[System] Act as an information elicitation agent for academic interviews.

[User] I think its ignorance and how people started, they see that it helps but to me it doesn’t because at times when that local tonsillectomy is done from home, at times it goes to some serious cases of septicemia and sometimes even the way it is cut, anemia sets in and even it claims the lives of very many children

[Assistant] They are dying?

[User] Yes

[Assistant] Is there anything done maybe to educate those old ladies, have you had the interaction with the old ladies where they do that?

[User] The problem maybe we can just communicate to them maybe when there is a radio program but those ladies, the traditional healers, they are not really very much close with the health centers and hospitals and you know with the nature of our work and the schedules, we are always busy, there is no way we can find them but anyway, we give the information to the clients who come, just as I can just say we give, there are those who take and there are those who don’t take the information we give them

[Assistant] Ok and then basically, the symptoms you said they describe is chest pain, fever...


[System] Act as an information elicitation agent for academic interviews.

[User] Yes

[Assistant] Is there anything done maybe to educate those old ladies, have you had the interaction with the old ladies where they do that?

[User] The problem maybe we can just communicate to them maybe when there is a radio program but those ladies, the traditional healers, they are not really very much close with the health centers and hospitals and you know with the nature of our work and the schedules, we are always busy, there is no way we can find them but anyway, we give the information to the clients who come, just as I can just say we give, there are those who take and there are those who don’t take the information we give them

[Assistant] Ok and then basically, the symptoms you said they describe is chest pain, fever...

[User] Yes fevers, joint pains and sometimes cough which has taken long and throat

[Assistant] And then if you look at them, are they good at follow up and adherence, the RHD patients, in your opinion.


[System] Act as an information elicitation agent for academic interviews.

[User] Yes fevers, joint pains and sometimes cough which has taken long and throat

[Assistant] And then if you look at them, are they good at follow up and adherence, the RHD patients, in your opinion.

[User] They do

[Assistant] They do.?

[User] Yes

[Assistant] If you tell them to come for the injections, do you think they come?


[System] Act as an information elicitation agent for academic interviews.

[User] They do

[Assistant] They do.?

[User] Yes

[Assistant] If you tell them to come for the injections, do you think they come?

[User] They do

[Assistant] What makes them to come?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes

[Assistant] If you tell them to come for the injections, do you think they come?

[User] They do

[Assistant] What makes them to come?

[User] It’s the way they are counselled, they well know of what taking place is and what may happen if they don’t follow the treatment, they do come

[Assistant] What else apart from the counselling, what makes some people to come?


[System] Act as an information elicitation agent for academic interviews.

[User] It’s the way they are counselled, they well know of what taking place is and what may happen if they don’t follow the treatment, they do come

[Assistant] What else apart from the counselling, what makes some people to come?

[User] Sometimes even from there I always tell them when they come ,transport is met like where I work as I told you, it’s like 17 kms and the boda is 6000shs, so when you come and go, that is 10,000shs plus minus eating something but always when they come, they are refunded their transport, so it makes them come because sometimes when you are referring, they tell you, you see musawo,there is no money, there is no what...but when I tell them, you go ,the money you are going to use for transport, they are going to refund it.you know in the village, you can pick a boda and waits for you to take you back, so that is how they are like trying to like meet ...Yeah, so the motivation is one, if you give them transport, two when you give them counselling

[Assistant] What else?

[User] Three is that, those ones who come to the hospital are those ones who care for their lives, so they take whatever advice you give

[Assistant] Any other, so how about those, do you think that there are those who don’t come or who miss their drugs


[System] Act as an information elicitation agent for academic interviews.

[User] Sometimes even from there I always tell them when they come ,transport is met like where I work as I told you, it’s like 17 kms and the boda is 6000shs, so when you come and go, that is 10,000shs plus minus eating something but always when they come, they are refunded their transport, so it makes them come because sometimes when you are referring, they tell you, you see musawo,there is no money, there is no what...but when I tell them, you go ,the money you are going to use for transport, they are going to refund it.you know in the village, you can pick a boda and waits for you to take you back, so that is how they are like trying to like meet ...Yeah, so the motivation is one, if you give them transport, two when you give them counselling

[Assistant] What else?

[User] Three is that, those ones who come to the hospital are those ones who care for their lives, so they take whatever advice you give

[Assistant] Any other, so how about those, do you think that there are those who don’t come or who miss their drugs

[User] Yes it is possible

[Assistant] Why do you think some people miss their drugs?


[System] Act as an information elicitation agent for academic interviews.

[User] Three is that, those ones who come to the hospital are those ones who care for their lives, so they take whatever advice you give

[Assistant] Any other, so how about those, do you think that there are those who don’t come or who miss their drugs

[User] Yes it is possible

[Assistant] Why do you think some people miss their drugs?

[User] Some of them just take things for granted like that you are told to go back and you don’t mostly when the disease starts, it looks very serious on the beginning of treatment, someone feels there is improvement and when they feel there is improvement, they think that they are healed then they will now miss to come and sometimes they forget the dates of appointments and others on realizing that they have passed laughs...they refuse to come

[Assistant] Why would they fear to come when they skip the dates of appointment?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes it is possible

[Assistant] Why do you think some people miss their drugs?

[User] Some of them just take things for granted like that you are told to go back and you don’t mostly when the disease starts, it looks very serious on the beginning of treatment, someone feels there is improvement and when they feel there is improvement, they think that they are healed then they will now miss to come and sometimes they forget the dates of appointments and others on realizing that they have passed laughs...they refuse to come

[Assistant] Why would they fear to come when they skip the dates of appointment?

[User] You know by the common saying, they say that for us the medics we are harsh because you are reaching here, the first thing I am not saying it has happened in the RHD but its common within health, not because the health workers are very bad but they know the implications of missing ,so of course definitely when you have passed by 3-4 weeks or even you have passed by 4-5 days, they will ask you why didn’t you come on the exact date because even the reasons they give do not impress the health workers like somebody will say I had gone to visit, such things, you find visit is not more important than health

[Assistant] Another thing just to take you back, have you encountered patients who go to those traditional, those elders in the villages who lied to you, when you asked them have you gone there and lied but you later discovered that surely ...


[System] Act as an information elicitation agent for academic interviews.

[User] Yes they are there, they lie, most especially with the middle age, they lie

[Assistant] They lie?

[User] Yes

[Assistant] Why?

[User] Of course they go there even when they are doing wrong things, they are guilty, they know it’s not right and definitely they will not, it’s not easy to start from there and because you are defeated from there and now you come to the health center

[Assistant] Ok, some of them lie?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes

[Assistant] Why?

[User] Of course they go there even when they are doing wrong things, they are guilty, they know it’s not right and definitely they will not, it’s not easy to start from there and because you are defeated from there and now you come to the health center

[Assistant] Ok, some of them lie?

[User] Yes, some of them lie but mostly mothers of very young children, they don’t lie because they know when you don’t tell the truth, it will not be well.

[Assistant] Ok, now then, how about those who miss their drugs when you give them a 30 days treatment, why do some of them not adhering to the drugs?


[System] Act as an information elicitation agent for academic interviews.

[User] Of course they go there even when they are doing wrong things, they are guilty, they know it’s not right and definitely they will not, it’s not easy to start from there and because you are defeated from there and now you come to the health center

[Assistant] Ok, some of them lie?

[User] Yes, some of them lie but mostly mothers of very young children, they don’t lie because they know when you don’t tell the truth, it will not be well.

[Assistant] Ok, now then, how about those who miss their drugs when you give them a 30 days treatment, why do some of them not adhering to the drugs?

[User] At first I said, sometimes its ignorance, at times they forget the drugs, at times they have started feeling fairer than before

[Assistant] ok and then ah...what are some of the barriers or problems that you face when you’re taking care of these patients, what do you think are the difficulties you get in caring for them?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes, some of them lie but mostly mothers of very young children, they don’t lie because they know when you don’t tell the truth, it will not be well.

[Assistant] Ok, now then, how about those who miss their drugs when you give them a 30 days treatment, why do some of them not adhering to the drugs?

[User] At first I said, sometimes its ignorance, at times they forget the drugs, at times they have started feeling fairer than before

[Assistant] ok and then ah...what are some of the barriers or problems that you face when you’re taking care of these patients, what do you think are the difficulties you get in caring for them?

[User] Ok we don’t, actually in a health center where we work, we don’t care for them from here because the drug is always taken there, we always refer them to come and get treatment from here, so to me I think we don’t face the difficulties, the only challenge is that they don’t come willingly to be accessed and referred by us, we talk a lot, health educate them and then they will start coming

[Assistant] Why do they resist coming here?


[System] Act as an information elicitation agent for academic interviews.

[User] At first I said, sometimes its ignorance, at times they forget the drugs, at times they have started feeling fairer than before

[Assistant] ok and then ah...what are some of the barriers or problems that you face when you’re taking care of these patients, what do you think are the difficulties you get in caring for them?

[User] Ok we don’t, actually in a health center where we work, we don’t care for them from here because the drug is always taken there, we always refer them to come and get treatment from here, so to me I think we don’t face the difficulties, the only challenge is that they don’t come willingly to be accessed and referred by us, we talk a lot, health educate them and then they will start coming

[Assistant] Why do they resist coming here?

[User] Sorry

[Assistant] Why do they resist coming here, why don’t they come willingly?


[System] Act as an information elicitation agent for academic interviews.

[User] Sorry

[Assistant] Why do they resist coming here, why don’t they come willingly?

[User] No, they come willingly but sometimes they are not aware of the problems, in the most cases, they are not aware

[Assistant] Ok

[User] They are not

[Assistant] And then for other illnesses that you face, what are some of the barriers you get in treating these patients?


[System] Act as an information elicitation agent for academic interviews.

[User] They are not

[Assistant] And then for other illnesses that you face, what are some of the barriers you get in treating these patients?

[User] One is lack of adherence, you like give treatment ,somebody goes to take it for two days, when there is improvement, she keeps it in the house, the next time another child is sick, she will start with the balance of the remaining drugs of another child unless the child starts feeling fair, it is stopped, two weeks later, the disease is back and the biggest challenge we have in the health setting is that the drugs that are provided by the national medical stores are not enough, they bring it like now and it has to serve for two months and at the end of one month’s sometimes the drugs is even over, the remaining one month, they come when there is no what...,when there is no drugs in the health center and always patients when they come and go back empty handed, they will not come back until they hear rumors that the vehicle has passed laughed...,then...

[Assistant] The vehicle?

[User] The national medical medicine vehicle, then they will know maybe drugs are brought, let me go and check

[Assistant] So even they know the vehicle?


[System] Act as an information elicitation agent for academic interviews.

[User] One is lack of adherence, you like give treatment ,somebody goes to take it for two days, when there is improvement, she keeps it in the house, the next time another child is sick, she will start with the balance of the remaining drugs of another child unless the child starts feeling fair, it is stopped, two weeks later, the disease is back and the biggest challenge we have in the health setting is that the drugs that are provided by the national medical stores are not enough, they bring it like now and it has to serve for two months and at the end of one month’s sometimes the drugs is even over, the remaining one month, they come when there is no what...,when there is no drugs in the health center and always patients when they come and go back empty handed, they will not come back until they hear rumors that the vehicle has passed laughed...,then...

[Assistant] The vehicle?

[User] The national medical medicine vehicle, then they will know maybe drugs are brought, let me go and check

[Assistant] So even they know the vehicle?

[User] Yes they know very well, that is why when drugs is brought, the population in the health center is too much, when drugs are not there, they will even relax, they become very few because they say even if you go, they will not give you anything, so that is the time they go to any drug shop and buy anything

[Assistant] So you told me usually when maybe those who miss appointments they come late, when they come to you, they say maybe we went for burials forgot, which other excuses do they give?


[System] Act as an information elicitation agent for academic interviews.

[User] The national medical medicine vehicle, then they will know maybe drugs are brought, let me go and check

[Assistant] So even they know the vehicle?

[User] Yes they know very well, that is why when drugs is brought, the population in the health center is too much, when drugs are not there, they will even relax, they become very few because they say even if you go, they will not give you anything, so that is the time they go to any drug shop and buy anything

[Assistant] So you told me usually when maybe those who miss appointments they come late, when they come to you, they say maybe we went for burials forgot, which other excuses do they give?

[User] Even I went for the visit

[Assistant] she went for the visit?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes they know very well, that is why when drugs is brought, the population in the health center is too much, when drugs are not there, they will even relax, they become very few because they say even if you go, they will not give you anything, so that is the time they go to any drug shop and buy anything

[Assistant] So you told me usually when maybe those who miss appointments they come late, when they come to you, they say maybe we went for burials forgot, which other excuses do they give?

[User] Even I went for the visit

[Assistant] she went for the visit?

[User] Yes, those ones

[Assistant] What else, what else do they tell you


[System] Act as an information elicitation agent for academic interviews.

[User] Even I went for the visit

[Assistant] she went for the visit?

[User] Yes, those ones

[Assistant] What else, what else do they tell you

[User] Sometimes I had a burial but those ones are guinuine,at times I went for a visit, at times I forgot, at times I thought I had gotten healed, there was no more pain and what have you

[Assistant] Those are the excuses they give?


[System] Act as an information elicitation agent for academic interviews.

[User] Sometimes I had a burial but those ones are guinuine,at times I went for a visit, at times I forgot, at times I thought I had gotten healed, there was no more pain and what have you

[Assistant] Those are the excuses they give?

[User] Yes

[Assistant] Any other?

[User] Those are the few I can remember

[Assistant] And so, according to you, why do you think they don’t come back apart from you said when they feel better, they relax, why, what else makes them not to come when they feel better? Your opinion now, what they tell you.


[System] Act as an information elicitation agent for academic interviews.

[User] Yes

[Assistant] Any other?

[User] Those are the few I can remember

[Assistant] And so, according to you, why do you think they don’t come back apart from you said when they feel better, they relax, why, what else makes them not to come when they feel better? Your opinion now, what they tell you.

[User] To me?

[Assistant] You said when they feel better, they give up


[System] Act as an information elicitation agent for academic interviews.

[User] Those are the few I can remember

[Assistant] And so, according to you, why do you think they don’t come back apart from you said when they feel better, they relax, why, what else makes them not to come when they feel better? Your opinion now, what they tell you.

[User] To me?

[Assistant] You said when they feel better, they give up

[User] When they feel better they relax

[Assistant] what else, what other barriers are they facing in coming for the treatment?


[System] Act as an information elicitation agent for academic interviews.

[User] Maybe at times is distance

[Assistant] The distance?

[User] Yes, the distance, the weather, the climate condition

[Assistant] Which weather

[User] Usually when it’s raining, like if it rains during day time, every activity is at stand still because in the village settings, they have ..., so you can’t start moving in the rain that you are coming for your appointment.

[Assistant] So the weather condition, the weather, the distance and when they feel better, they don’t come, any other that we have not talked about?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes, the distance, the weather, the climate condition

[Assistant] Which weather

[User] Usually when it’s raining, like if it rains during day time, every activity is at stand still because in the village settings, they have ..., so you can’t start moving in the rain that you are coming for your appointment.

[Assistant] So the weather condition, the weather, the distance and when they feel better, they don’t come, any other that we have not talked about?

[User] No

[Assistant] Now let’s look at the some of the local health barriers and we want to know which pieces are working for you and why and which ones are not working for you, when you look at the district administration and leadership, is it working for you, is it enabling you to do your work well when treating patients?


[System] Act as an information elicitation agent for academic interviews.

[User] Usually when it’s raining, like if it rains during day time, every activity is at stand still because in the village settings, they have ..., so you can’t start moving in the rain that you are coming for your appointment.

[Assistant] So the weather condition, the weather, the distance and when they feel better, they don’t come, any other that we have not talked about?

[User] No

[Assistant] Now let’s look at the some of the local health barriers and we want to know which pieces are working for you and why and which ones are not working for you, when you look at the district administration and leadership, is it working for you, is it enabling you to do your work well when treating patients?

[User] Yes

[Assistant] How, why do you feel like it’s working for you


[System] Act as an information elicitation agent for academic interviews.

[User] No

[Assistant] Now let’s look at the some of the local health barriers and we want to know which pieces are working for you and why and which ones are not working for you, when you look at the district administration and leadership, is it working for you, is it enabling you to do your work well when treating patients?

[User] Yes

[Assistant] How, why do you feel like it’s working for you

[User] The district administration?

[Assistant] And the leadership, is it working for you, does it make your work easy while you are working?


[System] Act as an information elicitation agent for academic interviews.

[User] The district administration?

[Assistant] And the leadership, is it working for you, does it make your work easy while you are working?

[User] Yes, they do, like in lira district, me I can’t blame any department because like in my health center, I always work hand in hand with them, I inform them of the challenges we have in hand in the health center and they always respond

[Assistant] They respond?

[User] Yes, like for instance in my unit, there was a lot of gaps but they helped me, the last one they had taken survey, there was no clean source of water but I know soon or later, it is going to be better and even my health center is heading to upgrading, actually they had even sent money but I think they diverted the money from up not from the district, they told us to wait for the next financial year, me I have no problems with the authorities, because first of all when it comes to lack of drugs in the unit, it’s not them, no

[Assistant] So ...what are the challenges you face in your administration, you know many cases come to your office, we don’t have this, we don’t have this, and how do you manage?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes, they do, like in lira district, me I can’t blame any department because like in my health center, I always work hand in hand with them, I inform them of the challenges we have in hand in the health center and they always respond

[Assistant] They respond?

[User] Yes, like for instance in my unit, there was a lot of gaps but they helped me, the last one they had taken survey, there was no clean source of water but I know soon or later, it is going to be better and even my health center is heading to upgrading, actually they had even sent money but I think they diverted the money from up not from the district, they told us to wait for the next financial year, me I have no problems with the authorities, because first of all when it comes to lack of drugs in the unit, it’s not them, no

[Assistant] So ...what are the challenges you face in your administration, you know many cases come to your office, we don’t have this, we don’t have this, and how do you manage?

[User] The biggest challenge I face is lack of drugs and other utilities, but how do I manage, I have to just convince the clients to buy from outside because you cannot tell them and sit to wait for the drugs to be brought

[Assistant] How about the work force, the number you have in the unit


[System] Act as an information elicitation agent for academic interviews.

[User] Yes, like for instance in my unit, there was a lot of gaps but they helped me, the last one they had taken survey, there was no clean source of water but I know soon or later, it is going to be better and even my health center is heading to upgrading, actually they had even sent money but I think they diverted the money from up not from the district, they told us to wait for the next financial year, me I have no problems with the authorities, because first of all when it comes to lack of drugs in the unit, it’s not them, no

[Assistant] So ...what are the challenges you face in your administration, you know many cases come to your office, we don’t have this, we don’t have this, and how do you manage?

[User] The biggest challenge I face is lack of drugs and other utilities, but how do I manage, I have to just convince the clients to buy from outside because you cannot tell them and sit to wait for the drugs to be brought

[Assistant] How about the work force, the number you have in the unit

[User] The number is less but still it’s from the ministry not from the district because the policy was passed long time, here is away they outline that in this level of health center, these are supposed to be the number of people working, although at the district setting, we still lack because we find some people whose names are there but they have gone back to school

[Assistant] So how do you manage patients with such challenges?


[System] Act as an information elicitation agent for academic interviews.

[User] The biggest challenge I face is lack of drugs and other utilities, but how do I manage, I have to just convince the clients to buy from outside because you cannot tell them and sit to wait for the drugs to be brought

[Assistant] How about the work force, the number you have in the unit

[User] The number is less but still it’s from the ministry not from the district because the policy was passed long time, here is away they outline that in this level of health center, these are supposed to be the number of people working, although at the district setting, we still lack because we find some people whose names are there but they have gone back to school

[Assistant] So how do you manage patients with such challenges?

[User] We balance ourselves with the few who are there using the duty roster so that all the days are cover with work meanwhile while some people also have their rest because you cannot capture human beings and tell him or her to work from January to 31st December

[Assistant] Ok, and then if you look at the funding for health care in general, is it working for you?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes

[Assistant] Ok, when you look at the time these patients wait before they are worked on, what do you have to say about it?

[User] The waiting time is long, right .it’s just due to few staffs in place because the staffs are few but they will want to see everybody and definitely the waiting time at times becomes long

[Assistant] Long?

[User] Yes

[Assistant] And then when you look at the quality of services which patients get, are you satisfied?


[System] Act as an information elicitation agent for academic interviews.

[User] The waiting time is long, right .it’s just due to few staffs in place because the staffs are few but they will want to see everybody and definitely the waiting time at times becomes long

[Assistant] Long?

[User] Yes

[Assistant] And then when you look at the quality of services which patients get, are you satisfied?

[User] Not quite although we try but in situation where you are alone in the consultation room and you have 80 patients out, sometimes you tend to like hurry in order to serve everybody but in hurrying, you will not give quality services to the client because sometimes some of them need your time, you need to talk to them, you need to access them, you need to counsel them but if you do that, then you will not serve the rest and the rest will go back very annoyed, now in order not to annoy them, you hurry, but you know medically when you hurry, you do not give quality service.

[Assistant] And when you look at the qualification of the health workers you have, are they adequate?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes

[Assistant] And then when you look at the quality of services which patients get, are you satisfied?

[User] Not quite although we try but in situation where you are alone in the consultation room and you have 80 patients out, sometimes you tend to like hurry in order to serve everybody but in hurrying, you will not give quality services to the client because sometimes some of them need your time, you need to talk to them, you need to access them, you need to counsel them but if you do that, then you will not serve the rest and the rest will go back very annoyed, now in order not to annoy them, you hurry, but you know medically when you hurry, you do not give quality service.

[Assistant] And when you look at the qualification of the health workers you have, are they adequate?

[User] Yes they are above, there are those that are adequate and those that are not adequate, but the challenge is, as I told you, the policy we are using now was passed long time when the population was not like now, so you find now because of the few staffs, due to the staffing levels which is not from here, at times even the cadre that is not supposed to do something goes ahead to do it hence leading to poor quality service like for instance maybe clinician is alone doing now some procedures, nursing assistant sits in the consultations, now nursing assistant cannot really access, diagnose and treat well

[Assistant] Ok, the medication you told me, definitely the drugs are not enough, and how about the diagnosis like in your health center, do you have like echo cardiography?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes they are above, there are those that are adequate and those that are not adequate, but the challenge is, as I told you, the policy we are using now was passed long time when the population was not like now, so you find now because of the few staffs, due to the staffing levels which is not from here, at times even the cadre that is not supposed to do something goes ahead to do it hence leading to poor quality service like for instance maybe clinician is alone doing now some procedures, nursing assistant sits in the consultations, now nursing assistant cannot really access, diagnose and treat well

[Assistant] Ok, the medication you told me, definitely the drugs are not enough, and how about the diagnosis like in your health center, do you have like echo cardiography?

[User] The what?

[Assistant] Echo cardiography

[User] No

[Assistant] You don’t have it


[System] Act as an information elicitation agent for academic interviews.

[User] The what?

[Assistant] Echo cardiography

[User] No

[Assistant] You don’t have it

[User] No, actually echo cardiography in the whole of lira, maybe it’s in two places, here and that one is it joint medical clinic, I don’t know if there is any but I used to know only two.

[Assistant] Those are the two that you know?


[System] Act as an information elicitation agent for academic interviews.

[User] No

[Assistant] You don’t have it

[User] No, actually echo cardiography in the whole of lira, maybe it’s in two places, here and that one is it joint medical clinic, I don’t know if there is any but I used to know only two.

[Assistant] Those are the two that you know?

[User] Yes and when you get out, you know its money

[Assistant] So in your center, do you have like any drugs like for heart failure drugs, drugs for BPG and anticoagulation drugs, do you have those drugs?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes and when you get out, you know its money

[Assistant] So in your center, do you have like any drugs like for heart failure drugs, drugs for BPG and anticoagulation drugs, do you have those drugs?

[User] No

[Assistant] No?

[User] Yes.

[Assistant] so patients from your area...


[System] Act as an information elicitation agent for academic interviews.

[User] No

[Assistant] No?

[User] Yes.

[Assistant] so patients from your area...

[User] laughs..., really far,

[Assistant] So they have to come here.


[System] Act as an information elicitation agent for academic interviews.

[User] Yes.

[Assistant] so patients from your area...

[User] laughs..., really far,

[Assistant] So they have to come here.

[User] They have to come

[Assistant] And when you look at the guidelines and protocols for RHD care, do you have any here?


[System] Act as an information elicitation agent for academic interviews.

[User] They have to come

[Assistant] And when you look at the guidelines and protocols for RHD care, do you have any here?

[User] The guidelines?

[Assistant] Yes.

[User] No

[Assistant] And how about, do you have the referral paths they have to refer the RHD patients


[System] Act as an information elicitation agent for academic interviews.

[User] The guidelines?

[Assistant] Yes.

[User] No

[Assistant] And how about, do you have the referral paths they have to refer the RHD patients

[User] We have the referral forms which have even the numbers, the telephone numbers and you can call ahead of time

[Assistant] Are they forms for the ministry or forms for the project


[System] Act as an information elicitation agent for academic interviews.

[User] No

[Assistant] And how about, do you have the referral paths they have to refer the RHD patients

[User] We have the referral forms which have even the numbers, the telephone numbers and you can call ahead of time

[Assistant] Are they forms for the ministry or forms for the project

[User] They are for the project, I don’t know if the forms is provided by the ministry but we received it through the project

[Assistant] Through the project?


[System] Act as an information elicitation agent for academic interviews.

[User] We have the referral forms which have even the numbers, the telephone numbers and you can call ahead of time

[Assistant] Are they forms for the ministry or forms for the project

[User] They are for the project, I don’t know if the forms is provided by the ministry but we received it through the project

[Assistant] Through the project?

[User] Yes

[Assistant] When you look at the medical records system and the way health information flows, are you happy with it, is it working for you in your health center?


[System] Act as an information elicitation agent for academic interviews.

[User] They are for the project, I don’t know if the forms is provided by the ministry but we received it through the project

[Assistant] Through the project?

[User] Yes

[Assistant] When you look at the medical records system and the way health information flows, are you happy with it, is it working for you in your health center?

[User] Yes, it is

[Assistant] Are the registries ok or is there any gap?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes

[Assistant] When you look at the medical records system and the way health information flows, are you happy with it, is it working for you in your health center?

[User] Yes, it is

[Assistant] Are the registries ok or is there any gap?

[User] No

[Assistant] Just in case someone wants to look at your records like for a year, is it easy for one to access the register or if I wanted to know like how many suspected RHD patients...


[System] Act as an information elicitation agent for academic interviews.

[User] Yes, it is

[Assistant] Are the registries ok or is there any gap?

[User] No

[Assistant] Just in case someone wants to look at your records like for a year, is it easy for one to access the register or if I wanted to know like how many suspected RHD patients...

[User] Except that, ok I hear that it’s a new HMIS tool, maybe its include that one but the old one we were using do not have the provision for that have the provision for that

[Assistant] And then if someone wants to track the suspected RHD patients or acute rheumatic fever that you had, would it be easy to get that?


[System] Act as an information elicitation agent for academic interviews.

[User] No

[Assistant] Just in case someone wants to look at your records like for a year, is it easy for one to access the register or if I wanted to know like how many suspected RHD patients...

[User] Except that, ok I hear that it’s a new HMIS tool, maybe its include that one but the old one we were using do not have the provision for that have the provision for that

[Assistant] And then if someone wants to track the suspected RHD patients or acute rheumatic fever that you had, would it be easy to get that?

[User] It will not be easy to get that because in the beginning even me I was not keeping the records, I could just fill the forms and I refer like that, now one time when they were asking how many are absent, I realized I was not keeping it, yeah and in the HMIS, once they find and whatever the provision for RHD is not there

[Assistant] Do you think it is very important to come up with the guidelines?


[System] Act as an information elicitation agent for academic interviews.

[User] Except that, ok I hear that it’s a new HMIS tool, maybe its include that one but the old one we were using do not have the provision for that have the provision for that

[Assistant] And then if someone wants to track the suspected RHD patients or acute rheumatic fever that you had, would it be easy to get that?

[User] It will not be easy to get that because in the beginning even me I was not keeping the records, I could just fill the forms and I refer like that, now one time when they were asking how many are absent, I realized I was not keeping it, yeah and in the HMIS, once they find and whatever the provision for RHD is not there

[Assistant] Do you think it is very important to come up with the guidelines?

[User] It is very important because the ministry knows what happens in the villages through the reporting system but now since it’s not there, we don’t report it directly

[Assistant] And then what has worked for you in your health center, what are some of those local system health enablers factors that have helped you do your work well, administration, has it worked for you?


[System] Act as an information elicitation agent for academic interviews.

[User] It is very important because the ministry knows what happens in the villages through the reporting system but now since it’s not there, we don’t report it directly

[Assistant] And then what has worked for you in your health center, what are some of those local system health enablers factors that have helped you do your work well, administration, has it worked for you?

[User] Yes

[Assistant] Funding

[User] Funding no

[Assistant] Laughs..., health workers, numbers and qualifications?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes

[Assistant] Funding

[User] Funding no

[Assistant] Laughs..., health workers, numbers and qualifications?

[User] That one even no, what has worked for me is the attitude at work, the few members, the few staffs, they have attitude

[Assistant] Ok, what else has motivated you to keep working?


[System] Act as an information elicitation agent for academic interviews.

[User] Funding no

[Assistant] Laughs..., health workers, numbers and qualifications?

[User] That one even no, what has worked for me is the attitude at work, the few members, the few staffs, they have attitude

[Assistant] Ok, what else has motivated you to keep working?

[User] The project always give some little token also although not regularly but that once in a while shows somebody is in care

[Assistant] Ok, let’s look at the perception of patient’s outcome, generally do you think the patients get the care that they need when they come to you?


[System] Act as an information elicitation agent for academic interviews.

[User] That one even no, what has worked for me is the attitude at work, the few members, the few staffs, they have attitude

[Assistant] Ok, what else has motivated you to keep working?

[User] The project always give some little token also although not regularly but that once in a while shows somebody is in care

[Assistant] Ok, let’s look at the perception of patient’s outcome, generally do you think the patients get the care that they need when they come to you?

[User] Yes, they do unless if the care that they need is not provided there that is when they don’t get because you know when you come like when I come to you whole heartedly that you are going to help me then you tell me you see, your condition, I cannot work on it, you go to Mulago, now I will start things like how will I reach Mulago, even if it’s the ambulance to take me, they will ask for transport, I mean the fuel, so it’s not easy but services that they can get, they get

[Assistant] Ok, do you think that surgeries can be offered to RHD patients


[System] Act as an information elicitation agent for academic interviews.

[User] The project always give some little token also although not regularly but that once in a while shows somebody is in care

[Assistant] Ok, let’s look at the perception of patient’s outcome, generally do you think the patients get the care that they need when they come to you?

[User] Yes, they do unless if the care that they need is not provided there that is when they don’t get because you know when you come like when I come to you whole heartedly that you are going to help me then you tell me you see, your condition, I cannot work on it, you go to Mulago, now I will start things like how will I reach Mulago, even if it’s the ambulance to take me, they will ask for transport, I mean the fuel, so it’s not easy but services that they can get, they get

[Assistant] Ok, do you think that surgeries can be offered to RHD patients

[User] Yes

[Assistant] Do you do it around here?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes, they do unless if the care that they need is not provided there that is when they don’t get because you know when you come like when I come to you whole heartedly that you are going to help me then you tell me you see, your condition, I cannot work on it, you go to Mulago, now I will start things like how will I reach Mulago, even if it’s the ambulance to take me, they will ask for transport, I mean the fuel, so it’s not easy but services that they can get, they get

[Assistant] Ok, do you think that surgeries can be offered to RHD patients

[User] Yes

[Assistant] Do you do it around here?

[User] No, I have not known about it because I had a friend who had a daughter with the heart condition, the man even lost a land because I referred them here but the condition, no I think even the project had not yet come so they were taken to the health center cardio echo was done but from the private clinic and they were referred to Mulago heart institute and there, they asked them some good millions of money which he had to come back and sell of his land even his business has collapsed but thank God, the child is well

[Assistant] Wow! That is wonderful, and the patient’s safety and the quality of care do you have any concerns? Are the patients managed in a safe way?


[System] Act as an information elicitation agent for academic interviews.

[User] No, I have not known about it because I had a friend who had a daughter with the heart condition, the man even lost a land because I referred them here but the condition, no I think even the project had not yet come so they were taken to the health center cardio echo was done but from the private clinic and they were referred to Mulago heart institute and there, they asked them some good millions of money which he had to come back and sell of his land even his business has collapsed but thank God, the child is well

[Assistant] Wow! That is wonderful, and the patient’s safety and the quality of care do you have any concerns? Are the patients managed in a safe way?

[User] Yes

[Assistant] why?

[User] sorry!

[Assistant] What are the reasons, why do you feel the quality of care they get and their safety is ok?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes

[Assistant] why?

[User] sorry!

[Assistant] What are the reasons, why do you feel the quality of care they get and their safety is ok?

[User] Because I see they are happy and they recover

[Assistant] And then have you witnessed, do you think that there are some of the preventable deaths which are occurring in the health center, preventable that the person shouldn’t have died but simply maybe there was some hindrance in the process?


[System] Act as an information elicitation agent for academic interviews.

[User] sorry!

[Assistant] What are the reasons, why do you feel the quality of care they get and their safety is ok?

[User] Because I see they are happy and they recover

[Assistant] And then have you witnessed, do you think that there are some of the preventable deaths which are occurring in the health center, preventable that the person shouldn’t have died but simply maybe there was some hindrance in the process?

[User] Yes, they are there

[Assistant] Any incidence that you recall?


[System] Act as an information elicitation agent for academic interviews.

[User] Because I see they are happy and they recover

[Assistant] And then have you witnessed, do you think that there are some of the preventable deaths which are occurring in the health center, preventable that the person shouldn’t have died but simply maybe there was some hindrance in the process?

[User] Yes, they are there

[Assistant] Any incidence that you recall?

[User] Last year around this time in December, the child was brought, the relative told me that they had a child who was not well, a child of 14 years, this child was taken to a certain private clinic, this child moving and he was shot from the chest with a ball and this was the child who was living with the grandmother, the child came back and did not tell the grandmother, after sometime he started feeling severe chest pain, they started treating the child everywhere with no improvement, the time I learnt of the child, he was in a private clinic on oxygen, they referred the child to lira hospital, then I called the acute rheumatic fever, they told us to bring the child, the child was accessed but from here and they found out that the heart was normal but rather the problem was with the lungs and it had grown advanced, the child passed on from here

[Assistant] So do you think there are some patients who are dying in the communities without presenting to the hospital


[System] Act as an information elicitation agent for academic interviews.

[User] Yes, they are there

[Assistant] Any incidence that you recall?

[User] Last year around this time in December, the child was brought, the relative told me that they had a child who was not well, a child of 14 years, this child was taken to a certain private clinic, this child moving and he was shot from the chest with a ball and this was the child who was living with the grandmother, the child came back and did not tell the grandmother, after sometime he started feeling severe chest pain, they started treating the child everywhere with no improvement, the time I learnt of the child, he was in a private clinic on oxygen, they referred the child to lira hospital, then I called the acute rheumatic fever, they told us to bring the child, the child was accessed but from here and they found out that the heart was normal but rather the problem was with the lungs and it had grown advanced, the child passed on from here

[Assistant] So do you think there are some patients who are dying in the communities without presenting to the hospital

[User] Yes, they are very many

[Assistant] Why? Why do you think so?


[System] Act as an information elicitation agent for academic interviews.

[User] Last year around this time in December, the child was brought, the relative told me that they had a child who was not well, a child of 14 years, this child was taken to a certain private clinic, this child moving and he was shot from the chest with a ball and this was the child who was living with the grandmother, the child came back and did not tell the grandmother, after sometime he started feeling severe chest pain, they started treating the child everywhere with no improvement, the time I learnt of the child, he was in a private clinic on oxygen, they referred the child to lira hospital, then I called the acute rheumatic fever, they told us to bring the child, the child was accessed but from here and they found out that the heart was normal but rather the problem was with the lungs and it had grown advanced, the child passed on from here

[Assistant] So do you think there are some patients who are dying in the communities without presenting to the hospital

[User] Yes, they are very many

[Assistant] Why? Why do you think so?

[User] I said earlier on that ignorance and poor health seeking behavior as some people in the village, by the way when you live in town, you don’t know what happens in the village, drunkardness is rampant in the village and any father who drinks doesn’t mind what happens in the environment, whether the wife is happy, the children are healthy, it’s not his, for him, he is there, they are very many.

[Assistant] What do we do?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes, they are very many

[Assistant] Why? Why do you think so?

[User] I said earlier on that ignorance and poor health seeking behavior as some people in the village, by the way when you live in town, you don’t know what happens in the village, drunkardness is rampant in the village and any father who drinks doesn’t mind what happens in the environment, whether the wife is happy, the children are healthy, it’s not his, for him, he is there, they are very many.

[Assistant] What do we do?

[User] We need to sensitize them using better channels maybe we can reach them over the radios, churches and whatever but they need serious sensitization

[Assistant] In your opinion, what are the two most common thing ministry of health should do to improve the patient’s outcome?


[System] Act as an information elicitation agent for academic interviews.

[User] I said earlier on that ignorance and poor health seeking behavior as some people in the village, by the way when you live in town, you don’t know what happens in the village, drunkardness is rampant in the village and any father who drinks doesn’t mind what happens in the environment, whether the wife is happy, the children are healthy, it’s not his, for him, he is there, they are very many.

[Assistant] What do we do?

[User] We need to sensitize them using better channels maybe we can reach them over the radios, churches and whatever but they need serious sensitization

[Assistant] In your opinion, what are the two most common thing ministry of health should do to improve the patient’s outcome?

[User] I beg your pardon

[Assistant] What are two most important things you think ministry of health could do to improve the outcome of our patients?


[System] Act as an information elicitation agent for academic interviews.

[User] I am fine and you.

[Assistant] I am good and how are you Mother?

[User] I am also fine.

[Assistant] You told me earlier that you are 69 years old, so I would like to know what was happening during the time you were born

[User] I was born when we were colonized by the Europeans.

[Assistant] Ohh, okay and which village were you born from?


[System] Act as an information elicitation agent for academic interviews.

[User] I was born when we were colonized by the Europeans.

[Assistant] Ohh, okay and which village were you born from?

[User] Msasa.

[Assistant] Which district?

[User] Handeni.

[Assistant] And it is in which ward?


[System] Act as an information elicitation agent for academic interviews.

[User] Msasa.

[Assistant] Which district?

[User] Handeni.

[Assistant] And it is in which ward?

[User] I did know by then I was young

[Assistant] Mother I would like to know the structure of your family like were you living with your father, mother and you children in one household or it was father, mother, children and other relatives in one household or how was it?


[System] Act as an information elicitation agent for academic interviews.

[User] Handeni.

[Assistant] And it is in which ward?

[User] I did know by then I was young

[Assistant] Mother I would like to know the structure of your family like were you living with your father, mother and you children in one household or it was father, mother, children and other relatives in one household or how was it?

[User] I was our parents me and my other siblings and also our grandmothers

[Assistant] How many grandmothers were you living with?


[System] Act as an information elicitation agent for academic interviews.

[User] I did know by then I was young

[Assistant] Mother I would like to know the structure of your family like were you living with your father, mother and you children in one household or it was father, mother, children and other relatives in one household or how was it?

[User] I was our parents me and my other siblings and also our grandmothers

[Assistant] How many grandmothers were you living with?

[User] Only one.

[Assistant] From which side?


[System] Act as an information elicitation agent for academic interviews.

[User] I was our parents me and my other siblings and also our grandmothers

[Assistant] How many grandmothers were you living with?

[User] Only one.

[Assistant] From which side?

[User] From my father’s side.

[Assistant] Okay, so it was father, mother, grandmother and you children living in one household like this?


[System] Act as an information elicitation agent for academic interviews.

[User] Only one.

[Assistant] From which side?

[User] From my father’s side.

[Assistant] Okay, so it was father, mother, grandmother and you children living in one household like this?

[User] Yes.

[Assistant] And what were the main activities your parents were involved in?


[System] Act as an information elicitation agent for academic interviews.

[User] From my father’s side.

[Assistant] Okay, so it was father, mother, grandmother and you children living in one household like this?

[User] Yes.

[Assistant] And what were the main activities your parents were involved in?

[User] It was farming.

[Assistant] Were there goats, chicken?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes.

[Assistant] And what were the main activities your parents were involved in?

[User] It was farming.

[Assistant] Were there goats, chicken?

[User] We had chicken only.

[Assistant] What were the roles and responsibilities of men by that time?


[System] Act as an information elicitation agent for academic interviews.

[User] It was farming.

[Assistant] Were there goats, chicken?

[User] We had chicken only.

[Assistant] What were the roles and responsibilities of men by that time?

[User] It was farming for all of them, meaning my father, mother and my grandmother.

[Assistant] Apart from farming what was his other duties and responsibilities?


[System] Act as an information elicitation agent for academic interviews.

[User] We had chicken only.

[Assistant] What were the roles and responsibilities of men by that time?

[User] It was farming for all of them, meaning my father, mother and my grandmother.

[Assistant] Apart from farming what was his other duties and responsibilities?

[User] He was working as a casual labourer.

[Assistant] And what about his responsibilities at home?


[System] Act as an information elicitation agent for academic interviews.

[User] It was farming for all of them, meaning my father, mother and my grandmother.

[Assistant] Apart from farming what was his other duties and responsibilities?

[User] He was working as a casual labourer.

[Assistant] And what about his responsibilities at home?

[User] It was just farming and when he gets home he will eat and rest.

[Assistant] And what about the responsibilities of women, I mean your mother and your grandmother at home?


[System] Act as an information elicitation agent for academic interviews.

[User] He was working as a casual labourer.

[Assistant] And what about his responsibilities at home?

[User] It was just farming and when he gets home he will eat and rest.

[Assistant] And what about the responsibilities of women, I mean your mother and your grandmother at home?

[User] When they come back from the farm they were doing household chores like sweeping the ground, washing dishes, cooking and fetching fire wood.

[Assistant] And what about girl child responsibilities at home?


[System] Act as an information elicitation agent for academic interviews.

[User] It was just farming and when he gets home he will eat and rest.

[Assistant] And what about the responsibilities of women, I mean your mother and your grandmother at home?

[User] When they come back from the farm they were doing household chores like sweeping the ground, washing dishes, cooking and fetching fire wood.

[Assistant] And what about girl child responsibilities at home?

[User] We were just there doing nothing because we were young so my mother used to cook for us.

[Assistant] Did you and your siblings go to school?


[System] Act as an information elicitation agent for academic interviews.

[User] When they come back from the farm they were doing household chores like sweeping the ground, washing dishes, cooking and fetching fire wood.

[Assistant] And what about girl child responsibilities at home?

[User] We were just there doing nothing because we were young so my mother used to cook for us.

[Assistant] Did you and your siblings go to school?

[User] Yes my siblings got the opportunity to get education.

[Assistant] Mother how many were you?


[System] Act as an information elicitation agent for academic interviews.

[User] We were just there doing nothing because we were young so my mother used to cook for us.

[Assistant] Did you and your siblings go to school?

[User] Yes my siblings got the opportunity to get education.

[Assistant] Mother how many were you?

[User] We are four.

[Assistant] So three of them were educated?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes my siblings got the opportunity to get education.

[Assistant] Mother how many were you?

[User] We are four.

[Assistant] So three of them were educated?

[User] Yes.

[Assistant] Up to which level?


[System] Act as an information elicitation agent for academic interviews.

[User] We are four.

[Assistant] So three of them were educated?

[User] Yes.

[Assistant] Up to which level?

[User] Both of them reached class seven.

[Assistant] Mother I would like to know how you were feeding when you were young?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes.

[Assistant] Up to which level?

[User] Both of them reached class seven.

[Assistant] Mother I would like to know how you were feeding when you were young?

[User] We were eating very well, we used to drink milk.

[Assistant] So what kind of food were you eating?


[System] Act as an information elicitation agent for academic interviews.

[User] Both of them reached class seven.

[Assistant] Mother I would like to know how you were feeding when you were young?

[User] We were eating very well, we used to drink milk.

[Assistant] So what kind of food were you eating?

[User] We were eating rice, ugali, milk.

[Assistant] And the food you were eating most?


[System] Act as an information elicitation agent for academic interviews.

[User] We were eating very well, we used to drink milk.

[Assistant] So what kind of food were you eating?

[User] We were eating rice, ugali, milk.

[Assistant] And the food you were eating most?

[User] Ugali.

[Assistant] Ugali and what?


[System] Act as an information elicitation agent for academic interviews.

[User] We were eating rice, ugali, milk.

[Assistant] And the food you were eating most?

[User] Ugali.

[Assistant] Ugali and what?

[User] Hombo, beans,

[Assistant] And what about your milk intake?


[System] Act as an information elicitation agent for academic interviews.

[User] Ugali.

[Assistant] Ugali and what?

[User] Hombo, beans,

[Assistant] And what about your milk intake?

[User] We used to drink at least a cup.

[Assistant] Is it every day?


[System] Act as an information elicitation agent for academic interviews.

[User] Hombo, beans,

[Assistant] And what about your milk intake?

[User] We used to drink at least a cup.

[Assistant] Is it every day?

[User] Ohh yes it is every day.

[Assistant] And what about the food you were eating rarely?


[System] Act as an information elicitation agent for academic interviews.

[User] We used to drink at least a cup.

[Assistant] Is it every day?

[User] Ohh yes it is every day.

[Assistant] And what about the food you were eating rarely?

[User] It is just ugali and porridge.

[Assistant] Father, I would like to know when you were young living with your parents what kind of food you were eating most?


[System] Act as an information elicitation agent for academic interviews.

[User] Ohh yes it is every day.

[Assistant] And what about the food you were eating rarely?

[User] It is just ugali and porridge.

[Assistant] Father, I would like to know when you were young living with your parents what kind of food you were eating most?

[User] It was just maize meal and wild vegetables.

[Assistant] Which type of wild vegetables are those?


[System] Act as an information elicitation agent for academic interviews.

[User] It is just ugali and porridge.

[Assistant] Father, I would like to know when you were young living with your parents what kind of food you were eating most?

[User] It was just maize meal and wild vegetables.

[Assistant] Which type of wild vegetables are those?

[User] Hare lettuce, Sodom apples, mabwando, night shade and we used oyster nuts, pumpkin seeds and also cucumber seeds and Kungujuu as oil. Our mother’s used to soak maize and grind using a stone.

[Assistant] And what about the food you were eating rarely?


[System] Act as an information elicitation agent for academic interviews.

[User] It was just maize meal and wild vegetables.

[Assistant] Which type of wild vegetables are those?

[User] Hare lettuce, Sodom apples, mabwando, night shade and we used oyster nuts, pumpkin seeds and also cucumber seeds and Kungujuu as oil. Our mother’s used to soak maize and grind using a stone.

[Assistant] And what about the food you were eating rarely?

[User] May be pork because we do not eat at all, otherwise we eat everything.

[Assistant] I mean the food you did not eat most of the time?


[System] Act as an information elicitation agent for academic interviews.

[User] Hare lettuce, Sodom apples, mabwando, night shade and we used oyster nuts, pumpkin seeds and also cucumber seeds and Kungujuu as oil. Our mother’s used to soak maize and grind using a stone.

[Assistant] And what about the food you were eating rarely?

[User] May be pork because we do not eat at all, otherwise we eat everything.

[Assistant] I mean the food you did not eat most of the time?

[User] May be rice we ate rarely, because we used to eat ugali three times a day every day.

[Assistant] And what about the special food prepared for a group of people like children or women?


[System] Act as an information elicitation agent for academic interviews.

[User] May be pork because we do not eat at all, otherwise we eat everything.

[Assistant] I mean the food you did not eat most of the time?

[User] May be rice we ate rarely, because we used to eat ugali three times a day every day.

[Assistant] And what about the special food prepared for a group of people like children or women?

[User] Babies were taking porridge, and for women them they were eating ugali crust and also ugali which stick on the wood spoon hahahaaaaa.

[Assistant] What about sick people?


[System] Act as an information elicitation agent for academic interviews.

[User] May be rice we ate rarely, because we used to eat ugali three times a day every day.

[Assistant] And what about the special food prepared for a group of people like children or women?

[User] Babies were taking porridge, and for women them they were eating ugali crust and also ugali which stick on the wood spoon hahahaaaaa.

[Assistant] What about sick people?

[User] Porridge and soft ugali.

[Assistant] What about pregnant women what kind of food were they eating?


[System] Act as an information elicitation agent for academic interviews.

[User] Babies were taking porridge, and for women them they were eating ugali crust and also ugali which stick on the wood spoon hahahaaaaa.

[Assistant] What about sick people?

[User] Porridge and soft ugali.

[Assistant] What about pregnant women what kind of food were they eating?

[User] Soft rice and bananas.

[Assistant] And where did you source your food?


[System] Act as an information elicitation agent for academic interviews.

[User] Porridge and soft ugali.

[Assistant] What about pregnant women what kind of food were they eating?

[User] Soft rice and bananas.

[Assistant] And where did you source your food?

[User] We used to farm and when the food got finished we were buying from the shops.

[Assistant] Which type of food were you growing?


[System] Act as an information elicitation agent for academic interviews.

[User] Soft rice and bananas.

[Assistant] And where did you source your food?

[User] We used to farm and when the food got finished we were buying from the shops.

[Assistant] Which type of food were you growing?

[User] Maize and sorghum.

[Assistant] And the food you were buying from the shops?


[System] Act as an information elicitation agent for academic interviews.

[User] We used to farm and when the food got finished we were buying from the shops.

[Assistant] Which type of food were you growing?

[User] Maize and sorghum.

[Assistant] And the food you were buying from the shops?

[User] Maize, rice, maize flour.

[Assistant] What about food you got from the wild?


[System] Act as an information elicitation agent for academic interviews.

[User] Maize and sorghum.

[Assistant] And the food you were buying from the shops?

[User] Maize, rice, maize flour.

[Assistant] What about food you got from the wild?

[User] Hare lettuce, kungujuu, nightshades, kungwija, and Sodom apples.

[Assistant] Mother, where were you sourcing food when you were young living with your parents?


[System] Act as an information elicitation agent for academic interviews.

[User] Maize, rice, maize flour.

[Assistant] What about food you got from the wild?

[User] Hare lettuce, kungujuu, nightshades, kungwija, and Sodom apples.

[Assistant] Mother, where were you sourcing food when you were young living with your parents?

[User] My father used to buy food from the shops,

[Assistant] And which type of food were you buying from the shops?


[System] Act as an information elicitation agent for academic interviews.

[User] Hare lettuce, kungujuu, nightshades, kungwija, and Sodom apples.

[Assistant] Mother, where were you sourcing food when you were young living with your parents?

[User] My father used to buy food from the shops,

[Assistant] And which type of food were you buying from the shops?

[User] Maize flour, rice and beans.

[Assistant] Father I would like to know who was making food decision in your family?


[System] Act as an information elicitation agent for academic interviews.

[User] My father used to buy food from the shops,

[Assistant] And which type of food were you buying from the shops?

[User] Maize flour, rice and beans.

[Assistant] Father I would like to know who was making food decision in your family?

[User] It was my father.

[Assistant] And who was making decision on the type of food to be prepared at home?


[System] Act as an information elicitation agent for academic interviews.

[User] Maize flour, rice and beans.

[Assistant] Father I would like to know who was making food decision in your family?

[User] It was my father.

[Assistant] And who was making decision on the type of food to be prepared at home?

[User] My father was responsible to provide food for our family and my mother used to tell my father when the food got finished so that he can buy so every decision was from my father.

[Assistant] You told me earlier that your parents were farmers so I would like to know what amount of food were you selling and consuming?


[System] Act as an information elicitation agent for academic interviews.

[User] It was my father.

[Assistant] And who was making decision on the type of food to be prepared at home?

[User] My father was responsible to provide food for our family and my mother used to tell my father when the food got finished so that he can buy so every decision was from my father.

[Assistant] You told me earlier that your parents were farmers so I would like to know what amount of food were you selling and consuming?

[User] Is it nowadays or in the past?

[Assistant] In the past.


[System] Act as an information elicitation agent for academic interviews.

[User] My father was responsible to provide food for our family and my mother used to tell my father when the food got finished so that he can buy so every decision was from my father.

[Assistant] You told me earlier that your parents were farmers so I would like to know what amount of food were you selling and consuming?

[User] Is it nowadays or in the past?

[Assistant] In the past.

[User] Our fathers used to farm only half an acre and whatever they have harvested they sell half and keep half for consumption.

[Assistant] And how were they using the money received from sale of food and who had the final decision on to spend the money.


[System] Act as an information elicitation agent for academic interviews.

[User] Is it nowadays or in the past?

[Assistant] In the past.

[User] Our fathers used to farm only half an acre and whatever they have harvested they sell half and keep half for consumption.

[Assistant] And how were they using the money received from sale of food and who had the final decision on to spend the money.

[User] My father was a decision maker, he used to direct my mother on how the money will be spent like this amount of money is for food or clothes.

[Assistant] And who was involved in the decision making process?


[System] Act as an information elicitation agent for academic interviews.

[User] Our fathers used to farm only half an acre and whatever they have harvested they sell half and keep half for consumption.

[Assistant] And how were they using the money received from sale of food and who had the final decision on to spend the money.

[User] My father was a decision maker, he used to direct my mother on how the money will be spent like this amount of money is for food or clothes.

[Assistant] And who was involved in the decision making process?

[User] My Mother because she is the one who knows the needs of the house.

[Assistant] Mother what about you, who used to make decisions on the type of food to be bought?


[System] Act as an information elicitation agent for academic interviews.

[User] My father was a decision maker, he used to direct my mother on how the money will be spent like this amount of money is for food or clothes.

[Assistant] And who was involved in the decision making process?

[User] My Mother because she is the one who knows the needs of the house.

[Assistant] Mother what about you, who used to make decisions on the type of food to be bought?

[User] It was my mother, but she used to tell my father that we do not have this and that so my father will give her money to buy food.

[Assistant] And who used to budget in your household?


[System] Act as an information elicitation agent for academic interviews.

[User] My Mother because she is the one who knows the needs of the house.

[Assistant] Mother what about you, who used to make decisions on the type of food to be bought?

[User] It was my mother, but she used to tell my father that we do not have this and that so my father will give her money to buy food.

[Assistant] And who used to budget in your household?

[User] My father was a decision maker.

[Assistant] What about you children were you involved in any way?


[System] Act as an information elicitation agent for academic interviews.

[User] It was my mother, but she used to tell my father that we do not have this and that so my father will give her money to buy food.

[Assistant] And who used to budget in your household?

[User] My father was a decision maker.

[Assistant] What about you children were you involved in any way?

[User] No we were not involved.

[Assistant] Father when you were growing up how did you know this child has grown up or what were the indication like or what did you see and came up with the conclusion that this is no longer a boy or girl he is a full grown man?


[System] Act as an information elicitation agent for academic interviews.

[User] My father was a decision maker.

[Assistant] What about you children were you involved in any way?

[User] No we were not involved.

[Assistant] Father when you were growing up how did you know this child has grown up or what were the indication like or what did you see and came up with the conclusion that this is no longer a boy or girl he is a full grown man?

[User] We say a boy has grown into adulthood when he reaches puberty.

[Assistant] So how did you know that you had reached puberty?


[System] Act as an information elicitation agent for academic interviews.

[User] No we were not involved.

[Assistant] Father when you were growing up how did you know this child has grown up or what were the indication like or what did you see and came up with the conclusion that this is no longer a boy or girl he is a full grown man?

[User] We say a boy has grown into adulthood when he reaches puberty.

[Assistant] So how did you know that you had reached puberty?

[User] You will know because you will see the body changes and there are some things you will be able to do.

[Assistant] So what happened after realizing that you are a grown up person? Was there any celebration?


[System] Act as an information elicitation agent for academic interviews.

[User] We say a boy has grown into adulthood when he reaches puberty.

[Assistant] So how did you know that you had reached puberty?

[User] You will know because you will see the body changes and there are some things you will be able to do.

[Assistant] So what happened after realizing that you are a grown up person? Was there any celebration?

[User] Yes there were ceremony to symbolize that as well as when a boy is circumcised.

[Assistant] At what age were boys circumcised?


[System] Act as an information elicitation agent for academic interviews.

[User] You will know because you will see the body changes and there are some things you will be able to do.

[Assistant] So what happened after realizing that you are a grown up person? Was there any celebration?

[User] Yes there were ceremony to symbolize that as well as when a boy is circumcised.

[Assistant] At what age were boys circumcised?

[User] When they were seven years.

[Assistant] So a boy of seven years you call them a grown up person?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes there were ceremony to symbolize that as well as when a boy is circumcised.

[Assistant] At what age were boys circumcised?

[User] When they were seven years.

[Assistant] So a boy of seven years you call them a grown up person?

[User] No it is not like that after circumcision he stays for another seven years until he is sexually matured and that is when he reaches puberty so from there he can also marry.

[Assistant]
Okay, and what about a female child? ##P478# #	When she reaches a certain age I think 15 years and her breast start to develop and also other things women knows.

Your wife told me she came to Kibaya village like 30 years ago what about you?


[System] Act as an information elicitation agent for academic interviews.

[User] When they were seven years.

[Assistant] So a boy of seven years you call them a grown up person?

[User] No it is not like that after circumcision he stays for another seven years until he is sexually matured and that is when he reaches puberty so from there he can also marry.

[Assistant]
Okay, and what about a female child? ##P478# #	When she reaches a certain age I think 15 years and her breast start to develop and also other things women knows.

Your wife told me she came to Kibaya village like 30 years ago what about you?

[User] I think it is the same time or even more.

[Assistant] So who else are you living with in your household for now?


[System] Act as an information elicitation agent for academic interviews.

[User] No it is not like that after circumcision he stays for another seven years until he is sexually matured and that is when he reaches puberty so from there he can also marry.

[Assistant]
Okay, and what about a female child? ##P478# #	When she reaches a certain age I think 15 years and her breast start to develop and also other things women knows.

Your wife told me she came to Kibaya village like 30 years ago what about you?

[User] I think it is the same time or even more.

[Assistant] So who else are you living with in your household for now?

[User] My wife, my father, children and grandchildren.

[Assistant] Are you living with your mother in law or uncles aunties?


[System] Act as an information elicitation agent for academic interviews.

[User] I think it is the same time or even more.

[Assistant] So who else are you living with in your household for now?

[User] My wife, my father, children and grandchildren.

[Assistant] Are you living with your mother in law or uncles aunties?

[User] No the one you asked me earlier are the ones I am living with.

[Assistant] Father I would like to know what activities your family is doing to earn a living?


[System] Act as an information elicitation agent for academic interviews.

[User] My wife, my father, children and grandchildren.

[Assistant] Are you living with your mother in law or uncles aunties?

[User] No the one you asked me earlier are the ones I am living with.

[Assistant] Father I would like to know what activities your family is doing to earn a living?

[User] We are farmers.

[Assistant] Is your family structure different to your parent’s family structure?


[System] Act as an information elicitation agent for academic interviews.

[User] No the one you asked me earlier are the ones I am living with.

[Assistant] Father I would like to know what activities your family is doing to earn a living?

[User] We are farmers.

[Assistant] Is your family structure different to your parent’s family structure?

[User] In the past I used to depend on my parents but nowadays I am the one who is providing for the family.

[Assistant] So how is it different? Because you told me earlier your parents used to farm and also rear animals and it is the same to you so my question is there difference in the way life was before and now?


[System] Act as an information elicitation agent for academic interviews.

[User] We are farmers.

[Assistant] Is your family structure different to your parent’s family structure?

[User] In the past I used to depend on my parents but nowadays I am the one who is providing for the family.

[Assistant] So how is it different? Because you told me earlier your parents used to farm and also rear animals and it is the same to you so my question is there difference in the way life was before and now?

[User] Yes there is difference because like this year our cows and goats died because of drought and I got sick so a lot of things happened.

[Assistant] Why nowadays there are a lot of changes cows are dying why all this is happening now?


[System] Act as an information elicitation agent for academic interviews.

[User] In the past I used to depend on my parents but nowadays I am the one who is providing for the family.

[Assistant] So how is it different? Because you told me earlier your parents used to farm and also rear animals and it is the same to you so my question is there difference in the way life was before and now?

[User] Yes there is difference because like this year our cows and goats died because of drought and I got sick so a lot of things happened.

[Assistant] Why nowadays there are a lot of changes cows are dying why all this is happening now?

[User] In the past we used to have doctors around the village and they were providing us with medicine for both human beings and animals.

[Assistant] How have these changes affecting you and your family?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes there is difference because like this year our cows and goats died because of drought and I got sick so a lot of things happened.

[Assistant] Why nowadays there are a lot of changes cows are dying why all this is happening now?

[User] In the past we used to have doctors around the village and they were providing us with medicine for both human beings and animals.

[Assistant] How have these changes affecting you and your family?

[User] We are affected because you do not have money to buy medicine and sometimes back we used to sell our cows or goat and buy medicine but nowadays we cannot do that because we do not even have goat to sell so our family and myself are affected.

[Assistant] What are the duties and responsibilities of men and women in your household starting with men?


[System] Act as an information elicitation agent for academic interviews.

[User] In the past we used to have doctors around the village and they were providing us with medicine for both human beings and animals.

[Assistant] How have these changes affecting you and your family?

[User] We are affected because you do not have money to buy medicine and sometimes back we used to sell our cows or goat and buy medicine but nowadays we cannot do that because we do not even have goat to sell so our family and myself are affected.

[Assistant] What are the duties and responsibilities of men and women in your household starting with men?

[User] It is mainly farming.

[Assistant] Which season is this?


[System] Act as an information elicitation agent for academic interviews.

[User] We are affected because you do not have money to buy medicine and sometimes back we used to sell our cows or goat and buy medicine but nowadays we cannot do that because we do not even have goat to sell so our family and myself are affected.

[Assistant] What are the duties and responsibilities of men and women in your household starting with men?

[User] It is mainly farming.

[Assistant] Which season is this?

[User] It is short rain season, so now people are planting maize and cowpeas.

[Assistant] Apart from farming what else men in your household do?


[System] Act as an information elicitation agent for academic interviews.

[User] It is mainly farming.

[Assistant] Which season is this?

[User] It is short rain season, so now people are planting maize and cowpeas.

[Assistant] Apart from farming what else men in your household do?

[User] We are not doing anything else apart from farming

[Assistant] And what about women what are their main duties?


[System] Act as an information elicitation agent for academic interviews.

[User] It is short rain season, so now people are planting maize and cowpeas.

[Assistant] Apart from farming what else men in your household do?

[User] We are not doing anything else apart from farming

[Assistant] And what about women what are their main duties?

[User] They cook for the family, fetching water, fetching firewood and washing dishes.

[Assistant] In the past when you were living with your parents what were the duties and responsibilities of men?


[System] Act as an information elicitation agent for academic interviews.

[User] We are not doing anything else apart from farming

[Assistant] And what about women what are their main duties?

[User] They cook for the family, fetching water, fetching firewood and washing dishes.

[Assistant] In the past when you were living with your parents what were the duties and responsibilities of men?

[User] My father was a farmer.

[Assistant] Apart from farming what else was he doing?


[System] Act as an information elicitation agent for academic interviews.

[User] They cook for the family, fetching water, fetching firewood and washing dishes.

[Assistant] In the past when you were living with your parents what were the duties and responsibilities of men?

[User] My father was a farmer.

[Assistant] Apart from farming what else was he doing?

[User] He was buying and selling cattle’s.

[Assistant] Father, you told me that your father was a farmer and a cattle vendor and your main activities is farming and you also rear livestock so why do you think there is a lifestyle changes?


[System] Act as an information elicitation agent for academic interviews.

[User] My father was a farmer.

[Assistant] Apart from farming what else was he doing?

[User] He was buying and selling cattle’s.

[Assistant] Father, you told me that your father was a farmer and a cattle vendor and your main activities is farming and you also rear livestock so why do you think there is a lifestyle changes?

[User] Nowadays life has become difficult our current government has made things difficult so if you try farming you cannot sell your produce because people do not have money so life has been very difficult for us because our livestock have died due to drought.

[Assistant] So how has these changes affected you?


[System] Act as an information elicitation agent for academic interviews.

[User] He was buying and selling cattle’s.

[Assistant] Father, you told me that your father was a farmer and a cattle vendor and your main activities is farming and you also rear livestock so why do you think there is a lifestyle changes?

[User] Nowadays life has become difficult our current government has made things difficult so if you try farming you cannot sell your produce because people do not have money so life has been very difficult for us because our livestock have died due to drought.

[Assistant] So how has these changes affected you?

[User] Yes we have been affected because we do have money and you know money is everything.

[Assistant] What are the responsibilities of male child in your household?


[System] Act as an information elicitation agent for academic interviews.

[User] Nowadays life has become difficult our current government has made things difficult so if you try farming you cannot sell your produce because people do not have money so life has been very difficult for us because our livestock have died due to drought.

[Assistant] So how has these changes affected you?

[User] Yes we have been affected because we do have money and you know money is everything.

[Assistant] What are the responsibilities of male child in your household?

[User] Their responsibilities is to work and earn a living but it is difficult to do that nowadays because our government has made life very difficult for us so I have to assist my children.

[Assistant] And how were your responsibilities when you were living with your parents?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes we have been affected because we do have money and you know money is everything.

[Assistant] What are the responsibilities of male child in your household?

[User] Their responsibilities is to work and earn a living but it is difficult to do that nowadays because our government has made life very difficult for us so I have to assist my children.

[Assistant] And how were your responsibilities when you were living with your parents?

[User] I used to depend on my father because I did not have children but now I have children so I have more responsibilities.

[Assistant] I mean what were your duties as a male child at home, example Maasai male child were involved in grazing the livestock so what about you?


[System] Act as an information elicitation agent for academic interviews.

[User] Their responsibilities is to work and earn a living but it is difficult to do that nowadays because our government has made life very difficult for us so I have to assist my children.

[Assistant] And how were your responsibilities when you were living with your parents?

[User] I used to depend on my father because I did not have children but now I have children so I have more responsibilities.

[Assistant] I mean what were your duties as a male child at home, example Maasai male child were involved in grazing the livestock so what about you?

[User] Okay, we were farming and that is our main duty and if you have cattle’s then a male child is supposed to graze them.

[Assistant] What were the duties of a female child?


[System] Act as an information elicitation agent for academic interviews.

[User] I used to depend on my father because I did not have children but now I have children so I have more responsibilities.

[Assistant] I mean what were your duties as a male child at home, example Maasai male child were involved in grazing the livestock so what about you?

[User] Okay, we were farming and that is our main duty and if you have cattle’s then a male child is supposed to graze them.

[Assistant] What were the duties of a female child?

[User] Cooking and fetching wild vegetables like hare lettuce, basically they were helping their mothers in whatever they were doing.

[Assistant] And what about nowadays what the duties of a female child?


[System] Act as an information elicitation agent for academic interviews.

[User] Okay, we were farming and that is our main duty and if you have cattle’s then a male child is supposed to graze them.

[Assistant] What were the duties of a female child?

[User] Cooking and fetching wild vegetables like hare lettuce, basically they were helping their mothers in whatever they were doing.

[Assistant] And what about nowadays what the duties of a female child?

[User] Fetching water, fetching firewood, going to the milling machine to grind maize, cooking food for the family, and also farming.

[Assistant] When we were here early this year we were told that people have changed their eating lifestyle the no longer eating the traditional food nowadays they are eating fish, chicken, chips, eggs especially Masaai’s I do not know if you Zigua have changed you eating lifestyle and also your method of cooking have also changed nowadays you fry food unlike before you were boiling food?


[System] Act as an information elicitation agent for academic interviews.

[User] Cooking and fetching wild vegetables like hare lettuce, basically they were helping their mothers in whatever they were doing.

[Assistant] And what about nowadays what the duties of a female child?

[User] Fetching water, fetching firewood, going to the milling machine to grind maize, cooking food for the family, and also farming.

[Assistant] When we were here early this year we were told that people have changed their eating lifestyle the no longer eating the traditional food nowadays they are eating fish, chicken, chips, eggs especially Masaai’s I do not know if you Zigua have changed you eating lifestyle and also your method of cooking have also changed nowadays you fry food unlike before you were boiling food?

[User] We are eating the same ugali and wild vegetables as we used to eat in the past.

[Assistant] Are the men eating lifestyle changed?


[System] Act as an information elicitation agent for academic interviews.

[User] Fetching water, fetching firewood, going to the milling machine to grind maize, cooking food for the family, and also farming.

[Assistant] When we were here early this year we were told that people have changed their eating lifestyle the no longer eating the traditional food nowadays they are eating fish, chicken, chips, eggs especially Masaai’s I do not know if you Zigua have changed you eating lifestyle and also your method of cooking have also changed nowadays you fry food unlike before you were boiling food?

[User] We are eating the same ugali and wild vegetables as we used to eat in the past.

[Assistant] Are the men eating lifestyle changed?

[User] Yes our eating lifestyle has changed nowadays we are using cooking oil which we do not know how it is made off, sugar, sodas they are affecting our stomach.

[Assistant] How is this cooking oil affecting you?


[System] Act as an information elicitation agent for academic interviews.

[User] We are eating the same ugali and wild vegetables as we used to eat in the past.

[Assistant] Are the men eating lifestyle changed?

[User] Yes our eating lifestyle has changed nowadays we are using cooking oil which we do not know how it is made off, sugar, sodas they are affecting our stomach.

[Assistant] How is this cooking oil affecting you?

[User] It is affecting our stomach; our stomach is used to our traditional cooking oil such as coconut oil

[Assistant] What about women eating lifestyle do you think it has changed?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes our eating lifestyle has changed nowadays we are using cooking oil which we do not know how it is made off, sugar, sodas they are affecting our stomach.

[Assistant] How is this cooking oil affecting you?

[User] It is affecting our stomach; our stomach is used to our traditional cooking oil such as coconut oil

[Assistant] What about women eating lifestyle do you think it has changed?

[User] Yes, Women are the ones preparing these foods we are eating and nowadays they must put oil in the vegetables, meat and beans, and the kind of cooking oil they are using is affecting our stomach.

[Assistant] What do you think has changed the eating lifestyle?


[System] Act as an information elicitation agent for academic interviews.

[User] It is affecting our stomach; our stomach is used to our traditional cooking oil such as coconut oil

[Assistant] What about women eating lifestyle do you think it has changed?

[User] Yes, Women are the ones preparing these foods we are eating and nowadays they must put oil in the vegetables, meat and beans, and the kind of cooking oil they are using is affecting our stomach.

[Assistant] What do you think has changed the eating lifestyle?

[User] Because nowadays people have developed and they do not want to plant pumpkin, oyster nut and cucumber they want sophisticated things and that is why we are affected.

[Assistant] When you say people have developed what do you mean?


[System] Act as an information elicitation agent for academic interviews.

[User] Yes, Women are the ones preparing these foods we are eating and nowadays they must put oil in the vegetables, meat and beans, and the kind of cooking oil they are using is affecting our stomach.

[Assistant] What do you think has changed the eating lifestyle?

[User] Because nowadays people have developed and they do not want to plant pumpkin, oyster nut and cucumber they want sophisticated things and that is why we are affected.

[Assistant] When you say people have developed what do you mean?

[User] I mean people who used the local oil like oyster nuts have died.

[Assistant] Do you think price of food has changed your eating lifestyle if you were to compare in the past and nowadays? For example are oyster nuts available in the market and what the price is?


[System] Act as an information elicitation agent for academic interviews.

[User] Because nowadays people have developed and they do not want to plant pumpkin, oyster nut and cucumber they want sophisticated things and that is why we are affected.

[Assistant] When you say people have developed what do you mean?

[User] I mean people who used the local oil like oyster nuts have died.

[Assistant] Do you think price of food has changed your eating lifestyle if you were to compare in the past and nowadays? For example are oyster nuts available in the market and what the price is?

[User] Oyster nuts are not available in the market nowadays and that is why we are now buying cooking oil.

[Assistant] And what about interaction with other tribes?


[System] Act as an information elicitation agent for academic interviews.

[User] I mean people who used the local oil like oyster nuts have died.

[Assistant] Do you think price of food has changed your eating lifestyle if you were to compare in the past and nowadays? For example are oyster nuts available in the market and what the price is?

[User] Oyster nuts are not available in the market nowadays and that is why we are now buying cooking oil.

[Assistant] And what about interaction with other tribes?

[User] Yes in the past we used to eat ugali with wild vegetables but now we are eating rice, ugali with different king of meat, bananas.

[Assistant] What are the reasons for these changes?


[System] Act as an information elicitation agent for academic interviews.

[User] Oyster nuts are not available in the market nowadays and that is why we are now buying cooking oil.

[Assistant] And what about interaction with other tribes?

[User] Yes in the past we used to eat ugali with wild vegetables but now we are eating rice, ugali with different king of meat, bananas.

[Assistant] What are the reasons for these changes?

[User] Because people have developed.

[Assistant] What about the perception that certain foods are associated with poverty