Masters of Public health

Permanent URI for this collectionhttps://hdl.handle.net/20.500.11951/1046

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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
Assessing the Knowledge Towards Hepatitis B Virus Among Pregnant Women Attending Antenatal Clinic at Queen Elizabeth Central Hospital, Malawi
(Uganda Christian University, 2025-04-24) Samuel Andrew Theu
Hepatitis B Virus (HBV) remains a major public health concern in Malawi, particularly among pregnant women due to its potential for vertical (mother-to-child) transmission. This study assessed knowledge related to HBV among 369 pregnant women attending antenatal care at Queen Elizabeth Central Hospital in Blantyre. Knowledge scores were used to categorize respondents into two groups: those with adequate knowledge (answered more than 5 questions correctly) and those with poor knowledge (answered 5 or fewer correctly). While 60.2% of the participants had heard of HBV, only 25.5% correctly identified it as a virus. This indicates that general awareness did not always correspond with scientific understanding. Many participants lacked clarity on HBV’s classification and transmission pathways—49.3% were unsure whether it is caused by a virus, and 54.7% were unaware of its viral nature. Knowledge of transmission routes was equally inconsistent. Only 17.9% believed it could be transmitted through casual contact, while 42.5% acknowledged the possibility of infection through an infected husband. Meanwhile, just 45.3% were aware of mother-to-child transmission during childbirth. Although more than half (53.4%) recognized the preventive role of the HBV vaccine, misconceptions around curability and risk persisted. About 50.7% believed HBV is curable, and only 33.3% acknowledged unsafe sex as a transmission risk. Furthermore, just 30.9% of respondents were aware that asymptomatic individuals can still transmit the virus. These knowledge gaps reflect limited understanding of key aspects that influence prevention and early detection. Statistical analysis revealed significant associations between knowledge levels and socio-demographic factors such as residence, education level, and income (p < 0.001). Women residing in urban areas or those with higher education and income levels were more likely to demonstrate accurate knowledge about HBV. These findings underscore the disparities in health literacy that may hinder public health efforts, particularly among rural and underserved populations. In conclusion, the study highlights a critical need for targeted educational interventions within antenatal care settings to improve HBV-related knowledge. By strengthening communication strategies and leveraging existing ANC touchpoints, healthcare providers can empower pregnant women with essential information, ultimately contributing to the reduction of HBV transmission and improved maternal and neonatal health outcomes.
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.
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.
Challenges and Coping Mechanisms of Caregivers of Children Between 3 and 8 Years With Autism Spectrum Disorders in Selected Kampala Schools Offering Special Needs and Inclusive Education Services
(Uganda Christian University, 2025-04-22) Simple Nyanjura Byaruhanga
Introduction: Autism spectrum disorder [ASD] can be hard on both the child and the parents, but especially the parents. ASD manifests in a variety of ways, including the inability to maintain eye contact and respond with appropriate facial expressions; the inability to respond to peers in a manner that fosters healthy social and emotional relationships and communication; delayed speech; and repetitive behavioral patterns. Methods: The study employed an interpretative phenomenological study design so that the researcher can get an in-depth understanding of the participants’ experiences as they shared them extensively. A sample of ten caregivers selected using purposive sampling participated in the study. A semi-structured interview guide was used in data collection, and thematic-reflexive approach to analyze the data. Results: The study revealed that motor delays, social-psychological delays, cognitive delays, and aggressive behavior were behaviors that triggered suspicion and later led caregivers to visit a health professional. Furthermore, the study featured a major theme, "Challenges experienced," which focused on the challenges faced by caregivers, including financial constraints, stigma, depression, and marital issues. Finally, the study focused on coping mechanisms, specifically emotional coping, and found that caregivers employed denial-based, pain-based, hopeful, and problem-focused responses. The data showed that caregivers employ various coping mechanisms such as faith in God, financial coping, social coping, and social support, particularly after participants disclosed their struggles to secure affordable and high-quality education for their children. Despite these ongoing challenges, the collective efforts and support networks have significantly improved the caregivers' ability to provide for their children's needs. Discussion: Caregivers faced significant challenges in accepting that their child is on the autism spectrum. Many experienced a delay in seeking help, initially noticing potential indicators but struggling to confront the hard reality of the diagnosis. This period of denial often led to emotional pain, isolation, and stigma. The support of family members, friends, and other parents of children on the spectrum played a crucial role in helping them come to terms with the diagnosis
Determinants of Modern Family Planning Methods Utilisation Among South Sudanese Refugee Women Aged 15–49 Years in Kiryandongo Refugee Settlement
(Uganda Christian University, 2024-05-23) Estella John Kasiano Kitale
Introduction: This study explored factors that influenced uptake of modern contraceptives among the group of South Sudanese refugee women of childbearing age in Kiryandongo Refugee settlement. Methodology: An analytical cross sectional mixed study was carried out amidst 312 women of childbearing age by administering structured questionnaire from Kobo collect tool to them. Key informants were interviewed for the qualitative arm. Data collection was conducted from July to August 2023; STATA software version 14 was used for analysis and thematic content analysis. Results: The study revealed that 22.1percent of the South Sudanese women of childbearing age used contraceptives methods. Tribe, monthly income of the respondents with [P-value, 0.001)], and [P-value (0.003)] respectively were found to be individual factors related to usage. Availability of the services [P-value (0.035) <0.05)], women who discuss with partners about modern FP [P-value (0.005) <0.05)], self-decision making for the FP method used [P-value (0.023) <0.05)], comfortability with the FP service delivery environment [P-value (0.002) <0.05)] were the respondent and health facility determinants associated with current uptake of the modern contraception method. Conclusions: our findings show a low uptake of modern contraceptive methods amongst South Sudanese women of childbearing age as compared to the current contraceptive use in Uganda which is 38% (UDHS, 2022). Recommendations: There is need to improve the outreaches within the settlement to give more information about the usefulness of FP also and provide FP services. Implement Counselling for refugees within the camp to encourage good decision making on uptake.
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.
Exploring the Barriers and Facilitators Towards Adherance to Sickle Cell Treatment Guidelines Among Medical Doctors at Mulago Hospital, Uganda
(Uganda Christian University, 2025-06-11) Joan Nasige
Background: Sickle Cell Disease (SCD) is a major global health issue, affecting over 4.4 million people, with 10%-40% of Africa's population suspected to be impacted. SubSaharan Africa accounts for 80% of cases, and the mortality rate for children under 5 is 90%, contributing to 7.3% of under-5 deaths in Africa in 2018. Uganda, with a national prevalence of 0.9%, faces a significant burden, especially in high-prevalence areas where rates reach 45%. Despite this, Uganda struggles with managing SCD, particularly due to non-adherence to treatment guidelines. This study examined the barriers and facilitators affecting medical doctors’ adherence to treatment protocols at MNRH. Method: This study used a phenomenological design, data was collected through key informant and in-depth interviews with the doctors working at the Sickle Cell Clinic of MNRH. These included the JHOs, SHOs, Medical Officers, and specialists/consultants. Participants were purposively selected, and the data was thematically analyzed through coding. Findings: Key facilitators to adherence included clinical experience, knowledge, continuous medical education, collaborative networks, supportive leadership, and accessible treatment guidelines. Barriers included individual factors like burnout, fatigue, and low motivation, as well as systemic issues such as lack of physical guidelines, fragmented care, heavy workload, inadequate staffing, and resource constraints, all of which impacted adherence to treatment guidelines. Discussion: Despite medical doctors’ awareness of the treatment guidelines, factors like burnout, inadequate infrastructure, lack of physical guidelines, and resource shortages prevent consistent long-term adherence. The study highlighted the need for improved resource allocation and infrastructure, better access to essential medications and equipment, and continuous education for healthcare workers to enhance adherence to the treatment guidelines.
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.
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 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.
Factors Associated With Solid Waste Minimisation Practices Among Food Vendors in Mukono Municipal Council
(Uganda Christian University, 2025-04-24) Muhammad Mukwaya
Introduction: Waste minimization is a set of process and practices intended to reduce the amount of waste produced and generated. By reducing or eliminating the generated and harmful waste, it supports and promotes more sustainable society. The process of solid waste minimization involves several steps ranked according to environmental impact namely, reducing, which offers the best outcomes for the environment is at the top of the priority order, followed by reuse, recycling, composting, incineration and disposal. Methods: The research was triangulated in nature, employing both quantitative and qualitative data collection methods. A descriptive cross-sectional survey and narrative design were employed. The study population comprised of food venders, stall workers, waste holders (hotels), waste collectors, and key informants such as health inspectors, environmental health officers, and law enforcement officers; totaling to 174 participants. Both simple random and purposively were used in selectin the study participants. Data collection instruments included questionnaires and interview guide. Results: Data was analyzed quantitatively and qualitatively. The chi-square analysis was used revealing that education level (χ² = 10.073, p = 0.007), time spent in business (χ² = 10.069, p = 0.007), awareness of waste minimization practices (χ² = 13.054, p = 0.022), and education on proper waste disposal (χ² = 15.652, p = 0.000) significantly affect waste minimization behaviors at a 5% significance level. Further, the findings indicate that individuals with higher education levels, greater business experience, and those who are aware of or educated about waste management practices are more likely to engage in recycling and reduction behaviors. In contrast, variables such as age (χ² = 0.287, p = 0.999), gender (χ² = 0.321, p = 0.852), and marital status (χ² = 0.615, p = 0.961) do not show significant associations with these practices. The study also finds that institutional factors like the provision of waste storage facilities and the presence of waste segregation bins influence waste minimization behaviors. These results emphasize the importance of targeted educational programs, awareness campaigns, and improved waste management infrastructure in promoting effective waste minimization strategies. Conclusion: Basing on the above, it is concluded that several individual and institutional factors greatly influence solid waste minimization practices among food vendors.
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 Underreporting in the Compassion Connect Health Management Information System Among Frontline Church Partners of Compassion International Uganda in the Central Region
(Uganda Christian University, 2024-10-04) Shellina Rwabyoma Abaho
Introduction: Health information reporting is fundamental in various organizations to ensure the smooth running of programs. Compassion International, a charity organization, employs a Health Management Information System to evaluate information such as medical incidence reporting and medical funds reimbursement requests. However, there has been a mismatch in reporting for the last eight years since the HMIS integration. The study aimed to explore the factors associated with underreporting medical incidents in Compassion Connect HMIS. Methods: A mixed methods study design with quantitative descriptive and qualitative methodologies was used to collect data among Central Region FCPS and key staff at Compassion’s National and Global levels. Key informant interviews were done with four key informants: two health specialists, one global health specialist, and one global health advisory team senior manager. The interviews were analyzed thematically using Atlas ti. Software. Descriptive statistics were used on categorical variables, while non-parametric tests were used to evaluate the Likert scale responses among 70 study participants. Likert Scale analysis and decisions of association were made based on the weighted mean of 2.78. Results: Considering a sample of 70 respondents, 46 were male (65.7%) while 24 (34.3%) were female. 58 (82.9%) participants were CDO-health professionals, while 9 (12.9%) were project directors and 3 (4.2%) occupied other roles. Most study participants 38 (54.3%) spent 1-5 years working at the FCP. 36 (51.4%) of the study participants never had a medical background, and over half of the study participants, 57 (51.4%), were ignorant about the FCP organizational policies, culture, and practices. HMIS complexity, Frontline Church Partner Procedures, National Procedures, Communication and feedback, and individual attitude were significantly associated with under-reporting with a mean value of 2.81, 3.84, 2.93, 3.26, and 3.23, respectively. Also, standardized indicators and training about Compassion Connect were significantly associated with underreporting. Conclusion: Developing the HMIS to capture the different information within Compassion International is vital in promoting evidence-based decision-making. Also, addressing the different factors leading to underreporting is vital in improving the data quality within the system, leading to better decision-making practices in the organization. Key Words: Health Management Information System, Compassion Connect, Data Quality, Underreporting.
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 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 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 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.
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.
Level of Utilisation and Associated Factors on Family Planning Among Females 15 – 19 Years at Kamuli General Hospital and Namwenda Hc IV, Kamuli District
(Uganda Christian University, 2024-08-16) Doreen Tukamushaba
This study was to establish the Level of utilization, and factors associated with family planning use among females 15–19 years at Kamuli general hospital and Namwenda HC IV, Kamuli district. The study specifically sought to determine the level of utilization of family planning services among females 15–19 years at Kamuli general hospital and Namwenda HC IV in Kamuli district and to identify the factors associated with the level of utilization of family planning services among females 15–19 years at Kamuli general hospital and Namwenda HC IV in Kamuli district. This study used both qualitative and quantitative methodologies in a descriptive cross-sectional design. The study involved 147 females aged 15-19 years. 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. Qualitative data was analyzed using Open Code software. Most (52.4%) of the respondents were aged between 18 and 19, with a mean age of 18.3 (SD=1.2). At the bivariate level of analysis, age (χ2=9.77,df =3, P-value=0.001), educational level (χ 2 =17.16, df =1, P-value=0.002), and marital status (χ 2=19.06, df =2, P-value=0.001),achievement of a number of desired children, (χ 2=13.66, df =1, P-value=0.001), knowledge about family planning method, (χ 2 =9.13, df =1, P-value=0.002), religious support for family planning (χ 2 =14.70, df =1, P-value=0.001), and attitude of the community towards family planning (χ 2=17.71, df =1, P-value=0.001), distance to the facility (χ 2=21.06, df =2, P-value=0.000), and knowledge of the availability of family planning at the facility (χ 2=19.44, df =1, P-value=0.000) were found to significantly influence the uptake of family planning. P-value <0.05. At multivariate level of analysis age (AOR=2.7; 95% CI: 0.65-1.99; p= 0.001), educational level (AOR=6.1; 95% CI: 1.11- 4.76; p= 0.000), religious support for FP (AOR=3.3; 95% CI: 0.06-2.75; p= 0.003) and distance to the health facility (AOR=5.1; 95% CI: 0.44-1.89; p= 0.001) were found to significantly influence the utilization of family planning. The study established that the prevalence of contraceptive use stood at (26.5%); this is low compared to the national prevalence target of 39.6% by 2025. Mass sensitization by the district health office, promotion of girl child education, the District health Officer should intentionally partner with faith, cultural leaders to meaningfully engage adolescents in marriage on use of family planning and educating the adolescents on use of family planning. The healthcare services providers of Kamuli General Hospital and Namwenda HCIV are advised to adopt a nonjudgmental approach, to enhance physical accessibility and to train nurses and other healthcare professionals on reproductive health needs of adolescents.

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