Impact of AIDS on the family and mortality in Uganda.

PIP: A study is being conducted to examine household composition and family structure in the context of high AIDS-related mortality in Hoima, Iganga, Kabale, Masaka, Mbale, and Mbarara districts. The first phase of the study involved the review of ethnographic materials on the populations in the six districts, collecting information from elders and youths through focus group discussions, and the administration of an individual elders' questionnaire. The second phase was a large-scale household survey in the districts to document recent changes in household composition and family structure, while phase three will be carried out three years after the second phase. That final phase will involve re-surveying areas covered in phase two to determine any subsequent changes which have occurred in the communities. This paper presents the results from the elder's survey conducted during phase one. A total of 143 elders, 109 men and 34 women, were interviewed. The respondents were at least 45 years old and all were heads of households. The survey posed questions on household composition, mortality, morbidity, the impact of AIDS upon the family, general health status of the community, and migration. Findings are presented on family composition and structure, AIDS mortality, feelings of loss by elders, and changes in funeral rites and inheritance.^ieng

Impact of AIDS on marriage patterns, customs and practices in Uganda.

PIP: A study is being conducted to examine household composition and family structure in the context of high AIDS-related mortality in Hoima, Iganga, Kabale, Masaka, Mbale, and Mbarara districts. The first phase of the study involved the review of ethnographic materials on the populations in the six districts, collecting information from elders and youths through focus group discussions, and the administration of an individual elders' questionnaire. The second phase was a large-scale household survey in the districts to document recent changes in household composition and family structure, while phase three will be carried out three years after the second phase. That final phase will involve re-surveying areas covered in phase two to determine any subsequent changes which have occurred in the communities. This paper presents the focus group discussion results from phase one. The participating 231 men and 218 women were aged 19-92 years and 14-92 years, respectively. It appears on the basis of the focus group discussions that marriage customs and practices have changed over time due to factors related to socioeconomic development, modernization, and Western culture. Recent changes in marriage have been closely connected with the AIDS epidemic in the country. The fear of potential partners being HIV-seropositive makes boys and girls reluctant to marry, while mutual monogamy among spouses, especially the young, seems to be gaining popularity. Many customs, however, still persist, such as parental participation in the introduction and negotiation for children's marriages, bride price, dowry, circumcision of boys before marriage, fining boys who elope with girls, and rewarding virginity at marriage.^ieng

Care for AIDS orphans in Uganda: findings from focus group discussions.

PIP: The care of AIDS orphans in several regions of Uganda has recently been studied. The study also investigated how the various societies in Uganda have coped with the orphan problem since the onset of the AIDS epidemic. Changes in past and present coping mechanisms are discussed, with recommendations made for the future. Data were collected during 1992 from 241 men and 218 women in focus groups in Uganda's Hoima, Kabale, Mbarara, Masaka, Iganga, and Mbale districts. The participating men and women were aged 19-92 years and 14-92 years, respectively. Orphan care by a surviving parent, care by relatives, and other assistance to orphans are discussed. Orphan care in Uganda has changed since the onset of the AIDS epidemic. The changes are due mainly to the large number of orphans which have overwhelmed the extended family structure. Nonetheless, relatives still care for orphans despite their own problems, albeit at great financial hardship to the caregivers. It is recommended that governmental and nongovernmental organizations increase their levels of assistance to households caring for orphans. The authors further note the higher mortality of orphans, how many people who care for orphans are either too old or too young to fulfill the responsibility which they have assumed, and stigmatization.^ieng

Sexual behaviour, reproductive health and contraceptive use among adolescents and young adults in Mbale District, Uganda.

Results from a survey of adolescents and young adults in Mbale District in Uganda are presented. First sexual experience among female and male respondents occurs at quite an early age, 15 years for males and 16 years for females. Most respondents claimed to have received information on reproductive health. The accuracy of these self-assessments was rather poor as a relatively small proportion of the respondents could identify the safe period in a woman's menstrual cycle. The incidence of adolescent pregnancy is generally high and slightly higher in rural than in urban areas. A relatively large proportion of pregnancies occur out of wedlock. The respondents' contraceptive knowledge was quite good but many still engaged in unprotected sexual relations. The most commonly used methods were the condom and the pill. The main reasons given for non-use were lack of knowledge about contraceptives, beliefs that they were not safe, and their non-availability. This calls for improvements in family planning education and in accessibility of contraceptives.

PIP: A 3-phase adolescent fertility survey was carried out in Uganda starting in 1988. This report presents data from household and individual questionnaires collected in Mbale District for the third phase in August 1990. 1357 adolescent and young adult respondents (15-24 years old) comprised the sample (146 urban males, 330 urban females, 356 rural males, and 525 rural females). Information was solicited on education, religion, employment, marital status, age at first intercourse, frequency of intercourse, number of partners, pregnancy, abortions, and childbearing, sexually transmitted disease experience and knowledge, and contraceptive knowledge and use. It was found that most of these young people were sexually active, and many initiated sexual activity before age 15 years. Most reported having received information about reproductive health, but few could identify the safe period in a woman's menstrual cycle. There were contradictions between behavior and attitudes, with many more young people reporting that they engaged in sexual behavior than reporting that they approved of premarital sex. Whereas levels of contraceptive knowledge were quite high, actual usage was very low. The condom, oral contraceptives, and rhythm method were most often used, but many respondents stated that they lacked enough knowledge to use contraceptive, they believed contraceptives were not safe, or contraceptives were not accessible to them. It is recommended that more educational programs be devised to counter the factors which will encourage high fertility in this population.

The value of children as a major influence on fertility in Uganda: a case study of Ankole.

PIP: In the high fertility area of Bankole, a 1985 study of the value of children to the Banyankole was conducted. Information on marriage patterns, perceptions of the pros and cons of children, and the costs and benefits of extended families was obtained through a random sampling of 900 household and surveys of more than 1000 ever-married man and 1000 ever-married women. A total fertility rate of 8.7 exists for the area, with rate differences observed between socioeconomic groups. Of pastoralists, peasants, and cultivators, the pastoralists reported the lowest fertility rate of 7.1, compared to the highest rate from the cultivators of 10.3. Despite the effect of education, employment, and religion in increasing the age of first marriage from 18 years in 1969 to 21.5 by 1985, cultural practices persist in encouraging high fertility levels. Pastoralist male migration for work during dry season, and the female return to her parents' home following delivery may be 2 practices contributing to a comparative lower fertility rate among this group. Absence of taboos regarding postpartum sexual abstinence among the Banyankole is a determinant of high fertility for the Ankole as a whole. With recorded 4% annual growth in the area, and governmental budgetary constraints to shifting funds into the social service sector, politically, culturally, and socially acceptable population policies are needed to combat pronatalist customs of the Ankole.^ieng