QUESTION

Design a proposal seeking to investigate the lifestyle, coping mechanisms,

income inflows and relationships among Marijuana smokers in Katwe,

Kampala (utilize a Qualitative approach)

TOPIC: Investigating the lifestyle, coping mechanisms, income sources, and social relationships among marijuana users in katwe informal settlement Kampala, uganda

CHAPTER ONE

INTRODUCTION

1.0 Introduction

This section will present; background of the study, Problem Statement, Purpose of the study, Specific Research Questions, Scope of the study, Scope of the study and Significance of the Study.

1.1 Background

The use of psychoactive substances remains a significant global public health challenge, especially among young people, who are defined by the World Health Organisation (WHO) as individuals aged 10–24 years (Peacock et al., 2019). Available evidence suggests that the use of psychoactive substances is likely to increase by 11% globally, and by 40% in Africa by 2030. The percentage increase in psychoactive substance use is likely to be much higher among young people especially in Africa, due to urbanisation and the fact that they currently use more drugs and at higher levels compared to adults and past generations. This is amid a reduction in the proportion of young people who perceive psychoactive substances such as cannabis as harmful. A recent systematic review indicated a prevalence of psychoactive substance use among young people in Sub-Saharan Africa as high as 41.6%. Psychoactive substance use among young people remains on the increase in Uganda (Ebrahim, Adams, & Demant, 2024). A recent survey among adolescent boys and young men in Kampala indicated a 10.5% (6.6% among in school and 21.9% among out-of-school adolescent boys and young men) prevalence of alcohol use in the past 30 days (Ssekamatte et al., 2023).

Although data are limited, there is evidence of a much higher prevalence of psychoactive substance use in informal settlements, which in the current study, we define as urban residences characterised by poor housing and overcrowding, and high poverty levels. The high prevalence of psychoactive substances in informal settlements is often driven by their widespread availability, peer pressure, curiosity, and psychological distress. The use of psychoactive substances has been further aggravated by the COVID-19 pandemic. The COVID-19 pandemic is associated with an increase in anxiety and depression due to a lack of social sup port, and loss of jobs and income among the residents of informal settlements (Rukundo, & Asasira, 2025).

An increase in sexual expectancies such as pleasure and performance, courage to approach a sexual partner, and a reduction in sexual inhibitions such as a lack of confidence often drive the use of psychoactive substances among young people in informal settlements. However, these substances impair cognition and decision making leading to risky sexual behaviours such as sexual intercourse while intoxicated. Sex under the influence of psychoactive substances compromises one’s ability to use condoms, and exacerbates the risk of sexual coercion and non-spousal sex. Consequently, this exposes psychoactive substance users to sexually trans mitted infections (STIs) including HIV, and unintended pregnancies (Ogundipe et al., 2018).

In Africa, urban slums are hotspots for illicit drug use due to high poverty, unemployment, and limited access to services, with studies indicating that deprivation drives risky behaviors including drug consumption as a coping mechanism. In East Africa, countries like Kenya and Uganda report elevated drug abuse in slums, linked to economic exclusion and social networks that perpetuate use. Uganda ranks among the top 10 African nations for marijuana consumption, with an estimated 2.6 million users nationwide, concentrated in urban areas like Kampala where domestic consumption is highest. Prevalence studies show 2.6–6.2% significant marijuana use among urban populations, often intertwined with mental health issues and other substances like khat or tobacco (Ssekamatte et al., 2022). Katwe, an informal settlement in Makindye Division, Kampala, exemplifies these challenges: home to over 17,000 residents across Katwe I and II parishes, it features high poverty (73% below poverty line in similar Nairobi slums), overcrowding, poor sanitation, unemployment, and social exclusion, making it a fertile ground for substance abuse as a survival strategy. Youth in such areas face heightened risks, with illicit drug use linked to economic desperation and weak social networks. This proposal seeks to explore how marijuana users in Katwe navigate daily life, employ coping strategies amid stigma and illegality, generate income, and maintain relationships, filling a gap in localized, qualitative research on urban slum dynamics

1.2 Problem Statement

Marijuana use is rising sharply among youth in urban informal settlements across Sub-Saharan Africa, driven by rapid urbanization, poverty, unemployment, and reduced perception of harm. Uganda ranks among Africa’s top consumers, with an estimated 2.6 million users and prevalence rates of 2.6–6.2% in urban areas, significantly higher in Kampala’s slums where over 50% of adults reportedly engage in psychoactive substance use. Katwe Informal Settlement in Makindye Division exemplifies this crisis: overcrowded, impoverished, and marked by poor sanitation and economic exclusion, it fosters marijuana consumption as a coping mechanism for stress, peer pressure, and psychological distress, worsened by COVID-19-related job and income losses.

Despite these trends, there is a critical lack of in-depth, localized research on the lived realities of marijuana users in Katwe. Existing studies focus primarily on prevalence and health risks, but neglect key interconnected aspects: daily lifestyles shaped by dependency, specific coping strategies amid stigma and illegality, informal income sources in high-unemployment settings, and impacts on social relationships (family, peers, and community networks). This knowledge gap impedes the design of effective, context-specific interventions, harm reduction programs, and policies. The study therefore addresses the need to comprehensively investigate how marijuana use influences lifestyle, coping mechanisms, income inflows, and social relationships among users in Katwe, to inform targeted support and break cycles of vulnerability in Uganda’s urban slums.

1.3 Purpose of the study

The primary purpose of this study is to gain a comprehensive understanding of the lived experiences of marijuana users in Katwe Informal Settlement, Kampala, by exploring their daily lifestyles, coping mechanisms, sources of income, and social relationships within the context of urban poverty, stigma, and socio-economic marginalization.

1.4 Specific Objectives

1. To explore and describe the daily lifestyles, routines, and behavioral patterns of marijuana users in Katwe Informal Settlement, including how substance use influences their time allocation, activities, and overall daily functioning.
2. To identify and examine the coping mechanisms employed by marijuana users to manage stress, psychological distress, stigma, health challenges, and economic hardships associated with living in an informal settlement.
3. To analyze the primary sources of income, economic strategies, and financial inflows among marijuana users in Katwe, highlighting the role of formal, informal, and potentially illicit activities in sustaining their livelihoods.

1.5 Specific Research Questions

1. What are the daily lifestyles, routines, and behavioral patterns of marijuana users in Katwe Informal Settlement, and how does substance use influence their time allocation, daily activities, and overall functioning?
2. What coping mechanisms do marijuana users in Katwe employ to manage stress, psychological distress, stigma, health challenges, and economic hardships linked to life in an informal settlement?
3. What are the primary sources of income, economic strategies, and financial inflows for marijuana users in Katwe, and how do formal, informal, and potentially illicit activities contribute to sustaining their livelihoods?

1.6 Scope of the study

This section includes; geographical scope, time scope and content scope.

1.6.1 Content scope;

The content of the study will include; the daily lifestyles, routines, and behavioural patterns of marijuana users, coping mechanisms do marijuana users and the primary sources of income, economic strategies, and financial inflows for marijuana users.

1.6.2 Time scope

The study will be conducted for a period of one month.

1.6.3 Geographical scope

The study will be carried out in Kampala.

1.7 Significance of the Study

This study holds important significance on multiple levels. First, it will provide an in-depth, contextualized understanding of the lived realities of marijuana users in Katwe Informal Settlement, moving beyond mere prevalence statistics and stigmatizing portrayals to offer an empathetic and nuanced portrayal of their daily lifestyles, coping mechanisms, income strategies, and social relationships. By giving voice to a highly marginalized and often criminalized group, the research will contribute to humanizing discourses on substance use in urban slums, challenging stereotypes and promoting more compassionate public attitudes in Uganda.

Second, the findings will generate evidence-based insights that can directly inform the design and implementation of targeted interventions, harm reduction programs, and community-based support services tailored to the unique socio-economic context of Katwe and similar informal settlements in Kampala. Policymakers, non-governmental organizations, public health practitioners, and local authorities will benefit from practical recommendations on addressing substance-related vulnerabilities, thereby enhancing the effectiveness of efforts to improve health outcomes, reduce stigma, and support economic resilience among affected individuals.

Third, the study will contribute to the academic and research literature on substance use in Sub-Saharan Africa, filling a critical gap in qualitative, locality-specific studies on marijuana users in urban informal settlements. It will enrich fields such as public health, sociology, urban studies, and development studies by highlighting the interplay between poverty, marginalization, and substance use, offering a valuable reference for future research and comparative analyses across African cities.

Finally, by uncovering the structural and social factors that sustain marijuana use in Katwe, the research has the potential to influence broader policy discussions on drug control, decriminalization debates, urban poverty alleviation, and youth empowerment in Uganda. The insights generated may support advocacy for more equitable, rights-based approaches to substance use, ultimately contributing to safer, healthier, and more inclusive urban communities.

CHAPTER TWO

LITERATURE REVIEW

2.0 Introduction

This section will indicate the discussions of the study inline with study objectives;

2.1 To explore and describe the daily lifestyles, routines, and behavioral patterns of marijuana users in Katwe Informal Settlement, including how substance use influences their time allocation, activities, and overall daily functioning.

Research on the daily lifestyles, routines, and behavioral patterns of marijuana users in low-income urban settings, particularly informal settlements in Sub-Saharan Africa, remains limited and largely indirect, with most studies focusing on prevalence, risk factors, and health outcomes rather than ethnographic descriptions of day-to-day functioning. In Uganda’s urban slums, including areas similar to Katwe in Kampala, psychoactive substance use, including marijuana, is prevalent among youth and adolescents, often intertwined with socioeconomic vulnerabilities such as unemployment, poverty, and limited social support (Kalungi et al., 2024; Swahn et al., 2020). For instance, cross-sectional studies in Kampala’s slums report higher rates of illicit drug use among out-of-school adolescents and those engaged in high-risk behaviors, suggesting that substance use disrupts educational and occupational routines, leading to irregular daily schedules dominated by informal survival activities (Kabwama et al., 2024).

Qualitative insights from related contexts indicate that marijuana use influences time allocation by serving as a coping mechanism for stress and boredom in environments characterized by economic exclusion and overcrowding. In Nairobi’s informal settlements, adolescents’ substance use patterns are linked to disrupted daily functioning, including reduced participation in formal education or employment, with users reporting altered routines involving peer socialization around substance consumption (Mutai et al., 2020). Similarly, in Ugandan slums, focus group discussions reveal that alcohol and drug use, including cannabis, occur in social contexts that shape leisure time, often replacing productive activities with prolonged idle periods or risky behaviors (Swahn et al., 2020). Heavy users experience impaired motivation and cognitive slowing, affecting overall daily functioning such as task completion and social engagement (Belete et al., 2023).

Across Sub-Saharan Africa, systematic reviews highlight that cannabis use among youth in urban poor areas is associated with behavioral patterns of poly-substance use and integration into daily leisure, potentially exacerbating cycles of marginalization by limiting time for skill-building or income-generating activities (Olawole-Isaac et al., 2018). However, no studies specifically detail routines in Katwe, underscoring a gap in understanding how marijuana influences time allocation (e.g., balancing substance-seeking with survival needs) and behavioral patterns in this localized context.

• To identify and examine the coping mechanisms employed by marijuana users to manage stress, psychological distress, stigma, health challenges, and economic hardships associated with living in an informal settlement.

Marijuana users frequently employ the substance as a primary coping mechanism for managing stress and psychological distress, particularly in contexts of socioeconomic vulnerability such as informal settlements. Stress-coping models of addiction posit that individuals use cannabis to reduce negative affect or enhance positive affect, often as an avoidance strategy that temporarily alleviates distress but may exacerbate long-term problems (Hyman & Sinha, 2009). Coping motives using cannabis to deal with negative emotions or life problems are among the most commonly reported reasons for use, strongly predicting frequency, problems, and dependence (Brodbeck et al., 2007; Buckner et al., 2007). In treatment-seeking populations, stress relief emerges as the predominant benefit and motivator for continued use (Copeland et al., 2001).

This pattern intensifies in low-resource settings, were economic hardships and poverty drive self-medication. In African urban slums, including those in Kampala, Uganda, and similar areas in Kenya and Nigeria, deprivation, unemployment, and trauma link to higher substance use as a survival strategy or emotional escape (Swahn et al., 2018; Paul et al., 2020). Young people in Sub-Saharan African informal settlements report using cannabis amid psychological distress amplified by poverty and limited mental health access, with prevalence rates elevated in slum environments (Culbreth et al., 2021; Kalungi et al., 2024).

Stigma compounds these challenges, layering social isolation and discrimination onto existing distress. Cannabis users, especially those with comorbidities or in marginalized groups, experience multiple stigmas from recreational drug perceptions, illegality, and intersections with poverty or illness leading to avoidance coping and heightened emotional burden (Bottorff et al., 2013). In developing countries, structural inequalities exacerbate this, where users in slums face additional exclusion, prompting concealed use or maladaptive strategies to mitigate judgment (Amegavi et al., 2023).

Health challenges, including withdrawal, comorbid mental disorders, and physical risks, further entrench reliance on cannabis for symptom management, creating a cycle where short-term relief perpetuates dependence (Moitra et al., 2015). Limited qualitative studies in African slums highlight how economic and environmental stressors in places like Katwe reinforce these mechanisms, underscoring the need for context-specific research on adaptive versus maladaptive coping in informal settlements.

2.3 To analyze the primary sources of income, economic strategies, and financial inflows among marijuana users in Katwe, highlighting the role of formal, informal, and potentially illicit activities in sustaining their livelihoods.

Urban informal settlements in Sub-Saharan Africa, including those in Uganda and Kenya, are characterized by high poverty, unemployment, and limited access to formal employment, forcing residents to rely heavily on informal economic activities for survival (African Population and Health Research Center, 2002; Swahn et al., 2018). In Kampala’s slums, such as Katwe, livelihoods often involve petty trading, casual labor, vending, and small-scale entrepreneurship, with many households operating below the poverty line and facing overcrowding and poor infrastructure (Rugadya et al., 2020). Substance users, including marijuana consumers, navigate these constraints through a mix of formal, informal, and potentially illicit strategies, where economic desperation intersects with substance dependency to shape income generation patterns.

Research on vulnerable youth in Kampala slums indicates that illicit drug and high-risk alcohol use are prevalent amid economic exclusion, with users often engaged in informal work such as street vending or casual day labor to fund daily needs and substance habits (Culbreth et al., 2021; Swahn et al., 2020). In similar contexts like Nairobi’s slums, adolescents and young adults involved in substance abuse report reliance on informal sources including petty trade, scavenging, and occasional crime, exacerbated by school dropout and limited skills training (Othieno et al., 2003). While direct studies on marijuana users’ incomes in Katwe are scarce, analogous findings from East African slums suggest that substance use acts as both a coping mechanism for poverty and a barrier to stable employment, leading to cyclical financial instability where earnings from informal activities are diverted to sustain use (Belete et al., 2023).

Potentially illicit activities, such as small-scale drug peddling or involvement in underground economies, emerge in some accounts of slum dwellers with substance dependencies, though evidence links this more broadly to heroin or multi-substance users rather than marijuana alone (McCurdy et al., 2005). In Uganda, where marijuana remains widely used despite legal restrictions, users in urban poor areas may supplement incomes through informal networks tied to substance distribution, though primary livelihoods remain rooted in non-drug-related informal sectors like hawking or construction labor (Kabwama et al., 2019). Overall, the literature underscores that economic strategies among substance users in slums prioritize short-term survival over long-term stability, with limited access to formal credit or jobs perpetuating vulnerability (Amuyunzu-Nyamongo & Othieno, 2012).

This gap in localized data on marijuana-specific income dynamics in Katwe highlights the need for targeted qualitative inquiry to elucidate how users balance formal opportunities (rare), informal hustles (dominant), and illicit risks in sustaining livelihoods.

CHAPTER THREE

METHODOLOGY

3.1 Introduction

This chapter presents the methodology that will be adopted during the study. It describes and discusses the research design, sample size and selection, the data collection methods used and their corresponding data collection instruments, data management and analysis procedure as well as steps that will be taken to ensure validity and reliability during the study and measurement of variables.

3.2 Research Design

The study will adopt a cross-sectional design. The cross-sectional design will be adopted because data will be collected from a cross section of respondents Kampala at a given point in time as suggested by Amin (2005).  The study will adopt qualitative approach.

3.3 Study Population

The study will select the rehab centres and interview a total of 30 people.

3.5 Sampling Techniques and Procedure

The research will use sampling techniques to select respondents to the study, namely, simple random and purposive sampling techniques. Simple random sampling will be used because it ensures generalizability of findings and minimizes bias (Sekaran, 2003).

3.6 Data collection Methods

The section presents data collection methods which include interview and documentary review.

3.6.1 Interview Method

The study will employ interview method. Interviews in this study will help the researcher obtain more information on the topic under investigation. Interviews will be used because they fetch a variety of ideas needed for the study and give a deeper understanding of the topic. This method will also be used because it will offer the researcher an opportunity to adapt questions, clarify the questions by using the appropriate language, clear doubts and establish rapport and probe for more information (Sekaran, 2003).

3.6.2 Document Review Method

The researcher will review documents to obtain recorded information that is related to the issue under investigation. This method will be used because it enables the researcher access data at his convenient time, obtain data that are thoughtful in that the informants have given attention in obtaining them and enables the researcher obtain data in the language of the respondent (Oso & Onen, 2008: 45).

3.7 Data Collection Instruments

The instruments used in this study will be interview guide and document review checklist.

3.7.1 Interview Guide

An unstructured interview will be used as a tool for collecting in depth information from the key informants. The guide will have list of topical issues and questions which will be explored while conducting the interviews.

3.7.2 Documentary Review Checklist

A document review checklist will be used to collect more in-depth data on the topic under investigation. This will also enable the researcher to supplement the data that is acquired from the interviews and questionnaires. The researcher will analyze the documents and publications related to the study topic. Documents that are expected to be reviewed include Ministry of Health reports, Journals, and Newspapers.

3.8 Validity and Reliability of the Research Instruments

3.8.1 Validity

Validity is defined as the extent to which results can be accurately interpreted and generalized to other populations (Oso & Onen, 2008). While Borg & Gall, 1989 as cited in Onyinkwa, (2013) validity is defined as the degree to which results obtained by the research instrument correctly represented to the phenomenon understudy and Mugenda & Mugenda, (1999) as the accuracy and meaningfulness of inferences which are based on the research results.

3.8.2 Reliability

According to Mugenda and Mugenda, (2003) reliability is the measure of the extent to which research instruments can provide the same results upon being tested repeatedly.

3.10 Data Analysis

Qualitative data will be analysed using content analysis. Responses from key informants will be grouped into recurrent issues. The recurrent issues which will emerge in relation to each guiding question will be presented in the results, with selected direct quotations from participants offered as illustrations.

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