This article presents findings on children’s experience in accessing and utilizing water in two sub-counties of Kagamba and Lwanda; one extremely water-scarce and the other relatively water plenty in Rakai district, Uganda. We answer the following question: How do children in a water-scarce context experience water and what does it mean for their wellbeing? A survey was conducted among school-going children aged 11-17 years (N=405), combined with focus group discussions with children and women. Access to adequate safe water was the fifth most frequently mentioned component of wellbeing. A majority of the children affirmed that water scarcity was the biggest threat to their wellbeing. Water scarcity posed both direct and indirect threats; the direct threat resulting from long distances and risks at the water point. Indirectly, the poor quality of water increased susceptibility to water-related illness. A majority of the children experienced a water problem in their home and were unhappy living in such a situation. Unhappiness also resulted from reduction of playing time, punishment and body aches. Fetching water made up the bulk of the chores performed by children, making it a drudgery due to using heavy water vessels, long distances covered and the number of trips to the water point per day. Childhood, in the context of domestic water scarcity encompasses vulnerability. It hence requires protection through the improvement of domestic water access, both in terms of quantity and quality.

Water scarcity research, in rural settings, mainly uses a hydrological lens. Basing on key informant interviews and documentary review, we argue that inadequate access in Rakai results from socio-political factors relating to infrastructural allocation and operation and maintenance of water facilities. In Uganda, Local governments play a role in making decisions and managing water-related services. The communities play a role in the continued functioning of water sources. The findings indicate that in Rakai, non-physical scarcity factors determine the point of water service location basing on political expediency; the water supply technology used is informed by economies of scale and not sustainability and robustness. Water source maintenance funding and the functionality of community-based management systems also influence water access. Community contribution and equitable distribution of water points are imperative in improving rural water access.

Antiretroviral therapy (ART) is considered the treatment that enables people living with HIV (PLHIV) to lead a “normal life”. In spite of the availability of free treatment, patients in resource-poor settings may continue to incur additional costs to realize a normal and full life. This article describes the monetary expenses and psychosocial distress people on free ART bear to live normally. We conducted in-depth interviews with 50 PLHIV on ART. We found that the demands of treatment, poverty, stigma, and health-system constraints interplay to necessitate that PLHIV bear continuous monetary and psychosocial costs to realize local values that define normal life. In the context, access to free medicines is not sufficient to enable PLHIV in resource-poor settings to normalize life. Policy makers and providers should consider proactively complementing free ART with mechanisms that empower PLHIV economically, enhance their problem-solving capacities, and provide an enabling environment if the objective of normalizing life is to be achieved.

Background Despite the national roll-out of free HIV medicines in Uganda and other sub-Saharan African countries, many HIV positive patients on antiretroviral therapy (ART) are at risk of non-adherence due to poverty and other structural and health system related constraints. However, several patients exhibit resilience by attaining and sustaining high levels of adherence amid adversity. Social capital, defined as resources embedded within social networks, is key in facilitating resilience but the mechanism through which it operates remains understudied. This article provides insights into mechanisms through which social capital enables patients on ART in a resource-poor setting to overcome risk and sustain adherence to treatment. Methodology The article draws from an ethnographic study of 50 adult male and female HIV patients enrolled at two treatment sites in Uganda, 15 of whom were followed-up for an extended period of six months for narrative interviews and observation. The patients were selected purposively on the basis of socio-demographic and treatment related criteria. Findings Social capital protects patients on ART against the risk of non-adherence in three ways. 1) It facilitates access to scarce resources; 2) encourages HIV patients to continue on treatment; and 3) averts risk for non-adherence. Conclusions Social capital is a key resource that can be harnessed to promote resilience among HIV patients in a resource-limited setting amid individual, structural and health system related barriers to ART adherence. Invigoration and maintenance of collectivist norms may however be necessary if its protective benefits are to be fully realized.

This chapter is primarily based on a study conducted in a rural community in south-central Uganda in Makondo Parish, Ndagwe sub-county, Lwengo district. The study, which employed mixed methods, investigated household dynamics in collection, transportation and use of safe-drinking water. The study findings are complemented by additional interviews with children water collectors in a peri-urban context in Wakiso District that sought, among others, to capture voices and perspectives of children regarding their experiences in water transportationWater transportation . Our findings confirm that the burden of collecting water for domestic use is almost exclusively a domain of children and their mothers or other female members of the household. The distances covered and the time spent in collecting water, the volumes and mode of transportation are all potentially hazardous to children's physical and emotional health, which inadvertently have not been addressed by rural water policy and interventions. We argue for water supply options and service interventions that are consciously designed to sustainably address risks and vulnerabilities associated with water collection and transportation by children. Ensuring increased coverage of improved water sources within a distance of one and a half kilometers, promotion of rain water harvesting in communities, ensuring sustainable operation and maintenance of point-water sources as well as protection of open water sources are some of the supply related interventions that could address the burden of children in water transportation. It is not the intention of this chapter to promote child involvement in work, but rather, to advocate for a service delivery environment that not only lessens the physical burden of water collection for children but also other environmental and social risks associated with their 'socially and culturally defined responsibility' of water collection.

Water has always been a crucial catalyst for human development. In Africa, competition among different sectors for this scarce resource remains a critcial challenge to water managers and decision-makers. Water and Development examines a range of issues, from governance to solar distillation, from gender to water pumps, using a range of research methods, from participant observation to GIS and SPSS data analysis. Throughout, however, there is the unifying thread of developing a participatory and sustainable approach to water which recognises it as an essential public necessity. Edited by Ronaldo Munck, Narathius Asingwire, Honor Fagan and Consolata Kabonesa, the result is essential reading both for students of development and the environment and for NGOs and policy-makers seeking a robust and transformational approach to water and development.

Community-based water management systems (CBWMSs) are now a popular policy strategy for sustainable rural safe water supply in Africa. However, the effectiveness of the model is marred by numerous bottlenecks of varying character and scale. This chapter, which is based on a case study of a rural parish in south-central Uganda, examines some of these bottlenecks. The study indicates that whereas CBWMSs are well known among water-sector actors as desirable for achieving functional sustainability of improved water facilities, conscious actions have not been taken to leverage the effectiveness of these water management systems. This failure is at the very heart of the weaknesses within the new policy frameworks which embrace principles of community participation, privatization, and public–private partnerships. The study advocates a public authority with renewed attention to local conditions that determine CBWMS effectiveness, especially in developing countries like Uganda.

INTRODUCTION:Studies show that HIV counseling and testing (HCT) can improve linkage to HIV prevention, care and treatment services. However, uptake of HCT among couples remains low in most settings. We investigated the determinants of HCT uptake among individuals in long-term relationships in two districts in Uganda.METHODS:This case-control study was conducted among 787 (400 in Kampala and 387 in Soroti) individuals in long-term sexual relationships, aged 18-54 years, using interviewer-administered questionnaires. Cases were individuals who had ever tested for HIV (selected from health facility records and traced in the community for interview) while controls were individuals who had never tested for HIV, identified from the same community as the cases. Data were collected on sociodemographic and behavioral characteristics; entered into FoxPro and analyzed using STATA version 12.1. We performed multivariable logistic regression to estimate the odds ratio (OR) and 95% Confidence Intervals (95%CI) associated with prior HCT and couples' HCT uptake, controlling for suspected confounders.RESULTS:Of the 787 participants, 522 had ever tested for HIV (cases) while 265 had never tested for HIV (controls). Compared to those that had never tested for HIV, those that had ever tested for HIV were significantly more likely to be females (Adj. OR=3.23, 95%CI: 2.27, 4.60), to be 25-29 years old (Adj. OR=2.15, 95%CI: 1.32, 3.50), to report exposure to a couples' HCT promotional campaign (Adj. OR=2.01, 95%CI: 1.30, 3.10) and to believe that HIV discordance is possible among married couples (Adj. OR=1.77, 95%CI: 1.20, 2.63). Compared to individuals that had ever received individual HCT, those that had ever received couples' HCT were significantly more likely to report prior discussion of HIV testing with partner (Adj. OR=4.35, 95%CI: 2.61, 7.28) and to be residents of Soroti district (Adj. OR=6.01, 95%CI: 3.74, 9.65).CONCLUSION:Prior HCT was significantly associated with female gender and exposure to a couples' HCT promotional campaign while prior couples' HCT was significantly associated with prior discussion of HIV testing with partner. To increase HIV testing among couples, these findings suggest a need for HCT promotional campaigns that promote communication about HCT between partners.

This report details some of the key findings of a sociological survey that was undertaken in rural Makondo Parish, Lwengo District in Uganda. The cross-sectional survey was carried out between September and November 2011 and covered all the 15 villages in the Parish. The broad aim of the survey was to assess the livelihoods, health, gender and water governance issues in Makondo Parish. Prior to the survey, several preliminary visits were made to the study area, which were then followed by a rigorous literature review on rural water governance, health and livelihoods in Uganda and globally so as to identify the major themes and variables. These themes were then used to develop a quantitative or structured questionnaire. The questionnaire was structured under the following headings: household and interviewer identification; respondents’ characteristics; household livelihoods and well-being, particularly poverty indicators like main source of income, money earned, dwelling type, and number of meals eaten; knowledge of the importance of safe water; access to safe water, such as type of water sources used, access to improved water sources, transportation of water; health issues like water-related diseases suffered, cost to the household of these diseases, steps taken to mitigate against the diseases; knowledge of hand-pump functionality; household water use and management, such as satisfaction with use, conflicts if any and decision-making on use; perceptions of safe water services and systems such as rating of safe water service delivery and why; knowledge of community-based water management systems and capacity building for sustainable utilisation of safe water. The final version was translated into Luganda, the local vernacular so as not to distort the meaning of the questions. This exercise was carried out by the Makerere University Institute of Languages, and the Luganda version was then used to train the Community Health Workers on how to administer and record standardised interviews, such as mastering the intended meaning of each and every question in the questionnaire, the expected data, recording and editing among others. The CHWs were also trained on how to use a GPS (Global Positioning System) unit so as to capture the necessary data for mapping the household locations. After training the CHWs, the questionnaire was piloted in one of the villages in a neighbouring Parish (called Nanywa) and again revised. The actual field work or data collection started with Misaana village in the North-Eastern part of Makondo Parish, then moved on to Luyiiyi-Kate, Luyiiyi-Protazio and ended with Kiguluka, the last village in the Parish on 14th November 2011. It took between three to four days on average to complete the survey in each village, and the first day of work in each village involved meeting the Village Chairpersons, explaining to then about the WIL Project, objectives of the survey and seeking their support in locating selected households for interviews. After every two-three days of data collection, meetings were held with the interviewers/CHWs to share fieldwork experiences as well as edit field questionnaires. A total of six hundred and six (606) households selected proportionately across the 15 villages in Makondo Parish were covered in the survey. Despite several challenges that were met during the survey, such as failure by interviewers/CHWs to complete their assigned households in time; heavy rains that made driving on the village roads quite difficult especially in Kiteredde, Kiyumbakimu and Kiguluka villages, the survey was a success and data collection ended quite successfully, as the originally targeted sample was attained.

Market access is increasingly relying on Information and communications technologies (ICTs) like telephony and internet that are only adopted haphazardly. Despite need for ICTs in Market Information Services (MIS), ICT usage in Africa is low. Little is known about ICTs for use in MIS including, technology, its potential users and characteristics of both entities. Closing such gaps was justified. The study determined ICT components used and factors influencing adoption and choice of components. Stratified random sampling was used to collect data using structured questionnaires from 150 farmers and 50 traders and analysed using STATA. Radio was most used old ICT whereas mobile phones were most used new ICT. Expensive handsets, poverty, poor power supply, lack of expertise and poor network coverage limited ICT use. Farmers with knowledge of ICT groups and those thinking that ICTs benefited agriculture were more likely adopters of ICT-based MIS. Family size and land farmed influenced farmers’ adoption, whereas age, trading experience, family size and monthly expenses influenced traders’ adoption. Farmers and traders who majorly used ICTs for making profit were more likely to use mobile phone whereas those who stayed further from towns were less likely to use the component. Key words: Information and communications technologies (ICTs), smallholder farmers, adoption, determinants, market information services, logit model, traders.

Market access is increasingly relying on ICTs that are adopted haphazardly yet less is known about available ICTs; technology, potential users, and characteristics of both entities hence the study assessed adoption of ICTs in market services by smallholders determining; components, factors influencing adoption, choice of combinations and 150 farmers and 50 traders were interviewed randomly. Majority of respondents had knowledge of ICT groups but only 22% had membership despite 80% agreeing that ICTs benefit agriculture. Radio and mobile phone were most used and poverty, poor power/network coverage limited ICT use whereas experience, family size and land farmed influenced adoption.

As the use of information and communication technologies (ICT) is embraced in Uganda, determinants of awareness of ICT based projects remain unknown. The intensity of use of mobile phones among smallholder farmers in the areas where such projects operate is unclear. To address this knowledge gap, 346 smallholder farmers in two ICT project sites in Mayuge and Apac districts were subjected to econometric analysis using bi-variate logistic and zero-inflated negative binomial regression models to ascertain determinants of projects’ awareness and intensity of use of mobile phones. The authors find that education, distance to input markets, and membership in a group positively influence awareness. The decision to use a mobile phone for agricultural purposes is affected by distance to electricity and land cultivated and negatively influenced by being a member of any farmer group. Lastly, intensity of mobile phone use is affected by age, farming as the major occupation, and distance to an internet facility, being a member of a project, having participated in an agricultural project before, value of assets, size of land cultivated, possession of a mobile phone, and proximity to agricultural offices. The paper discusses policy implications of these findings.

As the use of information and communication technologies (ICT) is embraced in Uganda, determinants of awareness of ICT based projects remain unknown. The intensity of use of mobile phones among smallholder farmers in the areas where such projects operate is unclear. To address this knowledge gap, 346 smallholder farmers in two ICT project sites in Mayuge and Apac districts were subjected to econometric analysis using bi-variate logistic and zero-inflated negative binomial regression models to ascertain determinants of projects’ awareness and intensity of use of mobile phones. The authors find that education, distance to input markets, and membership in a group positively influence awareness. The decision to use a mobile phone for agricultural purposes is affected by distance to electricity and land cultivated and negatively influenced by being a member of any farmer group. Lastly, intensity of mobile phone use is affected by age, farming as the major occupation, and distance to an internet facility, being a member of a project, having participated in an agricultural project before, value of assets, size of land cultivated, possession of a mobile phone, and proximity to agricultural offices. The paper discusses policy implications of these findings.

Access and use of information and communication technologies (ICTs) by the smallholder rural farmer is envisaged to improve their welfare due to increased access to input and output markets. This study analyzes the constraints to the use of such tools for market linkage in Uganda and policy implications. The paper draws from a case study of two local organizations ICT-based projects namely, Busoga Rural Open Source Development Initiative (BROSDI), and Women of Uganda Network (WOUGNET). The constraints identified include lack or poor to ICT tools, poor ICT infrastructure, inadequate resources and high levels of poverty, low levels of literacy, inappropriate modes of information transfer, socio-cultural dynamics and sustainability issues. The paper argues that reaching the poor illiterate smallholder farmers requires redesigning the information content and delivery modes so that the information comes in audio form and in ICT tools that do not require literature. Also the government and private sector need to work hand in hand to ensure access and usability of ICT tools in rural areas by the former investing more in making electricity available in rural communities and the latter extending network boosters to remote rural areas