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Background Climate change poses a threat to the sustainability of food production among small-scale rural communities in Sub-Saharan Africa that are dependent on rain-fed agriculture. Understanding farmers’ adaptations and the determinants of their adaptation strategies is crucial in designing realistic strategies and policies for agricultural development and food security. The main objectives of this study were to identify the adaptation strategies used by smallholder farmers to counter the perceived negative effects of climate change in northern Uganda, and factors influencing the use of specific adaptation strategies. A cross-sectional survey research design was employed to collect data from 395 randomly selected smallholder farmers’ household heads across two districts by the administration of a semi-structured questionnaire. Binary logistic regression was used to analyze the factors influencing farmers’ adaptation to climate change. Results The three most widely practiced adaptation strategies were planting of different crop varieties, planting drought-resistant varieties, and fallowing. Results of the binary logit regression model revealed that marital status of household head, access to credit, access to extension services, and farm income influenced farmers’ adoption of planting drought-resistant varieties as an adaptation strategy while access to credit, annual farm income, and time taken to market influenced adoption of planting improved seeds. Gender of household head and farm income had a positive influence on farmers’ adoption of fertilizer and pesticide use. Farming experience, farm income, and access to extension services and credit influenced farmers’ adoption of tree planting. Household size, farming experience, and time taken to market had positive influence on the use of fallowing, while size of land cultivated significantly influenced farmers’ planting of different crop varieties as an adaptation strategy. Conclusion Findings of the study suggest there are several factors that work together to influence adoption of specific adaptation strategies by smallholder farmers. This therefore calls for more effort from government to strengthen the provision of agricultural extension services by improving its climate information system, providing recommended agricultural inputs and training farmers on best agronomic practices to enhance their holistic adaptation to the effect of climate change.

Background To reduce the spread of COVID-19, several countries in Africa instituted countrywide lockdowns and other public health measures. Whereas lockdowns contributed to the control of the pandemic, there were concerns about the unintended consequences of these measures especially in the most vulnerable populations. We assessed unintended socio-economic and health consequences due to the COVID-19 pandemic and the mitigation measures among slum dwellers in Kampala to inform the on-going and future pandemic response strategies. Methods This was a mixed methods cross-sectional study conducted in Bwaise I and Bwaise III slums of Kawempe division, Kampala Uganda from October to December 2020. We used systematic sampling to randomly select 425 household heads for the face-to-face quantitative interviews. We also conducted six focus group discussions (FGDs) with slum dwellers and used photovoice among eight Community Health Workers (CHWs) to document unintended socio-economic and health consequences. Quantitative data were imported into STATA version 14.0 for analysis, while qualitative data were analysed thematically using NVivo version 12. Modified Poisson regression analysis was conducted to establish factors associated with impact on access to food. Results Most respondents reported limited access to food (71.1%; 302/425); disruption in education (77.1%; 270/350); drop in daily income and wages (86.1%; 329/382) and loss of employment (63.1; 125/198). Twenty five percent of the respondents (25.4%; 86/338) reported domestic violence as one of the challenges. Seven themes emerged from the qualitative findings on the impact of COVID-19 including: limited access to food; negative impact on children’s rights (child labour and teenage pregnancies) and education; poor housing and lack of accommodation; negative social behaviours; negative impact on family and child care; reduced income and employment; and negative impact on health and access to health care services. Conclusion The slum dwellers of Bwaise I and Bwaise III experienced several negative socio-economic and health consequences of COVID-19 and its prevention measures that severely affected their wellbeing. Children experienced severe consequences such as child labour and teenage pregnancies among the girls. Response activities should be contextualised to different settings and protocols to protect the vulnerable groups in the community such as children and women should be developed and mainstreamed in response activities.

Agricultural output marketing as an economic venture, increases smallholders' economic welfare (incomes) through market participation. However, the venture is plagued by inefficiencies that emanate from incomplete institutional and physical infrastructures as well as imperfect competition. Data were obtained from a random sample of 206 farmers in Nwoya district. A Tobit regression was conducted to determine the institutional (and technical) drivers of farmers' intra-household market participation decisions. The results revealed that variety used (p < 0.1), group membership (p < 0.01), markets (p < 0.05), road access (0.05), distance to markets (p < 0.05), total labor (p < 0.05) and household size (p < 0.1) significantly influenced intra-household market participation decisions. The outcome of this study provides a course-way upon which government institutions and relevant stakeholders can make strides through addressing policies aimed at enhancing sustainable economic welfare through increased productivity which reduces poverty and boosts food security among famers. Unlike other lowly developed economies, smallholder farmers especially in Sub-Saharan Africa continue to register low gains in terms of household economic welfare. Increase and sustainability in both productivity and market participation has for long been billed as a crucial pathway in ensuring continuous propagation of economic welfare. However, these ventures have continuously failed to deliver accordingly due to poorly instituted and hardly maintained institutional and physical (technical) infrastructures as well as competition. As an alternative, farmers have then to devise marketing decisions prudently and adeptly so as to realize the desired outcome (welfare). Moreover, when made prudently and calculative, intra-household marketing decisions have the capacity to improve on the household economic welfare and reduce on the poverty levels.

Background Investing in postharvest technologies is one way of reducing food losses with the aim of achieving food security, but it is often overlooked. In this study, we assessed the losses and costs associated with the harvest and postharvest practices used by smallholder bean farmers in Uganda. We also estimated the grain Moisture Content (MC) associated with traditional storage practices. Results Harvest and postharvest handling practices result in a loss of about 22% of the crop harvest. The cost associated with this loss is 17% of the output value. In addition, the common storage practices used by farmers are unable to maintain the required grain MC of ≤ 13%. As even a slight change in grain MC can significantly impact storage duration, we found that 74% of farmers fail to meet the required MC, resulting in a loss of anticipated price premiums over an average storage duration of 80 days. Our econometric estimates suggest that storing grain in bags placed above the floor surface could reduce MC by an additional 1.5%. Conclusions Our predictions indicate that farmers who use traditional practices should store bean grains for less than 60 days, or they should adopt better storage practices to increase shelf life and ensure food safety. If more farmers had placed their grain above the floor surface, 48% rather than 26% would have met the required MC at 90 days. It is worth noting that poor postharvest handling has significant economic implications and can lead to food safety concerns due to quality failures in the grain. To address these issues, there is a need to scale up interventions that increase farmer access to postharvest technologies.

Background Kampala city slums, with one million dwellers living in poor sanitary conditions, frequently experience cholera outbreaks. On 6 January 2019, Rubaga Division notified the Uganda Ministry of Health of a suspected cholera outbreak in Sembule village. We investigated to identify the source and mode of transmission, and recommended evidence-based interventions. Methods We defined a suspected case as onset of profuse, painless, acute watery diarrhoea in a Kampala City resident (≥ 2 years) from 28 December 2018 to 11 February 2019. A confirmed case was a suspected case with Vibrio cholerae identified from the patient’s stool specimen by culture. We found cases by record review and active community case-finding. We conducted a case–control study in Sembule village, the epi-center of this outbreak, to compare exposures between confirmed case-persons and asymptomatic controls, individually matched by age group. We overlaid rainfall data with the epidemic curve to identify temporal patterns between rain and illnesses. We conducted an environmental assessment, interviewed village local council members, and tested water samples from randomly-selected households and water sources using culture and PCR to identify V. cholerae . Results We identified 50 suspected case-patients, with three deaths (case-fatality rate: 6.0%). Of 45 case-patients with stool samples tested, 22 were confirmed positive for V. cholerae O1, serotype Ogawa . All age groups were affected; persons aged 5–14 years had the highest attack rate (AR) (8.2/100,000). The epidemic curve showed several point-source outbreaks; cases repeatedly spiked immediately following rainfall. Sembule village had a token-operated water tap, which had broken down 1 month before the outbreak, forcing residents to obtain water from one of three wells (Wells A, B, C) or a public tap. Environmental assessment showed that residents emptied their feces into a drainage channel connected to Well C. Drinking water from Well C was associated with illness (OR M–H  = 21, 95% CI 4.6–93). Drinking water from a public tap (OR M–H  = 0.07, 95% CI 0.014–0.304) was protective. Water from a container in one of eight households sampled tested positive for V. cholerae ; water from Well C had coliform counts ˃ 900/100 ml. Conclusions Drinking contaminated water from an unprotected well was associated with this cholera outbreak. We recommended emergency chlorination of drinking water, fixing the broken token tap, and closure of Well C.

Background Climate change poses severe threats to smallholder farmers' agricultural livelihoods and food security in Sub Saharan Africa. Understanding long-term rainfall trends of variability and extremes at local scales and perceptions regarding long-term changes in climate variables is important in planning appropriate adaptation measures to climate change. This paper examines the perception of farmers in Apac district regarding long-term changes in climate variables and analyzes the trend of occurrence in seasonal and annual rainfall in Apac district, northern Uganda. A cross-sectional survey design was employed to collect data on farmers' perceptions regarding long-term changes in climate from 260 randomly selected smallholder farmers’ households across two sub-counties in Apac district by administering semi-structured questionnaires in February 2018. Monthly rainfall data sets from the Uganda Meteorological Authority (UMA) for the period 1980 to 2019 for Apac district were also used to analyze trends of occurrences in seasonal and annual rainfall in the study area. The non-parametric Sequential Mann–Kendall (SMK) tests were employed at a 5% significance level to detect mean seasonal rainfall trends and abrupt change points. Results The majority of the respondents (87%) perceived a decrease in precipitation over the past 39 years. The plot of forward regression u ( t i ) values and backward regression u’ ( t i ) values showed interactions indicating rainfall trends, rainfall lower and upper limits and abrupt change points in the different cropping seasons. Analysis of historical series of mean monthly and annual rainfall showed an abrupt change in rainfall in March, April, May (MAM) season in 1982. Although the September, October and November (SON) season did not show a significant abrupt change, there was a significant (p < 0.05) increase in rainfall above the upper limit from 1994 to date. Conclusion The mean seasonal rainfall for MAM and SON cropping seasons in Apac district were highly variable from different time points within the past 39 years (1980–2019), while June, July, and August (JJA) did not realize a significant change in rainfall within the same study period that the two cropping seasons (MAM and SON) in the district experienced remarkable variations in rainfall. This, therefore, provides a basis for the government to strengthen the provision of an effective climate tailored agricultural advisory service to aid farmers’ adaptation planning at the local level and to assist smallholder farmers and land-use managers in developing effective adaptation management strategies to the effects of climate change.

Background It is assumed that the health conditions of urban women are superior to their rural counterparts. However, evidence from Asia and Africa, show that poor urban women and their families have worse access to antenatal care and facility childbirth compared to the rural women. The maternal, newborn, and child mortality rates as high as or higher than those in rural areas. In Uganda, maternal and newborn health data reflect similar trend. The aim of the study was to understand factors that influence use of maternal and newborn healthcare in two urban slums of Kampala, Uganda. Methods A qualitative study was conducted in urban slums of Kampala, Uganda and conducted 60 in-depth interviews with women who had given birth in the 12 months prior to data collection and traditional birth attendants, 23 key informant interviews with healthcare providers, coordinator of emergency ambulances/emergency medical technicians and the Kampala Capital City Authority health team, and 15 focus group discussions with partners of women who gave birth 12 months prior to data collection and community leaders. Data were thematically coded and analyzed using NVivo version 10 software. Results The main determinants that influenced access to and use of maternal and newborn health care in the slum communities included knowledge about when to seek care, decision-making power, financial ability, prior experience with the healthcare system, and the quality of care provided. Private facilities were perceived to be of higher quality, however women primarily sought care at public health facilities due to financial constraints. Reports of disrespectful treatment, neglect, and financial bribes by providers were common and linked to negative childbirth experiences. The lack of adequate infrastructure and basic medical equipment and medicine impacted patient experiences and provider ability to deliver quality care. Conclusions Despite availability of healthcare, urban women and their families are burdened by the financial costs of health care. Disrespectful and abusive treatment at hands of healthcare providers is common translating to negative healthcare experiences for women. There is a need to invest in quality of care through financial assistance programs, infrastructure improvements, and higher standards of provider accountability are needed.

BackgroundAdoption of improved agricultural technologies is important for increasing agricultural productivity, household income, food security, and reducing poverty. This paper assessed the impact of adopting improved post-harvest technologies and practices on the dietary diversity of smallholder agricultural households in northern Uganda.MethodsThe study used cross-sectional survey data from 722 smallholder households across nine districts of northern Uganda. These were districts where a donor funded project, Project for the Restoration of Livelihoods in Northern Uganda was implemented. The focus was on post-harvest (harvesting, drying, and storage) technologies and practices promoted under this project. Data was analyzed using descriptive statistics, as well as, inferential statistics. In the case of inferential statistics, binary probit regression analysis was used to assess factors influencing adoption of each technology, while, propensity score matching technique was used to compare household dietary diversity (HDD) of adopters and non-adopters.ResultsResults showed that most farmers decided to harvest at the right maturity, while, the use of tarpaulins was the only adopted drying technology. Less than a quarter of farmers had adopted PICS bags, super gunny bags, and polypropylene bags, as storage facilities. Regression results showed that age, gender, and education level of the household head, household labor, size of land owned, land acreage under crop production, access to credit, use of ox-plough, and access to agricultural markets had significant impact on farmer’s decision to adopt the technologies. Average Treatment Effects on the Treated (ATT) for HDD were positive and significant when households knew how to assess maturity, and also used tarpaulin and PICS bags. These findings indicate that these technologies were associated with increased levels of HDD. On the other hand, ATT was negative and significant for households that harvested at the right time, at the right maturity, used super gunny, and used polypropylene bags for storage.ConclusionsFindings of the study support the existence of a strong relationship between dietary diversity and the adoption of post-harvest technologies and practices. These findings highlight the need for targeted extension services and technology promotion to improve food security through dietary diversity.

Bovine fasciolosis (BF) is a parasitic disease of cattle that causes significant economic impacts to cattle farmers. The physical loses include weight loss, drop in productivity, liver condemnation and mortalities. This study assessed the prevalence, financial losses and risk factors associated with the disease in Lira and Gulu Districts, northern Uganda. A cross‐sectional study of 720 slaughter cattle from the abattoirs was conducted by macroscopic examination of the animals and carcasses during routine slaughter. In the farms, 120 rectal faecal samples were taken to a laboratory for Fasciola egg detection by simple microscopy, while risk factors were assessed by administering a questionnaire to farm owners. Prevalence of BF was highest (38%) within cattle in the age group of 1–3 years and lowest (18%) in those over 5 years. The overall BF prevalence was 48% and 26% by postmortem examination and coprology, respectively. The cattle body condition had a significant association ( p < 0.01) with prevalence of BF, in which emaciated cattle were most affected (59%), while fat ones had the least prevalence (15%). The annual financial loss due to BF infection was USD 89,099. The major risk factors associated with the disease at the farm level were communal grazing in swampy areas (82%) and watering cattle in swamps (71%). Farms where the source of drinking water was swamp water had higher chances ( p < 0.05) of their cattle having BF. An integrated approach using routine deworming programs, improvement of cattle management practices and control of snail intermediate hosts is recommended to effectively control the spread of BF.

This study assessed the factors associated with caregiver’s nutritional knowledge, attitude, and practices (KAP) as well as their implication on the nutritional status of children aged 6–24 months old in Soroti and Amuria districts, eastern Uganda. A cross-sectional research design was applied to collect primary data from 408 caregivers of children between 6 and 24 months. Data was collected using questionnaires and analyzed using descriptive and inferential statistics including regression analysis. Anthropometric approaches were used to assess the nutritional status of the reference child. Results showed that there was a generally low level of knowledge on complementary feeding (CF) among caregivers in this study. There was, however generally good attitude of caregivers towards CF. The findings on practices were mixed with both good practices such as feeding the child with colostrum and bad practices such earlier than recommended introduction of complementary foods. From this study, the average time for introduction of complementary foods was 4.4 months. This was less than the recommended 6 months with only 36% of the children being introduced to complementary feeding at the recommended 6 months. Caregiver’s nutritional knowledge was predicted by child’s sex, mother as caregiver and occupation of household head, while, caregiver’s attitude was predicted by household occupation and farming as source of foods in the case caregiver’s attitude. Results on influence knowledge and attitude on child nutritional status shows that attitude is a significant predictor of stunting and wasting, but not underweight, on the other hand, knowledge was not a significant predictor of child nutritional status. The study recommends the need to improve the level of knowledge of caregivers. This could be by introducing child nutrition education through available sources of information.