Abstract:
Introduction: Substance use is a rising public health issue worldwide and disproportionately affects marginalized communities, including indigenous populations such as the Batwa in Uganda. Cultural practices, limited access to health education, and socio-economic vulnerabilities contribute to risky behaviors and poor health outcomes related to substance use.
Aim: The study aimed to assess the knowledge, attitudes, and practices of substance use among the Batwa community in Kisoro District, Uganda, and to examine the socio-demographic factors influencing these behaviors.
Methods: A cross-sectional study design was used, involving both quantitative and qualitative approaches. Data were collected from 240 respondents aged 18 years and above using semi-structured questionnaires. Univariate, bivariate, and multivariate analyses were conducted alongside thematic analysis of open-ended responses.
Results: Alcohol (94.2%) and tobacco (45%) were the most commonly used substances. A significant proportion of respondents (71.7%) initiated substance use before the age of 16. Only 58.8% were aware of the potential health effects of substance use. Attitudes were generally permissive, especially toward alcohol, which was deeply embedded in cultural rituals. Substance use was significantly associated with sex, age group, and level of education. Barriers to seeking treatment included stigma, lack of financial resources, and fear of authorities.
Conclusion: Substance use among the Batwa community is widespread and influenced by cultural norms, social factors, and knowledge gaps. Despite recognition of its harmful effects, substance use remains normalized within the community.
Recommendations: There is an urgent need for culturally sensitive education and prevention programs, increased access to affordable treatment services, and the active involvement of traditional and religious leaders in behavior change communication. Further research should explore gender-specific experiences and assess the impact of community-based interventions.
