1
|
Mohammed A, Tareke AA, Keleb A, Kebede N, Tsega Y, Endawkie A, Kebede SD, Mesfin Abera K, Tilahun Abeje E, Bekele Enyew E, Daba C, Asmare L, Bayou FD, Endris H, Arefaynie M. Urban-rural disparities in minimum acceptable diet intake among children aged 6-23 months in Ethiopia: A multivariable Decomposition analysis of Ethiopian demographic and health survey 2019. Front Public Health 2024; 12:1361673. [PMID: 39086809 PMCID: PMC11290421 DOI: 10.3389/fpubh.2024.1361673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction The achievement of the minimum acceptable diet intake (MAD) stands at 14% among urban and 10% among rural under-five children in Ethiopia. Consequently, identifying the determinants of the urban-rural gap is vital for advancing Sustainable Development Goals (SDGs), fostering healthier communities, and developing evidence-driven approaches to enhance health outcomes and address disparities. Objective The objective of the study was to decompose the urban-rural disparities in minimum acceptable diet intake in Ethiopia using the Ethiopian Mini-Demographic and Health Survey 2019 data. Method The study was conducted using the Ethiopian Demographic and Health Survey 2019 report. A total of 1,496 weighted children aged 6-23 months were included using stratified sampling techniques. The main outcome variable minimum acceptable diet was calculated as a combined proportion of minimum dietary diversity and minimum meal frequency. A decomposition analysis was used to analyze the factors associated with the urban-rural discrepancy of minimum acceptable diet intake, and the results were presented using tables and figures. Result The magnitude of minimum acceptable diet among children aged 6-23 months in Ethiopia was 11.0%. There has been a significant disparity in the intake of minimum acceptable diet between urban and rural under-five children with 14 and 10%, respectively. Endowment factors were responsible for 70.2% of the discrepancy, followed by 45.1% with behavioral coefficients. Educational status of college and above was responsible for narrowing the gap between urban and rural residents by 23.9% (β = 0.1313, 95% CI: 0.0332-0.245). The number of children in the household and the age of the child between 18 and 23 months were responsible for widening the gap in minimum acceptable diet intake discrepancy between urban and rural residents by 30.7% and 3.36%, respectively (β = -0.002, 95% CI: -0.003 to -0.0011 and β = -30.7, 95% CI: -0.025 - -0.0085). From the effect coefficients, the effect of institutional delivery was responsible for 1.99% of the widening of the gap between urban and rural residents in minimum acceptable diet intake (β = -0.0862, 95% CI: -0.1711 - -0.0012). Conclusion There is a significant variation between urban and rural residents in minimum acceptable diet. The larger portion of the discrepancy was explained by the endowment effect. Educational status of mothers with college and above, parity, age of child, and place of delivery were the significant factors contributing to the discrepancy of minimum acceptable diet intake between urban and rural residents.
Collapse
Affiliation(s)
- Anissa Mohammed
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Abiyu Abadi Tareke
- Amref Health in Africa, COVID-219 Vaccine/Expanded Program for Immunization (EPI) Technical Assistant at West Gondar Zonal Health Department, Gondar, Ethiopia
| | - Awoke Keleb
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yawkal Tsega
- Department of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abel Endawkie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Shimels Derso Kebede
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Kaleab Mesfin Abera
- Department of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Eyob Tilahun Abeje
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Ermias Bekele Enyew
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Chala Daba
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Lakew Asmare
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Fekade Demeke Bayou
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Hussien Endris
- Department of Anaesthesia and Critical Care, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
2
|
kitaw TA, Tilahun BD, Abate BB, Haile RN. Minimum acceptable diet and its predictors among children aged 6-23 months in Ethiopia. A multilevel cloglog regression analysis. MATERNAL & CHILD NUTRITION 2024; 20:e13647. [PMID: 38530126 PMCID: PMC11168368 DOI: 10.1111/mcn.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/10/2024] [Accepted: 03/04/2024] [Indexed: 03/27/2024]
Abstract
Despite significant progress made previously and the recognized health benefits of optimal feeding practices, ensuring a minimum acceptable diet in developing countries like Ethiopia remains a formidable challenge. Additionally, there is a scarcity of data in this area. Therefore, our study aims to identify predictors of a minimum acceptable diet using a powerful tool called complementary log-log regression analysis. Thus, it contributes to accelerating the pathway of ending child undernutrition thereby promoting optimal child health. A multilevel analysis was conducted among a weighted sample of 1427 children aged 6-23 months using the 2019 Ethiopian Demographic Health Survey (EDHS). The EDHS sample was stratified and selected in two stages. A minimum acceptable diet is defined as a composite of children fed with both minimum dietary diversity and minimum meal frequency. Data extraction took place between August 1 and 30, 2023. We used STATA software version 17 for data analysis. A complementary log-log regression model was fitted to identify significant predictors of the minimum acceptable diet. A p-value of ≤0.05 was used to declare statistically significant predictors. Only 10.44% (95CI: 8.90-12.15) of the children meet the minimum acceptable diet. Child aged (18-23 month) (AOR = 1.78, 95CI:1.14-2.78)], mother's educational level (secondary and above education) (AOR = 279,95CI: 1.51-5.15), number of children three and above [(AOR = 0.78,95CI: 0.53-0.94], institutional delivery [AOR = 1.77,95CI: 1.11-3.11], having postnatal-check-up [AOR = 2.33,95CI: 1.59-3.41] and high community poverty level (AOR = 0.49,95CI: 0.29-0.85) were found to be predictors of minimum acceptable diet. In Ethiopia, only one in ten children achieve a minimum acceptable diet. Which is lower than the global report findings (16%). Enhancing maternal education programs and promoting family planning strategies to reduce household size are essential. Besides, encouraging institutional deliveries and postnatal check-ups are also recommended. It is necessary to implement targeted interventions for poverty reduction in communities to ensure that families can afford nutritious diets for their children.
Collapse
Affiliation(s)
| | | | - Biruk Beletew Abate
- Department of Nursing, College of Health ScienceWoldia UniversityWoldiaEthiopia
| | - Ribka Nigatu Haile
- Department of Nursing, College of Health ScienceWoldia UniversityWoldiaEthiopia
| |
Collapse
|
3
|
Kitaw TA, Abate BB, Derese Tilahun B, Haile RN. Geospatial pattern of level of minimum acceptable diet and its determinants among children aged 6-23 months in Ethiopia. Spatial and multiscale geographically weighted regression analysis. Front Public Health 2024; 12:1348755. [PMID: 38962777 PMCID: PMC11221355 DOI: 10.3389/fpubh.2024.1348755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 05/17/2024] [Indexed: 07/05/2024] Open
Abstract
Background Despite prior progress and the proven benefits of optimal feeding practices, improving child dietary intake in developing countries like Ethiopia remains challenging. In Ethiopia, over 89% of children fail to meet the minimum acceptable diet. Understanding the geographical disparity and determinants of minimum acceptable diet can enhance child feeding practices, promoting optimal child growth. Methods Spatial and multiscale geographically weighted regression analysis was conducted among 1,427 weighted sample children aged 6-23 months. ArcGIS Pro and SatScan version 9.6 were used to map the visual presentation of geographical distribution failed to achieve the minimum acceptable diet. A multiscale geographically weighted regression analysis was done to identify significant determinants of level of minimum acceptable diet. The statistical significance was declared at P-value <0.05. Results Overall, 89.56% (95CI: 87.85-91.10%) of children aged 6-23 months failed to achieve the recommended minimum acceptable diet. Significant spatial clustering was detected in the Somali, Afar regions, and northwestern Ethiopia. Children living in primary clusters were 3.6 times more likely to be unable to achieve the minimum acceptable diet (RR = 3.61, LLR =13.49, p < 0.001). Mother's with no formal education (Mean = 0.043, p-value = 0.000), family size above five (Mean = 0.076, p-value = 0.005), No media access (Mean = 0.059, p-value = 0.030), home delivery (Mean = 0.078, p-value = 0.002), and no postnatal checkup (Mean = 0.131, p-value = 0.000) were found to be spatially significant determinants of Inadequate minimum acceptable diet. Conclusion Level of minimum acceptable diet among children in Ethiopia varies geographically. Therefore, to improve child feeding practices in Ethiopia, it is highly recommended to deploy additional resources to high-need areas and implement programs that enhance women's education, maternal healthcare access, family planning, and media engagement.
Collapse
Affiliation(s)
- Tegene Atamenta Kitaw
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | | | | | | |
Collapse
|
4
|
Nakaggwa F, Kimuli D, Namuwenge N, Nsubuga RN, Nayebare H, Kaboine L, Baseka I, Kasule K, Nyakwezi S, Sevume S, Mubiru N, Amuron B, Bukenya D. Prevalence, patterns, and determinants of breastfeeding cessation among mothers of children under 24 months in Uganda. BMC Public Health 2024; 24:1512. [PMID: 38840094 PMCID: PMC11155002 DOI: 10.1186/s12889-024-19028-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 05/31/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Breastfeeding duration is a critical component of infant and child nutrition, providing immediate and long-term benefits to both children and their mothers. This study uses data from the lot quality assurance sampling (LQAS) survey to examine the prevalence, patterns, and determinants of breastfeeding cessation in Uganda. METHODS This study was a secondary analysis of data collected by the cross-sectional LQAS surveys in 2021 and 2022 covering 77 districts in Uganda. The LQAS survey methodology employs a systematic sampling approach to assess whether predefined quality standards are met within specific subgroups of a population. The study employed spatial analysis, bivariate analysis and logistic regression, both with and without clustering, to explore associations between independent variables and breastfeeding cessation. Unadjusted and adjusted odds ratios with 95% confidence intervals were calculated. Statistical significance was set at 5%. RESULTS Overall, the study analysed 26,377 records of mothers with children under 24 months old. The mothers' mean age was 27.9 years while that of their children was 11.0 months. While the general breastfeeding cessation rate was 17.7%, cessation was highest (49.7%) among mothers of children 18-23 months. Factors associated with increased odds of breastfeeding cessation included older child's age, older mother's age, using modern family planning, being pregnant and having an unknown pregnancy status. Lower odds of breastfeeding cessation were observed among mothers who; were married, lived in larger households, lived in rural residences, whose children received vitamin A supplementation and among all other regions compared to Kampala. CONCLUSION One in five mothers cessed breastfeeding before their child reached 2 years, with a significant increase in cessation odds among mothers of older children. These findings underscore the importance of interventions to promote breastfeeding continuation and adequate nutrition for non-breastfed infants, particularly in regions with high cessation rates.
Collapse
Affiliation(s)
- Florence Nakaggwa
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda.
| | - Derrick Kimuli
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Norah Namuwenge
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Rebecca N Nsubuga
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Hellen Nayebare
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Louis Kaboine
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Immaculate Baseka
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Kenneth Kasule
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Sheila Nyakwezi
- The United States Agency for International Development Uganda, US Mission Compound-South Wing, Kampala, Uganda
| | - Solome Sevume
- The United States Agency for International Development Uganda, US Mission Compound-South Wing, Kampala, Uganda
| | - Norbert Mubiru
- The United States Agency for International Development Uganda, US Mission Compound-South Wing, Kampala, Uganda
| | - Barbara Amuron
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Daraus Bukenya
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| |
Collapse
|
5
|
Kimuli D, Nakaggwa F, Namuwenge N, Nsubuga RN, Kasule K, Nyakwezi S, Odong J, Isabirye P, Sevume S, Mubiru N, Mwehire D, Matovu F, Wandera B, Amuron B, Bukenya D. Prevalence and determinants of minimum dietary diversity for women of reproductive age in Uganda. BMC Nutr 2024; 10:39. [PMID: 38429646 PMCID: PMC10908097 DOI: 10.1186/s40795-024-00858-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/22/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Globally, over a billion women of reproductive age (WRA) suffer from some kind of undernutrition micronutrient deficiencies, and/or anemia as a result of inadequate dietary diversity. This leads to poor maternal and child health outcomes, however, there is limited research on population level research on minimum dietary diversity for women (MDD-W). This study assessed the prevalence and predictors of MDD-W among WRA in Uganda. METHODS This study was a secondary analysis of data from the lot quality assurance sampling (LQAS) survey conducted across 55 Ugandan districts between May and September 2022. Women of various ages were interviewed across 5 study subgroups that this study used to construct its study population (WRA). Descriptive analyses, tests for outcome differences, and multilevel mixed-effects logistic regression were conducted at a 5% statistical significance level using STATA version 17. The results were reported using Adjusted Odds Ratios (aOR) as the measure of the outcome. RESULTS The study analyzed responses from 29,802 WRA with a mean age of 27.8 (± 6.8) years. Only 8.8% (95% CI 8.5-9.3) achieved the MDD-W, the least proportion was observed in the South-Central region (3.13%). In the adjusted analysis, WRA who were older than 25 years (aOR 1.1, 95% CI 1.1-1.3, p < 0.001), had secondary education (aOR = 1.4, 95% CI 1.1-1.7, p = 0.003) or above (aOR = 1.7, 95% CI 1.3-2.2, p < 0.001), and used modern contraceptives (aOR = 1.1, 95% CI 1.0-1.3, p = 0.01) were more likely to achieve the MDD-W. Conversely, WRA who travelled longer distances to the nearest household water source (aOR = 0.8, 95% CI 0.7-0.9, p = 0.002) and those residing in larger households (aOR = 0.9, 95% CI 0.8-1.0, p = 0.019) were less likely to achieve the MDD-W. CONCLUSION A low proportion of WRA met the MDD-W. Age, education level, household sizes and use of modern contraception were predictors of MDD-W among WRA in Uganda. MDD-W-related program efforts in Uganda should strengthen multisectoral collaboration with prioritization of younger women, education, household sizes and access to safe water sources.
Collapse
Affiliation(s)
- Derrick Kimuli
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda.
| | - Florence Nakaggwa
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Norah Namuwenge
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Rebecca N Nsubuga
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Kenneth Kasule
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Sheila Nyakwezi
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Jimmy Odong
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Paul Isabirye
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Solome Sevume
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Norbert Mubiru
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Daniel Mwehire
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Fatuma Matovu
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Bonnie Wandera
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Barbara Amuron
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Daraus Bukenya
- Social & Scientific Systems, Inc., DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| |
Collapse
|
6
|
Kimuli D, Nakaggwa F, Namuwenge N, Nsubuga RN, Isabirye P, Kasule K, Katwesige JF, Nyakwezi S, Sevume S, Mubiru N, Amuron B, Bukenya D. Sociodemographic and health-related factors associated with exclusive breastfeeding in 77 districts of Uganda. Int Breastfeed J 2023; 18:66. [PMID: 38053098 DOI: 10.1186/s13006-023-00604-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Uganda surpasses many African nations and the global average in exclusive breastfeeding (EBF) rates. Yet, malnutrition is a critical issue, with stunting impacting roughly 29% of children under 5 years. Enhancing EBF could mitigate such nutritional challenges. This study focused on determining the current EBF prevalence and identifying associated factors across 77 surveyed districts. METHODS Pooled data from the Lot Quality Assurance Sampling (LQAS) surveys conducted in 77 districts in Uganda during 2021 and 2022 were analyzed. The analysis involved 7,210 mothers of children under 6 months, EBF was considered as the proportion of infants who received breast milk only in the 24 hours before the survey. A mother practicing EBF was (1) currently breastfeeding (2) had not started giving foods other than breastmilk (3) had not given any other probed liquids or (4) semi-solid foods the previous day or night. Multivariable logistic regression was used to identify factors associated with EBF, presenting adjusted odds ratios (aOR) with corresponding 95% confidence intervals at a 5% significance level. RESULTS The prevalence of EBF was 62.3%. In the adjusted analysis, EBF was more common among older mothers 20-24 years, 25-29 years and 30 + years (aOR 1.4; 95% CI 1.2,1.6), (aOR 1.4; 95% CI 1.1, 1.6) and (aOR 1.3; 95% CI 1.1, 1.5) respectively compared to teenage mothers. Also, EBF was more likely among mothers who lived in rural areas compared to urban areas (aOR 1.1; 95% CI 1.0, 1.3) and those who attended antenatal care (ANC) (aOR 2.2; 95% CI 1.5, 3.1). On the contrary, EBF was less common for children aged 3-5 months compared to younger (aOR 0.5; 95% CI 0.5, 0.6) and children who had received Vitamin A supplementation (aOR 0.7; 95% 0.6, 0.8). CONCLUSION The study suggests that most districts in Uganda might not have made significant strides in improving EBF rates over the last twenty years, pointing to possible ongoing hurdles that need urgent attention. Particularly, there's a pressing need to focus on teenage mothers. Maintaining and strengthening programs that advocate EBF, such as ANC, is crucial to bridge the gaps and bring about more equitable rates among different groups.
Collapse
Affiliation(s)
- Derrick Kimuli
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda.
| | - Florence Nakaggwa
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Norah Namuwenge
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Rebecca N Nsubuga
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Paul Isabirye
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Kenneth Kasule
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Justine Fay Katwesige
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Sheila Nyakwezi
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Solome Sevume
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Norbert Mubiru
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Barbara Amuron
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Daraus Bukenya
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| |
Collapse
|