Background: The Home Management of Malaria (HMM) strategy was developed using chloroquine, a now obsolete drug, which has been replaced by artemisinin-based combination therapy (ACT) in health facility settings. Incorporation of ACT in HMM would greatly expand access to effective antimalarial therapy by the populations living in underserved areas in malaria endemic countries. The feasibility and acceptability of incorporating ACT in HMM needs to be evaluated.

Background: The use of artemisinin-based combination therapy (ACT) at the community level has been advocated as a means to increase access to effective antimalarial medicines by high risk groups living in underserved areas, mainly in sub-Saharan Africa. This strategy has been shown to be feasible and acceptable to the community. However, the parasitological effectiveness of ACT when dispensed by community medicine distributors (CMDs) within the context of home management of malaria (HMM) and used unsupervised by caregivers at home has not been evaluated.

Understanding the impact of commercial agriculture in the face of global change is critical to support strategies that ensure food security and alleviate poverty among households. We assessed the contribution of commercial sugarcane cultivation to household-level food security among smallholder farmers in Busoga sub-region, eastern Uganda. Land use changes are motivated by quick commercial gains rather than sustained food production; a situation that influences food security. The majority of households cultivate few crop varieties, lack adequate and nutritious foods, and have inadequate income to purchase food to meet their needs. Inadequacy of food within some commercial sugarcane-cultivating households suggests that generating income does not necessarily increase food security. To cope with food insecurity, households offer labour in exchange for food, borrow food, ration food, and at times steal. This is exacerbated by increasing food crop failures, large family sizes, trade in food items, and declining availability of food and land for food production. Commercial sugarcane cultivation is the main driver of food insecurity but given its perceived economic benefits, future sugarcane plantations expansion in the region is probably inevitable. Therefore, future policy should be designed to provide triple-win strategies (i.e., food security, poverty alleviation, and climate change adaptation) that provide sustainable livelihoods.

Understanding biodiversity in homegardens embedded in landscapes dominated by commercial monoculture agriculture is critical for sustainable management of agrobiodiversity and meeting rural households' needs in the face of global changes. We assessed agrobiodiversity in the 120 homegardens and its contribution to rural household livelihood strategies within a commercial monoculture sugarcane cultivation land matrix in eastern Uganda. We recorded a total of 68 plant species from 46 genera representing 27 families. Species richness spanned 6 to 19 species, and α-diversity (H') ranged from 0.6 to 2.3; with 86.67% of the homegardens having H' >1. Species composition differed significantly (global R ANOSIM = 0.153, p < 0.001) among the villages. The most important and commonly maintained plants were those that provided food, fuelwood and money income and included Zea mays L., Manihot esculenta, Phaesolus spp., Coffea sp., Musa spp., Ipomea batatus and Artocarpus heterophyllus. Most of the crops cited as useful by households were also frequent and visible in many of the homegardens. Although homegardens still hold some valuable plants, there is also loss of important plants from the agricultural system including cowpeas, soya beans, bambara groundnuts, finger millet, cotton, aerial yams and oysternut essential for sustaining household livelihoods. This loss, precipitated by increased land-use/cover change to commercial sugarcane plantations threatens agrobiodiversity conservation and the benefits households derive from homegardens. Our findings underline the importance of homegardens in the conservation of indigenous agrobiodiversity, and indicate that with the continued expansion of commercial sugarcane cultivation this opportunity may be lost. ARTICLE HISTORY