Masters in Public Health and Leadership (Save the Mothers)

Permanent URI for this collectionhttps://hdl.handle.net/20.500.11951/1043

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LEVEL AND FACTORS INFLUENCING THE UPTAKE OF HIV SELF-TESTING AMONG YOUNG PEOPLE AGED (15-24YEARS) IN SELECTED HEALTH FACILITIES IN MUKONO MUNICIPALITY
(Uganda Christian University, 2025-10-01) Kukundakwe Annah
Background: HIV remains a significant public health concern globally, with young people aged 15-24 years being particularly vulnerable to new infections. Despite efforts to promote HIV testing, many young individuals still face barriers such as stigma, confidentiality concerns, and limited access to healthcare services. HIV self-testing (HIVST) has emerged as an innovative and convenient strategy that allows individuals to test themselves privately, increasing accessibility and encouraging more people to know their status. However, the uptake of HIVST among young people remains varied, influenced by multiple factors. Objectives: This study aimed determine the level and factors influencing the uptake of HIV self-testing among young people aged (15-24years) in selected health facilities in Mukono Municipality. Methods: A cross-sectional employing both quantitative and qualitative approaches among young people aged (15-24years) in Mukono Municipality. Face-to-face interviews using structured questionnaires with the 191 young people aged (15-24years) in Mukono Municipality. Probability simple random sampling technique was used to select the health facilities and systematic sampling was used to select the study participants. The collected data were coded, entered Excel spreadsheet, and analyzed using SPSS version 26. Data was presented in the form of text, tables and graphs. Qualitative data was analyzed using thematic content analysis. Ethical approval and permission from the district were obtained prior to the study as well as consent was obtained from each respondent before the interaction. Logistic regression analysis was used to determine the factors associated with HIV self-testing, odd ratio was used as a measure of association between the two variables and data was presented in term so text, table and pie-charts. Results: A total of 191 study participants were interviewed with a response rate of 100%. From the study, the overall level of utilization of HIV self-Testing service was at 16.8%. Utilization of HIV self-Testing service was statistically significantly associated with not knowing how to use the HIV self-testing kit in case they needed to use it (AOR = 0.652, 95% CI: 0.107-0.951, p = 0.041), not feeling embarrassed about seeking HIV testing services, including HIV self-testing (HIVST) (AOR = 0.209, 95% CI: 0.170-0.618, p = 0.005), having two sexual partners (AOR = 3.907, 95% CI: 1.762-7.039, p = 0.002), not having a health facility or place to access HIVST kits (AOR = 0.377, 95% CI: 0.154-0.617, p = 0.024), living 6-10 km away from a health facility (AOR = 4.335, 95% CI: 1.179-8.940, p = 0.027) and not receiving health education on HIVST from any source (AOR = 0.328, 95% CI: 0.126-0.801, p = 0.036). Conclusion: The study found that utilization of HIV self-testing services was significantly associated with factors such as not knowing how to use the HIV self-testing kit, not feeling embarrassed about seeking HIV testing services, having two sexual partners, lack of access to a health facility for obtaining HIVST kits, living 6-10 km from a health facility, and not receiving health education on HIVST. It is recommended that efforts need to be made to improve education on HIVST, increase accessibility to kits, and reduce stigma associated with seeking HIV testing to enhance uptake among young people.
Factors Associated With Utilisation of Postpartum Family Planning Among Adolescent Mothers at Mubende Regional Referral Hospital, Mubende District
(Uganda Christian University, 2025-09-19) Rosamond Atenga
Postpartum family planning (PPFP) is critical in preventing unplanned pregnancies and improving maternal and child health outcomes. Despite national efforts in Uganda, adolescent mothers continue to exhibit low PPFP utilization, particularly in rural settings like Mubende District. This study aimed to determine the level of PPFP utilization and its associated factors among adolescent mothers at Mubende Regional Referral Hospital. A cross-sectional study employing both quantitative and qualitative approaches was conducted among 123 postpartum adolescent mothers aged 13–19 years. Convenience sampling was used to recruit participants at the postnatal care clinic. Data were collected using structured questionnaires and key informant interviews. Quantitative data were analyzed using SPSS v25, employing descriptive statistics, chi-square tests, and multivariate logistic regression to determine predictors of PPFP utilization. Qualitative data were analyzed thematically. The overall PPFP utilization rate was 61.8%. Injectables were the most commonly used method (48.5%), followed by implants (7.2%). Statistically significant predictors of PPFP utilization included discussing FP with a partner (p = 0.002), prior use of FP methods (p = 0.000), intention to use FP (p = 0.003), and being visited by a health worker (p = 0.020). Leadership support within the community was also significantly associated with PPFP uptake (p = 0.029). Multivariate analysis confirmed partner discussion (B = 0.349), type of method used (B = 0.359), and health worker visits (B = 0.344) as strong predictors. Despite moderate levels of PPFP utilization among adolescent mothers in Mubende, key factors such as partner involvement, method awareness, and health worker engagement significantly influence uptake. Interventions should prioritize couple counseling, community leader involvement, and adolescent-friendly services to improve PPFP coverage. The postpartum period, particularly the first 12 months following childbirth, presents a critical opportunity to initiate family planning (FP) interventions to prevent unintended pregnancies and improve maternal and child health outcomes. Globally, over 90% of women in the postpartum period express a desire to delay or avoid future pregnancies, yet many resume sexual activity without using contraceptives, increasing the risk of adverse health outcomes for both mothers and infants. Short inter-pregnancy intervals have been linked to complications such as miscarriage, anemia, and low birthweight. Postpartum Family Planning (PPFP) is defined as the prevention of unintended and closely spaced pregnancies during the first 12 months following childbirth. Despite its importance, PPFP remains underutilized, particularly among adolescents in low-resource settings. In Uganda, although 40% of women use modern FP methods, postpartum adolescent mothers exhibit significantly lower uptake rates (28%). In Mubende District, where adolescent deliveries constitute nearly half of all hospital births, PPFP coverage remains inadequate. Previous studies have largely focused on general populations of women, with limited attention to adolescents, a group particularly vulnerable to repeat pregnancies, school dropout, and socio-economic disadvantage. Moreover, few studies have explored PPFP uptake among adolescents in rural Ugandan settings such as Mubende. This study therefore aimed to determine the level of utilization and identify individual, community, and health facility-related factors associated with PPFP utilization among adolescent mothers at Mubende Regional Referral Hospital.
Study to Explore Lived Experience of Teenage Mothers During Pregnancy and Childbirth in Itojo Hospital, Ntungamo District
(Uganda Christian University, 2025-10-01) Grace Atim
Adolescence is a transitional stage from childhood to adulthood and is therefore a critical period in development, characterized by both opportunities and risks. By 2016, 16% of the world’s population were adolescents, with 82% residing in developing countries. Approximately 12 million births were attributed to 15–19-year-olds. Sub-Saharan Africa, particularly East Africa, exhibits high adolescent pregnancy rates, with figures reaching as high as 35.8% in Uganda. Among Uganda’s maternal mortality ratio of 198 per 100.000 live births, 17.1% were associated with adolescents aged 15-19. While research has been conducted to understand the factors contributing to such pregnancies, little is known about their lived experiences during early motherhood. Consequently, we aimed to explore the lived experiences of teenage mothers attending Itojo District Hospital in Ntungamo. Methodology A descriptive phenomenological study design was used to explore the lived experiences of mothers attending postnatal care. These mothers were identified and purposively selected to understand the individual, psychological, social, and cultural challenges they face. In-depth interviews were conducted with teenage mothers aged 13 to 19. The interviews were conducted in the local language, utilizing an interview guide and a tape recorder. Ethical approval was obtained for this study, and the mothers provided consent before participation. The interviews were then translated and analyzed using thematic analysis. Results The study revealed a complex interplay of stigma, emotional distress, disrupted education, strained family relationships, and limited access to financial support. Many participants reported feelings of guilt, shame, and anxiety, often compounded by a lack of support from partners, families, and communities. However, some also reported happy emotions and good family support, and some of these teenagers demonstrated resilience and determination to overcome these hardships for the well-being of their children. Conclusion The study found that becoming a mother at a young age is risky and challenging, involving physical issues like frequent illnesses, such as malaria, anemia, and excessive vomiting during pregnancy, as well as psychological challenges like stress, anxiety, fear, and suicidal thoughts. It also includes increased pressures of motherhood and social and cultural experiences, such as community judgment, lost dreams, and interrupted education. Efforts to support these young mothers during antenatal care with special adolescent ANC clinics and ongoing counseling, along with their partners, should be prioritized to improve outcomes not only during pregnancy but also in the postpartum period. Further research is needed on the lived experiences of teenage disabled girls during pregnancy, childbirth, and child-rearing.
Internal Auditing Quality and Accountability for Maternal Health in Government Hospitals in Uganda: A Case of Kalisizo General Hospital in Kyotera District
(Uganda Christian University, 2025-09-25) David Sansa Ngobi
This study investigated the contribution of internal audit quality to accountability practices in maternal health service delivery at Kalisizo General Hospital, Uganda. The study focused on three dimensions of internal audit quality: competence, independence, and management support. A descriptive cross-sectional survey design was employed, targeting a sample of 82 hospital staff, with data collected using structured questionnaires and analyzed using inferential statistics, specifically Pearson correlation analysis. The findings revealed statistically significant positive relationships between internal audit quality dimensions and accountability. Internal audit competence was significantly correlated with accountability (r = .642, p < .01), suggesting that higher qualifications, certification, and professional experience among auditors are associated with improved accountability practices. Internal audit independence also showed a significant positive correlation with accountability (r = .598, p < .01), indicating that unrestricted access, unbiased conduct, and freedom from management interference contribute to better oversight and transparency. Similarly, management support for internal audit was positively and significantly related to accountability (r = .675, p < .01), reflecting the critical role of funding, staffing, and implementation of audit recommendations. The study concludes that internal audit quality significantly influences accountability in maternal health service delivery. Strengthening auditor competence, safeguarding independence, and enhancing management support are essential strategies for improving governance and accountability in public health institutions.
PREVALENCE AND FACTORS ASSOCIATED WITH POSTPARTUM DEPRESSION AMONG POSTNATAL WOMEN SEEKING CARE IN NSINZE HEALTH CENTRE IV, NAMUTUMBA DISTRICT
(UGANDA CHRISTIAN UNIVERSITY, 2025-10-06) GALIKWOLEKA SUZAN LILLIAN
Introduction: Postpartum Depression is one of the most common and specific problems during pregnancy and after. Postpartum depression affects both the mothers and the development of the infant is affected negatively and yet routine screening of mental health in pregnant women has not been included into health services, specifically maternal health. Objective: To determine the prevalence and assess factors associated with postpartum depression among postnatal women seeking care in Nsinze Health Centre IV, Namutumba District. Setting: The study was conducted in Nsinze Health Centre 1V, Namutumba district in Uganda. Methods: A cross-sectional study was done between December 2023 and February 2024 among 377 mothers. Systematic random sampling was done. Postpartum depression was assessed using a structured interviewer administered questionnaire. Bivariate and multivariate logistic regression analysis were conducted. Findings with X 2 test of p<=05 were considered statistically significant. Results: Majority of the respondents were between the age of 25 to 35yrs. The prevalence of post-partum depression is 50.3%. The most critical risk factor identified is complications during pregnancy (High blood pressure, gestational diabetes, preeclampsia, placenta Previa or abrasion and Ectopic pregnancy), which affected women being 2.78 times more likely to experience postpartum depression (AOR = 2.78; P = 0.001). Conclusion: We found a high prevalence of PPD. Findings highlight key risk factors— pregnancy complications, familial depression history, age and buying expendables while at the facility and suggest the need for targeted interventions. Overall, proactive recognition and management of these risks by healthcare providers are essential for improving maternal PPD health outcomes.
LIVED EXPERIENCES IN THE UTILISATION OF MATERNAL HEALTH SERVICES AMONG WOMEN WITH HEARING DISABILITY IN KAMPALA DISTRICT
(Uganda Christian University, 2025-09-29) NAKABUUBI FAZIRAH
Introduction: Women with hearing disabilities encounter significant barriers in accessing maternal healthcare, yet their lived experiences remain under-documented in Uganda. Communication challenges, negative attitudes from health workers, and lack of institutional support often limit their access to quality care, undermining maternal health outcomes. This study explored the perceptions, challenges, support systems, and coping mechanisms of women with hearing impairments in utilizing maternal health services in Kampala district. Methods: The study adopted an existential phenomenological design, guided by Andersen’s Behavioral Model of Health Service Utilization. Thirteen women aged 18–49 with hearing disabilities who had utilized antenatal, delivery, or postnatal services were purposively sampled from Starkey Hearing Foundation Uganda. Data were collected through in-depth interviews and analyzed thematically using an inductive approach to generate themes that captured participants’ lived experiences. Findings: Four major themes emerged: (1) Perceptions of maternal health service provision indicated that women viewed services as designed mainly for abled mothers and reported low confidence in care accessibility; (2) Challenges/barriers to utilization included communication difficulties, absence of interpreters, stigma, discrimination, disrespect, and service delays were recurrent issues; (3) Support provided was mainly from spouses, family, and occasionally sympathetic health workers who played an essential role, though health system support remained minimal; and (4) Coping mechanisms showed that women relied on psychological preparation, disclosure of disability to health workers, use of hearing aids, and reliance on family or friends as informal interpreters. Conclusion: Maternal healthcare in Uganda is insufficiently inclusive for women with hearing impairments, leaving them vulnerable to poor health outcomes. Addressing these challenges requires disability sensitive service delivery, training of healthcare providers in sign language and respectful maternity care, and institutional provision of interpreters and assistive devices. The study offers evidence to guide policy reforms and interventions aimed at strengthening equity, advancing Universal Health Coverage, and achieving Sustainable Development Goal 3.
Internal Auditing Quality and Accountability for Maternal Health in Government Hospitals in Uganda: A Case of Kalisizo General Hospital in Kyotera District
(Uganda Christian University, 2025-09-24) David Ngobi Sansa
This study investigated the contribution of internal audit quality to accountability practices in maternal health service delivery at Kalisizo General Hospital, Uganda. The study focused on three dimensions of internal audit quality: competence, independence, and management support. A descriptive cross-sectional survey design was employed, targeting a sample of 82 hospital staff, with data collected using structured questionnaires and analyzed using inferential statistics, specifically Pearson correlation analysis. The findings revealed statistically significant positive relationships between internal audit quality dimensions and accountability. Internal audit competence was significantly correlated with accountability (r = .642, p < .01), suggesting that higher qualifications, certification, and professional experience among auditors are associated with improved accountability practices. Internal audit independence also showed a significant positive correlation with accountability (r = .598, p < .01), indicating that unrestricted access, unbiased conduct, and freedom from management interference contribute to better oversight and transparency. Similarly, management support for internal audit was positively and significantly related to accountability (r = .675, p < .01), reflecting the critical role of funding, staffing, and implementation of audit recommendations. The study concludes that internal audit quality significantly influences accountability in maternal health service delivery. Strengthening auditor competence, safeguarding independence, and enhancing management support are essential strategies for improving governance and accountability in public health institutions.
Health Facility readiness to accomodate physically disabled expectant women in soroti city
(Uganda Christian University, 2025-09-12) Gorreti Aanyu
Introduction: The care for disabled people especially the disabled expectant mothers is a very big challenge in most health facilities in Uganda today. The readiness to accommodate the physically disabled people in most health care facilities especially in the public facilities has continued to pose a challenge for both the medical personnel and the caretakers of the disabled beneficiaries of these services. This study aims at assessing the health facilities’ readiness to accommodate physically disabled expectant women in Soroti City. Methods: This was qualitative research with phenomenological study design and three methods for data collection were used. (1). In-depth interviews involving 10 midwives from 10 health facilities within Soroti City. (2). Feedback sessions from 60 physically disabled expectant mothers on the services acquired from the various health centres. (3). Observations of both on-going activities within the health facilities where the physically disabled expectant mothers receive services from and review of the existing records and data collection books. All these techniques were used in the data collection process for both the primary and secondary data. Results: The findings from 60 respondents and the 10 midwives as the sample from the total target population in the health facilities revealed greater insights into the readiness of these facilities to accommodate these physically disabled expectant women in Soroti City. More specifically, the research identified four main factors/challenges that influence the ability for the facilities to accommodate these physically disabled expectant women including: poor physical accessibility, language barrier, negative attitudes of health workers and long queues at the health facilities. The midwives also experience a lot challenges when providing care to physically disabled expectant women especially in the provision of ANC, Labour, Emergencies, Post-natal, and mobility within the facility. These challenges include: language barrier, poor attitude of the women, poor response to post antenatal services, shortage of assistance devices such as wheel chairs, crutches, and beds that do not support them in delivery. Conclusion: The health facilities are ready to accommodate disable expectant women to a small/limited extent. The study therefore recommends that in order for physically disabled expectant women with disabilities to enjoy their rights, there is need for certain measures to be put in place which include: awareness on Sexual and Reproductive Health (SRH) and disability, improving physical access to medical facilities, staff development among medical personnel, and adapting materials to fit persons with disabilities.
Resilience, Perceived Pregnancy - Related Stress and associated factors among Pregnant Refugee Adolescent Girls in Rhino Camp Refugee Settlement, Northwestern Uganda
(Uganda Christian University, 2025-08-07) Catherine Naluwende Nafula
Introduction. This study examined the relationship between resilience and perceived pregnancy-related stress among pregnant adolescent refugees in the Rhino Camp Refugee Settlement in Northwestern Uganda. The primary objectives were to determine the prevalence of perceived pregnancy-related stress and to assess the association between resilience and pregnancy-related stress in this population sample. Methodology. A cross-sectional design was used, incorporating both quantitative and qualitative methods. A total of 249 participants were recruited using systematic random sampling, with the sample size calculated based on an estimated adolescent pregnancy prevalence of 21.5% among Ugandan refugees. Quantitative data were analyzed using descriptive statistics and logistic regression to explore the associations between resilience, stress, and other variables. Qualitative data were analyzed thematically to identify key patterns and themes in the participants’ experiences. Results. Among the respondents, 77.2% (186) exhibited low resilience, and 80.5% (194) reported moderate pregnancy-related stress. There was a significant inverse correlation between resilience and perceived pregnancy-related stress (r = -0.15, p = 0.02). Multivariate analysis identified three independent predictors of increased pregnancy-related stress: lack of parental engagement in care (OR = 3.56, CI: 1.65–7.71), male partner rejection of the pregnancy (OR = 3.43, CI: 1.45–8.12), and reported feelings of shame (OR = 3.39, CI: 1.01–11.34). Conclusion. The findings indicate a significant inverse association between resilience and perceived pregnancy-related stress among pregnant adolescent refugees in Rhino Camp. Older adolescents and those who received greater parental support, which reflects higher social capital, demonstrated higher resilience. These results underscore the importance of social support and resilience as critical factors in mitigating pregnancy-related stress among adolescent refugees. Key Words: Adolescent pregnancy; Resilience; Pregnancy-related stress; Refugees Social support; Uganda
Determinants of Occupational Stress among Health Workers in the Accident and Emergency Departments in Mulago and Kirundu National Referal Hospitals in Kampala
(Uganda Christian University, 2025-07-01) Johnpaul Tebita
Occupational stress is an extensive matter rising from the interaction between job-related elements and an individual's psychological and physiological condition. It has become a universal concern. Beyond the personal well-being of individuals, the effects of occupational stress impact the dynamics of organizations, productivity, and the health of the workforce. Healthcare workers, in pressure settings like the Emergency Department, experience a more volume of occupational stress compared to other professions. The study employed a cross-sectional research methodology to investigate factors contributing to occupational stress among healthcare professionals in the Accident and Emergency Departments of two hospitals in Kampala. A census sampling method was used to include all eligible participants due to the small number of healthcare workers (73) in these departments. Data collection utilized the new Brief Job Stress Questionnaire with 57 items assessing occupational stressors, stress reactions, and buffering factors, alongside six additional items evaluating coping mechanisms. Data analysis was conducted at three levels—univariate, bivariate, and multivariate. Chi-square analysis was used at the bivariate level to identify significant associations between demographic, occupational characteristics, and stress levels, providing insights into the determinants of occupational stress. The participants were predominantly young (51.6% aged 20–30), female (60.9%), and working as nurses (51.6%) or doctors (45.3%), with most having 1–5 years of experience in their roles. The study revealed that 53.13% of respondents experienced moderate stress, while 26.56% reported high stress levels. Key factors associated with stress included age, marital status, education level, work hours, shift schedules, years of experience, church attendance, and involvement in extracurricular activities. Logistic regression identified that limited experience in the department (1–5 years) and longer working hours were significant predictors of stress, while participation in extracurricular activities reduced the likelihood of stress. The study also highlighted mixed coping strategies, with reliance on friends, faith, or personal time. The study highlighted work experience, hours worked, education level and coping mechanisms as key determinants of Occupational stress. By identifying these stressors, the findings provide a foundation for developing targeted interventions to mitigate stress and promote the well-being of healthcare workers in high-demand environments.
Risk Factors and Prevalance of Human Papilloma Virus Among HIV Positive Women Attending Antiretroviral Therapy Clinic in China-Uganda Friendship Hospital Naguru
(Uganda Christian University, 2025-05-23) Haliimah Nalubowa
Introduction: Human Papillomavirus (HPV) infection poses a significant public health challenge, especially among women aged 18 years and above, particularly in resource-constrained settings. Understanding the factors influencing HPV prevention and control is crucial for devising effective interventions. This study aimed to explore the determinants of HPV and prevalence among women aged 18 years and above at China-Uganda Friendship Hospital Naguru. Methodology: A quantitative cross-sectional study design was employed to gather data from a sample of women aged 18 years and above, attending ART clinic at China Uganda Friendship Hospital. The sample comprised of women who had tested for HPV. The study objectives were to determine the Prevalence of HPV, to identify socio demographic risk factors and to assess sexual behavior-related risk factors associated with HPV infection among HIV positive women 18 years and above attending the antiretroviral therapy clinic at China-Uganda Friendship Hospital Naguru. Data analysis utilized Stata 16 and logistic regression techniques to assess associations between predictor variables and HPV variables. Results: Results from 333 HIV-positive women aged 18 years and above revealed 21.6% tested positive for HPV, with education being the sole statistically significant predictor of HPV infection at the ART clinic (p=0.039, OR=1.71, 95% CI: 1.03-2.85). Conclusion: The study identified education level, HPV immunization status, and having three or more sexual partners as significant predictors of HPV infection among HIV-positive women at the ART clinic. These findings underscore the importance of education and promoting safer sexual practices to reduce HPV transmission.
EXPERIENCES OF MEDICAL NEGLIGENCE DURING CHILDBIRTH AMONG RURAL WOMEN IN NTENJERU SUB-COUNTY, MUKONO DISTRICT
(UGANDA CHRISTIAN UNIVERSITY, 2025-06-11) NAMARA SARAH GOLDEN
The study set out to research on the topic,‖lived experiences of medical negligence during childbirth among rural women in Ntenjeru sub-county, Mukono district‖ (i) The research topic was guided by three research objectives which were; To explore the mothers’ perceptions of medical negligence during childbirth among rural women.(ii)To understand the challenges faced by rural mothers who experience medical negligence during childbirth.(iii)To identify coping mechanisms which can handle challenges faced by rural mothers who experience medical negligence during childbirth. The study employed a phenomenological research design, utilizing a qualitative research approach. A total of 25 mothers who had experienced medical negligence constituted the participants for the study. Interviews were conducted with the 25 participants. Data was entered in NVivo version 14, coding was undertaken and themes were formed to make meaning out of the data. The data was analyzed thematically and presented verbatim. On objective one, the study concluded that mothers in the rural areas perceive health workers to be rude and not caring to pregnant mothers, perceived loss of trust in the government health facilities, perception on medical negligence included the cause of death for both the mother and the baby, mothers were not knowledgeable on long term effects of medical negligence, and mothers perceived medical negligence to cause trauma and anxiety. On objective two, the study concluded that, mothers received inadequate care, travelled long distances to access medical services, limited knowledge on medical negligence and financial difficulties were some of the challenges faced by the mothers. On objective three, the study concluded that, mothers coped with medical negligence by seeking second opinion of medical officers from personnel who they considered superior or more advanced in the medical field, made use of the support from family members, they utilised the help of village health teams, mothers consulted spiritual leaders to help them heal, and other mothers who could afford visited professional counsellors to help them heal. The study recommends that more sensitization is done to educate mothers on medical negligence. More recruitment of skilled health workers in government health centres
EFFECTS OF COVID-19 ON UPTAKE OF ANTENATAL CARE SERVICES BY PREGNANT MOTHERS IN BUKEDEA HEALTH CENTER IV, BUKEDEA DISTRICT
(UGANDA CHRISTIAN UNIVERSITY, 2025-06-10) NAMUTEBI ZUENA ASHLIEGH
The study aimed at assessing the effect of the Covid -19 pandemic and underlying factors affecting uptake of ANC services by pregnant women at Bukedea Health Center IV, Bukedea District. Study objectives included: to examine the influence of Covid -19 on uptake of ANC services among pregnant mothers during the Covid -19 pandemic; to assess the influence of government initiatives on uptake of ANC services among pregnant mothers during the Covid -19 pandemic; and to examine the perceived quality of health care on uptake of ANC services among pregnant women during the Covid -19 pandemic. A cross-sectional analytical research design was employed using both qualitative and quantitative approaches. The sample comprised of 120 pregnant women accessing ANC, ten (10) ANC health practitioners at Bukedea Health Center IV and six (6) district health stakeholders (comprising 1District Health Officer, 1Chief Administrative Officer, 1Chairperson LC V, 2District Health Inspectors and 1RDC). Simple random selection of the pregnant women and purposive sampling of the rest of the respondents (listed above) were carried out. Data was collected through questionnaires and interviews. Quantitative data was analyzed through the SPSS and thematic content analysis was used to analyze qualitative data. Study findings revealed that there was a significant relationship between Covid-19 pandemic and uptake of ANC services among pregnant women in Bukedea Health Centre IV ((Adjusted R square =0.6851). This implies that during Covid-19 pandemic, fear of contracting Covid-19; travel restrictions; the increased transport prices; and closure of ANC clinic limited pregnant women uptake to ANC services to the health facility. The findings also revealed that there was a significant relationship between government initiatives and uptake of ANC services among pregnant mothers during the Covid -19 pandemic in Bukedea Health Centre IV (Adjusted R squared =.203). This implies that ensuring adherence to government initiatives would lead to improvement in uptake of ANC services among pregnant mothers during the Covid -19 pandemic in Bukedea Health Centre IV. In other words, the existing institutional and legal framework, political will, government budget allocation, donor funding and stakeholder collaboration has an influence on uptake of ANC services among pregnant mothers. The findings further revealed that there is a significant relationship between perceived quality of health care and uptake of ANC services among pregnant mothers during the Covid -19 pandemic in Bukedea Health Centre IV (Adjusted R square = .464). This implies that in perceived quality of health care, attitude of health workers, time spent or long queues, the structure of the health facility, existence of women departments at the health facilities and payment for health care provided in health facilities influence pregnant women uptake of ANC services in health facility. Basing on the above findings, it is concluded that there is significant relationship between the Covid -19 pandemic, its underlying factors, and the uptake of ANC services by pregnant women at Bukedea Health Center IV. The study recommended that the government of Uganda to allow ANC outreach services so as to reach to the pregnant women who cannot access health facility during Covid-19 pandemic. More funding by the government and other development partners should focus on enhance outreach ANC services. The government to recruit more health workers, provide free mosquito nets and provide home-based health c
Barriers and Facilitators to the Utilization of Postpartum Depression Treatment Services among Adolescent Mothers at Kitagata Hospital in Sheema District
(Uganda Christian University, 2025-06-11) Joan Kansiime
Background: This study concentrated on exploring Barriers and Facilitators to the utilization of Postpartum Depression Treatment services among adolescent mothers at Kitagata Hospital in Sheema district, South Western Uganda. Individual, sociocultural and health facility factors were determined and examined. Methods: The study used the case study approach that allowed the collection of comprehensive information and understanding of the study participants‟ perceptive through in-depth interviews, documents and reports review. The research included 09 adolescent mothers who were 06 weeks to 6 months postpartum and 06 health workers who work in maternity and mental health care as key informants. The aim of the study was to explore the barriers and facilitators to the utilization of Postpartum Depression Treatment (PPDT) services among adolescent mothers at Kitagata Hospital in Sheema District. Results: The study identified Individual related issues ( Lack of knowledge of PPD, unawareness of available treatment services, Poor Attitude, Self-Stigma, poor help-seeking behavior, Low education Status, Distance of the Facility).Sociocultural related issues (Fear of stigmatization, Societal myths & expectations, PPD Literacy, Limited health centers, Unequal Gender Power Relations, Family Support). Health service-related issues (Awareness and Knowledge of the treatment services, Attitude, No readily available specialized doctors, Limited Resources, Understaffing, Clinic Privacy concerns, Follow up systems, Health Policies,) as barriers and facilitators of the utilization of postpartum depression treatment services among adolescent mothers at Kitagata Hospital in Sheema District. Conclusion: The results suggest focused training for health workers at primary care in maternal mental health including postpartum depression screening and management at Kitagata Hospital, integrating adolescent-friendly health services and initiating adolescent empowerment programs at the facility.
Teenage Pregnancy and Its Associated Factors Among Girls Seeking Care From Iganga General Hospital: A Post-COVID Era Perspective
(Uganda Christian University, 2025-05-09) Brenda Barbara Acheng
Introduction: Teenage pregnancy remains a global public health problem of concern among teenage girls and their children’s health and well-being with an annual number of 21 million girls aged from 15 to 19 years in developing regions becoming pregnant. Uganda with the highest rates of teenage pregnancies in sub-Saharan Africa, estimated at about 25% possess a serious problem on the health sector and the communities where teenage pregnancies contribute to 20% of infant deaths and 28% of maternal deaths. Objective; The aim of this study was to assess the prevalence of teenage pregnancy and its associated factors among teenage girls seeking care at Iganga General Hospital Iganga District Methods: A cross-sectional study was conducted among 292 teenage girls seeking care at Iganga General Hospital Iganga District in August 2024. An interviewer-administered questionnaire instrument was used to collect data, allowing for a snapshot assessment of the social demographic characteristics, knowledge, and sexual behaviors, family and societal factors related to teenage pregnancy. During sampling, consecutive sampling technique was used to select teenage girls who were found seeking care at Iganga General Hospital. Data were analyzed using STATA version 15, applying descriptive statistics and modified Poisson regression to assess independent associations with teenage pregnancy while reporting prevalence ratios as the measure of association. Results: The prevalence of teenage pregnancy among the 292 teenage girls seeking care at Iganga general hospital was 57.5% (n=168: 95%-CI: 51.64-63.27) Perceived knowledge on contraceptives with limited knowledge (aPR1.28 95%-CI:1.039-1.580, p-value=0.02), Employment status of participant with non-employed (aPR:1.37 95%-CI:1.008-1.858, pvalue:0.044) and Age at first xiii sexual intercourse with age >17yrs (aPRr:0.65 95%CI:0.492-0.863, p-value=0.003) were significantly associated with teenage pregnancy. Conclusion At Iganga General Hospital, the findings revealed that about 60% of the girls had been pregnant as teenagers. Employment position, age at first sexual encounter, and perceived understanding of contraceptive use are important factors linked to this problem. The implementation of community-wide programs that offer thorough sexual education in schools and nearby medical facilities, emphasizing safe sex, contraception, and the consequences of early pregnancies, is advised as a solution to this problem.
The Post–Facility Discharge Challenges on the Psycho-Social Well-Being of Mothers Caring for Preterm Babies in Jinja Regional Referral Hospital
(Uganda Christian University, 2025-05-08) Pascal Kiweewa
Background: Prematurity is the leading cause of mortality among newborns and infants under 1 year. The World Health Organization estimates that 15 million babies are born before term every year. Several interventions have been put in place to save the lives of preterm babies at the health facility level and less at the community level, and for the caregivers of preterm babies during the post-facility discharge. The post-facility discharge death among the preterm ranges from 11% to 28%. This study explored the post–facility Discharge Challenges on the Psycho-Social Well-being of mothers caring for Preterm Babies in Jinja Regional Referral Hospital. Methods: This study was conducted at Jinja Regional Referral Hospital in eastern Uganda. It employed a qualitative approach with two data collection phases. Phase 1 of data collection was in-depth interviews with mothers caring for preterm babies discharged from inpatient services but still attending premature clinic hours. Phase 2 is composed of Focus Group Discussions. We held 30 in-depth interviews and three FDGs 8 respondents each session, and a thematic approach to data analysis was used. Results: There were increased psycho-social challenges among mothers caring for preterm babies at home because of psychological distress and sleep deprivation. mothers perceived their babies as medically vulnerable alongside other post-facility discharge challenges like feeding, which was universally shared among all mothers, keeping the baby warm, and also juggling routine household activities. Spouses, relatives, and friends were the sources of emotional support. Mothers suggested that developing a peer-to-peer intervention can mitigate post-facility discharge challenges and improve post-facility discharge outcomes. Conclusion: The post-facility discharge challenges are attributed negatively to the psycho-social well-being of mothers. The majority of the mothers suffered psychological issues, including self-isolation and departing from social connections, sleep deprivation, and re-admission of the infants.
Depression Among Teenage Mothers in Kira Municipality, Wakiso District, Uganda: Prevalence, Associated Factors and Coping Mechanisms
(Uganda Christian University, 2025-04-24) Joselyn Nakyeyune
Depression among teenage mothers is an increasing public health concern globally. Although research on this subject is expanding, teenage mothers remain an understudied population. This study aimed to determine the prevalence of depression, identify associated factors, and examine the coping mechanisms adopted by teenage mothers in Kira Municipality, Wakiso District, Uganda. A mixed-methods convergent parallel research design was employed. Quantitative data were collected using a structured questionnaire incorporating the Beck Depression Inventory tool, while qualitative data were gathered through Focus Group Discussions and Key Informant Interviews. Findings revealed a high prevalence of depression among teenage mothers, affecting 79% of the study population at varying levels of severity: 27% had Major Depressive Disorder, 17% experienced moderate depression, 20% struggled with borderline clinical depression, and 15% exhibited mild-mood disturbances. Socio-cultural factors emerged as the most significant contributors to depression, largely due to fragmented social structures in the study area. To cope, teenage mothers adopted traditional and non-traditional mechanisms. However, most coping strategies did not fully align with the AAAQ framework, limiting equitable access to mental health support. These findings highlight the need for a multi-sectoral approach that ensures collaboration across different sectors to promote mental well-being of teenage mothers in Kira Municipality.
Factors Affecting Antiretroviral Therapy Adherence Among Adolescents Receiving Services From Four Selected Health Facilities in Iganga District
(Uganda Christian University, 2025-05-25) Joy Veronica Maraka
Introduction: The study examined the factors affecting antiretroviral therapy adherence among adolescents living with HIV in four selected health facilities in Iganga district, Uganda. Methods: A cross-sectional survey design was employed, with quantitative data collection from 222 adolescents aged 10-19 years who had been on ART for at least one year. Results: Utilizing the Morisky-Green-Levine Adherence Scale, the research assessed various adherence behaviors, revealing that 51.4% of respondents admit to occasionally forgetting their medication, while 48.6% report consistent adherence. The average adherence rate stood at 74.3%, suggesting a substantial proportion of adolescents’ exhibit adherence. Significant correlations emerged between ART adherence and health system-related factors, including distance to the HIV reference unit, health information dissemination, waiting times at the clinic, satisfaction with healthcare services, regular follow-up appointments, and support from healthcare providers. Notably, socio-economic factors exhibited a statistically significant positive correlation with adherence (Pearson Correlation = 0.271, p < 0.01), emphasizing their influential role. However, regression analysis reveals health system-related factors lack statistical significance as independent predictors of adherence (B = -0.173, p = 0.224). Conversely, socio-economic factors emerge as significant predictors of adherence (β = 0.306, p < 0.001). Furthermore, drug-related factors, such as the amount and frequency of drug intake, alongside awareness of therapy side-effects, display notable correlations with ART adherence. Conclusions: The study concluded that the current antiretroviral therapy (ART) adherence rate among adolescents in Iganga district is 74.3%, with 25.7% of adolescents not adhering to the therapy. Significant health system-related factors affecting adherence included distance to the HIV reference unit, health information dissemination, waiting times, satisfaction with healthcare services, regular follow up appointments, and supportive healthcare providers. Socio-economic and lifestyle factors, such as income, education, employment status, family support, and emotional well-being, also played a crucial role in adherence. Drug-related factors, including the amount and frequency of drugs, therapy side effects, and discomfort after taking medication, influenced adherence.
Lived Experiences of Labia Minora Elongation Among Adolescent Girls in Wakiso District
(Uganda Christian University, 2024-09-30) Zaituni Nabateregga
Introduction: Women and girls in different countries practice different Female Genital Modifications (FGMo) for several reasons which may include initiation to adulthood but also preparation for marriage. Labia Minora Elongation (LME) is among those practices carried out in different African countries; In Uganda it is mainly practiced in the central specifically the Buganda region. It refers to the elongation of the inner lips of the external female genitalia. The process takes a long time until the realization of the intended length which ranges from 2 to 8 cm is met. Like many Types 4 Female Genital Mutilation (FGM) practices that do not involve cutting, Labia Minora Elongation does not receive the much-needed attention like Type I, 2, and 3 from researchers, funders, and programmers yet it presents significant impact on the psychological and Physical wellbeing of adolescent girls. The study therefore set to describe the lived experiences of adolescent girls who have experienced Labia Minora Elongation in Wakiso district. Methods: The study used a phenomenological study design to describe the experiences of Labia Minora Elongation following initiation into the practice. In-depth interviews were held with 17 adolescent girls aged 10-15, who had experienced labia minora elongation and these were the primary sources of data. The study looked at the perceptions on LME, the process of elongating the labia minora, major challenges that adolescent girls face after Labia Minora Elongation initiation and the coping strategies they utilize. Findings: Labia Minora Elongation is an unpleasant prolonged process that subjects adolescent girls to months of physical and psychological suffering. It is presents challenges which are usually not acknowledged by the community, and this makes the whole experience a very difficult one. Adolescent girls experience a lot of pain, swelling of the Labia Minora, itchiness from the herbs used, stigma from peers and other psychological effects of engaging in a practice that they are compelled into and don’t fully understand. Discussion: The findings from this study revealed that girls are coerced into modifying their genitals thus there is need for awareness creation to help them have the right information and make their own informed decisions on whether to or not participate in the practice. Even though adolescent girls come up with coping mechanisms to deal with these challenges, they need to be protected against this practice that affects their wellbeing. The study findings will be used to inform policy formulation against the practice and sensitization interventions on the physical and psychological consequences of LME among adolescent girls. The findings will also provide an opportunity for more research on experiences of adolescent girls following LME practice and other silent effects impacting the psychical, sexual, and psychological wellbeing of Adolescents girls in the country and the region.
Access and Utilisation of Antenatal Care Services Among Women With Physical Disabilities Attending Mwananyamala Referral Hospital in Kinondoni District
(Uganda Christian University, 2024-09-26) Elia Macha
This qualitative study investigated the access and utilization of antenatal care services among pregnant women with physical disabilities attending Mwananyamala Referral Hospital in Kinondoni District, Tanzania. The specific objectives of the study were to identify barriers and challenges faced by physically disabled women in accessing antenatal care services, to explore the experiences and perspectives of physically disabled women regarding the quality antenatal care services they receive and to examine the support systems and accommodations required by physically disabled women to access antenatal care services effectively. The research employed a case study methodology, and 20 individuals were chosen using the purposive sample technique. Data were gathered through interview while data were analysed using content analysis. Findings from the study reveal a spectrum of barriers faced by physically disabled women, including physical limitations, attitudinal barriers from healthcare providers, policy-related challenges, transportation difficulties, and communication obstacles. Moreover, participants' narratives illuminate the significance of tailored support, education, and accessible infrastructure in facilitating positive antenatal care experiences for this population. From this study, we recommend that there is need to enhance accessibility infrastructure within healthcare facilities, improve transportation options for physically disabled women, and implement training programs for healthcare professionals to become more cognizant of and knowledgeable about the unique requirements of this population. Future research could further explore communication challenges, longitudinal health outcomes, and comparative studies across healthcare facilities, aiming to enhance inclusivity and quality of care for this vulnerable population.

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