Masters of Public health

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    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.
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    Service Provider Knowledge as A Factor for Family Planning Commodity Availability in Private Class C Drug Shops in Soroti District, Uganda
    (Uganda Christian University, 2024-03-28) Tom Makumbi
    Introduction: The major objective of the study was to determine the relationship between service provider knowledge and the availability of FP commodities at private Class C drug shops in Soroti District. These outlets can be a vital source of life saving FP commodities but service providers have low levels of knowledge and general biases based in myth/tradition on the effectiveness of modern FP commodities (Stanback, Otterness et al. 2011). Investigating dynamics of a possible relationship was warranted. Methodology: The study adopted an analytical cross-sectional survey design using quantitative techniques. Probabilistic sampling methods and statistical methods of data analysis were employed to establish relationships (if any) and evaluate significance for the phenomenon under study. Results: An average of 103 (91.96%, Max = 111/ Min = 85) of the 112 respondents had requisite FP knowledge and experience. Condoms were found to be the most numerous items, with 59 outlets (52.68%) stocking 1-30 patient packs, while 24 outlets (21.43%) stocked greater than 30 patient packs. ECPs and condoms were available in adequate volumes while COCs and POPS were only available in moderate and very low quantities respectively. POPs were the most out of stock items. Condoms were available in variety exceeding 2 brands but for only 12.5% of the subject facilities where condoms were found to be stocked. None of the facilities stocked female condoms. Lengthy stock-out days, sometimes in excess of 365 days, were reported. Conclusions: Whereas the study found that service providers had requisite knowledge and experience, it did not establish a fundamental significant relationship between service provider knowledge on FP with level of FP commodity availability. This could be attributed to the un-investigated interplay between the dependent variable and other factors such as availability of free public sector commodity supplies, supply chain gaps, client preferences, facility specialization, facility location and perceptions of commodity quality.
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    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.
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    Utilization of Immunization Services Among Infants 0-12 Months in Juba City
    (2024-04-04) John Matata
    Vaccine-Preventable Diseases (VPDs) still kill more than half a million children less than five years of age in Africa every year, representing approximately 56% of global deaths caused by VPDs. Globally, one hundred sixteen million children were immunized against Pentavalent (Diphtheria Tetanus Pertussis, HepB and Haemophilus) (Penta). (UNICEF, 2018). The main objective of the study was to determine utilization of immunization services among children 0-12 months in Juba City. The specific objectives were to determine the current level of immunization services, establish the social, economic, and cultural factors, determine the impact of male involvement and determine the health services factors influencing utilization of immunization services. A descriptive cross-sectional study employing mixed method (both qualitative and quantitative) was conducted among 416 participants in Juba City. This was done through systematic random sampling of every 9th household. The respondents were interviewed through structured questionnaires and key informant and focused group discussions were conducted. Findings indicated that at multivariate analysis, factors that statistically influenced immunization of infants aged 0-12 months were; age [x2 = 4.41, p-value 0.005<0.05], gender [x2 = 4.89, p-value 0.009<0.05], marital status [x2 = 2.59, p-value 0.009<0.05], income level [x2 = 1.90, p-value 0.001<0.05], Myths and misconception [x2 = 3.75, p-value 0.002<0.05], availability of health workers [x2 = 4.86, p-value 0.003<0.05], availability of vaccine [x2 = 2.45, p-value 0.006<0.05], and attitude of HWs [x2 = 3.91, p-value 0.004<0.05].It was concluded that the proportion of the children 0-12 months who had been immunized for DPT3 was 87.3% and Measles 55.5% within Juba City which shows incompleteness of immunization within the city; Gender (females), age, marital status and income level were social and economic factors that influenced utilisation of immunisation services. Male involvement factors that have a positive influence on utilisation of immunisation includes father taking their children for routine immunization, reminding the spouse of children’s immunization appointment, providing financial support to go for immunization and accompanying the spouse for routine child immunization. The availability of vaccines, attitude of health workers, and availability of health workers were health services factors that influenced the utilization of immunization services. It was recommended that Government of South Sudan and partners should endeavour to sensitize parents about the importance of completing the immunization schedule, especially with regard to Measles. Mass awareness campaigns be done at the community level together with the community enforce the message. Interventions to improve men's attitude to support their spouses to take their children for immunization be enhanced. Such interventions includes health education or peer education are needed to increase their involvement since their involvement influence immunization uptake positively. Government and partners should employ adequate health workers to address the issue of long waiting time not to discourage parents from bringing their children for services and also purchase and stock all the health facilities with adequate vaccines.
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    Predictors of Immunization Completion Among 12-23 Months Old Children in Kwania
    (2024-04-09) Samfan Thomas Omara
    Background Information Immunization is one of the most cost-effective public health interventions to address the morbidity and mortality attributable to vaccine-preventable diseases. However, predictors of immunization completion have not been well studied in Kwania. This study investigated predictors of immunization completion among children aged 12-23 months old in Kwania. Methods: This was a cross-sectional study design, a sample size of 409 children aged 12-23 months was considered. A multistage sampling technique was employed to select the study subject. Data was entered into SPSS version 23; univariate and multivariate logistic regression models were used to identify the association between the variables. A P-value <0 .05 was considered statistically significant at 95% CI. Results: Out of 409 children paired with their mothers, 77.3% completed their immunization. 89% of the caregivers had health cards and 91.2% at least attended ANC. Predictors of complete immunization in this study were; the presence of a health card (AOR: 1.57, P = 0.01), the child aged 16-20 months and above 20-23 months (AOR: 2.34, P = 0.01), and (AOR=4.07 p=0.00) respectively, ANC attendance (AOR: 2.01, P = 0.02) and positive attitude of health workers (AOR: 2.36, P = 0.01). Conclusion: Immunization completion among children aged 12-23 months in Kwania was 77.3%, below the national target of 90%. The child’s age, health cards, ANC attendance, and positive attitudes of health workers were associated with immunization completion. Therefore, the district stakeholders should mobilize the community to improve ANC attendance, provide health cards during vaccination, and innovate other strategic interventions to address adherence to immunization completion.