Decision Making and Children Health

Decision making referred to a choice reached after verifying available options to pursue a specific cause –which carried consequences (good and bad). It was as a result of a cost-benefit analysis of having children that a prospecting parent made, rather than making decisions based on urges or feelings because they (urges or feelings) did not think apart from causing excitement.

Attachment denoted the nature of the bond between the mother and the child while level of attachment implied the degree of the existing bond between the mother and the baby or child. And circumstances at conception were merging issues during, or at conception while for environment, experts attribute the term environment to virtually everything visible, invisible, practiced, imagined, or reasoned and about life processes –including man himself, or her self –and all interacting and relating in a certain way with each other.

Children in Uganda have been most marginalized with child-friendly health services only limited to referral hospitals. Elsewhere in the country children share facilities and health care services with adults –an indiscriminate administration of health, yet special care for them was paramount. Direct, structural and institutionalized violence too claims the lives and right morals of children. Domestic violence does not only take the life of one of the parents, but also is psychological violence –moreover the worst a human being can experience that, now, becomes a children affair to deal with or shared experience upon observing parents fight.

Cultural environment –which is discriminative according to gender; never recognizes the rights of children –and the reproductive health rights of women have turned out to be a huge and overwhelming social cost –inclusive of HIV spread and under-development. It becomes a way of life that suffocates the rights of women and children as men behave the way they want as suggested by their cultures.

The economic environment disables parent’s ability to further children’s education, or not even at all affording it, yet it is through child education that the future a community is secured with a productive citizenry. The cycle continues from children dropping out of school and opting to marry or succumbing to wrong and untimely choice to conceive, then the burden becomes a product to be handed over from one generation to another –rendering the talk of children rights a dream.

Now, that way of life is one that begins to dictate the quality of life of a children, level of attachment –where insecurities and future behavioral problems begin, irresponsible parenthood, reckless and risky behaviors of a parents as children observe, low or no health seeking as there will be no money and, ultimately, no motivation to adopt a healthy lifestyle –even when health guidelines are issued –which in turn affects children health, leads to broken family situations, or broken marriage relationships –and which as the saying goes, “if elephants fight it is the grass that suffers,” the consequences accruing from broken-family situation hit children hardest as all the anger gets projected to them in form of abuse and neglect.

And in bid to come out of poverty traps using the much respected cultural or traditional remedy systems, children, still, are the soft target like commodities (without life) to offer to the gods. These are innocent children: why all that? What about the plight children in areas once ravaged by war in northern and north eastern Uganda? How about those affected by annual floods and, in recent years, the landslides? Is our scope of children health catering for that? It is from such grounds that families and communities face accountability for in the child’s teen or youthful years. No shall we have a moral fabric in society, violent free generations because society simply ignores the root causes of structural violence –whose origin is quality of care of children right from conception. And who should save the children of Uganda?

Parenting is, thus, a responsibility one finds himself or herself under voluntarily or involuntary. During adolescence, gradual changes that may be cognitive, emotional, biological, physical and social or environment occur. The qualities of changes are influenced by how well decisions are made at different levels of interaction (cognition, instinct or biology, emotional, social and/or natural environment) in relation to one’s sexuality. It all begins at conception –through important stages of birth, special care of newborns, weaning, and child in playful stage, socialization and learning, gender roles or interests, young stardom, youthful period and adulthood.

Becoming a parent was not only an urge, or by accident as some young women say, but an issue to think about critically before making a decision, not even pressure from elders or traditions counted. It was important to look at children as human capital of the future –through integrating health care, nutrition, and early child care services for young children in developing countries. Problems faced by children in early years, such as stunted mental and physical development and lack of preparation for school set the stage for low academic achievement, high drop out, functional illiteracy, lack of productivity in the work force –and even delinquencies and dependency on society (Young M., 1996).

It did not matter what age of pregnancy, but from the time of conception. But for the purposes of this submission care had to start from the time one started developing feeling to become mother or father, because ultimately the quality of decisions made counted in determination child health. Brain studies demonstrated that early years were critical in the development of intelligence, personality, and social behavior before the age of three. Environment, thus, dramatically affected how the infant brain developed –moreover the impact of early childhood programs on personality and behavior became significant and long-lasting. Indeed childhood education reduced social costs, juvenile delinquencies and drug use (Young M., 1996).

Under difficult or challenging parenting environments, HIV/AIDS emerged as an environment problem as young people and parents were pressured to adopt risky behaviors as means to “survive.” According to Tigawalana D. (Sunday Monitor Sept. 19, 2010), Young people between the ages of 15 and 24 constituted young women as most vulnerable –unexplainable by biological factors, but gender inequalities that existed in African society.

More than 5000 women still died every year in child birth across the globe –with the majority of deaths occurring in developing countries –where health systems were weak or non-functional –and health workers scarce (Lirri, Sunday Monitor July 31, 2010).

In the review on orphans and vulnerable children policy, ministry of gender, labor and social development (2004), 38 of the population lived in absolute poverty –constituting 62% of children. And the number of children living below the poverty line was likely to rise due to high fertility rates, HIV/AIDS, other preventable diseases and insecurity. The causes of poverty included limited access to productive assets (especially women), limited utilization of improved production technologies, large families, alcoholism, unemployment, lack of markets, inadequate opportunities for education and lack of information.

“…so many children in need of education but numbers are so overwhelming. If there’s any support your organization can give us, that’s welcome. Government has given due attention to basic education resulting into substantial increase in enrollment. Unfortunately, there has been decline in primary school retention in the past few years due to high drop-outs."

Geoffrey Muzusa,
Community Development Officer, Jinja

Child care was a cost the prospecting parents needed to think about long before deciding to conceive. In fact, child care began at conception. Pregnancy as physiological stress when various body functions of the mother underwent strain, need an excellent died to keep replenishing the body. With ante natal requiring time, rural areas were located several distances from health centers, so it was less likely that affected parents would visit ante natal clinic as advised.

Yet because of the need for PMTCT, to help the mainly teenagers to conceive safely, and those with height related defects (short parents) associated to difficulty delivery as well as to receive counseling on issues related to physiological reactions of the mother, appropriate dressing of mother and child, appropriate diet, preventive measures against malaria, handling of sibling rivalry and children discipline (Ebrahim G.J., 1971).

While appreciating Ebrahim G.J. (1971) understanding of pregnancy as a physiological reaction, one important component ought not to be underestimated –the psychological implications (e.g. anxiety and depression). Successful child care ought to put that into consideration, otherwise the psychological implications potentially turned out to be the most damaging to the child, or baby. Cumberbatch CJ Eta l (2005) revealed that conditions that were, themselves, psychosocial: anxiety disorders (GAD, OCD, panic disorder, PTSD), mood disorders, and schizophrenia, all of which were a background for a disturbed pregnancy would complicate pregnancy denominated high risk for some other reason.

25% of adolescents became pregnant at 19 as by 2006. Fertility was high at 6.9 children per woman (2001). Contraceptive prevalence rate was at 22.8% in 2001 and 23.7% in 2006. Only 14% of the people were employed in wage employment and the rest in self employment in the informal sector. Females constituted majority of the population at 51%, 32% females at the age of 10 were illiterate, 36% reached primary level, and 18% secondary (National Population Policy for Social Transformation and Sustainable Development, 2008). It was, however, impressive to note improvement in decision making by adolescents as by 2006 could conceive at 19 years. With wage employment at 14% and contraceptive use at 23.7%, the situation was getting better. If decision makers embarked on developing the education sector to have more children complete secondary and train in skills formation, then Uganda would be in a pole position to not only improve livelihoods but make child care as a right real.

Broken-family events are a result of extended family system to stand the test of times (twentieth and twenty first century new world order). As the urge to have children arose as traditionally demanded from the ages of 18 and above or less, the new order, instead, required productivity of prospecting parents before, at all, they decided to have children. Having children is thus no longer fashionable, nor marrying until one’s decision was in agreement with the new order.

Those who are there even when economically liberated will tell you that things are not really good while gaining confidence that God will provide. The question of sustainability of care and love within a family set-up is ignored yet critical. It is, therefore, important that policy makers embark on massive gender-conscious literacy or education program intertwined with aspects that address reproductive health concerns, impart life skills, or vocational skills –all of which empower communities with tools of rightful decision making that go as far as influencing health children development, or for that make transform children rights talk from theory to practice. When structural change is registered, no more shall see Bukedde news paper pictures of sacrificed children or domestic violence, among other concerns.

Jacob Waiswa

Graduate Peace and Conflict Studies Program
Makerere University
P.O. Box 7062,
Kampala-Uganda
jwaiswa@arts.mak.ac.ug

DECISION MAKING FOR ORGANISATION DEVELOPMENT: THE CASE OF ORGANISATIONS IN BUSIA-DISTRICT

It takes a lot of effort to form, make paper-work and achieve organization objectives. Some people can be successful with project formulation, but fail at implementation –due to a number of factors that maybe; financial, legal, technical, environmental or political, among others.

But, even at implementation, like at every other developmental stage, there exists challenges ranging from administrative to financial accountability. Common in the administration department could be disagreements, role ambiguity, and formation of antagonistic groups –each working hard to suffocate progress under each other’s roles and responsibility (if any). Some people call it office politics.

Because administration is centralized, with powers entirely falling on the director’s shoulders, each of the groups will want to compete hard to win the directors favor and indispensability. And the director, with limited or no knowledge and skills in conflict resolution, is in many cases bases on rumors to make decisions.

Attempts to solve conflicts will only feature him carrying the rumor to the targeted person –from where tempers ensue, since the rumor might not have truth. The accused, thereon, develops a grudge on the rumor-monger. The organization head, on his part, will only walk away having made a statement to the accused, but without reaching a consensus.

It is in such state of affairs the organization head will seemingly flourish, which in a long run affects progress and quality of reports that have to be made. But, since himself is the head of monitoring and evaluation, he will always cook his reports for whoever needs them.

Noting that centralization of power makes organization boss very busy, never does he find time to make inquiries into raging conflict among his or her work force. Himself can be a source of conflict –when he crosses his boundaries to briefly manage and make reports for affiliated projects –whose heads are left with no powers, no confidence, and at times no work.

Being the founder, actual chairperson of the board of directors and director leaves no one to offer accountability to or make administrative checks and balances. He or she is only accountable to himself.

No one advises him on matters of policy and decision making. Uncertainty soon crops in as the founder and director lacks the capacity to run organizational programs, yet claiming to trust no one.

Since most of his time so far has been spent on resource mobilization since project formulation, it becomes the best skill possessed by the organizational director. Beyond that, he has to either hire unskilled and semi-skilled labor that never help much, exploit skilled labor without wage pay or partner with existing organization –with whom to share technical knowledge and skills.

The mismanagement on his or her part can be a disappointment to project partners –who eventually lose confidence in the director’s ability to run the organization. Funny enough, instead of accepting the weaknesses of his management style, he displaces self-inflicted frustration on project partners.

Hiring labor, according to him or her can never entail preparing guidelines and agreements or contracts that must be signed by hired worker. He applies verbal agreements whilst sure that they will be broken anytime –where verbal termination of work will not judge him in the way that disrupts his motive and prior decisions based on suspicion.

The project partners, on the other hand, use their bitterness to discourage other partners –including donors to bury their confidence in the director and his organization. This deepens the conflict –to even create psychological scars.

This, in future, affects new partnerships, as he will nurse suspicion and mistrust that whoever seeking to partner with him are likely to cause similar negative scenarios as previous encountered in fallen relations.

In case a new project partner, with whom he has mixed feelings (e.g. trust-mistrust) found his way to working with the traumatized director, entry initiation would be organized –involving telling stories about past negative experiences with ex-partners and setting expectations reviewable almost weekly.

Whatever program created by a project partner, upon rumor sent regarding it, could be called off until the planned activities are discussed and approved by the director. This is how far his or her sensitivity can be to whoever works with him.

Whilst in the field, his “spies” will report to the organization head every movement, action and words spoken by the project officer or business partner. The information carried to him is repackaged in the way that discredits the dynamic project officer before the organization head. It can be as though the spy-master’s preference is passiveness or idle-talk at work.

Decisions made are emotionally triggered (i.e. when happy, or fearful). Without having to consult anyone or make further inquiries, fear or anxiety-based decisions would be made against staff qualifying for it.

This, now, becomes the norm applicable in every organization development process –be it at recruitment, promotion, demotion or dismissal. Fear, to such a director, is perceivable as a threat not only for him, but organizational as well.

At this stage of affairs, he can hardly be separated from organization needs. He would assume that his bad taste should be the same to everyone that may be; his support staff, partners, and clients.

Such an organization would be the kind that collapses as soon as its director physically falls ill or dies. This would be so because he would not have prepared the organization for sustainability.

As a result, the disempowered workers will even consult for the obvious –fearing they will make mistakes costly to their careers. That soon turns them into statue workers, who are nothing-doers –yet pausing as staff at the organization.

Surprising, still, is be absence of a work plan. Neither is it known to staff nor organization frameworks, objectives or ideals. He, of the sort, runs the organization himself –since project or program descriptions are only known to him. Shrewd staff as he would perhaps expect could design and implement programs along side probable organization objectives –to keep busy.

An assembly, which in most constitutions is the highest decision-making body, is never followed. Decisions passed are only shelved once forwarded to him –in favor of rumors from conflicting parties about how the meeting went.

If part of agenda was to address staff conflicts, he would choose traditional one –famous to him that preserved conflicts. It seems like he found it was fan conflicting parties having to rush to him, one after another, to give their versions of the cause.

Yet, it would be focusing on resolutions reached at assemblies or recommendation in reports submitted that could be a basis of policy and decision making. Doing so, is what could eventually find a lasting solution for lingering fusses in the organization.

Otherwise, absence of such would not only stall organization progress, but lead to its collapse. No wonder, organizations found to nurse conflicts have had a history of failed programs.

Perhaps, if there was an active and most influential board of directors, they would help advice such a managerially-ill director with parameters –with which to direct the organization along set objectives –to realize real impact.

Unfortunately, for most non-government organization, especially of modern times, the aim of their establishment is mainly to employ the founder, rather than community development. In fact, a personal business. So, they fasten the idea formulation process and paper-work, as well as hire names of those who could act as members of board of directors –for the purposes of registration.

Unfortunately, the boards of directors are only involved to facilitate registration exercise. They never have a say or influence of how implementation and financial matters must be addressed. He or she, thus, studies reports with no body –as for financial accountability.

And, because of the past conflicts with previous business partners, and how dangerous they soured to largely and negatively affect organization development, the troubled director must have developed a mental disorder to now necessitate rehabilitation.

Regarding his managerial deficits, he will only have to try a recognized local management institution. Important to note also would be that, having successfully founded an organization can be unrelated to good management. Even when anyone smelt a rat as soon as he or she joined the organization and brought it to his attention; he, still, could claim was good manager.

At such a level of an organization; very young, and that has not impacted communities in which it operates, management must open up to forces of positive organization change; strictly following known and understood –established systems of conflict resolution and monitoring and evaluation.

Jacob Waiswa
Community Psychologist
DISHMA CONSULT

WORKING AND LIVING IN RURAL AREAS: IS IT CHALLENGING OR JUST NORMAL?

A CASE OF RURAL BUSOGA, EASTERN UGANDA

Different reasons explain why people go to rural areas –which might be unemployment characteristic of urban areas then compelling them to try out prospects of agriculture in rural areas, job transfers or deployments, and just to adventure –relax away from pressure-some town life.

As soon as one arrived there, all eyes would be on him or her. They rural people are best at telling -who is or not part of them. One could soon see defensive faces –which are usually natural ways organisms protect their territories from invaders. Rumors would then fast spread -regarding the arrival of an alien.

The seemingly “worse” scenario could be the case of a team -with almost equal ratio of men to women. This would easily trigger a mental flash that so was a wife or husband to the other.

For them women and men –working together are in a way working about, very close to or actually in a romantic relationship –especially if no team member crossed over to find a lover from the local community. There is a common believe that traveling without a wife or husband, shows evidence of “unmarried” person, and thus, too “single to be scooped by whoever picks confidence.

And when you live singly in a room or lodge, they would think and work around the clock so that a paired with an opposite sex is formed. Some of the tactics would, for example, be trying to propose or lobbying for you, ridiculing, flocking of mainly young women (including the married) parading onto your veranda or constantly use peeping gesture, everyday -for a chance of being met and perhaps action taken. In fact, it could be as though living in big brother house.

Like the saying goes, “Basoga are sex-maniacs,” rural areas, would prove it right. Surely, sex play is a strong mind-set there and as easily done anytime as taking tea. So if you do not join the “tea-taking” family, then labels like “you are impotent,” would ensue.

You would perhaps retain pity due to the facts that many young people stand a high risk of contracting HIV/AIDS and STIs every month, and teenagers getting married as early as 13 years. But to them, anyway, tea-taking would be important.

If no formal introductions were made to local authorities by a visiting team -within a day or few days later, they (authorities) would track them along until found and interrogated -to reduce on community suspicion and anxieties. Sometimes they would add “flavor” by teasing or bullying visitors -as if trying to identify themselves before them (visitors).

After getting direct information from the visitors, the local authorities or security personnel would then call a local meeting, with visitors in attendance -to counsel their suspicious subjects, and thereafter, urge them to support the visitors.

When they finally let the visitors into their territory, for different reasons, all would want to stick onto you. The elderly would, for example, want financial help, and the opposite sex –including the married ones, would compete for their share, while others might choose friendship. Any association with them would be seen as prestigious, and praises showered to whoever sought company.

What is shocking there too would be the fact that marriage concept either does not exist or simply not felt and practiced. Whether married or in presence of a spouse, fellows would not hesitate to make love advances to any of the visitors.

Besides, would want to deplete you of the limited belongings –including the current outfit at the time of meeting them. Imagine serving them out everyday, throughout your stay there -and one by one until the entire community is covered.

Declining to do “charity” because it is just one pair or an item for you could bring serious negative judgments, everyday defaming comments and insulting statements. They would choose to nourish their intentions by launching an opposition against your team’s organization’s programmes.

Their biggest victory would be “defection” of a team member to them. Thereon, it would be much easier to break into further -to the extent of stalling office business or team work.

They would use the departed person to win other team members to their side or “vote” to fight –using insulting labels, possibly until productivity was reduced to zero. As a consequence, the defected member could be the first to fall out or slow down team progress –since most of his or her time would be spend to please a bigger community set.

During the team’s stay, temptation could be that in order for their mission to succeed, community members must be given “energizers” or else petition organization bosses to provide “thank yous” –before or at the end of every community event.

One now wonders as to why communities would ask charity for charity. If for instance an organization provided them with free formal and informal education, why would they (communities), on the other hand, ask for money in return for the same services that benefit them? Come 2011, politicians will suffer.

To note is that from the day the team arrives to the end of the mission, communities evaluate team members –on the basis of culture and statuses verses local cases. And whoever took a chat with any member of the team, he or she would have important news for the rest (members of the community) –be it jokes or serious organization policy communiqué. It would be a talk to one person, as the same or amplified to the entire local community

They could confuse statements made by visitors for the purposes of entertaining their colleagues back home. Anything spoken out would potentially make important headlines for them.

If any member of the visiting team was found speaking to a community member, the rest would wonder about what might be the possible details of the chat. Indeed they would soon find out. Whilst there, It would be like living a celebrity life –surrounded with several paparazzi members.

They become so critical that any action and word spoken would be subjected to local norms scale for diagnosis. Very much so, they would want you to be like them. Their evaluating team or scouts could go as far as your bedroom area, lodge or house to monitor visitors’ behavioral pattern –whether they are consistent to their own or not.

In fact, there is never privacy, as people make it their job to check you out all the time, know your thinking process and hear something that could be reported, as they watch or observe.

Anything different from their norms and way of life is like being “criminal” -which could unfortunately or unfortunately raise more controversy than not about the visiting team.

Excesses of their actions, might force you, member of the team or entire group to become defensive -yet again, another disaster. They could begin referring to you as anti-people, as despising them or arrogant.

Very surprising, also, is that even when you get busy writing reports, they would still find it criminal and fail to recognize the fact that time, then, is organization’s or office’s.

They could be funny, expecting you to join them in idle talks -instead of following your office programme. If you were stuck in there doing work, they would make disturbing noise outside to seem like it were a communication demanding or asking you come to an end of it all and grant them your time, as well.

After sensing the danger of being social and free to them, and now in favor reserved life, one would think that alone has been a good decision. Yet too much, too less or no interaction could hardly resolve the matter. Instead, “criminal” branding would worse.

The ringing question would perhaps be: what do these people want or should the contract be terminated? If you are not strong enough to handle such pressure, probably self-destructive choices and decisions could be made.

Upon arrival, it would be important that the visiting team carry out survey of the area to orient themselves with the nature of people there. Such would provide them with ideas of who they are about to deal with. In case of a bothersome encounter with any member of the community, a team member would neither find it surprising nor difficulty dealing with them.

Much of what might be sent out to you must be given a deaf ear or blind eye most of the time -to avoid mental intoxication or getting burnout at the duty station, and at the expense of “minor” local community members.

Attention could be served to them only when done with work, though as a matter of good public relations, sometimes you may need to negotiate much of the time about your position.

Also, care must be taken to filter out information that is best for them. Only what is diagnosed as suitable could be relayed to them, rather than having to communicate each and everything.

Content must, therefore, be categorized into what could be considered as personal or office secrets, and that free for public consumption or take. Truly, with persistence, these people could know and understand who you are as well as your much cherished values.

Really, managing life there, would call for self-discipline from one or a few members –who then could motivate the “play little boys and girls” back to productivity. They could, for example, call for or organize regular meetings to solve team problems -as they arise.

As part of the way forward perhaps the remaining group could re-define themselves and re-think organization values, while at the same time accepting to work without the defected colleague.

Jacob Waiswa
Situation Health Analysis
waiswajacobo@yahoo.co.uk