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Global Health

Nakigudde Faridha Lukwago

School of Nursing, University of Michigan- Flint

NUR 412: Community Health Nursing

Dr. Jori. A. July

February .20. 2024

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Global Health

Uganda is a landlocked country with no sea outlet, situated at the edge of the equator. It is

considered a low-income country in East Africa, with neighbors such as the Democratic Republic

of Congo, Kenya, Tanzania, Rwanda, Burundi, and southern Sudan. The country has a tropical

climate with warm and rainy seasons. The country is divided into four regions with different

temperatures; the northern part of the county experiences hot and dry conditions since southern

Sudan borders it in the North and the hot and warm December march in the North. The southern

part of the country experiences cold with rainfall from April to November compared to other

regions. The central region is near the equator, experiencing warm and rainy seasons, and so is

the East(World Atlas,2024). The country has many tribes that speak different languages: English

and Swahili. The central region is more diverse since it is the capital city, and people move to

Kampala to get jobs and set up businesses. Each region produces its staple food, such as matooke

from the central, south, and west; the North has millet flour, and the East has cassava.

The Ugandan people enjoy feasting during burial ceremonies, weddings, birthdays, and

childbirth. Culture plays a huge role in everything, and respect for the elderly is one of them

(Every Culture, 2024). The World Bank shows Uganda's population of 47,249585 with a low

income of 703727949 as of 2022(World,2024). Uganda earns its revenue from petroleum,

tourism, and mineral development. It produces crops such as tea, sugar, livestock, coffee beans,

dried, smoked fish, edible oil, cotton, tobacco, and plantain, mining such as copper, gold, Iron

ore, lead, and lithium as its exports and imports vaccines, delivery trucks, packed medicaments,

etc. ([OEC,2021]). More than the food grown is needed for the growing population. The country

has rich loam soil that can feed a hundred million people, with 35% export earnings and 68%

working in agriculture. The agriculture sector faces challenges of packaging, storage etc.
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One of the sustainable development goals (SDGs) facing Uganda that needs to be improved to

meet goal three, defined as ensuring healthy lives and promoting well-being for all ages, is target

3.3, which specifically addresses HIV/AIDS. The target is defined as "By 2030, end the

epidemics of AIDS, tuberculosis, malaria, neglected tropical diseases and combat hepatitis,

waterborne diseases, and other communicable diseases."HIV/AIDS is one of the leading causes

of death in all ages and sex groups, which has impacted the lives of the people of the Ugandan

community. They will be taking medications for the rest of their lives, and the country does not

have the full potential to provide the required resources in all areas. Yet, the goal is to ensure

healthy lives and well-being for all people of all ages, especially HIV/AIDS patients under target

3.3. Uganda has made several implementations since the beginning of the epidemic. The

government and other non-international organizations have raised awareness and improved

community access to treatments, counseling, and prevention. A sociodemographic survey was

conducted in Masajja and Kibiri of Wakiso district Uganda to test and educate the community on

HIV and safe practices and explained that Uganda was one of the countries that made progress in

fighting against the HIV/AIDS epidemic, but in 2000 and in 2012 the number of new infections

emerged, the government of Uganda encouraged everyone to get tested through the use of media

asking people to receive treatment, testing and counseling (Vithalani & Villanueva, ). Achieving

SDG 3.3 would require maintaining the implementation and addressing the social determinants

of health to control the HIV/AIDS epidemic in Uganda effectively. Also, according to the

([WHO 2017]), President Yoweri Museveni Kaguta launched a fast-track initiative to end

HIV/AIDS in Uganda by 2030, which was said to be the first launch in the world with a five-

point plan to combat the epidemic to reach people who are most affected due to health care

disparities in the county that is low income.

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Back in 1990, Uganda was one of the countries that actively participated in the to have fought

against HIV/AIDS, and the medication was given to the community for free. However, some

cannot get it due to health care disparities, which have increased the number of deaths,

considering it to be the second killing death in Uganda. To reduce the rates, we will be focusing

on goal 3, target 3 of the sustainable developmental goal(SDG).

Collecting data on the HIV/AIDS mortality rate will determine what is required to meet goal 3.3.
Uganda, (2000). Uganda, current United United States,
States,2000 current
mortality rate fo 17000 annual
population with deaths(UAC,
HIV/AIDS for 2022)
all ages and sex
Population 52000(UAC,2022
living with new )
infections
Percentage of 90%(UAC,2022)
population who
live with
HIV/AIDS for
all ages and sex
Percentage of 94%
the population
on ART therapy
Number of 1400000
people living
with HIV/AIDS
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Uganda is a low-income country. It is also one of the countries that at one time managed to have

a reduction in the number of deaths from HIV/AIDS because of the programs that were set up.

However, as of now, the numbers are rising due to the challenges that are being faced while

implementing the measures towards achieving sustainable development goals three and target

3.3. According to a qualitative semi-structural interview carried out with health care workers and

people living with HIV at five clinics in Kampala to understand barriers of care. The interview

was conducted in Luganda language and translated; the interviewers found quite a few

challenges faced by the community while receiving treatments. The community was faced with

high stigma, low social support, alcohol use in men, fear of domestic violence and abandonment

in women not being able to talk about their status to their families and community members, the

use of alternative medicine, history of medication use, people visited the doctor for a reason,

others are in denial (Lofgren et al.; 2022).” Men use alcohol because they think it's the beat

copying mechanism even when receiving ART therapy, which is an indication of all medications.

The fear of domestic violence and abandonment by women of this community was explained that

their husbands at times stopped them from going to the clinic, took their medications away, beat

them and do abandon them, and left them with the children.”

Another barrier to mention is the high stigma of society towards people with HIV/AIDS,

especially in rural areas where there are more healthcare disparities for minorities. An example is

that of a pregnant woman with HIV/AIDS; you would need emotional and social support from

the community; a qualitative descriptive study was carried out on 15 participants using in-depth

interviews related to HIV stigma experiences and coping strategies among pregnant women in

rural areas in Kole, northern Uganda. Stated that women who are pregnant are being ridiculed

and experience social rejection due to HIV, which leaves them isolated (Jolle et al.,2022).
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It is also mentioned ( Lofgren et al., 2022) that a history of medication use is also a barrier the

community of Uganda faces because the first line of medication had so many side effects that led

people not want to take them anymore and had no knowledge about how good the new ART

therapy medications.

Children are emotionally driven beings who must be loved, accepted, and provided for. A study

aimed at exploring health professionals' perspectives on barriers to treatment seeking formal

health services among children and adolescents with HIV/AIDS and mental distress in Masaka

district, Uganda. There were barriers to treatment by the families having HIV/AIDS in the

Masaka community, with some being health systems, social issues related to poverty that the

mental status of the children face conditions such as hunger, violence, stigma home, lessness,

and the home left is the streets where they are faced with anxiety and their families have little or

no money to feed their families because they have spent the little on buying medications and

cannot even afford transportation to go to the hospital which is miles away. The county, being

low-income, cannot afford social support to the communities, which hinders the aim of

eradicating HIV/AIDS from Uganda in order to meet goal 3 target 3.3 (Mugisha et al.; 2020).

In conclusion, Uganda's progress in eradicating HIV/AIDS has decreased the number of HIV

/AIDS infections, achieved the 90-90-90 target by the year 2020, and the presidential fast track

initiative 2017. Though the implementations in place have progressed, they have also met some

challenges, and new infections have merged. With ongoing implementations, sustainable

development goals three and target 3.3 to eradicate HIV/AIDS will be met.
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References:

Jolle J, Kabunga A, Okello TO, Kadito EO, Aloka J, Otiti G, Aluko A A, Kumakechi E, Udho S

(2022). HIV-related stigma experiences and coping strategies among pregnant women in

rural Uganda: A qualitative descriptive study. PLoS ONE 17(10). https://doi.

org/10.1371/journal.pone.0272931

Lofgren, S. M., Tsui, S., Atuyambe, L., Ankunda, L., Komuhnedo, R., Wamala, N., Sadiq, A.,

Kirumira, P., Srishyla, D., Flynn, A., Pastick, K. A., Meya, D. B., Nakasujja, N., Porta, C. (2022).

Barriers to HIV care in Uganda and implications for universal test-and-treat: a qualitative

study. AIDS Care, 34(5), 597-605. https://doi.org/0.1080/09540121.2021.1946000. Epub 2021

July 27. PMID: 34314261; PMCID: PMC8792098.

Mugisha J, Kinyanda E, Osafo J, Nalukenge W, Knizek BL. (2020).Health care professionals'

perspectives on barriers to treatment seeking formal health services among orphan children and

adolescents with HIV/AIDS and mental distress in a rural district in central Uganda. Child

Adolescent Psychiatry Ment Health. https:// doi: 10.1186/s13034-020-00332-8. PMID:

32518588; PMCID: PMC7271468.

Population total Uganda. (2024). The World Bank data. Retrieved February 20, 2024,

from https://data.worldbank.org/indicator/SP.POP.TOTL?locations=UG

Uganda. (2021). OEC. Retrieved February 20, 2024,

from https://oec.world/en/profile/country/uga

Forum. (2024). Uganda. Countries and their culture. Retrieved February 20, 2024,

from https://www.everyculture.com/To-Z/Uganda.html
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Vithalani, J., & Villanueva, M. H. (2018). HIV Epidemiology in Uganda: A survey based on age,

gender, number of sexual partners, and frequency of testing. African Health Science, 523-

530. https://doi.org/10.4314/ahs.v18i3.8. PMID: 30602983; PMCID: PMC6307011.

World Atlas. (2024). Maps Of Uganda. World Atlas. Retrieved February 20, 2024,

from https://www.worldatlas.com/maps/uganda