Masters in Public Health and Leadership (Save the Mothers)

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    Lived Experiences of Seeking Care for Infertility Among Women at Two Selected Fertility Centers in Kampala District
    (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.
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    UPTAKE AND FACTORS ASSOCIATED WITH CERVICAL CANCER SCREEING AMONG WOMEN SEEKING FAMILY PLANNING SERVICES AT KAWEMPE NATIONAL REFERRAL HOSPITAL
    (2023-09) NIMUSIIMA ANITA
    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.
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    Risk factors for perinatal death in Juba Teaching Hospital, Case-Control study
    (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.
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    LEVEL AND FACTORS ASSOCIATED WITH UPTAKE OF IMPLANTS AMONG WOMEN OF REPRODUCTIVE AGE (15_49) IN TWIC EAST COMMUNITY, SOUTH SUDAN
    (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.