Browsing by Author "Lwenge, Mathias"

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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 Commission, 2023) Akankwasa, Edith; Kamya, Willy; Sendijja, Moses; Mudoola, Janet; Lwenge, Mathias; Anguyo DDM Onzima, Robert; Kasozi, Daniel; Byansi, Peter; Katongole, Simon Peter
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. 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. 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. 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.
Coronavirus Disease Pandemic Response in Uganda: Government Trust, Risk Perception and Willingness to Adhere to Public Health Measures Among Social Media Users
(2022) Kiconco, Arthur; Kabanda, Richard; Tugume, Abdulaziz; Mwagale, Ritah; Kananathan, Abirahmi; Bakyaita, Tabley; Nabukenya, Immaculate; Lwenge, Mathias; Kalenzi, Prisca U
Background: The Coronavirus Disease (COVID-19) pandemic has greatly affected many nations, and continues to be a global public health challenge. There is progress in responding to the pandemic including universal access to vaccines in most of the developed countries while access to the vaccines in resource limited countries is still limited to only priority groups. Despite the availability of vaccines, promotion of preventive measures through public health risk communication remains essential. Effective risk communication depends on understanding population factors that affect the response. This study assessed government trust, risk perception and willingness to adhere to COVID-19 preventive measures among social media users. Methods: This was an online analytical cross-sectional survey in Uganda. Data collection was conducted from 16-27 October 2020 using an online self-administered questionnaire. Data was analyzed using STATA and generalized linear modelling with modified Poisson regression was conducted to determine association between the variables. Results: Of 1,014 respondents, most 69.3% (703) were males, 77.71% (788) had completed tertiary education and 72.3% (733) were salaried employees. Overall trust in government response to COVID-19 pandemic was 40.1%. Most of the respondents 69.9% (n=1008) believed that COVID-19 is extremely likely to spread across the country. However, over a half 65.4% (n=994) perceived little or no risk of getting infected with COVID-19. More than half 53.55% (1014) were willing to receive vaccination against COVID-19 in case it was available. Factors positively associated with trust in government response to COVID-19 included being a student (APR 1.56, CI: 1.14-2.12, p=0.005), being in the 36-59 (APR 1.36, CI: 1.16-1.60, p<0.001) and 60+ (APR 1.98, CI: 1.40-2.28, p<0.001) age groups. Being male was negatively associated with trust in government (APR 0.84, CI: 0.72-0.92, p=0.04). Risk perception was associated with trust in government (APR 1.37 CI: 1.42-1.65, p=0.001). There was high level of willingness to adhere to COVID-19 preventive measures among respondents in the 36-59 (APR 1.02, CI: 1.0-1.03, p<0.01) and 60+ (APR 1.03; CI: 1.0-1.04, p<0.01) age groups while low level of willingness was associated with little or no trust in government response to COVID-19 (APR 0.97, CI: 0.95-0.98, P<0.01). Conclusions: The overall trust in government’s response was low. Majority of respondents believed that COVID-19 is extremely likely to spread across the country, but over a half perceived a low risk of getting infected with the virus. Respondents with low trust in government were less willing to adhere to COVID-19 preventive measures. Therefore, there should be interventions designed to improve people’s trust in government, as well as focusing public health risk communication to addressing misconceptions and misinformation about COVID-19 and improving risk perception by clarifying the key vulnerable populations.
Coverage of child disability detection, management, and rehabilitation health services in Central Uganda
(The East African Health Research Commission, 2024-06-24) Akankwasa, Edith; Kamya, Willy; Sendijja, Moses; Mudoola, Janet; Lwenge, Mathias; Onzima, Anguyo DDM Robert; Katongole, Simon-Peter
Child disability is a significant public health concern which impacts 1 in 20 children. Children with disabilities (CwDs) encounter deprivation of rights, biases in society, and a lack of access to necessary services, all of which are exacerbated by structural obstacles. This study assessed the coverage of child disability prevention, management and rehabilitation services in four districts of Central Uganda after two years of interventions to improve these services. The Lot Quality Assurance Sampling (LQAS) rapid health facility assessment method was employed to assess coverage of services based on sixteen indicators. The indicators were set based on constructs of: provision of disability-related services to CwDs; use of rehabilitation services; readiness of the health facilities (HFs) to provide basic disability management and rehabilitation services; community structures for linkage to disability management and rehabilitation services; psychosocial support provision; and upholding and protecting the rights of CwDs. A district-level decision rule was set based on 80% coverage target. Despite the interventions, the services have yet to provide the desired level of benefit to CwDs and their caregivers. Out of the sixteen indicators for healthcare service coverage for CwDs, only three attained the 80% coverage target. The findings suggest that greater focus by health service planners and project implementers is still needed, especially at the community and health facility levels to enhance the prevention, management and rehabilitation of CwDs. Psychosocial health services for caregivers of CwDs need special attention in order to achieve better service approaches.
Intrapersonal factors associated with cervical cancer screening among women in fishing communities of Entebbe Municipality, Wakiso District. a cross-sectional study
(Student's Journal of Health Research Africa, 2023-03-30) Keneemaa, Emily; Lwenge, Mathias; Nanyunja, Zaitune; Kawoozo, Barbara; Ampeire, Immaculate; Ssetaala, Ali; Mpendo, Juliet; Okech, Brenda; Okodan, Daniel
The chances of developing cervical cancer in Uganda continue to rise especially in the fishing communities due to the relatively higher prevalence of inter-related personal risk factors. This study aimed to examine the Intrapersonal Factors Associated with Cervical Cancer Screening Among Women in Fishing Communities of Entebbe Municipality, Wakiso District. Methodology A descriptive cross-sectional survey study was conducted among women in the fishing communities of Entebbe-Municipality Wakiso district in Central Uganda and utilized quantitative methods of data collection. Data were collected using a structured questionnaire with multiple-response questions. Data were analyzed using SPSS version 25, univariate, bivariate, and multivariate analysis were performed at 5% level significance. Results Of the 293 respondents that were interviewed, only 23.2% of women had ever been screened for cervical cancer. More than three-quarters of them knew that cervical cancer is not curable 234(79.9%). 150(51.2%) women mentioned that the age at the start of screening for cervical cancer in Uganda is 18 years and had 46% less prevalence of cervical cancer screening (cPR = 0.54 [0.33 - 0.90], p = 0.020). Among the perception attributes Cervical cancer screening prevalence was twice as high among women who agreed that cervical cancer is a curse from God (cPR = 2.43 [CI = 1.49 - 3.97], P = 0.000) compared to those who disagreed. Conclusion The intrapersonal factors associated with cervical cancer screening among women in the fishing communities of Entebbe municipality were mainly; marital status, employment status, knowledge of age at the start of the screening, and perceptions of the relevance of screening. Recommendation Communication and education should focus on awareness creation about the fact that even in a marriage where not much risky sexual behavior may be present, the risk of HPV infection remains apparent, for instance from sexually transmitted infections within the couple.
Malaria treatment health seeking behaviors among international students at the University of Ghana Legon
(PLOS, 2023-10-26) Lwenge, Mathias; Govule, Philip; Katongole, Simon Peter; Dako-Gyeke, Phyllis
Appropriate management of malaria demands early health seeking behaviour upon suspicion of malaria-like symptoms. This study examined malaria treatment seeking behaviour and associated factors among international students at University of Ghana. The study used a cross-sectional and quantitative approach. Data collection was undertaken using a structured questionnaire administered on a random sample of 264 international students. Data obtained on malaria treatment and factors influencing treatment behaviors were analyzed using IBM, SPSS Statistics version 22. Associations between individual characteristics and Malaria treatment seeking behavior was assessed by Pearson Chi-square(X2) test of independence. Binary logistic regression model was built using a backwards Wald approach, with variables retained at Wald p-value <0.05. The findings show that 35% of the respondents obtained self-prescribed antimalarial at their utmost first choice of Malaria treatment. At bivariate level, a significant relationship between Malaria health-care seeking behaviour and:- Respondents continent, X2(1, N = 264) = 7.936, p = .005; Service accessibility, X2(1, N = 264) = 7.624, p = .006; Wait time, X2(1, N = 264) = 22.514, p <0.001; Treatment cost, X2(1, N = 264) = 97.160, p <0.001; Health insurance, X2(1, N = 264) = 5.837, p = 0.016, and Perceived staff attitude, X2(1, N = 264) = 18.557, p < 0.001. At multivariable analysis, inappropriate malaria health seeking behaviours was associated with low perceived service accessibility as (≥30mins) (aOR = 6.67; p<0.001), perceived long wait time (≥30mins), (aOR = 5.94; p = 0.015), perceived treatment cost affordability (<15 GHC) (aOR = 19.88; p<0.001) and age group: -34-41years (aOR = 8.83; p<0.001). There were widespread inappropriate health-care seeking behavior for Malaria treatment among international students. Improving accessibility to malaria treatment services, reducing wait time at health facilities and the treatment cost will address inappropriate malaria treatment health seeking behaviours among the international students.