Gideon Rutaremwa

The vulnerability of older adults: wh at do census data say? An application to Uganda

Older adults are generally considered as being among the most vulnerable groups of the population. Yet, being over 55, 60 or 65 years old, does not necessarily mean being vulnerable in any way. Older adults are stakeholders in a social system in which they both receive and give. In Africa, where rapid population growth and economic changes have greatly transformed livelihoods in the past century, the social role of the older population has also undergone substantial change. Even in a context where their power is being eroded, older adults are often involved as providers until very late in life. In a situation where social security for pensioners is almost non-existent, elderly persons who need special care rely exclusively on their children or their social networks. According to their economic or family situation, the capability of older people to withstand difficulties is highly variable. In this context, we define in this paper two components of the vulnerability of older adults based on the structure of the household: structural and relational vulnerabilities. Then, using data from Uganda Population and Housing Censuses of 1991 and 2002, we measure the situations of vulnerability affecting older adults and possible changes that have taken place in this regard over the past two decades in this country. In Uganda older men and women are about equal in numbers. Men are less frequently in situations of vulnerability, however. Logically, the prevalence of vulnerability among older adults increases with age, but has not significantly changed from 1991 to 2002. Structural and relational vulnerability affect women much more frequently than men. Disability is more common among older adults in situations of structural vulnerability than among others, i.e. among older adults who live alone and have children in their care, which questions the capacity of family support systems to care for their members.

Loneliness among older persons in Uganda: examining social, economic and demographic risk factors

ABSTRACT Later-life loneliness is becoming an area of great concern in Uganda in light of gradual weakening of extended family as a source of old-age human support. Although information about the effects of feeling lonely exists, little is known about the associated risk factors within the countrys social and cultural setting. This paper discusses prevalence and correlates of feeling lonely among older persons. An interviewer-administered questionnaire was used to collect data on 605 older persons in a 2012 cross-sectional study. Respondents were asked to evaluate how they felt in terms of loneliness during the administration of the questionnaire. A total of ten focus group discussions and 12 key informant interviews were also conducted to collect qualitative data. Binary logistic regression was used to predict factors affecting loneliness. Findings indicate that approximately seven in ten older persons felt lonely. Elderly people residing in the urban area were more likely to be lonely than their counterparts staying in the rural environment. In comparison with married older persons, elderly people who were widowed were more likely to be lonely. Absence of a television and pension benefits and prevalence of limb joint ill-health predicted loneliness. The findings have several implications, including developing age-friendly urban centres, encouraging old-age social organisations, decentralising the elderly health-care system and establishing a special old-age fund.

Under-five mortality differentials in urban East Africa: A study of three capital cities

Studies have suggested that on average the big cities of East Africa enjoy more favorable living conditions compared to peri-urban and rural areas of this region. The current study aimed at examining under-five mortality differentials in the capital cities of East Africa and to establish whether there are substantial differences in infant and child mortality estimates in Nairobi, Dar-es-Salaam and Kampala. Using data from population and housing censuses of East Africa during the 1990s, the study examines differentials in under-five mortality in Nairobi, Kampala and Dar-es-Salaam. Analyses using a count-data regression model focused on some of the issues relevant in understanding urban differences in under-five mortality in East Africa. The findings suggest substantial variations in under-five mortality risks, with Nairobi experiencing lower infant and child mortality risks than either Kampala or Dar-es-Salaam. The key recommendation made from this study is that programmes aimed at improving the living conditions of urban dwellers should be promoted and that any future studies should focus on the living conditions among the poor urban dwellers and how these conditions interface with the health of the population.

Postpartum family planning utilization in Burundi and Rwanda: a comparative analysis of population based cross-sectional data

Introduction Promotion of modern family planning is a major policy action for Africa to harness the demographic dividend. Family planning is an important public health intervention for maternal and child health. Methods Analysis was based on data from Demographic and Health Surveys conducted in 2010 on samples of women from Burundi (3396) and Rwanda (4670). Descriptive and multivariate logistic regression analyses to examine the contribution and comparison of the various predictors of uptake of modern contraceptives during the postpartum period (PPFP) in the two countries were carried out using STATA statistical software. Results Descriptive findings show only 20% of the samples of women in Burundi used while more than half of the women (51%) were using PPFP. Utilization of PPFP was significantly associated with primary (OR = 1.3, 95% CI = 1.1-1.6) and higher education (OR = 2.2, 95% CI = 1.6-3.1) in Burundi. Similarly in Rwanda increased use of PPFP in primary was (OR = 1.4, 95% CI = 1.2-1.6) while secondary education (OR = 1.6, 95% CI = 1.2-2.1). Protestant women were less likely to use PPFP in both Burundi (OR = 0.75, 95% CI = 0.6-0.9) and Rwanda (OR = 0.69, 95% CI = 0.6-0.8). Other significant variables in the regression models of both countries included wealth status, age of woman, number of living children and exposure to media. Professional birth delivery assistance was significant only in Rwanda. Conclusion Enhancing postpartum contraceptive use should target women with low education, low wealth status, and that the media has an important role to play in this transformation. Policies and programs must be put in place to ensure that the rural urban differences are eradicated.

Old is Gold: What influences Older Persons' Engagement in Income-generating Activities in Uganda?

The paper discusses the engagement of older persons in income-generating activities in Uganda and examines factors that influence this involvement. Analysis is based on primary data collected from four randomly selected districts and one purposefully selected urban area of Uganda. A sample of 605 older males and females is used. Logistic regression is used in the analysis of factors influencing the engagement. Information from Focus Group Discussions and Key Informants is used to supplement the findings of the quantitative results. Findings indicate that relatively younger older persons (60-79) were more likely to be engaged in income-generating activities than their older counterparts (80 and over). In comparison with no education, older persons with primary and higher education were more likely to be engaged in income-generation. The elderly who owned any means of transport and domestic animals were more likely to be engaged in income-generation than those who did not own any transport facility and domestic livestock respectively. The elderly with feet joint ill-health were less likely to be involved in income-generation than their counterparts without such health challenge. The conclusion is that age, education, feet health status and ownership of domestic livestock and transport facility influenced engagement in income-generating activities.