Muni Repository (MR)
This repository contains open access publications of Muni University Library.
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Recent Submissions
Participation of livestock farmers and community animal health workers in one health intervention to control zoonotic diseases in Rwanda: a qualitative study
(Springer Nature, 2026-01-27) Hugor, Shema; Izudi, Jonathan; Shyaka, Anselme
Background
In zoonotic disease hotspots, engaging local communities in zoonotic disease monitoring and reporting is essential for effective prevention and early outbreak detection. In Rwanda, the Eastern Province has experienced nearly 90% of all zoonotic disease outbreaks. This qualitative study explored the participation of livestock farmers and community animal health workers (CAHWs) in One Health interventions aimed at controlling zoonotic disease outbreaks in Nyagatare district, Eastern Province, Rwanda.
Method
Among livestock farmers and CAHWs, we collected qualitative data through in-depth interviews and focused group discussions. We held key informant interviews with district-level officials, namely district veterinary, district health, and district environmental health officers, to validate the data from livestock farmers and CAHWs. The data were transcribed verbatim and verified by replaying the audio recordings. Content analysis was performed.
Results
Five major themes emerged as areas of participation: (i) capacity building focused on livestock management and livestock disease identification and prevention; (ii) community-level health education encompassing zoonotic disease risk communication and awareness raising; (iii) interruption of zoonotic disease transmission that comprised infection prevention and control, separation of sick and healthy livestock, quarantine, and zero grazing, adherence to guidelines, and the testing, treatment, spraying, and vaccination of livestock; (iv) collaboration with multiple sectors via training on zoonotic diseases, including its treatment, investigation, and prevention; and 5) zoonotic disease surveillance that included livestock monitoring and inspection for zoonotic diseases and the notification and reporting of zoonotic diseases to relevant authorities. The collaboration between the environmental health sector and the animal and human sectors was weak, while vaccination targeted mainly cattle but not small ruminants.
Conclusions
Livestock farmers and CAHWs participate in several One Health interventions aimed at controlling zoonotic diseases, particularly in vaccination campaigns for cattle, community sensitization, and basic animal husbandry practices. However, collaboration between the environmental health sector and the animal and human sectors was weak, vaccination efforts largely excluded small ruminants, and some farmers relied on local herbs for treatment due to limited access to professional veterinary services. Efforts to sustain the major areas of participation are needed, while weaker areas need strengthening.
Trauma led us to substance use: an interpretative phenomenological analysis of refugee youth experiences with substance use during the COVID-19 pandemic in Uganda
(BMJ Publishing, 2026-02-05) Akello, Sarah Racheal; Epuitai, Joshua; Ayiasi, Richard Mangwi; Kakyo, Tracy Alexis
Introduction: Refugee populations experience significant psychological stress in host countries. The COVID-19 pandemic worsened pre-existing vulnerabilities and also presented new vulnerabilities for substance use. The study was conducted to examine the pattern of substance use during and after the COVID-19 pandemic among youth residing in a rural refugee settlement camp in north-western Uganda.
Methods: The study was conducted in a refugee settlement camp in north-western Uganda. We used an interpretative phenomenological analysis framework to explore substance use among young people. We conducted eight in-depth interviews and four focus group discussions among youths between the ages of 18–30 years.
Results: We identified two master themes: (1) trauma led us to substance use and (2) desire for belonging and identity kept us in substance use. Young people recounted stories of trauma which served to initiate and promote substance use among them. COVID-19 restrictions on social isolation, social distancing and military enforcement of the restrictions exacerbated previous experiences of trauma resulting in substance use. Refugees, who were already separated from their families in the host country, engaged in substance use following further parental and social isolation, loneliness and reduced support systems in refugee camps. The reduced financial support, unemployment, closure of businesses and schools provided additional motivation to engage in substance use among young people. Surviving the refugee camp heightened the need for belonging to a group. The desire to belong in, to fit in and to stand out in the group altogether served to provide further avenues for substance use among young refugee populations.
Conclusion: Interventions for substance use among refugee youth, particularly during a pandemic, ought to consider the complex landscapes for refugees and their multiple layers of vulnerabilities. Peer pressures and group influence should be given special considerations while planning mitigation measures.
Working through community structures: the role of community health workers in cardio- metabolic disease care in Bidibidi, Uganda
(Bristol University Press, 2026-02-05) Dræbel, Tania Aase; Gyawali, Bishal; Ratib, Dricile; Nakanjako, Rita; Nanfuka, Esther Kalule; Raju, Emmanuel; Kyanddodo, David; Skovdal, Morten
This chapter examines how community health workers (CHWs) support refugees with diabetes and hypertension in accessing health services and engaging in self- and social care. Despite limited resources, CHWs perform three critical roles: 1. Relational Work: CHWs connect with the community, facilitate communication with healthcare staff, help patients re- engage with services, advocate for patients, and act as intermediaries. 2. Healthcare Work: CHWs monitor and screen for illnesses, refer complex cases, promote health, deliver medication, monitor adherence, and follow up with patients. 3. Community Engagement Work: CHWs assess community conditions, engage in sensitisation, and mobilise efforts. These three types of work are crucial to maintaining the continuity of care for refugees with chronic conditions. Our findings underscore the importance of CHWs and the need to integrate them into the formal healthcare system.
Differentiated effects of sources of malaria messages on mosquito bed net use among women of reproductive age in Uganda: a propensity score matched analysis
(Springer Nature, 2026-01-25) Mwebesa, Edson; Agbi, Delight Mawufemor; Iha, Daniel Thoya; Kogei, Dan Kipkosgei; Agasa, Lameck Ondieki; Kerich, Gregory Kibet; Mwangi, Ann
Introduction
Malaria remains a significant public health challenge, particularly in high-burden settings such as Uganda. Social and Behaviour Change Communication (SBCC) interventions play a vital role in influencing knowledge, attitudes, and practices related to malaria prevention. However, despite the widespread promotion of mosquito bed net (MBN) use, there is limited evidence on the comparative effectiveness of different media platforms in encouraging their adoption. This study estimated the effect of exposure to malaria messages from different media platforms on MBN use among women of reproductive age in Uganda using propensity score–matched analysis.
Methods
We conducted a secondary analysis of nationally representative data from the 2018–2019 Uganda Malaria Indicator Survey (UMIS), restricted to 3488 women aged 15–49 years who reported exposure to at least one malaria message. The primary outcome was MBN use, and the key exposures were nine distinct SBCC platforms. One-to-one nearest neighbour propensity score matching was applied, adjusting for key socio-demographic characteristics including age, education level, household wealth index, place of residence, and region. Propensity score matching analysis (PSMA) was applied to estimate the average treatment effect on the treated (ATT) for each platform, with ATT chosen to quantify effects among women who were actually exposed to malaria-related messages, adjusting for relevant observed covariates. Data analysis was done in Stata V14.0.
Results
Of the 3488 women included in the study, 73.2% reported using MBN the previous night before the survey. Propensity score matched analysis revealed that exposure to malaria messages through community health workers (ATT = 0.322, 95% CI 0.111, 0.533), community events (ATT = 0.296, 95% CI 0.085, 0.507), and social mobilization (ATT = 0.185, 95% CI 0.008, 0.362) significantly increased MBN use. Other effective channels included social media, radio, interpersonal communication, and billboards. Television exposure (ATT = 0.051; 95% CI − 0.062, 0.164) and exposure from other unspecified sources were not significantly associated with MBN use.
Conclusion
Among women exposed to malaria messages, exposure through community health workers and community events showed the strongest associations MBN use, followed by exposure through social mobilisation and other SBCC platforms. Exposure through television was not significantly associated with MBN use, suggesting that community-based and interpersonal communication channels may be more strongly associated with MBN utilisation than some mass media platforms.
Wearable Nanogenerators power health monitors in off-grid regions
(IEEE, 2025-12-29) Lamba, Akshit; Shamya, A; Fallah, Mohammed H.; Bahodirkhonugli, Sayfiddinov Izzatullakhon; Nallakumar, R.; Ali, Guma
Health monitoring devices in remote areas often don’t have reliable power, making it hard for healthcare staff to help these patients promptly. Because some regions lack reliable electricity, healthcare workers usually struggle to monitor heart rate, blood pressure, and temperature. We suggest combining wearable nanogenerators with health monitoring systems so that the user's motion powers them. Combining triboelectric and piezoelectric principles, the tiny devices can provide the electrical power needed to operate health monitors when people walk or move their arms. This system's algorithm for managing energy permits the devices to operate longer. Simulations of different motions confirm that the proposed system can provide sufficient electricity for the health monitors to run independently. This solution works best for hard-to-reach or underserved areas, providing a more sustainable and affordable alternative to standard power-dependent health devices. The novelty of this study lies in the integrated approach of coupling hybrid piezoelectric– triboelectric nanogenerators with an adaptive energy management algorithm designed specifically for wearable healthcare devices. Unlike prior works that focus primarily on material enhancement or single-source energy harvesting, this research emphasises a co-optimised framework that integrates motion-based energy conversion, storage regulation, and power utilisation control. The contribution of this work is the development of a self-sustaining, algorithm-governed wearable system capable of reliable health data monitoring in off-grid and energy-scarce environments.