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This research examines whether high temperatures and exposure to childhood rainfall and heat shocks are a cognitive drag on children in Uganda. First, it asks whether students perform worse on a test on hotter days. Second, it examines whether previous longer-term exposure to high temperatures and unusual rainfall influences current test scores and educational outcomes. The analysis shows that high temperatures on test dates harm test performance, especially for girls and children younger than ten, implying additional temperature control considerations for particular demographics. The analysis of childhood climate shocks, which employs within-parish distributions of rainfall and heat, shows that children who experience rain or heat above the $80^{th}$ percentile of the parish distribution from birth until age 4 have worse learning outcomes in math, English, or local language literacy.
Artisanal and small-scale gold mining offers opportunities to a diverse set of actors operating in formal, legal and clandestine realms. The sector has considerable expansion potential but it is hampered by corruption, illegal actors and a poorly regulated market. This chapter focuses on Artisanal and Small-Scale Miners (ASM) in Uganda, exploring ongoing tensions between ASM communities, mining firms, and the government. While enforcing health and safety laws in the extractive industry has proven challenging to departments responsible for worker health and safety, the government in Uganda is trying to establish a structured approach with detailed legal and technical collaboration between artisanal miners and technical people whose obligation is to offer legal and technical guidance in regulating ASM.
Virtual reality (VR) for mental health promotion remains understudied in low-income humanitarian settings. We examined the effectiveness of VR in reducing depression with urban refugee youth in Kampala, Uganda. This randomized controlled trial assessed VR alone (Arm 1), VR followed by Group Problem Management Plus (GPM+) (Arm 2) and a control group (Arm 3), with a peer-driven and convenience sample of refugee youth aged 16–25 in Kampala. The primary outcome, depression, was measured with the Patient Health Questionnaire-9. Secondary outcomes included: mental health literacy, mental health stigma, self-compassion, mental well-being and adaptive coping. Analyses were conducted at three time points (baseline, 8 weeks, 16 weeks) using generalized estimating equations. Among participants (n = 335, mean age: 20.77, standard deviation: 3.01; cisgender women: n = 158, cisgender men: n = 173, transgender women: n = 4), we found no depression reductions for Arms 1 or 2 at 16 weeks compared with Arm 3. At 16 weeks, mental health literacy was significantly higher for Arm 2 compared with Arm 3, and self-compassion was significantly higher in Arm 1 and Arm 2 compared with Arm 3. VR alongside GPM+ may benefit self-compassion and MHL among urban refugee youth in Kampala, but these interventions were not effective in reducing depression.
Leptospira are bacteria that cause leptospirosis in both humans and animals. Human Leptospira infections in Uganda are suspected to arise from animal–human interactions. From a nationwide survey to determine Leptospira prevalence and circulating sequence types in Uganda, we tested 2030 livestock kidney samples, and 117 small mammals (rodents and shrews) using real-time PCR targeting the lipL32 gene. Pathogenic Leptospira species were detected in 45 livestock samples but not in the small mammals. The prevalence was 6.12% in sheep, 4.25% in cattle, 2.08% in goats, and 0.46% in pigs. Sequence typing revealed that Leptospira borgpetersenii, Leptospira kirschneri, and Leptospira interrogans are widespread across Uganda, with 13 novel sequence types identified. These findings enhance the East African MLST database and support the hypothesis that domesticated animals may be a source of human leptospirosis in Uganda, highlighting the need for increased awareness among those in close contact with livestock.
Cancer is associated with physical, social, spiritual, and psychological changes in patients and their caregivers. However, in sub-Saharan Africa, there is lack of evidence on the impact of gender, social norms, and relationship dynamics in the face of terminal illness. The aim of this paper is to explore how gender identity, social norms, and power relations are impacted when a person is living in Uganda with advanced cancer.
Methods
Focus groups with adult men and women living with advanced cancer in Uganda were conducted. Interviews explored the social effects of cancer and common challenges, including how both disease and treatment affect the patient and marital relationships within their families. Participants’ recommendations were sought to improve the social well-being of patients and their families. Data were analyzed using inductive thematic analysis.
Results
Men and women experienced negative changes in their roles and identities, often feeling unable to fulfill their marital duties in terms of intimacy, their social roles and responsibilities based on societal expectations. Men expressed loss of a “masculine” identity when unable to provide economically for the household. This led to tension in the familial power dynamics, contributing to relationship breakdown and gender-based violence (GBV) against spouses. Women noted challenges with parenting, relationship breakdowns, and increased GBV.
Significance of results
Gender impacts the patient and the family dynamic throughout the life course, including during advanced cancer. Patients and caregivers experience a change in their roles and identities while coping with existential distress and end-of-life tasks. Given these results, gender considerations and dynamics should be incorporated into overall palliative care provision. In addition, there is a need to integrate GBV screening and support in cancer services to address social health and safety needs in the context of serious illness.
Low- and middle-income countries (LMICs) bear a disproportionate burden of mental illness, with limited access to biomedical care. This study examined pathways to care for psychosis in rural Uganda, exploring factors influencing treatment choices.
Methods
We conducted a mixed-methods study in Buyende District, Uganda, involving 67 in-depth interviews and 4 focus group discussions (data collection continued until thematic saturation was reached) with individuals with psychotic disorders, family members, and local leaders. Structured questionnaires were administered to 41 individuals with psychotic disorders.
Results
Three main themes emerged: (1) Positive attitudes towards biomedical providers, (2) Barriers to accessing biomedical care (3) Perceived etiologies of mental illness that influenced care-seeking behaviors. While 81% of participants eventually accessed biomedical care, the median time to first biomedical contact was 52 days, compared to 7 days for any care modality.
Conclusions
Despite a preference for biomedical care, structural barriers and diverse illness perceptions led many to seek pluralistic care pathways. Enhancing access to biomedical services and integrating traditional and faith healers could improve mental health outcomes in rural Uganda.
The conclusion of the book draws together the findings from the statistical analysis and the case studies, suggesting possible nuances and extensions to the theoretical framework. It further explores the financial statecraft of borrowers through short accounts of external finance and aid negotiations in Uganda, Senegal, and Laos. The chapter spells out policy implications of the argument, suggesting steps that policymakers in developing countries can take to derive the greatest benefit from their portfolio of external finance, as well as ways that traditional donor agencies can maintain and enhance their relevance. It concludes with reflections on the pertinence of the book's findings for developing countries in debt crisis, including those negotiating debt relief with diverse creditors.
This chapter tests the book’s arguments in a case study from Uganda. The Ugandan government faced a series of armed rebellions throughout the country from 1986 to 2006, and it forcibly relocated civilians while fighting some rebel groups but not others. This chapter draws on a wealth of information collected during six months of fieldwork in 2016 and 2017 on how, when, where, and why authorities employed displacement. By exploiting within-case variation in the location and timing of relocation by the same government, the chapter conducts a structured, controlled comparative analysis. Drawing on original data – including archival materials, subnational violence and displacement data, and hundreds of interviews and surveys with political officials, military officers, rank-and-file soldiers, civil society groups, journalists, community leaders, and civilians – it traces the decision by Ugandan counterinsurgents to employ forced relocation, examine the observable implications of the theory, and demonstrate the assortative logic of displacement. It also shows that alternative logics are insufficient to explain variation in this case.
Population displacement is a devastating feature of contemporary conflict with far-reaching political and humanitarian consequences. This book demonstrates the extent to which displacement is a deliberate strategy of war, not just a consequence of it. Moving beyond instances of ethnic cleansing, Adam Lichtenheld draws on field research in Uganda and Syria; case studies from Burundi, Indonesia, and Vietnam; and an original dataset of strategic displacement in 166 civil wars to show that armed groups often uproot civilians to sort the targeted population, not to get rid of it. When lacking information about opponents' identities and civilians' loyalties, combatants use human mobility to infer wartime affiliations through 'guilt by location'. Different displacement strategies occur in different types of civil wars, with some relying on spatial profiling, rather than ethnic profiling. As displacement reaches record highs, Lichtenheld's findings have important implications for the study of forced migration and policy responses to it.
By the second decade of independence, Uganda’s economy groaned under the pressures of domestic misrule and international turbulence. This chapter traces the variety of popular and state reactions as price inflation and commodity shortages came to prevail. Some Ugandans experienced shortages as an affront to their ethical expectations about merit and redistribution; they accused their compatriots of misdeeds and demanded their government better manage the economy. In response, large domains of economic life were criminalized as the state tried to redirect trade toward avenues more easily taxed or regulated, including through an Economic Crimes Tribunal that indicted innumerable Ugandans. Yet, smuggling, hoarding, and overcharging proved especially bedeviling to the state, Drawing on a range of police investigations, trial records, and petitions, this chapter details the sorts of opportunistic exchanges and engagements that characterized Uganda in the 1970s, an improvisational mix of dissidence and claims-making, acquiescence and rebuke that radically challenged sovereignty and citizenship.
Beginning in the late colonial period, banking and money became a central interface between the state and its subjects, with Ugandans demanding greater access to credit. In the years after independence, the government responded to expectations of commercial liberty by using savings and loans to turn colonial subjects into credible citizens—dutiful producers of export value whose personal “banking habit” would serve the nation as a whole. Whether through the Bank of Uganda’s national currency or the Uganda Commercial Bank’s vans circling the countryside, economic citizenship tried to sidestep the nation’s lack of affective solidarities by weaving together monetary ties. For many, this was welcome, but simultaneously, these financial interdependencies limited exchange across territorial borders. As a result, some people—among them, Asians, migrants, and residents of the border regions—were cast as suspicious subverters of the nation-state. Rather than a question of merely inclusion or exclusion, this chapter shows that postcolonial citizenship worked through “enforced membership,” as national currency imposed inclusion within the state’s monopoly on valuation, sometimes with violent implications (as in the case of the 1972 expulsion of Ugandan Asians).
How can societies effectively reduce crime without exacerbating adversarial relationships between the police and citizens? In recent decades, perhaps the most celebrated innovation in police reform has been the introduction of community policing, where citizens are involved in building channels of dialogue and improving police-citizen collaboration. Despite the widespread adoption of community policing in the United States and increasingly in the developing world, there is still limited credible evidence about whether it realistically increases trust in the police or reduces crime. Through simultaneously coordinated field experiments in a diversity of political contexts, this book presents the outcome of a major research initiative into the efficacy of community policing. Scholars from around the world uncover whether, and under what conditions, this highly influential strategy for tackling crime and insecurity is effective. With its highly innovative approach to cumulative learning, this project represents a new frontier in the study of police reform.
Decolonization in East Africa was more than a political event: it was a step towards economic self-determination. In this innovative book, historian and anthropologist Kevin Donovan analyses the contradictions of economic sovereignty and citizenship in Tanzania, Kenya and Uganda, placing money, credit, and smuggling at the center of the region's shifting fortunes. Using detailed archival and ethnographic research undertaken across the region, Donovan reframes twentieth century statecraft and argues that self-determination was, at most, partially fulfilled, with state monetary infrastructures doing as much to produce divisions and inequality as they did to produce nations. A range of dissident practices, including smuggling and counterfeiting, arose as people produced value on their own terms. Weaving together discussions of currency controls, bank nationalizations and coffee smuggling with wider conceptual interventions, Money, Value and the State traces the struggles between bankers, bureaucrats, farmers and smugglers that shaped East Africa's postcolonial political economy.
In this chapter, we test the efficacy of community policing in thirteen districts throughout rural Uganda. As in many authoritarian regimes, police in Uganda serve the dual role of providing security to citizens on the one hand and quelling dissent and opposition on behalf of the regime on the other. Community policing may help citizens delink the political arm of the police from less politicized local officers. The community policing initiative we study was locally designed and funded by the Ugandan police. Our evaluation combines administrative crime data from the Uganda Police Force with surveys of thousands of Ugandan citizens, local leaders, and police officers. While the initiative we study succeeded in increasing the frequency of interactions between citizens and the police in these far-flung villages and improved citizens’ understanding of the criminal justice system, we find no evidence that it reduced crime, enhanced perceptions of safety, improved attitudes towards the police, or strengthened norms of cooperation with the police. These results are consistent with other chapters in this volume and point to the potential limitations of community policing in low-income countries.
Anthrax is a bacterial zoonotic disease caused by Bacillus anthracis. We qualitatively examined facilitators and barriers to responding to a potential anthrax outbreak using the capability, opportunity, motivation behaviour model (COM-B model) in the high-risk rural district of Namisindwa, in Eastern Uganda. We chose the COM-B model because it provides a systematic approach for selecting evidence-based techniques and approaches for promoting the behavioural prompt response to anthrax outbreaks. Unpacking these facilitators and barriers enables the leaders and community members to understand existing resources and gaps so that they can leverage them for future anthrax outbreaks.
This was a qualitative cross-sectional study that was part of a bigger anthrax outbreak simulation study conducted in September 2023. We conducted 10 Key Informant interviews among key stakeholders. The interviews were audio recorded on Android-enabled phones and later transcribed verbatim. The transcripts were analyzed using a deductive thematic content approach through Nvivo 12.
The facilitators were; knowledge of respondents about anthrax disease and anthrax outbreak response, experience and presence of surveillance guidelines, availability of resources, and presence of communication channels. The identified barriers were; porous boarders that facilitate unregulated animal trade across, lack of essential personal protective equipment, and lack of funds for surveillance and response activities.
Generally, the district was partially ready for the next anthrax outbreak. The district was resourced in terms of human resources but lacked adequate funds for animal, environmental and human surveillance activities for anthrax and related response. The district technical staff had the knowledge required to respond to the anthrax outbreak but lacked adequate funds for animal, environmental and human surveillance for anthrax and related response. We think that our study findings are generalizable in similar settings and therefore call for the implementation of such periodic evaluations to help leverage the strong areas and improve other aspects. Anthrax is a growing threat in the region, and there should be proactive efforts in prevention, specifically, we recommend vaccination of livestock and further research for human vaccines.
At the moment of independence, the Karamoja region of northeastern Uganda occupied a unique position within the Ugandan state. Local communities existed largely outside the sovereignty of the state and remained disinvested from its politico-economic institutions, and policymakers saw Karamoja as a problematic challenge to their agendas of development, security, and nation-building. I contend that, in the years surrounding Uganda's independence, government officials, rural communities, and a small emergent local elite fiercely debated Karamoja's place in the Ugandan state in state spaces such as government headquarters, trading centers, and barazas. Examining these contestations in state spaces allows us to map the indigenous political epistemologies of Karamoja against the epistemology of statehood and demonstrates the diversity of political thought that existed in Karamoja. A look at political debates in Karamoja at the moment of independence also sheds light on gaps within the historiographies of belonging and marginality in African states and addresses Karamoja's exclusion from the historiography of Uganda.
Music enhances participation in emerging democracies where the rights of association, assemblage, and and the freedom of expression are suppressed by the state apparatus meant to guarantee them in the first place. Ugandan Afropop musician and politician, Robert Kyagulanya (aka Bobi Wine), composed the song “Tugambire ku Jennifer” (Tell Jennifer on Our Behalf), which articulated the social aspirations of Kampala’s street vendors. The song’s meaning does not begin and end with the composer’s intent but stretches to its effects on the listeners. Analyzing meaning through the lens of speech act theory provides an understanding of what music means when it simultaneously reflects and shapes society.
In 1945, actions which have been understood as strikes against wartime inflation occurred across colonized Africa: this essay identifies a deeper motivation in the events which happened in the Uganda Protectorate in early 1945. An understanding that people had a moral responsibility to act, and leaders had a moral responsibility to see them, to listen, and to respond led from a mobilization of workers on town streets, to efforts to see wrongful deaths acknowledged, to gatherings in the courtyard of the Buganda king in which he was almost overthrown. In each of the three stages of the protest, Ugandans of different ethnicities asserted an ethic of mutual obligation which acknowledged no boundary between the political and the economic, spoke to authority with an expectation that they would be heard, and drew on enduring knowledge of politics as well as a range of new ideas to solve the problems they confronted.