Browsing by Author "Japheth Kwiringira"

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Barriers to treatment seeking for depression among elderly service users at Butabika national referral and teaching hospital, Kampala- Uganda
(Aging & Mental Health, 2025-01-15) Sumani, Ganafa; Japheth Kwiringira; James Mugisha; Eddy Walakira
Objectives Depression among the elderly is a significant public health concern in Uganda, where cultural, social, and healthcare-related barriers hinder access to treatment and support. This study examines the barriers to mental health service access faced by elderly service-users in Uganda. Method Using an interpretive phenomenological approach, in-depth interviews were conducted to capture the lived experiences of elderly Baganda service users receiving treatment at Butabika National Referral and Teaching hospital. Results The findings reveal an intricate interaction between cultural, social, economic, and healthcare system-related barriers. Key barriers include limited mental health awareness, financial constraints, fragmentation, drug shortage and geographical access. Social and cultural stigma further exacerbate these challenges contributing to delayed or avoided help-seeking behaviours among the elderly. Conclusion The study highlights the intersectionality of aging and mental health issues, underscoring the urgent need for a comprehensive, integrated approach to mental health care for the elderly. This research calls for targeted interventions to reduce stigma, increase mental health literacy, and improve the accessibility and affordability of care for vulnerable elderly populations in Uganda. Such services can improve mental health outcomes and quality of life for the elderly in Uganda.
Examining the potential of mobile money-based health insurance for people living with HIV and hypertension or diabetes in Uganda
(Frontiers in Health Services, 2026-03-17) Zakumumpa, Henry; Ssempala Richard; Jepchirchir Kiplagat; Japheth Kwiringira; Wilm Quentin; Verena Struckmann
Background: Digital technologies are increasingly promoted as alternative pathways for financing universal health coverage (UHC) in sub-Saharan Africa, yet evidence on their acceptability among informal-sector populations remains limited. This study explored the acceptability of mobile money–based private health insurance among people living with HIV (PWH) with comorbid hypertension or diabetes in Uganda. Methods: We conducted an exploratory qualitative study in Fort Portal City, midwestern Uganda. Data were collected through four focus group discussions with PWH (n = 48) and 18 key informant interviews with representatives of telecom companies, private health insurers, regulators, and health providers. Data were analyzed thematically using an established analytical framework on facilitators and barriers to mobile health technologies. Results: PWH reported rising out-of-pocket expenditures for managing hypertension and diabetes compared to HIV care, which remains largely donor-funded. Facilitators to uptake included high mobile phone ownership, widespread use of mobile money, perceived affordability of monthly premiums (USD 1.35–8.20), prior experience with mobile money insurance, and convenience of digital payments. Barriers included limited understanding of insurance principles, mistrust of private insurers, fears of mobile money fraud, high internet data costs, intermittent electricity supply, and widespread poverty. Conclusion: Mobile money–based health insurance was perceived as affordable and acceptable among PWH with NCD comorbidities. However, low insurance literacy and mistrust of insurers remain major obstacles. Mobile money–based health insurance warrants further research as a complementary pathway for expanding health insurance coverage in Uganda and similar settings.