Browsing by Author "Atekyereza, Peter"

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Descending the sanitation ladder in urban Uganda: evidence from Kampala Slums
(BMC, 2014) Kwiringira, Japheth ; Atekyereza, Peter ; Niwagaba, Charles ; Günther, Isabel
Background: While the sanitation ladder is useful in analysing progressive improvements in sanitation, studies in Uganda have not indicated the sanitation barriers faced by the urban poor. There are various challenges in shared latrine use, cleaning and maintenance. Results from Kampala city indicate that, failure to clean and maintain sanitation infrastructure can lead to a reversal of the potential benefits that come with various sanitation facilities. Methods: A cross sectional qualitative study was conducted between March and May 2013. Data were collected through 18 focus group discussions (FGDs) held separately; one with women, men and youth respectively. We also used pictorial methods; in addition, 16 key informant interviews were conducted. Data were analysed using content thematic approach. Relevant quotations per thematic area were identified and have been used in the presentation of the results. Results: Whether a shared sanitation facility was improved or not, it was abandoned once it was not properly used and cleaned. The problem of using shared latrines began with the lack of proper latrine training when people do not know how to squat on the latrine hole. The constrained access and security concerns, obscure paths that were filthy especially at night, lack of light in the latrine cubicle, raised latrines sometimes up to two metres above the ground, coupled with lack of cleaning and emptying the shared facilities only made a bad situation worse. In this way, open defecation gradually substituted use of the available sanitation facilities. This paper argues that, filthy latrines have the same net effect as crude open defection. Conclusion: Whereas most sanitation campaigns are geared towards provision of improved sanitation infrastructure, these findings show that mere provision of infrastructure (improved or not) without adequate emphasis on proper use, cleaning and maintenance triggers an involuntary descent off the sanitation ladder. Understanding this reversal movement is critical in sustainable sanitation services and should be a concern for all actors.
Gender and cultural aspects of brucellosis transmission and management in Nakasongola cattle corridor in Uganda
(PLoS ONE, 2025-04-24) Kulabako, Christine Tricia; Neema, Stella; Ninsiima,Lesley Rose; Klein, Jörn; Nabawanuka, Lydia Namakula; Muleme, James; Romano, Javier Sánchez; Atekyereza, Peter
Background Brucellosis is a zoonotic disease with significant public health and economic effects on societies. In Uganda, brucellosis is endemic and a primary contributor in livestock productivity losses. This is more worrisome for populations in the cattle corridor with high reliance on cattle and milk for nutritional value and symbol in social relations and identity. The community’s social construction may affect comprehension of brucellosis hence leading to exposure and increased vulnerability to transmission. Despite brucellosis’ high prevalence in the cattle corridor, little attention has been paid to its social construction. Hence, this study explored the interplay between gender dynamics, vulnerability and social construction of brucellosis transmission, in consideration of the unique socio-cultural context that characterizes cattle corridor populations. Methods Using an exploratory qualitative approach, the study was conducted in Nakasongola cattle corridor within three sub counties; Nabiswera, Nakitoma and Wabinyonyi using key informant interviews (KIIs) and focus group discussions (FGDs). Purposive sampling was used to identify participants for the four FGD [8–12] each from a subcounty though one was combined and 15 KIIs. Data were collected using face -to -face interviews with an interview guide that was structured using the Socio Ecological Model of Human Behaviour framework (SEMHB) constructs. Thematic analysis was conducted in NVivo 12 Pro incorporating both deductive (guided by the SEMHB) and inductive approaches (guided by the data). Findings The study identified important themes under each SEMHB influence level (Individual, Interpersonal, Community and Societal level). The study indicates that social composition and role distribution are driven by social and cultural expectations and significantly contribute to exposure and vulnerability to infection in the cattle corridor. For instance, it is paramount that women undergoing marriage preparations to be fed on raw milk for a certain period prior to their ceremony to enhance beauty. Also, important to note that use of personal protection to assist births is viewed by the community as opposing cultural norms, creating a perception of detachment from the highly valued cattle. Another noteworthy finding is the level of knowledge on brucellosis in terms of symptoms, transmission route, prevention and treatment at the interpersonal level. Furthermore, findings show practices such as the consumption of raw milk and assisted births, as being rooted in the social cultural norms, hence critical for transmission of brucellosis. At the community and organizational levels, the findings indicate an inadequate level of knowledge sharing and reluctance towards preventive measures as structural factors for the transmission of brucellosis and are ingrained in family and power relations. Conclusion The findings highlight that the social construction of brucellosis transmission is rooted in gender roles, social- cultural and power structures highlighting the influence of living process and spaces, at the different societal levels. Such complex dynamics play a critical role in determining individuals’ susceptibility to infection as well as transmission potential of the disease-causing agent in cattle keeping communities. The gendered induced vulnerabilities related to the socio-cultural norms and familial roles, also play an important role in the exposure and spill over at the individual, interpersonal and community levels. The insufficient knowledge-sharing and reluctance to adopt preventive measures emerge as structural contributors to the persistence of brucellosis and other emerging zoonoses. These factors, intertwined with family dynamics and power relations, call for targeted interventions that address both individual behaviors and broader socio-cultural and institutional barriers to effective disease management and prevention. Conversely, policies that align with the community’s social construction, gender and context are more likely to be feasible, adopted and sustained by the affected population.
Gender variations in access, choice to use and cleaning of shared latrines; experiences from Kampala Slums, Uganda
(BMC, 2014) Kwiringira, Japheth; Atekyereza, Peter; Niwagaba, Charles; Günther, Isabel
Background: Sanitation is one of the most intimate issues that affect women, especially in slums of developing countries. There are few studies that have paid attention to the gender variations in access, choice to use and cleaning of shared latrines in slums. Methods: This paper draws on qualitative data from a cross sectional study conducted between 2012 and 2013 in six slums of Kampala City, Uganda. The study involved both women and men. Data were collected from 12 Focus Group Discussions (FGDs), 15 Key informant interviews; community transects and photographs of shared latrines. Results: Location of a shared latrine facility, distance, filthy, narrow and irregular paths; the time when a facility is visited (day or night), privacy and steep inclines were gender ‘filters’ to accessing shared latrines. A full latrine pit was more likely to inhibit access to and choice of a facility for women than men. Results indicate that the available coping mechanisms turned out to be gendered, with fewer options available for women than men. On the whole, women sought for privacy, easy reach, self-respect and esteem, cleanliness and privacy than men. While men like women also wanted clean facilities for use; they (men) were not keen on cleaning these facilities. The cleaning of shared latrines was seen by both women and men as a role for women. Conclusion: The presence of sanitation facilities as the first step in the access, choice, use, and cleaning by both women and men has distinct motivations and limitations along gender lines. The study confirms that the use and cleaning of latrines is regulated by gender in daily living. Using a latrine for women was much more than relieving oneself: it involved security, intimacy and health concerns.
Seasonal variations and shared latrine cleaning practices in the slums of Kampala city, Uganda
(BMC, 2016) Kwiringira, Japheth ; Atekyereza, Peter ; Niwagaba, Charles ; Kabumbuli, Robert ; Rwabukwali, Charles ; Kulabako, Robinah ; Günther, Isabel
Background: The effect of seasons on health outcomes is a reflection on the status of public health and the state of development in a given society. Evidence shows that in Sub-Saharan Africa, most infectious diseases flourish during the wet months of the year; while human activities in a context of constrained choices in life exacerbate the effects of seasons on human health. The paper argues that, the wet season and when human activities are at their peak, sanitation is most dire poor slum populations. Methods: A shared latrine cleaning observation was undertaken over a period of 6 months in the slums of Kampala city. Data was collected through facility observations, user group meetings, Focus group discussions and, key informant interviews. The photos of the observed sanitation facilities were taken and assessed for facility cleanliness or dirt. Shared latrine pictures, observations, Focus Group Discussion, community meetings and key informant interviews were analysed and subjected to an analysis over the wet, dry and human activity cycles before a facility was categorised as either ‘dirty’ or ‘clean’. Results: Human activity cycles also referred to as socio-economic seasons were, school days, holidays, weekends and market days. These have been called ‘impure’ seasons, while the ‘pure’ seasons were the wet and dry months: improved and unimproved facilities were negatively affected by the wet seasons and the peak seasons of human activity. Wet seasons were associated with, mud and stagnant water, flooding pits and a repugnant smell from the latrine cubicle which made cleaning difficult. During the dry season, latrines became relatively cleaner than during the wet season. The presence of many child(ren) users during school days as well as the influx of market goers for the roadside weekly markets compromised the cleaning outcomes for these shared sanitation facilities. Conclusion: Shared latrine cleaning in slums is impacted by seasonal variations related to weather conditions and human activity. The wet seasons made the already bad sanitation situation worse. The seasonal fluctuations in the state of shared slum sanitation relate to a wider malaise in the population and an implied capacity deficit among urban authorities. Poor sanitation in slums is part of a broader urban mismanagement conundrum pointing towards the urgent need for multiple interventions aimed at improving the general urban living conditions well beyond sanitation.
The role of culture in influencing sexual and reproductive health of pastoral adolescent girls in Karamoja sub-region in Uganda
(Springer, 2021) Achen, Stella; Atekyereza, Peter; Rwabukwali, Charles B.
Sexual and reproductive health (SRH) is vital for general health. However, problems of SRH such as unwanted pregnancies, sexually transmitted infections (STIs), and complications during pregnancy and childbirth among adolescents frequently arise due to risky sexual behaviour. Often, this challenge is linked to socio-cultural issues associated with sexuality which result in disparities in the SRH of adolescent girls. Culture provides rules of sexual conduct between sexes which shape knowledge, beliefs, and practices regarding the sexuality of adolescent girls and influence SRH. However, empirical evidence remains scarce on the role of culture in shaping sexuality which affects the SRH of adolescent girls of pastoral communities. This paper explores the role of culture in shaping the SRH of adolescent girls in the pastoral communities of Karamoja sub-region in Uganda. Using the ethnographic method, qualitative data from interviews, key informants, and focus groups was obtained from adolescent girls, key informants, and old women in Moroto District to understand the perceptions of sexuality. The authors made audio recordings and took field notes. Atlas.ti 8.4.15 was used to organize the data which was analysed using thematic analysis. The findings showed that the perception of wealth defines sexuality and influences SRH, social support for sexual assault victims promotes SRH, and beliefs and practices of sexuality shape the SRH of adolescent girls. Promoting a continuous awareness of the harmful cultural practices is vital in attaining SRH among pastoral adolescent girls. Understanding the role of culture in the influence of SRH is important for the effective provision of SRH services.