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Burt, Jessica Florence, Joseph Ouma, Lawrence Lubyayi, et al. "Indirect effects of COVID-19 on maternal, neonatal, child, sexual and reproductive health services in Kampala, Uganda." BMJ Global Health 6, no. 8 (2021): e006102. http://dx.doi.org/10.1136/bmjgh-2021-006102.
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BackgroundCOVID-19 impacted global maternal, neonatal and child health outcomes. We hypothesised that the early, strict lockdown that restricted individuals’ movements in Uganda limited access to services.MethodsAn observational study, using routinely collected data from Electronic Medical Records, was carried out, in Kawempe district, Kampala. An interrupted time series analysis assessed the impact on maternal, neonatal, child, sexual and reproductive health services from July 2019 to December 2020. Descriptive statistics summarised the main outcomes before (July 2019–March 2020), during (April 2020–June 2020) and after the national lockdown (July 2020–December 2020).ResultsBetween 1 July 2019 and 31 December 2020, there were 14 401 antenatal clinic, 33 499 deliveries, 111 658 childhood service and 57 174 sexual health attendances. All antenatal and vaccination services ceased in lockdown for 4 weeks.During the 3-month lockdown, the number of antenatal attendances significantly decreased and remain below pre-COVID levels (370 fewer/month). Attendances for prevention of mother-to-child transmission of HIV dropped then stabilised. Increases during lockdown and immediately postlockdown included the number of women treated for high blood pressure, eclampsia and pre-eclampsia (218 more/month), adverse pregnancy outcomes (stillbirths, low-birth-weight and premature infant births), the rate of neonatal unit admissions, neonatal deaths and abortions. Maternal mortality remained stable. Immunisation clinic attendance declined while neonatal death rate rose (from 39 to 49/1000 livebirths). The number of children treated for pneumonia, diarrhoea and malaria decreased during lockdown.ConclusionThe Ugandan response to COVID-19 negatively impacted maternal, child and neonatal health, with an increase seen in pregnancy complications and fetal and infant outcomes, likely due to delayed care-seeking behaviour. Decreased vaccination clinic attendance leaves a cohort of infants unprotected, affecting all vaccine-preventable diseases. Future pandemic responses must consider impacts of movement restrictions and access to preventative services to protect maternal and child health.
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Kiondo, Paul, Annettee Nakimuli, Samuel Ononge, Julius Namasake Wandabwa, and Milton Wamboko Musaba. "Predictors of Intrapartum Stillbirths among Women Delivering at Mulago Hospital, Kampala, Uganda." International Journal of Maternal and Child Health and AIDS (IJMA) 10, no. 2 (2021): 156–65. http://dx.doi.org/10.21106/ijma.409.
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Background: Over the last decade, Uganda has registered a significant improvement in the utilization of maternity care services. Unfortunately, this has not resulted in a significant and commensurate improvement in the maternal and child health (MCH) indicators. More than half of all the stillbirths (54 per 1,000 deliveries) occur in the peripartum period. Understanding the predictors of preventable stillbirths (SB) will inform the formulation of strategies to reduce this preventable loss of newborns in the intrapartum period. The objective of this study was to determine the predictors of intrapartum stillbirth among women delivering at Mulago National Referral and Teaching Hospital in Central Uganda. Methods: This was an unmatched case-control study conducted at Mulago Hospital from October 29, 2018 to October 30, 2019. A total of 474 women were included in the analysis: 158 as cases with an intrapartum stillbirth and 316 as controls without an intrapartum stillbirth. Bivariable and multivariable logistic regression was done to determine the predictors of intrapartum stillbirth. Results: The predictors of intrapartum stillbirth were history of being referred from lower health units to Mulago hospital (aOR 2.5, 95% CI:1.5-4.5); maternal age 35 years or more (aOR 2.9, 95% CI:1.01-8.4); antepartum hemorrhage (aOR 8.5, 95% CI:2.4-30.7); malpresentation (aOR 6.29; 95% CI:2.39-16.1); prolonged/obstructed labor (aOR 6.2; 95% CI:2.39-16.1); and cesarean delivery (aOR 7.6; 95% CI:3.2-13.7). Conclusion and Global Health Implications: Referral to hospital, maternal age 35 years and above, obstetric complication during labor, and cesarean delivery were predictors of intrapartum stillbirth in women delivering at Mulago hospital. Timely referral and improving access to quality intrapartum obstetric care have the potential to reduce the incidence of intrapartum SB in our community. Copyright © 2021 Kiondo et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.
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King, Rachel, Zubayiri Sebyala, Moses Ogwal, et al. "How men who have sex with men experience HIV health services in Kampala, Uganda." BMJ Global Health 5, no. 4 (2020): e001901. http://dx.doi.org/10.1136/bmjgh-2019-001901.
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In sub-Saharan Africa, men who have sex with men (MSM) are socially, largely hidden and face disproportionate risk for HIV infection. Attention to HIV epidemics among MSM in Uganda and elsewhere in sub-Saharan Africa has been obscured by repressive governmental policies, criminalisation, stigma and the lack of basic epidemiological data describing these epidemics. In this paper, we aim to explore healthcare access, experiences with HIV prevention services and structural barriers to using healthcare services in order to inform the acceptability of a combination HIV prevention package of services for men who have sex with men in Uganda. We held focus group discussions (FGDs) with both MSM and healthcare providers in Kampala, Uganda, to explore access to services and to inform prevention and care. Participants were recruited through theoretical sampling with criteria based on ability to answer the research questions. Descriptive thematic coding was used to analyse the FGD data. We described MSM experiences, both negative and positive, as they engaged with health services. Our findings showed that socio-structural factors, mediated by psychological and relational factors impacted MSM engagement in care. The socio-structural factors such as stigma, homophobia and policy issues emerged strongly as did the mediating factors such as relations with specific health staff and a social support structure. A combination intervention addressing structural, social and psychological barriers could have an impact even in the precarious policy environment where this study was conducted.
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Nabukeera, Madinah. "Recentralisation Of Performance Of Urban Solid Waste Management Service Delivery In Lubage-Kampala Uganda." Archives of Business Research 8, no. 8 (2020): 82–99. http://dx.doi.org/10.14738/abr.88.8859.
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Kampala is a government seat and the capital city of Uganda. Kampala has been referred to as an executive slum due to its breakdown in service delivery. Currently the city is facing increased population growth, increased demand for services, changing consumptions, rising income which has caused urbanization that resulted into increased solid waste generated. While Kampala has a lot of challenges i.e., garbage, potholes, sewer service, construction, traffic management, corruption, health services, environment, stray livestock and management of markets. The main objective of this papers was to investigate service delivery during the recentralization of the city in line with garbage tonnage. Secondary data from Lubaga division used with content analysis to analysis the collected data. Results indicated that a small number of trips and fuel consumption in December compared to October and November 2016. The fall in trend of garbage collected could be as a result of some measures like burning which are adopted by some households in Rubaga division. It is also believed that some KCCA garbage vehicles remain on the road sides and this would make it hard for some people who are far from the road to bring their garbage.
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Ekudo, J., D. Bwembo, and A. Agwang. "Working With the Commercial Motorists to Promote Cancer Awareness." Journal of Global Oncology 4, Supplement 2 (2018): 127s. http://dx.doi.org/10.1200/jgo.18.56500.
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Background and context: Motorcycle transport system also known as “BodaBoda”' is one of Uganda's commonest means of transport with over 10,000 motorists ridding on the streets of Kampala on daily basis according to the statistics from Kampala City Authority. HealthAid Uganda (HAU) strategically engaged the above group in to promotion of cancer awareness, screening and blood donation for cancer patients following the lack of blood at the cancer institute for cancer patients. The process was strengthened by working in partnership with the Uganda Bodaboda Association 2010, an umbrella association that brings all the motorists together. It also included the Uganda Police Services, Ministry of Health and the private sector. Aim: To use motorists to deliver cancer education, awareness and facilitate blood donation for cancer patients in Uganda. Strategy/Tactics: The event was branded with the theme “Know your health, donate blood, save life”. It involved mobilization of the motorcycle riders through the BodaBoda 2010 association, a cancer awareness motorcycle ride across Kampala City, led by the head of traffic Uganda police as the chief rider. This was conducted along Kampala road and finally convened on the Uganda railway grounds, where the event was crowned with cancer education, screening and blood donation for the cancer patients. Program/Policy process: Community involvement and advocacy. Outcomes: There were large number of motorcycle riders 1000 who passionately turned up for the community event, high expectations to know about cancer and being able to go with cancer education materials for their families and communities. Blood bank collection team declared collecting 400 units of blood. The head, Department of Non Communicable Diseases at the Ministry of Health appreciated the efforts of HAU and pledged that the MOH will strongly work and support HAU on the initiative. The event attracted over 1500 individuals both the motorcycle riders and the community. What was learned: Using popular service groups has a high success rate in delivering cancer awareness and screening services to the least households in the community. HAU's success in this strategy was accelerated by the principle in which it focuses on working with organized groups so as to reach the households with cancer information and empower them to be able to make best choices. HAU looks further to extending the same activities to other communities of similar nature.
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Kansiime, Peninah, Claire Van der Westhuizen, and Ashraf Kagee. "Barriers and facilitators to physical and mental health help-seeking among Congolese male refugee survivors of conflict-related sexual violence living in Kampala." Social Work and Social Sciences Review 19, no. 3 (2018): 152–73. http://dx.doi.org/10.1921/swssr.v19i3.1196.
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In Uganda, over 1.3 million refugees have fled armed conflicts from neighbouring countries, with about 251 730 refugees from the Democratic Republic of Congo (DRC) alone. In this article we report on a qualitative research study on the help-seeking behaviour of Congolese male refugee survivors of conflict-related sexual violence (CRSV) living in Kampala, Uganda. We recruited 10 Congolese male survivors of war-related rape and 6 Ugandan service providers (psychologists, social workers and physicians) who participated in individual interviews focused on barriers and facilitators to care seeking in Kampala, Uganda. We found that the major barriers to help-seeking were socio-cultural and political factors, health system and infrastructural barriers, poverty and livelihood barriers, physical effects of CRSV, fear of marital disharmony and breakup, and self-sufficiency The major facilitators were social support, symptom severity, professionalism among service providers, availability of free tailored services and information, education and communication. On the basis of our findings, we recommend that a multidisciplinary and multisectoral approach is important to address these barriers. In addition, we suggest that the Ugandan government should develop legislation and health policies to create protection for men who have experienced sexual violence.Keywords: armed conflict; conflict-related sexual violence; male refugee survivors; help-seeking; physical and mental health; barriers; and facilitators
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Wallace, Vuokko, Jed Boardman, and James Walsh. "Attitudes towards mental illness in Uganda: a survey in 18 districts." International Psychiatry 4, no. 1 (2007): 19–21. http://dx.doi.org/10.1192/s1749367600005130.
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Uganda, in common with many countries in sub-Saharan Africa, has many population risk factors predictive of high levels of mental disorder but poor coverage of mental healthcare (Kigozi, 2005). Recent population studies conducted in Uganda have shown rates of disorder in excess of 20% (Kasoro et al, 2002; Bolton et al, 2004; Ovuga et al, 2005) and the survey by Kasoro et al (2002) showed a high prevalence of patients with severe mental illness and poor access to services. There are 19 psychiatrists for 24.8 million people in Uganda, all but one of whom is based in the capital city, Kampala (Kigozi, 2005). The provision of mental health services relies on the use of psychiatric clinical officers (a cadre of trained mental health workers, similar to community psychiatric nurses, who currently cover 18 of the 56 districts in Uganda), primary care personnel, non-governmental organisations and members of the community. Liaison with traditional healers is encouraged (Ovuga et al, 1999).
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Balikuddembe, Joseph Kimuli. "Risk Mapping of Road Traffic Incidents in Greater Kampala Metropolitan Area for Planning of Emergency Medical Services." Prehospital and Disaster Medicine 34, s1 (2019): s165. http://dx.doi.org/10.1017/s1049023x19003765.
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Introduction:Compared to high-income countries, low and middle-income countries (LMICs) bear the heaviest brunt of road traffic incidents (RTIs), which is a serious public health and development burden. Like other LMICs, Uganda has been experiencing a worryingly high burden of RTIs and their associated impacts with the highest number of all the total registered RTIs in Uganda registered in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected.Aim:To aid in better planning of EMS for the victims of RTIs by using risk mapping of RTIs in the GKMA.Methods:A mixed methodological approach involving a systematic review, Delphi panel technique, retrospective data analysis, and a cross-sectional method.Results:With Uganda progressing forward as envisaged in its “Vision 2040,” the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth. This has significantly increased RTIs, which puts pressure on the pre-hospital emergency care for those affected unless necessary actions are taken.Discussion:Therefore, the road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that cause them, particularly in the GKMA which experiences the highest number of RTIs and Uganda as a whole. The WHO “Safe System Approach” is desirable for this purpose as it represents the most appropriate approach because it is broad enough to comprehensively manage any of the ongoing dynamics (political, socio-cultural or economical) that are known to contribute to RTIs.
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Nalubega, Phiona, Emilie Karafillakis, Lydia Atuhaire, et al. "Maternal Vaccination in Uganda: Exploring Pregnant Women, Community Leaders and Healthcare Workers’ Perceptions." Vaccines 9, no. 6 (2021): 552. http://dx.doi.org/10.3390/vaccines9060552.
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Background: We investigated pregnant women, community leaders, healthcare workers (HCWs) and programme managers’ perceptions of maternal vaccination in Kampala, Uganda. Methods: We conducted focus group discussions, key informant interviews and in-depth discussions with HCWs (3), community leaders (3), pregnant women (8) and programme managers (10) between November 2019 and October 2020. Data were analysed thematically. Results: Pregnant women, community leaders and some HCWs had limited maternal immunisation knowledge. There was confusion over what constitutes a vaccine. Pregnant women may not receive vaccines because of mistrust of government; use of expired vaccines; reliance on traditional medicine; religious beliefs; fear of side effects; HCWs attitudes; and logistical issues. The key facilitators of maternal vaccination were a desire to prevent diseases, positive influences from HCWs and information about vaccine side effects. Community leaders and some pregnant women highlighted that pregnant women do not make decisions about maternal vaccination independently and are influenced by different individuals, including other pregnant women, older people, partners, relatives (parents), community leaders, HCWs and the government. Conclusions: Our results indicate that public health messaging should target all community members, including partners and parents of pregnant women as well as HCWs, to improve knowledge of and confidence in maternal vaccines.
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Atuhaire, Ruth, Robert Wamala, Leonard K. Atuhaire, and Elizabeth Nansubuga. "Regional differentials in early antenatal care, health facility delivery and early postnatal care among women in Uganda." Journal of Economics and Behavioral Studies 13, no. 4(J) (2021): 17–30. http://dx.doi.org/10.22610/jebs.v13i4(j).3174.
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This study aimed at examining regional differentials in maternal healthcare services in Uganda. Using a sample of 1,521 women of reproductive ages (15-49) from Eastern and Western sub-regions of Uganda, and non-linear Oaxaca’ Blinder Multivariate Decomposition method, we assessed differentials in utilization of early antenatal care, health facility delivery and early postnatal care services among the women, henceforth, establishing main predictors of regional inequalities that will enable policymakers to make better evenly interventions and focused decisions. The study reveals that differentials in the utilization of maternal healthcare services are not only hindered by social and economic barriers, but also widespread disparities in the utilization of existing services. Significant differentials were attributed to both variation in women’s characteristics and effects of coefficients. Findings showed that the gap in early antenatal care would reduce on average by 31.6% and 34.7% of differences in availability of community health workers and media exposure respectively, were to disappear. Furthermore, the gap would increase on average by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth respectively. The gap in health facility delivery would reduce on average by 24.6% and 37.2% of differences in community health worker availability and media exposure were to disappear respectively and increase on average by 54.9% in the absence of variations in effects of maternal education. The gap in EPNC would reduce on average by 18.5% and 17.17% of differences in maternal education and community health worker availability were to disappear respectively and increase on average by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth respectively. Progress towards equitable maternal health care should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.
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Izudi, Jonathan, Sylvia Auma, and John Bosco Alege. "Early Diagnosis of HIV among Infants Born to HIV-Positive Mothers on Option-B Plus in Kampala, Uganda." AIDS Research and Treatment 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/4654763.
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Introduction. Globally, there is delay in accessing early HIV diagnosis (EID) among HIV exposed infants (HEIs). With paucity of data on EID use at Kisenyi Health Center, this study assessed factors associated with EID use among HEIs (HIV exposed infants). Method. This was a cross-sectional study of 246 HIV-positive mother-baby pairs. Data was collected by structured questionnaire, double-entered in EpiData, and analyzed with STATA using multinomial logistic regression at 5% significance level. Results. 132 (53.7%) HEIs were not tested, 60 (24.4%) tested outside EID guideline, and 54 (21.9%) tested per the guideline. Testing per guideline was associated with maternal age above 30 years (AOR = 2.75; 95% CI: 1.20–6.34; P=0.017); testing outside the guideline was associated with maternal HIV serostatus disclosure (AOR = 2.70; 95% CI: 1.10–6.63; P=0.003) and four or more antenatal care (ANC) visits (AOR = 3.25; 95% CI: 1.23–8.59; P=0.017). However, maternal knowledge of HIV transmission was associated with testing outside the guideline (AOR = 2.90; 95% CI: 1.10–7.65; P=0.032) and per the guideline (AOR = 3.70; 95% CI: 1.39–9.88; P=0.009). Conclusion. Timely EID testing was low. Improving maternal knowledge of EID during ANC visits and positive living empowerment is critical.
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Biirah, Judith, Alice Anika, and Richard Simon Zigler. "Influence of Attention-Deficit Hyperactivity Disorder (ADHD) on Academic Achievement of Learners in International Primary Schools in Mombasa (Kenya) and Kampala (Uganda): A Comparative Study." European Scientific Journal, ESJ 14, no. 29 (2018): 199. http://dx.doi.org/10.19044/esj.2018.v14n29p199.
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Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent disorders among school-going children. The aim of this study was to compare academic achievement of learners with and without ADHD in international primary schools of Mombasa (Kenya) and Kampala (Uganda). A comparative study was conducted among 377 respondents using Attention Deficit Hyperactivity Disorder Scale Questionnaire (SNAP-IV) which assessed the three ADHD subtypes in form of a closed-ended questionnaire. Results revealed that learners with ADHD had low overall academic achievement compared to those without ADHD in Mombasa (p <.001) and Kampala, (p <.001). Boys with ADHD in Mombasa had better grades than girls (M = 168.51, SD = 32.50 vs. M = 160.00, SD = 39.07) while girls with ADHD in Kampala had better grades than boys (M = 103.50, SD = 24.77 vs. M = 93.45, SD = 24.71). Learners with ADHD Inattentive subtype were greatly impaired compared to those with ADHD Hyperactive-Impulsive and Combined subtypes in both cities. ADHD significantly predicted academic achievement with higher variability in Kampala (55%) than Mombasa (10%). Attention-deficit hyperactivity disorder has a negative impact on academic achievement of learners with the condition. The study recommended integration of ADHD screening in school health services to enable early detection and management of the condition.
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Nsonga, Joseph, John Paul Dongo, Frank Mugabe, et al. "Screening tuberculosis patients for diabetes mellitus in a routine program setting in Kampala, Uganda: a cross-sectional study." F1000Research 8 (June 17, 2019): 872. http://dx.doi.org/10.12688/f1000research.19279.1.
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Background: Uganda is located in East Africa and is among the countries with the lowest income globally. The ten health centres in this project serve populations in the under-privileged communities of Kampala. The objective of the study was to implement diabetes mellitus (DM) screening among tuberculosis (TB) patients in a routine program setting with limited resources and high human immunodeficiency virus (HIV) prevalence. Methods: A descriptive cross-sectional observational study was conducted in ten health centres in Kampala, Uganda. As part of a project to implement DM screening in a routine setting, TB patients were screened for DM by trained health workers. A fasting blood glucose (FBG) value ≥7.0mmol/l was considered to indicate DM. For this study, aggregate data was collected and analysed using SPSS for Windows, version 13.0. Results: Among 4,590 TB patients registered, 4,016 (88.0%) were screened with random blood glucose (RBG). Of those with RBG ≥6.1mmol/l, 1,093 (83.3%) were screened with FBG. In total, 92 (2.3%) patients were diagnosed with DM and 66 (71.8%) of them were newly diagnosed. The proportion of TB patients screened with FBG in the health centres varied from 58.2% to 100%. The proportion of patients screened with FBG and the prevalence of DM were significantly higher in private health centres compared with public health centres. The health centres in peri-urban areas screened more patients with RBG than those in urban areas. Health centres without DM services screened a larger number of patients with RBG and FBG than those with DM services. Conclusions: It appears feasible to implement screening TB patients for DM in routine program settings with limited resources and high HIV prevalence. Its introduction requires close collaboration between TB and DM services. The challenges identified need government attention and certain institutional and service-related factors need to be better managed at times.
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Nsonga, Joseph, John Paul Dongo, Frank Mugabe, et al. "Screening tuberculosis patients for diabetes mellitus in a routine program setting in Kampala, Uganda: a cross-sectional study." F1000Research 8 (October 10, 2019): 872. http://dx.doi.org/10.12688/f1000research.19279.2.
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Background: Uganda is located in East Africa and is among the countries with the lowest income globally. The ten health centres in this project serve populations in the under-privileged communities of Kampala. The objective of the study was to implement diabetes mellitus (DM) screening among tuberculosis (TB) patients in a routine program setting with limited resources and high human immunodeficiency virus (HIV) prevalence. Methods: A descriptive cross-sectional observational study was conducted in ten health centres in Kampala, Uganda. As part of a project to implement DM screening in a routine setting, TB patients were screened for DM by trained health workers. A fasting blood glucose (FBG) value ≥7.0mmol/l was considered to indicate DM. For this study, aggregate data was collected and analysed using SPSS for Windows, version 13.0. Results: Among 4,590 TB patients registered, 4,016 (88.0%) were screened with random blood glucose (RBG). Of those with RBG ≥6.1mmol/l, 1,093 (83.3%) were screened with FBG. In total, 92 (2.3%) patients were diagnosed with DM and 66 (71.8%) of them were newly diagnosed. The proportion of TB patients screened with FBG in the health centres varied from 58.2% to 100%. The proportion of patients screened with FBG and the prevalence of DM were significantly higher in private health centres compared with public health centres. The health centres in peri-urban areas screened more patients with RBG than those in urban areas. These health centres without DM services screened a larger number of patients with RBG and FBG than those with DM services. Conclusions: It appears feasible to implement screening TB patients for DM in routine program settings with limited resources and high HIV prevalence. Its introduction requires close collaboration between TB and DM services. The challenges identified need government attention and certain institutional and service-related factors need to be better managed at times
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Petrushkin, Harry, Jed Boardman, and Emilio Ovuga. "Psychiatric disorders in HIV-positive individuals in urban Uganda." Psychiatric Bulletin 29, no. 12 (2005): 455–58. http://dx.doi.org/10.1192/pb.29.12.455.
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Aims and MethodThe study examined the prevalence of psychiatric disorders in people with HIV/AIDS attending the AIDS Support Organisation (TASO) clinic at Mulago Hospital, Kampala, Uganda and the preparedness of AIDS counsellors to deal with mental disorders. Forty-six patients were interviewed using the Mini International Psychiatric Interview to ascertain DSM–IV diagnoses. All 15 counsellors working at the clinic were interviewed.ResultsThe total prevalence of psychiatric disorder was 82.6 (38 out of 46 patients). Depressive and anxiety disorders were common. Non-affective psychoses were present in eight patients (17.4%), bipolar affective disorder in eight (17.4%) and major depression with melancholic features in five (10.9%); 8 (13%) had current suicidal thoughts. None of the people with psychiatric disorders were receiving mental health treatment. The prevalence of disorder as estimated by the counsellors ranged from 0 to 33%. Only one counsellor had received any formal training in mental disorders and only two thought that they could deal with these if they arose. The attitudes of counsellors towards people with mental disorders were mixed, but most believed that they should be trained to provide care.Clinical ImplicationsThere is a need to provide additional mental health services to the TASO clinic through appropriate training of TASO counsellors to improve their awareness of psychiatric disorders, delivery of some psychological therapies and liaison with the psychiatric services at Mulago Hospital, in addition to public mental health education. The psychiatric disorders experienced by those attending the clinic might put them at greater risk of contracting HIV/AIDS.
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Lubinga, S. N., and L. M. Du Plessis. "Exercising Democratic Rights and Obligations as a Mechanism for Improved Service Delivery: The Case of Kampala City, Uganda." Africa’s Public Service Delivery and Performance Review 4, no. 1 (2016): 94. http://dx.doi.org/10.4102/apsdpr.v4i1.107.
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Emanating from literature (Ministry of Local government 2013:10; Gaventa 2002: p.26; Odero 2004: p.2), it is apparent that participatory frameworks exist in Uganda. However, in spite of a two decade-plus long prevalence these democratic participatory frameworks, the services rendered to the citizens are still poor. For instance, the delivery of health services has remained pitiable and the majority of people have turned to private hospitals. The provision for adequate infrastructure for the children enrolled in primary schools remains a challenge to the education sector. Yet, access to safe water is estimated at as low as 9% in some districts, while an estimated 19% of the improved water supply systems are still not functioning (UBOS, 2010: pp.33-57). This is not only attesting the statement that participatory initiatives in Uganda are more like “wish lists” than substantive statements that are guaranteed in practice, but also raising the research question as to what extent does the exercise of democratic rights and obligations of citizens by citizen’s impact on public service delivery in Uganda? In answering this question, this paper applied a quantitative research method in which aself-administered questionnaire survey based on three variables used to measure the exercise of democratic rights and obligations was distributed to a representative sample of 100 participants from Kampala city selected from three urban division councils (Kawempe, Makindye and Kampala Central). Thereafter, using the ordered logistic regression model of analysis, constructed on the findings the paper divulges that the exercise of democratic rights and obligations by citizens has a positive implication towards quality service delivery. <br /><br />
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Nabudere, Harriet, Delius Asiimwe, and Rhona Mijumbi. "Task shifting in maternal and child health care: An evidence brief for Uganda." International Journal of Technology Assessment in Health Care 27, no. 2 (2011): 173–79. http://dx.doi.org/10.1017/s0266462311000055.
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The Problem: There is a shortage and maldistribution of medically trained health professionals to deliver cost-effective maternal and child health (MCH) services. Hence, cost-effective MCH services are not available to over half the population of Uganda and progress toward the Millennium Development Goals for MCH is slow. Optimizing the roles of less specialized health workers (“task shifting”) is one strategy to address the shortage and maldistribution of more specialized health professionals.Policy Options: (i) Lay health workers (community health workers) may reduce morbidity and mortality in children under five and neonates; and training for traditional birth attendants may improve perinatal outcomes and appropriate referrals. (ii) Nursing assistants in facilities might increase the time available from nurses, midwives, and doctors to provide care that requires more training. (iii) Nurses and midwives to deliver cost-effective MCH interventions in areas where there is a shortage of doctors. (iv) Drug dispensers to promote and deliver cost-effective MCH interventions and improve the quality of the services they provide. The costs and cost-effectiveness of all four options are uncertain. Given the limitations of the currently available evidence, rigorous evaluation and monitoring of resource use and activities is warranted for all four options.Implementation Strategies: A clear policy on optimizing health worker roles. Community mobilization and reduction of out-of-pocket costs to improve mothers’ knowledge and care-seeking behaviors, continuing education, and incentives to ensure health workers are competent and motivated, and community referral and transport schemes for MCH care are needed.
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Swahn, Monica, Melissa Haberlen, and Jane B. Palmier. "Alcohol and drug use and other high-risk behaviors among youth in the slums of Kampala, Uganda: Perceptions and contexts obtained through focus groups." International Journal of Alcohol and Drug Research 3, no. 4 (2014): 289–95. http://dx.doi.org/10.7895/ijadr.v3i4.171.
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Swahn, M., Haberlen, M., & Palmier, J. (2014). Alcohol and drug use and other high-risk behaviors among youth in the slums of Kampala, Uganda: Perceptions and contexts obtained through focus groups. The International Journal Of Alcohol And Drug Research, 3(4), 289-295. doi:http://dx.doi.org/10.7895/ijadr.v3i4.171Aims: The study seeks to determine perceptions of and contexts for risky behaviors among street and slum youth in Kampala, through focus groups.Design: Three 90-minute focus groups were conducted in Luganda (local language) to ask specific questions on alcohol and drug-related behaviors among youth in the slums.Setting: Uganda Youth Development Link drop-in centers for disadvantaged youth in Kampala.Participants: 31 participants, aged 14 to 24 years.Measures: The focus group probes were based on the World Health Organization report “Working With Street Children: Module 5: Determining the Needs and Problems of Street Children—A Training Package on Substance Use, Sexual and Reproductive Health Including HIV/AIDS and STDs.”Findings: Results show that these youth engage in a number of risky behaviors, including alcohol and drug abuse, fighting and weapon carrying, delinquency, prostitution and unsafe sexual behaviors.Conclusions: The study provides context for risky behaviors in this population, which can provide useful insights and help to guide resource allocation and intervention planning for services that seek to reduce adverse health outcomes in this vulnerable population, particularly those related to alcohol and drug use.
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Logie, Carmen Helen, Moses Okumu, Simon Mwima, et al. "Sexually transmitted infection testing awareness, uptake and diagnosis among urban refugee and displaced youth living in informal settlements in Kampala, Uganda: a cross-sectional study." BMJ Sexual & Reproductive Health 46, no. 3 (2019): 192–99. http://dx.doi.org/10.1136/bmjsrh-2019-200392.
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BackgroundSexually transmitted infection (STI) prevention needs among urban refugee and displaced youth are understudied. The study objective was to explore factors associated with the STI prevention cascade (STI services awareness, testing, diagnosis) among urban refugee and displaced youth in Kampala, Uganda.MethodsWe implemented a cross-sectional survey with youth aged 16–24 years in informal settlements in Kampala. We conducted bivariate and multivariable logistic regression analyses to identify social ecological (intrapersonal, interpersonal, community) level factors associated with STI testing services awareness, lifetime STI testing, and lifetime STI diagnosis.ResultsParticipants (n=445; mean age 19.3, SD 2.6, years) included young women (n=333, 74.8%) and young men (n=112, 25.2%). Less than half (43.8%) were aware of community STI services. One-quarter (26.1%) reported lifetime STI testing. Of these, 39.5% reported a lifetime STI diagnosis. In multivariable analyses among young women, age, lifetime sex partners, and lower adolescent sexual and reproductive health (SRH)-related stigma were associated with STI services awareness; and age, lower adolescent SRH-related stigma, and food security were associated with STI testing. Among young men, time in Uganda and lower HIV-related stigma were associated with STI services awareness; and age, condom self-efficacy, and increased adolescent SRH-related stigma were associated with testing. Lifetime sex partners, lower condom self-efficacy, and lower adolescent SRH-related stigma were associated with lifetime STI diagnosis.ConclusionsSocial ecological factors including stigma (adolescent SRH-related, HIV-related) were associated with STI testing and diagnosis among young urban refugees. Gender, age and stigma-tailored strategies can advance the STI prevention cascade among urban young refugees.
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Balkus, Jennifer E., Moni Neradilek, Lee Fairlie, et al. "Assessing pregnancy and neonatal outcomes in Malawi, South Africa, Uganda, and Zimbabwe: Results from a systematic chart review." PLOS ONE 16, no. 3 (2021): e0248423. http://dx.doi.org/10.1371/journal.pone.0248423.
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A systematic chart review was performed to estimate the frequency of pregnancy outcomes, pregnancy complications and neonatal outcomes at facilities in Blantyre, Malawi; Johannesburg, South Africa; Kampala, Uganda; and Chitungwiza and Harare, Zimbabwe to provide comparisons with estimates from an ongoing clinical trial evaluating the safety of two biomedical HIV prevention interventions in pregnancy. A multi-site, cross-sectional chart review was conducted at Maternal Obstetric Units and hospitals where women participating in the ongoing clinical trial would be expected to deliver. All individuals delivering at the designated facilities or admitted for postpartum care within seven days of a delivery elsewhere (home, health clinic, etc.) were included in the review. Data were abstracted for pregnancy outcomes, pregnancy complications, maternal and neonatal death, and congenital anomalies. Data from 10,138 records were abstracted across all four sites (Blantyre n = 2,384; Johannesburg n = 1,888; Kampala n = 3,708; Chitungwiza and Harare n = 2,158), which included 10,426 pregnancy outcomes. The prevalence of preterm birth was 13% (range across sites: 10.4–20.7) and 4.1% of deliveries resulted in stillbirth (range: 3.1–5.5). The most commonly noted pregnancy complication was gestational hypertension, reported among 4.4% of pregnancies. Among pregnancies resulting in a live birth, 15.5% were low birthweight (range: 13.8–17.4) and 2.0% resulted in neonatal death (range:1.2–3.2). Suspected congenital anomalies were noted in 1.2% of pregnancies. This study provides systematically collected data on background rates of pregnancy outcomes, pregnancy complications and neonatal outcomes that can be used as a reference in support of ongoing HIV prevention studies. In addition, estimates from this study provide important background data for future studies of investigational products evaluated in pregnancy in these urban settings.
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d'Ardenne, Patricia, Hanspeter Dorner, James Walugembe, et al. "Training in the management of post-traumatic stress disorder in Uganda." International Psychiatry 6, no. 3 (2009): 67–68. http://dx.doi.org/10.1192/s174936760000062x.
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The aims of this study were to establish the feasibility and effectiveness of training Ugandan mental health workers in the management of post-traumatic stress disorder (PTSD) based on guidelines from the UK National Institute of Health and Clinical Excellence (NICE). The Butabika Link is a mental health partnership between the East London Foundation NHS Trust (ELFT) and Butabika National Psychiatric Referral Hospital, Kampala, Uganda, supported by the Tropical Health Education Trust (THET), and based on the recommendations of the Crisp report (Crisp, 2007). The Link has worked on the principle that the most effective partnership between high-income and low- or middle-income countries is through organisations already delivering healthcare, that is, through the support of existing services. Butabika Hospital is a centre of excellence, serving an entire nation of 30 million people, many of them recovering from 20 years of armed conflict that took place mainly in the north of Uganda. In addition, Uganda has received refugees from conflicts in neighbouring states, including Congo, Rwanda, Kenya, Sudan and Burundi. The Ugandan Ministry of Health's Strategic Plan (2000) has prioritised post-conflict mental disorders and domestic violence, which is reflected in the vision of the Link's work.
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Mukuru, Moses, Suzanne N. Kiwanuka, Linda Gibson, and Freddie Ssengooba. "Challenges in implementing emergency obstetric care (EmOC) policies: perspectives and behaviours of frontline health workers in Uganda." Health Policy and Planning 36, no. 3 (2021): 260–72. http://dx.doi.org/10.1093/heapol/czab001.
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Abstract Uganda is among the sub-Saharan African Countries which continue to experience high preventable maternal mortality due to obstetric emergencies. Several Emergency Obstetric Care (EmOC) policies rolled out have never achieved their intended targets to date. To explore why upstream policy expectations were not achieved at the frontline during the MDG period, we examined the implementation of EmOC policies in Uganda by; exploring the barriers frontline implementers of EmOC policies faced, their coping behaviours and the consequences for maternal health. We conducted a retrospective exploratory qualitative study between March and June 2019 in Luwero, Iganga and Masindi districts selected based on differences in maternal mortality. Data were collected using 8 in-depth interviews with doctors and 17 midwives who provided EmOC services in Uganda’s public health facilities during the MDG period. We reviewed two national maternal health policy documents and interviewed two Ministry of Health Officials on referral by participants. Data analysis was guided by the theory of Street-Level Bureaucracy (SLB). Implementation of EmOC was affected by the incompatibility of policies with implementation systems. Street-level bureaucrats were expected to offer to their continuously increasing clients, sometimes presenting late, ideal EmOC services using an incomplete and unreliable package of inputs, supplies, inadequate workforce size and skills mix. To continue performing their duties and prevent services from total collapse, frontline implementers’ coping behaviours oftentimes involved improvization leading to delivery of incomplete and inconsistent EmOC service packages. This resulted in unresponsive EmOC services with mothers receiving inadequate interventions sometimes after major delays across different levels of care. We suggest that SLB theory can be enriched by reflecting on the consequences of the coping behaviours of street-level bureaucrats. Future reforms should align policies to implementation contexts and resources for optimal results.
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Pariyo, George W., Chrispus Mayora, Olico Okui, et al. "Exploring new health markets: experiences from informal providers of transport for maternal health services in Eastern Uganda." BMC International Health and Human Rights 11, Suppl 1 (2011): S10. http://dx.doi.org/10.1186/1472-698x-11-s1-s10.
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Walusimbi, J. Nabitwere. "Making a Difference in ABC Patients´ Quality of Life: Uganda´s Case." Journal of Global Oncology 4, Supplement 2 (2018): 98s. http://dx.doi.org/10.1200/jgo.18.69900.
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Background: According to UWOCASO's research “Assessment of clinical and psychological needs of metastatic breast cancer patients, challenges and gaps in meeting their needs in Uganda” metastatic breast cancer (MBC) is not well understood, patients often feel isolated, invisible and stigmatized, have limited access to targeted treatment, specialized and comprehensive supportive services. Provision of information for available services and options for their care including open communication with health care providers, access to psychosocial services, pain control, financial support and cost of the treatment were important needs during the study. Patients end into depression, drop out of care thus compromising their quality of life. This project was designed as an intervention to address the unmet needs and barriers that limit access to supportive services. Aim: To improve access to supportive services for ABC patients and their families in Kampala and Wakiso districts. Methods: Fifteen (15) patients with advanced and metastatic breast cancer who were not respondents for the SAPRC research were recruited from the patients who sought psychosocial support from UWOCASO for a systematic follow-up. Using a bio-psycho-social (BPS) tool baseline data were collected to assess their psychosocial situation before our intervention and after 12 months. Baseline data were compared with the outcome. Results: At seven months more than 70% of patients had restored hope, pain kept under control, resumed treatment, reunited with families and some received in-kind and financial support. 30% of the patients passed on with no pain and legally supported. 2 patients were enrolled into a compassionate program for a targeted therapy. Conclusion: Patients living with advanced breast cancer have various needs that can only be met by a well-coordinated team of experts. UWOCASO's patient navigation program is important to bridge the gap between experts and improve access to supportive services.
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Orach, Christopher Garimoi. "Maternal Mortality Estimated Using the Sisterhood Method in Gulu District, Uganda." Tropical Doctor 30, no. 2 (2000): 72–74. http://dx.doi.org/10.1177/004947550003000205.
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A community-based retrospective maternal mortality study using the Sisterhood method was conducted in Gulu district between February and March 1996. The objectives were to estimate the magnitude of and identify factors associated with maternal mortality in the district. Atotal of 5522 adult respondents, randomly selected from 27 parishes, of the five counties in the district were interviewed. Between 1960–1996 324 maternal deaths occurred in the sisterhood sample. The maternal mortality rate (MMR) was estimated to be 662 per 100 000 deliveries [95% confidence interval (CI) 421–839 per 100 deliveries]. The leading causes of maternal death were: haemorrhage 45.1%; obstructed labour 26.2%; puerperal sepsis 9.6%; anaemia 2.2%; AIDS 2.2%; and gunshot wounds (GSW) 1.0%. Factors associated with maternal mortality included: age − 31.8% of the mothers who died were below 20 years; education − 57.1% had no formal education; 65% of the mothers had delivered at home, 50.6% had been attended to by untrained traditional birth attendants (TBAs), while 37.8% were attended to by relatives. The MMR was found to be 1.3 times higher than the estimated national MMR of 500 per 100 000 deliveries. Most maternal deaths (80.9%) were due to preventable causes, being related to low socioeconomic status and low-level education of women in the district. The intractable civil war in the district was a major underlying and contributory factor to the high maternal mortality in the area. A multifaceted approach to reduce maternal mortality in the district should target improving the socioeconomic conditions in the district with special emphasis on encouraging and supporting female education. Intensive education on maternal healthcare in antenatal clinics be conducted targeting husbands/spouses and relatives who care for the prenatal/pregnant and postnatal mothers. There is need for more trained TBAs per village who should be given effective support supervision. Ambulance transport services, motor and bicycle be made available at the district and community levels. At a national level the security situation should be improved in the district.
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Rujumba, Joseph, Jaco Homsy, Femke Bannink Mbazzi, et al. "Pregnant women, their male partners and health care providers’ perceptions of HIV self-testing in Kampala, Uganda: Implications for integration in prevention of mother-to-child transmission programs and scale-up." PLOS ONE 16, no. 6 (2021): e0253616. http://dx.doi.org/10.1371/journal.pone.0253616.
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Background HIV status awareness is critical for HIV prevention and care but HIV testing rates remain low in Uganda, especially among men. One suggested approach to increase access and utilisation of HIV testing services is HIV self-testing. We explored perceptions of pregnant and lactating women and their male partners who attended antenatal care, and health care providers in a government hospital in Kampala, Uganda, about HIV self-testing for initial or repeat testing for women and their partners during pregnancy and postpartum We draw implications for scaling-up this new testing approach in Uganda. Methods This was a qualitative study conducted at Mulago National Referral Hospital, Kampala, Uganda, between April and December 2017. We conducted in-depth interviews with five pregnant or lactating women and their five male partners; five focus group discussions (two with women, two with health workers and one with male partners of women attending antenatal care) and five key informant interviews with health workers providing prevention of mother-to-child HIV transmission (PMTCT) services. Data were analysed using content thematic approach. Results There was limited awareness about HIV self-testing especially among pregnant or lactating women and their male partners. Study participants mentioned that HIV self-testing would enable people to know their HIV status faster, they thought the approach would be cost- and time-saving compared to health facility-based HIV testing, improve confidentiality and reduce stigma for those who test HIV positive. They expressed however, a general fear that HIV self-testing would lead to harm to self and others in case one tested HIV positive, including suicide, violence among couples, intentional transmission of HIV, and limited linkage to care due to lack of counselling. The likely misinterpretation of HIV test results especially among those with no or limited education, and possible coercion exerted by male partners on their wives were other potential concerns raised about the use of HIV self-testing. Conclusions There was limited knowledge about HIV self-testing among pregnant and lactating women, their partners and health workers. While the self-testing modality was perceived to be critical for helping people, especially those in casual and distant relationships, to know their HIV status and that of their partners, most study participants believed that HIV self-testing could potentially result in a multitude of negative outcomes in the absence of pre- and post-test counselling. Successful scale-up and integration of self-testing in HIV programs requires community education, provision of information materials and making self-test kits accessible and affordable, especially in rural areas.
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Yang, Ying Ying, Gabriella Kaddu, David Ngendahimana, et al. "Trends and determinants of stunting among under-5s: evidence from the 1995, 2001, 2006 and 2011 Uganda Demographic and Health Surveys." Public Health Nutrition 21, no. 16 (2018): 2915–28. http://dx.doi.org/10.1017/s1368980018001982.
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AbstractObjectiveTo describe trends of childhood stunting among under-5s in Uganda and to assess the impact of maternal education, wealth and residence on stunting.DesignSerial and pooled cross-sectional analyses of data from Uganda Demographic and Health Surveys (UDHS) of 1995, 2001, 2006 and 2011. Prevalence of stunting and mean height-for-age Z-score were computed by maternal education, wealth index, region and other sociodemographic characteristics. Multivariable logistic and linear regression models were fitted to survey-specific and pooled data to estimate independent associations between covariates and stunting or Z-score. Sampling weights were applied in all analyses.SettingUganda.SubjectsChildren aged <5 years.ResultsWeighted sample size was 14 747 children. Stunting prevalence decreased from 44·8% in 1995 to 33·2% in 2011. UDHS reported stunting as 38% in 1995, underestimating the decline because of transitioning from National Center for Health Statistics/Centers for Disease Control and Prevention standards to WHO standards. Nevertheless, one in three Ugandan children was still stunted by 2011. South Western, Mid Western, Kampala and East Central regions had highest odds of stunting. Being born in a poor or middle-income household, of a teen mother, without secondary education were associated with stunting. Other persistent stunting predictors included small birth size, male gender and age 2–3 years.ConclusionsSustained decrease in stunting suggests that child nutrition interventions have been successful; however, current prevalence does not meet Millennium Development Goals. Stunting remains a public health concern and must be addressed. Customizing established measures such as female education and wealth creation while targeting the most vulnerable groups may further reduce childhood stunting.
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Kisakye, Angela N., Rornald Muhumuza Kananura, Elizabeth Ekirapa-Kiracho, et al. "Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda." Global Health Action 10, sup4 (2017): 1345496. http://dx.doi.org/10.1080/16549716.2017.1345496.
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Kalule-Sabiti, Ishmael, Acheampong Yaw Amoateng, and Mirriam Ngake. "The Effect of Socio-demographic Factors on the Utilization of Maternal Health Care Services in Uganda." African Population Studies 28, no. 1 (2014): 515. http://dx.doi.org/10.11564/28-1-504.
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Bergmann, Julie N., Rhoda K. Wanyenze, Fred Makumbi, Rose Naigino, Susan M. Kiene, and Jamila K. Stockman. "Maternal Influences on Access to and Use of Infant ARVs and HIV Health Services in Uganda." AIDS and Behavior 21, no. 9 (2016): 2693–702. http://dx.doi.org/10.1007/s10461-016-1528-1.
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Ellis, Cathryn, Laura Schummers, and Jean-Francois Rostoker. "Reducing Maternal Mortality in Uganda: Applying the “Three Delays” Framework." International Journal of Childbirth 1, no. 4 (2011): 218–26. http://dx.doi.org/10.1891/2156-5287.1.4.218.
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PURPOSE: This article examines maternal mortality in Uganda through the “Three Delays” framework. This framework asserts that maternal mortality in developing countries results from three delays to accessing appropriate health care: (a) the delay in making a timely decision to seek medical assistance, (b) the delay in reaching a health facility, and (c) the delay in provision of adequate care at a health facility.STUDY DESIGN: This study provides a review and synthesis of literature published about maternal mortality, the “Three Delays” concept, Uganda, and sub-Saharan Africa between 1995 and 2010.MAJOR FINDINGS: The “Three Delays” framework has relevance in the Ugandan context. This framework allows for an integrated and critical analysis of the interactions between cultural factors that contribute to the first delay and inadequate emergency obstetrical care related to the third delay.MAJOR CONCLUSION: In order to reduce maternal mortality in Uganda, governments and institutions must become responsive to the cultural and health needs of women and their families. Initiatives that increase educational and financial status of women, antenatal care, and rates of institutional care may reduce maternal mortality in the long term. Improvements to emergency obstetrical services are likely to have the most significant impact in the short term.
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Okungu, Vincent, Marshal Mweu, and Janine Mans. "SUSTAINABILITY, EQUITY AND EFFECTIVENESS IN PUBLIC FINANCING FOR HEALTH IN UGANDA: AN ASSESSMENT OF MATERNAL AND CHILD HEALTH SERVICES." International Journal of Health Services Research and Policy 4, no. 3 (2019): 233–46. http://dx.doi.org/10.23884/ijhsrp.2019.4.3.08.
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Dwinata, Indra, Dian Pratiwi Ahmad, and Dian Sidik Arsyad. "The Analysis of Factors that Related to Advanced Pentavalent Immunization Status in Sinjai Regency." Jurnal Berkala Epidemiologi 7, no. 1 (2019): 1. http://dx.doi.org/10.20473/jbe.v7i12019.1-8.
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Background: Basic pentavalent immunization coverage in Sinjai Regency in 2017 has reached the target, but the advanced pentavalent immunization rate is still low (52.90%). This condition leads to make a huge gap in toddlers’ immunization status. Purpose: This study aims to determine the factors associated with advanced pentavalent immunization status in the work area of Kampala Health Service Center (PUSKESMAS), Sinjai Regency. Methods: The cross-sectional study was used in this study. The mothers who have the children aged 18-36 months were used as population. About 145 samples were obtained by using simple random sampling technique. The two-way data collection technique, namely primary data obtained through questionnaires and secondary data obtained from the evaluation data of pentavalent immunization at Kampala Health Service Center, Sinjai Regency. Furthermore, chi-square was used for data analysis. Results: Generally, the respondents were 25-29 years old in average (26.90%) and had a high school/ equivalent education degree (53.80%). The respondents’ occupation are mostly housewives (83, 40%). Moreover, the toddlers were 24-29 months-old (46.90%) in average. This study showed that the majority of respondents did not take advanced pentavalent immunization (61.38%). Factors affecting the immunization status of the pentavalent were maternal knowledge (p = 0.03), family support (p= <0.01), and the role of health workers (p= <0.01). Surprisingly, the maternal attitude (p=0.57) and access to immunization services (p=0.17) were not related to advanced pentavalent immunization status. Conclusion: There was a relationship between maternal knowledge, family support, and the role of health workers with advanced pentavalent immunization status
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Andriano, Liliana, and Christiaan W. S. Monden. "The Causal Effect of Maternal Education on Child Mortality: Evidence From a Quasi-Experiment in Malawi and Uganda." Demography 56, no. 5 (2019): 1765–90. http://dx.doi.org/10.1007/s13524-019-00812-3.
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Abstract Since the 1980s, the demographic literature has suggested that maternal schooling plays a key role in determining children’s chances of survival in low- and middle-income countries; however, few studies have successfully identified a causal relationship between maternal education and under-5 mortality. To identify such a causal effect, we exploited exogenous variation in maternal education induced by schooling reforms introducing universal primary education in the second half of the 1990s in Malawi and Uganda. Using a two-stage residual inclusion approach and combining individual-level data from Demographic and Health Surveys with district-level data on the intensity of the reform, we tested whether increased maternal schooling reduced children’s probability of dying before age 5. In Malawi, for each additional year of maternal education, children have a 10 % lower probability of dying; in Uganda, the odds of dying for children of women with one additional year of education are 16.6 % lower. We also explored which pathways might explain this effect of maternal education. The estimates suggest that financial barriers to medical care, attitudes toward modern health services, and rejection of domestic violence may play a role. Moreover, being more educated seems to confer enhanced proximity to a health facility and knowledge about the transmission of AIDS in Malawi, and wealth and improved personal illness control in Uganda.
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Mutebi, Aloysius, Rornald Muhumuza Kananura, Elizabeth Ekirapa-Kiracho, et al. "Characteristics of community savings groups in rural Eastern Uganda: opportunities for improving access to maternal health services." Global Health Action 10, sup4 (2017): 1347363. http://dx.doi.org/10.1080/16549716.2017.1347363.
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Nabukeera, Madinah. "The impact of the Country’s health services’ expenditure on the success of MDGs, Goal 4/SDG 3: Reduction of child mortality in Uganda (2000-2016)." Archives of Business Research 8, no. 8 (2020): 69–82. http://dx.doi.org/10.14738/abr.88.8858.
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Safeguarding access to health services is a serious challenge for poor countries if the Sustainable Development Goals are to (SDGs) are to be achieved. This paper scrutinizes the case of Uganda, a country which is trying to improve its health sector amid a lot of challenges between 2000-2016 to assess how the country has performed in the reduction of child mortality given its expenditure. This study involved analyzing the available data drawn from various sources i.e., time series data on public health expenditure was obtained from Ministry of Health reports and the budget and Ministerial Policy Statements for the period 2000-2016. This data was further demarcated into parameters such as per capita government spending on health in Uganda shillings, health spending as a proportion of Gross Democratic Product (GDP) and private health spending as a proportion of total health spending. Findings revealed that non-significant negative effect of GDP per capita growth on infant mortality rate from 2000 to 2016, a negative effect of GDP per capita on under-five mortality in Uganda from 2000 to 2016, albeit the effect is non-significant (P>0.05), decline in Maternal Mortality Rate (MMR) from 527 death per 100,000 live birth in 1995 to 336 death per 100,000 live birth in 2016, and there is a negative but insignificant effect of health sector budget allocation on the MMR in Uganda since the P-value (0.199). Maternal mortality fell significantly in Uganda due to some interventions in the health sector. The decline is likely to have been cause due to supply and demand situations. There is need to improve funding in the health sector in order to improve quality health services through better coordination, health management, transportation, access, infrastructure at the district level.
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King, Rachel, Eva Muhanguzi, Miriam Nakitto, et al. "Mobility study of young women who exchange sex for money or commodities using Google Maps and qualitative methods in Kampala, Uganda." BMJ Open 11, no. 5 (2021): e043078. http://dx.doi.org/10.1136/bmjopen-2020-043078.
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ObjectivesWe aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to gauge how mobility may hinder access to health services and enhance HIV risk in a highly vulnerable population.SettingParticipants were recruited from a clinic in Kampala, Uganda set up for women at high risk of HIV infection.ParticipantsAdolescent girls and young women engaged in sex for money and/or commodities are at particular risk in countries with high HIV prevalence and high fertility rates. High mobility increases exposure to HIV risk. Women participants were eligible for the parent study if aged 15–24 years, HIV negative and engaged in sex work. For this substudy, 34 qualitative interviews were held with 14 sex workers (6 HIV positive, 8 HIV negative), 6 health worker/policy makers, 3 peer educators, 5 ‘queen mothers’ and 6 male partnersMeasuresParticipants used Google Maps to identify work venues at 12-month and 18-month study visits. We also conducted 34 interviews on mobility with: high-risk women, male partners, health workers and sex-worker managers. Topics included: distance, frequency and reasons for mobility. We used Python software to analyse mapping data.ResultsInterviews found in depth narratives describing lack of education and employment opportunities, violence, lack of agency, social, sexual and familial support networks and poverty as a complex web of reasons for high mobility among young sex workers.ConclusionsYoung women at high risk are highly mobile. Reasons for mobility impact access and retention to health services and research activities. Strategies to improve retention in care should be cognisant and tailored to suit mobility patterns.Trial registration numberNCT03203200.
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Franco, Gabala, Juliet Ndibaisa, and Namumbya Slivia. "Women Mobile Lifeline Channel Is a Key Stimulant of MCH Services Use in Resource Constrained Settings: A Success Story of Women Health Channel Uganda." Iproceedings 5, no. 1 (2019): e15239. http://dx.doi.org/10.2196/15239.
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Background Uganda has made progress in recent decades; however, the country still ranks among the top 10 countries in the world with high maternal, newborn, and child mortality rates. 336 women in every 100000 live births die due to preventable pregnancy related causes (under-five mortality rate 64/1000 live births; infant mortality rate 43/1000 live births; and neonatal mortality rate 27/1000 live births). Despite the growing global focus on reaching the last mile that necessitates the development of mHealth tools that best reach, empower, and mobilize the last mile women to seek and utilize critical and life-saving health care services as a vehicle for accelerating reduction of maternal and child deaths, mHealth tools in Uganda continue to limit focus on reporting and trucking of health indicators. Objective MIRA Channel is a single-window app with multiple channels on prenatal care, child immunization, newborn care, and family planning with the objective to improve maternal and child health outcomes in rural and resource-constrained settings. The app delivers information to women through interactive edutainment tools that builds on their knowledge, thus creating awareness on critical health issues and preempt timely use of MCH services. Methods Women Health Channel Uganda piloted the Women Mobile Lifeline Channel app in 15 public health facilities in Jinja district, Uganda, and particularly targeted pregnant women. A systematic review of records, particularly the health facility ANC register, was done to estimate the facility clientele size. Purposive random sampling was used to arrive at the survey sample. Two contact midwives and 5 VHTs were selected, trained, and given a connected mobile device at each of the implementing health facilities. Recruitment of women on the platform was done by VHTs using connected phones at community level, and 3489 pregnant women were studied for 16 months. Data was collected at baseline and at end line. Results Both at baseline and at end line, information on knowledge as well as usage of key MCH services was collected. All women had heard of ANC and the recommended place of delivery; however, only 59% at baseline had knowledge of the exact recommended number of ANC visits as opposed to 94% at end line. At baseline, 36% of women reported to have attended ANC 4 or more times at the most recent pregnancy as opposed to 82% at end line, while 63% of women at baseline reported to have given birth in a health facility for the previous pregnancy as opposed to 94% at end line. Sven neonatal deaths were reported in the cohort at baseline as opposed to 0 maternal deaths and 1 neonatal death at end line. Conclusions The pilot showed that one critical determinant of use of MCH services is the overall client knowledge and the perceived available support mechanism in the face of challenges. mHealth tools ought to expand focus to include stimulation of two-way mobile-based interactions that reinforce behavior change and preempt use as such. The Women Mobile Lifeline Channel that Women Health Channel is implementing offers lenses for Uganda and other countries to walk towards meaningful ICT integration in health.
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Beyeza-Kashesya, Jolly, Frank Kaharuza, and Daniel Murokora. "The advantage of professional organizations as advocates for improved funding of maternal and child health services in Uganda." International Journal of Gynecology & Obstetrics 127 (August 1, 2014): S52—S55. http://dx.doi.org/10.1016/j.ijgo.2014.07.013.
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Ogwang, Tom, and Frank Vanclay. "Social Impacts of Land Acquisition for Oil and Gas Development in Uganda." Land 8, no. 7 (2019): 109. http://dx.doi.org/10.3390/land8070109.
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Uganda’s oil and gas sector has transitioned from the exploration phase to the development phase in preparation for oil production (the operations phase). The extraction, processing, and distribution of oil require a great deal of infrastructure, which demands considerable acquisition of land from communities surrounding project sites. Here, we examine the social impacts of project land acquisition associated with oil production in the Albertine Graben region of Uganda. We specifically consider five major oil related projects that have or will displace people, and we discuss the consequences of this actual or future displacement on the lives and livelihoods of local people. The projects are: Tilenga; Kingfisher; the East African Crude Oil Pipeline; the Kabaale Industrial Park; and the Hoima–Kampala Petroleum Products Pipeline. Our findings reveal both positive and negative outcomes for local communities. People with qualifications have benefited or will benefit from the job opportunities arising from the projects and from the much-needed infrastructure (i.e., roads, health centres, airport) that has been or will be built. However, many people have been displaced, causing food insecurity, the disintegration of social and cultural cohesion, and reduced access to social services. The influx of immigrants has increased tensions because of increasing competition for jobs. Crime and social issues such as prostitution have also increased and are expected to increase.
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Isaac Ocheng V. O., Isaac, Eddy Ika, and Kizito Omona [PhD]. "Factors Influencing Utilization of Maternal Health Services by Adolescent Young Mothers Aged 15-19 Years in Kiryandongo General Hospital." International Journal of Medicine 9, no. 1 (2021): 31. http://dx.doi.org/10.14419/ijm.v9i1.31389.
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Background: In Uganda, 25 % of adolescents age 15-19 have already begun childbearing, 19 % have already given birth and another 5 % pregnant with their first child. Utilization of maternal health services is, therefore, an effective approach to reducing the risk of maternal morbidity and mortality. Low utilization of Maternal Health Services (MHS) has been registered in many parts of Uganda.Objective: To identify the key factors that influenced the utilization of MHS by adolescent young mothers aged 15-19years in Kiryandongo general HospitalMethods: A Cross Sectional analytical design, both quantitative and qualitative was used. A total of 98 adolescent young mothers were randomly selected. Data was collected using semi-structure questionnaires and analyzed using SPSS version 19.Results: Level of utilization of MHS was 44.9%. The socio-demographic (personal) factors that significantly influenced MHS utilization were; maternal age (COR= 0.29; 95% CI: 0.13-0.67, p = 0.003), husband’s education level (COR= 0.19; 95% CI: 0.08-0.47, p =0.000) and husband’s monthly income (COR= 0.35; 95% CI: 0.15-0.80, p = 0.012). Health System factors that influenced MHS utilization included; Time for travelling to reach health facility (COR=2.39; 95% CI: 1.03-5.52, p = 0.040) and Cost of the health services (COR= 2.68; 95% CI: 1.17-6.15, p =0.019).Conclusion: Strategies in addressing decision-making norms, engaging in massive community dialogue and designing appropriate communication strategies may help improve MHS utilization.
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Agwang, A., H. Ngonzi, and J. Ekudo. "Working With Organized Groups to Change Cultural Beliefs and Norms Toward Cancer in Uganda." Journal of Global Oncology 4, Supplement 2 (2018): 142s. http://dx.doi.org/10.1200/jgo.18.56900.
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Background and context: Cultural norms, beliefs and practices are great hindrance to efforts toward early detection and treatment of cancer in Uganda as most of the individuals believe its witchcraft, curse or bad luck. Working with organized groups such as churches, cultural associations, women associations, is key in changing such beliefs. HealthAid Uganda (HAU) for the last 3 years has worked in partnership with Watoto Church among other groups to deliver cancer awareness, screening and screening for other health problems in the districts of Mukono, Kampala and Wakiso. Aim: To mobilize organized groups within the community to raise awareness about cancer to correct prevailing myths, misconceptions and negative cultural beliefs, norms and practices. Strategy/Tactics: HAU built a strong partnership with its target groups one of which being Watoto church with whom joint planning activities were carried out. It involved the review of HAU's previous community health outreaches as a source of experience. The review also gave insight into the development of the activity plan; including the services to be rendered, the community leaders to be involved and the day in which the events would be conducted. The event included health talks on HPV, cervical and breast cancer, testimonies by the survivors, practical demonstration for self-breast examination, cervical cancer screening and distribution of cancer education materials. Program/Policy process: Involvement of community groups and champions in changing beliefs toward cancer epidemic is key. Outcomes: There was increased spirit of partnership which attracted various civil society organizations with Watoto church being the key partner. The government health center administration recognized efforts and pledged to offer further support in mobilizing the community. The awareness walk attracted public participation and need for the services. It demonstrated need to further work with organized groups within the community to form cancer task force groups to bring cancer information to every household. The events were covered by media, leading to increased demand for the services provided, with estimated 1500 individuals who received with both awareness, screening and consultative services. What was learned: HAU-Watoto partnership involvement showed that working with organized groups produces better results in cancer control and treatment in Uganda. Indeed changing cultural beliefs, norms and practices toward cancer prevention and control can be a success story if working with organized local groups is taken into consideration as a tool to reaching out to individuals and the approach during this year showed much more results than 2016.
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Massavon, William, Calistus Wilunda, Maria Nannini, et al. "Community perceptions on demand-side incentives to promote institutional delivery in Oyam district, Uganda: a qualitative study." BMJ Open 9, no. 9 (2019): e026851. http://dx.doi.org/10.1136/bmjopen-2018-026851.
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ObjectiveTo examine the perceptions of community members and other stakeholders on the use of baby kits and transport vouchers to improve the utilisation of childbirth services.DesignA qualitative study.SettingOyam district, Uganda.ParticipantsWe conducted 10 focus group discussions with 59 women and 55 men, and 18 key informant interviews with local leaders, village health team members, health facility staff and district health management team members. We analysed the data using qualitative content analysis.ResultsFive broad themes emerged: (1) context, (2) community support for the interventions, (3) health-seeking behaviours postintervention, (4) undesirable effects of the interventions and (5) implementation issues and lessons learnt. Context regarded perceived long distances to health facilities and high transport costs. Regarding community support for the interventions, the schemes were perceived to be acceptable and helpful particularly to the most vulnerable. Transport vouchers were preferred over baby kits, although both interventions were perceived to be necessary. Health-seeking behaviours entailed perceived increased utilisation of maternal health services and ‘bypassing’, promotion of collaboration between traditional birth attendants and formal health workers, stimulation of men’s involvement in maternal health, and increased community awareness of maternal health. Undesirable effects of the interventions included increased workload for health workers, sustainability concerns and perceived encouragement to reproduce and dependency. Implementation issues included information gaps leading to confusion, mistrust and discontent, transport voucher scheme design; implementation; and payment problems, poor attitude of some health workers and poor quality of care, insecurity, and a shortage of baby kits. Community involvement was key to solving the challenges.ConclusionsThe study provides further insights into the implementation of incentive schemes to improve maternal health services utilisation. The findings are relevant for planning and implementing similar schemes in low-income countries.
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Dey, Teesta, Sam Ononge, Andrew Weeks, and Lenka Benova. "Immediate postnatal care following childbirth in Ugandan health facilities: an analysis of Demographic and Health Surveys between 2001 and 2016." BMJ Global Health 6, no. 4 (2021): e004230. http://dx.doi.org/10.1136/bmjgh-2020-004230.
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IntroductionProgress in reducing maternal and neonatal mortality, particularly in sub-Saharan Africa, is insufficient to achieve the Sustainable Developmental Goals by 2030. The first 24 hours following childbirth (immediate postnatal period), where the majority of morbidity and mortality occurs, is critical for mothers and babies. In Uganda,<50% of women reported receiving such care. This paper describes the coverage, changes over time and determinants of immediate postnatal care in Uganda after facility births between 2001 and 2016.MethodsWe analysed the 2006, 2011 and 2016 Ugandan Demographic and Health Surveys, including women 15–49 years with most recent live birth in a healthcare facility during the survey 5-year recall period. Immediate postnatal care coverage and changes over time were presented descriptively. Multivariable logistic regression was used to examine determinants of immediate postnatal care.ResultsData from 12 872 mothers were analysed. Between 2006 and 2016, births in healthcare facilities increased from 44.6% (95% CI: 41.9% to 47.3%) to 75.2% (95% CI: 73.4% to 77.0%) and coverage of immediate maternal postnatal care from 35.7% (95% CI 33.4% to 38.1%) to 65.0% (95% CI: 63.2% to 66.7%). The majority of first checks occurred between 1 and 4 hours post partum; the median time reduced from 4 hours to 1 hour. The most important factor associated with receipt of immediate postnatal care was women having a caesarean section birth adjusted OR (aOR) 2.93 (95% CI: 2.28 to 3.75). Other significant factors included exposure to mass media aOR 1.38 (95% CI: 1.15 to 1.65), baby being weighed at birth aOR 1.84 (95% CI: 1.58 to 2.14) and receipt of antenatal care with 4+Antenatal visits aOR 2.34 (95% CI: 1.50 to 3.64).ConclusionIn Uganda, a large gap in coverage remains and universal immediate postnatal care has not materialised through increasing facility-based births or longer length of stay. To ensure universal coverage of high-quality care during this critical time, we recommend that maternal and newborn services should be integrated and actively involve mothers and their partners.
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Lanfranchi, Martina, and Adeyinka M. Akinsulure-Smith. "The Role of Mental Health Counselors in International Human Rights: Reflections on Counseling Services with Urban Refugees at the Refugee Law Project in Kampala, Uganda." International Journal for the Advancement of Counselling 40, no. 4 (2018): 365–86. http://dx.doi.org/10.1007/s10447-018-9331-5.
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Egami, Hiroyuki, and Tomoya Matsumoto. "Mobile Money Use and Healthcare Utilization: Evidence from Rural Uganda." Sustainability 12, no. 9 (2020): 3741. http://dx.doi.org/10.3390/su12093741.
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Lack of cash on hand is a significant obstacle in accessing healthcare services in developing countries. Many expectant mothers in the least developed countries do not receive sufficient care during pregnancy due to financial constraints. If such hurdles in accessing healthcare can be overcome, it will contribute to reduction in maternal and newborn mortality, which is a key target of Sustainable Development Goal 3. This study reports the first assessment of the impact of mobile money services on maternal care utilization. We hypothesize that mobile money adoption would motivate rural Ugandan women to receive antenatal care and to deliver their children at health facilities or with skilled birth attendants. By receiving remittances utilizing mobile money, poor rural households may obtain more cash in hand, which might change women’s health-seeking behavior. We apply community- and mother-fixed effects models with heterogeneity analysis to longitudinal panel data (the RePEAT [Research on Poverty, Environment, and Agricultural Technology] survey) of three waves (2009, 2012, and 2015). The analysis uses pregnancy reports of 2007–2015 from 586 rural Ugandan households. We find suggestive evidence that mobile money adoption positively affects the take-up of antenatal care. Heterogeneity analysis indicates that mobile money brings a larger benefit to geographically challenged households by easing their liquidity constraint as they face higher cost of traveling to distant health facilities. The models failed to reject the null hypothesis of no mobile money effect on the delivery-related outcome variables. This study suggests that promoting financial inclusion by means of mobile money motivates women in rural and remote areas to make antenatal care visits while the evidence of such effect is not found for take-up of facility delivery or delivery with skilled birth attendants.
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Balikuddembe, Joseph Kimuli, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati, and Owais Raza. "Weaknesses and Capacities Affecting the Prehospital Emergency Care for Victims of Road Traffic Incidents in the Greater Kampala Metropolitan Area: A Cross-Sectional Study." Prehospital and Disaster Medicine 34, s1 (2019): s177. http://dx.doi.org/10.1017/s1049023x19004072.
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Introduction:Prehospital emergency care is a vital and integral component of health systems, particularly in resource-constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities, and trauma caused by road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the prehospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA).Methods:A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims’ pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions, respectively. Data were descriptively analyzed, and a principal component analysis was employed to identify the most influential weaknesses and capacities affecting the prehospital emergency care for the victims of RTI in the GKMA.Results:From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 20164. key weaknesses and 5 key capacities were identified to affect the prehospital emergency care for RTI victims in the GKMA. Although some strengths exist, (e.g., ambulance facilitation, EMS structuring, and coordination), the key weaknesses affecting the pre-hospital care for victims were noted to relate to the absence of predefined EMS systems, particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment, insufficient skills/training of the first responders, inadequate EMS resources, and avoidable delays to respond and transport RTI victims to medical facilities.Discussion:Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.
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Mayora, Chrispus, Elizabeth Ekirapa-Kiracho, David Bishai, David H. Peters, Olico Okui, and Sebastian Baine. "Incremental cost of increasing access to maternal health care services: perspectives from a demand and supply side intervention in Eastern Uganda." Cost Effectiveness and Resource Allocation 12, no. 1 (2014): 14. http://dx.doi.org/10.1186/1478-7547-12-14.
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Mwase, I., M. Hutchins, A. Cameron, et al. "Experiences of using the toll-free telephone line to access maternal and newborn health services in central Uganda: a qualitative study." Public Health 179 (February 2020): 1–8. http://dx.doi.org/10.1016/j.puhe.2019.09.015.
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Nathan, Isabirye, Agnes Nyabigambo, Agnes Kayego, Peter Waiswa, Kele Moley, and Salimah Walani. "Readiness for implementation of preconception care in Uganda; a review on the current policy, health system barriers, opportunities and way forward." International Journal of Pregnancy & Child Birth 7, no. 3 (2021): 68–72. http://dx.doi.org/10.15406/ipcb.2021.07.00231.
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Background: Uganda like other low-income countries, preconception health has received no attention. Communications in this article are derived from preliminary findings of an ongoing preconception baseline pilot in Luuka-a rural eastern district of Uganda. This is a phased study, including a desk review of literature and a short baseline pilot. Methods: The review followed the methodology of systematic reviews. Key electronic databases were searched including PUBMED/MEDLINE and google scholar. Also, reports from ministries/academic institution libraries and views from experts were done. English articles published post 2000, covering preconception care, barriers, facilitators and policies were included in the review. Out of 110 shortlisted abstracts, 28 were included. Studies were extracted onto structured formats and analysed using the narrative synthesis approach. Results: There exist unstructured preconception health and service guidelines in Uganda. Barriers to preconception service integration into the district’s health system include; lack of a clear policy, careworn health system and care seeker related factors. Opportunities for preconception service integration include; poor maternal and neonatal health indicators, positive change in health seeking behaviour, existence of a gap in the care continuum, functional VHT system to link the community to services, anticipated roll out of key family care practises by Ministry of Health Uganda, and improved access to radio & mobile phones. Conclusion: Formulation of clear preconception guidelines, testing health system integration approaches, stakeholders’ engagement, awareness creation and strengthening the supply side is recommended as a way forward