Doreen Nakalembe

Climate-related hazards such as floods and droughts disrupt household access to safe water, sanitation, and hygiene (WASH), undermining progress toward the Sustainable Development Goals (SDGs). Evidence on how household characteristics such as housing type, altitude, subjective social status, and disability status shape vulnerability to floods and drought and related risk mitigation in informal settlements remains limited. This study, therefore, assessed the vulnerability to climate impacts on WASH, risk mitigation, and its determinants among households in informal settlements in Eastern Uganda. This cross-sectional study applied nexus thinking and used an adapted questionnaire, informed by the World Health Organisation’s climate vulnerability checklist, to collect data from 589 households in Eastern Uganda. Quantitative data on household characteristics, documented flood and drought impacts, as well as risk mitigation measures, were collected. Robust least squares regression was used to show predictors of climate impact scores as well as risk mitigation scores at 95% confidence level. Results show that 21.4% reported increased susceptibility to waterborne diseases due to contamination from animal faeces and sewage. Vulnerability to flood impacts was higher among households living in temporary housing or with disabled members, but lower among those in higher-altitude areas or with higher subjective socioeconomic status. Higher subjective social status was also linked to reduced drought impacts, whereas temporary housing reduced the capacity to mitigate drought risk. Overall, climate-related hazards compromise WASH in informal settlements, with cascading effects on health, education, food security, gender equality, and poverty reduction. These findings highlight the need to strengthen water governance, promote integrated (nexus) approaches, and build resilient WASH systems through multi-sectoral partnerships to mitigate climate risks in vulnerable communities.

Background: In Uganda, urban centres face a high prevalence of HIV, exacerbated by misinformation(inaccurate or false beliefs about HIV transmission, prevention, or treatment), low testing rates, and non-disclosure of HIV status (not revealing one’s HIV test result, particularly to sexual partners).However, evidence on the prevalence and determinants of HIV-related misinformation, testing, and disclosure within these urban and peri-urban centres remains limited. This study assessed the prevalence of HIV testing, misinformation, and non-disclosure in selected urban and peri-urban centres of West Nile, Eastern and Northern Uganda to inform targeted interventions aimed at improving HIV awareness, increasing the uptake of HIV testing services, and facilitating disclosure. Methods: A cross-sectional study was conducted among 930 households in five urban and peri-urban centres in Uganda. A multistage sampling technique was used to select participants. A digitised, structured questionnaire preloaded on the KoboCollect mobile application was used to collect data. Data were downloaded in Microsoft Excel and exported into Stata version 14 for statistical analysis. Modified Poisson regression was used to determine the factors associated with the outcome variables. Results: About 93.2% of respondents were misinformed about HIV, 20.8% had not disclosed their HIV status, and 3.3% had never been tested for HIV. Having a primary level of education (PR:0.96, 95% CI:0.93–0.99, p = 0.035) and spending more than 6 years in the area (PR: 1.05, 95% CI:1.00-1.10, p = 0.029) were associated with “HIV-related misinformation.” Being knowledgeable about some special drugs that a doctor or a nurse could give to a woman infected with the HIV/AIDs virus to reduce the risk of transmission to the baby (PR:1.03, 95% CI:1.00-1.07, p = 0.024) was associated with “HIV testing”. Being married (PR:0.89, 95% CI:0.65 − 0.12, p < 0.001 was associated with “non-disclosure” of HIV status. Conclusion: This study highlights the ongoing challenge of HIV/AIDS misinformation among urban populations in Uganda. While progress has been made in testing and disclosure, factors such as education, length of residence, and knowledge significantly influence these outcomes. These findings emphasise the importance of targeted educational interventions that provide clear, accurate HIV/AIDS information to enhance awareness, increase testing rates, and support the disclosure of HIV status.

Hepatitis B Virus (HBV) infection remains a significant global public health challenge especially in low-and-middle income countries. Although there are significant global and national efforts to control Hepatitis B, equitable distribution and access to prevention services such as testing and vaccination remains a challenge. Efforts to increase access are hindered by inadequate evidence on the availability and distribution of HBV services. This cross-sectional study aimed at generating evidence of the distribution of HBV prevention services in Wakiso District, Uganda. A total of 55 healthcare facilities (HCFs) including 4 hospitals, and 51 primary care facilities were surveyed. Data were collected using an electronic structured questionnaire and analysed using STATA 14.0. A chi-square test was performed to establish the relationship between HCF characteristics and the availability of hepatitis B services. ArcGIS (version 10.1) was used to generate maps to illustrate the distribution of hepatitis B prevention services. We found out that the hepatitis B vaccine was available in only 27.3% (15) of the HCF, and 60% (33) had testing services. Receipt of the hepatitis B vaccine doses in the last 12 months was associated with the level (p = ≤0.001) and location (p = 0.030) of HCF. Availability of the hepatitis B vaccine at the time of the survey was associated with the level (p = 0.002) and location (p = 0.010) of HCF. The availability of hepatitis B testing services was associated with the level (p = 0.031), ownership (p≤0.001) and location (p = 0.010) of HCF. HCFs offering vaccination and testing services were mostly in urban areas, and close to Kampala, Uganda’s capital. Based on this study, hepatitis B prevention services were sub-optimal across all HCF levels, locations, and ownership. There is a need to extend hepatitis B prevention services to rural, public and private-not-for-profit HCFs.

Introduction Despite global and national efforts in place for the prevention and control of Hepatitis B, there remains a gap in access to hepatitis B prevention services such as testing and vaccination. Nonetheless, there is limited evidence of the geospatial distribution of Hepatitis B services. This study established the geospatial distribution of HBV vaccination services in Wakiso District, Uganda. Materials and methods A cross-sectional quantitative descriptive study was conducted among 55 healthcare facilities including 6 hospitals, and 49 primary care facilities in Wakiso district. Data were collected using the KoboCollect application. Quantitative data were analysed using STATA 14.0. A chi-square test was performed to establish the relationship between healthcare facility characteristics and the availability of hepatitis B services. ArcGIS (version 10.1) was used for analysis of geospatial data. Results The hepatitis B vaccine was available in only 27.3 % (15) of the facilities, and 60% (33) had testing services. Receipt of the hepatitis B vaccine doses in the last 12 months was associated with the level of healthcare facility (p=≤0.001) and location (p=0.030). Availability of the Hepatitis B vaccines at the time of the survey was associated with the level of healthcare facility (p=0.002) and location (p=0.010). Availability of hepatitis B testing services was associated with level of healthcare facility (p=0.031), ownership (p≤0.001) and location (p=0.010). Healthcare facilities offering vaccination and testing services were mostly in urban healthcare facilities, and close to Kampala, Uganda’s capital. Conclusion Hepatitis B services were sub-optimal across all healthcare facility levels, locations, and ownership. The majority of the hepatitis B prevention services were provided in urban settings, close to major towns, municipalities, and the city. This calls a extension of hepatitis B prevention services to rural, public and PNFP healthcare facilities.