UCU Digital Institutional Repository(UCUDIR)

Welcome to the Uganda Christian University Digital Institutional Repositoy (UCUDIR). This is the University's official Institutional Repository. It aims to collect, preserve and showcase the intellectual output of staff and students of UCU. This growing collection of research includes peer-reviewed articles, book chapters, working papers, theses, and more.

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Recent Submissions

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Mediating Effect of Strategy Implementation on the Relationship Between TMT Characteristics and Performance of Ugandan State Agencies
(European Scientific Institute, 2022-11-30) Arthur Nuwagaba; Owino Joseph; Caren Angima; Vincent Machuki
This study aims to determine the mediating effect of strategy implementation on the relationship between TMT characteristics and the performance of Ugandan state agencies. The study was anchored on the theories of the upper echelon and dynamic capabilities. The study adopted a descriptive cross-sectional research design. The target population of the study was the 201 state agencies in Uganda. The study adopted at least three members of the TMT depending on the number of TMT members of the 160 selected state agencies in Uganda to gather the required information. Primary data was gathered using a structured questionnaire that was administered online. Inferential statistics employed regression analysis to test the hypothesis and draw conclusions. Haye’s (2022) PROCESS 4 (model 4) was utilised to test the hypothesis of this study. Furthermore, strategy implementation partially mediates the relationship between TMT characteristics and performance (Indirect effect of strategy implementation, b=.385, p<0.05 and the direct effect, b = .267, p<0.05). From the findings of this study, the research concludes that strategy implementation has a significant partial European Scientific Journal, ESJ ISSN: 1857-7881 (Print) e - ISSN 1857-7431 November 2022 edition Vol.18, No.34 www.eujournal.org 55 mediating effect on the relationship between TMT characteristics and the performance of Ugandan state agencies. In addition, the results imply that the specific mechanism by which the connection between TMT characteristics and the performance of Ugandan state agencies occurs is direct, strategy implementation contributes a part to the relationship. This study recommends that individuals that make the TMT should have significant expert capabilities that give relevance while formulating and executing strategies. The study also recommends that strategy implementation should have a framework that is not affected by politics and corruption. This study also recommends that state agencies in Uganda create a prize and acknowledgment framework for TMTs and personnel who succeed in strategy implementation so they can be persuaded. This is because it is through strategy implementation that the state agencies in Uganda can follow through on their directives and further improve service delivery. Rewards give a chance to the TMTs and staff to contend among themselves and this would bring quality, efficiency, proficiency, and adequacy in delivering services.
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Service Quality, Customer Loyalty and Customer Retention Among Private Health Care Services in Mbarara City
(Scientific Research Publishing, 2024-01-19) Nayiga Harriet; Nuwagaba Arthur; Mabel Birungi Komunda; Tom Mugizi
This study aimed to investigate the relationships between service quality, customer loyalty, and customer retention within private healthcare facilities in Mbarara City. It specifically focused on how service quality affects cus- tomer retention and loyalty, and how loyalty in turn influences retention. A cross-sectional design was used, with data collection and analysis conducted quantitatively. The study encompassed 36 operational private healthcare centres, with their customers serving as the subjects of the investigation.The study distributed self-administered closed-ended questionnaires to the participants, and the data collected was later processed and analysed using Statistical Package for Social Scientists (SPSS), version 21. To address the research objectives, Pearson correlation was utilized to examine the rela-tionships between the variables under investigation, while Ordinary Least Square regression was employed to assess the model’s predictive capability.The study revealed a noteworthy positive relationship between service qual- ity and customer loyalty, as well as a significant positive correlation be-tween customer loyalty and customer retention. However, it was deter- mined that the link between service quality and customer retention was not statistically significant. Therefore, there is a need for private healthcare management to focus on service quality to improve customer loyalty. This means that activities related to the reliability of the health staff, positive re- sponsiveness of the doctors and other employees in the health centres, en-suring that the patients are assured of quality service and equipping the health facility with the right machines that can test and treat diseases, this will help in improving customer loyalty hence customer retention among private health care services in Mbarara City. How to cite this paper: Harriet, N., Ar-thur, N., Komunda, M. B., & Mugizi, T. (2024). Service Quality, Customer Loyalty and Customer Retention among Private Health Care Services in Mbarara City.
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Once-Daily Dolutegravir-Based Antiretroviral Therapy in Infants and Children Living With HIV From Age 4 Weeks: Results From the Below 14 kg Cohort in the Randomised ODYSSEY Trial
(Elsevier, 2022-09) Pauline Amuge; Abbas Lugemwa; Ben Wynne; Hilda A Mujuru; Avy Violari; Cissy M Kityo; Moherndran Archary; Ebrahim Variava; Ellen White; Rebecca M Turner; Clare Shakeshaft; Shabinah Ali; Kusum J Nathoo; Lorna Atwine; Afaaf Liberty; Dickson Bbuye; Elizabeth Kaudha; Rosie Mngqibisa; Modehei Mosala; Vivian Mumbiro; Annet Nanduudu; Rogers Ankunda; Lindiwe Maseko; Adeodata R Kekitiinwa; Carlo Giaquinto; Pablo Rojo; Diana M Gibb; Anna Turkova; Deborah Ford
Background Young children living with HIV have few treatment options. We aimed to assess the efficacy and safety of dolutegravir-based antiretroviral therapy (ART) in children weighing between 3 kg and less than 14 kg. Methods ODYSSEY is an open-label, randomised, non-inferiority trial (10% margin) comparing dolutegravir-based ART with standard of care and comprises two cohorts (children weighing ≥14 kg and <14 kg). Children weighing less than 14 kg starting first-line or second-line ART were enrolled in seven HIV treatment centres in South Africa, Uganda, and Zimbabwe. Randomisation, which was computer generated by the trial statistician, was stratified by first-line or second-line ART and three weight bands. Dispersible 5 mg dolutegravir was dosed according to WHO weight bands. The primary outcome was the Kaplan-Meier estimated proportion of children with virological or clinical failure by 96 weeks, defined as: confirmed viral load of at least 400 copies per mL after week 36; absence of virological suppression by 24 weeks followed by a switch to second-line or third-line ART; all-cause death; or a new or recurrent WHO stage 4 or severe WHO stage 3 event. The primary outcome was assessed by intention to treat in all randomly assigned participants. A primary Bayesian analysis of the difference in the proportion of children meeting the primary outcome between treatment groups incorporated evidence from the higher weight cohort (≥14 kg) in a prior distribution. A frequentist analysis was also done of the lower weight cohort (<14 kg) alone. Safety analyses are presented for all randomly assigned children in this study (<14 kg cohort). ODYSSEY is registered with ClinicalTrials.gov, NCT02259127. Findings Between July 5, 2018, and Aug 26, 2019, 85 children weighing less than 14 kg were randomly assigned toreceive dolutegravir (n=42) or standard of care (n=43; 32 [74%] receiving protease inhibitor-based ART). Median age was 1·4 years (IQR 0·6–2·0) and median weight 8·1 kg (5·4–10·0). 72 (85%) children started first-line ART and 13 (15%) started second-line ART. Median follow-up was 124 weeks (112–137). By 96 weeks, treatment failure occurred in 12 children in the dolutegravir group (Kaplan-Meier estimated proportion 31%) versus 21 (48%) in the standard-of- care group. The Bayesian estimated difference in treatment failure (dolutegravir minus standard of care) was –10% (95% CI –19% to –2%; p=0·020), demonstrating superiority of dolutegravir. The frequentist estimated difference was –18% (–36% to 2%; p=0·057). 15 serious adverse events were reported in 11 (26%) children in the dolutegravir group, including two deaths, and 19 were reported in 11 (26%) children in the standard-of-care group, including four deaths (hazard ratio [HR] 1·08 [95% CI 0·47–2·49]; p=0·86). 36 adverse events of grade 3 or higher were reported in 19 (45%) children in the dolutegravir group, versus 34 events in 21 (49%) children in the standard-of-care group (HR 0·93 [0·50–1·74]; p=0·83). No events were considered related to dolutegravir.
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Experiences of Attending Maternal Health Education Sessions Among Women From the Islands of Lake Kivu, Rusizi District, Rwanda; a Qualitative Research
(2024-04-12) Adriana Jacoba Lena Bergman
Background The maternal mortality ratio in Rwanda remains high at 245 (2017) deaths per 100,000 live births (WHO, 2019). Besides improving maternal health, women’s positive experiences during ANC and childbirth can create the foundation for healthy motherhood (WHO, 2016). Maternal health education is an useful intervention to promote health care, birth preparedness and reduce the maternal mortality rate. The purpose of this study is to identify the gaps and contribute to improving maternal health education to improve maternal health and positive experiences of women during pregnancy, childbirth, and post-natal period. Research Methodology Qualitative phenomenological research has been conducted to investigate the experiences of maternal health education sessions among women of reproductive age (15-49 years) from the islands of Gihaya, Nkombo, and Ishywa, Rusizi-district, Rwanda. Primary data has been collected through face-to-face verbal semi-structured interviews. All interviews were audio recorded and transcribed verbatim in English. The data was analyzed by open coding, axial coding, and selected coding. Results and findings The experiences are multidimensional and interlinked. From the data analysis, three main themes came up, which have been used to identify the women's experiences. The first theme is: 1. My life has improved. This theme shows the personal change and narratives of the participants. The second theme: 2. happiness and joy, whereby the participants describe their feelings. The third theme: 3. expectations, needs, and improvement, whereby the participants describe their expectations, needs, and improvement toward maternal health education. Conclusion Based on qualitative analysis of the data collected in the research area it can be concluded that the experiences of women on the islands of Gihaya, Nkombo, and Ishywa were mainly positive. Suggesting that maternal health education sessions contributed to a positive experience in pregnancy.
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Breastfeeding Practices and Experiences Among Working Mothers: A Case Study of Primary School Teachers and Nurses in Goma Division, Mukono Municipality
(2024-04-11) Stella Asayo
Introduction: Public health specialists recognize that breastfeeding is an unmatched way of providing ultimate food for the healthy growth and development of infants. In fact, it is recognized as an integral part of the reproductive process with important implications for the health of both the infant and the mothers. To this, global world health experts recommend that all newborns should be exclusively fed on breast milk without any additional food or drink for up to six months. Methods: This was purely qualitative research that adopted a case study research design with the aim of finding out the experiences of mothers in formal employment practicing breastfeeding and how work influences breastfeeding among formally employed mothers in Goma Division-Mukono Municipality. Findings: The study findings revealed that mothers in formal employment experience heavy work load, tight work schedules, very minimal institutional support towards practicing breastfeeding; as such most of breastfeeding mothers ended up failing in principles to successfully achieve the goal of breastfeeding their infants. Results: The researcher recommends government to consider extending the maternity leave duration from the current 3 months to 6 months with flexible working hours to breastfeeding mothers to allow them sufficient time to breastfeed, and the government should make regular follow ups with all intuitions to ensure that they implement the maternity leave policy to breastfeeding mothers. Key works: Breastfeeding, work experience, maternal leave, institutional support
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Experiences of Nurses in the Management of Patients Presenting With Kala-Azar at Amudat Hospital, Amudat District
(2024) Daniel Powon Kalepon
Introduction: Visceral leishmaniasis (VL)/Kala-azar continues to be one of the neglected tropical diseases (NTD) of public health threat. The experiences of nurses in the management of the increasing cases of VL infection remains not well understood. The overarching aim for this study was to understand the nurses’ experiences in management of Kala-azar as an effort to design strategies to alleviate gaps and ensure quality healthcare to patients at Amudat hospital. Methods: We conducted a phenomenological study amongst nurses. We collected nurses’ experiences in terms of; motivators, attitudes, skills, knowledge, and policies in the management of Kala-azar patients through in-depth interviews. Data was analysed thematically using Atlas ti, version 8. Major themes of the findings were recorded. Results: Nurses’ exhibited good clinical practices, positive motivation, used updated case management guidelines, had continuous professional development, received medical supplies, exhibited professionalism and teamwork, and there was Community surveillance for VL. However, they noticed Knowledge gap among patients, inadequate infrastructure, high staff Workload, delayed payments, and little close monitoring. Conclusion: The experience and training of nurses is critical in the management of VL. Nurses have considerable knowledge and skills in the management of VL at Amudat Hospital. Nurses face challenges in management of Kala-azar patients including finances, human resource gap, infrastructure, and patients’ knowledge gap about Kala-azar infection. Recommendations: Nurses’ experiences show potential for elimination of the Kala-azar infection in Amudat. We recommend the Uganda’s Ministry of Health to accelerate measures to eliminate VL such as; community sensitization about Kala-azar, training traditional herbalists on case definition for Kala-azar infection, construct large Kala-azar ward, recruit more staff, and improve the payment schedules for nurses at Amudat hospital.
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Level and Factors Associated With Utilization of Postnatal Care Services Among Mothers in Iganga General Hospital
(2023) Betty Nakintu
Introduction: PNC is very critical for detection and management of complications in postpartum period for protecting maternal and child health unfortunately the PNC utilization is still low in Uganda. On average in Uganda postnatal care service utilization is lower at 54% and in Iganga hospital was estimated to be at 23% (AHSR, 2021). Objective: The main objective of the study was to determine level and assess factors associated with utilization of postnatal care services among mothers within one week, at 2 weeks and 6 weeks in iganga general hospital in Iganga general hospital. Method: Analytical cross-sectional study design was used to collect quantitative data on the level and factors associated with PNC services at Iganga hospital. Data was collected using semi structured questionnaires for Young Child Clinic (YCC) services. A total of 177 participants were interviewed on socio-demographic characteristics, PNC services utilization and its associated factors. SPSS version was used to analyze the data. Results: Bivariate and multivariate logistic regression models were fitted to identify factors associated with postnatal care utilization within one week, at 2 weeks and at 6 weeks at p value of < 0.05. The study revealed that the level of PNC utilization was at 28% which is lower than the national average of 54%. The identified associated factors with significance were; lack of information on PNC at p-value of 0.001, Husband support at p-value of 0.002, health workers not providing a full PNC package at p-value 0.002 and lack of privacy at p-value of 0.010. Recommendations: Health providers should always educate pregnant women on PNC utilization during ANC visits as it prepares mothers to utilize the service and this improves health outcomes for both mothers and babies. Always provide privacy and offer a full PNC package to mothers and their babies in the postnatal unit. Iganga Hospital and other health stakeholders in Iganga district should sensitize male spouses on the importance of PNC and to fully support their female spouses. I also recommend for further research on PNC utilization in other districts of Uganda for appropriate inference and attract the attention of policy makers.
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The Depiction of Women in Contemporary Femrite Short Story Anthologies
(2024-04-19) Fortunate Kansiime
Gender representation in female-authored literary texts has hitherto been characterised as a positive representation of women contrary to the former subjective misrepresentation and underrepresentation of women by male authors. The study sought to broaden the understanding of women's depiction in contemporary female-authored FEMRITE short story anthologies. It investigated the depiction of women's character traits, assigned roles, and gender-related themes in female-authored short story anthologies published by FEMRITE Publications Limited, Uganda. The study analysed fifteen short stories, selecting five from each of the three FEMRITE-published short story anthologies selected for the study. These were: Pumpkin Seeds and Other Gifts (2009) edited by Hellen Moffet and Violet Barungi, Summoning the Rains (2012) edited by Hilda Twongyeirwe and Ellen Banda-Aaku, and Nothing to See Here (2015) edited by Hilda Twongyeirwe). The short story anthologies used for the study consisted of short narratives compiled in the FEMRITE Annual Residency for African Women Writers. Feminism is a theory that premises itself on the importance of gender equality that develops an account, identify the causes and effects of women’s subordination and prescribes the strategies for women’s liberation. This theory was employed in the study to ascertain the representation of women and their struggles to gain equality and fair treatment from the point of view of female authors. Gender theory, which describes gender roles, was also used in the study to examine the roles assigned to female characters and roles of female authors in the struggle to gain equality in female-authored texts. The study employed a qualitative approach based on the collection of textual material, analysis, and interpretation of the texts. Data were presented, analysed, interpreted, and discussed using a textual checklist based on the feminist and gender literary theories. The findings of this research indicate that the study achieved its purpose/objectives and successfully answered its research questions. The research recommends that works of female authors should be made available and accessible to the public since they create a positive representation of women. It further recommended that the publication of more female-authored literature be used to sensitize the population about issues of gender equality, and human rights support and writing more reviews about the FEMRITE short story anthologies that have not received much scholarly attention.
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Factors Associated With Men’s Level of Awareness of Obstetric Danger Signs, Birth Preparedness and Complication Readiness in Mparo Town Council, Rukiga District
(2024-04-16) Anne Kikundwa
Background: Child birth is a special moment for parents, families and communities but also a time of intense vulnerability . (Wassihun and Zeleke, (2018) .In many developing countries including Uganda, maternal morbidity and mortality still pose a substantial burden. Raising awareness of men about the danger signs of pregnancy and childbirth is the first essential step in appropriate and timely obstetric care . (Bogale, D., Markos, D. 2015). Awareness of obstetric danger signs facilitates men in making a joint decision with their partners regarding accessing antenatal and delivery care.. Men play a central role in deciding and influencing positive actions to support their spouses during pregnancy, labour and delivery (August, F., Pembe, A. B., Mpembeni, R., Axemo, P., & Darj, E. (2015) Objective: This study aimed at determining factors associated with men's level of awareness of obstetric danger signs, birth preparedness and complication readiness in Mparo Town Council, Rukiga district. Methodology: This was a cross sectional study that enrolled 384 eligible husbands to women that delivered within the past one year from Mparo health centre IV, in Mparo Town Council, Rukiga District, Uganda. The men were interviewed using a structured English questionnaire (also translated in Rukiga) with closed and open ended questions. Systematic random sampling method was used to select the men to be interviewed. Descriptive and inferential analysis was done and associations between independent and dependent variables were computed. Results: Of the 384 men who were interviewed, 365 (95%) had attended ANC with their spouses at least once and 226 (59%) made four or more visits. Mean age was 26.8 and majority had two or more children. Awareness of danger signs was low 119(31%); commonly mentioned danger signs were vaginal bleeding 311 (81.2%), swelling of fingers, face and legs 177 (46.3%) and severe headache with blurred vision 167 (43.6%). In bivariate analysis age, education and occupation were associated with awareness on obstetric danger signs, birth preparedness and complication readiness (P≤0.05). In multivariate logistic regression, age and occupation were statistically significant associated with awareness of obstetric danger signs. Being older in age was eight times more likely (OR 8.1; CI 1.6- 42) to have an influence on awareness of obstetric danger signs compared to young ones (≤20 years); self-employed men were two times more likely (OR=1.9; CI; 1.1-3.3) to have awareness on danger signs compared to being employed. Of the 69 (17.9%) men who reported a danger sign in the last wife’s pregnancy, 51 (75 %) took appropriate health seeking action. Conclusion: Awareness of obstetric danger signs, birth preparedness and complication readiness is low. Key words: awareness, Danger signs, Pregnancy, Birth preparedness, Complication readiness, Health seeking actions
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Factors Associated With Viral Load Nonsuppression Among Children and Adolscents Living With HIV Enrolled to the Orphans and Vulnerable Children Program at the Mildmay Center of Excellence in Wakiso District
(2024-04-17) Sarah Namutosi
Introduction This study was to determine the prevalence and factors associated with viral load non-suppression among children and adolescents orphan and vulnerable children program at MildMay center of Excellence. The study specifically sought to determine the prevalence of viral load non-suppression among children and adolescent enrolled on to the OVC program at Mild May center of Excellence in Wakiso, to explore the individual factors associated with VL non-suppression among children and adolescents enrolled on to the OVC program at Mild May center of Excellence in Wakiso and to determine the treatment-related factors associated with VL non-suppression among children and adolescents enrolled on to the OVC program at Mild May center of Excellence in Wakiso. Method This was across-sectional study design that employed both qualitative and quantitative methods. A total of 219 children and adolescent were enrolled in the study. Data was collected using a questionnaire and key informant interview guide. The data was then analyzed at univariate, bivariate and multivariate level using SPSS version 20. Results Majority 83(37.9%) of the respondents were aged 10-14 years. With the mean age being 9yrs. At bivariate level of analysis age (X2=12.671, df =3, P-value=0.001), sex (X2=17.04, df =1, P-value=0.000), residence (X2=9.87, df =1, P-value=0.002), educational level (X2=11.31, df =3, P-value=0.001), duration on ART, (X2=8.17, df =2, P-value=0.001) and starting regimen (X2=14.67, df =1, P-value=0.000), adherence (X2=19.56, df =3, P-value=0.000) and disclosure status (X2=11.60, df =1, P-value=0.001) were significantly associated with viral non suppression among children and adolescents enrolled on to the OVC program P-value <0.05. At multivariate level, sex (AOR=2; 95% CI: 1.321- 2.048; p= 0.000), starting regimen (AOR=5; 95% CI: 1.895- 2.833; p= 0.003), adherence (AOR=6; 95% CI: 1.620- 1.901; p= 0.000) and disclosure (AOR=0.6; 95% CI: 1.461- 1.986; p= 0.002) were independently associated with viral non-suppression among children and adolescent enrolled on to the OVC program at Mild May center of Excellence in Wakiso Conclusion The study found out that the prevalence of non-suppression among children and adolescent enrolled on to the OVC program at Mild May center in Wakiso stood at 17.4%. this prevalence is higher than the UNAIDs 10%, and therefore directly affects the 3rd 95 in the UNAIDS 95,95, 95 targets. It can also be concluded that there are individual and treatment related factors that are associated with viral non-suppression among children and adolescent enrolled on to the OVC program as shown in the results above Recommendations Practitioners therefore should targeted mass campaign and sensitization to both care givers and clients on the effects of having a high viral load, there should be a deliberate effort by health workers at Mild May to address barriers to good adherence with ultimate aim of improving on the virological outcome, deliberate efforts on supported disclosure to children and adolescents twelve years and above and Continuous medical education and skilling of health care workers by the program on ART optimization for children and adolescents. Policy makers at ministry of health to enforce proper management of non-suppressors with emphasis on the male child and strengthen strategies on monitoring of non suppressed children and adolescents at all levels