mental disorder. In Uganda, although suspected, there is limited evidence of depression among refugees. This study intended to examine the prevalence of depression in a refugee sample in the Nakivale refugee camp in Uganda. Data was collected using a community cross-sectional design. A total of 146 refugees were selected randomly for the study. Data was collected using the Patient Health Questionnaire and a Socio-Demographic Questionnaire. Descriptive statistics and Pearson’s Chi-Square test were used in data analysis. All statistics were tested at .05 significant levels. The results showed that 81% of the respondents had symptoms of depressions. Also the study showed that gender difference in depression was not statistically significant. Age and marital status had statistically significant correlation with depression. Based on the results, there is need for screening of mental health in refugees using tools especially custom-made for refugee group. Also there is need to develop the culturally appropriate interventions to improve the quality of mental health of refugees in Uganda.

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