Faculty of Public Health, Nursing and Midwifery

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Forms and Determinants of Domestic Violence: Acase of Pregnant Women in Mukono Municipality-Uganda
(Uganda Christian University, 2015-10-26) Richard Mulindwa
Background: Domestic violence against women is a common occurrence all over the world. It cuts across age, ethnicity, religion and educational barriers (Brown ridge, 2009) Domestic violence can take various forms: it can be physical, psychological or sexual. Domestic violence during pregnancy is associated with adverse pregnancy outcomes such as low birth weight, spontaneous abortion, bleeding during pregnancy, preterm Labor, preterm delivery and higher neonatal death (WHO/UNAID, 2010) In a study done in Rakai district of Uganda, 30% of the women had experienced physical threats or physical abuse from their current partners but there is no information about DV particularly in pregnancy, a vulnerable stage in woman’s life. Objective of the study: This study is intended to determine forms and associated factors of domestic violence among pregnant women in Mukono municipality Methods: This study was among the pregnant women. Across sectional study employing a mixed method research design. It utilized both quantitative and qualitative methods of data collection. Qualitative research methods were utilized mainly because of the need for an in-depth understanding of social phenomenon using flexible methods such as interview, Semi-structured and open ended questions while quantitative method was applied to explain the qualitative data
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.
Lived Experiences of Seeking Care for Infertility Among Women at Two Selected Fertility Centers in Kampala District
(Uganda Christrian University, 2023-09) Jude C. Onwueme
Infertility is a complex challenge and a medical condition which affects many individuals globally. It affects both males and females in diverse proportions informing a plethora of unpleasant experiences which inflicts pains. In most cultures the world over, especially in Sub-Saharan Africa, women bear the burden of “involuntary childlessness”, which over 48million couples around the globe are faced with. Women living with infertility are constrained to prove their womanhood through motherhood, thus informing their quest for treatment even from a wide range of unqualified medics and unheralded sources. The quest to achieve conception through treatment, presents with physical, social, psychological, spiritual and financial challenges. This study explored the perceptions about infertility which the women seeking treatment had, their perceptions of the causes of infertility and adjoining risk factors, the challenges they face as it relates to the cost of treatment and the coping mechanisms (strategies) they employed while undergoing treatment, at two fertility centres in Kampala district. In-depth interviews were conducted with 20 women seeking treatment for infertility, selected and recruited using purposive sampling method (in which the participants were randomly picked). Data generated from the study showed that most women seeking treatment for infertility had limited knowledge about infertility and its causes. Also, the cost of treatment of infertility was a burden to most women thus adversely influencing accessibility of treatment and completion of treatment. It was also observed that women employed different mechanisms in their bid to cope with the treatment. Therefore, effective dissemination of information on infertility and its causes, would ameliorate challenges faced. Financial interventions through health insurance schemes are also needed in order to present women seeking treatment with the opportunity of achieving conception. Concerted efforts should also be made by fertility treatment providers and care givers, towards assisting women seeking treatment in coping effectively.
Uptake and Factors Associated with Cervical Cancer Screeing Among Women Seeking Family Planning Services at Kawempe National Referral Hospital
(Uganda Christian University, 2023-09) Anita Nimusiima
Purpose of the study. Cervical cancer screening among women seeking family planning services at Kawempe National Referral Hospital. The study aimed to determine the uptake of cervical cancer screening and establish factors associated with cervical cancer screening among women seeking family planning services at Kawempe National Referral Hospital. Methods. The study design was a descriptive cross-sectional study, which measured factors associated with women seeking family planning services at Kawempe National Referral Hospital. Primary data was obtained from women seeking family planning services using semi-structured questionnaires and Key informant interviews at Kawempe National Referral Hospital. Results. The participants were 138 women aged 18 to 49 years. Forty-nine percent of the respondents had attained ordinary level of education, 32.61% were Protestants and 17.39% were Pentecostal.43.58% agree with lack of access to information, 37.68% agree that take long in the line because women who come for the services are many. 40.58% agree that services are only during weekdays and 32.61% agree that cervical cancer screening services reach their community.34.78% disagree that costs are high, 31.16% disagree with poor infrastructure and 47.10% agree with lack of transport to visit health centers. Just over one-third fear receiving a diagnosis of the disease, 31.88% agree that the vaginal examination to carry out the test is embarrassing but 40.58% disagree that there was no privacy since it is done by male providers. Twenty-nine percent disagree that a woman has to get permission from her husband. 71.01% agree that they have ever heard about Cervical cancer, but only 65.22% have ever heard about cervical cancer screening and only 30.43% have done cervical cancer screening. The uptake of Cervical cancer screening was low, only one-third of the respondents have done cervical cancer screening. Conclusion. Nearly two-thirds of the women had ever heard of cervical cancer and nearly the same number had heard of cancer screening but only one-third had carried out cervical cancer screening suggesting a big gap between knowledge and practice.
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.
The Effects of Integrating a Pain Assessment Scale on the Surgical Ward Nurse’s Knowledge, Attitude, and Practice Regarding Post-Operative Pain Management in Mengo Hospital Kampala, Uganda.
(Uganda Christian University, 2023-09-08) Betty Nabiwande Musisi
Abstract Background Post operative pain remains one of the greatest concerns for patients following surgery. Pain is an unpleasant sensory and emotional experience accompanied by actual and potential tissue damage. Failure to promptly assess and manage pain may upshot into postoperative complications like hypertension, depression, lengthened hospital stays, and overall patients’ poor health outcomes. Objective The purpose of this study was to describe the effect of integrating the pain assessment scale on the nurse’s knowledge, attitude, and practice toward post-operative pain management in the surgical ward in Mengo hospital, Kampala. Methods At the surgical wards (obstetrics/gynecology & other general surgical procedures), nurses participated in a descriptive quantitative cross-sectional, quasi-experimental study. A total of 60 nurses participated in the study by applying the educational intervention of integrating the PAS into postoperative pain management using a 4-point Likert scale. The practice was observed using a checklist. Data were analyzed using SPSS version 20. A chi-square test was done, and significantly associated factors were acknowledged. Results In the pretest and posttest, the mean total knowledge scores about post-operative pain treatment were (M= 62.83, SD= 9.583), t = -59, P=0.01, respectively. The results raise concerns about the respondents' intolerable lack of understanding regarding how to manage patients' post-operative pain. Conclusion Nurses’ low level of knowledge, unacceptable attitude, and practice were acknowledged. Nursing curricula both at Under-Graduate and master’s should be undertaken to ensure relevant, appropriate information equips nurses to effectively manage pain.
A Criterion - Based Audit of Postnatal services Given to Mothers and Newborns Within 24 Hours of Birth in the General Hospital in Western Uganda
(Uganda Christian University, 2023-09-12) AGNES AGWANG
Abstract Background: Postnatal care is a key global intervention and a major safe motherhood initiative recommended for reducing maternal and neonatal mortality globally. Criterion-based audit helps measure the quality of postnatal care reliably and checks adherence to World Health Organization criteria and standards. This study assessed the quality of postnatal care services offered to mothers and their babies within 24 hours using a baseline Criterion-based audit at the general hospital. Methods: Mixed methods used on a facility Criterion-based audit with descriptive cross-sectional and explorative study design. Study population comprised of quarterly recorded and reviewed maternal postnatal files. A questionnaire and key informant interview guide were used. A systematic sampling technique was used for selecting files while key informants were selected purposively. Data was analyzed using SPSS version 20. Qualitative data was transcribed using related concepts to form themes and sub themes. Results: 248 files reviewed. Assessment of the mothers and their babies within one hour after birth almost met the WHO standards in all the parameters except after birth pains and incision site for cesarean mothers. Within 6 hours, assessments fell far below the WHO criteria and standards, including records of potentially life-threatening conditions and information shared upon discharge. No mental health information was shared upon discharge. Immediate care of the newborn almost met the WHO criteria and standards except for stimulation of the baby, use of ambu bag and mask, and use of resuscitation drugs. Six hours and subsequently the standards were not met (head circumference, temperature, bladder and bowel function, color of the eyes, cord checked and skin color), including records of potentially life-threatening conditions. Information on discharge was shared except delayed bath and continuity of prescribed treatment. Factors associated with quality of postnatal care included lack of guidelines, understaffing, inadequate sundries and equipment. Conclusion and recommendations: Assessment of the mothers and their babies after six hours of birth did not meet the WHO criteria and standards. Criterion-Based Audit of postnatal services in this study revealed that attention was given in improving the quality of postnatal care than it did before through, adopting WHO guidelines for postnatal care, improving the staffing levels and their general welfare. Criterion-based Audits can be used in other maternity departments like antenatal clinic and labour ward to assess quality of care.
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.
Effect of an Orientation Activity on the Perception and Attitude on First Year Direct Bachelors Nursing Students towards the Nursing Profession, A Study Done in Four Universities in Central Uganda.
(Uganda Christian University, 2023-09-15) AISA NAKAWUNDE
Background and Objective: The roles that nurses play in health care are numerous but not well known to the public nor to the students who join nursing. The students instead join with various misperceptions of the profession and they have limited awareness of the different opportunities in nursing. Without any intervention to correct the misperceptions, the students’ attitude towards their chosen nursing course remains questionable and this can affect their performance in school and the quality of nurses they make after school. Orientation programs have been proven to clear misperceptions and promote a positive attitude towards nursing, but their effect has not been studied in Uganda. The purpose of this study was therefore, to determine how an orientation activity affects the perception and attitude of first year nursing students towards the Nursing profession. Method: It was a descriptive quantitative study with a pre-post interventional design (quasi experimental). It was carried out in four universities in central Uganda and 64 students participated. Pre-test data was collected, followed by a one-hour orientation presentation about nursing professionalism, roles and specialties among others in each institution. Then, Post- data was collected two weeks later using self-administered questionnaires. Data was analyzed using stata version 16, and descriptive statistics included: mean, standard deviation, and frequencies. The relationship between variables was examined using a paired T-test with a P value of < 0.05 to measure significance. Results: Students had favorable perceptions in some aspects before the presentation, for example like; the need of knowledge and skills to practice(M=2.1, SD=.9), professional autonomy(M=2.1, SD=.9), gender(M=2.1, SD=.9), nurses’ contribution to research(M=2.1, SD=.9), etc. However, their ideas about nursing were found to be limited and unfavorable in some other aspects before the presentation for example on: nurses pay (M=2.1, SD=.9), marriage (M=2.8, SD=.9), advanced roles (M=2.9, SD= .8), males make good nurses (M=3, SD=.9). Following the presentation, students became more aware of the roles and opportunities in nursing like professionalism, advanced roles, marriage and specialties. Therefore, the presentation had a significant effect on the students perception as shown by the paired T-test (Pr(|T| > |t|)= 0.033 & Pr(T > t)= 0.016 > 0.05) at 5% level. Although some aspects of attitude obtained favorable mean scores, students had an unfavorable score on their comfort in attending to the hygiene needs of others (M=2.7, SD: .9) and this was one of the lowest mean scores before and after the presentation. There was little but no change in their attitude except increment in their intention to remain in nursing following the presentation. Conclusion: These findings reveal that students have some favorable perception of nursing at the beginning of the course. However, their ideas are limited and unfavorable in some other aspects of nursing. Also, unfavorable attitude towards nursing was noted before and after the presentation in very important profession aspects. An orientation activity can improve students’ perceptions and attitude towards nursing, but more effort is needed to change the students’ attitude towards caring for the hygiene needs of others. Educators should pick interest in knowing the students’ perception at the beginning of their course and create intentional positive professional experiences to correct any misperception and influence students’ attitude towards nursing.
The Effect of Intergrating the Pain Assessment Scale to the Nurses Knowledge,Attitude,and Practice Towards Post Operative Pain Management on the Surgical Wards
(Uganda Christian University, 2023-09-19) Betty Nabiwande Musisi
Level and Factors Associated with Uptake of Implants Among Women of Reproductive Age (15_49) in Twic East Community, South Sudan
(Uganda Christian University, 2023-09-19) John Thon Riak Yom
ABSTRACT Introduction: Implants are among the modern contraceptive methods that are hormonal, long-acting, and reversible contraceptives. They are small, thin, and flexible plastic rods that release a progestin hormone in the body, either levonorgestrel (Jadelle and Sino implant) or etonogestrel (Implanon). Methods: The research was a community-based cross sectional study. The main source of information for this research was primary data, which was collected from respondents’ households by use of questionnaires, a structured open-ended questionnaire was used as a data collection instrument, and the descriptive statistics and multiple regression analysis were used for the analysis of data. Results: The level of uptake of implants among women of reproductive age in Twic East Community, South Sudan was at 40 percent, with a 95% confidence interval of 33.7 percent to 46.5 percent. At multivariate level, after assessing for interaction and confounding, the factors that were significantly associated with uptake of implants were 45-49 years age group (aPR=0.25, 95%CI: 0.08- 0.78, p-value=0.017), Anglican and other religion (aPR=0.60, 95%CI: 0.37- 0.95, p-value=0.031; aPR=0.48, 95%CI: 0.30- 0.78, p-value=0.003), having 3-5 and 6-10 children (aPR=1.86, 95%CI: 1.24- 2.78, P-value=0.003; aPR=3.67, 95%CI: 1.69- 7.99, P-value=0.001), having still birth pregnancy outcome (aPR=4.35, 95%CI: 2.56- 7.39, P-value=0.001), not had unplanned pregnancy (aPR=0.45, 95%CI: 0.29- 0.69, P-value=0.001) and not discussing with husband about implants (aPR=0.21, 95%CI: 0.12- 0.37, P-value=0.001). Conclusion: Our study found uptake of implants among the women of reproductive age at 40 percent. Policies targeted to women of age group 45 to 49 years to encourage more use of implants, more sensitization of husbands on implants will further help to increase uptake of implants and consequently prevent unplanned pregnancies.
Risk Factors for Perinatal Death in Juba Teaching Hospital, Case-Control Study
(Uganda Christian University, 2023-09-22) TABAN GEOFREY COLLINS
Abstract: Background: This study was carried out in Juba teaching hospital to determine the risk factors associated with perinatal death in South Sudan. South Sudan is among the countries with high perinatal mortality despite the pregnant women attend their antennal care services and childbirth free of charge in public health facility. The perinatal deaths were estimated as high as 30 deaths per 1000 live births. Although stillbirth prevention is part of Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) continuum of care, less information are available, and it was not easily accessible because of limited publication about the stillbirth in South Sudan; neither government set stillbirths reduction targets nor developed plan to prevent stillbirth nor the risk factors for perinatal death in South Sudan had been studied. Lack of information on major perinatal risk factors can lead to continue perinatal deaths, SDG target 3.2 of reducing Neonatal Mortality Rate to 12 per 1000 live births and Under 5 Mortality Rate to 25 per1000 live births cannot be achieved without reducing Perinatal Mortality Rate. Since the underlying causes or specific risk factors are not clear, action to reduce this problem up-to date has been ineffective because specific obstacles to be addressed in this high perinatal death is still unknown. Method: Case-control study was carried out targeting mothers where babies were remained alive by the end of the first week after birth (controls) and mothers of children born in Juba whose babies died in the perinatal period-Uterine Fetal Death (IUFD) or death in first week of life after birth (cases). Results: The finding shows seven (7) risk factors were found significantly associated with perinatal death. The risk factors were (1) maternal alcohol consumption, (2) maternal occupation, (3) delivery at home, (3) bleeding in pregnancy, (4) low birth weight, (5) Lower gestation, (6) lack of ANC attendance, (7) HIV positive mothers. Conclusion: Maternal characteristics The associated risk with maternal alcohol consumption indicates lack of knowledge on pregnancy care and risky lifestyles during pregnancy. Maternal factors The associated risk of bleeding in pregnancy is indicative of lack of knowledge on danger signs in pregnancy which goes on unattended until too late to intervene. The high risk associated with home delivery shows cultural preference and lack of awareness on importance of health facility delivery despite of free health care services at all public health facilities. Neonatal factors The associated risk of low birth weight and low gestational age still reflects lack of knowledge in maternal well-being during pregnancy regarding prevention of maternal complications, unhealthy lifestyles, and poor feeding. Health Facility factors The associated risk with health facility which required skill birth attendant to check fetal heartbeats but failed to do so indicate knowledge gaps in monitoring and management of labor among health care providers.
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.
Describe the Knowledge and Attitude on the Use of International Guidelines for Management of Patients with Heart Failure Among Nurses at the Uganda Heart Institute, Mulago Hospital.
(2024-03-25) Atifa Munanda
Background and aim: Heart failure is a raising public health issue globally. In Uganda HF affects more than 15 % Ugandans annually, and results to increased hospital length of stay, frequent re-hospitalizations, increase hospital costs and premature deaths among those affected. The aim of study is to describe the knowledge and attitude on the use of international guidelines for managing HF among nurses at the Uganda Heart Institute. Methods: The study employed descriptive cross-Sectional study design of quantitative approach of data collection. The research was conducted on 72 nurses who have worked for more than six months in Uganda heart institute. The questionnaire consisted of 30 questions that assessed knowledge and attitude of nurses on the use of international guidelines. The study questionnaire was conducted on the month of June 2023 to July 2023. Results: A total of 72 nurses participated in this study. Average age was 36.7 years with minimum age 27 and maximum age 58 years. 67% of the respondents were below 40 years. Overall, 46.9% of the respondents had good knowledge about management of heart failure using international guidelines. Among the 72 respondents 48(66.7%) had positive attitude towards heart failure management (M = 3.8, SD= 3.3), male had nearly equal attitude compared to female (70.0% vs. 68.7%), participants who had an experience of more than 20 years had a better attitude compared to all categories of experience. Discussions and conclusion: participants had a good knowledge compared to the results from other studies. The knowledge was associated with knowledge years of experience and some forms of specialization. The results showed good attitude which was similar to other studies. Increasing awareness on the use of international guidelines might further improve knowledge.
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.

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