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Hypertension is an important contributor to global burden of disease and mortality, and is a growing public health problem in sub-Saharan Africa. However, most sub-Saharan African countries lack detailed countrywide data on hypertension and other non-communicable diseases (NCD) risk factors that would provide benchmark information for design of appropriate interventions. We analyzed blood pressure data from Uganda's nationwide NCD risk factor survey conducted in 2014, to describe the prevalence and distribution of hypertension in the Ugandan population, and to identify the associated factors. The NCD risk factor survey drew a countrywide sample stratified by the four regions of the country, and with separate estimates for rural and urban areas. The World Health Organization's STEPs tool was used to collect data on demographic and behavioral characteristics, and physical and biochemical measurements. Prevalence rate ratios (PRR) using modified Poison regression modelling was used to identify factors associated with hypertension. Of the 3906 participants, 1033 were classified as hypertensive, giving an overall prevalence of 26.4%. Prevalence was highest in the central region at 28.5%, followed by the eastern region at 26.4%, western region at 26.3%, and northern region at 23.3%. Prevalence in urban areas was 28.9%, and 25.8% in rural areas. The differences between regions, and between rural-urban areas were not statistically significant. Only 7.7% of participants with hypertension were aware of their high blood pressure. The prevalence of pre-hypertension was also high at 36.9%. The only modifiable factor found to be associated with hypertension was higher body mass index (BMI). Compared to participants with BMI less than 25 kg/m2, prevalence was significantly higher among participants with BMI between 25 to 29.9 kg/m2 with an adjusted PRR = 1.46 [95% CI = 1.25-1.71], and even higher among obese participants (BMI ≥ 30 kg/m2) with an adjusted PRR = 1.60 [95% CI = 1.29-1.99]. The un-modifiable factor found to be associated with hypertension was older age with an adjusted PRR of 1.02 [95% CI = 1.02-1.03] per yearly increase in age. The prevalence of hypertension in Uganda is high, with no significant differences in distribution by geographical location. Only 7.7% of persons with hypertension were aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure. Thus a big percentage of persons with hypertension are at high risk of hypertension-related cardiovascular NCDs.

Background Modification of known risk factors has been the most tested strategy for dealing with non-communicable diseases (NCDs). The cumulative number of NCD risk factors exhibited by an individual depicts a disease burden. However, understanding the risk factors associated with increased NCD burden has been constrained by scarcity of nationally representative data, especially in the developing countries and not well explored in the developed countries as well. Methods Assessment of key risk factors for NCDs using population data drawn from 3987 participants in a nationally representative baseline survey in Uganda was made. Five key risk factors considered for the indicator variable included: high frequency of tobacco smoking, less than five servings of fruit and vegetables per day, low physical activity levels, high body mass index and raised blood pressure. We developed a composite indicator dependent variable with counts of number of risk factors associated with NCDs per participant. A statistical modeling framework was developed and a multinomial logistic regression model was fitted. The endogenous and exogenous predictors of NCD cumulative risk factors were assessed. Results A novel model framework for cumulative number of NCD risk factors was developed. Most respondents, 38 · 6% exhibited one or two NCD risk factors each. Of the total sample, 56 · 4% had at least two risk factors whereas only 5.3% showed no risk factor at all. Body mass index, systolic blood pressure, diastolic blood pressure, consumption of fruit and vegetables, age, region, residence, type of residence and land tenure system were statistically significant predictors of number of NCD risk factors ( p  < 0 · 05). With exception to diastolic blood pressure, increase in age, body mass index, systolic blood pressure and reduction in daily fruit and vegetable servings were found to significantly increase the relative risks of exhibiting cumulative NCD risk factors. Compared to the urban residence status, the relative risk of living in a rural area significantly increased the risk of having 1 or 2 risk factors by a multiple of 1.55. Conclusions The non-communicable disease burden is on the increase, with more participants reporting to have at least two risk factors. Our findings imply that, besides endogenous factors, exogenous factors such as region, residence status, land tenure system and behavioral characteristics have significant causal effects on the cumulative NCD risk factors. Subsequently, while developing interventions to combat cumulative risk factors of NCDs, the Ministry of Health needs to employ a more holistic approach to facilitate equitable health and sensitization across age, residence and regional divide.

Background Hypertension is an important contributor to global burden of disease and mortality, and is a growing public health problem in sub-Saharan Africa. However, most sub-Saharan African countries lack detailed countrywide data on hypertension and other non-communicable diseases (NCD) risk factors that would provide benchmark information for design of appropriate interventions. We analyzed blood pressure data from Uganda's nationwide NCD risk factor survey conducted in 2014, to describe the prevalence and distribution of hypertension in the Ugandan population, and to identify the associated factors. Methods The NCD risk factor survey drew a countrywide sample stratified by the four regions of the country, and with separate estimates for rural and urban areas. The World Health Organization's STEPs tool was used to collect data on demographic and behavioral characteristics, and physical and biochemical measurements. Prevalence rate ratios (PRR) using modified Poison regression modelling was used to identify factors associated with hypertension. Results Of the 3906 participants, 1033 were classified as hypertensive, giving an overall prevalence of 26.4%. Prevalence was highest in the central region at 28.5%, followed by the eastern region at 26.4%, western region at 26.3%, and northern region at 23.3%. Prevalence in urban areas was 28.9%, and 25.8% in rural areas. The differences between regions, and between rural-urban areas were not statistically significant. Only 7.7% of participants with hypertension were aware of their high blood pressure. The prevalence of pre-hypertension was also high at 36.9%. The only modifiable factor found to be associated with hypertension was higher body mass index (BMI). Compared to participants with BMI less than 25 kg/m2, prevalence was significantly higher among participants with BMI between 25 to 29.9 kg/m2 with an adjusted PRR = 1.46 [95% CI = 1.25-1.71], and even higher among obese participants (BMI greater than or equal to 30 kg/m2) with an adjusted PRR = 1.60 [95% CI = 1.29-1.99]. The un-modifiable factor found to be associated with hypertension was older age with an adjusted PRR of 1.02 [95% CI = 1.02-1.03] per yearly increase in age. Conclusions The prevalence of hypertension in Uganda is high, with no significant differences in distribution by geographical location. Only 7.7% of persons with hypertension were aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure. Thus a big percentage of persons with hypertension are at high risk of hypertension-related cardiovascular NCDs.

In this paper we compute a multi-dimensional poverty index (MPI) for Uganda following the approach proposed by Alkire and Forster (2007). Using household survey data we show how the incidence of multi-dimensional poverty has fallen in recent years and we use the decomposability features of the index to explain the drivers of reduction in multi-dimensional poverty. We also compare the results from Uganda with other countries for which the MPI has been computed and we note some caveats in such a comparison. The robustness of our estimates is tested in a stochastic dominance framework and using statistical inference. Notably, we extend the one-dimensional analysis of stochastic dominance to take into account household size in a second dimension, which is particularly important as some of the MPI indicators are sensitive to the number of household members. By exploiting a unique subsample of the integrated household survey programme in Uganda, which has not previously been analysed, we are also able to match the data-set used for the MPI with data used to compute the conventional estimates of monetary poverty. This enables a more robust assessment of the complementarities of the two types of poverty measures than has been previously possible.

\"Agriculture is vital to the economies of Sub-Saharan Africa: two-thirds of the region's people depend on it for their livelihoods. Nevertheless, agricultural productivity in most of the region is stagnant or declining, in large part because of land degradation. Soil erosion and soil nutrient depletion degraded almost 70 percent of the region's land between 1945 and 1990; 20 percent of total agricultural land has been severely degraded. If left unchecked, land degradation could seriously threaten the progress of economic growth and poverty reduction in Africa. Within this context, most African countries strive to achieve poverty reduction and sustainable land management. In designing policies to achieve these objectives concurrently, a clear understanding of their linkage is crucial. Nonetheless, the relationships between poverty and land management are complex, context specific, and resource specific, and empirical evidence to demonstrate their linkage has been limited. This analysis seeks to improve the understanding of this linkage by examining how poverty (broadly defined to include limited access to capital, infrastructure, and services) influences land-management practices, land degradation, crop productivity, and household incomes. In particular, the study focuses on how factors susceptible to policy initiatives--such as education, agricultural technical assistance, and credit-- affect households' land management decisions. Uganda was chosen to serve as a case study of these issues, for several reasons. Of all Sub-Saharan African nations, Uganda has some of the most severe soil nutrient depletion in Africa: about 1.2 percent of nutrient stock stored in the topsoil is depleted by farmers each year. Also, the country contains a wide variety of agroecological zones (AEZs), making it an appropriate microcosm of Sub-Saharan Africa. The Ugandan government has also been conducting ambitious poverty-reduction and conservation efforts, and a study such as this one serves to measure those efforts. Working with the Uganda Bureau of Statistics (UBOS), the authors drew on Uganda's 2002-03 National Household Survey, as well as a specific survey conducted to collect poverty, land management, and land-degradation data at the household and plot levels.\" from text

\"Community-based Natural Resource Management (NRM) is increasingly becoming an important approach for addressing natural resource degradation in low income countries. This study analyzes the determinants of enactment, awareness of and compliance with by-laws related to Natural Resource Management (NRM) in order to draw policy implications that could be used to increase the effectiveness of by-laws in managing natural resources sustainably. We found a strong association between awareness and compliance with NRM bylaws. This suggests the need to promote environmental education as part of the strategy to increase compliance with NRM bylaws. Econometric analysis of the survey data indicates factors that are associated with enactment of local NRM bylaws, and awareness of and compliance with NRM requirements... These findings imply that improving awareness of NRM requirements is critical to increase compliance with such requirements. Awareness is greater in areas closer to all-weather roads, probably due to better access to information in such areas. Development of roads and communication can thus facilitate better community NRM. Other low cost options to increase awareness could include use of radio programs, environmental education in schools, resource user seminars, brochures, and district level training workshops...Several dimensions of poverty, including greater income poverty, poor education, and poor access to credit are associated with lower compliance with tree planting and protection requirements. This supports the hypothesis of a poverty-natural resource degradation trap, and suggests that measures to reduce poverty can have \"win-win\" benefits helping to improve NRM as well\" from Author's Abstract

Analysis of five nationally representative household surveys from Uganda show a fall in poverty from 1992-1997. Using an absolute poverty line calculated following Ravallion and Bidani, we find 56% of Ugandans were poor in 1992 falling to 44% in 1997/8. The conclusion that poverty fell is robust to the choice of poverty measure and poverty line. General growth accounts for most of the fall in poverty, although there was also an improvement in the progressivity of the distribution. Up to 1995/96, half of the fall in poverty was attributable to coffee-growing households. Poverty increased in households with non-working heads.

IntroductionPre-exposure prophylaxis (PrEP) use among cisgender female sex workers (FSWs), a population at disproportionately high HIV acquisition risk in Uganda, remains suboptimal. Uptake and continued use are constrained by barriers, such as limited clinical hours, long distances to access facility-based PrEP services, and high mobility among FSWs. Community pharmacies may offer a more accessible PrEP delivery model due to extended operating hours and convenient locations. This study aims to evaluate the accessibility and capacity of pharmacies in Kampala, Uganda, to serve as potential sites for PrEP delivery.Methods and analysisWe will conduct a concurrent mixed-methods study combining geospatial mapping, structured surveys, a discrete choice experiment (DCE), and in-depth interviews (IDIs). First, the study will compare the reach and accessibility of PrEP services through community pharmacies versus public healthcare facilities. To highlight PrEP service reach, we will use geospatial analysis to map pharmacies, PrEP clinics, FSW hotspots (i.e., areas where sex is exchanged), and HIV incidence. We will also calculate a PrEP facility needs ratio (number of PrEP facilities/HIV incidence) for each of Kampala’s administrative divisions and estimate travel distance and time to access PrEP services using cost–distance analysis. Perceived accessibility of PrEP services will be assessed through FSW surveys (n=50) and IDIs (n=20–30), guided by Levesque’s framework. Then, we will evaluate pharmacy capacity via surveys (n=274) and IDIs (n=20–30), exploring infrastructure, resources, and staff perspectives, informed by the Consolidated Framework for Implementation Research. Additionally, a DCE will be embedded in the pharmacy survey to elicit staff preferences for delivery approaches and analysed using mixed logit models. Finally, we will integrate quantitative and qualitative findings to provide a broad assessment of whether pharmacies are suitable venues for PrEP delivery to FSWs in Kampala. Enrolment will begin by April 2026 for FSWs and July 2026 for pharmacy staff.Ethics and disseminationEthical approval has been obtained from the Infectious Diseases Institute Research Ethics Committee (IDI-REC-2025-175) and the Uganda National Council for Science and Technology (HS6178ES). Written informed consent will be obtained from all participants. We will disseminate study findings through stakeholder meetings, scientific conferences, and peer-reviewed publications.

Brucellosis is a worldwide recognized bacterial zoonotic disease. There is currently no information on bovine brucellosis sero-prevalence in South Sudan regardless of the economic, social and public health impact on populations. Therefore, for the first time in 33 years, we report the sero-prevalence of brucellosis in cattle and their herders. Furthermore, we characterize the drivers associated with the disease at the human-animal interface in Bahr el Ghazal region, South Sudan. A total of 893 and 87 animal and human sera respectively were examined between December 2015 and May 2016. Rose Bengal Plate Test (RBPT) and Competitive Enzyme Linked Immuno Sorbent Assay (c-ELISA) were used in parallel to detect anti-Brucella antibodies. Questionnaires were administered to collect relevant metadata used for the association analysis in R version 3.2.3. Odds Ratio (OR) and Confidence Intervals (CI) were determined. Overall bovine brucellosis prevalence was 31% (95%CI = 28.0-34.2), with the highest 63% (95%CI = 53-70) and lowest 10% (95%CI = 4.5-20.1) prevalence estimates in Wau and Gogrial states respectively. The bovine sero-prevalence was approximately equally distributed among the male 30.4% (26.9-34.2) and the females 32.5% (26.8-38.7). Poor body condition (OR = 0.22; 95%CI = 0.07-0.54) and larger herd sizes (OR = 0.05; 95%CI = 0.008-0.173) were protective factors for brucellosis, while the opposite was true for the second (OR = 1.70; 95%CI = 1.08-2.67) and third (OR = 2.5; 95%CI = 1.46-4.47) lactation stage. The overall brucellosis sero-prevalence in herders was estimated at 33.3% (23.9-44.3). We report a high prevalence of anti-Brucella antibodies in cattle and their herders in Bahr el Ghazal, indicating an enzootic status in the cattle population being an important source of infection for humans. This represents a genuine public health challenge. Therefore, there is need to raise awareness and build capacity and infrastructure in this fragile state to underwrite future public health strategies for brucellosis.