The prevalence and factors associated with behavioural problems among primary school children in Kampala, Uganda

Behavioural problems are common among school-aged children in low-resource environments. These issues impact children’s mental health, academic performance, and overall growth and development. Understanding the scope of these problems will help guide the implementation of support programmes. Although it is widely recognised that behavioural problems are common among children in Uganda, their true prevalence remains largely unknown, which hampers prioritising support efforts. In this study, we aimed to determine the prevalence and factors associated with common behavioural problems among children in Kampala. We conducted a cross-sectional survey of 476 primary school children aged 10–14 years from four primary schools in Kampala, Uganda, between March and June 2025, using the Youth Self-Report. Frequencies and percentages were calculated to determine prevalence, while Pearson’s chi-square test and logistic regression were used to identify associated factors at the 5% significance level. Overall, 64% of school-aged children exhibited behavioural problems, with 74% showing higher clinical levels of internalising issues. The most common behavioural symptoms were anxious/depressed (72.6%), followed by withdrawn/depressed (65.5%) and somatic complaints (65.5%). Multivariate analysis revealed that gender, age, and school class were strongly associated with behavioural problems. Being male was associated with higher odds of reporting anxiety/depression (AOR 1.94, 95% CI 1.26–2.99, p <.00), thought problems (AOR 1. 98, 95% CI 1.35–2.91, p <.00), and rule- breaking behaviours (AOR 1. 53, 95% CI 1.01–2.32, p <.05). Older children showed higher rates of aggressive behaviours (AOR 2.17, 95% CI 1.21–3.91, p <.01). Additionally, being in primary five and six was associated with increased odds of total behavioural problems (AOR 3.46, 95% CI 1.09–10.97, p <.05) and (AOR 3.10, 95% CI 1.00–9.63, p <.05), respectively. Overall, behavioural problems are prevalent among school children in Kampala, Uganda, with most at a clinical level, underscoring the need for immediate interventions. Boys should be prioritised when implementing support programmes.