Makerere University

About: Makerere University is a education organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Public health. The organization has 7220 authors who have published 12405 publications receiving 366520 citations. The organization is also known as: Makerere University Kampala & MUK.

Men “missing” from population-based HIV testing: insights from qualitative research

Abstract: Men's uptake of HIV testing is critical to the success of "test and treat" strategies in generalized epidemics. This study sought to identify cultural factors and community processes that influence men's HIV testing uptake in the baseline year of an ongoing test-and-treat trial among 334,479 persons in eastern Africa (SEARCH, NCT#01864603). Data were collected using participant observation at mobile community health campaigns (CHCs) (n = 28); focus group discussions (n = 8 groups) with CHC participants; and in-depth interviews with care providers (n = 50), leaders (n = 32), and members (n = 112) of eight communities in Kenya and Uganda. An 8-person research team defined analytical codes and iteratively refined them during data collection using grounded theoretical approaches, and textual data were coded using Atlas.ti software. Structural and cultural barriers, including men's mobility and gender norms valorizing risk-taking and discouraging health-seeking behavior, were observed, and contributed to men's lower participation in HIV testing relative to women. Men's labor opportunities often require extended absences from households: during planting season, men guarded fields from monkeys from dawn until nightfall; lake fishermen traveled long distances and circulated between beaches. Men often tested "by proxy", believing their wives' HIV test results to be their status. Debates about HIV risks were vigorous, with many men questioning "traditional" masculine gender norms that enhanced risks. The promise of antiretroviral therapy (ART) to prolong health was a motivating factor for many men to participate in testing. Flexibility in operating hours of HIV testing including late evening and weekend times along with multiple convenient locations that moved were cited as facilitating factors enhancing male participating in HIV testing. Mobile testing reduced but did not eliminate barriers to men's participation in a large-scale "test & treat" effort. However, transformations in gender norms related to HIV testing and care-seeking are underway in eastern Africa and should be supported.

Perfect Competition, Urbanization, and Tax Incidence in the Retail Gasoline Market

Abstract: I. INTRODUCTION In applied tax incidence studies, it is typically assumed that prices respond one-for-one to changes in sales and excise taxes (Chernick and Reschovsky 1997; Pechman 1985; Shepard 1976; State of Wisconsin Department of Revenue 2004; Wiese, Rose, and Schluter 1995; Zupnick 1975). Is this assumption reasonable? Despite the fundamental role of tax incidence in the study of public finance, there is surprisingly little empirical analysis that sheds light on who bears the burden of taxes. In this article, we examine the incidence of state gasoline excise taxes using monthly price data for all 50 states in the United States over the period 1984-1999. Our estimation results generally indicate full shifting of gasoline taxes to the final consumer, with changes in gasoline taxes fully reflected in the tax-inclusive gasoline price almost instantly. We also find that the incidence of excise taxes depends on the competitiveness of retail gasoline markets (e.g., urban vs. rural markets). Gasoline markets in urban states typically exhibit full shifting, but those in rural states demonstrate somewhat less than full shifting. Although the issue of sales and excise tax incidence has received considerable attention over the years, most research has focused on tax incidence theory, and the standard conclusion of much of this theoretical analysis is that consumers bear the full burden of any sales and excise taxes. (1) Based primarily on this theoretical foundation, most applied incidence studies assume that sales and excise taxes are fully reflected in consumer prices, and the distribution of tax burdens across income classes necessarily reflects this assumption. However, actual empirical testing of this assumption of full forward shifting has been surprisingly sparse. (2) In important recent research, Poterba (1996) and Besley and Rosen (1999) have conducted empirical analyses of the incidence of excise taxes. Poterba (1996) uses city-specific clothing and personal care price data covering the 1947-1977 and the 1925-1939 periods to examine the degree to which state and local retail sales taxes are shifted to consumers, with two data sets based on Bureau of Labor Statistics (BLS) city-specific consumer price indices. Using these BLS data on tax-inclusive prices, Poterba (1996) constructs quarterly price indices for each of 28 Standard Metropolitan Statistical Areas (SMSAs). Many of these 28 SMSAs experienced significant changes in sales tax rates, and Poterba (1996) uses these tax "shocks" to determine the incidence of sales taxes. His estimation results are somewhat variable, but in general he finds for the postwar period that taxes are fully shifted to consumers; in some cases, he finds limited evidence of overshifting, although it is never possible to reject the null hypothesis that prices rise "point-for-point" with the changes in the tax, and he also finds that full shifting typically (though not always) occurs in the first quarter of the tax change. Poterba (1996) also examines tax incidence for individual SMSAs during the Depression era, and his results indicate significant differences across metropolitan areas in the degree of tax shifting. For example, prices on women's clothing in Chicago show significant overshifting, but Atlanta shows negative shifting, a result that does not seem plausible. Besley and Rosen (1999) also examine the incidence of sales taxes using price data for 12 narrowly defined commodities in 155 different U.S. cities, using quarterly price data for the period 1982-1990 issued by the American Chamber of Commerce Researchers Association (ACCRA). (3) They not only find full shifting for a number of commodities but also find overshifting for more than half the products, a result they attribute to imperfect competition in the retail sector. While this recent empirical research has significantly expanded our understanding of the actual nature of sales and excise tax incidence, we believe that our work here on gasoline excise taxes makes several contributions to the empirical literature. …

The right to culture and the culture of rights: a critical perspective on women’s sexual rights in Africa

Abstract: The opposition of ‘culture’ and ‘rights’ is not uncommon in feminist legal discourse. This article argues that such an approach is fraught with danger as it creates an extremely restrictive framework within which African women can challenge domination; it limits our strategic interventions for transforming society and essentially plays into the hands of those seeking to perpetuate and solidify the existing structures of patriarchy. Drawing examples from a parallel research on Gender, Law and Sexuality, I propose that a more critical and interpretative approach to these two concepts may present a different perspective to portrayals of ‘tradition’ as constraining and/or fixed often displayed in mainstream feminist legal thinking.

Autopsy causes of death in HIV-positive individuals in sub-Saharan Africa and correlation with clinical diagnoses.

Abstract: Despite the persistently high HIV-related mortality in sub-Saharan Africa, limited information on the causes of death is available. Pathological autopsies are the gold standard to establish causes of death. In this review we describe the autopsy series performed among HIV-infected individuals in sub-Saharan Africa over the last two decades. We identified nine complete and 11 partial or minimally invasive autopsy series. Complete autopsies were performed in 593 HIV-positive adults and 177 HIV-positive children. Postmortem diagnoses were mainly infectious diseases. Tuberculosis was the most frequent, present in 21-54% of HIV-positive adults and was considered the cause of death in 32-45%. Overall, pulmonary infections accounted for approximately 66% of pathology and central nervous system infections for approximately 20%. A high discordance between clinical and postmortem diagnoses was observed. This review emphasizes the need for reliable information on causes of death in order to improve HIV patient care, guide further research, and inform health policy.