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Causal loop diagrams (CLDs) are a systems thinking method that can be used to visualize and unpack complex health system behaviour. They can be employed prospectively or retrospectively to identify the mechanisms and consequences of policies or interventions designed to strengthen health systems and inform discussion with policymakers and stakeholders on actions that may alleviate sub-optimal outcomes. Whilst the use of CLDs in health systems research has generally increased, there is still limited use in low- and middle-income settings. In addition to their suitability for evaluating complex systems, CLDs can be developed where opportunities for primary data collection may be limited (such as in humanitarian or conflict settings) and instead be formulated using secondary data, published or grey literature, health surveys/reports and policy documents. The purpose of this paper is to provide a step-by-step guide for designing a health system research study that uses CLDs as their chosen research method, with particular attention to issues of relevance to research in low- and middle-income countries (LMICs). The guidance draws on examples from the LMIC literature and authors’ own experience of using CLDs in this research area. This paper guides researchers in addressing the following four questions in the study design process; (1) What is the scope of this research? (2) What data do I need to collect or source? (3) What is my chosen method for CLD development? (4) How will I validate the CLD? In providing supporting information to readers on avenues for addressing these key design questions, authors hope to promote CLDs for wider use by health system researchers working in LMICs.

Among the 62 Bothriocline plant species, Bothriocline auriculata is the only endemic species in Uganda. Although this species is capable of thriving in diverse agroecosystems including mountainous areas, bamboo thickets, montane and tropical rainforests, it is only sited along Mt. Elgon slopes, the species’ native ecosystem. Unfortunately, for the last two decades, the species’ native ecosystem is undergoing very rapid deterioration as the increasing human populations have no option for survival but to clear protective forests and vegetation for arable farming, grazing and settlement. Despite the proven ecological importance of Bothriocline auriculata as a fodder plant, nutrient recycling and biodiversity in contributing to ecosystem balance, the species is declining at unprecedented rates. Consequently, the Bothriocline auriculata is now on the blink of extinction and is classified as critically endangered. This project aimed to rescue and conserve this species to ensure its full recovery, restoration and conservation under protected ecosystems. The specimens were rescued from the native ecosystem and multiplied into 150 juvenile seedlings. The seedlings exhibited a faster growth rate under well-nourished and moist soil conditions and vice versa. The data confirm the species’ ability to thrive in protected ecosystems with favorable weather and soil conditions for ex-situ conservation.

Introduction: Keeping HIV-infected adults away from the health care system during the COVID-19 travel restrictions, presents a challenge to HIV treatment adherence. Methods: This study focused on the initial two phases where Phase 1 designed a Makerere College of Health Sciences (MakCHS) Unstructured Supplementary Service Data (USSD)-based application; and Phase 2 piloted patient enrolment onto the application and determined the feasibility of remote follow-up of patients receiving long-term antiretroviral therapy (ART). Results: A off/online user application, MakCHS Health app, was developed. Overall, 112 patients [(66(59%) female] receiving ART at Mulago ISS clinic, Kampala, were enrolled onto the MakCHS Health app. Up to 89 (80%) utilized the app to access medical help. Patients’ medical queries included needs for drug refills, missed taking HIV medication, medical illnesses, access to COVID-19 vaccination and other personal needs that required clinicians’ attention. Conclusion: Piloting a MakCHS Health application for patient follow-up was feasible and well-received by HIV treatment providers and patients receiving ART. We recommend scale up of the application to enroll all patients receiving long-term treatment for HIV/AIDS, and subsequently expand to. other HIV treatment programs in similar settings. Keywords: M-Health; patient follow up; Chronic HIV treatment; Antiretroviral therapy.

To identify a suitable substrate to enhance sustainable access to affordable quality feed protein in Uganda, growth performance and nutritional composition of housefly larvae grown on three common substrates; cow dung (CD) chicken manure (CM) and brewery waste (BW) for 5 days was determined. Eighteen bags were randomly filled with one kilogram (1000g) of each of the three substrate in six replicates were allowed to attract adult housefly that deposited eggs whose larvae were harvested on the 3 rd , 4 th, and 5th day. The weight of larvae was 43.72 for CM, 39.65 for BW and 33.91 for CD. The crude protein ranged from 45.38-44.21 for CD, 48.60-53.0 for CM and 46.24-50, 32 for BW and significantly differed among substrates (p

Food security (FS) challenges exist in both the developed and the developing countries, the difference being the severity and the proportion of the population affected. Previous studies maintain that chronic food insecurity at subsistence farming level has persisted due to a number of factors including unsustainable subsistence agriculture and livelihood policies, lack of inputs, poor conservation methods, weak extension services, unregulated markets, limited land among others. This article investigates FS challenges at subsistence farming level using system dynamics tools. The emerging system dynamics model is conceptualised into four sectors; food production, sales, income and food consumption, representing a real-life food security system. The model is used to evaluate policies for better livelihoods as well as explore strategies for profitable subsistence farming and food security.

Food security concepts are extensively used in households as a measure of welfare, to conceptualise operational usefulness in the design, implementation, and evaluation of policies. Most research is focused on improving food security and sustainability and the patterns still remain tenuous. This article explores food security indicators for sustainability by using system dynamics to understand the interconnectedness of the food security system. This is done by analysing quantitative and qualitative concepts of food security indicators. The simulation result shows dynamics of cropland decreasing with increasing population as they need food, energy and space to survive.

Information communication technologies can only be beneficial to developing countries struggling to build adaptation capacity if technology adoption frameworks are tailored to suit their specific characteristics. The lack of timely, accurate, and reliable weather data and the increasing rate at which climate-related disasters are destroying lives and property in Uganda is evident of lack of good weather forecasts. The study set out to investigate the factors affecting ICT adoption and determine the technologies being used to respond to climate change effects. Specifically, the study set out the extent of use and the factors hindering or guiding ICT adoption. Factors hindering ICT adoption ranging from poor infrastructure to limited government support were established. The strategies that can be used to resolve challenges of ICT adoption, the major stakeholders, their responsibilities and how ICT adoption and utilisation can be enhanced to benefit other sectors of the economy is presented.