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2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonard Kibirige ◽  
Jonathan Izudi ◽  
Stephen Okoboi

Abstract Introduction Discontinuation of tuberculosis treatment (DTT) among children in sub-Saharan Africa is a major obstacle to effective tuberculosis (TB) control and has the potential to worsen the emergence of multi-drug resistant TB and death. DTT in children is understudied in Uganda. We examined the level and factors associated with DTT among children at four large health facilities in Kampala Capital City Authority and documented the reasons for DTT from treatment supporters and healthcare provider perspectives. Methods We conducted a retrospective analysis of records for children < 15 years diagnosed and treated for TB between January 2018 and December 2019. We held focus group discussions with treatment supporters and key informant interviews with healthcare providers. We defined DTT as the stoppage of TB treatment for 30 or more consecutive days. We used a stepwise generalized linear model to assess factors independently associated with DTT and content analysis for the qualitative data reported using sub-themes. Results Of 312 participants enrolled, 35 (11.2%) had discontinued TB treatment. The reasons for DTT included lack of privacy at healthcare facilities for children with TB and their treatment supporters, the disappearance of TB symptoms following treatment initiation, poor implementation of the community-based directly observed therapy short-course (CB-DOTS) strategy, insufficient funding to the TB program, and frequent stock-outs of TB drugs. DTT was more likely during the continuation phase of TB treatment compared to the intensive phase (Adjusted odds ratio (aOR), 5.22; 95% Confidence Interval (CI), 1.76–17.52) and when the treatment supporter was employed compared to when the treatment supporter was unemployed (aOR, 3.60; 95% CI, 1.34–11.38). Conclusion Many children with TB discontinue TB treatment and this might exacerbate TB morbidity and mortality. To mitigate DTT, healthcare providers should ensure children with TB and their treatment supporters are accorded privacy during service provision and provide more information about TB symptom resolution and treatment duration versus the need to complete treatment. The district and national TB control programs should address gaps in funding to TB care, the supply of TB drugs, and the implementation of the CB-DOTS strategy.


2021 ◽  
Author(s):  
Leonard Kibirige ◽  
Jonathan Izudi ◽  
Stephen Okoboi

Abstract Introduction: Discontinuation of tuberculosis treatment (DTT) among children in sub-Saharan Africa is a major obstacle to effective tuberculosis (TB) control and has the potential to worsen the emergence of multi-drug resistant TB and death. DTT in children is understudied in Uganda. We examined the level and factors associated with DTT among children at four large health facilities in Kampala Capital City Authority and documented the reasons for DTT from treatment supporters and healthcare provider perspectives. Methods: We conducted a retrospective cohort analysis of records for children <15 years diagnosed and treated for TB between January 2018 and December 2019. We held focus group discussions with treatment supporters and key informant interviews with healthcare providers. We defined DTT as the stoppage of TB treatment for 30 or more consecutive days. We used a stepwise generalized linear model to assess factors independently associated with DTT and content analysis for the qualitative data reported using sub-themes. Results: Of 312 participants enrolled, 35 (11.2%) had discontinued TB treatment. The reasons for DTT included lack of privacy at healthcare facilities for children with TB and their treatment supporters, the disappearance of TB symptoms following treatment initiation, poor implementation of the community-based directly observed therapy short-course (CB-DOTS) strategy, insufficient funding to the TB program, and frequent stock-outs of TB drugs. DTT was more likely during the continuation phase of TB treatment compared to the intensive phase (Adjusted odds ratio (aOR), 5.22; 95% Confidence Interval (CI), 1.76-17.52) and when the treatment supporter was employed compared to when the treatment supporter was unemployed (aOR, 3.60; 95% CI, 1.34-11.38). Conclusion: Many children with TB discontinue TB treatment and this might exacerbate TB morbidity and mortality. Treatment supporters of children with TB should be provided with detailed and consistent health education messages about TB treatment duration, the benefits of treatment completion, and risks of treatment discontinuation. The district and national TB control programs should address gaps in funding to TB care and the supply of TB drugs.


2021 ◽  
Vol 3 (1) ◽  
pp. 1-7
Author(s):  
Stephen Mukiibi ◽  
Jennifer Nalubwama Machyo

This paper discusses house transformation by owners in Kampala, the capital city of Uganda, examining the reasons for the phenomenon and highlighting its nature, opportunities it offers and what be done to formalise it and take advantage of some of these opportunities for the benefit of the community. The main objective of the study was to investigate the factors and processes leading to house transformation in Kampala’s owner-occupied houses. The study revealed that the processes of house development and transformation in Kampala are largely informal, excluding professionals and local authorities. House transformations were a means of expression of the changing needs of the owners, in terms of sizes, income, class and status. House transformations are characterised by phased alterations/modifications, which result in more space for the household needs, income generation and house improvement and status uplift. The process being widespread, almost inevitable and addressing the largely genuine concern. The research recommends formalisation of guided house transformation and phased construction by Kampala Capital City Authority (KCCA) under the consultation of house-owners and professionals.


2020 ◽  
pp. 016001762094608
Author(s):  
Amitrajeet A. Batabyal

We study the decision problems faced by a city authority (CA) who focuses on two different objectives in her attempt to attract members of the creative class to her city by providing a local public good (LPG). First, we compute the maximum tax that a creative class member is willing to pay to enjoy the LPG on offer by living in the CA’s city. Second, assuming that the CA acts like a “monopolist” interested in maximizing the total benefit to her city, we determine the number of members N to attract to her city and the amount of the LPG L to provide so that the total benefit is maximized. Third, supposing that the CA maximizes the welfare of an individual member, we ascertain the values of N and L that maximize this individual welfare. Finally, we compare and contrast the outcomes that arise from the CA’s focus on these two distinct objectives.


2020 ◽  
Vol 6 (1) ◽  
pp. 10-17
Author(s):  
Hnes I. ◽  
◽  
Ivanochko U. ◽  
Voloshyn M.

2020 ◽  
Author(s):  
KAJOBA ABDUL RAHIM

<p>Public Reform and Development Secretariat GoK,(2005) reports indicates that corruption and discretionary powers contribute to the poor delivery of services in government apparatuses and departments. The loss of control of records has consequences for all citizens, especially for the poorest who are least able to defend themselves. Relevant and accurate public records are essential to preserving the rule of law and demonstrating fair, equal, and consistent treatment of citizens. All citizens are entitled to access to records and information yet in most cases, they do not get them or if they do, it takes a long time because of inadequate information systems, lack of appropriate use of technology as well as challenges to do with the human resources establishment and functions. By using an internet data search on government reports ,books, journalS, articles, and websites Paper is going to investigate<b> </b>on the effect of record management on public procurement performance in Kampala Capital City Authority. </p>


2020 ◽  
Author(s):  
KAJOBA ABDUL RAHIM

<p>Public Reform and Development Secretariat GoK,(2005) reports indicates that corruption and discretionary powers contribute to the poor delivery of services in government apparatuses and departments. The loss of control of records has consequences for all citizens, especially for the poorest who are least able to defend themselves. Relevant and accurate public records are essential to preserving the rule of law and demonstrating fair, equal, and consistent treatment of citizens. All citizens are entitled to access to records and information yet in most cases, they do not get them or if they do, it takes a long time because of inadequate information systems, lack of appropriate use of technology as well as challenges to do with the human resources establishment and functions. By using an internet data search on government reports ,books, journalS, articles, and websites Paper is going to investigate<b> </b>on the effect of record management on public procurement performance in Kampala Capital City Authority. </p>


2020 ◽  
Vol 3 (3) ◽  
pp. p116
Author(s):  
Nabukeera Madinah (PhD)

Recentralisation in of Kampala City took effect in 2010 under the Kampala Capital City Authority (KCCA) Act with responsibility to manage the city on behalf of government of Uganda with the view to improve service delivery. The dynamics provided for both decentralization and Recentralisation policies during its implementation which led to shift of powers back to the centre. The study focused on quantitative data analysis and finding reviled 60.8 percent of female under school going age are not attending school, there is 98.9 percent have access to clean piped water, 62 percent of solid waste is from residential areas, 8.2 percent use commercial toilets and 72.6 percent are 5 kilometers away from the health facility hence a significant improvement in service delivery.


Urban Studies ◽  
2020 ◽  
pp. 004209802091033
Author(s):  
Yunji Kim ◽  
Austin M Aldag ◽  
Mildred E Warner

While some US cities and states have taken the lead in protecting labour rights, a counter-trend is found in state pre-emptions – state laws that prohibit cities from making any ordinances or laws related to certain policy areas. What drives these state-level actions that undermine progressive city leadership in the USA? We examine recent state legislations that pre-empt city authority to regulate labour conditions and protect labour rights in the private and public sectors (i.e. minimum wage, paid leave, fair scheduling, right to work, prevailing wage). We use a 50-state regression model to explore what differentiates states with more pre-emption of labour rights and potential sources of pushback. States with low minimum wages, which have never had strong labour protections, pre-empt more. Unions can be sources of pushback – greater unionisation is linked to fewer pre-emptions. However, in Republican-controlled states, more unionisation is linked to more pre-emptions. We use Wisconsin as an example of a state that adopted anti-union policies – despite strong pushback from the public – to explore how strong labour protections can act as a ‘trigger’ for states to undermine labour rights.


Geoforum ◽  
2019 ◽  
Vol 100 ◽  
pp. 229-235 ◽  
Author(s):  
Ilan Wiesel ◽  
Robert Freestone
Keyword(s):  

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