Young women living in Kampala, Uganda, often face adversities related to Social Determinants of Mental Health (SDoMH) including poverty, food scarcity, environmental stressors such as high levels of community violence, and lack of adequate healthcare access. Two consecutive pilot studies were conducted to assess the feasibility and acceptability of survey questions, wearable fitness trackers, and daily diaries before launching a larger prospective cohort study. Preliminary associations between SDoMH factors with depressive symptoms, stress levels, and life satisfaction were examined among the total sample of 60 women across two pilot studies. A total of 32.2% of respondents (out of n = 59) reported being depressed most or all of the time in the past 30 days. Frequent depressive symptoms correlated with food insecurity (${\chi }^2$ = 5.38, df = 1, p = 0.02). Higher stress levels were significantly associated with lower overall life satisfaction scores (t = 2.74, df = 6.20, p = 0.03). Additionally, frequent depressive symptoms were associated with lower satisfaction scores in the living conditions and lifestyle domain (t = 2.22, df = 36.18, p = 0.03). However, overall life satisfaction scores and other domains (social relationships and personal independence) were not statistically associated with frequent depressive symptoms. Identifying the most impactful SDoMH factors among young women in Kampala can inform targeted approaches to improve mental health outcomes.

In many regions globally, including low-resource settings, there is a growing trend towards using mHealth technology, such as wearable sensors, to enhance health behaviors and outcomes. However, adoption of such devices in research conducted in low-resource settings lags behind use in high-resource areas. Moreover, there is a scarcity of research that specifically examines the user experience, readiness for and challenges of integrating wearable sensors into health research and community interventions in low-resource settings specifically. This study summarizes the reactions and experiences of young women (N = 57), ages 18 to 24 years, living in poverty in Kampala, Uganda, who wore Garmin vívoactive 3 smartwatches for five days for a research project. Data collected from the Garmins included participant location, sleep, and heart rate. Through six focus group discussions, we gathered insights about the participants’ experiences and perceptions of the wearable devices. Overall, the wearable devices were met with great interest and enthusiasm by participants. The findings were organized across 10 domains to highlight reactions and experiences pertaining to device settings, challenges encountered with the device, reports of discomfort/comfort, satisfaction, changes in daily activities, changes to sleep, speculative device usage, community reactions, community dynamics and curiosity, and general device comfort. The study sheds light on the introduction of new technology in a low-resource setting and also on the complex interplay between technology and culture in Kampala’s slums. We also learned some insights into how wearable devices and perceptions may influence behaviors and social dynamics. These practical insights are shared to benefit future research and applications by health practitioners and clinicians to advance and enhance the implementation and effectiveness of wearable devices in similar contexts and populations. These insights and user experiences, if incorporated, may enhance device acceptance and data quality for those conducting research in similar settings or seeking to address population-specific needs and health issues.

This paper examines the link between place and mental health using a qualitative assessment and focus group discussion with young women, ages 18 to 24 years of age, residing in three slums in Kampala, Uganda. The assessment, conducted in August of 2022, engaged 15 women who participated in Uganda Youth Development Drop-in center activities. The objective was to assess mental health and the link between place and mental health. Facilitated group discussions and photograph review yielded the following results. In terms of understanding their views of mental health and wellbeing, participants clearly focused on feelings. However, they also assessed resilience, the environment and a person’s choice as relating to their mental health. Participants also found the physical spaces related to sports, education, worship, workplaces and green space to be linked to happiness. In terms of the attributes that were linked to sadness, participants listed the physical locations where drugs are sold, clubs for dancing and partying and also sanitation issues in the community. Participants frequently reported on the social environment and reflected on harassment, discrimination, alcohol use and criminal behavior that did not reflect a specific physical space, but rather the embedded social interactions they may face or observe by living in close proximity to hotspots for criminal activity. Given the dire shortages of mental health services and care that are available in this setting, a better understanding of young women’s perceptions of place and mental health will be key for low-cost interventions and strategies to mitigate the contextual factors that may exacerbate mental illness.

Background: Despite the high prevalence of alcohol use and marketing in many settings across sub-Saharan Africa, few studies have systematically sought to assess alcohol marketing exposure, particularly in vulnerable areas such as urban slums where alcohol is often highly prevalent but where educational programs and alcohol prevention messages are scarce. Objective: To pilot test the development and implementation of environmental scans of alcohol advertisements in five urban slums across different areas of Kampala, Uganda: Bwaise, Kamwokya, Makindye, Nakulabye, and Nateete. Methods: Each of the five scans was conducted in geographical circles, within a 500-m radius of a Uganda Youth Development Link (UYDEL) drop-in Center using a container-based approach. Using a Garmin GPS with photo capabilities and a tablet for data entry, teams of at least two trained researchers walked the main roads within the target area and gathered information about each alcohol advertisement including its location, type, size, and placement and other characteristics. Data with the GPS coordinates, photos and descriptive details of the adverts were merged for analyses. Results: A total of 235 alcohol adverts were found across all five data collection sites reflecting 32 different brands. The majority of the adverts (85.8%) were smaller and medium sizes placed by restaurants and bars, stores and kiosks, and liquor stores. The most frequently noted types of alcohol in the adverts were spirits (50.6%) and beer (30.6%). Recommendations: The pilot test of the methodology we developed indicated that implementation was feasible, although challenges were noted. Since monitoring alcohol marketing is key for addressing underage alcohol use and harm, the advantages and disadvantages of the approach we developed are discussed. Future research needs to strengthen and simplify strategies for monitoring alcohol marketing in low-resource settings such as urban slums which have unique features that need to be considered. Meanwhile, the findings may yield valuable information for stakeholders and to guide intervention developments and alcohol marketing policy to protect youth.

This study sought to determine the level of concordance between self-reported alcohol use and the presence of its urinary ethyl glucuronide (EtG) metabolite in women living in urban Kampala. In 2023, we recruited 300 young women, ages 18 to 24 years, to participate in a prospective cohort study across three sites in urban Kampala (i.e., Banda, Bwaise, and Makindye) to examine the mechanistic pathways of mental illness. As part of the baseline assessment, participants were asked to complete a research assistant-administered survey and to provide a urine sample to screen for 16 different substances and/or their metabolites, including EtG. Overall, 58% (n = 174) reported to have ever consumed alcohol and 23% (n = 68) to have used it in the past month. Among the 300 women, 10% (n = 30) had EtG levels in their urine sample and of these, 40% (n = 12) reported to have never consumed alcohol, using a self-reported survey (p = 0.035). Recent alcohol use was relatively low among the women in this study. However, the discordance between self-reported alcohol use and the presence of EtG presents concerns about the accuracy of self-reported alcohol use. Additional research is needed to contextualize self-reported alcohol use, social desirability, and the implications for alcohol prevention and intervention strategies for young women in urban Kampala.