Masters of Public Health

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

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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.
Level of Utilisation and Associated Factors on Family Planning Among Females 15 – 19 Years at Kamuli General Hospital and Namwenda Hc IV, Kamuli District
(Uganda Christian University, 2024-08-16) Doreen Tukamushaba
This study was to establish the Level of utilization, and factors associated with family planning use among females 15–19 years at Kamuli general hospital and Namwenda HC IV, Kamuli district. The study specifically sought to determine the level of utilization of family planning services among females 15–19 years at Kamuli general hospital and Namwenda HC IV in Kamuli district and to identify the factors associated with the level of utilization of family planning services among females 15–19 years at Kamuli general hospital and Namwenda HC IV in Kamuli district. This study used both qualitative and quantitative methodologies in a descriptive cross-sectional design. The study involved 147 females aged 15-19 years. 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. Qualitative data was analyzed using Open Code software. Most (52.4%) of the respondents were aged between 18 and 19, with a mean age of 18.3 (SD=1.2). At the bivariate level of analysis, age (χ2=9.77,df =3, P-value=0.001), educational level (χ 2 =17.16, df =1, P-value=0.002), and marital status (χ 2=19.06, df =2, P-value=0.001),achievement of a number of desired children, (χ 2=13.66, df =1, P-value=0.001), knowledge about family planning method, (χ 2 =9.13, df =1, P-value=0.002), religious support for family planning (χ 2 =14.70, df =1, P-value=0.001), and attitude of the community towards family planning (χ 2=17.71, df =1, P-value=0.001), distance to the facility (χ 2=21.06, df =2, P-value=0.000), and knowledge of the availability of family planning at the facility (χ 2=19.44, df =1, P-value=0.000) were found to significantly influence the uptake of family planning. P-value <0.05. At multivariate level of analysis age (AOR=2.7; 95% CI: 0.65-1.99; p= 0.001), educational level (AOR=6.1; 95% CI: 1.11- 4.76; p= 0.000), religious support for FP (AOR=3.3; 95% CI: 0.06-2.75; p= 0.003) and distance to the health facility (AOR=5.1; 95% CI: 0.44-1.89; p= 0.001) were found to significantly influence the utilization of family planning. The study established that the prevalence of contraceptive use stood at (26.5%); this is low compared to the national prevalence target of 39.6% by 2025. Mass sensitization by the district health office, promotion of girl child education, the District health Officer should intentionally partner with faith, cultural leaders to meaningfully engage adolescents in marriage on use of family planning and educating the adolescents on use of family planning. The healthcare services providers of Kamuli General Hospital and Namwenda HCIV are advised to adopt a nonjudgmental approach, to enhance physical accessibility and to train nurses and other healthcare professionals on reproductive health needs of adolescents.
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) Samuel Andrew Theu
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) Isaac Senda
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) Robinnah Nakayima
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) Dianah Anyine
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.

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