Masters of Public health

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Knowledge, Response, and Perceived Risk Towards Coronavirus Disease 2019 Among Village Health Teams in Kassanda District, Uganda
(Uganda Christian University, 2023-09-07) Isaac Mashate
Introduction: Despite the recent progress in COVID-19 vaccine development and implementation, COVID-19 remains a threat to the global healthcare systems. VHTs are key in the management of the pandemic and thus important in the system knowledge, response, and perceived risk towards coronavirus disease. Study Objective: To assess the level of knowledge and associated factors, response activities, and perceived risk of COVID-19 among Village Health Teams in Kassanda district Methodology: This was a descriptive cross-sectional study, involving mixed methods of data collection. A sample of 273 VHTs participated in the study. Data entry and cleaning was done using Ms Excel 2016 and analyzed with STATA version 14.0. Quantitative data analysis was done at univariate level to generate frequencies, proportions and percentages., bivariate and multivariate analysis was done to generate Odds Ratios (ORs), 95% confidence intervals and p- values were used to infer statistical associations between the predictor and outcome variables. Logistic regression was conducted providing crude and adjusted odds ratios and their corresponding 95% confidence intervals (CIs). Results: A total of 273 respondents were involved in this study. Of these, more than half 54.6% (149/273) of the participants were female, about half 49.1% (134/273) had attained O’level education. More than three quarters 84.6% (231/273) of the VHTs had high level of knowledge. Secondary education (adj. OR = 2.6, 95% CI; 1.25, 5.61 p = 0.01), and source of training being District Health Team (adj. OR = 7.7, 95% CI; 3.16, 18.85 p<0.001) were factors found to be associated with the level of knowledge of VHTs on COVID-19. The response activities of VHTs that were involved in the COVID-19 response in Kassanda district were community sensitization, follow up of Covid 19 positive cases and support home-based care for mild cases. Conclusion: The level of knowledge of VHTs on COVID-19 was high. The factors associated with the level of knowledge of VHTs on COVID-19 was secondary education and source of training being District Health Team. The response activities of VHTs carried out during the Covid 19 pandemic was community sensitization, follow up of Covid 19 positive cases and support home-based care for mild cases.
Modern Contraceptive Utilization Among Women of Reproductive Age in Terekeka county, Central Equatoria State, South Sudan
(Uganda Christian University, 2023-09-12) Alex David Imba
Introduction: This study investigated modern contraceptive utilization among women of reproductive age in Terekeka County. Methodology: A mixed cross-sectional study design was adopted and quantitative data was collected from 384 women of reproductive age through structured interviews while qualitative data was obtained using focus group discussions and key informant interviews. Data collection was conducted from August to September 2021 and analysis was done using the Statistical Package for Social Scientists (SPSS) version 23.0 and thematic content analysis. Results: The study revealed the level of education of women (AOR=8.68, Confidence interval: 3.22-23.42), occupation of women (X2=19.56, p-value <0.001), religion of women – Muslim (X2=7.45, p-value=0.02) and having 6-12 number of children (AOR=5.36, Confidence Interval: 0.66-43.79) were the socio-demographic determinants while age of women and their marital status were not associated with modern contraceptive use. Knowledge on modern contraceptives (AOR=3.7, Confidence Interval: 1.43-9.61), free family planning services (X2=23.39, p-value <0.001), access – waiting for less than 30 minutes at health facility (AOR=6.80, Confidence Interval: 2.41-19.15) and husband’s support (X2=19.28, p-value <0.001) were found to be the health services factors. The prevalence of modern contraceptive utilization in Terekeka County was 21.88% (Confidence Interval: 18.02-26.29). Conclusions: Level of education of woman, occupation, religion (Muslim), number of live children, knowledge on modern contraceptives, access and partner’s support were positively associated to modern contraceptive utilization while age of woman, marital status and traditional healers were not. The prevalence of modern contraceptive utilization among women of reproductive age was 21.88% (CI: 18.02-26.29), higher than 5% (FP2020 FPET, 2016) as well as the South Sudan government target of 10%. Recommendations: Implement demand creation activities - awareness, Family planning services providers to encourage partners’ support and further research on why Terekeka County has higher prevalence.
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.
Service Provider Knowledge as A Factor for Family Planning Commodity Availability in Private Class C Drug Shops in Soroti District, Uganda
(Uganda Christian University, 2024-03-28) Tom Makumbi
Introduction: The major objective of the study was to determine the relationship between service provider knowledge and the availability of FP commodities at private Class C drug shops in Soroti District. These outlets can be a vital source of life saving FP commodities but service providers have low levels of knowledge and general biases based in myth/tradition on the effectiveness of modern FP commodities (Stanback, Otterness et al. 2011). Investigating dynamics of a possible relationship was warranted. Methodology: The study adopted an analytical cross-sectional survey design using quantitative techniques. Probabilistic sampling methods and statistical methods of data analysis were employed to establish relationships (if any) and evaluate significance for the phenomenon under study. Results: An average of 103 (91.96%, Max = 111/ Min = 85) of the 112 respondents had requisite FP knowledge and experience. Condoms were found to be the most numerous items, with 59 outlets (52.68%) stocking 1-30 patient packs, while 24 outlets (21.43%) stocked greater than 30 patient packs. ECPs and condoms were available in adequate volumes while COCs and POPS were only available in moderate and very low quantities respectively. POPs were the most out of stock items. Condoms were available in variety exceeding 2 brands but for only 12.5% of the subject facilities where condoms were found to be stocked. None of the facilities stocked female condoms. Lengthy stock-out days, sometimes in excess of 365 days, were reported. Conclusions: Whereas the study found that service providers had requisite knowledge and experience, it did not establish a fundamental significant relationship between service provider knowledge on FP with level of FP commodity availability. This could be attributed to the un-investigated interplay between the dependent variable and other factors such as availability of free public sector commodity supplies, supply chain gaps, client preferences, facility specialization, facility location and perceptions of commodity quality.
Assessment of Factors Associated With Electronic Waste Disposal in Lugazi Municipal Council, Buikwe District
(2024-04-02) Yusufu Kazibwe
Introduction The study was to assess the factors associated with electronic waste disposal in Lugazi Municipal Council. The study specifically sought to assess the knowledge of the community on the effects of poor e-waste disposal, to identify the practices for disposal of e-waste by the community of Lugazi Municipal Council and to explore the extent of awareness and implementation of the existing legislation by Lugazi Municipal Council in the management of electronic waste. Method A descriptive crossectional study design employing both qualitative and quantitative methods was used. A total of 385 respondents were enrolled in the study. Self-administered questionnaires were used to collect quantitative data from the respondents while FGDs and key informant interview guides were used to collect qualitative information from the participants. Quantitative data was analyzed using SPSS version 20 and qualitative data was analyzed using NVIVO. Quantitative data was analyzed at univariate, bivariate and multivariate level. Result. Majority 189 (49.1%) of the respondents were aged between 25-34 years. At bivariate level of analysis, educational level (X2=13.980, df =3, P-value=0.030), knowledge of waste that falls under e-waste (X2=41. X 648, df =4, P-value=0.000), knowledge of the effect of poor e-waste management (X2=450.886, df =3, P-value=0.000,), training on electronic waste management (X2=59.382, df =1, P-value=0.000) and how e-waste is stored in the shop (X2=15.091, df =3, P-value=0.02) was found to significantly influence proper e-waste disposal <0.05 At multivariate level, knowledge of electronic waste (AOR4.8; 95% CI: 1.40-7.39; p= 0.002), Effects of poor electronic waste (AOR=5.8; 95% CI: 1.27-22.42; p= 0.001) and training on electronic waste (AOR=8.8; 95% CI: 1.04-8.68; p= 0.000) were independently associated with proper electronic waste disposal p-value <0.05. Conclusion This study established that only 12% of the respondents properly disposed of e-wastes (i.e disposal after segregation). This study also found out that, knowledge of electronic waste (AOR4.8; 95% CI: 1.40-7.39; p= 0.002). Effects of poor electronic waste (AOR=5.8; 95% CI: 1.27-22.42; p= 0.001). and training on electronic waste (AOR=8.8; 95% CI: 1.04-8.68; p= 0.000) were independently associated with proper electronic waste disposal p-value <0.05 Recommendation From the study findings, there is need for sensitizing electronic dealers on the disposal of electronic waste, by the Municipal Council and the Central Government. There is need for deliberate effort by the ministry of water and environment to disseminate policy guidelines on electronic waste to the population specifically electronic consumers/electronic waste dealers and in order to improve disposal and minimize the effects of poor e-waste disposal, the government should consider putting up e-waste recycling plants so as to reduce the volume of e-waste disposed in the environment.
Utilization of Immunization Services Among Infants 0-12 Months in Juba City
(2024-04-04) John Matata
Vaccine-Preventable Diseases (VPDs) still kill more than half a million children less than five years of age in Africa every year, representing approximately 56% of global deaths caused by VPDs. Globally, one hundred sixteen million children were immunized against Pentavalent (Diphtheria Tetanus Pertussis, HepB and Haemophilus) (Penta). (UNICEF, 2018). The main objective of the study was to determine utilization of immunization services among children 0-12 months in Juba City. The specific objectives were to determine the current level of immunization services, establish the social, economic, and cultural factors, determine the impact of male involvement and determine the health services factors influencing utilization of immunization services. A descriptive cross-sectional study employing mixed method (both qualitative and quantitative) was conducted among 416 participants in Juba City. This was done through systematic random sampling of every 9th household. The respondents were interviewed through structured questionnaires and key informant and focused group discussions were conducted. Findings indicated that at multivariate analysis, factors that statistically influenced immunization of infants aged 0-12 months were; age [x2 = 4.41, p-value 0.005<0.05], gender [x2 = 4.89, p-value 0.009<0.05], marital status [x2 = 2.59, p-value 0.009<0.05], income level [x2 = 1.90, p-value 0.001<0.05], Myths and misconception [x2 = 3.75, p-value 0.002<0.05], availability of health workers [x2 = 4.86, p-value 0.003<0.05], availability of vaccine [x2 = 2.45, p-value 0.006<0.05], and attitude of HWs [x2 = 3.91, p-value 0.004<0.05].It was concluded that the proportion of the children 0-12 months who had been immunized for DPT3 was 87.3% and Measles 55.5% within Juba City which shows incompleteness of immunization within the city; Gender (females), age, marital status and income level were social and economic factors that influenced utilisation of immunisation services. Male involvement factors that have a positive influence on utilisation of immunisation includes father taking their children for routine immunization, reminding the spouse of children’s immunization appointment, providing financial support to go for immunization and accompanying the spouse for routine child immunization. The availability of vaccines, attitude of health workers, and availability of health workers were health services factors that influenced the utilization of immunization services. It was recommended that Government of South Sudan and partners should endeavour to sensitize parents about the importance of completing the immunization schedule, especially with regard to Measles. Mass awareness campaigns be done at the community level together with the community enforce the message. Interventions to improve men's attitude to support their spouses to take their children for immunization be enhanced. Such interventions includes health education or peer education are needed to increase their involvement since their involvement influence immunization uptake positively. Government and partners should employ adequate health workers to address the issue of long waiting time not to discourage parents from bringing their children for services and also purchase and stock all the health facilities with adequate vaccines.
The Determinants of Utilisation of Antenatal Care Services During the First Trimester of Pregnancy. A Study of Adolesent Mothers Attending Gulu Regional Referral Hospital
(2024-04-05) Jane Tolit Akullu
Adolescents who receive antenatal care (ANC) have the opportunity to recognize and react to the warning signs and symptoms of obstetric issues. One of the most important factors in determining a safe birth and positive birth outcomes is the use of enough ANC. The goal of this study was to determine the factors that affect utilization of ANC services among adolescents at the Gulu Regional Referral Hospital during the first trimester. The study used an analytical cross-sectional design with mixed method approach. The study's participants were 402 teenagers (10-19 years old) chosen at random from the ANC clinic. The researcher administered a questionnaire and performed six in-depth interviews. Descriptive and inferential statistics were used to examine the quantitative data that had been collected. Codification and themes were used for qualitative data. The utilization of ANC in first trimester was at 43.3%. Age (aOR:0.6, 95% CI: 0.41-0.94, p=0.025), being separated (aOR:0.4, 95% CI: 0.23-0.75, p=0.006), being single (aOR:0.2, 95% CI: 0.12-0.33, p =0.001), having attained tertiary level of education (aOR:12.2, 95% CI: 3.18-45.1, p =0.001), living with little information on the timing of ANC, lack of autonomy, lack of confidentiality, and delays at the clinic severely impacted the utilization of ANC in first trimester. In conclusion, raising ANC utilization is very important. Intervention for this include giving adolescents the right instructions, moving or setting up a clinic just for teenagers, improving time management, and hiring more midwives.
Factors Affecting Male Partner Involvement in MCH Among Families in Humanitarian Settings. A case Study of Imvepi Refugee Camp
(2024-04-06) Allen Namazzi
A study on “Factors Affecting Male Partner Involvement in MCH among Families in Humanitarian Settings: a case study of Imvepi refugee camp”. It aimed at addressing the following objectives: i) To establish the level of male partner involvement in maternal and newborn health among families in Imvepi refugee settlement, ii) To identify the perceived facilitators/enablers of male partner involvement in maternal and newborn health among South Sudanese in Imvepi refugee settlement, and iii) To establish the perceived barriers that hinder male partners from actively participating in maternal and newborn health. The study used a descriptive cross-sectional community-based survey, that employed both qualitative and quantitative data collection methods. Data was collected through one-on-one interviews, Focus Group Discussions and Key Informant interviews using questionnaires and semi-structured interview schedules with a response rate of 97.6%. Stratified random sampling, Simple random sampling and Purposive sampling techniques were used accordingly to sample respondents. Qualitative data was transcribed verbatim in a local language and then translated into English language. However, quantitative data was analyzed using Statistical Package for Social Scientists version 20.0 into frequencies and percentages. It was noted that men in humanitarian settings were more involved than their counterparts due to increased knowledge of obstetric and newborn dangers signs among men as well as accessibility of healthcare facilities. On the contrary, men were still hindered by financial constraints and cultural connotations surrounding childbirth. In the quest to reduce preventable maternal and infant deaths coupled with the influx of refugees, there is need for governments to reduce out of pocket expenditures associated with healthcare services and invest in sensitizing communities on the critical role played by all stakeholders.
Predictors of Immunization Completion Among 12-23 Months Old Children in Kwania
(2024-04-09) Samfan Thomas Omara
Background Information Immunization is one of the most cost-effective public health interventions to address the morbidity and mortality attributable to vaccine-preventable diseases. However, predictors of immunization completion have not been well studied in Kwania. This study investigated predictors of immunization completion among children aged 12-23 months old in Kwania. Methods: This was a cross-sectional study design, a sample size of 409 children aged 12-23 months was considered. A multistage sampling technique was employed to select the study subject. Data was entered into SPSS version 23; univariate and multivariate logistic regression models were used to identify the association between the variables. A P-value <0 .05 was considered statistically significant at 95% CI. Results: Out of 409 children paired with their mothers, 77.3% completed their immunization. 89% of the caregivers had health cards and 91.2% at least attended ANC. Predictors of complete immunization in this study were; the presence of a health card (AOR: 1.57, P = 0.01), the child aged 16-20 months and above 20-23 months (AOR: 2.34, P = 0.01), and (AOR=4.07 p=0.00) respectively, ANC attendance (AOR: 2.01, P = 0.02) and positive attitude of health workers (AOR: 2.36, P = 0.01). Conclusion: Immunization completion among children aged 12-23 months in Kwania was 77.3%, below the national target of 90%. The child’s age, health cards, ANC attendance, and positive attitudes of health workers were associated with immunization completion. Therefore, the district stakeholders should mobilize the community to improve ANC attendance, provide health cards during vaccination, and innovate other strategic interventions to address adherence to immunization completion.
Barriers to Utilization of Modern Contraceptive Methods Used by Females Aged 15-24 Years. A Case Study of Moyo District
(2024-04-11) Luchio Mua Azoru
Introduction: Modern contraceptives are medical procedures that interfere with reproduction or acts of sexual intercourse. Moyo district contraceptive prevalence used by females aged 15-24 years is 6.03% which is far from the national target. The low contraceptive use among this age group results in high school drops, unwanted pregnancy, early child marriage, and community disputes. General Objective: To evaluate barriers associated with the utilization of modern contraceptive methods used by females aged 15-24 years in Moyo district. Methodology: A cross-sectional design with mixed methods of quantitative and qualitative approaches was used. The reason of using cross-sectional design is to measure the exposure and outcome variables at the same time, its relatively quick and inexpensive, and findings can be used to create an in-depth research study. Multistage sampling was used to draw 423 participants for quantitative and 23 participants were purposively selected for Qualitative study based on knowledge and experience, the results were analyzed using SPSS Version 20 and open code software and presented in the form of tables, pie charts, graphs, and descriptives. Results: The findings indicated marital status OR 3.193, P-Value 0.000 and CI (2.002-5.091), Family/Community influence OR 1.644, P-Value 0.019 and CI (1.084-2.493) and Cultural influence OR 2.004, P-Value 0.006 and CI (1.218-3.298) tend to be associated with using contraceptives. Desire for children OR 0.459, P-Value 0.002 and CI (0.279-0.756) and long waiting time OR 0.442, P-Value 0.003 and CI (0.258-0.756) tend to be not associated with the use of modern contraceptives. Conclusion: The findings of this study have shown both individual and socio-cultural factors contribute to low utilization of modern contraceptives among females aged 15-24 years and these needs to be address with involvement of different stakeholders.
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
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
Factors Influencing Exclusive Breastfeeding in Bundibugyo District, Uganda
(Uganda Christian University, 2024-04-25) Rita Ntegyereize
Background: Immediate and exclusive breastfeeding have been recognised by the WHO and UNICEF as important and necessary public health practices that can help prevent child morbidity and mortality, and to satisfy sustainable development goal (SDG) 2.2 “end all forms of malnutrition by 2030”. Despite this realisation, efforts to promote and embrace immediate and exclusive breastfeeding have achieved limited success in Bundibugyo district. Problem: While many parts of Uganda including Bundibugyo district have a culture of breastfeeding, exclusive breastfeeding has remained low at 44% as compared to the national average of 66%. Objectives: The study established prevalence of exclusive breastfeeding in children within the age range of 0-6 months and the factors that influence exclusive breastfeeding among mothers in Bundibugyo district. Methods: The study used a cross-sectional mixed methods design. Both qualitative and quantitative approaches were used to collect data. Findings: The prevalence of exclusive breastfeeding among the study participants was at 47%, which is below the national average of 66%. The prevalence of exclusive breastfeeding declined as the children grew older. Majority of the mothers reported having initiated their children on breast milk in the first hour after birth. Majority (75%) of the mothers delivered from a health facility. The study found statistically significant association between health facility delivery, ANC 4+( 4 or more ANC Visits), baby age, and exclusive breastfeeding. Mother’s characteristics like age, level of education, marital status, mother knowledge and attitude, influenced exclusive breastfeeding. Conclusion and recommendations: The study findings point to important individual level, interpersonal, and institutional/organizational level factors that influence EBF. Several misconceptions about EBF such as child’s refusal of other feeds in future exist and are a barrier to sustainable EBF practice in Bundibugyo. Strategies to increase mothers’ knowledge, improve attitude towards ANC and facility deliveries are recommended.
Factors Associated With Utilization of Health Facility Based Delivery Services Among Mothers in Kacheri Sub-county, Kotido District
(Uganda Christian University, 2024-04-26) Tosquine Harriet Akech
Introduction: This study was conducted to determine the factors associated with health facility utilization during delivery among mothers in Kacheri Sub County, Ko-tido District. The major aim in this study was to determine the level of utilization of facility deliveries and the factors associated with health facility delivery services among mothers in Kacheri Sub County, Kotido District. Methods: A facility-based analytical cross-sectional research design, was considered more appropriate to study the level and determinants of health facility delivery among mothers in Kacheri Sub County, Kotido District. The research study was conducted in two health facilities that serve the communities in Kacheri sub-county in Kotido district that is Kacheri HCIII and Lokiding HCII. A sample of 384 mothers was determined using Cochran Formula (Cochran 1977). A structured questionnaire was used during data collection through face to face interviews with selected par-ticipants. The Statistical Package for Social Sciences (SPSS) Version 7 was used to analyze the data by identifying predictors that are independent for the use of health services for childbirth, logistic regression was employed. The odds ratio (OR) and their confidence level of 95% were presented. Results: The study findings indicate that majority of the mothers in the study 244 (62.6%) delivered in health facilities compared to 112 (28.9%) deliveries occurred at home without any assistance of skilled personnel as compared to 25(6.4%) were de-liveries conducted by traditional birth attendants and others (on the way) 09(2.3%) delivery occurs on the way to health facility respectively. The study also identified ANC visits, Education levels, marital status, employment, proximity to a medical facility, and frequency of prenatal care visits are known as important predictors with delivering in health facilities. Conclusion and recommendations: Although the utilization of health facilities deliv-eries in Kacheri sub-county was moderately high compared to those who gave birth at home. The study identified the education levels, marital status, employment, proximity to a medical facility, and frequency of prenatal care visits as major pre-dictors associated with delivering in health facilities. Besides, mothers who attend-ed some formal education had some knowledge on the benefits of health facility delivery and interest in delivering in the health facility. The study recommends in-tensifying sensitization of mothers, frequent ANC visits, improving transport sys-tems and sensitizing the communities to keep younger girls in schools to prevent teenage pregnancies as key in improving health facility deliveries.
Factors Associated With the Low Utilization of Modern Methods Family Planning Services Among Women in Bumufuni, Manafawa District
(Uganda Christian University, 2024-04-30) Joyce Nekesa
This study assessed the factors associated with the low utilization of modern methods of family planning services among women of 18–39years in Bumufuni, Manafawa district, and specifically sought to establish the demographic factors associated with the low utilization of Family Planning services among women of 18–39 years, the Socio- cultural factors associated with the low utilization of Family Planning services among women of 18–39 years, and the health-related factors associated with the low utilization of Family Planning services among women of 18–39 years. Method: This was a cross sectional study design employing quantitative methods. A total 133 women aged 18-39 years were enrolled in the study. interviewer administered questionnaire was used to collect quantitative data from the respondents. Data was then analyzed at univariate, bivariate and multivariate level using SPSS version 20. Results: Majority 64 (48.1) of the respondents were aged 25-29years and 88(66.9%) of them were married. At bivariate level of analysis, age (X2=17.17, df =4, P-value=0.001),, educational level (X2=16.77, df =3, P-value=0.000), religion(X2=23.39, df =2, P-value=0.000), and occupation (X2=14.51, df =1, P-value=0.002), who makes decision on the type of family planning and number of children (X2=17.16, df =1, P-value=0.002), if the community have taboos about modern family planning methods (X2=13.13, df =1, P-value=0.001), and men’s feeling about family planning (X2=19.69, df =1, P-value=0.001), where to get family planning services (X2=12.33, df =1, P-value=0.003), distance to the nearest facility (X2=21.01, df =1, P-value=0.000), and waiting time (X2=19.80, df =2, P-value=0.001), were found to be statistically significant P-value<0.05 At multivariate level of analysis, age (AOR=1.8; 95% CI: 1.23-3.10; p= 0.002), educational level (AOR=0.3; 95% CI: 1.12-2.04; p= 0.000), religion (AOR=4.3; 95% CI: 1.08-5.66 p= 0.000), decision about family size and family planning (AOR=0.4; 95% CI: 1.24-4.00; p= 0.000),, distance to the health facility (AOR=0.4; 95% CI: 1.11-5.34; p= 0.003), and waiting time at the facility (AOR=0.3; 95% CI: 1.99-4.91; p= 0.003),were found to independently associated with the low uptake of family planning p-value <0.05
Factors Associated With Viral Non-suppression Among Adolescents 10–19 Years Accessing Anti-retroviral Therapy in Nwoya District-Uganda
(Uganda Christian University, 2024-04-30) James Okello
Introduction: In this study, adolescents accessing ART in the Nwoya District between the ages of 10 and 19 were examined for factors that may contribute to viral non-suppression. The study's specific objectives were to determine the prevalence of viral non-suppression among adolescents accessing ART in Nwoya district who are 10 to 19 years old, to identify health facility-related factors associated with this condition, to identify caregiver-related factors associated with viral non-suppression among adolescents accessing ART in Nwoya district, and to evaluate behavioral risk factors. Method: This study used both qualitative and quantitative methodologies in a descriptive cross-sectional design. The study involved 225 young people in the Nwoya district who were HIV-positive and were aged 10 to 19. Data was collected using a questionnaire and key informant interview guide. The data was then analyzed at univariate, bivariate, and multivariate levels using SPSS version 20. Results:The majority 122(54.2%) of the respondents were aged 14-19 years with the mean age being 15.2 years. At the bivariate level of analysis, it was found that age, duration on ART, and attitude of health care workers were correlated with viral con-suppression (X2=14.711, df =1, P-value=0.000). The distance from home to health facility (X2=19.045, df =4, P-value=0.001), ability to continuously receive counseling from counseling (X2=9.741, df =1, P-value=0.002), the relationship between the adolescent and guardian; (X2=2.610, df =2, P-value=0.000) also had a strong correlation with viral non-suppression among adolescents. Knowledge of the use of ARV drugs; (X2=7.321, df =4, P-value=0.007) and Engagement in sexual activity since being diagnosed with HIV; (X2=5.894, df =1, P-value=0.015) significantly influenced being non suppressed. P-value <0.05. At the multivariate level, the attitude of health workers; (AOR=5.11,95% CI:1.048-1.419, P=0.002), distance from home to health facility; (AOR=0.038, 95% CI:0.007-1.946,p=0.000), knowledge on the use of ARVs; (AOR=0.028,95%CI: 0.006-0.757, p=0.003) and the relationship between the adolescent and guardian; (AOR=7.401,95% CI: 0.328-1.673, P=0.012) were independently correlated with viral load non-suppression among adolescents in Nwoya district. Therefore, 61 (27.1%) teenagers accessing ART in Nwoya district had viral non-suppression. Also from the above findings, it can be deduced that there are many factors connected to viral non-suppression in adolescents accessing ART in Nwoya District who are 10 to 19 years old, including caregiver factors, behavioral factors, and healthcare facility factors like the attitude of healthcare workers. There is a need for a multi-sectoral approach to deal with barriers to viral suppression. there is a need for implementing partners (IPs) working in the district to support ART outreach to reduce the distance to the health facilities, health education, and counseling should be emphasized, and training of health workers on how to handle adolescents living with HIV to improve on their skills and attitude towards adolescents living with HIV.
Factors Associated With Men’s Low Participation in Postpartum Family Planning at Kawolo Hospital, Buikwe District
(Uganda Christian University, 2024-05-02) Paddy Tumwesigye
Postpartum contraceptive use is not only important to reduce unintended pregnancies but also pregnancies that are too closely spaced. Male participation focuses on the involvement of males in at least one of the following activities: discussion or spousal communication, support approval, and contraceptive use of the Husband. The study assessed the factors associated with Low Participation of Men in Postpartum Family Planning in Kawolo Hospital, Buikwe District. The study employed an analytical cross-sectional study design involving collection of quantitative data with a sample of 371 study participants. Data was collected using questionnaires. The study employed Spss for data entry, cleaning and analysis. Out of the 371-sample size of the study, the response rate amounted to 350(94.4%). The study found out that Individual Factors associated with Men’s Participation in Postpartum Family Planning in reference to the expected number of children (2-4 children 57.1%), (64% were in a polygamous relationship) and respondents went to school was at 78%). Furthermore, male participation in postpartum family planning was substantially correlated with approval of family planning usage, understanding of family planning, and information source. Comparing respondents who permitted family planning usage at home to those who did not, it was found out that those who approved were more likely to utilize family planning services. The study concluded that the level of male Participation in postpartum family planning is low and there are some areas that need to be improved both by the government and other non-governmental organizations in trying to increase the postpartum family planning.
Prevalence and Factors Associated With Use of Condoms Among Adolescents (Boys and Girls) in Selected Health Facilities in Amolatar District, Uganda
(Uganda Christian University, 2024-05-07) Jimmy Odongo
Condom use prevalence is a measure of number of times one uses condom during different sexual intercourse. In Africa condom is the main contraceptive use especially male condoms (about 70%). Several factors enhance use and there are also a number of factors that inhibit condom use among sexually active people including adolescents. This research determined condom use prevalence, factors that enhanced and inhibit condom use among adolescents in Amolatar district. A descriptive cross sectional research design was used; the study was conducted in four purposively selected sub-counties being mother sub-counties in Amolatar district. A total of 194 respondents were randomly selected, Descriptive statistics, Pearson chi-square tests and multivariable logistic regression were used to analyse data. Results indicate that users and non-users of condom differed in a number of socio-economic characteristics. Users were older, better educated and were manly boys. Multivariable logistic regression results indicate that, ease of access to condoms and affordability of condoms by adolescents enhanced the use of condom among adolescents. On the other hand, un-affordability of condom and reduction of sexual pleasure inhibited use of condoms. The prevalence of condom use in Amolatar among adolescents was found to be at 64%, however, there is need to increase it through advocacy
Adolescent Sexual and Reproductive Health Needs and Services for In-School Deaf Adolescents in Uganda School for the Deaf and Mulago School for the Deaf
(Uganda Christian University, 2024-05-08) Dorothy Ajete
Sexual and reproductive health is a critical societal and personal concern; and this phenomenon strongly applies to the young population in the adolescent age bracket. Some of the common consequences of not managing adolescents sexual and reproductive health includes; early sexual encounters, teen age pregnancy, rape, defilement and others. Therefore, this study focused on SRH needs and services of in-school deaf adolescents. This study aimed at examining the various sexual and reproductive health (SRH) needs and services offered to in-school deaf adolescents in two deaf schools in Uganda. The researcher used a cross-sectional research design deploying a mixed method approach in collecting data. The total sample size was 136, of which115 deaf adolescents were surveyed, and 7 key informants were interviewed (2 head teachers, senior women, matron each and 1 senior male teacher). The study finding revealed that majority of the study respondents identified life skills, provision of school health program and sensitive counseling sessions as their preferred SRH needs; language barrier was cited as the biggest challenge in accessing SRH services. Provision of life skills coupled with counselling sessions will play a major role in enhancing the deaf adolescent’s self-esteem and their ability to utilize SRH services. As such the researcher recommends the deaf adolescents be given life skills, government and school administrations to commit to communicating SRH issues in ways understandable by the deaf, and parents to get involved in supporting their deaf children to learn more about SRH. Key Words: Sexual reproductive health, deaf adolescents, health services
Satisfaction With Clinical Care and Associated Factors Among Palliative Care Patients at Bukavu Provincial General Reference Hospital, Democratic Republic of Congo
(Uganda Christian University, 2024-05-15) Guillain Lwesso
Background: Patient satisfaction is a vital indicator of quality of healthcare. This study assessed the level of patient satisfaction with palliative care services and associated factors among adult HIV-positive patients receiving palliative care services at HPGRB . Methods: A cross-sectional study enrolled 376 adult HIV-positive patients receiving palliative care at HPGRB using simple random sampling. A structured questionnaire assessed socio-demographics, health facility factors, and satisfaction using 18 Likert scale questions. Satisfaction was defined as a score above the median of possible scores. logistical regression was used to identified factors associated with satisfaction among patients receiving palliative care services. STATA v17.0 was used to analyze the data. Results: The satisfaction level was 59.3% (95% CI: 54.3, 64.2). Being female (aPR 2.0, 95% CI: 1.7, 2.9), employed (aPR 3.5, 95% CI: 2.1, 5.9), and aged ≥50 years (aPR 6.3, 95% CI: 2.5, 13.9) were associated with higher satisfaction. Being non-Catholic (aPR 0.4, 95% CI: 0.2, 0.6) and waiting >3 hours (aPR 0.5, 95% CI: 0.4, 0.6) predicted lower satisfaction. Conclusion: Satisfaction with palliative care at HPGRB is suboptimal. Targeted quality improvement initiatives focusing on waiting times, staff interactions, and expectations of non-Catholic patients could significantly improve satisfaction which would ultimately improve the quality of care.

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