Urban green spaces (UGS) may improve mental health in high-income countries. However, evidence from low-income African countries is scarce. Here, we assessed the associations of UGS with depressive and anxiety symptoms among adult residents of Kampala District (Uganda), the potential effect modification by sociodemographic factors, and the mediation roles of social interaction, outdoor physical activity, and residential distance to major roads as a proxy of traffic-related air pollution. We conducted a cross-sectional survey among 641 adults. We objectively measured UGS using the Normalized Difference Vegetation Index (NDVI) within buffers of 100 m and 1,000 m around the residences. We assessed the utilization of UGS as a self-reported frequency (never, occasionally, and frequently) by which individuals visited UGS in the past 6 months. The Patient Health Questionnaire-9 and the Generalized Anxiety Disorder 7-item scale were used to examine the severity of depressive and anxiety symptoms respectively. We used modified Poisson regression models to obtain prevalence ratios (PR) with their 95 % confidence intervals (CI), stratified our models, and conducted mediation analyses. We observed an inverse association between UGS and both outcomes. For example, an inter-quartile range increase in UGS within a 100 m buffer was associated with a 6 % and 8 % decrease in depressive and anxiety symptoms, respectively (PR=0.94; 95 % CI=0.89–0.99, and PR=0.92; 95 % CI=0.85–0.95, respectively). Consistently, frequent visits to UGS relative to no visits were associated with a 33 % and 35 % lower prevalence of depressive and anxiety symptoms (PR=0.67; 95 %CI=0.53–0.84, and PR=0.65; 95 %CI=0.47–0.91, respectively). Depending on the UGS metric, we observed varying potential effect modification findings by sex, age, and educational level. Finally, residential distance to major roads emerged as a mediator in the association between residential surrounding greenness and depressive symptoms. Our study suggests that UGS may also improve the mental health among residents of rapidly urbanizing African low-income cities.

We implemented a multidisciplinary project between Uganda and the UK aimed at strengthening antimicrobial stewardship (AMS) in Wakiso district, with a focus on capacity building, stakeholder engagement, and knowledge exchange using a One Health approach. Project activities included: trainings and workshops on antimicrobial resistance (AMR), AMS, infection prevention and control (IPC); Global Point Prevalence Survey (GPPS) data collection and analysis; and the mentorship of lower level health facilities. Our project demonstrated that AMS interventions using a One Health approach can enhance understanding of the prudent use of antimicrobials and improve practices at health facilities and within communities.

Background: Mental health remains a low priority issue in many low- and middle-income countries where both biomedical practitioners and traditional healers provide essential services. While the collaboration between these two types of providers is essential for comprehensive care, their integration within Uganda’s mental health service delivery system remains insufficient. This study therefore explored collaboration between biomedical and traditional providers in mental health service delivery in Wakiso district, Uganda. Methods: We conducted a qualitative study that employed key informant interviews to collect data. Thirty-four (34) key informants including 15 biomedical practitioners, 11 traditional healers, and 8 national level stakeholders such as policy makers participated in the study. All interviews were audio recorded and transcribed. Thematic analysis was conducted with the support of NVivo 2020 (QSR International). Results: Two main themes emerged from the study: the role of traditional healers in the mental health service delivery; and challenges affecting collaboration of traditional healers and biomedical practitioners. The study established that although not fully recognised, traditional healers played an important role in mental health through easing access to health services, affordability of their services, and the trust that communities had in traditional medicine. Non-inclusive mental health policy, power imbalances, and limited funding for mental health research were the main challenges identified regarding the collaboration between traditional healers and biomedical practitioners in mental health service provision. Conclusions: Traditional healers are actively involved in mental health service provision in Uganda. Collaboration between traditional healers and biomedical practitioners could be enhanced by various stakeholders including policy makers recognising the contribution of traditional medicine, ensuring inclusive mental health policies, and increased resources for mental health research.