The Psycho-social behavioural determinants and "At Risk" Contexts in Uganda

MARPS IN UGANDA has concluded an appraisal exercise of MARPs issues in 10 regions covering Uganda from July 2010-August 2011. The objective was: to gauge topography, characteristics and contexts within which MARPs and Key affected populations are defined in Uganda as well as showing need for clarity and specificity of programmes targeting overall MARPs and key affected populations.

Methodology: 13,250 key leaders were interviewed around vulnerability, environment, economic and socio-politico status that affect MARPs; 270 men only board game groups, 150 pool kiosks and 25 University-based groups were used to generate information on substance use; 52 MSM/TG safe spaces were used to generate information on repercussions of Criminalisation; MARPs were sub-divided further into key affected populations ( MSM, TG, Sex-workers and  Substance Users); 2500 men were probed for health, development and social issues in communities; 120 lower level government key persons were asked about MARPs and a possibility of existence for programming targeting MARPs; Reviews and actual visits to 12,200 CSOs/FBOs/NGOs/Development Partners to check concrete plans targeting MARPs were done.  25 religious/cultural-based leaders were interviewed on their role in eradicating violence, abuse, discrimination and stigma.

Findings: Vulnerability is due to environment, economic and socio-politico status; Criminalisation; Men and the environment have a big role in promoting critical health, development and social issues in communities; local governments are a potential for programming targeting MARPs if they have flexible planning side by side with indicative planning; CSOs/FBOs/NGOs/Development Partners have concrete plans targeting MARPs but religious/cultural influence seems to fuel violence, abuse, discrimination and stigma; Key affected populations’ needs are Psycho-socio-behavioural and few organisations have solid plans to address them; Community structures are a potential to address both MARPs and key affected populations’ issues; Comprehensive knowledge on HIV/STIs prevention still low; Knowledge, attitude and Practices geared towards preserving quality life are influenced by many factors; Factors include: Condition, geographical location, age, education, family status, settlements (urban/rural), occupation and gender/sexuality/orientation.

 Conclusion: MARPs such as: Fisher folk, Long distance Truckers, Uniformed services and in-mates have effective programming. Programmes targeting key affected populations should involve their input, should follow characteristics and typology informed by them and should address broader issues of violence, abuse, discrimination and stigma including decriminalisation. Key affected populations’ issues such as: Drug users should be addressed using harm reduction mechanisms; sex-workers’ issues should be addressed to promote reduction in risks exposure; MSM/TG issues should be addressed in such a way as to promote dignity and self esteem.