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The 2020 COVID-19 Non-Pharmaceutical Containment Measures – Adherence and Impact on Livelihoods in Rural Uganda

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By Dr. Dan Kajungu and MUCHAP/IMHDSS Team

Uganda is currently experiencing a second wave of the COVID-19 pandemic with an upsurge of cases. The country registered an 81% increase in the number of COVID-19 cases between March and April 2021, which indicates resurgence or another wave in the pandemic. From 200 cases per day in April, now the country is recording over 500 cases per day. The vaccines uptake has improved only recently, and the population has ignored the Ministry of Health (MoH) Standard Operating Procedures (SOPs) meant to contain transmission. Since March 2021, when the COVID-19 AstraZeneca vaccine was introduced, about 541,569 persons have so far been vaccinated.

On 6th June, new control measures were announced to mitigate the transmission. The Makerere University Centre for Health and Population Research (MUCHAP) which runs a longitudinal population-based cohort of Iganga and Mayuge districts (Iganga Mayuge Health and Demographic Surveillance Site) conducted a community survey to understand how citizens responded to the non-pharmaceutical interventional measures, and the impact on their livelihood. This survey was part of the routine community surveys that a typical health and demographic surveillance site conducts to understand the population dynamics in population cohorts. The hybrid survey involved about 2,000 households in rural and peri-urban settings using a questionnaire that adopted some questions from the Wellcome Trust COVID-19 tool. It was a hybrid of on-phone and physical interviews conducted between July and August 2020 right after the relaxation of restriction in Uganda. Community based surveys provide information on what to expect when piloting and implementing interventions in populations. In addition to the demographic and household characteristics, questions sought to understand the extent of community adherence to COVID-19 control measures and probed about the impact on socio-economic and access to health services.

Adherence to preventive measures: The survey found that 94% of the respondents adhered to COVID-19 non-medical control measures that were enforceable by security personnel. It was different for non-pharmaceutical measures that were largely dependent on individual enforcement or discipline and this averaged at 43% of the respondents. Six in ten respondents reported doing most of their work from home and half (50%) avoided seeking medical care at health facilities during lockdown.

The non-pharmaceutical guidelines included using preventive actions like social-distancing, hand washing with soap, the use of alcohol-based hand sanitizing gels as well as wearing of face masks. Citizens were encouraged to stay at home with the exception of essential workers who rendered critical services. Some community members could not adhere, not because they do not take it as a priority but because of the cost implications.

Socio-economic impact: There was change in the living arrangement in 12% of the households mostly because someone moved out or into the household. Community members reported a reduction (64%) in the income for household members with some experiencing a complete stop in earnings (6%). Residents in rural settings reported more reduction in income compared to Peri-urban residents (78% vs 74%). There are seemingly unique circumstances that need to be considered as interventions and decisions are made. For instance, it should not be surprising that a household cannot afford to have a bar of soap, a face mask, an alcohol-based hand sanitizing gel and social distance because of the living structures. In some cases, even accessing water is a luxury for some homes. There are some homesteads that are unable to grow food or earn an income from selling cash crops because they leased their pieces of land for large scale sugarcane growing 3 or 4 years ago, with just a house and a few feet of compound to spare. Unfortunately, such individuals have no access to social media where they can express their predicament.

The survey further found out that during the 2020 lockdown period, there was a general increase in violence against men, children, and women. There were cases of child neglect as well as marital problems. The survey found that 53% of the respondents reported increase in marital problems, while violence against women during the lockdown was reported by 51% of the respondents and was more common among rural residents compared to their Peri-urban counterparts. Residents could not access what they considered essential needs like transport and education services, which were directly affected by government directives and other community services. Communication was the most affected essential service reported.

Access to Health Services: 26% of the interviewed community members who were on daily medication due to a chronic or long-term condition reported running out of drugs during lockdown. Non-affordability due to the cost was the main reason in 54% of respondents, while 19% reported cases of stock-outs at both public and private health facilities and 10% were restricted by lockdown measures.

In another review of the immunisation records at Busowubi Health Centre III in Iganga district, it was clear that during the lockdown, utilisation of immunization services was severely affected (manuscript is undergoing peer review). Children did not complete their scheduled vaccine doses which calls for catch up vaccination drives. People could not go to health facilities because of fear of acquiring infection and restricted movements of boda-boda.

Please see Downloads for the detailed report.

Mark Wamai

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Directorate of Graduate Training concludes 9-day Phd Cross Cutting Training

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By: Moses Lutaaya

The Directorate of Graduate Training has completed a 9- day PhD crosscutting training course, inducting three groups of PhD students. The groups of students included those in Cohort 1, Cohort 2 and the Non Cohort PhD students. The number of PhD student participants were over 300 students learning via both face to face and online.

The training that started on Monday 2nd June 2025, took place in the New Library Building.

In his closing remarks, the Director of Graduate Training Prof. Julius Kikooma encouraged the PhD students to put up a spirited fight that would see them remain in the cohort up to the end of the three years of their doctoral studies.

“Get organized, show seriousness in your doctoral pursuit, stay together, make use of your supervisors as and when you need them. We will fully support you in your Doctoral academic journey.” Prof. Kikooma said.

Prof. Kikooma emphasized the need for PhD graduate training saying, “We need more research for the University and Country. This cannot be achieved without increasing the number of graduate students especially PhDs.”

At their different stages of PhD doctoral training, Prof. Kikooma encouraged the students to give feedback to the Directorate and the supervisors so that they are served seamlessly.

Prof. Kikooma further informed the students that going forward, they must cover all the three mandatory cross cutting courses meant to be taught under the three-year program of their doctoral studies.

“All three foundation courses including Scholarly Writing, Advanced Research Methods and Philosophy of Methods will be covered. Tighten your belts. We want to ensure that all these structured programs prepare you for the foundations you need for next two years of research. Success becomes easy when you undertake foundations.”

He challenged the students to use the program in guiding their research directions, making informed decision, improving their critical thinking and consumption of knowledge.

Dr. Dixon Knanakulya, one of the trainers of the doctoral students said, “At PhD level, it is no longer a normal research. It is at a level of knowledge production. The students must understand the main philosophical assumption behind the research methods they use and they must consider the ethical implications of their research. Philosophy of Methods enables them to go through that.”

“PhD students must be creative, innovative and start at the level of researching in the mind. This challenges them to think differently.” He added.

He further said that Philosophy of Methods helps in researches done at the different aspects of the national development plan. “Usually, the students question how the National plans are come up with and support improvement of government policies.”

Dr. Kanakulya added that the research output can be used by government for improvement because it is done by highly skilled researchers. Adding, “They come with very good insights which can be taken on to improve implementation of government programs such as Emyoga and Parish Development Model (PDM).”

He further said that policies are not enough without the social conditions and mindset of the people, saying that PhD scholars can help government know the social conditions and apply policies better.

The Cohort 1 PhD students’ president Mr. Wanyakoko Ebiru Moses said, “This training is extremely important for each student under taking doctoral studies and without it, they cannot acquire the fundamental skills they need to become independent researchers.”

He added that with the knowledge acquired in the Philosophy of Methods training, they will focus on research that aims to resolve societal and community problems.

Dr. Robert Kakuru, the President of Makerere University Academic Staff Association said that Philosophy of Methods is an important pillar in the doctoral journey of every PhD student.

“The Course, Philosophy of Method provides a critical foundation and Philosophical grounding for research methods that doctoral students use to undertake their respective studies. The course further underlines other critical issues that graduate students ought to know, integrate, adopt or adapt in their doctoral journeys.” He said.

Dr. Jim Spire Ssentongo, a senior lecturer and coordinator of the training said, “Philosophy of Methods builds a mass of critical researchers who are able to look at the world not from a narrow point of view but a holistic and broad based sense of understanding reality.”

He added, “Students understand how they can imagine the world to be. They take into account assumptions which inform the methods of research used, how they conduct themselves during research and how they approach respondents during the research process. Such assumptions are laid bear in this training and it helps participants to understand the things they have always held at the back of their minds without deliberately knowing that these are the assumptions they hold and this is how they affect and influence studies.”  

Dr. Ssentongo further said that once PhD students are engaged in reality in its broadness with right assumptions, they are then better placed as researchers to investigate such realities and that whatever they investigate, be it related to the National Development Plan and National Development Initiatives like Emyoga and Parish Development Model. This training positions, them at a more critical level as researchers not only in terms of assumptions but also being thinkers.

The Philosophy of Methods training was supported by the ICARTA – Institutionalization of Advanced Research Training in Africa, a NORHED II Project at Makerere University.

Mak Editor

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CARTA Early Career Researchers in Action

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A photo montage of Dr. Godwin Anywar at the project ‘Traditional medicine in Transition (TMT)’ at the Institute of Systematic and Evolutionary Botany (ISEB) and Botanical Garden, University of Zurich, Switzerland. 4th-12th June 2025. Photo: LinkedIn/Dr. Godwin Anywar

Godwin Anywar, cohort 6, facilitated a brainstorming session on grant writing and application during the research planning and conceptualization workshop and exhibition from a cooperative research and exhibition project, ‘Traditional Medicine in Transition,’ at the Institute of Systematic and Evolutionary Botany (ISEB) and Botanical Garden, University of Zurich, from June 4 to 12, 2025.

Within the month, Godwin also joined the Rising Scholars as a mentor. Formerly known as AuthorAID, Rising Scholars is a global network offering free support, mentorship, training, and resources to researchers across the Global South.

Source: CARTA Newsletter Issue 90

Mark Wamai

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Advancing Regional Health Priorities Through the CARTA Research Hubs

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Training of pre-service cadres in outbreak investigation. Photo: CARTA

Strengthening Research Capacity to Tackle Emerging Infectious Diseases in East Africa

Africa continues to shoulder over 80% of the global infectious disease burden, with emerging and re-emerging infectious diseases (EIDs and REIDs) like Ebola, COVID-19, tuberculosis, and Rift Valley fever posing serious threats to health systems, economies, and regional security. In biologically fragile regions like East Africa, home to dense populations, climate-sensitive ecosystems, and porous borders, multidisciplinary, cross-border responses are essential. 

To tackle this, the Emerging and Re-emerging Infectious Diseases (TERID) Research Hub has been established under CARTA and is hosted at Makerere University. Led by CARTA graduate Charles Kato, TERID brings together a multidisciplinary team of researchers to fill critical gaps in disease surveillance, policy, prevention, and rapid response, strengthening regional capacity through high-impact, locally relevant science. Learn more

Source: CARTA Newsletter Issue 90

Mark Wamai

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