Browsing by Author "Otieno, Emmanuel"

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Factors Influencing Access to Sexual and Reproductive Health Information among Adolescents Aged 12-19 Years in Mukono Municipality Schools: A Cross-Sectional Study
(ShahidSadoughi University of Medical Sciences, 2024-06-12) Namyalo, Josephine; Sentumbwe, Dissan; Nakalega, Annet Patience; Kobusingye, Jacqueline; Otieno, Emmanuel
Background: Adolescent sexual and reproductive health is one of the essential health care services that promote a adolescent’s health. Complications of unwanted pregnancies lead to school dropouts’, disability and mortality. However, many adolescents 12-19 years face barriers to reproductive health information about their health and rights. And are unable to access services needed to protect their health. This study aimed to assess factors influencing access to Sexual and Reproductive Health Information among adolescents aged 12-19 years in Mukono municipality schools, Uganda. Methods: Analytical cross-sectional survey and simple random sampling were used to select 384 participants between July and December 2022 in Mukono municipality. A Self-administered structured was used to collect data. Data was analyzed using descriptive statistics, chi-square test, and a modified Poisson regression model. Results: Findings showed the mean age of participants was 16.1 (S.D + 2) years. The proportion of access to information was 80.27%. Significant factors strongly associated with access to sexual and reproductive health information were being Moslem (OR: 0.284 (0.089-0.912)], going to hospital [OR: 2.350 (1.143-4.828)], distance 3-5 Kms from home to nearest health facility [OR: 0.41 (0.176-0.912)]. Conclusion: Two of every ten participants had access to Sexual Reproductive Health and Rights information. Significant determinants were radio media and print newspapers. Stakeholders should advocate for adolescents’ increased access to healthcare information to avert the upsurge in related diseases. Policy makers should review and monitor new guidelines for Adolescent and School health inclusive of sexuality and reproductive health. Thus, improve health equity for all.
Health Financing and Policies in the Transition to Universal Health Coverage–Uganda as a Spotlight
(SSRN, 2024-05-20) Otieno, Emmanuel; Yaya, Togo; Namyalo, Josephine; Alira, Racheal
The problem of the uninsured has been a major focus of health policy debate for decades all over the World. The call for drastic change in the health sector has never been so urgent today than ever before. Humanity faces enormous crises and health related challenges. Before the pandemic the global economy was staggering and fragile; the consequent recovery has increased inequalities in access to health needs. Consequently, creating societies that may be unproductive and unsustainable. This requires transformative health reforms based on health financing and policy aspects. Yet the sector’s mainstream persists in doing business as usual, with no meaningful impact to global aspirations set out in the 2030 Agenda for Universal Health Coverage. The purpose of this perspective is to lay out a framework for policymakers to think about how policy reforms might fit to context of universal health coverage in low- and middle-income countries. The future of health insurance and the pursuit of innovative health financing approaches that we need to know to achieve implementation of National Health Insurance Scheme in Uganda.
Maternal health information seeking behaviors and perceptions among Ugandan pregnant women: theory-informed study
(Gonabad University of Medical Sciences (GMU), Iran, 2026-01-01) Namyalo, Josephine; Kiva, S. Joseph; Otieno, Emmanuel
Background: Although the maternal mortality ratio has declined in Uganda, but it remains a public health threat, constraining the achievement of maternal mortality targets. Research suggests that health information-seeking behavior is significant for understanding different maternal health outcomes. This study aimed to understand the underlying factors affecting health information-seeking behaviors among pregnant women in selected hospitals in Mukono and Kampala Districts, Uganda. Methods: Utilizing a qualitative design, 24 pregnant women aged 16-24 years who were seeking antenatal care (ANC) from Mukono, Nagalama, and Naguru Hospitals were recruited through purposive sampling. Focus group discussions (FGDs) and key informant interviews (KIIs) were conducted. The data were analyzed using thematic analysis. Results: Data analysis identified 20 codes that generated three themes: reasons for seeking information, challenges faced in seeking information, and behavioral change communication strategies. Conclusion: Findings showed pregnant women accessed information from health workers. The main barrier to receiving information was different reporting times for ANC. There is a need to develop a centralized, standardized health information repository and to provide continuous professional development to providers. Future research should examine interventions to improve health-seeking information behavior across various cultural contexts.
Perceptions and experiences of willingness to pay for community based health insurance: a qualitative study
(Academic Research and Publishing, 2025-03-31) Otieno, Emmanuel; Mukasa, Norman; Odoch, Florence Ajok; Ddamulira, Christopher; Nuwagaba, Ddezi; Namyalo, Josepine; Walimbwa, Aliyi; Basaza, Robert K.
The study objective was to explore perceptions and experiences of willingness to pay for community-based health insurance and factors that affect their willingness to pay among farming households in Uganda. A qualitative study was done among 33 participants in Uganda. An explorative study design with the phenomenological approach was employed. Both purposive and snowball sampling techniques were used. Isingiro District was selected because it is geographically serviced by community-based health insurance schemes in a region with the largest proportion of members at 57%. Consequently, there is augmented availability of data and generalized results. Key informant interviews and focus group discussions were conducted via semi-structured questionnaires. A univariate and inductive thematic analysis were done. Findings show low level of awareness, perception of low income, high amount of premium, good perception of health status are the barriers to pay and indicate the elderly population are unwilling to pay for the community-based health insurance scheme. Yet, the scheme is designed to ameliorate healthcare encounters of such vulnerable groups. This study provides timely evidence and impetus for strategies that address the increasing burden of healthcare. In conclusion, there has been low level of awareness about community-based health insurance. This study proposes to expand universal health coverage of informal sector workers through increased sensitization and capacity to pay premium. Also, the age factor highlights the need to customize premium for membership based on demographic landscape of the communities. To effectively address the future of community-based health schemes, it is critical to develop effective community evidence-based policy options for a sustainable scheme model. This intervention could engender access to a holistic healthcare service by the informal sector. Thus, it may fast-track the achievement of universal health coverage agenda by 2030.
Perinatal Mortality and Its Predictors in Beni City, Democratic Republic of Congo a Cross-sectional Study
(BMC, 2023) Kahiririaa, Mathe Julien; Namyalo, Josephine; Otieno, Emmanuel; Mubarak, Nasur
Background: Globally, perinatal mortality rates have decreased considerably in the last 30 years. However, in sub-Saharan African countries perinatal mortality remains a public health burden. Therefore, this study aimed to determine the Perinatal Mortality Rate and the factors associated with perinatal mortality in Beni City, Northeastern Democratic Republic of Congo. Methods: A hospital-based retrospective cross-sectional study was conducted among 1394 deliveries that were documented in Beni General Referral Hospital from 2 January to May 31, 2022. The study was done in the conflictridden Beni city of the North Kivu Province. Analysis was done using Open Epi and SPSS version 22. Binary and Multivariate logistic regression analyses were performed. Odds ratio with 95% confidence interval was used to measure strength of association. Results: Findings indicate that 60.7% of 1394 participants were below the age of 21 years, and 95.1% (1325) Beni residents. The Perinatal Mortality Rate was 42.3 per 1000 live births. Majority (51) of the postpartum women who experienced perinatal mortality didn`t have a history of perinatal mortality as compared to their counterparts. Multivariable analysis revealed that birth weight (AoR = 0.082, 95% CI 0.014–0.449, p < 0.05) and Apgar score in the 10th minute (AoR = 0.082, 95% CI 0.000- 0.043, p < 0.05) were significantly associated with Perinatal mortality. Conclusion: The high perinatal mortality rate in Beni General Referral Hospital, approximately four in every 100 births remains a disturbing public health concern of which is attributable to low birth weight and Apgar score. This study may help policymakers and healthcare providers to design preventive interventions.
Prevalence and correlates of intimate partner sexual violence among pregnant women in Lamwo district – Northern Uganda
(Global Health Institute, 2026-04-17) Lanyero, Joan; Otieno, Emmanuel; Nsubuga, Mushin; Kobusingye, Jackline; Namyalo, Josephine
Background and Aims: Intimate Partner Violence (IPV) is a silent pandemic, associated with 10% of all violent deaths and 290,000 years lost to morbidity. Intimate partner violence has been explicitly associated with not only health consequences of gynaecological and psychological nature among women but also deaths. The sexual form of intimate partner violence which increases in intensity during pregnancy is associated with higher risk of morbidity. The purpose of this study was to assess the prevalence and correlates of intimate partner sexual violence during pregnancy among pregnant women in Lamwo district, Northern Uganda. Methods: A cross-sectional study was done at 6 facilities in Lamwo district from January-February 2022. Stratified and simple random sampling were used to sample 260 pregnant women out of a pregnant women population size of 810 women who sought antenatal care on a monthly basis from health facilities. The structured interviews were used for data collection. Data was entered in Epi Info version 7.0 and analysed in SPSS version 25 using the log-binomial model. A multivariate analysis was done. Statistical significance was set at p<0.05. Results: The results showed a 24% prevalence of IPSV with 73% of pregnant women denying the use of measures to protect them from sexually transmitted infections. Pregnant women who were carrying their first, second, and third pregnancies were more likely to experience IPSV than women with more than 3 pregnancies (aPR 5.307 [CI = 1.965 -14.335], p = 0.001). In addition, women whose spouses had a habit of engaging in fights, had ever physically abused them, and had a preference for the gender of children demonstrated an increased prevalence of IPSV. Conclusion: Out of every 10 pregnant women in the sample, two of them were sexually violated. The lower the gravidity and parity, the more likely to experience IPSV. Gravidity correlated more with IPSV than any other IPSV factor. The findings from this study may inform health interventions aimed at reducing intimate partner sexual violence.
The Paradox of the Ugandan Health Insurance System: Challenges and Opportunities for Health Reform: Challenges and Opportunities for Health Reform
(The Korean Society for Preventive Medicine, 2023-12-12) Otieno, Emmanuel; Namyalo, Josephine
For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of health care reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda’s health sector