Masters of Public health

Permanent URI for this collection

https://hdl.handle.net/20.500.11951/1046

Browse

Recent Submissions

Now showing 1 - 5 of 12
  • Thumbnail Image
    Item
    Experiences of Nurses in the Management of Patients Presenting With Kala-Azar at Amudat Hospital, Amudat District
    (2024) Daniel Powon Kalepon
    Introduction: Visceral leishmaniasis (VL)/Kala-azar continues to be one of the neglected tropical diseases (NTD) of public health threat. The experiences of nurses in the management of the increasing cases of VL infection remains not well understood. The overarching aim for this study was to understand the nurses’ experiences in management of Kala-azar as an effort to design strategies to alleviate gaps and ensure quality healthcare to patients at Amudat hospital. Methods: We conducted a phenomenological study amongst nurses. We collected nurses’ experiences in terms of; motivators, attitudes, skills, knowledge, and policies in the management of Kala-azar patients through in-depth interviews. Data was analysed thematically using Atlas ti, version 8. Major themes of the findings were recorded. Results: Nurses’ exhibited good clinical practices, positive motivation, used updated case management guidelines, had continuous professional development, received medical supplies, exhibited professionalism and teamwork, and there was Community surveillance for VL. However, they noticed Knowledge gap among patients, inadequate infrastructure, high staff Workload, delayed payments, and little close monitoring. Conclusion: The experience and training of nurses is critical in the management of VL. Nurses have considerable knowledge and skills in the management of VL at Amudat Hospital. Nurses face challenges in management of Kala-azar patients including finances, human resource gap, infrastructure, and patients’ knowledge gap about Kala-azar infection. Recommendations: Nurses’ experiences show potential for elimination of the Kala-azar infection in Amudat. We recommend the Uganda’s Ministry of Health to accelerate measures to eliminate VL such as; community sensitization about Kala-azar, training traditional herbalists on case definition for Kala-azar infection, construct large Kala-azar ward, recruit more staff, and improve the payment schedules for nurses at Amudat hospital.
  • Thumbnail Image
    Item
    Factors Associated With Men’s Level of Awareness of Obstetric Danger Signs, Birth Preparedness and Complication Readiness in Mparo Town Council, Rukiga District
    (2024-04-16) Anne Kikundwa
    Background: Child birth is a special moment for parents, families and communities but also a time of intense vulnerability . (Wassihun and Zeleke, (2018) .In many developing countries including Uganda, maternal morbidity and mortality still pose a substantial burden. Raising awareness of men about the danger signs of pregnancy and childbirth is the first essential step in appropriate and timely obstetric care . (Bogale, D., Markos, D. 2015). Awareness of obstetric danger signs facilitates men in making a joint decision with their partners regarding accessing antenatal and delivery care.. Men play a central role in deciding and influencing positive actions to support their spouses during pregnancy, labour and delivery (August, F., Pembe, A. B., Mpembeni, R., Axemo, P., & Darj, E. (2015) Objective: This study aimed at determining factors associated with men's level of awareness of obstetric danger signs, birth preparedness and complication readiness in Mparo Town Council, Rukiga district. Methodology: This was a cross sectional study that enrolled 384 eligible husbands to women that delivered within the past one year from Mparo health centre IV, in Mparo Town Council, Rukiga District, Uganda. The men were interviewed using a structured English questionnaire (also translated in Rukiga) with closed and open ended questions. Systematic random sampling method was used to select the men to be interviewed. Descriptive and inferential analysis was done and associations between independent and dependent variables were computed. Results: Of the 384 men who were interviewed, 365 (95%) had attended ANC with their spouses at least once and 226 (59%) made four or more visits. Mean age was 26.8 and majority had two or more children. Awareness of danger signs was low 119(31%); commonly mentioned danger signs were vaginal bleeding 311 (81.2%), swelling of fingers, face and legs 177 (46.3%) and severe headache with blurred vision 167 (43.6%). In bivariate analysis age, education and occupation were associated with awareness on obstetric danger signs, birth preparedness and complication readiness (P≤0.05). In multivariate logistic regression, age and occupation were statistically significant associated with awareness of obstetric danger signs. Being older in age was eight times more likely (OR 8.1; CI 1.6- 42) to have an influence on awareness of obstetric danger signs compared to young ones (≤20 years); self-employed men were two times more likely (OR=1.9; CI; 1.1-3.3) to have awareness on danger signs compared to being employed. Of the 69 (17.9%) men who reported a danger sign in the last wife’s pregnancy, 51 (75 %) took appropriate health seeking action. Conclusion: Awareness of obstetric danger signs, birth preparedness and complication readiness is low. Key words: awareness, Danger signs, Pregnancy, Birth preparedness, Complication readiness, Health seeking actions
  • Thumbnail Image
    Item
    Factors Associated With Viral Load Nonsuppression Among Children and Adolscents Living With HIV Enrolled to the Orphans and Vulnerable Children Program at the Mildmay Center of Excellence in Wakiso District
    (2024-04-17) Sarah Namutosi
    Introduction This study was to determine the prevalence and factors associated with viral load non-suppression among children and adolescents orphan and vulnerable children program at MildMay center of Excellence. The study specifically sought to determine the prevalence of viral load non-suppression among children and adolescent enrolled on to the OVC program at Mild May center of Excellence in Wakiso, to explore the individual factors associated with VL non-suppression among children and adolescents enrolled on to the OVC program at Mild May center of Excellence in Wakiso and to determine the treatment-related factors associated with VL non-suppression among children and adolescents enrolled on to the OVC program at Mild May center of Excellence in Wakiso. Method This was across-sectional study design that employed both qualitative and quantitative methods. A total of 219 children and adolescent were enrolled in the study. Data was collected using a questionnaire and key informant interview guide. The data was then analyzed at univariate, bivariate and multivariate level using SPSS version 20. Results Majority 83(37.9%) of the respondents were aged 10-14 years. With the mean age being 9yrs. At bivariate level of analysis age (X2=12.671, df =3, P-value=0.001), sex (X2=17.04, df =1, P-value=0.000), residence (X2=9.87, df =1, P-value=0.002), educational level (X2=11.31, df =3, P-value=0.001), duration on ART, (X2=8.17, df =2, P-value=0.001) and starting regimen (X2=14.67, df =1, P-value=0.000), adherence (X2=19.56, df =3, P-value=0.000) and disclosure status (X2=11.60, df =1, P-value=0.001) were significantly associated with viral non suppression among children and adolescents enrolled on to the OVC program P-value <0.05. At multivariate level, sex (AOR=2; 95% CI: 1.321- 2.048; p= 0.000), starting regimen (AOR=5; 95% CI: 1.895- 2.833; p= 0.003), adherence (AOR=6; 95% CI: 1.620- 1.901; p= 0.000) and disclosure (AOR=0.6; 95% CI: 1.461- 1.986; p= 0.002) were independently associated with viral non-suppression among children and adolescent enrolled on to the OVC program at Mild May center of Excellence in Wakiso Conclusion The study found out that the prevalence of non-suppression among children and adolescent enrolled on to the OVC program at Mild May center in Wakiso stood at 17.4%. this prevalence is higher than the UNAIDs 10%, and therefore directly affects the 3rd 95 in the UNAIDS 95,95, 95 targets. It can also be concluded that there are individual and treatment related factors that are associated with viral non-suppression among children and adolescent enrolled on to the OVC program as shown in the results above Recommendations Practitioners therefore should targeted mass campaign and sensitization to both care givers and clients on the effects of having a high viral load, there should be a deliberate effort by health workers at Mild May to address barriers to good adherence with ultimate aim of improving on the virological outcome, deliberate efforts on supported disclosure to children and adolescents twelve years and above and Continuous medical education and skilling of health care workers by the program on ART optimization for children and adolescents. Policy makers at ministry of health to enforce proper management of non-suppressors with emphasis on the male child and strengthen strategies on monitoring of non suppressed children and adolescents at all levels
  • Thumbnail Image
    Item
    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.
  • Thumbnail Image
    Item
    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.