Background Unacceptably high levels of childhood malnutrition have been registered in all regions of Uganda over the years. Buhweju district alone contributed 46% prevalence of childhood malnutrition to the 47.8% estimated national prevalence for the whole of western Uganda in 2014. This study assessed health provider and caregiver opinions on factors responsible for persistent malnutrition among under five children in Engaju and Nyakishana sub counties. Methods In this phenomenological qualitative study, we conducted two key informant interviews and six focus group discussions with Village Health Team members and care takers of under five children in Engaju and Nyakishana sub-counties respectively.to explore their opinions on the factors responsible for persistent malnutrition in Buhweju District in May 2018. Data were thematically analyzed manually and using Atals Ti 7.5. Results Historical and geographical challenges, poverty and economic occupation, parental alcoholism and domestic violence as well as inadequate childcare services were identified as factors responsible for persistent malnutrition among under five children in Engaju and Nyakishana sub counties. Conclusion Persistent malnutrition in under five children is mainly due to historical and geographical challenges and its associated factors that include poverty and economic occupation, parental alcoholism and domestic violence and inadequate childcare services. Thus literacy education for mothers and young adolescent boys and girls through engaging local leaders, local nongovernmental organizations and Companies operating in the district to contribute to social services provision would limit the domestic violence and increase sensitization on male responsibilities in the children care in Buhweju district.

Background The nutritional well-being of infants and young children is influenced by economic, environmental and maternal factors that range from food intake, health, sanitation and care. All regions of Uganda have registered unacceptably high levels of childhood malnutrition over the years, although with an uneven distribution across regions. This study assessed health provider and caregiver perspectives on factors responsible for persistent malnutrition among children aged 0-59 months in Engaju and Nyakishana sub counties in Buhweju district.Methods In this phenomenological qualitative study, we conducted six Focus group discussions with Village Health Team members and care takers of children aged 0-59 months in Engaju and Nyakishana sub-counties and two key informant interviews with two members of the district health team to explore their perceptives on the factors responsible for persistent malnutrition in Buhweju District in May 2018. Data were thematically analyzed manually and using Atals Ti 7.5Results Historical and geographical challenges, poverty and economic occupation, parental alcoholism and domestic violence as well as inadequate childcare services were identified as factors responsible for persistent malnutrition among children aged 0-59 months in Engaju and Nyakishana sub counties in Buhweju district Conclusion Persistent malnutrition in children aged 0-59 months in Buhweju district is mainly due to historical and geographical challenges and its associated factors that include poverty and economic occupation, parental alcoholism and domestic violence and inadequate childcare services . Addressing these factors from the grassroots up through, multisectoral collaboration between infrastructure, Agriculture, Education and health, engaging communities and effective policy changes and implementation has the potential to improve the nutrition status of children in Buhweju district

Background In many resource constrained countries Uganda inclusive, women continue to give birth from home/in the community where there are no weighing scales to measure and record birth weight. There is also lack of enough weighing scales and skilled health personnel at health facility level to ensure that birth weight for every child is timely determined. Birth weight is an indicator of the chances for survival, growth, long-term health and psychosocial development of neonates. Different anthropometric parameters are reliable surrogates of birth weight although they are highly contextual. This study assessed the best anthropometric surrogate of birth weight usable at facility and community levels in western Uganda. Methods A cross sectional study was conducted between July and September 2017, whereby anthropometric values of 553 neonates born at Mbarara Regional Referral Hospital were measured by two midwives and later repeated by two community health workers to determine the reproducibility. Data regarding birth weight, height, foot length and circumference of head, mid upper arm, chest, thigh and calf were collected and recorded. Frequencies, percentages and mean and standard deviation were used to describe categorical and continuous demographics of neonates respectively. Pearson correlations, specificity, sensitivity, likelihood ratios, diagnostic odds ratios and area under the curve (AUC) were determined and used to establish the most reliable anthropometric parameter that best estimates birth weight of neonates. Results Chest Circumference was the most reliable parameter (AUC= 0.89, DOR= 33.57). There were statistical significant mean differences in all the anthropometric measurements made by midwives and CHWs except for chest circumference (Mean difference = 0.03 cm, 95% CI: -0.22-0.29, p = 0.7963) and foot length (Mean difference = 0.03 cm, 95% CI: -0.22-0.29, p = 0.7963). Conclusions Chest circumference taken within 24 hours after birth is the best nthropometricsurrogate measure of birthweight. Community Health workers can measure chest circumference with almost the same accuracy like midwives.

Background Nutritional well-being is fundamental to the attainment of the full social, economic, mental and physical potential of individuals, communities and populations. The nutritional well-being of infants and young children is positively and negatively affected by economic, environmental and maternal factors that range from food intake, health, sanitation and care. Several initiatives such as growth monitoring, vitamin A distribution, deworming programs have been undertaken to reduce the impact of nutritional deficiency and promotion of health of children under five years in Uganda. All regions of Uganda have registered unacceptably high levels of childhood malnutrition over the years, although with an uneven distribution across regions. Western Uganda has persistently registered the highest levels of malnutrition with Buhweju district having the highest levels above the national average. This study assessed health provider and caregiver perspectives on factors responsible for persistent malnutrition among children aged 0-59 months in Engaju and Nyakishana sub counties in Buhweju district.Methods Focus group discussions and key informant interviews with Village Health Team members and care takers of children aged 0-59 months in Engaju and Nyakishana sub-counties and healthcare providers in Buhweju district were conducted respectively to explore their perceptives on the factors responsible for persistent malnutrition in Buhweju District in May 2018.Results Inadequate childcare services, poverty and economic occupation, parental alcoholism and domestic violence as well as historic and geographic challenges were identified as factors responsible for persistent malnutrition among children aged 0-59 months in Engaju and Nyakishana sub counties in Buhweju district Conclusion Several factors are responsible for persistent malnutrition of children aged 0-59 months in Buhweju. Some can be readily addressed and should lead to improvement in the nutrition status of children in Buhweju district.

Availability of clean drinking water is a universal human right. The quality of water differs across communities. When the quality is good, community members are the primary beneficiaries but they are also the first ones to experience the consequences of deteriorating quality of water. In most communities, the inhabitants are able to tell if their drinking water is safe and of quality basing on organoleptic properties. The community perceptions and practices about safety and quality of drinking water are informed by their attitudes and levels of knowledge about water quality. This study aimed to assess community perceptions and practices on quality and safety of drinking water in Mbarara city, south western Uganda. A qualitative study was conducted between May and July 2022. Six focus group discussions among community members and four Key informant interviews with stakeholders in the water service were conducted. Data was analysed basing on predetermined themes of: 1) perceived quality of water 2) perceived factors associated with water quality 3) practices related to water quality and 4) perceived solutions for improving water safety and quality. Drinking water safety and quality in Mbarara city is perceived as not good, dirty, salty and limited in supply and the water sources are shared with animals. The poor quality of drinking water is due to poor waste disposal, poor treatment, poor maintenance of systems, flooding, political interference, deficiency in city planning, increase in population growth and water hyacinth. Sensitizing the communities, community participation, proper water treatment and surveillance and monitoring are solutions to ensuring provision, use and maintenance of safe and quality drinking water in Mbarara city.