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.

Introduction: Climate change is an emerging global health crisis, particularly in low-resource settings like Uganda’s urban slums. These areas face significant challenges in mitigating climate risks, exacerbating the vulnerability of residents. This study aims to assess the prevalence of climate change anxiety and its association with generalised anxiety among young women living in urban slums. Understanding this relationship is crucial for developing community-based mental health strategies and resilience-building initiatives to address the psychological impact of climate change. Methods: This study utilises baseline data from ‘The Onward Project On Wellbeing and Adversity’ (TOPOWA), a prospective cohort study focused on mental illness and social determinants of health among young women aged 18–24 years living in Kampala’s urban slums. A total of 300 women were recruited from three sites: Banda, Bwaise and Makindye. At baseline, interviewer-administered surveys measured climate change anxiety using the 13-item Climate Anxiety Scale and generalised anxiety using a 7-item scale. Bivariate and multivariate analyses were conducted to determine the associations between climate anxiety, generalised anxiety and demographic factors. Results: Of the 249 women included in the analysis, 21% reported moderate to severe levels of climate change anxiety, while the remaining 79% experienced mild to minimal levels. Multivariate analysis revealed a strong association between higher levels of generalised anxiety and increased climate change anxiety. Additionally, older age was linked to higher climate anxiety, whereas higher education levels and living in multigenerational households were associated with lower levels of climate anxiety. Conclusion: One in five young women in Kampala’s urban slums experiences moderate to severe climate change anxiety, closely linked to generalised anxiety. These findings highlight the urgent need for targeted mental health interventions and community-based resilience programmes. Leveraging family support in multigenerational households may also play a role in reducing climate-related anxiety and fostering adaptive coping mechanisms.

Unintended pregnancies among adolescent and young women in low- and middle-income countries pose major public health challenges, underscoring the need for improved access to modern contraceptives. This study examined prevalence, preferences, and correlates of modern contraceptive use among young women living in urban slums of Kampala, Uganda, to inform targeted interventions. We analyzed baseline data from The Onward Project On Wellbeing and Adversity (TOPOWA), an NIH-funded, multi-component prospective cohort study on mental health among women aged 18–24 years. In 2023, 300 participants were recruited from three sites (Banda, Bwaise, Makindye). Interviewer-administered surveys assessed contraceptive choices, lifestyle, and demographic factors. Modified Poisson regression was used to examine correlates of contraceptive use. Among participants, 66.0% had ever used contraception, 40.0% were current users, and 38.0% reported modern contraceptive use. Multivariable analyses showed that having a consistent partner (PR = 3.28; 95% CI: 1.90–5.67), engaging in sex work (PR = 2.10; 95% CI: 1.46–3.02), older age (PR = 1.08; 95% CI: 1.01–1.16), and having children (PR = 1.72; 95% CI: 1.12–2.66) were associated with higher modern contraceptive use. Findings highlight important gaps in sustained contraceptive use and the need for tailored interventions addressing economic, social, and educational barriers to improve reproductive health in this low-resource setting.

Vocational training can lead to higher employment rates and improved incomes, particularly for young women in low-resource settings like Kampala’s slums. Despite these benefits, further research is needed to understand the full impact and mechanisms of vocational training on youth in low-resource environments. In 2022, a focus group project, part of a larger study, involved 60 women aged 18 to 24, recruited from three Youth Support Centers operated by the Uganda Youth Development Link (UYDEL) in Kampala. Six focus groups (about 10 women in each group) were held to explore urban stress and how vocational training might mitigate social and environmental stressors and improve mental health. Data analysis conducted using NVivo software identified five key themes: economic benefits, skill development, building confidence and self-esteem, improved social and behavioral well-being, and enhanced lifestyle and quality of life. This formative research underscores that vocational training benefits young women, highlighting outcomes such as job acquisition, financial empowerment, and skill development. Additionally, self-esteem and confidence development emphasize the training’s role in fostering mental health and agency and addressing gender inequality. These findings underscore the value of vocational training in enhancing the mental health and overall well-being of young women and suggest areas for future research for how to best optimize and scale these programs in low-resource settings.

The purpose of this study was to use the Columbia Suicide Severity Rating Scale (C-SSRS) to assess the prevalence and patterns of suicidality among young women living in poverty to guide effective, targeted interventions for vulnerable populations. Data were drawn from ‘The Onward Project On Wellbeing and Adversity’ (TOPOWA) study, a prospective cohort examining mental health in the context of social determinants of young women aged 18 to 24 years in Kampala’s urban slums. A cohort of 300 women, recruited from three study sites, participated in baseline assessments. Suicidality was assessed using the C-SSRS. Demographic and psychosocial factors and their associations with suicidality are presented. Of the 300 women participants, 66.0% had some secondary education and 62.0% had children, with most of them living with their children (81.7%). Suicidal thoughts were reported by 46.0%, and 17.3% had attempted suicide, with poisoning (23.1%) and hanging (21.2%) being the most common methods. The prevalence of suicidality in this population was very high, indicating significant unmet mental health needs. Since not all suicide attempts are associated with preceding thoughts or plans, it is crucial to consider a broader range of risk factors and warning signs. Social support systems and socioeconomic strengthening may be fruitful strategies for the prevention of suicidality in this population.