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Nshakira-Rukundo, Emmanuel, Essa Chanie Mussa, Nathan Nshakira, Nicolas Gerber e Joachim von Braun. "Impact of community-based health insurance on utilisation of preventive health services in rural Uganda: a propensity score matching approach". International Journal of Health Economics and Management 21, n. 2 (10 febbraio 2021): 203–27. http://dx.doi.org/10.1007/s10754-021-09294-6.
Testo completoAbstract (sommario):
AbstractThe effect of voluntary health insurance on preventive health has received limited research attention in developing countries, even when they suffer immensely from easily preventable illnesses. This paper surveys households in rural south-western Uganda, which are geographically serviced by a voluntary Community-based health insurance scheme, and applied propensity score matching to assess the effect of enrolment on using mosquito nets and deworming under-five children. We find that enrolment in the scheme increased the probability of using a mosquito net by 26% and deworming by 18%. We postulate that these findings are partly mediated by information diffusion and social networks, financial protection, which gives households the capacity to save and use service more, especially curative services that are delivered alongside preventive services. This paper provides more insight into the broader effects of health insurance in developing countries, beyond financial protection and utilisation of hospital-based services.
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Makika, Maya, Fred Matovu, Wasswa Matovu e Mesele Araya. "Effect of Out-of-Pocket Health Expenditure on Household Welfare: Evidence from Uganda National Household Survey: 2016–2017". Tanzanian Economic Review 12, n. 1 (30 giugno 2022): 18–34. http://dx.doi.org/10.56279/ter.v12i1.94.
Testo completoAbstract (sommario):
Out-of-Pocket health expenditures (OOP) in Uganda are increasingly rising due to the limited share of the national budget allocation to the health sector. Using Uganda National Household Survey data (UNHS) 2016/17, this study investigates the effect of OOP health expenditures on household welfare in Uganda. Due to the presence of endogeneity, the study employs a robust sampling instrumental variable technique to control for simultaneous causality between household welfare and the OOP health expenditure variable in the model. The findings show that a unit increase in OOP health expenditure reduces household food consumption expenditure by 9% and the household asset base by 2%, respectively. This study thus recommends the effective implementation of the Uganda National Health Insurance Scheme (NHIS), increased investment in preventive care services, and promotion of activities aimed at empowering health beneficiaries in Uganda to improve their household welfare.
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Basaza, Robert, Otieno Emmanuel e Christopher Keith Haddock. "Assessment of needle stick injuries among healthcare workers: A cross-sectional study from Kakiri military and SOS hospitals, Uganda". International Journal of Healthcare 8, n. 1 (7 dicembre 2021): 10. http://dx.doi.org/10.5430/ijh.v8n1p10.
Testo completoAbstract (sommario):
The Ugandan military medical services work together with the civilian public health system to deliver quality healthcare. This Partnership is the mainstay of health service delivery in Uganda. The burden of needle stick injuries (NSIs) is increasing in Uganda’s larger health industry; however, data on needle stick injury in military and public health facilities is lacking. No published data exist on comparative studies for a mix of facilities both military and civilian health settings. This study represents the first time this issue has been studied in a military or public health hospital in Uganda. A hospital-based, cross-sectional study was conducted in July 2018 to September 2019 in Kakiri Military and SOS Hospitals in Uganda using a structured questionnaire. Respondents were purposively selected based on the objectives of study, occupation status and department (N = 310). The overall prevalence of NSIs among respondents was 27.2% and prevalence rates for the two facilities was nearly identical. The largest percentage of NSIs occurred during drawing venous blood samples (49.4%). Significant predictors of NSI were gender, occupational status, age, poor knowledge on prevention and post exposure of NSI, and less professional experience. Infection control practices were lacking in both selected health facilities. Over a quarter of HCWs in Uganda reported NSIs, which places them at significant health risk. Fostering the practice of universal precautions, best infection control practices and training of healthcare workers on bio-safety measures can reduce the prevalence of NSIs.
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Kanobere, Harbart. "Enhancing IPTp Program Implementation: Provider Practices, Challenges, and Malaria Prevalence among Pregnant Women in Uganda". IDOSR JOURNAL OF SCIENCE AND TECHNOLOGY 10, n. 1 (13 marzo 2024): 43–50. http://dx.doi.org/10.59298/idosr/jst/24/101.234350.
Testo completoAbstract (sommario):
Malaria remains a formidable public health threat, particularly in sub-Saharan Africa, where pregnant women face heightened vulnerability. Intermittent Preventive Treatment in pregnancy with Sulfadoxine Pyrimethamine (IPTp-SP) stands as a pivotal strategy in malaria prevention efforts. However, its full potential is hindered by challenges in implementation. This study, conducted at Bushenyi Health Centre IV in Uganda, scrutinized provider practices, challenges encountered, and malaria prevalence among pregnant women attending antenatal care services. Through a descriptive cross-sectional approach involving 151 pregnant mothers and 15 antenatal care providers, analysis revealed noteworthy insights. While a majority of pregnant women received IPTp-SP, adherence to WHO guidelines regarding administration timing and frequency was suboptimal. Notably, over half of the providers reported stockouts of IPTp-SP, leading to significant delays in replenishment and impeding service delivery. Moreover, providers identified a crucial link between women's knowledge and IPTp uptake. The study also uncovered a malaria prevalence of 7.9% among pregnant women. These findings underscore the urgent need to address implementation challenges, particularly in supply chain management and health education, to fortify malaria prevention strategies for pregnant women in Uganda. Keywords: Malaria, Pregnant women, IPTp-SP, Antenatal care, Implementation challenges, Supply chain management, Health education, Uganda.
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Muga, Winstoun, e Emmy Kageha Igonya. "'What are you doing here?': (mis)trust, COVID-19 pandemic, and sexual reproductive health rights". Journal of the British Academy 11s6 (2023): 49–67. http://dx.doi.org/10.5871/jba/011s6.049.
Testo completoAbstract (sommario):
We explore how the government’s messaging on COVID-19 pandemic response perpetuated mistrust and impeded people’s ability to access and utilise sexual and reproductive health (SRH) services. While the need for SRH information increased, public health messages fostered mistrust in sexual and reproductive health services. We draw on in-depth interviews and focus group discussions conducted among women, girls, and healthcare providers in five African countries (Burkina Faso, Ethiopia, Kenya, Malawi, and Uganda) between May and October 2021. We show how trust was largely eroded through preventive measures, such as stay-at-home directives, social distancing, curfews, and lockdowns. We argue that, on one hand, while state-led epidemic preparedness and response were geared towards the common good, i.e., controlling the virus, on the other hand, de-prioritisation of much-needed services for sexual and reproductive health and rights (SRHR), as well as a lack of transparency among some of the service providers, bred mistrust in healthcare. We conclude that ambiguity in communication and implementation of COVID-19 prevention measures further compromised access to and utilisation of sexual and reproductive health services.
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Nalukwago, Judith, Bolanle Olapeju, Anna Passaniti, Musa Kimbowa, Arzum Ciloglu, Glory Mkandawire, Richard Kabanda e Douglas Storey. "Effects of Coronavirus Pandemic on Young Adults’ Ability to Access Health Services and Practice Recommended Preventive Measures". Global Journal of Health Science 13, n. 11 (20 settembre 2021): 14. http://dx.doi.org/10.5539/gjhs.v13n11p14.
Testo completoAbstract (sommario):
Given the limited attention to young adults as key contributors to the spread of COVID-19 in Uganda, this study examines the effects of the outbreak on the ability of young adults aged 18-29 to access health services and practice preventive measures. A national population-based mobile phone survey was conducted in December 2020. Multivariable regression analyses were used to explore the effect of the COVID-19 pandemic on access to health care services. Control variables included region, education level, parity, and source of health information. The majority (98%) perceived COVID-19 as a serious threat to Ugandans. Although the majority reported handwashing (97%) and masking (92%), fewer respondents avoided shaking hands (39%), ensured physical distancing (57%), avoided groups of more than four people (43%), stayed home most days (30%), avoided touching eyes, nose, and mouth (14%), and practiced sneezing/coughing into their elbow (7%). Participants noted that the COVID-19 pandemic affected their ability to access family planning (40%), HIV (49%), maternal health (55%), child health (56%), and malaria (63%) services. The perceived effect of the COVID-19 pandemic on services was higher for those in the Northern region (OR= 2.00, 95% CI 1.00-4.02), those with higher education OR= 2.26, 95% CI 1.28-3.99), those with five plus children (OR= 2.05, 95% CI 0.92-4.56), and those who trust radio for COVID-19 information (OR= 1.65, 95% CI 1.01-2.67). The findings show the pragmatic importance of understanding the dynamic characteristics and behavioral patterns of young adults in the context of COVID-19 to inform targeted programming.
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Dongo, John Paul, Stephen M. Graham, Joseph Nsonga, Fred Wabwire-Mangen, Elizabeth Maleche-Obimbo, Ezekiel Mupere, Rodrigo Nyinoburyo et al. "Implementation of an Effective Decentralised Programme for Detection, Treatment and Prevention of Tuberculosis in Children". Tropical Medicine and Infectious Disease 6, n. 3 (14 luglio 2021): 131. http://dx.doi.org/10.3390/tropicalmed6030131.
Testo completoAbstract (sommario):
Childhood tuberculosis (TB) is consistently under-detected in most high-burden countries, including Uganda, especially in young children at high risk for severe disease and mortality. TB preventive treatment (TPT) for high-risk child contacts is also poorly implemented. The centralised concentration of services for child TB at the referral level is a major challenge in the prevention, detection and treatment of TB in children. In 2015, the DETECT Child TB Project was implemented in two districts of Uganda and involved decentralisation of healthcare services for child TB from tertiary to primary healthcare facilities, along with establishing linkages to support community-based household contact screening and management. The intervention resulted in improved case finding of child and adult TB cases, improved treatment outcomes for child TB and high uptake and completion of TPT for eligible child contacts. A detailed description of the development and implementation of this project is provided, along with findings from an external evaluation. The ongoing mentorship and practical support for health workers to deliver optimal services in this context were critical to complement the use of training and training tools. A summary of the project’s outcomes is provided along with the key challenges identified and the lessons learnt.
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Ssewanyana, Sarah, e Ibrahim Kasirye. "The Cost Effectiveness of Family Planning Services in Uganda". Journal of African Development 20, n. 1 (1 aprile 2018): 3–11. http://dx.doi.org/10.5325/jafrideve.20.1.0003.
Testo completoAbstract (sommario):
Abstract Although Uganda has devoted an increasing amount of resources to health interventions, funding for reproductive health services as well as general health sector remains inadequate. This study examines the cost effectiveness of four family planning interventions, namely, oral contraception, female sterilization, injectables, and condoms. Using the 2006 Uganda Demographic and Health Survey and the Uganda National Household Survey data we estimate cost effectiveness ratios in relation to the number of births averted for women aged 15-49 years. We find that only one out of five women using some form of contraceptive and a quarter of the women using contraceptives rely on traditional methods that are less effective in preventing child births. With regard to efficiency, we find that injectables are the most cost effective intervention. Nonetheless, we do not recommend solely targeting women in the reproductive age category with this particular method of contraception without due regard to differences in physiology and socioeconomic characteristics.
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Ndagire, Emma, Yoshito Kawakatsu, Hadija Nalubwama, Jenifer Atala, Rachel Sarnacki, Jafesi Pulle, Rakeli Kyarimpa et al. "Examining the Ugandan health system’s readiness to deliver rheumatic heart disease-related services". PLOS Neglected Tropical Diseases 15, n. 2 (16 febbraio 2021): e0009164. http://dx.doi.org/10.1371/journal.pntd.0009164.
Testo completoAbstract (sommario):
Background In 2018, the World Health Assembly mandated Member States to take action on rheumatic heart disease (RHD), which persists in countries with weak health systems. We conducted an assessment of the current state of RHD-related healthcare in Uganda. Methodology/Principal findings This was a mixed-methods, deductive simultaneous design study conducted in four districts of Uganda. Using census sampling, we surveyed health facilities in each district using an RHD survey instrument that was modeled after the WHO SARA tool. We interviewed health workers with experience managing RHD, purposively sampling to ensure a range of qualification and geographic variation. Our final sample included 402 facilities and 36 health workers. We found major gaps in knowledge of clinical guidelines and availability of diagnostic tests. Antibiotics used in RHD prevention were widely available, but cardiovascular medications were scarce. Higher levels of service readiness were found among facilities in the western region (Mbarara district) and private facilities. Level III health centers were the most prepared for delivering secondary prevention. Health worker interviews revealed that limited awareness of RHD at the district level, lack of diagnostic tests and case management registries, and absence of clearly articulated RHD policies and budget prioritization were the main barriers to providing RHD-related healthcare. Conclusions/Significance Uganda’s readiness to implement the World Health Assembly RHD Resolution is low. The forthcoming national RHD strategy must focus on decentralizing RHD diagnosis and prevention to the district level, emphasizing specialized training of the primary healthcare workforce and strengthening supply chains of diagnostics and essential medicines.
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King, Rachel, Zubayiri Sebyala, Moses Ogwal, George Aluzimbi, Rose Apondi, Steven Reynolds, Patrick Sullivan e Wolfgang Hladik. "How men who have sex with men experience HIV health services in Kampala, Uganda". BMJ Global Health 5, n. 4 (aprile 2020): e001901. http://dx.doi.org/10.1136/bmjgh-2019-001901.
Testo completoAbstract (sommario):
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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Kirungi Kasozi, Gloria, Julius Kasozi, Frank Pio Kiyingi e Miph Musoke. "School-Based Sexual and Reproductive Health Services for Prevention of Adolescent Pregnancy in the Hoima District, Uganda: Cluster Randomized Controlled Trial". Methods and Protocols 2, n. 1 (4 marzo 2019): 21. http://dx.doi.org/10.3390/mps2010021.
Testo completoAbstract (sommario):
Uganda has persistently had high adolescent pregnancy prevalence; 25% for the last 10 years. This protocol presents the design of a Cluster Randomized Controlled Trial (CRCT) to investigate the effectiveness of School-Based Sexual and Reproductive Health (SBSRH) interventions on prevention of pregnancy among school girls aged 15–19 years in the Hoima District, Uganda. 18 secondary schools (clusters) will be selected using cluster sampling and allocated 1:1 into control or intervention group stratified by geographical location. 1080 (60 each cluster) participants/girls aged 15–19 years will be selected using simple random sampling. The intervention group will receive tailored SRH information, in-school medical care and referral over 12 months. The control group will receive no intervention from the research team; however, they can access alternative services elsewhere if they wish. Data will be obtained at baseline, 6 months and 12 months. The outcomes are reduction in occurrence of pregnancy, utilization of SRH services and sexual behavioral change. To our knowledge, this is the first CRCT providing combined SRH interventions for prevention of adolescent pregnancy in Uganda. If effective, it could have great potential in preventing adolescent pregnancy. Trial Registration: Pan African Clinical Trial Registry (PACTR201810882140200) Registered on 16 October 2018.
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Nyqvist, Martina Björkman, Andrea Guariso, Jakob Svensson e David Yanagizawa-Drott. "Reducing Child Mortality in the Last Mile: Experimental Evidence on Community Health Promoters in Uganda". American Economic Journal: Applied Economics 11, n. 3 (1 luglio 2019): 155–92. http://dx.doi.org/10.1257/app.20170201.
Testo completoAbstract (sommario):
The delivery of basic health products and services remains abysmal in many parts of the world where child mortality is high. This paper shows the results from a large-scale randomized evaluation of a novel approach to health care delivery. In randomly selected villages, a sales agent was locally recruited and incentivized to conduct home visits, educate households on essential health behaviors, provide medical advice and referrals, and sell preventive and curative health products. Results after 3 years show substantial health impact: under 5-years child mortality was reduced by 27 percent at an estimated average cost of $68 per life-year saved. (JEL I12, I18, J13, O15, O18)
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Richard, Kirungi, e Nayebare Julian. "Comprehensive Assessment of Factors Affecting Malaria Prevalence among Pregnant Women in Nyabubare Health Centre III, Bushenyi District, Uganda: Implications for Public Health Intervention". IDOSR JOURNAL OF BIOCHEMISTRY, BIOTECHNOLOGY AND ALLIED FIELDS 9, n. 1 (11 aprile 2024): 46–54. http://dx.doi.org/10.59298/idosr/jbbaf/24/91.4654.
Testo completoAbstract (sommario):
Malaria remains a significant global health burden, particularly among pregnant women, with adverse outcomes such as maternal mortality and low birth weight. This study comprehensively investigates the multifaceted factors influencing malaria prevalence among pregnant women attending Nyabubare Health Centre III in Bushenyi District, Uganda. Utilizing a mixed-methods approach, data were collected through structured interviews and documentary review from a sample of 86 respondents, including 80 pregnant women and 6 health workers. Descriptive analysis revealed poverty, deficiency in malaria control measures, low education levels, environmental factors such as swamps and floods, age, limited access to health facilities, and climatic changes as major determinants of malaria prevalence among pregnant women. Despite a relatively low malaria prevalence, knowledge gaps regarding malaria prevention were identified. The findings underscore the urgent need for targeted public health interventions, including subsidies for preventive equipment, sustained information campaigns, and improvements in healthcare services to enhance malaria prevention and control among pregnant women in the region. This study provides valuable insights for policymakers and healthcare practitioners to develop effective strategies to mitigate the impact of malaria on maternal and child health in resource-limited settings. Keywords: Prevalence of malaria, pregnant women, and knowledge
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Van Leeuwen, James, Humphrey Nabimanya, Andrew Ward, Ryan Grundy e Mark Thrun. "Music Festivals Serving as a Catalyst for Collaborative HIV Prevention Education and Expanded HIV Testing in Rural Uganda". International Journal of Community Development 6, n. 1 (9 giugno 2018): 1. http://dx.doi.org/10.11634/233028791503915.
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From 2014 through 2016, we produced a music festival in rural Kabale, Uganda in order to facilitate HIV testing and reproductive health services offered by NGOs specializing in HIV and sexual health. Our aim was to assess the effectiveness of a music festival to engage persons in sexual health and HIV screening services. Clinical service data was compiled and analyzed. Between 2014 and 2016, over 38,000 persons attended the annual festivals and were exposed to HIV prevention messaging. Over 7,000 persons have been tested for HIV. In 2016, 4,588 HIV tests were performed. In addition, 36 long-acting means of contraception were placed, 33 women were screened for cervical cancer, 2 tubal ligations were performed, and 193 men were referred for circumcision. Music festivals created a novel opportunity to provide sexual health services including prevention education, reproductive healthcare, and HIV testing to persons at risk for HIV in rural Uganda.
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Akankwasa, Edith, Willy Kamya, Moses Sendijja, Janet Mudoola, Mathias Lwenge, Robert Anguyo DDM Onzima, Daniel Kasozi, Peter Byansi e Simon Peter Katongole. "Assessment of Safe Motherhood Health Service Coverage, Birth Defects Detection and Child Disability Prevention Using Lot Quality Assurance Sampling in Central Uganda". East African Health Research Journal 7, n. 1 (12 luglio 2023): 7–19. http://dx.doi.org/10.24248/eahrj.v7i1.703.
Testo completoAbstract (sommario):
Introduction: It is crucial to have satisfactory coverage of safe motherhood services in order to prevent birth defects and child disabilities. Mildmay Uganda Institute of Health Sciences (MIHS) implemented a safe motherhood project aimed at preventing birth defects and child disabilities. Methods: Three years after the project’s implementation, a rapid cross-sectional health facility survey was conducted in 4 districts of central Uganda to assess the coverage of key safe motherhood and early childhood services. The Lot Quality Assurance Sampling approach was used to assess coverage of 16 indicators in the areas of ANC, skilled birth attendance, early childhood care, postnatal care, and knowledge about child disability prevention. A Decision Rule was set at 80% upper threshold to classify the performance of health facilities at the district level. Results: The survey found that there was variation in performance across indicators and districts. All districts achieved the 80% coverage target in ANC first visit, mothers who received at least two doses of Fansidar for intermittent preventive treatment of malaria in pregnancy, and mothers with knowledge of the action to take in case they suspect childhood disability. Folic acid supplementation during pregnancy and screening for birth defects using the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score had overall coverage above the target, but one district each had coverage below target in each of these 2 indicators. The coverage target was not reached in the rest of the survey indicators in each of the districts. Conclusion: Well-performing districts, especially in indicators with inconsistent performance, offer valuable insights for learning and adapting interventions in districts that do not meet the desired coverage of those particular indicators. Considering the disparities in performance among different indicators and districts, project planners should adopt, modify and implement successful strategies in districts and indicators that perform well. By doing so, they can enhance the performance of under performing districts or indicators.
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Burt, Jessica Florence, Joseph Ouma, Lawrence Lubyayi, Alexander Amone, Lorna Aol, Musa Sekikubo, Annettee Nakimuli et al. "Indirect effects of COVID-19 on maternal, neonatal, child, sexual and reproductive health services in Kampala, Uganda". BMJ Global Health 6, n. 8 (agosto 2021): e006102. http://dx.doi.org/10.1136/bmjgh-2021-006102.
Testo completoAbstract (sommario):
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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ILUKOR, J., R. BIRNER, P. B. RWAMIGISA e N. NANTIMA. "THE PROVISION OF VETERINARY SERVICES: WHO ARE THE INFLUENTIAL ACTORS AND WHAT ARE THE GOVERNANCE CHALLENGES? A CASE STUDY OF UGANDA". Experimental Agriculture 51, n. 3 (16 gennaio 2015): 408–34. http://dx.doi.org/10.1017/s0014479714000398.
Testo completoAbstract (sommario):
SUMMARYAs a result of continued fiscal challenges from the late 1980s to date, the government of Uganda liberalized and decentralized the provision of veterinary services. As a result, many actors are involved in providing veterinary services without adequate regulation and supervision. With the resurgence of infectious diseases, and increased economic and health risks, especially to the rural poor, there is the need to understand relational patterns of actors to ensure good governance, and address emerging and re-emerging risks of animal diseases. A participatory mapping tool called Process Net-Map was used to identify relevant actors and assess their influence in the delivery of clinical and preventive veterinary services in both pastoral and intensive livestock production systems. The tool also served to elicit governance challenges in veterinary service delivery. The results reveal that important social relations in veterinary service delivery include the following: (1) Cooperation between private veterinarians and paraprofessionals as well as private veterinarians and government veterinarians in intensive production systems; and (2) cooperation between NGOs, government veterinarians and community-based animal health workers in pastoral areas. Staff absenteeism, insufficient and unpredictable budgets, weak legislation, exclusion of technical staff from the decision-making process and policy illogicality were identified as major governance problems of veterinary service delivery. The paper concludes that given the existing fiscal challenges, the key to improving animal service delivery in Uganda is getting priorities, policies and institutions right.
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Waiswa, Peter, Flavia Mpanga, Danstan Bagenda, Rornald Muhumuza Kananura, Thomas O’Connell, Dorcus Kiwanuka Henriksson, Theresa Diaz et al. "Child health and the implementation of Community and District-management Empowerment for Scale-up (CODES) in Uganda: a randomised controlled trial". BMJ Global Health 6, n. 6 (giugno 2021): e006084. http://dx.doi.org/10.1136/bmjgh-2021-006084.
Testo completoAbstract (sommario):
IntroductionUganda’s district-level administrative units buttress the public healthcare system. In many districts, however, local capacity is incommensurate with that required to plan and implement quality health interventions. This study investigates how a district management strategy informed by local data and community dialogue influences health services.MethodsA 3-year randomised controlled trial (RCT) comprised of 16 Ugandan districts tested a management approach, Community and District-management Empowerment for Scale-up (CODES). Eight districts were randomly selected for each of the intervention and comparison areas. The approach relies on a customised set of data-driven diagnostic tools to identify and resolve health system bottlenecks. Using a difference-in-differences approach, the authors performed an intention-to-treat analysis of protective, preventive and curative practices for malaria, pneumonia and diarrhoea among children aged 5 and younger.ResultsIntervention districts reported significant net increases in the treatment of malaria (+23%), pneumonia (+19%) and diarrhoea (+13%) and improved stool disposal (+10%). Coverage rates for immunisation and vitamin A consumption saw similar improvements. By engaging communities and district managers in a common quest to solve local bottlenecks, CODES fostered demand for health services. However, limited fiscal space-constrained district managers’ ability to implement solutions identified through CODES.ConclusionData-driven district management interventions can positively impact child health outcomes, with clinically significant improvements in the treatment of malaria, pneumonia and diarrhoea as well as stool disposal. The findings recommend the model’s suitability for health systems strengthening in Uganda and other decentralised contexts.Trial registration numberISRCTN15705788.
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Ssekamatte, Tonny, John Bosco Isunju, Aisha Nalugya, Solomon Tsebeni Wafula, Rebecca Nuwematsiko, Doreen Nakalembe, Winnifred K. Kansiime et al. "Distribution of Hepatitis B prevention services in Wakiso District, Central Uganda". PLOS Global Public Health 3, n. 9 (22 settembre 2023): e0000478. http://dx.doi.org/10.1371/journal.pgph.0000478.
Testo completoAbstract (sommario):
Hepatitis B Virus (HBV) infection remains a significant global public health challenge especially in low-and-middle income countries. Although there are significant global and national efforts to control Hepatitis B, equitable distribution and access to prevention services such as testing and vaccination remains a challenge. Efforts to increase access are hindered by inadequate evidence on the availability and distribution of HBV services. This cross-sectional study aimed at generating evidence of the distribution of HBV prevention services in Wakiso District, Uganda. A total of 55 healthcare facilities (HCFs) including 4 hospitals, and 51 primary care facilities were surveyed. Data were collected using an electronic structured questionnaire and analysed using STATA 14.0. A chi-square test was performed to establish the relationship between HCF characteristics and the availability of hepatitis B services. ArcGIS (version 10.1) was used to generate maps to illustrate the distribution of hepatitis B prevention services. We found out that the hepatitis B vaccine was available in only 27.3% (15) of the HCF, and 60% (33) had testing services. Receipt of the hepatitis B vaccine doses in the last 12 months was associated with the level (p = ≤0.001) and location (p = 0.030) of HCF. Availability of the hepatitis B vaccine at the time of the survey was associated with the level (p = 0.002) and location (p = 0.010) of HCF. The availability of hepatitis B testing services was associated with the level (p = 0.031), ownership (p≤0.001) and location (p = 0.010) of HCF. HCFs offering vaccination and testing services were mostly in urban areas, and close to Kampala, Uganda’s capital. Based on this study, hepatitis B prevention services were sub-optimal across all HCF levels, locations, and ownership. There is a need to extend hepatitis B prevention services to rural, public and private-not-for-profit HCFs.
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Sheehan, Mia, Hallie Dau, Maryam AboMoslim, Priscilla Naguti, Nelly Mwandacha, Amy Booth, Laurie Smith, Jackson Orem, Gina Ogilvie e Carolyn Nakisige. "Assessing Differences in Healthcare Access for Women in Rural Uganda by HIV Status". JCO Global Oncology 10, Supplement_1 (luglio 2024): 18. http://dx.doi.org/10.1200/go-24-20000.
Testo completoAbstract (sommario):
PURPOSE Although a preventable disease, cervical cancer is a leading cause of cancer death among women in low- and middle-income countries (LMICs). Uganda has one of the highest cervical cancer incidence rates, largely due to limited accessibility and availability of screening services. Human immunodeficiency virus (HIV) positive women are significantly more likely to develop cervical cancer and face barriers to accessing healthcare when compared to HIV-negative women. As such, HIV-positive women represent a priority population for cervical cancer prevention. This study aims to compare how HIV-positive and HIV-negative women in rural Uganda access health services to inform the integration of cervical cancer screening with HIV care. METHODS This cross-sectional study recruited women living in the South Busoga District Reserve from January to August 2023. Women were eligible if they were aged 30 to 49 years old, had no history of cervical cancer screening or treatment, had no previous hysterectomy, and could provide informed consent. Participants completed a survey administered by village health teams, which included questions on HIV status, demographics, healthcare access, and services received. The data was analyzed using bivariate descriptive statistics, including chi-square and Fisher's exact tests. RESULTS Among the 1437 participants included in the analysis, 8.8% were HIV-positive. The majority of the respondents were between 30-39 years of age, were married, had received primary education or higher, and were farmers. The majority of women in both groups had accessed outreach visits (HIV-positive = 89.0%, HIV-negative = 85.8%) and health centers (HIV-positive = 96.1%, HIV-negative = 80.2%). The most commonly received services among both groups of women at outreach visits and health centers were immunization and antenatal care, respectively. CONCLUSION Our study demonstrated that there were no significant differences in healthcare access between HIV-positive and HIV-negative women in rural Uganda. Additionally, the high usage of healthcare services by women living with HIV suggests that the integration of cervical cancer and HIV screening may facilitate early detection and prevention of cervical cancer among this population. This can reduce the burden of disease in Uganda and further contribute to the World Health Organization's initiative to eradicate cervical cancer.
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Ssaka, Mustafa, Charles Lwanga, Tunc Eren e Orhan Alimoglu. "Community use of masks as a preventive measure for Covid-19 in Kabale district of Uganda". International Journal of Human and Health Sciences (IJHHS) 5, n. 2 (4 ottobre 2020): 267. http://dx.doi.org/10.31344/ijhhs.v5i2.274.
Testo completoAbstract (sommario):
Coronavirus disease 2019 (Covid-19) caused a global pandemic and by June 1st, 2020, the global numbers of Covid-19 cases reached six million with more than 370,000 deaths. Community-wide mask wearing may contribute to the control of Covid-19 by reducing the amount of emission of infected saliva and respiratory droplets from persons with subclinical or mild Covid-19. However, use of masks in public and in health care facilities has been controversial as different organizations and agencies established different guidelines. In Uganda, not any reports on mask utilization practices have been published yet. Therefore, this report aims at documenting mask use practices, as observed in our interactions with non-Covid-19 patients and their relatives at Kabale regional referral hospital as well as Kabale town residents. It was observed that many non-Covid-19 patients and the relatives of hospitalized patients only wear their masks on reaching the hospital premises while community members of Kabale town wear their masks only in the presence of security agencies and individuals in the public only wear masks in places where they would be refused from services without masks. Wearing of masks in public places and health care facilities together with other preventive measures including hand hygiene, social distancing and wearing of full personal protective equipment for health care providers working on Covid-19 patients are key measures in preventing the spread of infection. There is an increased need for intensified community educational activities on public awareness of the importance of appropriate use of masks.International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 267-270
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Mukose, Aggrey David, Hilde Bastiaens, Esther Buregyeya, Rose Naigino, Fredrick Makumbi, Joshua Musinguzi, Jean-Pierre Van geertruyden e Rhoda K. Wanyenze. "Health Provider Perspectives of Health Facility Preparedness and Organization in Implementation of Option B+ among Pregnant and Lactating Women in Central Uganda: A Qualitative Study". Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (1 gennaio 2019): 232595821983393. http://dx.doi.org/10.1177/2325958219833930.
Testo completoAbstract (sommario):
Introduction: Uganda adopted Option B+ for prevention of mother-to-child transmission (PMTCT) of HIV in 2012. However, there is limited data on preparedness and organization of Option B+ services. These data are critical in informing PMTCT programs and provision of universal antiretroviral therapy (ART) for all populations. This study explored health providers’ experiences of preparedness and organization of Option B+ services in Central Uganda. Methods: Key informant interviews with 54 health providers from 6 health facilities in 3 districts were conducted. Thematic approach was employed to analyze data. Results: Themes identified on preparedness were training of frontline health providers and provision of Option B+ guidelines, supervision and mentorship, and provision of essential medicines and medical health supplies, whereas those concerning organization were HIV counseling and testing, ART initiation, follow-up, and patient support mechanisms. Innovations like use of expert clients, assessing women’s readiness to start Option B+, and retaining women in antenatal care clinic depending on the need are important in provision of Option B+. Conclusion: This study provides insights into preparedness and organization of Option B+ services which are important in provision of Option B+ and universal ART for all populations. Research around models of follow-up is recommended.
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Kamulegeya, Louis H., Joseph Ssebwana, Wilson Abigaba, John M. Bwanika e Davis Musinguzi. "Mobile Health in Uganda: A Case Study of the Medical Concierge Group". East Africa Science 1, n. 1 (25 marzo 2019): 9–14. http://dx.doi.org/10.24248/easci.v1.iss1.12.
Testo completoAbstract (sommario):
The ubiquity of mobile phones offers an opportunity for a paradigm change in health-care delivery, which may offer solutions to some of the challenges faced by the health sector in Uganda. The Medical Concierge Group (TMCG) is a digital health company, headquartered in Uganda, which leverages on mobile phone-based platforms – such as short messaging service (SMS), voice calling – and social media to deliver health services. Just over two-thirds (68%) of users of TMCG’s services are males between 18 and 30 years of age. SMS reminders have improved the honouring of health facility appointments among HIV-positive clients, from 60% to 90%; retention rates at supported health facilities have improved from 45% to 89%. Furthermore, information dissemination has been achieved via mobile SMS, wherein subscribers can access health content on diverse topics – such as HIV/AIDS prevention and family planning – by sending messages to a pre-defined short code to a phone line. Over 900 beneficiaries have accessed health content via SMS subscriptions. Social media platforms, including Facebook and Twitter, are used for health information dissemination and have enabled a wider reach to over 13 million beneficiaries accessing health information on TMCG’s Facebook page alone. Tailoring mobile phone-based health content to meet the target beneficiaries’ needs is critical for TMCG’s impact and uptake. With rising rates of phone ownership and Internet connectivity in Uganda, mobile phones offer an affordable and proven adoptable avenue to overcome the chronic challenges faced by the health sector.
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Kamulegeya, Louis H., Joseph Ssebwana, Wilson Abigaba, John M. Bwanika e Davis Musinguzi. "Mobile Health in Uganda: A Case Study of the Medical Concierge Group". East Africa Science 1, n. 1 (25 marzo 2019): 9–14. http://dx.doi.org/10.24248/easci.v1.iss1.3.
Testo completoAbstract (sommario):
The ubiquity of mobile phones offers an opportunity for a paradigm change in health-care delivery, which may offer solutions to some of the challenges faced by the health sector in Uganda. The Medical Concierge Group (TMCG) is a digital health company, headquartered in Uganda, which leverages on mobile phone-based platforms – such as short messaging service (SMS), voice calling – and social media to deliver health services. Just over two-thirds (68%) of users of TMCG’s services are males between 18 and 30 years of age. SMS reminders have improved the honouring of health facility appointments among HIV-positive clients, from 60% to 90%; retention rates at supported health facilities have improved from 45% to 89%. Furthermore, information dissemination has been achieved via mobile SMS, wherein subscribers can access health content on diverse topics – such as HIV/AIDS prevention and family planning – by sending messages to a pre-defined short code to a phone line. Over 900 beneficiaries have accessed health content via SMS subscriptions. Social media platforms, including Facebook and Twitter, are used for health information dissemination and have enabled a wider reach to over 13 million beneficiaries accessing health information on TMCG’s Facebook page alone. Tailoring mobile phone-based health content to meet the target beneficiaries’ needs is critical for TMCG’s impact and uptake. With rising rates of phone ownership and Internet connectivity in Uganda, mobile phones offer an affordable and proven adoptable avenue to overcome the chronic challenges faced by the health sector.
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Kamulegeya, Louis H., Joseph Ssebwana, Wilson Abigaba, John M. Bwanika e Davis Musinguzi. "Mobile Health in Uganda: A Case Study of the Medical Concierge Group". East Africa Science 1, n. 1 (25 marzo 2019): 9–14. http://dx.doi.org/10.24248/easci.v1i1.3.
Testo completoAbstract (sommario):
The ubiquity of mobile phones offers an opportunity for a paradigm change in health-care delivery, which may offer solutions to some of the challenges faced by the health sector in Uganda. The Medical Concierge Group (TMCG) is a digital health company, headquartered in Uganda, which leverages on mobile phone-based platforms – such as short messaging service (SMS), voice calling – and social media to deliver health services. Just over two-thirds (68%) of users of TMCG’s services are males between 18 and 30 years of age. SMS reminders have improved the honouring of health facility appointments among HIV-positive clients, from 60% to 90%; retention rates at supported health facilities have improved from 45% to 89%. Furthermore, information dissemination has been achieved via mobile SMS, wherein subscribers can access health content on diverse topics – such as HIV/AIDS prevention and family planning – by sending messages to a pre-defined short code to a phone line. Over 900 beneficiaries have accessed health content via SMS subscriptions. Social media platforms, including Facebook and Twitter, are used for health information dissemination and have enabled a wider reach to over 13 million beneficiaries accessing health information on TMCG’s Facebook page alone. Tailoring mobile phone-based health content to meet the target beneficiaries’ needs is critical for TMCG’s impact and uptake. With rising rates of phone ownership and Internet connectivity in Uganda, mobile phones offer an affordable and proven adoptable avenue to overcome the chronic challenges faced by the health sector.
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MBONYE, A. K., K. S. HANSEN, F. WAMONO e P. MAGNUSSEN. "BARRIERS TO PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV SERVICES IN UGANDA". Journal of Biosocial Science 42, n. 2 (9 novembre 2009): 271–83. http://dx.doi.org/10.1017/s002193200999040x.
Testo completoAbstract (sommario):
SummaryUnderstanding care-seeking practices and barriers to prevention of mother-to-child transmission (PMTCT) of HIV is necessary in designing effective programmes to address the high disease burden due to HIV/AIDS in Uganda. This study explored perceptions, care-seeking practices and barriers to PMTCT among young and HIV-positive women. A household survey (10,706 women aged 14–49 years), twelve focus group discussions and 66 key informant interviews were carried out between January and April 2009 in Wakiso district, central Uganda. Results show that access to PMTCT services (family planning, HIV counselling and testing and delivery at health units) was poor. Decision making was an important factor in accessing PMTCT services. Socioeconomic factors (wealth quintile, age, education level) and institutional practices also influenced access to PMTCT. Overall, having had an HIV test was highest when both men and women made decisions together or when women were empowered to make their own decisions. This was significant across wealth quintiles (p=0.0001), age groups (p=0.0001) and education levels (p=0.0001). The least level of HIV testing was when men made decisions for their spouses; and this was the case with family planning and deliveries at health units. Other barriers to PMTCT were fear of women and male spouses to have an HIV test and the perception that HIV testing is compulsory in antenatal clinics. In conclusion, to increase access to PMTCT among women, especially the young, poor and least educated, there is a need to empower them to make decisions on health seeking, and also to empower men to support their spouses to make good decisions. Other barriers like fear of having an HIV test should be addressed through appropriate counselling of clients.
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Miller, Amanda P., Leo Ziegel, Stephen Mugamba, Emmanuel Kyasanku, Jennifer A. Wagman, Violet Nkwanzi-Lubega, Gertrude Nakigozi et al. "Not Enough Money and Too Many Thoughts: Exploring Perceptions of Mental Health in Two Ugandan Districts Through the Mental Health Literacy Framework". Qualitative Health Research 31, n. 5 (15 gennaio 2021): 967–82. http://dx.doi.org/10.1177/1049732320986164.
Testo completoAbstract (sommario):
Mental health disorders account for a heavy disease burden in Uganda. In order to provide culturally appropriate mental health prevention and treatment approaches, it is necessary to understand how mental health is conceptualized in the population. Three focus group discussions (FGDs) and 31 in-depth interviews (IDIs) were conducted with men and women aged 14 to 62 years residing in rural, urban, and semi-urban low-income communities in central and western Uganda to explore perceptions and knowledge of mental health. Interpretive thematic analysis was undertaken; results were organized through the lens of the mental health literacy framework. Environmental and societal stressors were identified as primary underlying causes of poor mental health. While participants recognized symptoms of poor mental health, gaps in mental health literacy also emerged. Mental health resources are needed in this setting and additional qualitative work assessing knowledge and attitudes toward mental health care seeking behavior can inform the development of acceptable integrated services.
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Nakiganda, Lydia J., Benjamin R. Bavinton, Andrew E. Grulich, David Serwadda, Rosette Nakubulwa, Isobel M. Poynten e Stephen Bell. "Social Influences on Engagement With HIV Testing, Treatment and Care Services Among Men Who Have Sex With Men Living in Rural Uganda". Qualitative Health Research 32, n. 4 (18 dicembre 2021): 635–45. http://dx.doi.org/10.1177/10497323211058162.
Testo completoAbstract (sommario):
Men who have sex with men in Uganda are a heterogenous, discriminated population, experiencing high HIV burden, limited access to HIV testing, and low treatment adherence. We contribute to the lack of information about men who have sex with men in rural Uganda by using socio-ecological analyses to examine the social influences shaping their engagement with HIV services. Based on in-depth interviews with 16 men, our findings reveal the inhibitive influence of interpersonal relationships with sexual partners, peers and families, and institutional influences within health service and non-governmental organizational settings. Yet men take action to strategize and seek support to enhance engagement with HIV care in heavily criminalized and stigmatized settings. Future HIV prevention, testing, treatment, and care responses could draw on what affected individuals and communities are already doing to enhance access to HIV services and the effective support strategies of some non-governmental organizations and healthcare workers.
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Chongsuwat, Tana, Aaliyah O. Ibrahim, Ann E. Evensen, James H. Conway, Margaret Zwick e William Oloya. "Health facility assessments of cervical cancer prevention, early diagnosis, and treatment services in Gulu, Uganda". PLOS Global Public Health 3, n. 2 (15 febbraio 2023): e0000785. http://dx.doi.org/10.1371/journal.pgph.0000785.
Testo completoAbstract (sommario):
Background Cervical cancer is ranked globally in the top three cancers for women younger than 45 years, with the average age of death at 59 years of age. The highest burden of disease is in low-to-middle income countries (LMICs), responsible for 90% of the 311,000 cervical cancer deaths in 2018. This growing health disparity is due to the lack of quality screening and treatment programs, low human papillomavirus (HPV) vaccination rates, and high human immunodeficiency virus (HIV) co-infection rates. To address these gaps in care, we need to develop a clear understanding of the resources and capabilities of LMICs’ health care facilities to provide prevention, early diagnosis through screening, and treatment for cervical cancer. Objectives This project aimed to assess baseline available cervical cancer prevention, early diagnosis, and treatment resources, at facilities designated as Health Center III or above, in Gulu, Uganda. Methods We adapted the World Health Organization’s Harmonized Health Facility Assessment for our own HFA and grading scale, deploying it in October 2021 for a cross-sectional analysis of 21 health facilities in Gulu. Results Grading of Health Center IIIs (n = 16) concluded that 37% had “excellent” or “good” resources available, and 63% of facilities had “poor” or “fair” resources available. Grading of Health Center IVs and above (n = 5) concluded that 60% of facilities had “excellent” or “good” resources, and 40% had “fair” resources available. Discussion The analysis of health facilities in Gulu demonstrated subpar resources available for cervical cancer prevention, early diagnosis, and treatment. Focused efforts are needed to expand health centers’ resources and capability to address rising cervical cancer rates and related health disparities in LMICs. The development process for this project’s HFA can be applied to global cervical cancer programming to determine gaps in resources and indicate areas to target improved health equity.
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Seeberger, Ulrike G., e Joseph J. Valadez. "Are health workers reduced to being drug dispensers of antiretroviral treatment? A randomized cross-sectional assessment of the quality of health care for HIV patients in northern Uganda". Health Policy and Planning 34, n. 8 (13 agosto 2019): 559–65. http://dx.doi.org/10.1093/heapol/czz074.
Testo completoAbstract (sommario):
Abstract High quality of care (QoC) for antiretroviral treatment (ART) is essential to prevent treatment failure. Uganda, as many sub-Saharan African countries, increased access to ART by decentralizing provision to districts. However, little is known whether this rapid scale-up maintained high-quality clinical services. We assess the quality of ART in the Acholi and Lango sub-regions of northern Uganda to identify whether the technical quality of critical ART sub-system needs improvement. We conducted a randomized cross-sectional survey among health facilities (HF) in Acholi (n = 11) and Lango (n = 10). Applying lot quality assurance sampling principles with a rapid health facility assessment tool, we assessed ART services vis-à-vis national treatment guidelines using 37 indicators. We interviewed health workers (n = 21) using structured questionnaires, directly observed clinical consultations (n = 126) and assessed HF infrastructure, human resources, medical supplies and patient records in each health facility (n = 21). The district QoC performance standard was 80% of HF had to comply with each guideline. Neither sub-region complied with treatment guidelines. No HF displayed adequate: patient monitoring, physical examination, training, supervision and regular monitoring of patients’ immunology. The full range of first and second line antiretroviral (ARV) medication was not available in Acholi while Lango had sufficient stocks. Clinicians dispensed available ARVs without benefit of physical examination or immunological monitoring. Patients reported compliance with drug use (>80%). Patients’ knowledge of preventing HIV/AIDS transmission concentrated on condom use; otherwise it was poor. The poor ART QoC in northern Uganda raises major questions about ART quality although ARVs were dispensed. Poor clinical care renders patients’ reports of treatment compliance as insufficient evidence that it takes place. Further studies need to test patients’ immunological status and QoC in more regions of Uganda and elsewhere in sub-Saharan Africa to identify topical and geographical areas which are priorities for improving HIV care.
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Mugisha, J. O., A. Edwards, N. Naidoo, S. Chatterji, J. Seeley e P. Kowal. "Longitudinal data resource from the Wellbeing of Older People cohort of people aged >50 years in Uganda and South Africa from 2009 to 2019". South African Medical Journal 113, n. 9 (4 settembre 2023): 36–41. http://dx.doi.org/10.7196/samj.2023.v113i8.16706.
Testo completoAbstract (sommario):
Background. The population of people aged ≥60 years continues to increase globally, and has been projected by the United NationsPopulation Division to increase to 21% of the total population by 2050. In addition, the number of older people living with HIV hascontinued to increase owing to the introduction of antiretroviral therapy as a treatment for HIV-infected people. Most of the older people living with HIV are in sub-Saharan Africa, an area that faces the biggest burden of HIV globally. Despite the high burden, there are limited reliable data on how HIV directly and indirectly affects the health and wellbeing of older people within this region.Objective. To showcase the availability of data on how HIV directly and indirectly affects the health and wellbeing of older people in Uganda and South Africa (SA).Methods. The World Health Organization Study on global AGEing and adult health (SAGE), in collaboration with Medical ResearchCouncil/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI and LSHTM) UgandaResearch Unit and the Africa Health Research Institute (AHRI) in SA, started the SAGE Wellbeing of Older People Study (WOPS) inUganda and SA in 2009. Since initiation, respondents have been surveyed every 2 years, with four waves of surveys conducted in Uganda and three waves in South Africa.Results. The available datasets consist of two cohorts of people, aged >50 years, who were surveyed every 2 years between 2009 and2018. The prevalence of HIV positivity over this period increased from 39% to 54% in Uganda and 48% to 62% in SA. The datasetsprovide comparisons of variables at a household level and at an individual level. At the individual level, the following measures can becompared longitudinally for a 10-year period for the following variables: sociodemographic characteristics; work history and benefits;health states and descriptions; anthropometrics performance tests and biomarkers; risk factors and preventive health behaviours;chronic conditions and health services coverage; healthcare utilisation; social cohesion; subjective wellbeing and quality of life; andimpact of caregiving.Conclusion. This article describes the WOPS in Uganda and SA, the population coverage of this study, and the survey frequency of WOPS, survey measures, data resources available, the data resource access and the strengths and weaknesses of the study. The article invites interested researchers to further analyse the data and answer research questions of interest to enhance the impact of these data.
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M Nanteza, Barbara, Ronald H Gray, David Serwadda, C. Kennedy e Fredrick Makumbi. "VMMC clients’ perception of increased risk of HIV infection, circumcision preferred choice of method, providers’ socio-demographics and mode of service delivery". African Health Sciences 20, n. 4 (16 dicembre 2020): 1562–72. http://dx.doi.org/10.4314/ahs.v20i4.8.
Testo completoAbstract (sommario):
Introduction: Voluntary medical male circumcision (VMMC) is a scientifically proven HIV prevention intervention. Uganda, like many countries has been implementing VMMC for over 10 years but uptake is still low especially in northern Uganda. To attain 80% needed for public health impact, scale-up was recommended with many innovations implemented with sub-optimal results. This study therefore wanted to find out some of the correlates of VMMC uptake in Gulu district, northern Uganda.
Methods: Two studies were conducted separately but data was analyzed for this study. For the quantitative study, propor- tions and frequencies were used to measure perception of increased risk of HIV infection using age, gender, occupation, marital and circumcision status. Qualitative study provided data from FGDs, IDIs and KIIs were first transcribed in Acholi and then translated in English. Transcripts were uploaded in MAXDQA software for data management. A code book for emerging themes was developed.
Results: A total of 548 respondents were interviewed for the quantitative study, where two thirds (66%) of the participants perceived themselves to be at increased risk of HIV infection. For the qualitative study, 149 participants from 19 FGDs, 11 KIIs and 9 IDIs were interviewed. Data were analyzed thematically using both inductive and deductive approaches. Devices were preferred to conventional surgery while mobile services were preferred to static services. However, there were diver- gent views regarding circumcision service providers’ socio-demographics and these were influenced mainly by age, level of education and location.
Conclusion: People in Northern Uganda perceived themselves to be at an increased risk of HIV infection. They preferred devices to conventional surgery, mobile services to static services but had varying views about the socio-demographics of the service providers.
Keywords: Male circumcision; challenges; HIV prevention.
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Mbonye, A. K., K. S. Hansen, F. Wamono e P. Magnussen. "Integration of malaria and HIV/AIDS prevention services through the private sector in Uganda". International Health 2, n. 1 (marzo 2010): 52–58. http://dx.doi.org/10.1016/j.inhe.2009.11.003.
Testo completo
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Musoke, David, Micheal Jonga, Gloria Kisakye Ndagire, Benon Musasizi, Amanuel Gidebo, Asrat Tolossa, Maya Thomas, Peter Waiswa e Richard Rumsey. "Involvement of community health workers in the COVID-19 pandemic response in Uganda: A qualitative study". PLOS Global Public Health 4, n. 6 (21 giugno 2024): e0003312. http://dx.doi.org/10.1371/journal.pgph.0003312.
Testo completoAbstract (sommario):
Community Health Workers (CHWs) are a key human resource for health particularly in low- and middle-income countries. In many parts of the world, CHWs are known to have played an instrumental role in controlling the COVID-19 pandemic. This study explored the involvement of CHWs in the COVID-19 response in Uganda. A qualitative study that involved 10 focus group discussions (FGDs) among CHWs was conducted. The study was carried out in 5 districts of Amuria, Karenga, Kamwenge, Bugiri and Pader. The FGD guide used explored the role of CHWs in the COVID-19 response in their communities including lived experiences, challenges, and coping mechanisms. The data were analyzed thematically with the support of NVivo version 12 pro (QSR International). CHWs were at the frontline of COVID-19 prevention interventions at households and in the community. CHWs raised awareness on prevention measures including wearing face masks, hand hygiene, and social distancing. They identified suspected cases such as new members entering the community, as well as individuals returning from abroad with signs and symptoms of COVID-19. CHWs mobilized the community and increased awareness on COVID-19 vaccination which played an important role in reducing misinformation. They also supported home-based management of mild COVID-19 cases through isolation of patients; provided health and nutritional guidance among patients in their homes; and referred suspected cases to health facilities for testing and management. Both monetary and non-monetary incentives were provided to support CHWs in the COVID-19 response. However, the adequacy and timing of the incentives were inadequate. Routine services of CHWs such as health promotion and treatment of childhood illnesses were disrupted during the pandemic. CHWs played an instrumental role in response to the pandemic especially on surveillance, risk communication, and observance of preventing measures. Strategies to ensure that routine services of CHWs are not disrupted during pandemics are needed.
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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 (maggio 2019): s165. http://dx.doi.org/10.1017/s1049023x19003765.
Testo completoAbstract (sommario):
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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Akunzirwe, Rebecca, Sabrina Bakeera-Kitaka, Joan N. Kalyango, Jane Frances Zalwango, Judith Amutuhaire Ssemasaazi, Tom Okello, Remmy Buhuguru, Sarah Kiguli, Aloysius G. Mubuuke e Sam Ononge. "Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda". PLOS ONE 17, n. 11 (1 novembre 2022): e0275905. http://dx.doi.org/10.1371/journal.pone.0275905.
Testo completoAbstract (sommario):
Background Group antenatal care (G-ANC), an alternative to focused ANC (F-ANC), involves grouping mothers by gestational and maternal age. In high-income countries, G-ANC has been associated with improved utilization of health care services like Prevention of Mother to Child Transmission (PMTCT) of HIV services. Some low-resource countries with poor utilization of health care services have piloted G-ANC. However, there is limited evidence of its efficiency. We, therefore, compared G-ANC versus F-ANC with regards to optimal utilization of PMTCT of HIV services and assessed associated factors thereof among adolescent mothers in eastern Uganda. We defined optimal utilization of PMTCT of HIV services as the adolescent being up to date with HIV counseling and testing. If found HIV negative, subsequent timely re-testing. If found HIV positive, initiation of antiretroviral therapy (ART) under option B plus for the mother. While for the infant, it entailed safe delivery, testing, feeding, and appropriate HIV chemotherapy. Methods From February to April 2020, we conducted a cross-sectional study among 528 adolescent mothers in four sites in eastern Uganda. We assessed the optimal utilization of PMTCT of HIV services among adolescent mothers that had attended G-ANC versus F-ANC at the post-natal care or immunization clinics. We also assessed the factors associated with optimal utilization of PMTCT of HIV services among these mothers. Results Optimal utilization of PMTCT was higher among those in G-ANC than in F-ANC (74.7% vs 41.2, p-0.0162). There was a statistically significant association between having attended G-ANC and optimal utilization of PMTCT [PR = 1.080, 95%CI (1.067–1.093)]. Other factors independently associated with optimal utilization were; having a partner that tested for HIV [PR = 1.075, 95%CI (1.048–1.103)], trimester of first ANC visit: second trimester [PR = 0.929, 95%CI (0.902–0.957)] and third trimester [PR = 0.725, 95%CI (0.616–0.853)], and the health facility attended: Bugembe HCIV [PR = 1.126, 95%CI (1.113–1.139)] and Jinja regional referral hospital [PR = 0.851, 95%CI (0.841–0.861] Conclusions Adolescent mothers under G-ANC had significantly higher optimal utilization of PMTCT of HIV services compared to those under F-ANC. We recommend that the Ministry of Health considers widely implementing G-ANC, especially for adolescent mothers.
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Khanakwa, Sarah, e Josue Mbonigaba. "Institutional Arrangements for Providing HIV and AIDS Services in Uganda: A Transaction Cost Economics Analysis". Health Services Insights 15 (gennaio 2022): 117863292210960. http://dx.doi.org/10.1177/11786329221096046.
Testo completoAbstract (sommario):
Transaction cost economics (TCE) theory predicts that features of institutional arrangements determine the intensity of their governance instruments. Consequently, institutional features link to transaction costs, but the linkages have received little attention in the public health literature. This study sought to address this gap. It examined the governance features of institutional arrangements and their transaction cost implications for providing HIV prevention and social support services in Uganda. The analysis was based on 4 proposed TCE governance instruments: administrative controls, adaptation, incentives and contract laws. These governance instruments were assessed in 3 modes of delivery( institutional arrangments) for HIV and AIDS Services in Uganda: Contracting-Out – the case of DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe); a Public-Non-Governmental Organisation (NGO) partnership – the case of the CHAI (Community-led HIV/AIDS Initiative); and direct Public Sector Delivery. These assessed delivery modes follow Williamson’s TCE framework of 3 institutional arrangements to deliver goods and services, notably market, hybrid (partnership) and internal (hierarchy) delivery, with related governance features. Within this framework, the discriminating alignment hypothesis guided the analysis. According to the hypothesis, the delivery modes of goods and services result in smaller transaction costs when their governance features are as predicted by TCE. The hypothesis was assessed by analysing, with qualitative methods, the differences in HIV and AIDS services characteristics across the 3 arrangements and their differences with theory prediction, and hence the difference in transaction cost implications. The study found that the delivery arrangements that minimised cost are those whose HIV and AIDS services were aligned with the TCE theory prediction. The aligned ‘public-NGO partnership’ arrangement (CHAI) had fewer sources of transactional costs than the misaligned arrangements – ‘contracting-out’ (DREAMS) and ‘public sector’. The analysis revealed that the DREAMS and public sector delivery models suffered some flaws in efficiencies. DREAMS had high administrative controls, high-powered tangible incentive intensity and intensive monitoring mechanisms for performance adaptation due to the lack of ‘trust’ on the part of the financing agency, contrary to the TCE prediction. In contrast with the TCE prediction, low administrative controls in the public sector arose from the failure to invest in performance monitoring systems. The high-powered incentive intensity and low administrative controls observed in the CHAI arrangement primarily stemmed from the reliance on informal institutions (trust, social expectations and reputation) rather than principal-agent arms-length sanctions. These results suggest that the level of transaction costs is associated with features of institutional arrangements. The valuable insights from TCE could contribute to policymaking during the design of institutional arrangements to efficiently deliver HIV and AIDS services.
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Kironde, Ezra Conrad. "Understanding Knowledge, Attitude, and Uptake of Cervical Cancer Screening among Women in Kiryandongo General Hospital". IDOSR JOURNAL OF SCIENCE AND TECHNOLOGY 10, n. 1 (1 aprile 2024): 23–34. http://dx.doi.org/10.59298/idosr/jst/24/101.233439.
Testo completoAbstract (sommario):
Cervical cancer remains a significant public health concern globally, particularly in low-income countries where mortality rates are disproportionately high. This cross-sectional study aimed to assess the knowledge, attitude, and uptake of cervical cancer screening among reproductive-aged women attending Kiryandongo General Hospital in Uganda. A sample size of 288 participants was determined using a modified Daniel’s formula, and data was collected using investigator-administered questionnaires. Results revealed that while the majority of participants had heard about cervical cancer, knowledge about its causative agent, risk factors, and preventive measures was low. Despite this, a considerable proportion expressed positive attitudes towards screening and willingness to undergo screening. However, the uptake of cervical cancer screening was alarmingly low, with only 4.9% of participants having been screened. These findings underscore the urgent need for comprehensive awareness campaigns and improved access to screening services in order to address the knowledge gaps and increase uptake of cervical cancer screening among women in the study area. Keywords: Cervical Cancer Screening, Pap smears, Health education, Knowledge, Attitude, Uptake, Reproductive-aged women
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Kabwama, Steven Ndugwa, Rhoda K. Wanyenze, Suzanne N. Kiwanuka, Alice Namale, Rawlance Ndejjo, Fred Monje, William Wang et al. "Interventions for Maintenance of Essential Health Service Delivery during the COVID-19 Response in Uganda, between March 2020 and April 2021". International Journal of Environmental Research and Public Health 19, n. 19 (30 settembre 2022): 12522. http://dx.doi.org/10.3390/ijerph191912522.
Testo completoAbstract (sommario):
Introduction: The COVID-19 pandemic overwhelmed health systems globally and affected the delivery of health services. We conducted a study in Uganda to describe the interventions adopted to maintain the delivery of other health services. Methods: We reviewed documents and interviewed 21 key informants. Thematic analysis was conducted to identify themes using the World Health Organization health system building blocks as a guiding framework. Results: Governance strategies included the establishment of coordination committees and the development and dissemination of guidelines. Infrastructure and commodity strategies included the review of drug supply plans and allowing emergency orders. Workforce strategies included the provision of infection prevention and control equipment, recruitment and provision of incentives. Service delivery modifications included the designation of facilities for COVID-19 management, patient self-management, dispensing drugs for longer periods and the leveraging community patient networks to distribute medicines. However, multi-month drug dispensing led to drug stock-outs while community drug distribution was associated with stigma. Conclusions: Health service maintenance during emergencies requires coordination to harness existing health system investments. The essential services continuity committee coordinated efforts to maintain services and should remain a critical element of emergency response. Self-management and leveraging patient networks should address stigma to support service continuity in similar settings and strengthen service delivery beyond the pandemic.
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Mukose, Aggrey D., Senait Kebede, Christine Muhumuza, Fredrick Makumbi, Henry Komakech, Esther Bayiga, Denis Busobozi et al. "Costs and Cost Drivers of Providing Option B+ Services to Mother-Baby Pairs for PMTCT of HIV in Health Centre IV Facilities in Jinja District, Uganda". BioMed Research International 2020 (20 maggio 2020): 1–9. http://dx.doi.org/10.1155/2020/2875864.
Testo completoAbstract (sommario):
Background. In 2013, the World Health Organization (WHO) revised the 2012 guidelines on use of antiretroviral drugs (ARVs) for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV). The new guidelines recommended lifelong antiretroviral therapy (ART) for all HIV-positive pregnant and breastfeeding women irrespective of CD4 count or clinical stage (also referred to as Option B+). Uganda started implementing Option B+ in 2012 basing on the 2012 WHO guidelines. Despite the impressive benefits of the Option B+ strategy, implementation challenges, including cost burden and mother-baby pairs lost to follow-up, threatened its overall effectiveness. The researchers were unable to identify any studies conducted to assess costs and cost drivers associated with provision of Option B+ services to mother-baby pairs in HIV care in Uganda. Therefore, this study determined costs and cost drivers of providing Option B+ services to mother-baby pairs over a two-year period (2014–2015) in selected health facilities in Jinja district, Uganda. Methods. The estimated costs of providing Option B+ to mother-baby pairs derived from the provider perspective were evaluated at four health centres (HC) in Jinja district. A retrospective, ingredient-based costing approach was used to collect data for 2014 as base year using a standardized cost data capture tool. All costs were valued in United States dollars (USD) using the 2014 midyear exchange rate. Costs incurred in the second year (2015) were obtained by inflating the 2014 costs by the ratio of 2015 and 2014 USA Gross Domestic Product (GDP) implicit price deflator. Results. The average total cost of Option B+ services per HC was 66,512.7 (range: 32,168.2–102,831.1) USD over the 2-year period. The average unit cost of Option B+ services per mother-baby pair was USD 441.9 (range: 422.5–502.6). ART for mothers was the biggest driver of total mean costs (percent contribution: 62.6%; range: 56.0%–65.5%) followed by facility personnel (percent contribution: 8.2%; range: 7.7%–11.6%), and facility-level monitoring and quality improvement (percent contribution: 6.0%; range: 3.2%–12.3%). Conclusions and Recommendations. ART for mothers was the major cost driver. Efforts to lower the cost of ART for PMTCT would make delivery of Option B+ affordable and sustainable.
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Ogata, Ai, Fred Wambuzi, Brenda D. Nakirya e Alex Onzima. "Schoolchildren's Lifestyle and Behaviors Relating to Obesity: Collaborative Study in Urban Uganda". Evidence-Based Nursing Research 5, n. 2 (14 aprile 2023): 48–57. http://dx.doi.org/10.47104/ebnrojs3.v5i2.262.
Testo completoAbstract (sommario):
Context: Child obesity, one of the major contributors to noncommunicable diseases in developing countries, is rising following drastic economic growth and lifestyle changes. In Uganda, noncommunicable diseases as a cause of death have increased from 15% in 1990 to 35% in 2019.
Aim: The study aimed to investigate schoolchildren’s obesity status, lifestyle behaviors, and the factors of obesity in urban Uganda.
Methods: The study was conducted with a cross-sectional, descriptive quantitative design. The survey using the researcher-developed questionnaire and physical measurement tools for 330 children aged 9 to 11 years old in 6 elementary schools in urban Uganda in November 2018. The Japanese Red Cross College of Nursing Institutional Review Board approved this study (Approval Number: 2018-066).
Results: Obesity status among schoolchildren in urban Uganda was 67.6% normal, 25.2% underweight, 5.4% overweight, and 1.8% obese.
Conclusion: Obesity and overweight have not been predominant in this population. However, children's growth must be carefully monitored to prevent future overweight and obesity due to the limited availability of school health services and rapid lifestyle changes. Demographic factors associated with obesity status (waist-hip ratio, body fat, and body mass index) were gender, financial access to food, screen time, sleep time, and sleep hours. Based on this study in Uganda, the researchers expect to develop further collaborative child obesity prevention projects.
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Agwang, A., H. Ngonzi e J. Ekudo. "Working With Organized Groups to Change Cultural Beliefs and Norms Toward Cancer in Uganda". Journal of Global Oncology 4, Supplement 2 (1 ottobre 2018): 142s. http://dx.doi.org/10.1200/jgo.18.56900.
Testo completoAbstract (sommario):
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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Olebo, David Francis. "Investigating Infection Prevention and Control Practices among Healthcare Workers in Kasese District, Uganda: Factors and Implications for Ebola Preparedness". Public Health Open Access 8, n. 1 (2024): 1–10. http://dx.doi.org/10.23880/phoa-16000261.
Testo completoAbstract (sommario):
The World Health Organization (WHO) African region often faces numerous public health emergencies, with a significant proportion caused by infectious diseases. Ebola virus disease (EVD) is a high-consequence pathogen of particular concern due to its high mortality rate and potential for global transmission. The study aimed to investigate infection prevention and control (IPC) practices with factors associated with the practice among health care workers (HCWs) in Kasese district, Uganda. The study design was cross-sectional, utilizing both qualitative and quantitative methods. The study population consisted of HCWs working in six selected Health Centre III facilities in sub-counties bordering the Democratic Republic of Congo (DRC). A sample of 106 HCWs was purposively selected and data collection involved structured questionnaires, and then data analysis was done using descriptive statistics and logistic regression. The study reveals that a majority of HCWs were female (55.7%), worked in outpatient departments (49.1%), had 6-10 years of service (43.4%), held certificates as their highest education level (48.1%), and were predominantly nurses (53.8%). IPC practices were found to be low, with 72.6% of participants exhibiting inappropriate IPC practices. Individual factors influencing low IPC practices included the duration of IPC training, knowledge, attitude towards IPC, and education level, all statistically significant (P < 0.05). Similarly, health facility factors such as the accessibility of IPC guidelines and personal protective equipment (PPE), availability of sanitizer/soap, and proper and continuous IPC training/continuing medical education (CME) were associated with low IPC practice (P < 0.05). In conclusion, the study highlights a low level of IPC practice among HCWs in Health Centre Threes in Kasese District, with both individual and health facility factors contributing to this issue. Recommendations include training HCWs in IPC and organizing regular cascade training, providing IPC knowledge as part of their daily duties, ensuring confidence in managing Ebola during outbreaks, maintaining IPC strategies implemented during EVD outbreaks, and supplying IPC materials to healthcare facilities. These efforts, coupled with increased staffing, can significantly enhance protection and performance in public healthcare services.
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Rujumba, Joseph, Jaco Homsy, Femke Bannink Mbazzi, Zikulah Namukwaya, Alexander Amone, Gordon Rukundo, Elly Katabira, Josaphat Byamugisha, Mary Glenn Fowler e Rachel L. King. "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, n. 6 (29 giugno 2021): e0253616. http://dx.doi.org/10.1371/journal.pone.0253616.
Testo completoAbstract (sommario):
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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Mugisha, E., G. H. van Rensburg e E. Potgieter. "Strategic Framework for Increasing Accessibility and Utilization of Voluntary Counseling and Testing Services in Uganda". AIDS Research and Treatment 2011 (2011): 1–9. http://dx.doi.org/10.1155/2011/912650.
Testo completoAbstract (sommario):
Despite the usefulness of VCT service as an entry point to prevention for the HIV-uninfected people and care, treatment and support for those who test HIV positive, VCT service remains poorly utilized among the fishing communities. The aim of the study was to identify factors influencing VCT service delivery and utilisation among fishing communities in Uganda and consequently, formulated a strategic framework for improving VCT service delivery and utilisation in the fishing communities. The study followed a 3-phased approach, collecting and analyzing quantitative data from Kasenyi fishing community under phase I, collecting and analyzing qualitative data from hospital managers and VCT counselors in phases II and III, respectively. Results indicate that VCT services delivery and utilisation is affected by factors at government (macro) level, the institution (meso) level, and at the individual (micro) level. Based on this, a strategic framework was designed, expected to increase VCT service availability, accessibility, and acceptability if applied. The researcher recommends the use of this useful tool in the design of VCT programs.
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Ssemata, Andrew Sentoogo, Chiti Bwalya, Richard Muhumuza, Denis Ndekezi, Madalitso Mbewe, Musonda Simwinga, Virginia Bond e Janet Seeley. "Assessing knowledge, acceptability and social implications of a peer-to-peer HIV self-testing kit distribution model among adolescents aged 15–24 in Zambia and Uganda—HISTAZU: a mixed-method study protocol". BMJ Open 12, n. 5 (maggio 2022): e059340. http://dx.doi.org/10.1136/bmjopen-2021-059340.
Testo completoAbstract (sommario):
IntroductionHIV self-testing (HIVST) across sub-Saharan African countries may be acceptable as it overcomes significant barriers to clinic-based HIV testing services such as privacy and confidentiality. There are a number of suggested HIVST distribution models. However, they may not be responsive to the testing service needs of adolescents and young people (AYP). We will investigate the knowledge, acceptability and social implications of a peer-to-peer distribution model of HIVST kits on uptake of HIV prevention including pre-exposure prophylaxis, condoms, and voluntary medical male circumcision and testing services and linkage to anti-retroviral therapy among AYP aged 15–24 in Zambia and Uganda.Methods and analysisWe will conduct an exploratory mixed methods study among AYP aged 15–24 in Uganda and Zambia. Qualitative data will be collected using audio-recorded in-depth interviews (IDIs), focus group discussions (FGDs), and participant observations. All IDIs and FGDs will be transcribed verbatim, coded and analysed through a thematic-content analysis. The quantitative data will be collected through a structured survey questionnaire derived from the preliminary findings of the qualitative work and programme evaluation quantitative data collected on uptake of services from a Zambian trial. The quantitative phase will evaluate the number of AYP reached and interested in HIVST and the implication of this on household social relations and social harms. The quantitative data will be analysed through bivariate analyses. The study will explore any social–cultural and study design barriers or facilitators to uptake of HIVST.Ethics and disseminationThis study is approved by the Uganda Virus Research Institute Research and Ethics committee, Uganda National Council for Science and Technology, University of Zambia Biomedical Ethics Committee, Zambia National Health Research Authority and the London School of Hygiene and Tropical Medicine. Dissemination activities will involve publications in peer-reviewed journals, presentations at conferences and stakeholder meetings in the communities.
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Geofrey, Kajura. "Determinants Impacting the Use of Antibiotics Among Patients Visiting the Dental Clinic at Kampala International University Teaching Hospital in Bushenyi-Ishaka Municipality, Western Uganda". INOSR EXPERIMENTAL SCIENCES 12, n. 2 (18 settembre 2023): 104–18. http://dx.doi.org/10.59298/inosres/2023/2.8.1000.
Testo completoAbstract (sommario):
The primary objective of this investigation was to identify the factors influencing the usage of antibiotics among patients seeking care at the Dental Clinic within Kampala International University Teaching Hospital, situated in Bushenyi-Ishaka Municipality, Western Uganda. The study employed a cross-sectional hospital-based survey, gathering data between February and July 2022. This design enables the collection of specific parameters at a single point in time. Analyzed data was presented through tables and figures, illustrating frequencies and proportions. For continuous variables, univariate analysis was conducted, presenting measures of central tendency (such as mean, median, and mode) and measures of dispersion (like range, interquartile range, and standard deviation) for various independent variables. The study revealed that financial constraints were cited by patients and health center nurses as a significant factor causing delays in seeking dental care and occasionally resulting in non-attendance at the dental department. From interviews, patient-related factors emerged, including knowledge about oral health services, awareness of services offered in dental clinics, perceived necessity, fear, anxiety, and access to oral health services. Consequently, the study recommended an enhancement in oral health education initiatives, particularly leveraging media channels, due to a shortage of community oral health personnel. The aim is to extensively educate the population about preventing oral diseases and the appropriate timing for seeking oral health services, enabling individuals to make well-informed decisions regarding their oral health. Keywords: Antibiotics, bacterial infections, Dental Clinic, Oral health.
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Muhumuza, Richard, Andrew Sentoogo Ssemata, Ayoub Kakande, Nadia Ahmed, Millicent Atujuna, Mangxilana Nomvuyo, Linda-Gail Bekker et al. "Exploring Perceived Barriers and Facilitators of PrEP Uptake among Young People in Uganda, Zimbabwe, and South Africa". Archives of Sexual Behavior 50, n. 4 (maggio 2021): 1729–42. http://dx.doi.org/10.1007/s10508-020-01880-y.
Testo completoAbstract (sommario):
Abstract Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. Few studies have explored adolescents and young people’s perspectives toward PrEP. We conducted 24 group discussions and 60 in-depth interviews with males and females aged 13–24 years in Uganda, Zimbabwe, and South Africa between September 2018 and February 2019. We used the framework approach to generate themes and key concepts for analysis following the social ecological model. Young people expressed a willingness to use PrEP and identified potential barriers and facilitators of PrEP uptake. Barriers included factors at individual (fear of HIV, fear of side effects, and PrEP characteristics), interpersonal (parental influence, absence of a sexual partner), community (peer influence, social stigma), institutional (long waiting times at clinics, attitudes of health workers), and structural (cost of PrEP and mode of administration, accessibility concerns) levels. Facilitators included factors at individual (high HIV risk perception and preventing HIV/desire to remain HIV negative), interpersonal (peer influence, social support and care for PrEP uptake), community (adequate PrEP information and sensitization, evidence of PrEP efficacy and safety), institutional (convenient and responsive services, provision of appropriate and sufficiently resourced services), and structural (access and availability of PrEP, cost of PrEP) levels. The findings indicated that PrEP is an acceptable HIV prevention method. PrEP uptake is linked to personal and environmental factors that need to be considered for successful PrEP roll-out. Multi-level interventions needed to promote PrEP uptake should consider the social and structural drivers and focus on ways that can inspire PrEP uptake and limit the barriers.
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Odulusi, Daniel. "Cost effectiveness analysis of typhoid fever vaccination in an endemic district of Kabale, Uganda". International Journal Of Community Medicine And Public Health 9, n. 11 (29 ottobre 2022): 4030. http://dx.doi.org/10.18203/2394-6040.ijcmph20222896.
Testo completoAbstract (sommario):
Background: Typhoid fever is a preventable disease that affects the livelihood security of households and communities, accounting for a significant portion of the disease burden in Kabale district. Various preventive programs to control this burden such as curative services and vaccination are being implemented without empirical evidence of the effectiveness of either program in terms of costs and outcomes.Methodology: The study design is a mixed methods design in which for specific research objectives a cross-sectional survey was carried out in addition to a retrospective costing analysis. The outcome being a cost effectiveness evaluation of vaccination against typhoid with the comparator being no vaccination, expressed as the incremental cost effectiveness ratio. Results: Incidence rate of 39.8 per 1000, a case fatality rate of 0.061, and cost of illness of $75.62 for inpatient care and $33.85 for an outpatient case, with an average cost of illness of typhoid fever in Kabale district to be $54.74. In addition, typhoid fever costs Kabale district $217,158.8, of which $119,814.92 could be saved if a typhoid fever vaccination program is carried out, that will avert 2,189 cases of typhoid every year for three years. Vaccination results in 28,428.32 DALYs avoided. The resulting ICER of -6.348 reveals that the vaccination program against typhoid fever is both extremely cheaper and very effective in averting both typhoid cases and costs.Conclusions: a one-time fixed-post typhoid vaccination campaign in Kabale District, Uganda, was estimated to be a very highly cost-effective intervention from the public sector health care delivery perspective.
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Babughirana, Geoffrey, Sanne Gerards, Alex Mokori, Benon Musasizi, Nathan Isabirye, Isaac Charles Baigereza, Grace Rukanda, Emmanuel Bussaja, Stef Kremers e Jessica Gubbels. "Effects of Implementing the Timed and Targeted Counselling Model on Pregnancy Outcomes and Newborn Survival in Rural Uganda: Protocol for a Quasi-Experimental Study". Methods and Protocols 3, n. 4 (29 ottobre 2020): 73. http://dx.doi.org/10.3390/mps3040073.
Testo completoAbstract (sommario):
Background: Although mortality rates have declined in Uganda over the last decade, maternal mortality is still high at 336 deaths per 100,000 live births, as is infant mortality at 43 deaths per 1000 live births. One in every 19 babies born in Uganda does not live to celebrate their first birthday. Many of these deaths occur within the first 28 days of life, forming the single largest category of death. Promising effects for preventing death are expected from timed and targeted counselling (ttC), an intervention package of key messages and actions that address integrated health and nutrition needs of the mothers and children, barriers and negotiation agreement, to cause sustainable behavioural change at specific timelines in the first 1000 days. Methods: The study has a quasi-experimental design in order to evaluate the implementation and effectiveness of the ttC intervention. Participants are pregnant women who have been registered by village health team (VHT) members and who live in Hoima (intervention region) or Masindi (control region) districts, who will be monitored throughout their pregnancy up to at least six weeks after delivery. A multi-stage sampling technique will be employed to select participants, the study sites being purposively chosen. Sample size is determined using the pregnancy rate from the population estimates, resulting in a total required sample of 1218 (609 each in the intervention and control group). Study instruments that will be used include the Ugandan VHT household register (in which all mothers to be studied will be registered), the ttC register (an additional tool for the study area), and a study questionnaire, to collect data at outcome level. Univariate, bivariate and multivariate analyses will be performed using SPSS to evaluate intervention effects on outcomes (e.g., relationship between pregnancy outcomes and antenatal attendance). In addition, quantitative findings will be triangulated with qualitative data, and collected through interviews and focus group discussions with participants and implementers. Discussion: The proposed study will examine the effectiveness of implementing ttC to improve maternal and child outcomes in Uganda. If ttC is effective, broader implementation of appropriate antenatal services can be advised as essential newborn care improvements. Trial registration: PACTR, PACTR202002812123868. Registered on 25 February 2020.