Masters of Public Health

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

Browse

Now showing 1 - 20 of 48

Menstrual Hygiene Management and associated factors among adolescent girls in Tapac Sub county, Moroto district, Karamoja region
(Uganda Christian University, 2026-04-27) Esther Loma
Background: An estimated 1.8 billion women menstruate globally each month, including adolescent girls in and out of school. Despite being a natural biological process, poor menstrual hygiene management (MHM) exposes adolescent girls to adverse health and social outcomes such as urinary tract infections, reproductive tract infections, HIV infection, mental health challenges, school absenteeism and dropout, and increased risk of adolescent pregnancy. These challenges are more pronounced in Uganda, particularly in the Karamoja sub-region, where access to menstrual hygiene information, materials, and supportive environments remains limited. However, there is limited empirical evidence on MHM adequacy and its associated factors in Tapac Sub-county. Objective: To assess menstrual hygiene management and its associated factors among adolescent girls in Tapac Sub-county, Moroto District, Karamoja region. Methods: An analytical cross-sectional study design was used among adolescent girls aged 13–18 years in Tapac Sub-county. A multistage sampling technique involving stratification of parishes, random selection of villages, and systematic household sampling was employed. Data were collected using a pre-tested structured questionnaire translated into Ngakarimojong. Data were analyzed using SPSS version 26 using descriptive statistics and log-binomial regression to determine factors associated with adequate MHM. Results: The proportion of adolescent girls who adequately practiced menstrual hygiene management was 21%. Factors associated with lower MHM adequacy included younger age (13–15 years) (aPR = 0.313; 95% CI: 0.211–0.465; p < 0.001) and menstrual duration of fewer than five days (aPR = 0.523; 95% CI: 0.341–0.802; p = 0.003). Factors positively associated with adequate MHM included being currently in school (aPR = 2.099; 95% CI: 1.388–3.174; p < 0.001), primary education level (aPR = 2.247; 95% CI: 1.207–4.183; p = 0.011), knowledge of appropriate menstrual materials (aPR = 3.284; 95% CI: 2.274–4.743; p < 0.001), and regular menstrual cycles (aPR = 2.180; 95% CI: 1.141–4.165; p = 0.018). Parental factors such as having an educated mother (aOR = 2.424; 95% CI: 1.394–4.214; p = 0.002), educated father (aOR = 1.909; 95% CI: 1.105–3.295; p = 0.020), and parental education on MHM – especially from fathers (aPR = 4.283; 95% CI: 2.870–6.392; p < 0.001) – were significantly associated with improved MHM. Additional factors included smaller household size, presence of other menstruating schoolgirls, and supportive school policies allowing menstrual management during school hours. Conclusion: Menstrual hygiene management among adolescent girls in Tapac Sub-county is inadequate, with only 2 in 10 girls practicing adequate MHM. This places the majority at risk of adverse health and social outcomes. There is a need for integrated, multi-level interventions targeting intrapersonal, interpersonal, and community factors to improve menstrual hygiene practices in the region.
Assessing Factors Associated With Stock-outs of Reproductive Health Commodities in Selected Health Facilities of Wakiso District, Uganda
(Uganda Christian University, 2026-04-14) Sandra Wanyenze Magona
Background: In Uganda, despite the reduced costs of reproductive health (RH) commodities and increased support from the Ministry of Health and partners such as UNFPA,stock-outs of these commodities remain a persistent challenge.There is a need to understand and document the factors associated with stock-outs and the barriers, facilitators and experiences in reproductive health commodities management. Objective: To determine factors influencing stock out levels of reproductive health commodities and explore the barriers, facilitators and experiences of healthcare workers regarding the management of reproductive health commodities in selected health facilities of Wakiso district. Methods: A mixed study was employed concurrently in this study. Both quantitative and qualitative data were collected at the same time. Quantitative data was collected from the stockcards while qualitative data was collected using a pre-tested, semi-structured interview guide. Results: Stock-out level for RH commodities was 10.1% with HCIV and HCIIIs experiencing the highest percentage. Injectables contraceptives Medroxyprogesterone acetate 104mg/0.65mL, SC and Medroxyprogesterone acetate 150mg/mL being the most affected and Levonorgestrel 30mcg tabs (Microlut) the least affected. Training in supply chain management remained significantly associated with reduced stockouts, as facilities with trained staff were less likely to face stockouts (aPR = 0.77; 95% CI: 0.599– 0.985, p = 0.038). Delays in delivery also showed a strong association, with facilities that experienced delivery delays being less likely to face stockouts (aPR=0.54;95% CI:0.433–0.668, p<0.001).In addition, support supervision was significantly associated with increased stockouts (aPR=1.54; 95% CI:1.083–2.192, p=0.016). Qualitative findings provided factors associated to the depicted stockout levels, such as limited supply chain training, limitations in support supervision, delays in supply deliveries from National Medical Stores, and inadequate budget for commodities. Quantitative findings provided barriers such as limited storage space,inadequate funds for redistribution logistics, facilitators such as functional stock monitoring systems, collaboration and support from Village Health Teams, support from development partners and non-government organizations and lastly experiences on how they coped such as redistribution, and submitting emergency orders. Conclusion: This study examined the level of stockouts, the factors linked to them, and the challenges in managing reproductive health (RH) commodities in Wakiso District. The results showed a relatively low stockout rate of 10.1%, with higher levels at HC IVs and HC IIIs, especially for injectable contraceptives and 3-year implants due to high demand. Factors such as training in supply chain management, delivery delays, and support supervision were associated with stockouts, showing the complexity of the supply system. Interviews also revealed challenges like poor record-keeping, difficulties in redistributing stock, and limited resources, as well as ways facilities cope with shortages. Overall, the study provides useful information to help improve the supply system and reduce stockouts of RH commodities in Wakiso District. Results:
Prevalence, Factors Associated With Malnutrition Among Children Under Five Years in Al-Shabbah Children’s Hospital-Juba, South Sudan
(Uganda Christian University, 2026-04-09) Osman Mohammed Abduelgabar Ibraheim
Malnutrition is a serious medical condition, which results from relative, absolute, or excess deficiency of one or more essential nutrients in the human body (Mengistu et al., 2013). It is a direct cause of mortality, and a major disabler preventing children who survive to reach their full developmental potential. Hence, the purpose of this study was to investigate the prevalence of malnutrition and associated factors among children under the age of five years in Al-Shabbah Children´s Hospital Juba, South Sudan. Specifically, the study sought to determine the association between maternal factors, child related factors, and service factors related with malnutrition among children under the age of five years. The cross-sectional design and logistic regression was the main methods of data analysis. The findings indicated that 72.9% of children under five years were affected by Malnutrition including 54.3% classified as severely or moderately acutely malnourished (SAM & MAM). Specific nutritional indicators showed that underweight (WAZ) affected 59.9%, wasting (WHZ) affected 60.6%, and stunting (HAZ) affected 24.2% of children, reflecting both acute and chronic undernutrition. Maternal factors were strongly associated with malnutrition of children under the age of five years in Al-Shabbah Children´s Hospital. Children of mothers with no formal education (43.9%) had over three times higher odds of malnutrition compared to those whose mothers had tertiary education (AOR = 3.52, 95% CI: 1.68–7.35, p = 0.001). Lack of postnatal care attendance (49.8% of mothers) also increased the risk (AOR = 2.15, 95% CI: 1.10–4.20, p = 0.024). Among child-related factors, children aged 7–18 months (47.6% of the sample) were most vulnerable, highlighting the critical period of transition from exclusive breastfeeding to complementary feeding (AOR = 0.42, 95% CI: 0.21–0.85, p = 0.015). Male sex and low birth weight were associated with higher malnutrition descriptively but were not significant after adjustment. Health facility factors influenced malnutrition outcomes, with adequate availability and accessibility of services improving child nutrition (AOR = 1.56, 95% CI: 0.97–2.50, p = 0.003). Other facility-related factors, including place of care, distance, and health worker attitude, were not independently significant but remain important for program planning. It is concluded that, At Al-Shabbah Children’s Hospital, 72.9% of children under five are malnourished (54.3% SAM & MAM), with underweight affecting 59.9%, wasting 60.6%, and stunting 24.2%, highlighting a critical need for targeted nutrition interventions. Overall, these findings underscore that integrated interventions are needed, targeting maternal education, postnatal care utilization, age-specific child nutrition interventions, and strengthened, accessible health services, to reduce the high prevalence of malnutrition in children under five.
Perceptions and Attitudes Toward Participation in HIV/Aids Clinical Trials Among Adolescents and Young Adults Living With HIV in a Suburban Area of Kampala, Uganda.
(Uganda Christian University, 2025-05-02) Stella Namukwaya
Background: This study explores the perceptions and attitudes of adolescents and young adults living with HIV (AYALHIV) toward participation in HIV/AIDS clinical trials in a suburban area of Kampala,Uganda. Although clinical trials are essential for advancing HIV treatment, participation rates among adolescents and young adults remain low, particularly in sub-Saharan Africa. Methods: Using a descriptive qualitative approach, the study involved in-depth interviews (IDI’s) and focus group discussions (FGD’s) with AYALHIV aged 13-24 years attending the Joint Clinical Research Centre (JCRC) paediatric clinic in Lubowa. Results: Findings revealed low awareness and knowledge of clinical trials among participants, with most learning about trials through healthcare providers or peers. Major barriers to participation included fear of side effects, practical challenges such as transportation, and concerns about privacy due to HIV-related stigma. However, several facilitators were also identified, such as family and peer support, access to clear information, and a strong sense of altruism among older participants who viewed trial participation as contributing to the broader fight against HIV/AIDS. Conclusions: The study concludes that while there are significant barriers, addressing logistical issues, improving educational outreach, and emphasizing altruistic motivations could enhance participation. Recommendations: Doing targeted educational campaigns, increasing logistical support, and community-based initiatives to reduce stigma and promote trial participation among AYALHIV. By understanding and addressing these factors, future HIV clinical trials can become more inclusive, contributing to more effective research and better health outcomes for adolescents and young adults living with HIV.
Factors Associated with Self-induced Abortions Among Women of Reproductive Age (15-49) Years in Jinja Regional Referral Hospital- Jinja City
(Uganda Christian University, 2026-02-18) Esther Omoding Arongat
This study aimed to investigate the factors associated with Self-induced abortions among women of reproductive age of 15-49 years in Jinja regional referral hospital- Jinja city. The specific objectives were to determine the behavioural factors associated with self-induced abortions, examine the socio-demographic factors associated with Self-induced to Abortions and to establish the reproductive health behavioural factors associated with Self-induced Abortions among women of reproductive age of (15-49) years in Jinja Regional Referral Hospital. The quantitative cross-sectional study design. Krejcie and Morgan's (1970) method was used to draw a sample size of 327 women, from a population of 2,200 women of reproductive age of (15-49) years in Jinja Regional Referral Hospital The sample was selected using a systematic random sampling technique and the data was entered in SPSS version 23 for analysis. The validity and reliability of data was verified using the content validity index and the Cronbach alpha coefficient. For descriptive purposes, the researcher used the mean and standard deviation to analyse the data. Data was tested for correlation to establish the association between the study variables. Using inferential statistics, the data was analysed for regression to establish the predictor power of variables on the outcome variable. The study findings demonstrated a significant correlation between Self-Induced Abortion, Socio-Demographic Factors, Reproductive Health Behaviours, and Abortions among women of reproductive age of (15-49) years. The regression results revealed that self-managed abortion, socio-demographic factors, and reproductive health behaviour significantly predict self-induced abortion among (15-49-year-old women at a 1% significance level. Factors like self-induced abortion, socio-demographic factors, and reproductive health behaviour account for 44.8% of Self-induced abortion among (15-49) year old women, while other factors account for 55.2%. The study recommends that Health educators should collaborate with community leaders to educate women aged 15-49 on self-management techniques, contraceptive access, and reproductive health rights. They should lobby for financial aid for abortion services, advocate for flexible work hours and paid leave, and implement comprehensive sexual health education programs. Regular health check-ups can help address misconceptions and promote safe practices.
Assessing Barriers and Facilitators for Contraceptive Utilisation Among Adolescent Girls and Young Women Aged (15-24 Years) in Kiyindi Town Council, Buikwe District
(Uganda Christian University, 2026-01-28) Alex K. Bahima
Introduction: The study focused on establishing Barriers and Facilitators for Contraceptive Utilization among Adolescent Girls and Young Women Aged (15-24 Years) in Kiyindi Town Council, Buikwe District. Specifically, to understand AGYW perceptions of family planning access and utilization, explore barriers for family planning use among adolescent girls and young women and to understand facilitators for family planning use among adolescent girls and young women. Methods: The study adopted a narrative research design while applying qualitative methodologies. The study interviewed 40 adolescent girls and young women and 10 Key Informants as the sample size that were selected using purposive, snow ball and convenience sampling. Data was collected using interview Method and focus group discussion. The researcher used NVivo software and thematic analysis where the interview responses were transcribed, sorted, classified into themes and categories in order to answer the pertinent research questions. Results/Findings: The study found out that AGYW perception and attitude towards contraception is generally good. Some AGYW use herbs, while others take pills, and others use monthly injectable contraceptives (Depo-Provera). Another section of AGYW use implants while a cross-section of other AGYW use condoms majorly provided by their male counterparts. This implies that at least the majority AGYW have access to their preferred contraceptive methods and the ability to determine if, when and how often to reproduce. However, the study also found out that culture influences the usage of family planning because large families are still valued, and the use of contraception is viewed as contrary to these norms. Economic factors also influence the use of family planning and worse still, AGYW from especially lower-income families face barriers to accessing family planning services due to costs such as transport and cost of the method itself. The study also revealed that facilitators for contraceptive uptake in Kiyindi Town council among AGYW include individual factors like knowledge and perceived benefits, interpersonal factors such as partner/peer approval, and health system factors like accessibility and provider attitudes. Conclusion: Individual, interpersonal, community, and health systems factors all play a significant role in shaping contraceptive use. Understanding barriers and facilitators to contraceptive use among AGYW aged 15-24 is crucial for improving their reproductive health outcomes in Kiyindi Town council. Key words: Family planning, Adolescent girls and young women, access and Utilization.
Substance Use Among Students at the Kampala Campus of Uganda Christian University
(Uganda Christian University, 2025-10-20) Nakiwala Lillian
Substance use among the youth is a major public health problem facing the world today. The WHO statistics report of 2023 showed that the per capita consumption of alcohol in Uganda was 12.21litres of alcohol per year. This is much higher than the African region average consumption of 6.3 litres and the global average of 6.18litres of alcohol per person per year. Furthermore, the national referral hospital Butabika showed that 40% of all its hospital admissions were related to drug use with over 35% of its clients from tertiary institutions. Of the 35%, college and university students are the bigger proportion of substance use. Although substance use is a growing problem in institutions, there is limited information about its magnitude and the predisposing factors. This study sought to examine the prevalence and determinants of substance use among students at Uganda Christian University Kampala campus Methods-A quantitative cross-sectional study was used to collect data from 300 respondents between the ages of 18 and 30 years. Sample size was determined using Krejcie and Morgan 1970 formula for cross- sectional studies. A multi-stage sampling technique was used to determine the study participants. The data was analyzed using SPSS version 26 Results- The findings revealed that the overall prevalence for substance use among students at Uganda Christian university at Kampala campus was 91.3% and among the factors influencing substance use; peer pressure was ranked highest followed by recreation or source of enjoyment. Escape from stress related factors was also mentioned as one of the other factors that attributed to substance usage. Alcohol was the major substance used followed by cigarette smoking and marijuana. Conclusion. The study concluded that it was clear that a greater proportion of students in the sample, (91.3%) used substances and that the respondents who had friends that used substances were more likely to use or start using. This implies that peer influence and socio influence were among the major factors influencing substance use among students.
Family Planning Uptake Among Female Sex Workers in Kawempe Division Kampala
(Uganda Christian University, 2025-10-23) Berina Kamahoro
Introduction The study aimed to investigate the factors associated with Family Planning uptake among Female Sex Workers of reproductive age (15-49 years) in Kawempe division. The study objectives were; 1)to assess the proportion of FSW utilizing Family Planning in Kawempe Division, 2) to determine factors affecting utilization of Family Planning among commercial sex workers in Kawempe Division, and 3) to explore barriers to utilization of Family Planning among female commercial sex workers in Kawempe Division. Method The study adopted a descriptive and correlational research design with both qualitative and quantitative data collection method. A total of 334 commercial female sex workers were randomly selected from the community. Data was collected using a pretested questionnaire, and administered by the research assistant that were trained to conduct this survey. Qualitative data was collected from 5 key informant interviews. Quantitative data were analyzed using logistic regression to establish factors affecting uptake of Family Planning. Results The findings indicated that out of 332 respondents, 251 (75.6%) of them reported that they were currently using family planning, majority 120(47.8%) reported using condom, followed by 91(36.2%) of the respondents who reported using injecta plan The multivariate logistic regression analysis reveals , age(AOR=4.6; 95% CI: 1.22- 7.12; p= 0.000),, marital status (AOR=0.8; 95% CI: 1.44- 8.09; p= 0.002), educational level(AOR=4.6; 95% CI: 0.01- 8.67; p= 0.001),, distance to the facility(AOR=6.2; 95% CI: 1.73- 9.85; p= 0.002), reasons for not using family planning(AOR=0.8; 95% CI: 1.80- 4.43; p= 0.000),and waiting time at the facility(AOR=5.2; 95% CI: 2.06- 9.88; p= 0.000), independently influenced the uptake of family planning among female sex workers. P-value <0.05 The barrier to family planning among were fear of health risks like cancer, stigmatization from health professionals, lack of knowledge about service locations, time constraints, and financial issues among others Conclusion This study established that the uptake of family planning among female sex workers stood at 75.6%. This below the target considering the fact that it is expected that 100% of female sexworkers should be on some family planning method. Female sex workers experience exclusion in utilizing reproductive healthcare services. As such, healthcare services are advised to adopt a nonjudgmental approach, to enhance physical accessibility and to train nurses and other healthcare professionals on reproductive health needs of female sex workers.
Uptake, Perceptions and Associated Factors on Premarital Sickle Cell Trait (Sct) Testing Services Among Married Individuals in Mityana Municipality, Mityana District
(Uganda Christian University, 2025-09-29) Nalweyiso, Martha Dorcas
Introduction: Sickle Cell Disease (SCD) is one of the biggest health challenges worldwide. The greatest burden exists in Sub-Saharan Africa, where 75% of the world's SCD occurs. Preventive approaches include screening couples intending to have children by inexpensive and reliable blood tests in addition to genetic counselling. However, there is a lack of information about the adoption of these approaches to aid in creating meaningful, tailored interventions. Objective: To determine the uptake of premarital sickle cell trait testing, explore the perceptions and associated factors among married individuals in Mityana Municipality, Mityana District. Methods: A convergent parallel mixed-methods design was employed. The quantitative component employed a cross-sectional design, involving 272 consecutively sampled married individuals who had married between January 2023 and December 2024. Uptake was summarised as a proportion, along with its associated 95% confidence interval (95% CI). Mixed effects modified Poisson regression (with robust standard errors) was used to determine the factors associated with the uptake of SCTT. The qualitative component employed an exploratory descriptive design using in-depth interviews with 17 purposively selected married individuals. The data was analysed using deductive thematic analysis. Results: The uptake of SCTT identified among the married individuals was 14.71% (95% CI: 9.03-23.04). Multivariable analysis results revealed that, age of 18-30 years (adjusted prevalence ratio (aPR): 1.23, 95%CI: 1.08-1.40, P=0.004), being Muslim (aPR: 1.10, 95% CI: 1.07-1.14, P<0.001), a family history of SCD (aPR: 1.17, 95% CI: 1.07-1.27, P=0.001) and not attending antenatal (ANC) visits (aPR: 0.92, 95% CI: 0.86-0.98, P=0.009). Qualitative findings revealed perceptions around SCTT, i.e. perceived barriers highlighting health care and socio-cultural issues hindering testing, perceived benefits highlighting socio-cultural issues favouring testing, perceived severity highlighting especially around the presentation of SCD, perceived susceptibility highlighting the possible causes/transmission of SCD, perceived threats highlighting family issues around testing or SCD, and cues for action highlighting the concerns for improvement of SCT testing. Conclusion: The study revealed a low uptake of SCTT among married individuals living in Mityana Municipality, Mityana District. Younger age groups, being Muslim, a family history of SCD and attending antenatal care visits were associated with better uptake rates. The perceptions are multifaceted, highlighting that complex patterns influence the uptake of the test. These findings highlight the need for community sensitisation of SCT testing, improve awareness among religious leaders, improve access to sickle cell testing facilities, and emphasise the need for premarital SCTT during hospital and church marriage counselling.
Knowledge,Attitude and Uptake Levels of Hepatitis b vaccination among boda-boda riders in Goma subcounty, Mukono District
(Uganda Christian University, 2025-10-14) Namusubo Walyomu Angel Barbara
Globally, hepatitis B affects 240 million people. Each year an estimated 650 000 people die from hepatitis B-related liver disease or liver cancer. It is endemic in much of the developing world, where between 8 and 10 per cent of the population are infected. In most developed countries the prevalence is much lower (less than 1 per cent) and the risks of transmission tend to be restricted to particular groups where exposure to blood is likely. It has caused epidemics in parts of Asia and Africa. Hepatitis B is endemic in China and in various parts of Asia. Methods: A cross-sectional survey design was employed in the study, the population consisted of registered Boda-boda Riders that operate in Goma Division. The sample was reached at using Yamanes formula, and multistage sampling including cluster and simple random sampling were used pick bodaboda participants. The study used the questionnaire survey method for data collection, and data was analysed at a univariated level. Respondents were considered to have adequate knowledge on the HBV infection if the mean percentage scores is ≥50% and poor knowledge if the mean percentage score is below ≤50%. For attitude, the rating was as follows; ≤50% indicated negative attitude, ≥50 signified positive attitude. Likewise, perception was measured as follows; ≤50% indicated poor perception whiles ≥50 signified good perception (Likerts scale). Results: Most of the respondents were aged between 30 and 40 years (52.6%), while the youngest group, those under 25, made up the least (1.3%). When it came to worship attendance, over a third (34%) reported attending once a week. Out of the 154 respondents, only 39.6% reported having received the vaccine, while the majority (60.4%) had not been vaccinated at all. Among those who had been vaccinated, half (50%) had completed all the recommended 3 doses. While 59.5% of the respondents had heard of Hepatitis B, a significant proportion (34%) had never heard of it. Misconceptions were commonfor instance, 58.4% believed the infection could be spread through the air, and 63.6% thought it could be contracted by sharing utensils like spoons or bowls. Although just under half (49.4%) had heard of the vaccine before, a big majority (81.2%) agreed that even healthy individuals need vaccination. Encouragingly, 92.2% expressed willingness to get vaccinated, and 80.5% were open to being tested for the virus. Conclusion: The study found a generally low uptake of the Hepatitis B vaccine among Boda-Boda riders in Goma Division, with only 39.6% of respondents reporting having received at least one dose, and just 50% of these completing all three recommended doses. This highlights a concerning gap in protection among a population frequently exposed to health risks.
Exploring Community Knowledge, Attitudes and Perceptions Towards Cerebral Palsy Family Rehabilitative Services in Kawempe Division, Kampala
(Uganda Christian University, 2025-10-03) Nakalembe, Ruth
ABSTRACT Background: Cerebral palsy (CP) is a leading cause of childhood disability worldwide, with a disproportionate burden in low-resource settings. In Uganda, research has largely focused on the clinical aspects of CP, with limited attention to community knowledge, perceptions, and barriers to rehabilitation, particularly in urban informal settlements. This study explored community knowledge, attitudes, perceptions, and challenges in accessing family-directed CP rehabilitation services in Kawempe Division, Kampala. Methods: A cross-sectional mixed-methods study was conducted among 306 community members. Quantitative data were collected using structured questionnaires and analyzed descriptively and through regression modeling to determine predictors of CP knowledge. Qualitative data were generated from eight focus group discussions and five key informant interviews with community residents, caregivers, health workers, and opinion leaders. Thematic analysis was performed, and findings were triangulated to enhance interpretation. Results: Of the 306 participants, 57% (174/306) had ever heard of CP. While 73% (223/306) recognized mobility challenges as symptoms, only 42% (128/306) correctly identified CP as a neurological condition, and none mentioned physiotherapy as part of management. Knowledge was significantly higher among older participants, those with higher education, and those who personally knew a family with a child with CP (AOR = 6.0, 95% CI: 3.6–10.0, p < 0.001). Community attitudes showed limited acceptance: only 44% (134/306) felt comfortable interacting with individuals with CP, and 30% (92/306) would object to their child playing with a child with CP. Stigma was reinforced by misconceptions, with 22% (67/306) perceiving CP as a curse. Despite this, 86% (263/306) recognized rehabilitation as very important, and nearly all (98%, 300/306) emphasized the need for healthcare worker training in CP care. Access to services was constrained by financial costs (73%), lack of awareness (62%), stigma (51%), and transport barriers (41%). Qualitative narratives underscored affordability struggles, reliance on traditional healers, and limited community support. Conclusion: Awareness of cerebral palsy in Kawempe Division remains limited, with misconceptions and stigma continuing to shape community attitudes. Access to rehabilitation is further constrained by financial, informational, and service-related barriers. Strengthening community education, enhancing healthcare worker training, and expanding affordable, community-based rehabilitation services are critical to promoting inclusion and improving the quality of life for children with CP and their families in urban Uganda.
Predictors and Barriers to Family Planning Access Through Pharmacies and Drug Shops Among Young Women 15 – 24 Years in Nsangi, Wakiso
(UGANDA CHRISTIAN UNIVERSITY, 2025-10-08) Damalie Bajunga Nabweteme
Background: Pharmacies and drug shops provide a unique opportunity for expanding FP access to adolescent girls and young women (Gonsalves et al., 2023), however there are still obstacles to access FP services through these outlets. The objective of the study was to understand the predictors and barriers to accessing FP services through pharmacies and drug shops among AGYW 15–24 years in Nsangi, Wakiso District. Methods: This was a cross-sectional mixed methods study, where both quantitative and qualitative techniques were used to collect data to understand the level of access to FP, the predictors and barriers to accessing FP services through pharmacies and drug shops. AGYW aged 15 -24 years were selected using a simple random sampling technique and the key informants were purposively selected. Structured questionnaire was used to collect quantitative data while Key informant interview (KII) guide was used to collect qualitative data. Qualitative data was analyzed using STATA version 15 while the qualitative data was analyzed manually using thematic analysis. Results: 384 AGYW participated in the study. The mean age was 20.74, about 41.7% were aged 22-24years while 17% were aged between 15-18 years. 65.4% had access to FP, however, those aged between 22–24 years were 5.6 times more likely to access FP services compared to those aged 15–18 years (AOR = 5.6, 95% CI: 1.79–17.38). AGYW who didn’t find privacy at the point of access were 53% less likely to access the FP services as compared to those who found privacy [C0R = 0.47] 95% CI (0.11, 1.83)]. Those whose culture did not accept the FP use were 44% less likely to access the FP as compared to those whose culture accepted it [C0R = 0.44] 95% CI (0.14, 1.87)] Conclusion. Age and being sexually active were key predictors of access to FP, while cost of contraceptives, lack of privacy and cultural unacceptance were key barriers to accessing FP services through pharmacies and drug shops among young women.
The Determinants of Nutritional Status among young pregnant mothers attending selected public health facilities in Iganga
(Uganda Christian University, 2025-10-02) Lunkuse Arnetia Patience
ABSTRACT Background: Inadequate nutritional status among young expectant mothers in rural settings like Iganga are critical issues for public health which has negative impact on maternal and child health. This study aimed to identify the determinants influencing the nutritional status of young pregnant mothers aged 24 years and below who are attending selected public health facilities in Iganga, Uganda. Methods: This was a decretive cross sectional mixed study. A semi structured questionnaire was used to collect data from 273 young pregnant women who were sampled using a simple random sampling method. Qualitative data was collected from health workers, village leaders and a small number of young pregnant women. Principles of saturation were followed for qualitative component. Quantitative data was analyzed using SPSS and thematic analysis was done for the qualitative component. Results: 26.7% of the participants had poor nutrition status. The significant factors at multivariate analysis were practices done when planning to conceive such as fitness (AOR=0.3, 95% CI [0.08-0.83], p=0.023), number of children (AOR=0.7, 95% CI [0.36-1.38], p=0.002), level of education (AOR=0.5, 95% CI [0.23-105], p=0.000), skipping meals (AOR=1.2, 95% CI [0.67-1.98], p=0.004) and use of herbal products due to cultural taboos (AOR=0.7, 95% CI [0.39-1.28], p=0.051). From qualitative data, the identified factors were; relying on certain types of foods due to poverty, inadequate food, eating on certain kind of foods that lack nutrition values, feeling sick to cook and being neglected by their husbands. Conclusion: This study found a high prevalence of poor nutrition status among young pregnant women. The significant factors included smoking practices, having many children, skipping meals, level of education, use of herbal medicine, poverty and lack of support from husbands. Recommendations: Husbands and family members should provide adequate support to pregnant women such as assistance in provision of funds and house chores when weak.
Exploring Community Knowledge, Attitudes and Perceptions Towards Cerebral Palsy Family Rehabilitative Services in Kawempe Division, Kampala
(Uganda Christian University, 2025-10-03) Nakalembe, Ruth
Background: Cerebral palsy (CP) is a leading cause of childhood disability worldwide, with a disproportionate burden in low-resource settings. In Uganda, research has largely focused on the clinical aspects of CP, with limited attention to community knowledge, perceptions, and barriers to rehabilitation, particularly in urban informal settlements. This study explored community knowledge, attitudes, perceptions, and challenges in accessing family-directed CP rehabilitation services in Kawempe Division, Kampala. Methods: A cross-sectional mixed-methods study was conducted among 306 community members. Quantitative data were collected using structured questionnaires and analyzed descriptively and through regression modeling to determine predictors of CP knowledge. Qualitative data were generated from eight focus group discussions and five key informant interviews with community residents, caregivers, health workers, and opinion leaders. Thematic analysis was performed, and findings were triangulated to enhance interpretation. Results: Of the 306 participants, 57% (174/306) had ever heard of CP. While 73% (223/306) recognized mobility challenges as symptoms, only 42% (128/306) correctly identified CP as a neurological condition, and none mentioned physiotherapy as part of management. Knowledge was significantly higher among older participants, those with higher education, and those who personally knew a family with a child with CP (AOR = 6.0, 95% CI: 3.6–10.0, p < 0.001). Community attitudes showed limited acceptance: only 44% (134/306) felt comfortable interacting with individuals with CP, and 30% (92/306) would object to their child playing with a child with CP. Stigma was reinforced by misconceptions, with 22% (67/306) perceiving CP as a curse. Despite this, 86% (263/306) recognized rehabilitation as very important, and nearly all (98%, 300/306) emphasized the need for healthcare worker training in CP care. Access to services was constrained by financial costs (73%), lack of awareness (62%), stigma (51%), and transport barriers (41%). Qualitative narratives underscored affordability struggles, reliance on traditional healers, and limited community support. Conclusion: Awareness of cerebral palsy in Kawempe Division remains limited, with misconceptions and stigma continuing to shape community attitudes. Access to rehabilitation is further constrained by financial, informational, and service-related barriers. Strengthening community education, enhancing healthcare worker training, and expanding affordable, community-based rehabilitation services are critical to promoting inclusion and improving the quality of life for children with CP and their families in urban Uganda.
Prevalence and Determinants of Anemia among Reproductive-Age Women Who Delivered by Cesarean Section in Uganda: Evidence from the 2022 Uganda Demographic and Health Survey
(Uganda Christian University, 2025-09-24) ITHUNGU MARTHA
Anemia among women with previous C-section delivery significantly impacts on their health outcomes, particularly in countries like Uganda, where maternal healthcare disparities and food insecurity persist. This study examined the prevalence and determinants of this public health burden among C-section women age 15-49 years in Uganda, focusing on socio-demographic, obstetric, maternal, nutritional and preventive factors. While employing the modified Poisson regression model, the study utilized a cross-sectional secondary data of 1,066 women who had C-Section from the Uganda Demographic and Health Survey (UDHS) 2022 to examine the determinants of anemia among these women. The findings were reported as adjusted Risk Ratios (aRR) with the 95% Confidence Intervals (CI). The results show that about one in ten women who had a C-section were affected by anemia. The multivariable modified Poisson regression identified significant associations between anemia and place of residence, household size, deworming treatment, and birth interval. Specifically, C-section women living in rural residents (aRR 0.957; 95% CI: 0.917 – 0.999), those in households with less than five people (aRR 0.961; 95% CI: 0.924 – 1), and women who did not deworm (aRR 0.947; 95% CI: 0.908 – 0.986) had lower risk while those with birth intervals of less than two years (aRR 1.040; 95% CI: 1.003 – 1.078) had a higher risk of being anaemia. These findings indicated relatively high anemia among C-section women, underscoring the need for implementation of programs such as nutritional counseling, routine anemia screening, consistent supply of iron supplements to help replenish lost nutrients thus enhancing better health outcomes. Family planning initiatives may also help educate women on the value of adequate child spacing. The paradoxical finding that not taking deworming treatment lowers the risk of anemia, underscores the need for further research to explore this relationship.
Compliance to Hand Hygiene Among Healthcare Workers in Maternity Wards in Comprehensive Emergency, Obstetric and New-Born Care Health Facilities in Lira City and Lira District, Uganda
(Uganda Christian University, 2025-08) Rotich, Leonard
This study examined compliance to hand hygiene among healthcare workers in maternity wards in Lango subregion, Uganda, where maternal and neonatal mortality remains high, with sepsis being one of the major contributors. Sepsis is often caused by infections spread via healthcare workers’ hands. Despite hand hygiene being a simple, cost-effective preventive measure, adherence remains low globally, especially in low-income settings. This mixed-methods cross-sectional study was conducted in CEmONC facilities in Lira City and Lira District. Quantitative data were collected by observations of compliance with the WHO's five moments of hand hygiene, and a checklist to assess availability of hand hygiene resources. Qualitative insights were gathered from interviews of health workers on drivers of compliance. Hand hygiene compliance was suboptimal at 54%, and varied significantly by facility level (p<0.001), facility ownership (p=0.005) and indication (p<0.001). While 83% of the facilities had at least one functioning handwashing facility, only 67% had alcohol-based hand rub (ABHR), with postnatal rooms particularly under-resourced. Key drivers of compliance included both health system factors: availability of supplies, workload and staffing and individual/organizational factors: knowledge and awareness, perceived risk and procedure type, reminders at workplace, monitoring and institutional support, being watched, attitude and beliefs, and hypersensitivity to soap or ABHR. Recommendations include: ensuring consistent supply of hand hygiene materials, particularly in postnatal wards, providing regular training and mentorship, enhancing monitoring and accountability, improving visibility of hygiene protocols, addressing staffing shortages, and conducting further research on adherence to proper hand hygiene techniques.
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
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.
Uptake of Cervical Cancer Screening Services Among Women Aged 25-49 Years: A Cross-sectional Study at Kidera HC IV
(Uganda Christian University, 2025-05-30) Christine Gwokyalya
Introduction: Cervical cancer has been noted as a major public health concern especially in developing countries. This indicates that there is need for more efforts in the developing countries like Uganda to prevent cervical cancer among women. Therefore, there is need to establish more evidence on the uptake of cervical screening uptake to facilitate the development of informed cervical prevention intervention with the country. Objective of the study: This study aimed at determining uptake of cervical cancer screening services among women aged 25-49 years; across sectional study at Kidera HC IV. Methodology: This study was conducted at a facility and used both qualitative and quantitative research methods. Quantitative data was collected through interviewer-administered questionnaires, while qualitative data was gathered through key informant interviews. The data was analyzed using descriptive statistics at the univariate analysis stage. The participants selfreported their uptake of cervical cancer screening services. Factors influencing the uptake of cervical cancer screening services among women aged 25-49 years were determined using binary logistic regression at the bi variate analysis stage. A multiple logistic regression model was then used to account for any confounding factors at the multivariate analysis stage. The qualitative data was analyzed using thematic analysis. Results: The uptake of cervical cancer screening services among women aged 25-49 years was 60%, with 55% having been screened 2-3 years ago from the time of the study. Factors positively associated with uptake included being a Seventh-day Adventist (SDA), having a mother as the decision-maker at home, receiving quality services at the health facility, and having high knowledge about cervical cancer. However, having a business occupation was negatively associated with uptake (P<0.005). Challenges limiting access to screening services included inadequate skilled health workforce, shortages of medical supplies, lack of awareness, unwillingness to be screened, and poor community attitudes. Conclusion: Though the uptake of cervical cancer among women aged 25-49 years was high, more interventions including sensitization and lobbying for medical supplies are needed to address most of the challenges that limit the uptake of cervical cancer screening services among women.
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.

Browse

Recent Submissions