Browsing by Author "Waako, Paul"

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    Catching babies, carrying traditions : the voices and practices of traditional birth attendants in Mayuge District, East central Uganda.
    (BMC, 2025) Kagoya, Enid Kawala; Auma, Proscovia; Mugabi, Joshua; Kawala, Elizabeth; Asabawebwa, Deogratias; Mugahi, Richard; Mutunda, Brenda Doreen; Gamubaka, Richard; Namaganda, Agnes; Nsubuga, Allan G.; Akello, Jackline; Waako, Paul; Mugabe, Kenneth
    Background: Traditional Birth Attendants (TBAs) continue to support maternal and newborn care in rural Uganda, particularly where access to formal health facilities is limited. Their roles are deeply embedded in local culture and community trust, yet national policies provide inconsistent guidance on their engagement within the formal health system. Objective: To explore the evolution, experiences, practices, challenges, and perceived support needs of TBAs in Mayuge District, and examine their interaction with formal health structures. Methods: A qualitative narrative study was conducted with 15 purposively selected TBAs from all sub-counties of Mayuge District. In-depth interviews lasting 60 to 90 min were held at participants’ homes or workplaces. Participants described and demonstrated their maternal care practices. Audio recordings were transcribed, translated, and analyzed thematically. Results: Seven key themes emerged from the study: (1) Historical Developments and Evolution of TBAs, highlighting diverse pathways into practice such as apprenticeship, family mentorship, formal Ministry of Health training, and community programs; (2) Practices, Methods, and Approaches, detailing TBAs’ provision of antenatal, delivery, and postnatal care, and management of maternal and newborn complications using both traditional and modern methods including newborn resuscitation; (3) Infection Prevention and Control, revealing variable use of personal protective equipment and inconsistent waste disposal practices constrained by limited resources; (4) Maternal and Perinatal Death Surveillance and Response (MPDSR) Process, illustrating TBAs’ limited participation in formal death notifications and reviews; (5) Referral Process, highlighting complex referral behaviors involving health facilities, fellow TBAs, and traditional healers; (6) Socio-Cultural Influences on TBA Services, encompassing the impact of poverty, gender roles, community trust, and cultural norms; and (7) Challenges in Providing Safe and Effective Care, including barriers such as negative attitudes from health workers, transport difficulties, competition, and lack of formal support. Conclusion: TBAs in Mayuge District play a vital role in culturally grounded maternal care but face numerous challenges due to limited formal integration and support. Strategies are needed to strengthen collaboration, provide targeted training, and clarify policy to improve maternal and newborn health outcomes in underserved areas. Keywords: Traditional birth attendants, Maternal and newborn health, Socio-cultural determinants, Referral practices, Health system integration, Rural uganda
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    Community perspectives regarding preparedness, response and prevention of ebola virus disease amidst COVID-19 pandemic, an exploratory descriptive qualitative study using a community engagement approach in Mbale City.
    (Research Square, 2024) Kagoya, Enid Kawala; Nsubuga, Allan G.; Ewing, Helen; Atuhairwe, Irene; Ijangolet, Esther; Otim, Eric; Ronald, Kibuuka; Jesca, Atugonza; Okello, Francis; Nakattudde, Prossy; Nyangoma, Faith; Namara, Racheal; Nakabaale, Mark; Nakawuka, Betty; Nakawuki, Ashley; Kizito, Prisca; Waako, Paul; Wandabwa, Julius; Makoko, Tonny Brian; Musaba, Milton; Ahaisibwe, Bonaventure; Barugahare, Banson
    Background: Ebola virus disease (EVD) is a rare and deadly infectious hemorrhagic fever disease. Four of the 6 known Ebola virus species can cause human disease. Since 1976, EVD outbreaks have been recorded sporadically in East, Central, and West Africa. Uganda has experienced 6 documented outbreaks of EVD since 2000 that can be attributed to 3 species of Ebola viruses (Zaire, Sudan, and Bundibugyo). Despite substantial advances in clinical management, the case fatality ratio for EVD remains high, reaching more than 60% for the Zaire Ebola virus in 2018–2020. Methods. The study followed a descriptive qualitative study design. Data were collected using an interviewer-administered questionnaire with both closed and open-ended questions. Data were analysed using ATLAS Pro. Results: Our results illustrate the lack of health education in the community among the different categories of people and this comes from an emic perspective. We identified 4 high-level themes and 19 subthemes, (1) Knowledge of Ebola Virus Disease, (2) Prevention of EVD in the community, (3) Preparedness for Ebola Virus Disease, and (4) Community response to Ebola Virus Disease and the final thematic area (4) which included giving first aid, using traditional medicines, and approaching a health facility among others. Conclusions: With all the available information about the previous outbreaks in Uganda, it is surprising that less effort was made this time round to take local sensibilities and culture into account among other social factors contributing to the poor practices of masses toward the EVD, preparedness, prevention, and response. Keywords: Ebola Virus Disease, Preparedness, Response and Prevention, Community Engagement
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    Coping mechanisms for students with mental disorders : an exploratory qualitative study at Busitema University’s Mbale and Busia campuses.
    (PLOS One, 2025) Kagoya, Enid Kawala; Mpagi, Joseph; Waako, Paul; Muhwezi, Martha R. L.; Namaganda, Agnes; Nsubuga, Allan G.; Atala, Christine Etoko; Okello, Francis; Okibure, Ambrose; Kibuuka, Ronald; Wandera, Ernest; Ndamanywa, Kalisiti; Kirabira, Joseph
    In recent years, Ugandan universities have faced a rising incidence of mental health issues among students, with prevalence rates of mental disorders reaching up to 60% among undergraduates. These challenges significantly impact both academic performance and social interactions. This study aimed to investigate the coping mechanisms among students with mental disorders at Busitema University. We conducted 42 key informant interviews with students diagnosed with mental disorders, as determined by the Mini International Neuropsychiatric Interview. Interviews were guided by a structured protocol developed by the research team, and all participants provided informed consent. The interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. This approach was chosen for its efficiency and directness. Nvivo software facilitated the coding and organization of themes. The study identified several coping strategies used by students at the two Busitema University campuses. Five main themes emerged: Alcohol and Substance Use, Use of Sedatives, Social and Personal Initiatives, Seeking Counseling Services, Withdrawal and Confrontation, and Faith Healing. Various subthemes were also noted, including substance use, withdrawal, confrontations, witchcraft, participation in co-curricular activities, abortions, and seeking psychosocial support. These findings are detailed in Table 2. Addressing the mental health challenges faced by university students requires a thorough understanding of their coping strategies. While some strategies are self-developed, others involve university-led interventions. It is crucial to reinforce effective coping mechanisms and address detrimental ones to improve students’ mental health outcomes. Mental disorders, coping strategies, university students, Uganda
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    Deciphering the molecular mechanism of aloe-emodin in managing type II diabetes mellitus using network pharmacology, molecular docking, and molecular dynamics simulation approaches.
    (Springer Nature, 2025) Obakiro, Samuel Baker; Kiyimba, Kenedy; Gavamukulya, Yahaya; Maseruka, Richard; Nabitandikwa, Catherine; Kibuuka, Ronald; Lulenzi, Jalia; Lukwago, Tonny Wotoyitide; Chebijira, Mercy; Opio, Moses; Tracy, Edeya Sharon; Kibuule, Dan; Oriko, Richard Owor; Waako, Paul; Makaye, Angela; Shadrack, Daniel M.; Andima, Moses
    Aloe-emodin (AE) has drawn interest due to its potential activity against type II diabetes mellitus (T2DM). However, the mechanisms underlying its antidiabetic activity are not well explored. Using network pharmacology, molecular docking and molecular dynamics simulation studies, we investigated its molecular mechanisms in the management of T2DM. Potential target genes of AE were predicted using the Swiss Target Prediction (http://www.swisstargetprediction.ch/) database. The GeneCards, OMIM and DisGeNET databases were used to compile a comprehensive list of genes associated with T2DM. A compound-disease-target network was constructed, and protein–protein interaction networks were analysed to identify hub genes. Finally, molecular docking and interaction analysis between AE and the identified proteins were performed using AutoDock tools. Investigation of AE targets and genes associated with T2DM identified 32 overlapping genes. Gene ontology studies revealed that AE may exert its anti-diabetic effects by modulating glucose metabolism and enhancing cellular response to glucose. Furthermore, KEGG pathway analysis suggested that AE influences these processes by targeting pathways related to apoptosis, insulin resistance, and T2DM signaling. The core target proteins identified were TNF, ALB, TP53, PPARG, BCL2, CASP3, and EGFR. AE interaction with each of these proteins exhibited a binding energy of>−5 kcal/mol, with TNF showing the lowest binding energy (−7.75 kcal/mol). Molecular dynamics simulation further validated the molecular docking results with TNF and EGFR exhibiting a strong affinity for AE and forming stable interactions. AE exerts its antidiabetic activity through multiple mechanisms, with the most significant being the amelioration of pancreatic β-cell apoptosis by binding to and inhibiting the actions of TNFα. Further cellular and molecular studies are needed to validate these findings. Keywords Aloe emodin · Type II diabetes mellitus · Network pharmacology · Molecular docking In Silico Pharmacology (2025) 13:45
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    Effect of pre-operative bicarbonate infusion on maternal and perinatal outcomes among women with obstructed labour in Mbale hospital: A double blind randomized controlled trial
    (PLOS One, 2021) Musaba, Milton W.; Wandabwa, Julius N.; Ndeezi, Grace; Weeks, Andrew D.; Mukunya, David; Waako, Paul; Nankabirwa, Victoria; Tulyamuhika Mugabe, Kenneth; Semakula, Daniel; Tumwine, James K.; Barageine, Justus K.
    Introduction Oral bicarbonate solution is known to improve both maternal and perinatal outcomes among women with abnormal labour (dystocia). Its effectiveness and safety among women with obstructed labour is not known. Objective To determine the effect and safety of a single-dose preoperative infusion of sodium bicarbonate on maternal and fetal blood lactate and clinical outcomes among women with obstructed labour (OL) in Mbale hospital. Methods We conducted a double blind, randomised controlled trial from July 2018 to September 2019. The participants were women with OL at term (>37 weeks’ gestation), carrying a singleton pregnancy with no other obstetric emergency, medical comorbidity or laboratory derangements. Intervention A total of 477 women with OL were randomized to receive 50ml of 8.4% sodium bicarbonate (238 women) or 50 mL of 0.9% sodium chloride (239 women). In both the intervention and controls arms, each participant was preoperatively given a single dose intravenous bolus. Every participant received 1.5 L of normal saline in one hour as part of standard preoperative care. Outcome measures Our primary outcome was the mean difference in maternal venous blood lactate at one hour between the two arms. The secondary outcomes were umbilical cord blood lactate levels at birth, neonatal sepsis and early neonatal death upto 7 days postnatal, as well as the side effects of sodium bicarbonate, primary postpartum hemorrhage, maternal sepsis and mortality at 14 days postpartum. Results The median maternal venous lactate was 6.4 (IQR 3.3–12.3) in the intervention and 7.5 (IQR 4.0–15.8) in the control group, with a statistically non-significant median difference of 1.2 mmol/L; p-value = 0.087. Vargha and Delaney effect size was 0.46 (95% CI 0.40–0.51) implying very little if any effect at all. Conclusion The 4.2g of preoperative intravenous sodium bicarbonate was safe but made little or no difference on blood lactate levels.
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    Exploring barriers and facilitators of preceptorship in undergraduate health professions education : insights from a qualitative needs assessment among preceptors in Eastern Uganda.
    (BMC, 2025) Wani, Solomon; Nantale, Ritah; Atuhairwe, Irene; Makoko, Brian Tonny; Okello, Francis; Waako, Paul; Twineamatsiko, Andrew; Agaba, Brian; Nyalihama, Alain; Kibuule, Dan; Kagoya, Enid Kawala
    Background: Clinical preceptorship plays a critical role in bridging theoretical knowledge and practical skills for health professions students. In resource-constrained settings like Eastern Uganda, understanding what facilitates effective preceptorship is essential for improving clinical education outcomes. This study explores the barriers and facilitators to preceptorship among clinical preceptors and faculty at Busitema University, Mbale College of Health Sciences, and Mbale Regional Referral Hospital. Methods: We conducted 15 in-depth interviews with clinical preceptors, including faculty and clinical staff from Busitema University, Mbale College of Health Sciences, and Mbale Regional Referral Hospital. Participants were purposively selected based on experience, education level, medical care, and leadership roles. We conducted the interviews between May 2024 and June 2024, audio-recorded, were transcribed verbatim, and thematically analyzed using Atlas.ti version 9. Results: Three key facilitators and six barriers to preceptorship emerged from the analysis. The facilitators included: support from Seed Global Health through donations of medical tools, equipment, and healthcare worker training; strong commitment and willingness among health workers at Mbale Regional Referral Hospital to teach students; and, support from faculty and postgraduate students at Busitema University. Barriers were: high numbers of students in clinical settings; poor communication and coordination between academic institutions and clinical sites; limited preceptorship skills and knowledge among clinical preceptors; shortages of faculty preceptors; insufficient time for clinical rotations; and inadequate models and equipment for simulation-based teaching. To address these challenges, preceptors recommended better coordination and student orientation, phased placement in smaller groups, training and refresher courses to strengthen preceptorship capacity, increased faculty presence in wards, and provision of essential medical equipment. Conclusion: Effective preceptorship in resource-limited settings depends on leveraging facilitators while addressing persistent barriers. External partnerships, staff commitment, and faculty support are valuable enablers, but their impact is undermined by overcrowding, poor coordination, and resource shortages. Actionable strategies such as structured communication between training institutions and hospitals, phased student placement, targeted preceptor training, and investments in teaching equipment can mitigate barriers and reinforce facilitators. Strengthening these systems is vital for sustaining high-quality clinical education in Uganda and similar contexts. Keywords: Preceptorship, Barriers, Facilitators, Medical education, Uganda
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    Factors associated with longer hospital stay following caesarean section birth at a tertiary hospital in Eastern Uganda.
    (Research Square, 2025) Thaddeus, Jude Mulowooza; Tweheyo, Ronald; Babuya, Jonathan; Atuhairwe, Irene; Makoko, Brian Tonny; Waako, Paul; Twineamatsiko, Andrew; Agaba, Brian; Stephen, Obbo; Kavuma, Pontian Kiwanuka; Kibuule, Dan; Kayemba, Frank; Kagoya, Enid Kawala
    Background. Caesarean Section(C/S) is a lifesaving procedure for both the mother and the baby but it is associated with various post-operative complications and longer hospital stays. Prolonged Hospitalization after a Caesarean section can be stressful for both the healthcare providers and the mothers while also risking them acquiring hospital acquired infections. Factors related to longer hospital stays among mothers delivered by C/S have not been well explored. This study aimed to determine the factors associated with longer (> 4 days) hospital stay following Caesarean birth at Mbale Regional Referral Hospital. Methods This was a retrospective cross-sectional study carried out at Mbale Regional Referral Hospital (MRRH) between December 2023 and May 2024 accessed in June 2024. A total of 536 patient files of women who underwent Caesarean section were randomly selected and reviewed. Data on social demographics, obstetric characteristics and other surgical details including outcomes was extracted and recorded using an online data collection tool. Descriptive analysis to summarise the data and logistic regression to identify factors associated with longer hospital stays were done, and P-values < 0.05 significance level at a 95% confidence interval were considered. Results The mean hospital stay was 4.02 days (SD ± 2.87). Nearly half of the women (47.6%) were referred from other health facilities with most caesarean sections (70.9%) sanctioned by junior house officers. Preoperative prophylactic antibiotics were administered in 85.4% and spinal anaesthesia was used in 98.5% of the Csections. In multivariable analysis, lack of a complete blood count, vaginal preparation, intravenous fluids before surgery and a patient undergoing general anesthesia were significantly related to longer hospital stays. Conclusion Multiple factors are associated with longer hospital stays at Mbale Regional Referral Hospital. Improvement of evidence-based practices such as the intravenous fluids, vaginal preparation and basic laboratory investigations before surgery and use of spinal anesthesia can help to reduce hospital stay and its associated risks. Keywords: Caesarean section, longer hospital stay, postoperative complications
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    In vitro antiplasmodial activity, acute toxicity and phytochemical quantification of selected medicinal plants used for the management of uncomplicated malaria in eastern Uganda.
    (Elsevier Ltd., 2025) Obakiro, Samuel Baker; Nabitandikwa, Catherine; Kiyimba, Kenedy; Ocan, Moses; Gavamukulya, Yahaya; Andima, Moses; Lukwago, Tonny Wotoyitide; Maseruka, Richard; Chebijira, Mercy; Opio, Moses; Hokello, Joseph Francis; Kibuule, Dan; Nabatanzi, Alice; Orena, Stephen; Waako, Paul; Owor, Richard Oriko
    Ethnopharmacological relevance The emergence of artemisinin resistance and limited antimalarial drug access in Uganda has increased reliance on herbal medicines as complementary and alternative therapies. Indigenous use of Albizia coriaria, Zanthoxylum chalybeum, Entada abyssinica, Maytenus senegalensis, and Kigelia Africana for malaria treatment is widespread but scientific evidence of their efficacy and safety was limited. Aim of the study This study aimed to validate the traditional antimalarial use of the five medicinal plants by evaluating their phytochemical composition, acute toxicity, and in vitro antiplasmodial activity against chloroquine-sensitive (3D7), chloroquine-resistant (Dd2) and clinical P. falciparum isolates. Materials and methods Phytochemical screening and quantification was conducted on 70 % hydroethanolic extracts from dried plant samples using UV–Vis spectrophotometry. The acute oral toxicity testing was conducted in Wistar albino rats using OECD 423 limit dose test. The antiplasmodial efficacy was evaluated using a 72-h SYBR Green assay on Plasmodium falciparum laboratory strains (3D7, Dd2) and clinical isolates. Results Alkaloids, flavonoids, tannins, and terpenoids were present in all the plant samples in varying quantities. Z. chalybeum was the most potent extract (IC50 0.81–1.28 μg/ml), followed by A. coriaria and E. abyssinica (IC50 10–50 μg/ml). M. senegalensis showed weak activity while K. africana was largely inactive (IC50 > 100 μg/ml). A. coriaria and M. senegalensis showed moderate acute toxicity (LD50 < 2000 mg/kg), while the other extracts showed no severe signs of acute toxicity in Wistar albino rats (LD50 > 2000 mg/kg). Conclusion Zanthoxylum chalybeum, Albizia coriaria and Entada abyssinica demonstrated promising antiplasmodial activity that supports their traditional use in management of malaria. However, more efficacy studies using in vivo models, sub-chronic and chronic toxicity studies particularly on A. coriaria and advanced phytochemical profiling are needed to delineate their therapeutic potential before being prioritized for development of standardized herbal remedies and novel antimalarial drugs.
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    In vitro antiplasmodial activity, acute toxicity and phytochemical quantification of selected medicinal plants used in symptomatic management of malaria in eastern Uganda.
    (Elsevier Ltd., 2025) Obakiroa, Samuel Baker; Nabitandikwa, Catherine; Kiyimba, Kenedy; Ocan, Moses; Gavamukulya, Yahaya; Andima, Moses; Lukwago, Tonny Wotoyitide; Maseruka, Richard; Mercy, Chebijira; Opio, Moses; Hokello, Joseph; Kibuule, Dan; Nabatanzi, Alice; Orenah, Stephen; Waako, Paul; Owor, Oriko Richard
    Ethnopharmacological relevance: The emergence of artemisinin resistance alongside limited antimalarial access in Uganda has intensified the use of herbal medicines as complementary and alternative therapies. Whereas there is widespread indigenous use of Zanthoxylum chalybeum, Albizia coriaria, Entada abyssinica, Maytenus senegalensis, and Kigelia Africana in treatment of malaria, there was limited scientific evidence of efficacy and safety. Aim of the study: This study assessed the in vitro antiplasmodial activity, acute toxicity, and phytochemical composition of the five plants so as to identify alternative sources of antimalarial drugs. Materials and methods: Phytochemical screening and quantification was conducted on ethanolic extracts from dried samples using UV-Vis spectrophotometry. The acute toxicity testing was conducted in Wistar albino rats using limit dose test and the antiplasmodial efficacy evaluated using a 72-hour SYBR Green assay on Plasmodium falciparum laboratory and clinical isolates. Results: Alkaloids, flavonoids, tannins, and terpenoids were present in all the samples. Z. chalybeum was the most potent, with IC50 values as low as 0.90 and 1.54 µg/ml against both chloroquine-sensitive (3D7) and resistant (Dd2) strains respectively. Albizia coriaria and Entada abyssinica also displayed moderate activity, with IC50s ranging from 30.26 to 101.26 µg/ml. Acute toxicity studies indicated that most extracts were relatively safe in Wistar albino rats, except for A. coriaria and M. senegalensis, which were moderately toxic with median lethal less than 2000mg/kg. Conclusion: Z. chalybeum, A. coriaria and E. abyssinica are promising medicinal plants for developing novel and effective antimalarial drugs, especially against drug-resistant strains that warrant more phytochemical and pharmacological studies. Keywords: Medicinal plants, Malaria, Antiplasmodial activity, Phytochemicals, Drug resistance
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    Incidence and determinants of perinatal mortality among women with obstructed labour in eastern Uganda: a prospective cohort study
    (Springer Nature, 2021) Musaba, Milton W.; Ndeezi, Grace; Barageine, Justus K.; Weeks, Andrew D.; Wandabwa, Julius N.; Mukunya, David; Waako, Paul; Odongkara, Beatrice; Arach, Agnes; Tulya-muhika Mugabe, Kenneth; Kasede Napyo, Agnes; Nankabirwa, Victoria; Tumwine, James K.
    Background: In Uganda, the incidence and determinants of perinatal death in obstructed labour are not well documented. We determined the incidence and determinants of perinatal mortality among women with obstructed labour in Eastern Uganda. Methods: Between July 2018 and September 2019, 584 with obstructed labour were recruited and followed up to the 7th day postnatal. Information on maternal characteristics, obstetric factors and laboratory parameters was collected. Each patient received the standard perioperative care. We used a generalized linear model for the Poisson family, with a log link and robust variance estimation to determine the association between the exposure variables and perinatal death. Results: Of the 623 women diagnosed with obstructed labour, 584 met the eligibility criteria. There were 24 fresh still births (FSB) and 32 early neonatal deaths (ENND) giving an FSB rate of 43.8 (95% CI 28.3–64.4) deaths per 1000 total births; early neonatal death rate of 58.4 (95% CI 40.3–81.4) deaths per 1000 and an overall perinatal mortality rate of 102.2 (95% CI 79.4–130.6) deaths in the first 7 days of life. A mother being referred in active labour adjusted risk ratio of 2.84 (95% CI: 1.35–5.96) and having high blood lactate levels at recruitment adjusted risk ratio 2.71 (95% CI: 1.26–4.24) were the determinants of perinatal deaths. Conclusions: The incidence of perinatal death was four times the regional and national average. Babies to women referred in active labour and those with high maternal blood lactate were more likely to die. Keywords: Obstructed labour, Perinatal death, Determinants, Lactate
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    Integrating STEM Education in Uganda’s Higher Education to Produce Skills Required to Stimulate Industrialisation and Sustainable Economic Growth.
    (The Uganda Higher Education Review Journal, 2024) Nalule, Rebecca Muhumuza; Muhumuza, Asaph Keikara; Mbabazi, Fulgensia Kamugisha; Kyomuhangi, Annet; Mwasa, Abubakar; Oyem, Anselm O.; Kadedesya, Stephen; Nabirye, Topista; Nanyondo, Josephine; Wamakote, Leonard; Muweesi, Charles; Atibuni, Dennis; Ocen, Gilbert; Semwogerere, Twaib; Olema, David C.; Kanyarusoke, Kant; Rwahwire, Samson; Nabasa, Lillian Gimugumi; Aguti, Jessica Norah; Biira, Saphina; Kucel, Samuel Baker; Waako, Paul; Mwesigwa, Sheldon Fred
    The high cost of education, coupled with the high rate of unemployment, is a major concern for developing countries, including Uganda. The economic growth of any developing nation heavily relies on its capacity to create sustainable job opportunities across various sectors. An education based on Science, Technology, Engineering and Mathematics (STEM) can serve as a powerful driving force to overcome barriers and achieve this crucial milestone. The traditional methods of teaching, learning and research in higher institutions of learning (HIL) in Uganda mainly emphasise theoretical knowledge rather than practical skills development. This leads to a wider gap in the skills required of graduates for job creation, industrialisation and stimulating economic growth. This study aims to investigate the key factors that should be considered for the effective integration of STEM education into Uganda’s higher education (HE) in relation to the needs of industry and community development. By adopting integrated STEM education, we envision that empowered graduates will become innovators and job creators. To gather comprehensive insights into the perception of integrated STEM education in HIL, qualitative data was collected from 42 respondents using an online semi structured questionnaire. The data was analysed using descriptive statistics. The study established that although some integrated STEM education exists in academia, industry and the community, its full integration is limited by the inadequacy of quality staff, funding and the rather weak collaboration and partnership between academia, industry and community. The study recommends that there is need to enhance the integration of STEM education into Uganda’s HIL by recruiting quality staff, increasing funding and strengthening collaboration and partnership between academia, industry and community. This will produce skilled graduates who are job creators and highly employable in industry, a requisite for sustainable economic growth in the 21st century. Keywords: STEM education; Higher education; Job creation; Industrialisation; Sustainable economic growth.
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    Sacred birth, clean hands : infection prevention as ritual and practice among traditional birth attendants in Mayuge district, east central Uganda.
    (Research Square, 2025) Kagoya, Enid Kawala; Auma, Proscovia; Mugabi, Joshua; Kawala, Elizabeth; Asabawebwa, Deogratias; Mugahi, Richard; Waako, Paul; Mugabe, Kenneth; Barugahare, Banson
    This study explored how Traditional Birth Attendants (TBAs) in rural Uganda implement infection prevention and control (IPC) through a blend of cultural traditions and hygiene practices. Using ethnographic methods, including interviews and observations, it found that TBAs view cleanliness as both a sacred obligation and a critical part of protecting maternal health. Despite facing limited training and resources, TBAs showed a strong commitment to infection prevention, positioning them as essential yet often under-recognized actors in maternal care. Introduction The study investigated IPC practices among TBAs in rural Uganda, situating them within a broader cultural and spiritual framework. It emphasized how TBAs integrate traditional knowledge with selected biomedical practices to ensure maternal safety. This intersection of ritual and hygiene highlights the TBAs' central role in rural maternal healthcare. Objective The main objective was to explore how TBAs interpret, adapt, and implement IPC practices by drawing from both cultural beliefs and biomedical hygiene principles in the context of rural Uganda. Methods A qualitative research approach was used, involving in-depth interviews and direct observations with 15 TBAs in Mayuge District. Data collection focused on everyday IPC practices such as waste disposal, hand hygiene, and use of protective materials. Thematic analysis helped identify recurring patterns and contextual challenges in IPC implementation. Results The findings revealed that TBAs practice IPC through a hybrid model that blends ritual and hygiene. Placenta disposal, symbolic use of gloves, and improvised handwashing with soap, herbs, or oil were common. Despite limited formal training, TBAs showed innovation and commitment to safe deliveries, although resource scarcity and misalignment with formal guidelines posed challenges. Conclusion The study highlighted the creative and spiritually informed IPC strategies of TBAs in rural Uganda, showing how they skillfully navigate material shortages and cultural expectations. These frontline caregivers operate with dedication and contextual intelligence, underscoring the need for culturally sensitive training and support to enhance maternal and newborn outcomes in under-resourced settings. Keywords: Traditional Birth Attendants, Infection Prevention and Control, Maternal Health, Uganda, Ritual Hygiene, Hybrid Care Practices, Ethnography, Community Health, Safe Delivery, Cultural Beliefs
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    ‘They treat you like their own’ perspectives and lived experiences of postpartum women seeking health services from traditional birth attendants (TBAs) in Mayuge district east central Uganda.
    (Research Square, 2025) Kagoya, Enid Kawala; Auma, Proscovia; Mugabi, Joshua; Kawala, Elizabeth; Asabawebwa, Deogratias; Mugahi, Richard; Mutunda, Brenda Doreen; Twineamatsiko, Andrew; Kabene, Mercy Jackline; Frank, Kayemba; Waako, Paul; Mugabe, Kenneth; Akello, Jackline
    Background In Uganda, despite ongoing efforts to promote skilled birth attendance, many women in rural communities continue to deliver with Traditional Birth Attendants (TBAs). Understanding the reasons behind this preference and the nature of care provided by TBAs is critical for informing maternal health policy and community-level interventions. Objective To explore the experiences, perceptions, and underlying factors influencing the continued use of TBAs for childbirth among postpartum women in Mayuge District, Eastern Uganda. Methods A descriptive qualitative study was conducted in Mayuge District. In-depth interviews were held with 12 postpartum women who had delivered with TBAs within the past six months. Participants were purposively selected to capture variation in age, parity, and location. Data were collected using a semi structured interview guide, audio-recorded, transcribed verbatim, and translated into English. Thematic analysis was conducted using both inductive and deductive coding in NVivo 13. Results Five overarching themes emerged: (1) Health System Barriers, including poor access to health facilities, transport challenges, and mistreatment by health workers; (2) Perceived Benefits of TBA Care, such as affordability, emotional support, privacy, and flexible payment options; (3) Traditional Practices and Beliefs, with participants emphasizing cultural alignment, spiritual care, and birth rituals provided by TBAs; (4) Health Risks and Limits of TBA Care, reflecting awareness of complications, delayed referrals, and lack of emergency support; and (5) Community Influence, where social norms, peer recommendations, and collective trust in TBAs shaped decision-making. A cross-cutting theme of husband and family involvement also significantly influenced birth location choices. Conclusion The continued reliance on TBAs is shaped by a complex interplay of structural barriers, cultural values, perceived advantages, and community dynamics. Interventions to improve maternal health in rural Uganda should address health system gaps, promote respectful and culturally sensitive facility-based care, and engage families and communities in birth preparedness efforts. Keywords: Traditional Birth Attendants, Postpartum Women, Maternal Health, Uganda, Qualitative Study, Health-Seeking Behavior, Cultural Beliefs, Health System Barriers, Community Influence.
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    Unraveling the therapeutic potential of tephrosia linearis : anti-inflammatory, analgesic activity, and molecular docking approaches.
    (Elsevier Ltd, 2025) Opio, Moses; Kiyimba, Kenedy; Nabitandikwa, Catherine; Maseruka, Richard; Wotoyitidde, Tony Lukwago; Andima, Moses; Chebijira, Mercy; Edeya, Sharon Tracy; Nabatanzi, Alice; Gavamukulya, Yahaya; Kibuule, Dan; Waako, Paul; Owor, Richard Oriko; Obakiro, Samuel Baker
    Background Inflammatory diseases such as arthritis affect over 300 million people globally. The current treatment mainly involves the use of Non-Steroidal Anti-inflammatory drugs (NSAIDS) which possess several adverse drug reactions that are sometimes life threatening. This has prompted many patients to gain interest in plant-based remedies. Tephrosia linearis (Willd.) Pers (Fabaceae) is widely used in Uganda to manage symptoms of inflammation. However, there was a paucity of information concerning its analgesic and anti-inflammatory activities. This study investigated the anti-inflammatory, analgesic, and acute toxicity effects of ethanolic extracts from the aerial parts of Tephrosia linearis in Wistar albino rats. Methods Plant samples were collected from Katakwi District, Eastern Uganda and extracted using 70 % ethanol. Quantitative phytochemical analysis was conducted using UV/Vis spectroscopy. Acute toxicity was assessed using Lorke’s method, while analgesic and anti-inflammatory activities were evaluated through Complete Freud’s Adjuvant-induced arthritis model. Three doses of T. linearis (200, 400, and 800 mg/kg) were compared with a control group receiving 20 mg/kg of diclofenac. Three marker compounds were assessed using in silico modeling to predict their pharmacokinetic properties, organ toxicity, and binding energy against selected protein targets involved in inflammation. Results The ethanolic extract contained significant concentrations of flavonoids (82.9 ± 0.1 mg/g), tannins (140.2 ± 0.9 mg/g), alkaloids (93.4 ± 1.0 mg/g), and triterpenoids (76.1 ± 1.5 mg/g). No toxic effects were observed at doses below 2000 mg/kg, with an estimated LD50 of 2692 mg/kg. The extract exhibited a non-dose dependent analgesic and anti-inflammatory activities that were significantly lower than that of diclofenac (p < 0.05). Molecular docking revealed strong binding affinities for apigenin, luteolin, and velutin with COX2, PLA2, and TNFα. Conclusion This study supports T. linearis as a safe herbal remedy for managing inflammation, suggesting further optimization through active ingredient isolation for enhanced therapeutic outcomes.
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    Watching over life : practices and meanings of postpartum vital signs monitoring in eastern Uganda.
    (medRxiv, 2025) Babuya, Jonathan; Kayemba, Frank; Waiswa, Sinani; Nsubuga, Allan G.; Ewing, Helen; Atuhairwe, Irene; Ijangolet, Esther; Otim, Eric; Ronald, Kibuuka; Jesca, Atugonza; Okello, Francis; Nakattudde, Prossy; Nyangoma, Faith; Nakawuka, Betty; Kabahinda, Nichola; Kamwesigye, Assen; Apoya, Jill; Waako, Paul; Wandabwa, Julius; Musaba, Milton; Bonaventure, Ahaisibwe; Aeby, Tod; Nandutu, Sarah; Mugabe, Kenneth; Pangholi, Kennedy; Nahurira, Doreck; Agaba, Brian; Mbwali, Immaculate; Bahati, Johnson; Kagoya, Enid Kawala
    Introduction Postnatal deaths account for about one-third of maternal mortality in Low- and middle-income countries (LMICs). Nearly half occur within the first 24 hours and are preventable through continuous inpatient monitoring. This study assessed maternal mortality within the first 24 postnatal hours; and the current postpartum monitoring practices, including the availability of monitoring charts and the frequency of vital sign assessments in eastern Uganda. Methods This cross-sectional study reviewed the medical records of all postpartum women admitted at Mbale Regional Referral Hospital, Eastern Uganda, between August 2022 and February 2023. A semi-structured data extraction form was used. The outcome variable was postpartum monitoring; categorized as "No" for women with no vital signs monitored and "Yes" for those with at least one vital sign monitored. Descriptive analysis was performed using Stata Version 17.0, and Poisson regression was employed to explore the association between various factors and postpartum monitoring. Results Medical records of 2,717 postpartum mothers were reviewed. The median (interquartile range) age was 25(20-30) years. A minority (34%; 910/2717) of mothers had vital sign observation charts in their medical records and very few (4%; 110/2717) had a fluid balance chart. About 49 24% (651/2717) of mothers had at least one vital sign recorded. Blood pressure was the most (16.8%; 456/2717) recorded vital sign followed by pulse rate (13.6%; 369/2717). Respiratory rate and temperature were the least monitored vital signs with 1.2% and 1.1% records respectively. Mothers who delivered by C-section had a 151% higher prevalence of postpartum monitoring compared to those who had a vaginal delivery (aPR: 2.51; 95% CI: 2.19–2.89). Maternal mortality rate on the first postpartum day was 8.8 per 1000, with postpartum hemorrhage accounting for 61%. Conclusion Postpartum vital signs monitoring was low. LMICs need to devise means of automating the monitoring process.