Masters of Public health

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

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Assessing the Knowledge Towards Hepatitis B Virus Among Pregnant Women Attending Antenatal Clinic at Queen Elizabeth Central Hospital, Malawi
(Uganda Christian University, 2025-04-24) Theu Andrew Samuel
Hepatitis B Virus (HBV) remains a major public health concern in Malawi, particularly among pregnant women due to its potential for vertical (mother-to-child) transmission. This study assessed knowledge related to HBV among 369 pregnant women attending antenatal care at Queen Elizabeth Central Hospital in Blantyre. Knowledge scores were used to categorize respondents into two groups: those with adequate knowledge (answered more than 5 questions correctly) and those with poor knowledge (answered 5 or fewer correctly). While 60.2% of the participants had heard of HBV, only 25.5% correctly identified it as a virus. This indicates that general awareness did not always correspond with scientific understanding. Many participants lacked clarity on HBV’s classification and transmission pathways—49.3% were unsure whether it is caused by a virus, and 54.7% were unaware of its viral nature. Knowledge of transmission routes was equally inconsistent. Only 17.9% believed it could be transmitted through casual contact, while 42.5% acknowledged the possibility of infection through an infected husband. Meanwhile, just 45.3% were aware of mother-to-child transmission during childbirth. Although more than half (53.4%) recognized the preventive role of the HBV vaccine, misconceptions around curability and risk persisted. About 50.7% believed HBV is curable, and only 33.3% acknowledged unsafe sex as a transmission risk. Furthermore, just 30.9% of respondents were aware that asymptomatic individuals can still transmit the virus. These knowledge gaps reflect limited understanding of key aspects that influence prevention and early detection. Statistical analysis revealed significant associations between knowledge levels and socio-demographic factors such as residence, education level, and income (p < 0.001). Women residing in urban areas or those with higher education and income levels were more likely to demonstrate accurate knowledge about HBV. These findings underscore the disparities in health literacy that may hinder public health efforts, particularly among rural and underserved populations. In conclusion, the study highlights a critical need for targeted educational interventions within antenatal care settings to improve HBV-related knowledge. By strengthening communication strategies and leveraging existing ANC touchpoints, healthcare providers can empower pregnant women with essential information, ultimately contributing to the reduction of HBV transmission and improved maternal and neonatal health outcomes.
Psychological Well-Being and Associated Factors Among Adolescent and Adult Mothers Between the Age of 10 to 49 Years In in Malongo Sub-county, Mayuge District
(Uganda Christian University, 2025-04-28) Senda Isaac
Introduction: Motherhood is a transformational adventure that brings happiness, difficulties, and significant transformations to a woman's existence. The study assessed the psychological well-being and associated factors among adolescent and adult mothers in Malongo sub-county, Mayuge district. Methodology: The study Employed a descriptive cross-sectional survey based on a quantitative approach to collect data from 356 mothers using a researcher-administered, structured questionnaire. Frequency tables were generated for the variables at the univariate level, and a chi-square distribution was employed at the bivariate analysis. Further, an ordered logistic regression was used to establish the factors that predicted psychological well-being. The analysis was significant at a 95% level of confidence. Results: Results indicated that the majority of the respondents were adult mothers (79.77%), with adolescent mothers comprising the remaining respondents (20.23%). The largest proportion (43.54%) were aged 20–29, over half (51.97%) were Basoga, the majority (52.81%) had completed primary education. At the bivariate level, there was a statistically significant relationship between Tribe (p=0.026), education level (p=0.012), religiosity (number of times one went to the mosque or church in a week) (p=0.016), employment status (p=0.011), Category of mother (p=0.024), Employment status of the husband (p = 0.008), monthly income of the husband (p=0.004), supportiveness of the husband (p=0.026), education level of the mother (p=0.003), people’s concern/interest in what one does (p=0.025), ease of accessing practical help (p=0.001 and psychological well-being. Further, mothers who were divorced, separated, and windowed, those who didn’t participate in women groups displayed diminished PWB in contrast to their counterparts who are married, participated in women groups respectively. Conclusion: A 20% prevalence for adolescent mothers underscores the urgent need for targeted interventions aimed at reducing adolescent pregnancies. Moreover, the disparity in PWB among adolescent and adult mothers calls for targeted mental health support. Key factors such as marital status, employment, education, and social support significantly influenced psychological well-being, suggesting that policies aimed at improving women's access to education, economic empowerment, and family stability can enhance maternal mental health
Prevalence and Factors Associated With Post Natal Health Care Services Utilisation Among Multiparous Women in Buyamba County, Rakai District Uganda
(Uganda Christian University, 2025-04-22) Nakayima Robinnah
The utilization of postnatal healthcare services in Uganda (49.6%) remains in the low as compared to the global World Health Organization recommendation. Mothers remain at a risk of developing complication as a result of low-rate postnatal care service utilization. This study's main goal was to evaluate the prevalence and risk factors for postpartum healthcare service use among multiparous women in Buyamba County, Rakai District. The study employed a community-based cross–sectional survey design based on a quantitative approach. Researcher administered structured questionnaires were used to collect data from 350 multiparous women in Buyamba county. The bivariate relationships between the covariates and postnatal care service utilisation were verified using the Chi-square test, and the factors predicting postnatal care service use were identified by multivariate logistic regression. Results indicated that; the majority of participants (30.8%) were in the 35–44 age range, more than half had completed primary school, over 38.6% were Anglicans, and 81.9% were married. The prevalence of PNC use at the time of study was 94.0% The major predisposing factors that significantly associated with postnatal care service utilization were; Being younger in age (aOR=1.959, 95%CI: 0.256 - 5.592), completing only primary school (aOR = 0.472, 95%CI: 0.091 - 2.467), not attending ANC (aOR = 0.128, 95%CI: 0.009 - 1.847), not hearing about PNC (aOR = 0.876, 95%CI: 0.175-4.395). The need factors associated with PNC use were; never spending money to access PNC (aOR = 1.453, 95%CI: 0.084 - 3.461), travelling more than 5 km to the facility (aOR = 0.722, 95%CI: 0.272 - 1.845) and having an illiterate husband (aOR = 0.822, 95%CI: 0.183 - 2.690). There is need to; strengthen health education, leverage media, and engaging communities to raise awareness, particularly among young mothers. Enhance accessibility through infrastructure, mobile clinics, and health workers, while addressing financial barriers with subsidized care and insurance, is crucial. Family engagement, women's empowerment, and integrating antenatal with postnatal care are vital for informed decision-making and equitable access.
Prevalence and Factors Associated With Substance Use Among Girls in Compassion International Aided Projects in Nakawa and Kawempe Divisions, Kampala District
(Uganda Christian University, 2025-04-22) Anyine Dianah
Introduction: The global burden of disease estimated that the world's top three killers were, in order, illicit substances, alcohol, and tobacco. Further predictions indicate that smoking tobacco will cause 1 billion deaths worldwide in the 21st century. In addition, it is predicted that the percentage of people who currently drink will increase from 47% in 2017 to 50%, while the percentage of people who abstain from alcohol will decrease from 43% in 2017 to 40% in 2030. Methods: The study used a cross-sectional survey, employing quantitative research. Simple random sampling was employed, identifying 367 young girls aged 13 to 22 who are supported in their school by the Compassion aided project in the Nakawa and Kawempe divisions who participated in the study. A structured questionnaire was developed and used in the study, it had closed-ended questions. Data was analyzed at three levels; univariate, bivariate and multivariate at a confidence level of 95%. Results: The results revealed that a significant proportion of respondents (55.86%) reported having used substances, with alcohol being the most commonly used substance (48.29%), followed by cocaine (11.22%). Substance use was more prevalent among older girls, particularly those above 18 years (64.76%) and among those with guardians or parents who used substances. Factors such as poor relationships with parents, peer influence, and lack of proper guidance were identified as contributing to substances use. Additionally, faith-based practices, such as regular church attendance, were associated with a lower likelihood of substance use. Statistical analysis confirmed significant associations between substance use and various demographic, familial, and religious factors Conclusion: In conclusion, the study reveals that substance use among girls is influenced by a combination of demographic, familial, and social factors. Older age, poor parental relationships, and exposure to substance use within the family significantly increase the likelihood of substance use. Peer influence and inadequate guidance also contribute to the problem. However, religious practices, particularly regular church attendance, emerge as protective factors, reducing the probability of substance use. These findings emphasize the need for targeted interventions that strengthen family bonds, provide proper guidance, and leverage the role of faith-based communities to mitigate substances abuse among girls.
Factors Associated With Underreporting in the Compassion Connect Health Management Information System Among Frontline Church Partners of Compassion International Uganda in the Central Region
(Uganda Christian University, 2024-10-04) Shellina Rwabyoma Abaho
Introduction: Health information reporting is fundamental in various organizations to ensure the smooth running of programs. Compassion International, a charity organization, employs a Health Management Information System to evaluate information such as medical incidence reporting and medical funds reimbursement requests. However, there has been a mismatch in reporting for the last eight years since the HMIS integration. The study aimed to explore the factors associated with underreporting medical incidents in Compassion Connect HMIS. Methods: A mixed methods study design with quantitative descriptive and qualitative methodologies was used to collect data among Central Region FCPS and key staff at Compassion’s National and Global levels. Key informant interviews were done with four key informants: two health specialists, one global health specialist, and one global health advisory team senior manager. The interviews were analyzed thematically using Atlas ti. Software. Descriptive statistics were used on categorical variables, while non-parametric tests were used to evaluate the Likert scale responses among 70 study participants. Likert Scale analysis and decisions of association were made based on the weighted mean of 2.78. Results: Considering a sample of 70 respondents, 46 were male (65.7%) while 24 (34.3%) were female. 58 (82.9%) participants were CDO-health professionals, while 9 (12.9%) were project directors and 3 (4.2%) occupied other roles. Most study participants 38 (54.3%) spent 1-5 years working at the FCP. 36 (51.4%) of the study participants never had a medical background, and over half of the study participants, 57 (51.4%), were ignorant about the FCP organizational policies, culture, and practices. HMIS complexity, Frontline Church Partner Procedures, National Procedures, Communication and feedback, and individual attitude were significantly associated with under-reporting with a mean value of 2.81, 3.84, 2.93, 3.26, and 3.23, respectively. Also, standardized indicators and training about Compassion Connect were significantly associated with underreporting. Conclusion: Developing the HMIS to capture the different information within Compassion International is vital in promoting evidence-based decision-making. Also, addressing the different factors leading to underreporting is vital in improving the data quality within the system, leading to better decision-making practices in the organization. Key Words: Health Management Information System, Compassion Connect, Data Quality, Underreporting.
Prevalence and Factors Associated With Road Traffic Accidents Among Boda-Boda Riders in Gulu City, Northern Uganda
(Uganda Christian University, 2024-09-28) Keneddy Chandiga
Background: Road traffic injuries pose a disproportionate public health threat in the low and middle-income countries like Uganda, with 85% of all the fatalities and 90% of all disability-adjusted life years lost reported. Road accidents in Uganda continue to increase and occur from different regions and towns across the country including Gulu city. Objective: The main objective of this study was to establish the prevalence, and factors associated with road traffic accidents among Boda-boda motorcycle riders in Gulu city, Northern Uganda. Method: A cross-sectional study utilizing quantitative methods of data collection. A total of 276 randomly selected boda-boda riders were interviewed from 78 Boda-Boda stages in Gulu city. A kobo collect software was used to collect data. Data was analyzed using Stata version 15 software. Logistic regression was used to determine the prevalence of RTAs and the associated factors and obtained adjusted odds ratios (aORs). Result: The study findings revealed that road traffic accident among the boda-boda riders in Gulu city is (64.1%) and Boda-boda riders carrying passengers and luggage (aOR = 4.5, 95% CI:3.2-6.3, p < 0.001), not owning motorcycles (aOR = 2.9, 95% CI: [1.2-4.8], p = 0.016), consuming alcohol before riding (aOR = 2.5, 95% CI:1.1-3.9], p = 0.042). answering phone calls while riding (aOR =2.2, 95% CI:1.3-3.6], p = 0.026) and not having licenses (aOR =1.72, 95% CI: 0.3 – 0.8] p=0.04) were significantly associated with Road Traffic accident. Conclusion The study reveals a high prevalence of road traffic accidents (RTA) among Boda-Boda riders in Gulu City, highlighting the need to implement multi-sectoral interventions aimed at changing riders’ behavior. Coordinated efforts should involve the government, law enforcement agencies, and regulatory bodies to strengthen the enforcement of policies that ensure safer road use. Additionally, continuous awareness campaigns and stricter monitoring of compliance with traffic regulations to improve road safety.
Determinants of Modern Family Planning Methods Utilisation Among South Sudanese Refugee Women Aged 15–49 Years in Kiryandongo Refugee Settlement
(Uganda Christian University, 2024-05-23) Estella John Kasiano Kitale
Introduction: This study explored factors that influenced uptake of modern contraceptives among the group of South Sudanese refugee women of childbearing age in Kiryandongo Refugee settlement. Methodology: An analytical cross sectional mixed study was carried out amidst 312 women of childbearing age by administering structured questionnaire from Kobo collect tool to them. Key informants were interviewed for the qualitative arm. Data collection was conducted from July to August 2023; STATA software version 14 was used for analysis and thematic content analysis. Results: The study revealed that 22.1percent of the South Sudanese women of childbearing age used contraceptives methods. Tribe, monthly income of the respondents with [P-value, 0.001)], and [P-value (0.003)] respectively were found to be individual factors related to usage. Availability of the services [P-value (0.035) <0.05)], women who discuss with partners about modern FP [P-value (0.005) <0.05)], self-decision making for the FP method used [P-value (0.023) <0.05)], comfortability with the FP service delivery environment [P-value (0.002) <0.05)] were the respondent and health facility determinants associated with current uptake of the modern contraception method. Conclusions: our findings show a low uptake of modern contraceptive methods amongst South Sudanese women of childbearing age as compared to the current contraceptive use in Uganda which is 38% (UDHS, 2022). Recommendations: There is need to improve the outreaches within the settlement to give more information about the usefulness of FP also and provide FP services. Implement Counselling for refugees within the camp to encourage good decision making on uptake.
Satisfaction With Clinical Care and Associated Factors Among Palliative Care Patients at Bukavu Provincial General Reference Hospital, Democratic Republic of Congo
(Uganda Christian University, 2024-05-15) Guillain Lwesso
Background: Patient satisfaction is a vital indicator of quality of healthcare. This study assessed the level of patient satisfaction with palliative care services and associated factors among adult HIV-positive patients receiving palliative care services at HPGRB . Methods: A cross-sectional study enrolled 376 adult HIV-positive patients receiving palliative care at HPGRB using simple random sampling. A structured questionnaire assessed socio-demographics, health facility factors, and satisfaction using 18 Likert scale questions. Satisfaction was defined as a score above the median of possible scores. logistical regression was used to identified factors associated with satisfaction among patients receiving palliative care services. STATA v17.0 was used to analyze the data. Results: The satisfaction level was 59.3% (95% CI: 54.3, 64.2). Being female (aPR 2.0, 95% CI: 1.7, 2.9), employed (aPR 3.5, 95% CI: 2.1, 5.9), and aged ≥50 years (aPR 6.3, 95% CI: 2.5, 13.9) were associated with higher satisfaction. Being non-Catholic (aPR 0.4, 95% CI: 0.2, 0.6) and waiting >3 hours (aPR 0.5, 95% CI: 0.4, 0.6) predicted lower satisfaction. Conclusion: Satisfaction with palliative care at HPGRB is suboptimal. Targeted quality improvement initiatives focusing on waiting times, staff interactions, and expectations of non-Catholic patients could significantly improve satisfaction which would ultimately improve the quality of care.
Adolescent Sexual and Reproductive Health Needs and Services for In-School Deaf Adolescents in Uganda School for the Deaf and Mulago School for the Deaf
(Uganda Christian University, 2024-05-08) Dorothy Ajete
Sexual and reproductive health is a critical societal and personal concern; and this phenomenon strongly applies to the young population in the adolescent age bracket. Some of the common consequences of not managing adolescents sexual and reproductive health includes; early sexual encounters, teen age pregnancy, rape, defilement and others. Therefore, this study focused on SRH needs and services of in-school deaf adolescents. This study aimed at examining the various sexual and reproductive health (SRH) needs and services offered to in-school deaf adolescents in two deaf schools in Uganda. The researcher used a cross-sectional research design deploying a mixed method approach in collecting data. The total sample size was 136, of which115 deaf adolescents were surveyed, and 7 key informants were interviewed (2 head teachers, senior women, matron each and 1 senior male teacher). The study finding revealed that majority of the study respondents identified life skills, provision of school health program and sensitive counseling sessions as their preferred SRH needs; language barrier was cited as the biggest challenge in accessing SRH services. Provision of life skills coupled with counselling sessions will play a major role in enhancing the deaf adolescent’s self-esteem and their ability to utilize SRH services. As such the researcher recommends the deaf adolescents be given life skills, government and school administrations to commit to communicating SRH issues in ways understandable by the deaf, and parents to get involved in supporting their deaf children to learn more about SRH. Key Words: Sexual reproductive health, deaf adolescents, health services
Prevalence and Factors Associated With Use of Condoms Among Adolescents (Boys and Girls) in Selected Health Facilities in Amolatar District, Uganda
(Uganda Christian University, 2024-05-07) Jimmy Odongo
Condom use prevalence is a measure of number of times one uses condom during different sexual intercourse. In Africa condom is the main contraceptive use especially male condoms (about 70%). Several factors enhance use and there are also a number of factors that inhibit condom use among sexually active people including adolescents. This research determined condom use prevalence, factors that enhanced and inhibit condom use among adolescents in Amolatar district. A descriptive cross sectional research design was used; the study was conducted in four purposively selected sub-counties being mother sub-counties in Amolatar district. A total of 194 respondents were randomly selected, Descriptive statistics, Pearson chi-square tests and multivariable logistic regression were used to analyse data. Results indicate that users and non-users of condom differed in a number of socio-economic characteristics. Users were older, better educated and were manly boys. Multivariable logistic regression results indicate that, ease of access to condoms and affordability of condoms by adolescents enhanced the use of condom among adolescents. On the other hand, un-affordability of condom and reduction of sexual pleasure inhibited use of condoms. The prevalence of condom use in Amolatar among adolescents was found to be at 64%, however, there is need to increase it through advocacy
Factors Associated With Men’s Low Participation in Postpartum Family Planning at Kawolo Hospital, Buikwe District
(Uganda Christian University, 2024-05-02) Paddy Tumwesigye
Postpartum contraceptive use is not only important to reduce unintended pregnancies but also pregnancies that are too closely spaced. Male participation focuses on the involvement of males in at least one of the following activities: discussion or spousal communication, support approval, and contraceptive use of the Husband. The study assessed the factors associated with Low Participation of Men in Postpartum Family Planning in Kawolo Hospital, Buikwe District. The study employed an analytical cross-sectional study design involving collection of quantitative data with a sample of 371 study participants. Data was collected using questionnaires. The study employed Spss for data entry, cleaning and analysis. Out of the 371-sample size of the study, the response rate amounted to 350(94.4%). The study found out that Individual Factors associated with Men’s Participation in Postpartum Family Planning in reference to the expected number of children (2-4 children 57.1%), (64% were in a polygamous relationship) and respondents went to school was at 78%). Furthermore, male participation in postpartum family planning was substantially correlated with approval of family planning usage, understanding of family planning, and information source. Comparing respondents who permitted family planning usage at home to those who did not, it was found out that those who approved were more likely to utilize family planning services. The study concluded that the level of male Participation in postpartum family planning is low and there are some areas that need to be improved both by the government and other non-governmental organizations in trying to increase the postpartum family planning.
Factors Associated With the Low Utilization of Modern Methods Family Planning Services Among Women in Bumufuni, Manafawa District
(Uganda Christian University, 2024-04-30) Joyce Nekesa
This study assessed the factors associated with the low utilization of modern methods of family planning services among women of 18–39years in Bumufuni, Manafawa district, and specifically sought to establish the demographic factors associated with the low utilization of Family Planning services among women of 18–39 years, the Socio- cultural factors associated with the low utilization of Family Planning services among women of 18–39 years, and the health-related factors associated with the low utilization of Family Planning services among women of 18–39 years. Method: This was a cross sectional study design employing quantitative methods. A total 133 women aged 18-39 years were enrolled in the study. interviewer administered questionnaire was used to collect quantitative data from the respondents. Data was then analyzed at univariate, bivariate and multivariate level using SPSS version 20. Results: Majority 64 (48.1) of the respondents were aged 25-29years and 88(66.9%) of them were married. At bivariate level of analysis, age (X2=17.17, df =4, P-value=0.001),, educational level (X2=16.77, df =3, P-value=0.000), religion(X2=23.39, df =2, P-value=0.000), and occupation (X2=14.51, df =1, P-value=0.002), who makes decision on the type of family planning and number of children (X2=17.16, df =1, P-value=0.002), if the community have taboos about modern family planning methods (X2=13.13, df =1, P-value=0.001), and men’s feeling about family planning (X2=19.69, df =1, P-value=0.001), where to get family planning services (X2=12.33, df =1, P-value=0.003), distance to the nearest facility (X2=21.01, df =1, P-value=0.000), and waiting time (X2=19.80, df =2, P-value=0.001), were found to be statistically significant P-value<0.05 At multivariate level of analysis, age (AOR=1.8; 95% CI: 1.23-3.10; p= 0.002), educational level (AOR=0.3; 95% CI: 1.12-2.04; p= 0.000), religion (AOR=4.3; 95% CI: 1.08-5.66 p= 0.000), decision about family size and family planning (AOR=0.4; 95% CI: 1.24-4.00; p= 0.000),, distance to the health facility (AOR=0.4; 95% CI: 1.11-5.34; p= 0.003), and waiting time at the facility (AOR=0.3; 95% CI: 1.99-4.91; p= 0.003),were found to independently associated with the low uptake of family planning p-value <0.05
Factors Associated With Viral Non-suppression Among Adolescents 10–19 Years Accessing Anti-retroviral Therapy in Nwoya District-Uganda
(Uganda Christian University, 2024-04-30) James Okello
Introduction: In this study, adolescents accessing ART in the Nwoya District between the ages of 10 and 19 were examined for factors that may contribute to viral non-suppression. The study's specific objectives were to determine the prevalence of viral non-suppression among adolescents accessing ART in Nwoya district who are 10 to 19 years old, to identify health facility-related factors associated with this condition, to identify caregiver-related factors associated with viral non-suppression among adolescents accessing ART in Nwoya district, and to evaluate behavioral risk factors. Method: This study used both qualitative and quantitative methodologies in a descriptive cross-sectional design. The study involved 225 young people in the Nwoya district who were HIV-positive and were aged 10 to 19. Data was collected using a questionnaire and key informant interview guide. The data was then analyzed at univariate, bivariate, and multivariate levels using SPSS version 20. Results:The majority 122(54.2%) of the respondents were aged 14-19 years with the mean age being 15.2 years. At the bivariate level of analysis, it was found that age, duration on ART, and attitude of health care workers were correlated with viral con-suppression (X2=14.711, df =1, P-value=0.000). The distance from home to health facility (X2=19.045, df =4, P-value=0.001), ability to continuously receive counseling from counseling (X2=9.741, df =1, P-value=0.002), the relationship between the adolescent and guardian; (X2=2.610, df =2, P-value=0.000) also had a strong correlation with viral non-suppression among adolescents. Knowledge of the use of ARV drugs; (X2=7.321, df =4, P-value=0.007) and Engagement in sexual activity since being diagnosed with HIV; (X2=5.894, df =1, P-value=0.015) significantly influenced being non suppressed. P-value <0.05. At the multivariate level, the attitude of health workers; (AOR=5.11,95% CI:1.048-1.419, P=0.002), distance from home to health facility; (AOR=0.038, 95% CI:0.007-1.946,p=0.000), knowledge on the use of ARVs; (AOR=0.028,95%CI: 0.006-0.757, p=0.003) and the relationship between the adolescent and guardian; (AOR=7.401,95% CI: 0.328-1.673, P=0.012) were independently correlated with viral load non-suppression among adolescents in Nwoya district. Therefore, 61 (27.1%) teenagers accessing ART in Nwoya district had viral non-suppression. Also from the above findings, it can be deduced that there are many factors connected to viral non-suppression in adolescents accessing ART in Nwoya District who are 10 to 19 years old, including caregiver factors, behavioral factors, and healthcare facility factors like the attitude of healthcare workers. There is a need for a multi-sectoral approach to deal with barriers to viral suppression. there is a need for implementing partners (IPs) working in the district to support ART outreach to reduce the distance to the health facilities, health education, and counseling should be emphasized, and training of health workers on how to handle adolescents living with HIV to improve on their skills and attitude towards adolescents living with HIV.
Factors Influencing Exclusive Breastfeeding in Bundibugyo District, Uganda
(Uganda Christian University, 2024-04-25) Rita Ntegyereize
Background: Immediate and exclusive breastfeeding have been recognised by the WHO and UNICEF as important and necessary public health practices that can help prevent child morbidity and mortality, and to satisfy sustainable development goal (SDG) 2.2 “end all forms of malnutrition by 2030”. Despite this realisation, efforts to promote and embrace immediate and exclusive breastfeeding have achieved limited success in Bundibugyo district. Problem: While many parts of Uganda including Bundibugyo district have a culture of breastfeeding, exclusive breastfeeding has remained low at 44% as compared to the national average of 66%. Objectives: The study established prevalence of exclusive breastfeeding in children within the age range of 0-6 months and the factors that influence exclusive breastfeeding among mothers in Bundibugyo district. Methods: The study used a cross-sectional mixed methods design. Both qualitative and quantitative approaches were used to collect data. Findings: The prevalence of exclusive breastfeeding among the study participants was at 47%, which is below the national average of 66%. The prevalence of exclusive breastfeeding declined as the children grew older. Majority of the mothers reported having initiated their children on breast milk in the first hour after birth. Majority (75%) of the mothers delivered from a health facility. The study found statistically significant association between health facility delivery, ANC 4+( 4 or more ANC Visits), baby age, and exclusive breastfeeding. Mother’s characteristics like age, level of education, marital status, mother knowledge and attitude, influenced exclusive breastfeeding. Conclusion and recommendations: The study findings point to important individual level, interpersonal, and institutional/organizational level factors that influence EBF. Several misconceptions about EBF such as child’s refusal of other feeds in future exist and are a barrier to sustainable EBF practice in Bundibugyo. Strategies to increase mothers’ knowledge, improve attitude towards ANC and facility deliveries are recommended.
Factors Associated With Utilization of Health Facility Based Delivery Services Among Mothers in Kacheri Sub-county, Kotido District
(Uganda Christian University, 2024-04-26) Tosquine Harriet Akech
Introduction: This study was conducted to determine the factors associated with health facility utilization during delivery among mothers in Kacheri Sub County, Ko-tido District. The major aim in this study was to determine the level of utilization of facility deliveries and the factors associated with health facility delivery services among mothers in Kacheri Sub County, Kotido District. Methods: A facility-based analytical cross-sectional research design, was considered more appropriate to study the level and determinants of health facility delivery among mothers in Kacheri Sub County, Kotido District. The research study was conducted in two health facilities that serve the communities in Kacheri sub-county in Kotido district that is Kacheri HCIII and Lokiding HCII. A sample of 384 mothers was determined using Cochran Formula (Cochran 1977). A structured questionnaire was used during data collection through face to face interviews with selected par-ticipants. The Statistical Package for Social Sciences (SPSS) Version 7 was used to analyze the data by identifying predictors that are independent for the use of health services for childbirth, logistic regression was employed. The odds ratio (OR) and their confidence level of 95% were presented. Results: The study findings indicate that majority of the mothers in the study 244 (62.6%) delivered in health facilities compared to 112 (28.9%) deliveries occurred at home without any assistance of skilled personnel as compared to 25(6.4%) were de-liveries conducted by traditional birth attendants and others (on the way) 09(2.3%) delivery occurs on the way to health facility respectively. The study also identified ANC visits, Education levels, marital status, employment, proximity to a medical facility, and frequency of prenatal care visits are known as important predictors with delivering in health facilities. Conclusion and recommendations: Although the utilization of health facilities deliv-eries in Kacheri sub-county was moderately high compared to those who gave birth at home. The study identified the education levels, marital status, employment, proximity to a medical facility, and frequency of prenatal care visits as major pre-dictors associated with delivering in health facilities. Besides, mothers who attend-ed some formal education had some knowledge on the benefits of health facility delivery and interest in delivering in the health facility. The study recommends in-tensifying sensitization of mothers, frequent ANC visits, improving transport sys-tems and sensitizing the communities to keep younger girls in schools to prevent teenage pregnancies as key in improving health facility deliveries.
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.
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
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
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.
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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