Department of Psychiatry

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An Analysis of Post-Traumatic Stress Disorder and Quality of Life Among Adults Living with HIV in Western Uganda
(HIV/AIDS - Research and Palliative, 2024) Kabunga, Amir; Kigongo, Eustes; Udho, Samson; Auma, Anna Grace; Tumwesigye, Raymond; Musinguzi, Marvin; Acup, Walter; Akello, Anne Ruth; Okalo, Ponsiano; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Halima, Namata
Background: HIV/AIDS remains a significant global public health issue, profoundly impacting infected individuals. Living with HIV involves complex mental health dynamics, with post-traumatic stress disorder (PTSD) being a prevalent challenge. This study aims to examine the correlation between PTSD and quality of life among HIV-positive individuals in western Uganda. Material and Methods: Conducted between May and July 2023, this facility-based cross-sectional study surveyed 439 participants from four HIV clinics in southwestern Uganda. Data were collected through interviewer-administered questionnaires, analyzed using descriptive statistics, simple linear regression, and multiple linear regression (p<0.05). Results: Respondents had a mean age of 40.6 years, with 68.3% female, 54.9% married, and 55.1% lacking formal education. The reported PTSD prevalence among HIV-positive individuals was 33.7%, significantly correlating with reduced overall quality of life (β = −4.52; p<0.001). The social quality of life had the highest mean score of 14.24 (±3.45) while the environmental quality of life had the lowest mean score 11.89 (±2.68). Conclusion: Our study reveals a concerning prevalence of PTSD, affecting 1 in 3 individuals, emphasizing the pressing need for comprehensive mental health support within HIV care settings. We observed a significant negative impact of PTSD on overall quality of life, particularly in physical and social aspects. Integrating mental health screening into routine HIV care is crucial, using validated tools like the PSTD Checklist Civilian Version, alongside training for healthcare providers to recognize PTSD symptoms in the context of HIV diagnosis and treatment.
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.
Burnout and coping mechanisms among healthcare professionals in central Uganda
(Psychiatry, 2024) Kabunga, Amir; Kigongo, Eustes; Okalo, Ponsiano; Udho, Samson; Auma, Anna Grace; Tumwesigye, Raymond; Akello, Anne Ruth; Musinguzi, Marvin; Acup, Walter; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Namata, Haliama
Background: The escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout among healthcare providers, emphasizing the need for well-being interventions. This study investigates burnout and coping mechanisms among healthcare professionals in central Uganda, addressing the dearth of knowledge about coping strategies specific to the region. Methods: An analytical facility cross-sectional study was conducted in five healthcare facilities in central Uganda between June to July 2023. Participants included physicians, nurses, and technicians actively engaged in direct patient care. Data were collected using socio-demographic surveys, the Professional Quality of Life (ProQOL-5), and the Brief-COPE tools. Results: The study revealed a high prevalence of burnout, with 39.8% of participants experiencing significant levels. Active coping, positive reframing, and denial were negatively correlated with low burnout levels. Dysfunctional coping, specifically self-distraction and denial, showed positive correlations with average and high burnout levels. Emotion-focused coping mechanisms were not employed across burnout levels. Conclusions: The results emphasize the demanding nature of healthcare roles in the region and highlight the need for comprehensive, context-specific interventions to address burnout globally. While some healthcare professionals utilized adaptive strategies such as seeking social support, engaging in self-care activities, and utilizing problem-solving skills, others resorted to maladaptive coping mechanisms such as substance use and avoidance behaviors. This dichotomy highlights the need for targeted interventions to promote adaptive coping strategies and mitigate the negative impact of maladaptive behaviors on individual well-being and patient care
Burnout and quality of life among healthcare workers in central Uganda
(PLoS ONE, 2024) Kabunga, Amir; Kigongo, Eustes; Okalo, Ponsiano; Udho, Samson; Auma, Anna Grace; Tumwesigye, Raymond; Akello, Anne Ruth; Musinguzi, Marvin; Acup, Walter; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Namata, Haliama
Background The widespread problem of burnout among healthcare workers is not only common but also a significant concern that impacts the entire healthcare system in Uganda. It is essential to understand the connection between burnout and quality of life among healthcare workers in the specific context of central Uganda, where healthcare professionals face high patient volumes, limited resources, exposure to infectious diseases, and socioeconomic challenges. This study examined the relationship between burnout and quality of life among healthcare workers in central Uganda. Methods This research utilized a cross-sectional study conducted across various healthcare settings in central Uganda. The data were analyzed at descriptive, bivariate, and multivariate levels. The relationship between dependent and independent variables was evaluated using an independent t-test for binary variables and a one-way analysis of variance (ANOVA) for categorical variables. Significance was determined with a reported p-value, with relationships deemed significant at p < 0.2. For multivariable analysis, multiple linear regression was employed using a forward selection method, with significance set at 5% (p < 0.05). Results Our findings indicate that nearly 40% of healthcare workers reported experiencing high levels of burnout. The average score for overall quality of life was 10.71 (±4.89), with variations observed across different domains. The study reveals a significant connection between socio-demographic factors, burnout, and overall quality of life, emphasizing the impact of job category, supervisory support, sleep quality, and burnout on the well-being of healthcare workers. Predictive analysis illustrates how these factors influence both overall quality of life scores and scores in specific domains. Particularly noteworthy is that nurses and technicians tend to have a lower quality of life compared to physicians. Conclusion The results underscore the relationship between socio-demographic factors, burnout, and particular aspects of quality of life. Notably, job category, supervisory support, sleep quality, and burnout stand out as significant factors shaping the well-being of healthcare workers. Nurses and technicians encounter distinct challenges, suggesting the need for interventions tailored to their needs. Addressing issues such as inadequate supervisory support, burnout, and sleep-related problems is recognized as a potential approach to improving the overall quality of life among healthcare workers.
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.
Career Info, Counseling And Occupational Choices Among Learners In Secondary In Mbarara District, Uganda
(Researchjournali’s Journal of Economics, 2020) Kabunga, Amir
There is an increasing demand for career info and counselling services worldwide. Push and pull factors arising from labour market reforms and modernization of education and training systems in developing and middle-income countries call for the improvement of career info and counselling provision. Thus this study intended to determine the association between career info and occupational choices among secondary schools in Mbarara district, Uganda. 11,316 form six learners aged 17-20 took part in the study. This study adapted a causal-comparative research design. Simple random sampling was used to select 383 participants. Researcher-made questionnaires were used to collect data. Data analysis was done using Pearson‘s correlation coefficient r with the help of R (R Core Team, 2015). The results of the study showed that there was a positive significant association between occupation choice and career info and counselling (r= 0.127, p{0.019} <0.05). Counsellors in schools need professional training and skills to enable them to use standardized assessment instruments including the Self-Directed Search and Strong Interest Inventory to simplify and clarify learners’ personality, career interests, ability and principles. Again, career resource libraries with job search webs and manuals and information on employers should be established in secondary schools.
Chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda
(Wiley Nursing Open, 2023) Kabunga, Amir; Kigongo, Eustes; Udho, Samson; Auma, Anna Grace; Okalo, Ponsiano; Apili, Brenda; Namata, Halimah; Nalwoga, Viola
Aim: This study aimed to assess chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda, conducted between May and June 2022. Design: Institutional-based cross-sectional design conducted between May and June 2022. Methods: The study included 498 participants recruited from six health facilities. A 12-Item Short Form Survey tool was used to collect data on chronic stress, while a researcher-developed questionnaire was used to collect data on coping strategies. Descriptive statistics, binary logistic regression and multiple regression were con ducted for data analysis. A p-value of 0.05 was considered statistically significant. Results: Out of 498 participants, 153 (30.7%) were aged between 31 and 40 years, 341 (68.5%) were female, 288 (57.8%) were married, and 266 (53.4%) had less than Diploma. Of the 498 participants, 351 (70.5%) experienced chronic stress. The protective factors against chronic stress were being married (AOR: 0.132; 95% CI: 0.043–0.408; p< 0.001), optimizing shift length (AOR: 0.056; 95% CI: 0.027–0.115; p< 0.001), religiosity/Spirituality (AOR: 2.750; 95% CI: 1.376–5.497; p= 0.004), and regular exercise and breaks (AOR: 0.405; 95% CI: 0.223–0.737; p= 0.003)
Chronic stress and its correlates among nurses: A case of Central Uganda
(Avicenna J Neuro Psycho Physiology, 2023) Kabunga, Amir; Kigongo, Eustes; Udho, Samson; Musinguzi, Marvin; Tumwesigye, Raymond; Acup, Walter
Background: Despite an overwhelming disease burden, nursing shortages are evident in Sub-Saharan Africa, with the potential for significant healthcare crises. Nurses face increased work demands and chronic stress due to a skilled personnel shortage, which may lead to stress. The present study aimed to examine chronic stress and its correlates among nurses in central Uganda. Methods: The 12-item Short Form Survey (SF-12) for the assessment of chronic stress among nurses, a validated and standardized tool, was used in this cross-sectional study in 2022. For explanatory analysis, the items were combined with dichotomous variables reflecting predictors of chronic stress. These items were used to create dichotomous variables denoting frequent and demanding challenges for exploratory analysis. The relationship between the variables and high levels of chronic stress was investigated using a multivariate logistic regression model. Results: Based on the findings, the majority, 485 (76.0%), had chronic stress. The results indicate that the correlates of chronic stress among participants were widowhood (AOR: 0.040; 95% CI: 0.013-0.127; P= <0.001), being worried about looming deadlines (aOR: 0.003; 95% CI: 0.001-0.023; P = <0.001), long working hours (AOR: 0.283; 95% CI: 0.159-0.504; p=<0.001), insufficient job control (AOR: 0.304; 95% CI: 0.127-0.727; P = 0.007), and inadequate rewards (AOR: 2.554; 95% CI: 1.170-5.574; P = 0.019). Conclusion: According to our findings, three in four nurses in central Uganda suffer from chronic stress. This can exert a negative impact on their overall well-being and caring behaviors. Chronic stress was associated with widowhood, a looming deadline, long working hours, insufficient job control, and inadequate rewards. It is critical to adapt interventions, such as hiring additional nurses, to reduce workload and ensure adequate rest periods.
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 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.
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.
The Coronavirus Anxiety Scale: Cross-National Measurement Invariance and Convergent Validity Evidence
(American Psychological Association, 2023) Kabunga, Amir
Coronavirus Anxiety Scale (CAS) is a widely used measure that captures somatic symptoms of coronavirusrelated anxiety. In a large-scale collaboration spanning 60 countries (Ntotal = 21,513), we examined the CAS’s measurement invariance and assessed the convergent validity of CAS scores in relation to the fear of COVID-19 (FCV-19S) and the satisfaction with life (SWLS-3) scales. We utilized both conventional exact invariance tests and alignment procedures, with results revealing that the single-factor model fit the data well in almost all countries. Partial scalar invariance was supported in a subset of 56 countries. To ensure the robustness of results, given the unbalanced samples, we employed resampling techniques both with and without replacement and found the results were more stable in larger samples. The alignment procedure demonstrated a high degree of measurement invariance with 9% of the parameters exhibiting noninvariance. We also conducted simulations of alignment using the parameters estimated in the current model. Findings demonstrated reliability of the means but indicated challenges in estimating the latent variances. Strong positive correlations between CAS and FCV-19S estimated with all three different approaches were found in most countries. Correlations of CAS and SWLS-3 were weak and negative but significantly differed from zero in several countries. Overall, the study provided support for the measurement invariance of the CAS and offered evidence of its convergent validity while also highlighting issues with variance estimation.
COVID-19 and Its Related Stigma: A Qualitative Study Among Survivors in Kampala, Uganda
(Stigma and Health. Advance online publication, 2021) Kabunga, Amir
COVID-19-related stigma is gradually becoming a global problem among COVID-19 survivors with deleterious effects on quality of life. However, this social problem has received little attention in research and policy. This study aimed at exploring the COVID-19-related stigma among survivors in Kampala, Uganda. A cross-sectional exploratory research design was used among COVID-19 survivors in Kampala district. Thirty COVID-19 survivors were examined using in-depth interviews. Data obtained were analyzed using thematic approach. The findings of study indicated that COVID-19-related stigma is prevalent. The common form of stigma was social rejection and labeling. Results showed that the survivors of COVID-19 pandemic faced social rejection and community ostracism. Based on the results, reducing stigmatization of the COVID-19 survivors is vital to control the spread of the pandemic. Thus, an all-inclusive effort is needed to address COVID-19-related stigma and its debilitating consequences by health workers and policymakers
Depression and Associated Factors Among Refugees Amidst Covid-19 in Nakivale Refugee Camp in Uganda
(Journal of Neurology Research Review & Reports, 2021) Kabunga, Amir; Anyayo, Lucas
The COVID-19 pandemic and health measures to prevent it have unprecedented effects on the mental health of the refugees. However, the situation of refugees in developing countries is unclear. Thus, this study estimated the prevalence of and associated demographic factors during the COVID-19 pandemic. The study employed a cross-sectional survey carried out in June 2020 in which 146 adult refugees from Nakivale settlement camp were randomly selected to fill out a questionnaires-demographics and PHQ9. Results revealed that the majority of respondents were female (53%) and 47% had a depressive disorder. There was no statistical relationship between demographics (gender, age, and marital status) and depressive disorders. In Conclusion, findings indicate that depressive disorders are prevalent among refugees in the Nakivale settlement and it is important to identify refugees affected mentally and given proper treatment
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.
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.
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.
Enhancing Mental Health Counseling for Education Professionals in Africa: Addressing Unique Needs and Improving Outcomes
(B P International, 2024) Kabunga, Amir; Nalwoga, Viola; Kigongo, Eustes; Anyolitho, Maxson Kenneth; Musinguzi, Marvin; Okalo, Ponsiano; Shikanga, Enos Mwirotsi
In the vibrant and varied educational landscapes of Africa, the voices of resilience, dedication, and passion often overshadow the quieter, yet significant, struggles faced by those who shape our future: the education professionals. As we delve into “Enhancing Mental Health Counseling for Education Professionals in Africa: Addressing Unique Needs and Improving Outcomes,” we approach this endeavor with profound respect and commitment to the well-being of those who nurture the minds of tomorrow. Education professionals hold a critical role in shaping both the intellectual and emotional development of the next generation. Their unwavering commitment to education lays the groundwork for a better future. However, in the pursuit of academic excellence, their own mental health often remains neglected. This book aims to shed light on the critical intersection of mental health and education, specifically addressing the unique challenges encountered by educators across the diverse African continent. Throughout these pages, we delve into the cultural and contextual factors that influence the experiences of education professionals in Africa. We emphasize that the well-being of educators is intrinsically linked to the health and effectiveness of the educational systems they support. By examining mental health counseling as a transformative tool, we highlight its potential to build resilience, promote self-care, and enhance overall professional satisfaction. This book is more than an academic exploration; it is a call to action. We urge educational institutions, policymakers, and communities to prioritize the mental health of their educators. We advocate for a shift in perspective, encouraging the creation of environments where seeking mental health support is seen not as a weakness but as a reflection of the strength and dedication inherent in the teaching profession. As we address the nuanced issues of mental health counseling tailored to the African educational context, we hope this book will serve as a comprehensive guide, a source of inspiration, and a catalyst for positive change. It is our aspiration that this work will elevate the conversation around the mental well-being of education professionals and place it at the center of educational discourse. In our shared quest for educational excellence, let us remember that the well-being of those who facilitate learning is a fundamental pillar. Together, let us embark on a transformative journey to create nurturing and supportive environments for the individuals who are shaping the minds of the future. Keywords: Mental health counseling, education professionals, Africa, cultural sensitivity, resilience in education, and traditional practices in counseling
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.
Exploring Effective Approaches: Integrating Mental Health Services into HIV Clinics in Northern Uganda
(HIV/AIDS - Research and Palliative Care, 2024) Kabunga, Amir; Namata, Halimah; Kigongo, Eustes; Musinguzi, Marvin; Tumwesigye, Raymond; Auma, Anna Grace; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Okalo, Ponsiano; Nalwoga, Viola; Udho, Samson
Background: Integrating mental health services into HIV clinics is recognized as a promising strategy. However, the literature reveals gaps, particularly in the unique context of Northern Uganda, where factors such as historical conflict, stigma, and limited resources pose potential barriers. Material and Methods: This qualitative study, conducted between October and November 2023, employed a phenomenological design. The study involved primary healthcare facilities across diverse urban and rural settings, focusing on healthcare providers, village health teams, and service users. A purposive sampling approach ensured diverse demographics and perspectives. In-depth interviews and focus group discussions were conducted, with healthcare providers and service users participating individually, and village health teams engaged in group discussions. Thematic analysis was employed during data analysis. Results: Findings revealed a predominance of females among healthcare providers (18 of 30) and service users (16 of 25), as well as in VHTs. Average ages were 33.4 (healthcare providers), 38.5 (service users), and 35.1 (VHTs). Most healthcare providers (15) held diplomas, while 12 service users and 4 VHTs had certificates. The majority of healthcare providers (n=20) and 4 VHTs had 6–10 years of experience. Thematic analysis highlighted three key themes: benefits of integrated mental health services, implementation challenges, and the role of community engagement and cultural sensitivity. Conclusion: This study contributes valuable insights into the integration of mental health services into HIV clinics in Northern Uganda. The perceived benefits, challenges, and importance of cultural sensitivity and community engagement should guide future interventions, fostering a holistic approach that enhances the overall well-being of individuals living with HIV/AIDS in the region. Policymakers can use this information to advocate for resource allocation, training programs, and policy changes that support the integration of mental health services into HIV clinics in a way that addresses the identified challenges

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