Stephen Ojiambo Wandera

Prevalence and correlates of disability among older Ugandans: evidence from the Uganda National Household Survey

Background Nationally representative evidence on the burden and determinants of disability among older people in sub-Saharan Africa in general, and Uganda in particular, is limited. Objective The aim of this study was to estimate the prevalence and investigate the correlates of disability among older people in Uganda. Design We conducted secondary analysis of data from a sample of 2,382 older persons from the Uganda National Household Survey. Disability was operationalized as either: 1) having a lot of difficulty on any one question; 2) being unable to perform on any one question; or, 3) having some difficulty with two of the six domains. We used frequency distributions for description, chi-square tests for initial associations, and multivariable logistic regressions to assess the associations. Results A third of the older population was disabled. Among all older persons, disability was associated with advancement in age (OR=4.91, 95% CI: 3.38–7.13), rural residence (0.56, 0.37–0.85), living alone (1.56, 1.07–2.27), separated or divorced (1.96, 1.31–2.94) or widowed (1.86, 1.32–2.61) marital status, households’ dependence on remittances (1.48, 1.10–1.98), ill health (2.48, 1.95–3.15), and non-communicable diseases (NCDs) (1.81, 0.80–2.33). Gender was not associated with disability among older persons. Conclusions Disability was associated with advancement in age, rural residence, living alone, divorced/separated/widowed marital status, dependence on remittances, ill health, and NCDs. Interventions to improve health and functioning of older people need to focus on addressing social inequalities and on the early preventive interventions and management of NCDs in old age in Uganda.

Empowerment, partner’s behaviours and intimate partner physical violence among married women in Uganda

BackgroundThere is dearth of knowledge and research about the role of empowerment, partners’ behaviours and intimate partner physical violence (IPPV) among married women in Uganda. This paper examined the influence of women’s empowerment and partners’ behaviours on IPPV among married women in Uganda.MethodsThe 2011 Uganda Demographic and Health Survey data were used, selecting a weighted sample of 1,307 women in union considered for the domestic violence module. Cross tabulations (chi-square tests) and multivariate logistic regressions were used to identify factors associated with IPPV.ResultsThe prevalence of IPPV among women in union in Uganda is still high (41%). Women’s occupation was the only measure of empowerment that was significantly associated with IPPV, where women in professional employment were less likely to experience IPPV. Women from wealthy households were less likely to experience IPPV. IPPV was more likely to be reported by women who had ever had children and witnessed parental IPPV. IPPV was also more likely to be reported by women whose husbands or partners: accused them of unfaithfulness, did not permit them to meet female friends, insisted on knowing their whereabouts and sometimes or often got drunk. Women who were afraid their partners were also more likely to report IPPV.ConclusionIn the Ugandan context, women’s empowerment as assessed by the UDHS has limited mitigating effect on IPPV in the face of partners’ negative behaviours and history of witnessing parental violence.

Prevalence and risk factors for self-reported non-communicable diseases among older Ugandans: a cross-sectional study

Background There is limited evidence about the prevalence and risk factors for non-communicable diseases (NCDs) among older Ugandans. Therefore, this article is aimed at investigating the prevalence of self-reported NCDs and their associated risk factors using a nationally representative sample. Design We conducted a secondary analysis of the 2010 Uganda National Household Survey (UNHS) using a weighted sample of 2,382 older people. Frequency distributions for descriptive statistics and Pearson chi-square tests to identify the association between self-reported NCDs and selected explanatory variables were done. Finally, multivariable complementary log–log regressions to estimate the risk factors for self-reported NCDs among older people in Uganda were done. Results About 2 in 10 (23%) older persons reported at least one NCD [including hypertension (16%), diabetes (3%), and heart disease (9%)]. Among all older people, reporting NCDs was higher among those aged 60–69 and 70–79; Muslims; and Pentecostals and Seventh Day Adventists (SDAs). In addition, the likelihood of reporting NCDs was higher among older persons who depended on remittances and earned wages; owned a bicycle; were sick in the last 30 days; were disabled; and were women. Conversely, the odds of reporting NCDs were lower for those who were relatives of household heads and were poor. Conclusions In Uganda, self-reported NCDs were associated with advanced age, being a woman, having a disability, ill health in the past 30 days, being rich, depended on remittances and earning wages, being Muslim, Pentecostal and SDAs, and household headship. The Ministry of Health should prevent and manage NCDs by creating awareness in the public and improving the supply of essential drugs for these health conditions. Finally, there is a need for specialised surveillance studies of older people to monitor the trends and patterns of NCDs over time.

Factors associated with self-reported ill health among older Ugandans: a cross sectional study.

Highlights • We estimate the prevalence of self-reported ill health among older people in Uganda.• Cross sectional national survey data of 2382 older persons is used.• Most (62%) older Ugandans reported ill health.• The women, oldest old, household heads, Catholics reported poorer health.• Those with non-communicable diseases (NCDs) and disability reported poor health.

Partners’ controlling behaviors and intimate partner sexual violence among married women in Uganda

BackgroundStudies on the association between partners’ controlling behaviors and intimate partner sexual violence (IPSV) in Uganda are limited. The aim of this paper was to investigate the association between IPSV and partners’ controlling behaviors among married women in Uganda.MethodsWe used the 2011 Uganda Demographic and Health Survey (UDHS) data, and selected a weighted sample of 1,307 women who were in a union, out of those considered for the domestic violence module. We used chi-squared tests and multivariable logistic regressions to investigate the factors associated with IPSV, including partners’ controlling behaviors.ResultsMore than a quarter (27%) of women who were in a union in Uganda reported IPSV. The odds of reporting IPSV were higher among women whose partners were jealous if they talked with other men (OR = 1.81; 95% CI: 1.22-2.68), if their partners accused them of unfaithfulness (OR = 1.50; 95% CI: 1.03-2.19) and if their partners did not permit them to meet with female friends (OR = 1.63; 95% CI: 1.11-2.39). The odds of IPSV were also higher among women whose partners tried to limit contact with their family (OR = 1.73; 95% CI: 1.11-2.67) and often got drunk (OR = 1.80; 95% CI: 1.15-2.81). Finally, women who were sometimes or often afraid of their partners (OR = 1.78; 95% CI: 1.21-2.60 and OR = 1.56; 95% CI: 1.04-2.40 respectively) were more likely to report IPSV.ConclusionIn Uganda, women’s socio-economic and demographic background and empowerment had no mitigating effect on IPSV in the face of their partners’ dysfunctional behaviors. Interventions addressing IPSV should place more emphasis on reducing partners’ controlling behaviors and the prevention of problem drinking.

UN Census "Households" and Local Interpretations in Africa Since Independence

Since the 1950s, the UN Statistical Division has encouraged nations to standardize the definitions used in data collection. A key concept in censuses and surveys is the household: This is the unit for which information is collected and analyzed, and is thus an important dimension of data that are the basis for many policies. We aim to understand the tensions between conformity with UN guidelines and national priorities. We analyze the documentation around the UN household definition over this period. Using detailed census and survey documentary data for several African countries, especially Burkina Faso, Senegal, Uganda, and Tanzania, we examine the disparities between national census definitions of “household” and the UN definition. Perspectives from interviews with key informants within national statistical offices demonstrate the variability in the importance accorded to the UN harmonization aims and the problems that arise when these standardized approaches interact with local norms and living arrangements.

Spousal sexual violence, sexual behavior and sexually transmitted infections among ever-married women in Uganda

Despite the increasing recognition of the significance of spousal sexual violence in developing countries, evidence on its consequences for reproductive health remains limited. The aim of the paper was to examine the relationship between spousal sexual violence (SSV) and sexually transmitted infections (STIs) using a sample of 1749 ever-married women, from the 2006 Uganda Demographic and Health Survey. Pearson Chi-square tests and binary logistic regressions were used to investigate associations between SSV, STIs and selected reproductive health outcomes. From the analyses, 25% and 15% of ever-married women experienced SSV and reported STIs, respectively in the last 12 months. Women who experienced SSV were twice more likely to have had STIs in the last 12 months compared to those who did not. SSV is an important social and public health problem having implications on womens reproductive health and interventions to improve it should directly address the issue of spousal sexual violence.

Understanding the vulnerability of older adults: extent of and breaches in support systems in Uganda

ABSTRACT Older adults’ vulnerability and resilience are a result of processes constructed throughout the lifecycle. In Uganda, older people almost always rely exclusively on their social networks for care and economic support when in need. These support systems are mainly family based, and play a role of safety net for their older members. However, localised in-depth studies have pointed out the limitations of family-based support systems, especially in the context of the HIV/AIDS epidemic. This paper uses 83 in-depth interviews conducted in various settings across Uganda with older people and their family members on the subject of their support systems. Over and above the lack of immediate/personal resources characterising most older people, our results highlight the importance of the extent of support systems and resource diversity. Most of the people in our case studies had lost descendants due to the civil war, the HIV/AIDS epidemic, or simply family break-ups, events which often create large breaches and gaps in support systems. Few older people can be resilient in this situation, primarily because there are often not enough resources available in their support networks to cover the needs of all, especially education for the young and health-care access for the old.

Independent and combined effects of maternal smoking and solid fuel on infant and child mortality in sub-Saharan Africa.

To estimate the independent and combined risks of infant and child mortality associated with maternal smoking and use of solid fuel in sub‐Saharan Africa.

Intimate partner violence and current modern contraceptive use among married women in Uganda: a cross-sectional study

Introduction This paper examined the relationship between Intimate Partner Violence (IPV) and current modern contraceptive use (MCU) among married women in Uganda. Methods We used the 2011 Uganda Demographic and Health Survey (UDHS) data, selecting a weighted sample of 1,307 married women from the domestic violence module. Chi-squared tests and multivariate complementary log-log (clog-log) regressions were used to examine the relationship between IPV and current MCU, controlling for womens socio-demographic factors. Results Significant predictors of current MCU (25.3%) among married women were: womens reported ability to ask a partner to use a condom, number of living children and wealth index. The odds of current MCU were higher among women who could ask their partners to use a condom (aOR = 1.87, 95% CI: 1.26-2.78), had more than one child (aOR = 2.05, 95% CI: 1.07,3.93) and were from better wealth indices for example the richest (aOR = 2.52, 95% CI: 1.25-5.08). IPV was not associated with current MCU independently and after adjusting for womens socio-demographic factors. Conclusion In Ugandas context, IPV was not associated with current MCU. Interventions to promote MCU should enhance womens capacity to negotiate MCU within union and target women of lower socio-economic status.