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.

Boost resilience of small and mid-sized cities.

Abstract: Smaller settlements are growing faster than megacities — and they need more protection from extreme events, write Joern Birkmann and colleagues.

The impact of male circumcision on HIV incidence and cost per infection prevented: a stochastic simulation model from Rakai, Uganda.

Abstract: The objectives were to estimate the impact of male circumcision on HIV incidence the number of procedures per HIV infection averted and costs per infection averted. A stochastic simulation model with empirically derived parameters from a cohort in Rakai Uganda was used to estimate HIV incidence assuming that male circumcision reduced the risks of HIV acquisition with rate ratios (RR) ranging from 0.3 to 0.6 in men their female partners and in both sexes combined with circumcision coverage 0-100%. The reproductive number (R0) was also estimated. The number of HIV infections averted per circumcision was estimated from the incident cases in the absence of surgery minus the projected number of incident cases over 10 years following circumcision. The cost per procedure ($69.00) was used to estimate the cost per HIV infection averted. Baseline HIV incidence was 1.2/100 person-years. Male circumcision could markedly reduce HIV incidence in this population particularly if there was preventative efficacy in both sexes. Under many scenarios with RR = 0.5 circumcision could reduce R0 to < 1.0 and potentially abort the epidemic. The number of surgeries per infection averted over 10 years was 19-58 and the costs per infection averted was $1269-3911 depending on the efficacy of circumcision for either or both sexes assuming 75% service coverage. However behavioral disinhibition could offset any benefits of circumcision. Male circumcision could have substantial impact on the HIV epidemic and provide a cost-effective prevention strategy if benefits are not countered by behavioral disinhibition. (authors)

Poor newborn care practices - a population based survey in eastern Uganda

Abstract: Four million neonatal deaths are estimated to occur each year and almost all in low income countries, especially among the poorest. There is a paucity of data on newborn health from sub-Saharan Africa and few studies have assessed inequity in uptake of newborn care practices. We assessed socioeconomic differences in use of newborn care practices in order to inform policy and programming in Uganda. All mothers with infants aged 1-4 months (n = 414) in a Demographic Surveillance Site were interviewed. Households were stratified into quintiles of socioeconomic status (SES). Three composite outcomes (good neonatal feeding, good cord care, and optimal thermal care) were created by combining related individual practices from a list of twelve antenatal/essential newborn care practices. Multiple logistic regression analysis was used to identify determinants of each dichotomised composite outcome. There were low levels of coverage of newborn care practices among both the poorest and the least poor. SES and place of birth were not associated with any of the composite newborn care practices. Of newborns, 46% had a facility delivery and only 38% were judged to have had good cord care, 42% optimal thermal care, and 57% were considered to have had adequate neonatal feeding. Mothers were putting powder on the cord; using a bottle to feed the baby; and mixing/replacing breast milk with various substitutes. Multiparous mothers were less likely to have safe cord practices (OR 0.5, CI 0.3 - 0.9) as were mothers whose labour began at night (OR 0.6, CI 0.4 - 0.9). Newborn care practices in this setting are low and do not differ much by socioeconomic group. Despite being established policy, most neonatal interventions are not reaching newborns, suggesting a "policy-to-practice gap". To improve newborn survival, newborn care should be integrated into the current maternal and child interventions, and should be implemented at both community and health facility level as part of a universal coverage strategy.

Tracking global climate change adaptation among governments

Abstract: The Paris Agreement and Katowice Climate Package articulate a clear mandate for all parties to undertake and document adaptation progress. Yet persistent challenges have prevented substantive developments in tracking adaptation and the assessment of adaptation actions and their outcomes. Here, we provide an overview of the challenges of adaptation tracking and propose a comprehensive conceptual framework for assessing adaptation progress by governments that is scalable over time and across contexts. The framework addresses the core components of adaptation assessment (vulnerability, goals and targets, adaptation efforts, and adaptation results) and characterizes subcomponents focused on adaptation effort (leadership, organizations and policy). In particular, we highlight how critical insights can be uncovered by systematically tracking policy efforts over time, and discusses novel approaches to data collection. The Paris Agreement places new emphasis on the need to take stock of adaptation progress. This Perspective discusses the conceptual and methodological challenges associated with monitoring adaptation and provides a comprehensive framework for tracking progress among governments.