Browsing by Author "Amongin, Dinah"
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Item Improving the Quality of Maternity Services in Uganda Through Accelerated Implementation of Essential Interventions by Healthcare Professional Associations(John Wiley & Sons, Inc., 2017-06-20) Cintia, Cintia; Kwizera, Amata; Jacob, Sue; Amongin, Dinah; Ngonzi, Joseph; Namisi, P. Charles; Byaruhanga, Romano; Rushwan, Hamid; Cooper, Peter; Day‐Stirk, Frances; Berrueta, Mabel; García‐Elorrio, Ezequiel; Belizán, M. JoséObjective To assess whether the implementation of a package of activities through the joint action of the three international healthcare professionals associations (HCPAs) increased the use of intrapartum and postnatal essential interventions (EIs) in two hospitals in Uganda. Methods A non‐controlled before‐and‐after study was undertaken to evaluate the effect of a package of activities designed to change practice relating to nine EIs among providers. Coverage of the EIs was measured in a 3‐month pre‐implementation period and a 3‐month post‐implementation period in 2014. Data were obtained for women older than 18 years who delivered vaginally or by cesarean. Results Overall, 4816 women were included. Level of use remained high for EIs used widely at baseline. Some EIs that had low use at baseline did not show improvement after the implementation. Promotion of breastfeeding showed a significant improvement in the Kampala hospital, from 8.5% (8/94) to 25.6% (30/117; P=0.001), whereas promotion of hygiene in cord care improved at the Mbarara hospital, from 0.1% (2/1592) to 46.0% (622/1351; P<0.001). Conclusion These exploratory results show that a package delivered through the joint work of the three HCPAs was feasible to implement along with rigorous data collection. Although the data show disparities, trends suggest that improvement could be achieved.Item Predictors of survival among older adults with HIV in Uganda’s AIDS support organization centers of excellence (1987 2023): a retrospective longitudinal study(Springer Nature Link, 2025-02-26) Atuhairwe, Christine; Atuhaire, Leonard; Wandera, Ojambo Stephen; Amongin, Dinah; Ochieng, Titus; Misinde, CyprianThe growing number of older adults living with HIV, facilitated by wider access to antiretroviral therapy (ART), presents unique challenges. This study aims to identify predictors of survival among older persons living with HIV receiving ART in Uganda’s AIDS Support Organization Centers of Excellence (1987–2023). Understanding these predictors can inform effective clinical interventions to improve outcomes for this population. This study conducted a retrospective analysis of medical records from 11 TASO centers of excellence in Uganda (1987–2023). Using Cox proportional hazards regression, we identified factors associated with survival among older adults living with HIV. TASO centers of excellence in Entebbe, Gulu, Jinja, Masaka, Masindi, Mbale, Mbarara, Mulago, Rukungiri, Soroti, and Tororo. Cox proportional hazards regression analysis identified factors influencing survival among older persons living with HIV (OPLHIV). Of the 30,758 OPLHIV medical records analyzed (1987–2023), 72.5% were active on ART, 5.9% had died, 15.2% were lost to follow-up, and 5.6% transferred to other facilities. Survival was significantly associated with: gender (female, HR = 1.19, p < 0.001), marital status (married, HR = 0.99, p < 0.001; separated/divorced, HR = 0.85, p < 0.001), WHO clinical stage (II, HR = 1.66, p < 0.001), viral load (> 200 copies/ml, HR = 1.49, p < 0.001), and ART adherence (fair, HR = 0.94, p = 0.157). Key predictors of survival among Older Adults Living with HIV (OPLHIV) include: female gender, age 50–59, weight 51–70 kg, married status, viral load > 200 copies/ml, WHO HIV clinical stage II, paid employment, and ART adherence. To improve survival outcomes, consistent clinical screenings of WHO clinical stages, viral load, and ART adherence are essential. These measures can guide healthcare providers in making informed treatment decisions to enhance survival and quality of life for OPLHIV in Uganda. Strengthen routine monitoring of viral load, ART adherence, and WHO clinical staging. Provide targeted support to married and separated/divorced adults to improve their survival chances. Address gender disparities in care to enhance outcomes for females. Focus on maintaining ART adherence and viral suppression to reduce mortality risks.Item Prevalence, regional distribution, and determinants of infertility in Uganda between 2006 and 2016: analysis of three demographic and health surveys(2024) Zaake, Daniel; Amongin, Dinah; Beňová, Lenka; Kiwanuka, N. Suzanne; Nalwadda, K, Christine; Nakafeero, Mary; Riese, Sara; Kayiira, Anthony; Asefa, AntenehLow- and middle-income countries, particularly in the African region in-country distribution and determinants of infertility are understudied. In this study, we aimed to estimate the prevalence, regional distribution, and determinants of infertility in Uganda to inform programming. We estimated the prevalence of primary and secondary infertility among women aged 20-49 years using data from the three rounds of the Uganda Demographic and Health Survey 2006, 2011, and 2016, and compared the differences across geographic regions. We pooled data sets for all three years and conducted logistic regression to identify factors associated with infertility. We included 16,537 women aged 20-49 years for analysis of primary infertility and 12,628 for secondary infertility. The overall prevalence of infertility (pooled across the three surveys was 6.4%. The prevalence of primary infertility was 1.4% (95% Confidence interval, CI=1.0-1.8), 0.7% (95% CI=0.5-1.0) and 0.8% (95% CI=0.6-1.0) in 2006, 2011 and 2016, respectively. The prevalence of secondary infertility was 7.4% (95% CI=6.5-8.4), 6.9% (95% CI=5.9-8.0) and 7.1% (95% CI=6.4-7.9) in 2006, 2011, and 2016 respectively. The prevalence of primary infertility was similar across regions. Secondary infertility was highest in the Central (7.9%, 95% CI= 6.1-10.3, in 2016) and Northern regions (7.4%, 95% CI=6.1-8.9, in 2016). In all survey years, women with higher education had lower odds of secondary infertility compared to women with no education (adjusted odds ratio, aOR=0.54, 95% CI=0.35-0.83; P < 0.001). Our results suggest that the prevalence of primary infertility is similar across regions, whereas secondary infertility varies by region, with higher prevalence in Central and Northern regions. More research is required to understand the drivers behind the variation of secondary infertility across regions to inform policy and decision making
