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ItemMakerere University assessing factors affecting contraceptive self-injection (SI) uptake among women in Uganda.(Makerere University, 2026)Depot medroxyprogesterone acetate subcutaneous (DMPA-SC) self-injection is a self-care family planning intervention that improves women's autonomy and access to contraception. However, evidence on factors influencing its uptake in Uganda remains limited. This study assessed the predictors of DMPA-SC self-injection uptake among women of reproductive age in Uganda. A cross-sectional analytical study was conducted using secondary data from 243 women who received DMPA-SC self-injection training through a Population Services International Uganda (PSIU) programme between May and June 2023. Descriptive statistics summarized participant characteristics, while Fisher's Exact Test assessed bivariate associations between selected predictors and DMPA-SC self-injection uptake. Variables significant at the bivariate level were included in an adjusted Firth penalized logistic regression model to identify independent predictors of uptake. A bootstrap sensitivity analysis with 5,000 resamples was performed to assess the robustness of the model estimates. Overall, 97.1% of the women adopted DMPA-SC self-injection. At the bivariate level, knowledge, confidence, awareness of side effects, and training/support were significantly associated with uptake. In the adjusted Firth regression model, awareness of side effects was the only independent predictor of uptake (adjusted OR = 104.30, p = 0.002). Bootstrap analysis demonstrated that this association remained stable across repeated resampling, supporting the robustness of the findings. The study concludes that awareness of side effects plays a critical role in promoting DMPASC self-injection uptake among trained women. Strengthening counselling on potential side effects and their management should therefore be prioritized within family planning programmes to promote informed decision-making and improve uptake. Future studies should use larger and more representative samples to validate these findings and assess determinants of continued self-injection use.
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ItemRisky sexual behaviours, coping responses and parent-adolescent communication in South-Central Uganda( 2026)Adolescents in Uganda face multiple vulnerabilities and exposures to risks. Approximately 25% of Ugandan teenagers become pregnant by the age of 19 years. This study explored and examined risky sexual behaviours, coping responses and parent communication among adolescents in South-Central Uganda. This was a mixed-methods study design. Quantitative study utilised secondary data from round 19 of the Rakai Community Cohort Study (RCCS), a longitudinal population-based HIV surveillance cohort. The qualitative study involved focus group discussions, in-depth interviews with adolescents and key informant interviews with parents/caregivers. Chi-square, logistic regression and negative binomial regression models were fitted to determine the risky sexual behaviours among adolescents. Qualitative data analysis adopted an interpretivist thematic content analysis approach to understand adolescent coping responses and adolescent communication. Adolescents aged 18-19 exhibited a significantly higher incidence of risky sexual behaviours compared to those aged 15-17 (aIRR = 2.01, 95% CI: 1.77-2.28). 17 years (aIRR = 2.01, 95% CI: 1.77-2.28). On the other hand, school attendance and being a student were protective factors (aIRR = 0.38, 95% CI: 0.32-0.44), reducing the likelihood of risky sexual engagement. Also, the likelihood of RSB reduces with higher education. Living in a single-mother family structure (aIRR = 1.36, 95% CI: 1.15-1.60), with other relatives (aIRR = 1.34, 95% CI: 1.12-1.60), with non-relatives (aIRR = 1.53, 95% CI: 1.21-1.94), or alone (adolescent-headed) (aIRR = 1.68, 95% CI: 1.34-2.10) were all associated with higher incidence rates compared to living with both biological parents. Parents acknowledged that talking with adolescents could help reduce risky sexual behaviour. Parental talks on sexual matters were usually unplanned and happened when triggered by specific incidents. Evidence from the results suggests that adolescents engage in risky sexual behaviours, including non-marital sexual partnerships, multiple sexual partners, unprotected sex with a non-marital partner, and transactional sex. Parent-adolescent communication on sexual matters is essential/pertinent approach is needed to reduce/avert the associated risks. There is a need for continuous engagement of all different stakeholders involved in adolescent work to have targeted interventions to prevent risky sexual behaviours among young people.
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ItemRisk factors associated with five-year survival among leukemia patients in Uganda: evidence from the Uganda cancer institute.(Makerere University, 2026)This was a retrospective study that investigated the factors associated with the five-year survival rates of leukemia patients in Uganda conducted at Uganda Cancer Institute (UCI) using the available electronic secondary data on leukemia patients at the Centre registry. The study considered data on patients diagnosed with leukemia between 1st January 2014 to 31st December 2015. Survival of the 349 patients up to 2020 was considered. Those alive at the end of 2020 were censored. A Cox Proportional Hazards model was used to model prognostic factors. A total of 349 respondents were analyzed in this study. Majority were males accounting for (57. 6%). The sample was also comprised of individuals belonging to different age groups. Patients aged above 60 years had only 1.33 times greater hazard of dying compared to children aged between 1 to 15 years (HR = 1.33, 95%CI: 1.136, 1.785). Married had 1.89 times greater hazard of dying as compared to the single, while the divorced/separated had 2.68 times higher hazard of dying compared to the single. HIV positive patients had 1.63 times higher hazard of dying than those who were HIV negative. On the stage of diagnosis, patients who were diagnosed at a later stage had 1.63 times greater hazard than those diagnosed at an early stage. Patients who received chemotherapy had about 0.46 times lower hazard of dying, while those who received immunotherapy had 0.02 times less risk of leukemia than those who received radiotherapy. Therefore, the government of Uganda through the Ministry of Health and other stakeholders should focus on more interventions that promote the sensitization of patients on the factors associated with the survival of leukemia patients to overcome the observed disparities in survival of leukemia patients.
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ItemPredictors of physical intimate partner violence against men in Uganda: A generalized structural equation modelling approach.(Makerere University, 2026)Intimate Partner Violence (IPV) against men is a significant but understudied public health issue in sub-Saharan Africa. This study investigates the predictors of physical IPV against men in Uganda by analyzing the complex direct and indirect pathways leading to violence. Using a quantitative cross-sectional design with secondary data from the 2016 Uganda Demographic and Health Survey (UDHS), a final sample of 2,625 ever-married/cohabiting men aged 15-54 was analyzed. Data was analyzed using Generalized Structural Equation Modelling (GSEM) to test mediation hypotheses. The study found prevalence of physical IPV (11.45%), which was directly driven by partner behavioral factors and indirectly by social economic factors. Results revealed that men were significantly more likely to experience physical IPV if their partners exhibited controlling behaviors with less (β=4.35, p=0.047), many (β=1.596, p<0.001) compared to those with no controlling behaviors or used alcohol (β=0.851, p<0.001). Men in polygamous unions were significantly more likely to experience physical IPV (β=0.359, p=0.027). On the other hand, educated men were significantly less likely to experience physical IPV with primary (β=-0.641, p=0.008). Secondary (β=-0.797, p=0.004). higher (β=0.804, p=0.013) compared to men with no education. Men in age group (45-54) were significantly less likely to experience physical IPV (β=-0.487, p=0.049) compared to (15-24) age group. Socioeconomic factors operated largely through indirect pathways. Education exhibited a graded protective effect: compared to men with no education, Primary (β=-0.875, p<0.001), Secondary (β=-0.999, p<0.001) and Higher (β=0.888, p<0.001) men were less likely to experience IPV, mediated by reduced partner alcohol use. Education on the other hand had a positive effect: men with Primary or Secondary education were more likely to experience IPV than those with No education (β=0.780, p=0.004), (β=0.808, p=0.005) respectively mediated by increased number of controlling behaviors. Wealth also showed a positive effect with Rich men being significantly more likely to experience physical IPV than the poor (β=0.306, p=0.027) mediated by many controlling behaviors. Polygamy (2+ wives) also showed a positive effect versus monogamy (β=0.383, p<0.001), with men in polygamous unions being more likely to experience IPV, mediated by partner alcohol use. Physical IPV against men is directly fueled by partner behaviors (control and alcohol use), and socioeconomic status exerts influence directly to a smaller extent and indirectly to a larger extent through these mediators. Interventions must therefore be integrated, focusing on economic empowerment, addressing female partner alcohol abuse, and challenging norms around controlling behaviors. This study provides a critical evidence base for the inclusion of men in IPV discourse and policy in Uganda.
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ItemDetecting tax evaders in Uganda : a comparison of logistic regression and finite mixture of logistic regression(Makerere University, 2023)This paper presents data mining techniques to predict VAT evaders for inclusion in the audit plan. A dataset of 1,311 registered VAT taxpayers in Large Taxpayers’ Office and Medium Taxpayers’ Office for the period FY2017/18 across 11 features was used. An exploratory data analysis was used to establish the hidden patterns in the dataset and backward elimination method was used to identify the significant features for model development. Logistic regression (LR) and finite mixture logistic regression with and without concomitant variable were used to detect VAT evaders. BIC was used to select between the FMLR model with and without concomitant variable. Results of each technique were compared and the best technique was chosen based on accuracy, precision and recall were used to evaluate model performance. Findings of the study showed that number of no sales return, tax office, business sector and number of late payments were identified as significant features in VAT evasion detection. FMLR without concomitant variable had a lower BIC compared to FMLR with concomitant variable and was therefore considered. Model performance evaluation between FMLR without concomitant variable and LR was carried out and FMLR outperformed LR in accuracy, recall and precision. Though LR has been extensively used as a solution to tax evasion problems, the findings of the study suggest that FMLR provide better results compared to LR. The findings of the study can be utilized by URA with emphasis on the four (4) significant variables to detect VAT evaders for inclusion in the Audit plan. URA and future studies may employ other: evader attributes, data mining techniques and model performance evaluation metrics on similar dataset and compare the results.