Research Articles

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A prolonged, community-wide cholera outbreak associated with drinking water contaminated by sewage in Kasese District, western Uganda
(BMC, 2018) Kwesiga, Benon; Pande, Gerald; Ario, Alex Riolexus; Tumwesigye, Nazarius Mbona; Matovu, Joseph K. B.; Zhu, Bao-Ping
Background: In May 2015, a cholera outbreak that had lasted 3 months and infected over 100 people was reported in Kasese District, Uganda, where multiple cholera outbreaks had occurred previously. We conducted an investigation to identify the mode of transmission to guide control measures. Methods: We defined a suspected case as onset of acute watery diarrhoea from 1 February 2015 onwards in a Kasese resident. A confirmed case was a suspected case with Vibrio cholerae O1 El Tor, serotype Inaba cultured from a stool sample. We reviewed medical records to find cases. We conducted a case-control study to compare exposures among confirmed case-persons and asymptomatic controls, matched by village and age-group. We conducted environmental assessments. We tested water samples from the most affected area for total coliforms using the Most Probable Number (MPN) method. Results: We identified 183 suspected cases including 61 confirmed cases of Vibrio cholerae 01; serotype Inaba, with onset between February and July 2015. 2 case-persons died of cholera. The outbreak occurred in 80 villages and affected all age groups; the highest attack rate occurred in the 5–14 year age group (4.1/10,000). The outbreak started in Bwera Sub-County bordering the Democratic Republic of Congo and spread eastward through sustained community transmission. The first case-persons were involved in cross-border trading. The case-control study, which involved 49 confirmed cases and 201 controls, showed that 94% (46/49) of case-persons compared with 79% (160/201) of control-persons drank water without boiling or treatment (ORM-H=4.8, 95% CI: 1.3–18). Water collected from the two main sources, i.e., public pipes (consumed by 39% of case-persons and 38% of control-persons) or streams (consumed by 29% of case-persons and 24% control-persons) had high coliform counts, a marker of faecal contamination. Environmental assessment revealed evidence of open defecation along the streams. No food items were significantly associated with illness. Conclusions: This prolonged, community-wide cholera outbreak was associated with drinking water contaminated by faecal matter and cross-border trading. We recommended rigorous disposal of patients’ faeces, chlorination of piped water, and boiling or treatment of drinking water. The outbreak stopped 6 weeks after these recommendations were implemented.
Academic Collaboration in Africa and Asia: Current Status, Challenges, and Emerging Trends and Strategies
(International Journal of African Higher Education, 2022) El Allame, Yamina El Kirat; Dunrong, Bie; Anas, Hajar; Jie, Ma; Amutuhaire, Tibelius; Yifan, Huang; Elghazali, Oumaima; Jingran, Yu
South-South cooperation has garnered much attention in recent times among states, policymakers, and academics and its scope is growing to encompass economic cooperation and health, education, research, and development initiatives. This article examines the current status of academic partnerships between institutions in Asia and Africa, the challenges confronting them, and the emerging trends and strategies. Practical examples are provided to showcase the current practices and challenges in each region. The article also highlights academic cooperation experiences during the COVID-19 pandemic and identifies the emerging trends and challenges in academic collaboration in Asia and Africa in the post-pandemic era. It proposes strategies for future NorthSouth, North-South-South, and South-South academic collaboration. During the pandemic, academic cooperation in teaching, learning, and research across borders has demonstrated resilience and sustainability. Increased opportunities for collaboration within, between, and beyond Asia and Africa are being provided by technology-enhanced collaborative modes. However, the digital divide within and across the two continents will impact the future modalities of academic collaboration.
Alcohol Consumption among HIV-Infected Persons in a Large Urban HIV Clinic in Kampala Uganda: A Constellation of Harmful Behaviors
(PLoS ONE, 2015) Wandera, Bonnie; Tumwesigye, Nazarius Mbona; Nankabirwa, Joaniter Immaculate; Kambugu, Andrew Ddungu; Parkes-Ratanshi, Rosalind; Mafigiri, David Kaawa; Kapiga, Saidi; Sethi, Ajay K.
Introduction Alcohol use by persons living with HIV/AIDS (PLWHA) negatively impacts the public health benefits of antiretroviral therapy (ART). Using a standardized alcohol assessment tool, we estimate the prevalence of alcohol use, identify associated factors, and test the association of alcohol misuse with sexual risk behaviors among PLWHA in Uganda. Methods A cross-section of PLWHA in Kampala were interviewed regarding their sexual behavior and self-reported alcohol consumption in the previous 6 months. Alcohol use was assessed using the alcohol use disorders identification test (AUDIT). Gender-stratified log binomial regression analyses were used to identify independent factors associated with alcohol misuse and to test whether alcohol misuse was associated with risky sexual behaviors. Results Of the 725 subjects enrolled, 235 (33%) reported any alcohol use and 135 (18.6%) reported alcohol misuse, while 38 (5.2%) drank hazardous levels of alcohol. Alcohol misuse was more likely among subjects not yet on ART (adjusted prevalence ratio [aPR] was 1.65 p=0.043 for males and 1.79, p=0.019 for females) and those with self-reported poor adherence (aPR for males=1.56, p=0.052, and for females=1.93, p=0.0189). Belonging to Pentecostal or Muslim religious denominations was protective against alcohol misuse compared to belonging to Anglican and Catholic denominations in both sexes (aPR=0.11 for men, p<0.001, and aPR=0.32 for women, p=0.003). Alcohol misuse was independently associated with reporting risky sexual behaviors (aPR=1.67; 95% CI: 1.07–2.60, p=0.023) among males, but not significant among females (aPR=1.29; 95% CI: 0.95–1.74, p=0.098). Nondisclosure of HIV positive status to sexual partner was significantly associated with risky sex in both males (aPR=1.69; p=0.014) and females (aPR 2.45; p<0.001). Conclusion Alcohol use among PLWHA was high, and was associated with self-reported medication non-adherence, non-disclosure of HIV positive status to sexual partner(s), and risky sexual behaviors among male subjects. Interventions targeting alcohol use and the associated negative behaviors should be tested in this setting.
AMNESTY AS A PANACEA TO CONFLICT: AN ASSESSMENT OF THE CONTRIBUTION OF AMNESTY TO CONFLICT RESOLUTION AND SUSTAINABLE PEACE IN UGANDA
(International Journal of Scientific and Research Publications Year of Publishing: 2019, 2019) MURAMUZI, Innocent; MAWA, Michael; Ngabirano, Maximiano
This paper addresses the inherent powerful nature of Amnesty in ending intractable conflicts. Ceteris paribus, cessation of conflict was expected once the amnesty Act was promulgated. However, since the promulgation of the Amnesty Act (2000), there are insurgents still at large that have not taken advantage of the Amnesty Act.
Awareness of pubertal body changes among primary school children aged 10– 14 years in Eastern Uganda; challenges and opportunities
(BMC, 2022) Bunoti, Sarah Nantono; Tumwesigye, Nazarius Mbona; Atuyambe, Lynn
Background: Globally, programs that educate young people about pubertal body changes are vital. In some communities, teaching sexual education in schools has been the subject of debate. This is probably why access to sexual and reproductive health information and resources is still a challenge to children aged 10–14 years. Methods: We conducted a qualitative study design among school children aged 10–14 years. Data were collected from 19 focus group discussions (FGDs) in 16 primary schools purposively selected from Eastern Uganda. Data were transcribed, coded and thematically analysed. Results: We established that girls in rural schools were aware of their body changes than those from urban schools. Boys in urban schools were knowledgeable of pubertal body changes than those from rural schools. We further found that girls experienced pubertal-related challenges amongst themselves and boys including lack of shavers, pain while shaving, rape, bad boy–girl relationships, unwanted early pregnancies, limited funds to buy pads, menstrual pain, etc. Boys too indicated that they experienced similar challenges and these included lack of shavers, pain during and after shaving, changes in height, raping of girls, bad boy–girl relationships, peer pressure, HIV and other STIs, limited infrastructure, voice changes, bad body odour etc. Girls and boys endeavoured to overcome pubertal-related challenges by utilising advise from teachers, parents and friends. Conclusion: Boys and girls who were knowledgeable about puberty body changes possessed opportunities that enable them to cope with pubertal-related challenges.
Cultures at Crossroads: Culturally Induced Body Marks in the Regime of Universal Human Rights in Eastern Uganda
(International Journal of Research in Sociology and Anthropology (IJRSA), 2026) Barigye, Godfrey; Ngabirano, Maximiano; Tino, Jennifer Opio
This study, "Cultures at Crossroads: Culturally Induced Body Marks in the Regime of Universal Human Rights in Eastern Uganda," explores the role of traditional body markings in the social and cultural identities of the Bamasaba, Sabiny, and Pokot communities in Eastern Uganda. These groups, each with distinct body marking practices such as male and female circumcision, use these rites to signal important cultural transitions and maintain communal cohesion. Drawing on two studies conducted in 2019 and 2024, the research examines how these practices are perceived in light of global human rights discourses, which often challenge traditional cultural practices in favor of universal rights standards. The study highlights the tension between traditional cultural practices and the universal human rights framework, especially in relation to gender and bodily integrity. In particular, female circumcision practices among the Sabiny and Pokot face significant opposition from human rights advocates, while male circumcision, often viewed through a medical lens as a means to prevent HIV, continues to be practiced as a rite of passage among the Bamasaba. This research further considers how body markings are intertwined with gender roles, social status, and the negotiation of identity within both local and global contexts. By examining the intersection of body, society, and cultural traditions, the study argues that these practices serve not only as cultural markers but also as sites for resistance and negotiation, where traditional communities strive to balance cultural preservation with the demands of modernity and human rights. The research concludes by calling for a more nuanced understanding of cultural practices within the human rights discourse, emphasizing the need for cultural sensitivity and the recognition of the meanings that these practices hold within the communities that continue to uphold them.
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.
Early alcohol use and problem drinking among students in Zambia and Uganda
(Journal of Public Health in Africa 2011, 2011-04) Swahn, Monica H.; Ali, Bina; Palmier, Jane; Tumwesigye, Nazarius Mbona; Sikazwe, George; Twa-Twa, Jeremiahs; Kasirye Rogers
Excessive alcohol use is a serious public health concern worldwide, but less attention has been given to the prevalence, risk and protective factors, and consequences of early alcohol use in low-income, developing countries. The purpose of this study was to determine the associations between early alcohol use, before age 13, and problem drinking among adolescents in Uganda and Zambia. Data from students in Zambia (n=2257; 2004) and Uganda (n=3215; 2003) were obtained from the crosssectional Global School-Based Student Health Survey (GSHS). The self-administered questionnaires were completed by students primarily 13 to 16 years of age. Multiple statistical models were computed using logistic regression analyses to test the associations between early alcohol initiation and problem drinking, while controlling for possible confounding factors (e.g., current alcohol use, bullying victimization, sadness, lack of friends, missing school, lack of parental monitoring, and drug use). Results show that early alcohol initiation was associated with problem drinking in both Zambia (AOR=1.28; 95% CI:1.02-1.61) and Uganda (AOR=1.48; 95% CI: 1.11-1.98) among youth after controlling for demographic characteristics, risky behaviors, and other possible confounders. The study shows that there is a significant association between alcohol initiation before 13 years of age and problem drinking among youth in these two countries. These findings underscore the need for interventions and strict alcohol controls as an important policy strategy for reducing alcohol use and its dire consequences among vulnerable youth.
Efficacy of a Single, Brief Alcohol Reduction Intervention among Men and Women Living with HIV/AIDS and Using Alcohol in Kampala, Uganda: A Randomized Trial
(SAGE, 2017) Wandera, Bonnie; Tumwesigye, Nazarius Mbona; Nankabirwa, Joaniter Immaculate; Mafigiri, David Kaawa; Parkes-Ratanshi, Rosalind M.; Kapiga, Saidi; Hahn, Judith; Sethi, Ajay K.
We evaluated the efficacy of a brief motivational intervention (MI) counseling in reducing alcohol consumption among persons living with HIV/AIDS in Kampala, Uganda. Persons living with HIV/AIDS with Alcohol Use Disorders Identification Tool (AUDIT) score 3 points were randomized to either standardized positive prevention counseling alone or in combination with alcohol brief MI counseling. The mean change in AUDIT-C scores over 6 months was compared by treatment arm. The mean (standard deviation [SD]) AUDIT-C scores were 6.3 (2.3) and 6.8 (2.3) for control and MI arms (P ¼ .1) at baseline, respectively, and change in mean AUDIT-C score was not statistically different between arms over the 6 months (P ¼ .8). However, there was a statistically significant decrease in mean AUDIT-C score ( 1.10; 95% confidence interval: 2.19 to 0.02, P ¼ .046) among women in the MI arm. There was a nondifferential reduction in alcohol consumption overall, but MI appeared effective among women only. Studies with more than 1 counseling session and evaluation of gender differences in treatment response are needed.
Ethnic Identity and Militarism Historical realities shaping Conflicts in South Sudan
(Uganda Martyrs University, 2014) Ngabirano, Maximiano
Financing Higher Education: Who Pays, Who Benefits, and Who Should Pay for University Education in Uganda
(EAST AFRICAN NATURE & SCIENCE ORGANIZATION, 2022) Amutuhaire, Tibelius
This paper analyses the existing modes of financing a university education in Uganda. Different parties, including the state, the student (household), donors, and the institution itself, are financing university education in Uganda. However, students are the primary source of funds for university education. Over the years, the fees charged to university students have been increasing to the extent that they are now becoming unaffordable to many students considering the current average annual household income. While the government is involved in funding university education, the level of involvement is unsatisfactory besides being discriminative. The existing government sponsorship scheme indirectly favours students from affluent families and denies access to poor students. The existing loan scheme focuses only on STEM courses and ignores students whose potentials are in the arts sector. However, in doing all this, the state uses taxpayers' money. Indirectly, poor households finance the education of students from affluent families while students from low-income families must struggle on their own. Therefore, it is submitted in this paper that the existing funding mechanism for university education in Uganda should be revisited and made fair, sustainable, and inclusive. The paper reviews literature relevant to the topic by adopting a general literature review methodology. It highlights the involvement of different partners that finance university education in Uganda and the benefits of university education. The paper submits that a better funding model for university education should involve the student, the university, and the state should take the leading role.
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.
Genital infections and risk of premature rupture of membranes in Mulago Hospital, Uganda: a case control study
(BMC, 2015) Nakubulwa , Sarah; Kaye, Dan K.; Bwanga, Freddie; Tumwesigye, Nazarius Mbona; Mirembe, Florence M.
Background: Inflammatory mediators that weaken and cause membrane rupture are released during the course of genital infections among pregnant women. We set out to determine the association of common genital infections (Trichomonas vaginalis, syphilis, Neisseria gonorrhea, Chlamydia trachomatis, Group B Streptococcus, Bacterial vaginosis, Herpes Simplex Virus Type 2 and candidiasis) and premature rupture of membranes in Mulago hospital, Uganda. Methods: We conducted an unmatched case–control study among women who were in the third trimester of pregnancy at New Mulago hospital, Uganda. The cases had PROM and the controls had intact membranes during latent phase of labour in the labour ward. We used interviewer-administered questionnaires to collect data on sociodemographic characteristics, obstetric and medical history. Laboratory tests were conducted to identify T. vaginalis, syphilis, N. gonorrhea, C. trachomatis, Group B Streptococcus, Bacterial vaginosis, Herpes Simplex Virus Type 2 (HSV-2) and candidiasis. Logistic regression models were used to estimate the odds ratios (OR) and 95 % CI of the association between genital infections and PROM. Results: There was an association between PROM and abnormal vaginal discharge (OR = 2.02, 95 % CI 1.10–3.70 and AOR = 2.30, 95 % CI 1.18–4.47), presence of candidiasis (OR = 0.27, 95 % CI 0.14–0.52 and AOR = 0.22, 95 % CI 0.10–0.46) and T. vaginalis (OR = 2.98, 95 % CI 1.18–7.56 and AOR = 4.22, 95 % CI 1.51–11.80). However, there was no association between PROM and presence of C. trachomatis (OR = 2.05, 95 % CI 0.37–11.49) and HSV-2 serostatus (OR = 1.15, 95 % CI 0.63–2.09). Few or no patients with Bacterial vaginosis, Neisseria gonorrhoea, Group B streptococcus or syphilis were identified among the cases and controls. Co-infection of Trichomoniasis and candidiasis was not associated with PROM (AOR = 1.34, 95 % CI 0.16–11.10). Co infection with T. vaginalis and C. trachomatis was associated with PROM (OR = 3.09, 95 % CI 1.21–7.84 and AOR = 4.22, 95 % CI 1.51–11.83). Conclusion: Trichomonas vaginalis alone, T. vaginalis with C. trachomatis co-infection and abnormal per vaginal discharge were found as risk factors for PROM. There was no association of HSV-2 serostatus, syphilis, N. gonorrhea, C. trachomatis, Group B Streptococcus and Bacterial vaginosis with PROM. Candidiasis seemed to have a protective effect on PROM.
Higher education and social responsibility: a proposal for internationalization of university—community engagements; perspectives from Uganda
(BMC, 2023) Amutuhaire, Tibelius
One of the traditional missions for universities was community service which was updated to entail community engagement. Community engagement is a component of the internationalization of higher education which aspires to improve service delivery within society. Though universities in Uganda have always engaged with communities, they have always done so disregarding the international dimension of higher education. Simultaneously, contemporary approaches to internationalization are primarily concerned with scholarly debate and discussion of societal challenges. However, merging internationalization with community engagement would better serve local and global communities. This is now more relevant considering global challenges such as COVID-19, terrorism, and climate change. Universities should now work more closely with communities to enrich scholarship, contribute to public good aims, and address the current critical social issues. Therefore, university–community engagement should go beyond institutional and disciplinary boundaries that restrict possibilities for fruitful engagement with local and global communities in today’s rapidly changing world. This paper explores the international dimension of community engagement in Uganda’s universities. Using a narrative literature review, the paper highlights how to merge internationalization with community engagement without reproducing inequalities but emphasizing fairness and social justice. The paper holds that community engagement should be integrated into the broader internationalization agenda of universities for better service delivery.
Higher Education Systems and International Student Mobility in East Africa
(International Journal of African Higher Education, 2025) Amutuhaire, Tibelius
The internationalization of higher education (IHE) — especially through international student mobility (ISM) — has been widely studied, but most of this scholarship draws on evidence and perspectives from the global North. As a result, research on IHE often overlooks the specifc historical, political, and socioeconomic contexts that shape student mobility within Africa. This paper employs a mixed-methods approach to investigate how students’ perceptions of the quality, governance, and reputation of HE systems in both their home and host countries inﬂuence patterns of intra-Africa student mobility, drawing on evidence from East Africa. The fndings suggest that the movement of students within the region is shaped not only by practical considerations, but also by colonial legacies, each country’s history of hosting international students, and the impact of neoliberal reforms in HE. By situating student mobility within these broader structural and historical contexts, this study contributes to a more nuanced understanding of how HE systems shape mobility within Africa and adds to the growing body of critical scholarship on internationalization. Ultimately, this work points to the need for more regionally grounded research on student mobility across the global South.
IMPROVING ACCESS AND EQUITY IN EAST AFRICAN HIGHER EDUCATION THROUGH INTERNATIONALIZATION
(Forum for International Research in Education, 2023) Amutuhaire, Tibelius
The 1998 UNESCO World Conference on Higher Education in Paris recommended that global higher education institutions should internationalize and reduce inequalities between developed and emerging countries. Since then, universities strive to incorporate an international dimension in their service. The aim was initially guided by the 20th century understanding of internationalization being just, fair, and an equitable process that promotes peace and mutual understanding. However, under the influence of the General Agreement on Trade in Services and competition, internationalization changed focus and became less inclusive. This paper explores inclusive international education in East Africa using narrative review methodology. Findings suggest that rather than promoting access and equity in higher education, internationalization, for example, excludes economically disadvantaged, disabled, and adult learners. Thus, in addition to internationalization at home, inclusive internationalization abroad strategies should be devised. Internationalization of higher education is more valuable if it translates into fair, just, and peaceful social systems.
Influence of pregnancy perceptions on patterns of seeking antenatal care among women in reproductive age of Masaka District, Uganda
(Tanzania Journal of Health Research, 2014-10) ATEKYEREZA, PETER R.; MUBIRU, KENNETH
Maternal mortality remains a challenge in Sub-Saharan Africa including Uganda. Antenatal Care (ANC) is one of the recommended measures to improve maternal and child health. However, the influence of pregnancy definition and perception on patterns of seeking regular and timely antenatal care among women in the reproductive age group (15-49 years) is not known. The objectives of this study were to: (i) understand the women’s social definitions and perceptions on their pregnancy; (ii) understand the sociocultural beliefs related to pregnancy among women of the reproductive age group; and, (iii) examine the influence of social definitions, perceptions and beliefs about pregnancy on women’s antenatal care seeking behaviour patterns to inform the decentralised health care delivery system in Uganda. A total of 45 women, mothers and expectant women who were purposively selected from Kimanya sub county of Masaka district in Uganda participated in the study. Ten key informant interviews and four Focus Group Discussions (FGDs) were also conducted. Key findings indicate that the women’s socio-definitions and perceptions of pregnancy influence their seeking behaviour on antenatal health care. To the women with a positive orientation towards antenatal care, pregnancy provides joy, happiness, pride, promotes their social status and safe-guards their marriage. Pregnancy is rewarding with care, love, support and gifts. Women who shun antenatal care perceive pregnancy to be a source of misery, sadness, pain and suffering. It is an uncomfortable and regrettable experience. Women also hold socio-cultural beliefs on pregnancy, which are culturally constructed and rooted in taboos, rituals and practices of their communities. It is therefore important to sensitise women and those who attend to them when they are pregnant to understand these perceptions and definitions to motivate them to seek antenatal and postnatal care for better maternal and child health.
Intra-Africa Student Mobility and Social Class Reproduction: Implications for Equity and Inclusivity
(SAGE, 2025) Amutuhaire, Tibelius
Abstract International Student Mobility (ISM) is the most popular activity in the internationalization of higher education, and it has grown over the years in terms of numbers and study destinations. This study examines intra-African student mobility using evidence from East Africa and theoretical orientations of critical internationalization, which holds that internationalization thrives on and propagates inequalities between individuals and social systems. The study investigated the extent to which intra-African ISM reproduces social inequalities using data collected through mixed methods and analyzed using SPSS and thematic analysis. The study shows that international students in Uganda are mainly from the East African region and are from the wealthiest families. The findings further indicate that these students and their households seek to reproduce their social status by participating in ISM. However, expanding mobility opportunities in favor of students from lower social classes would make internationalization more equitable and inclusive.
Intra-Africa Student Mobility from a Critical Perspective
(Critical Internationalization Studies Review, 2025) Amutuhaire, Tibelius

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