Browsing by Author "Nanyingi, Miisa"

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Adherence to Laboratory Findings in the Management of Malaria in The High and Low Transmission Areas of Nakasongola and Kabalore Districts of Uganda
(2008) Nanyingi, Miisa
Malaria is one of the leading causes of morbidity and mortality in Africa today. It is estimated that a single bout of malaria in Africa costs a sum equivalent to earning for over ten working days. In Uganda, more than 95% of the malaria cases are due to Plasmodium falciparum, the most virulent parasite species that causes severe forms of disease. It has acquired resistance to the commonly used and cheap antimalarial medicines like Chloroquine and Sulfadoxine/Pyrimethamine (CQ/SP) combination. The Uganda Government changed the malaria treatment policy in 2005 to include Artemisinin Combination Therapies (ACTs) as first line treatment for the uncomplicated malaria. Whereas prompt and accurate laboratory diagnosis of malaria is the key to the effective management malaria, clinical syndromic diagnosis has been the most widely used approach in Uganda. This was widely advocated for in sub-Saharan Africa as a means of increasing antimalarial coverage and reducing the risk of progression to severe disease and death. However, such practice was only tolerated in the era of inexpensive and safe antimalarial therapy of CQ/SP. An adult course of the new recommended first-line ACTs costs more than 10 times the cost of a course of CQ/SP. It is therefore difficult to afford this treatment at individual and national levels. Therefore, presumptive treatment becomes economically and clinically less acceptable and raises a need for a more accurate diagnosis. To make a definitive diagnosis of malaria, demonstration of the parasite in the blood is essential. However, it was not whether health workers have started adopting the reliance on laboratory results before making antimalarial prescriptions. The study was an attempt to understand the practices of health workers in the health facilities with laboratory services in one high and one low malaria transmission areas of Uganda. Nine health facilities in Nakasongola and Kabalore were selected on the basis of possession of functional laboratory services and 487 patients with fever/receiving antimalarial treatment were enrolled for the survey. It was found that access to laboratory services was limited to a small population. Although the majority of patients reporting to these health facilities (over 95% for the two districts) were sent to the laboratory, only 52% and 32% of those that received their results for Nakasongola and Kabarole respectively tested positive for the presence of malaria parasites. However, all patients reporting to the health facilities with fever still received antimalarials despite health worker training and guidelines under the new first-line treatment policy. This meant that health workers have not changed their prescription practices and laboratory findings were not being used in the management of malaria.
Application of workload indicators of staffing needs (WISN) in determining health workers' requirements for Mityana general hospital, Uganda
(International Journal of Public Health Research, 2015-08-30) Govule, Philip; Mugisha, John Francis; Katongole, Simon Peter; Bikaitwoha, Maniple Evard; Nanyingi, Miisa; Anguyo, Robert; Onzima, DDM
With reducing number of health workers amidst increasing disease burden, ever increasing population and limited resources, health systems are faced with challenges of providing adequate and quality health care globally. The application of provider-population ratio or fixed staff establishments have overtime, not matched the changing human resource needs of health care organizations. This study aimed to estimate human resource requirements of Mityana hospital basing on workload as an alternative to the existing approaches. Methodology: We employed descriptive cross-sectional design and the Workload Indicator of Staffing Needs (WISN) methodology. We utilized focus group discussion, observation and document review to obtain information from key informants; generated annual service statistics from the hospital’s records. The quantitative data were analyzed using the WISN software and spread sheet. Results: All the cadres studied had the same hours of work in a year (1,664), except nursing assistants whose annual available working time was1,696 hours. All the cadres were experiencing additional workload due to use of their time for activities other than their primary duties. Medical officers used more than 50% of their time for such (non-primary) activities compared to the laboratory staff (15%). As a result, the calculated WISN staff requirements were very high compared to the existing staff levels. Mityana hospital had 44% of the posts filled for the studied cadres. The nurses and midwives had the highest calculated requirements (72 and 45 respectively) and the highest staff positions filled (57% and 84% respectively) making them experience the lowest work pressure (49% each). The highest work pressure was experienced by medical officers and medical clinical officers (82% each). Conclusion: The study reveals shortages in health workforce in Mityana hospital. Non-primary activities contributed to work pressure in different units of the hospital, resulting into long hours of shifts which could have compromised quality of health care. This method (WISN) estimates staffing requirements based on actual service provision. Stakeholders facing human resource challenges and scarcity can employ it in prioritizing health cadres for recruitment and deployment based on existing work pressure.
Cancer Risk Studies and Priority Areas for Cancer Risk Appraisal in Uganda
(Annals of Global Health, 2020) Jatho, Alfred; Thang Tran, Binh; Marcos Cambia, Jansen; Nanyingi, Miisa; Mugume Mugisha, Noleb
Research into aetiologies and prevention of the commonest cancers and implementation of primary and secondary prevention can reduce cancer risk and improve quality of life. Moreover, monitoring the prevalence of cancer risk factors in a specific population helps guide cancer prevention and early detection efforts and national cancer control programming. This article aims to provide the scope and findings of cancer risk studies conducted in Uganda to guide researchers, health-care professionals, and policymakers. Methods: Between November 2019 to January 2020, we searched peer-reviewed published articles in Pubmed, EMBASE and Cochrane Library (Cochrane central register of controlled trials-CENTRAL). We followed the recommendation of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – the PRISMA. The primary focus was to identify cancer risk and prevention studies conducted in Uganda and published in peer-reviewed journals from January 2000 and January 2020. We used key Boolean search terms with their associated database strings. We identified 416 articles, screened 269 non-duplicate articles and obtained 77 full-text articles for review. Out of the 77 studies, we identified one (1%) randomized trial, two (2.5%) retrospective cohort studies and 14 (18%) case-control studies, 46 (60%) cross-sectional studies, five (6.4%) ecological studies, three panel studies (4%) and six (8%) qualitative studies. Cervical cancer was the most studied type of cancer in Uganda (23.4%, n = 18 studies), followed by lymphomas – both Hodgkin and NonHodgkin sub-types (20.7%), n = 16 studies) and breast cancer (15.6%, n = 12 studies). In lymphoma studies, Burkitt lymphoma was the most studied type of lymphoma (76%, n = 13 studies). The studies concentrated on specific cancer risk awareness, risk perceptions, attitudes, uptake of screening, uptake of human papillomavirus vaccination, the prevalence of some of the known cancer risk factors and obstacles to accessing screening services. The unmet need for comprehensive cancer risk and prevention studies is enormous in Uganda. Future studies need to comprehensively investigate the known and putative cancer risk factors and prioritize the application of the higher-hierarchy evidence-generating epidemiological studies to guide planning of the national cancer control program.
Common Medical Errors and Error Reporting Systems in Selected Hospitals of Central Uganda
(International Journal of Public Health Research, 2015-08-30) Katongole, Simon Peter; Anguyo, Robert DDM Onzima; Nanyingi, Miisa; Nakiwala, Stella Regina
Medical errors are under studied in the developing world, therefore, this study set out to identify common errors committed during provision of health care and error management systems in the hospitals with reference to central Uganda. This was a descriptive cross sectional study carried out between January 16th and January 22nd 2012 in four hospitals in central Uganda (2 Public hospitals and 2 Catholic Private not for profit hospitals). A total of 160 health workers participated in the study. Respondents were interviewed the on errors they had committed or witnessed happening in their hospitals during the 3 months preceding this study. Patients’ records of the three months preceding the study were also reviewed to identify the common medical errors that had been committed. Of the six hundred and eighteen records that were reviewed’ medication (17.2%) and diagnostic (40.5%) were the commonest medical errors. Health workers too mentioned medication (58%) and diagnostic (53%) as the commonest errors they had witnessed or committed in the hospitals. No formal error reporting system existed in all the hospitals. Errors committed or witnessed were mainly disclosed to supervisors and/or colleagues during handover of duty and informal interactions. Lack of feedback, fear of punishment and litigation were the major impediments to disclosing errors. Error reporting importance was highly perceived by health workers. Instituting a mechanism of formal error reporting and management should be considered by the hospitals and the ministry of health so that errors can be used as a mechanism for ‘prevention by past experience’
Determinants of adolescent and youth sexual and reproductive health service utilization in hard-to-reach communities of Amudat District, Uganda
(African Journals Online, 2021-08) Ssebadduka, Bernadette; Nanyingi, Miisa
INTRODUCTION Uganda has one of the largest adolescent and youth populations globally and yet access and utilization of sexual and reproductive health services (SRH) among this population remains inadequate, especially in hard-to-reach communities. This study sought to establish the contextual determinants of service utilization in Amudat District, a hard-to-reach community in Karamoja, Uganda. MATERIALS AND METHODS A community based descriptive cross-sectional study was conducted using random sampling of 503 respondents recruited after informed consent. Data were collected using interviewer administered questionnaires, entered into epidata 3.1 and analysed using STATA version 12. For quantitative data, logistic regression analysis was used to determine factors associated with services utilization. Qualitative data were analysed by content analysis, for themes. RESULTS Older adolescents and youth out-of-school were more likely to utilise services, with religion and socially accepted norms additionally determining utilisation of services. CONCLUSION Strengthening social services that keep adolescents in school; supporting community engagement through youth gatekeepers particularly youth champions, religious and cultural leaders; while fostering family values that favour SRH discussions will increase access to and use of SRH services in hard-to-reach communities. RECOMMENDATIONS Promote culturally adapted sexuality education; prevent child marriage, and provide youth friendly SRH services aligned to need in Amudat and similar settings.
Determining Healthcare Workforce Requirements for Kuluva Hospital in West Nile-Uganda, using the Workload Indicators of Staffing Need (WISN)
(Research Square, 2023-04-29) Anguyo DDM Onzima, Robert; Govule, Philip; Apangu, Titus; Harogha, Alan; Wibale, Wilson; Debo, Ronald; Ambayo, Richard; Lulua Awudo, Jimmy; Maryekmungu, Immaculate; Likico Bayoru, Aziku Celina; Nanyingi, Miisa; Karengera, Innocent
Health workforce shortage is a major threat to global public health with a greater implication for low resourced countries. The right placement of the available staff in many health facilities remains a challenge due to inadequate information on exact workload and work pressure that staff undergo in course of work. This study aimed to determine the need for key health workforce cadre in Kuluva hospital using Workload Indicators of Staffing Need (WISN) methodology. The study followed a predominantly quantitative approach of Workload Indicator Staffing Needs (WISN) methodology. We held a meeting with hospital management to understand policy issues and procedures. The key staff were interviewed in departments, available records reviewed, practices observed to establish the available working time, activity standards and time taken to perform other supportive activities. Service statistics was generated from HMIS data of 2016/17. Data was analyzed manually using calculator and Microsoft Excel spreadsheet. All cadre categories had the same available working time of 1,504 hours in a year with 105 staff of the studied cadres required to perform all activities in Kuluva hospital based on WISN calculation. Although overall work pressure was 30%, 5 out of 7 staff cadre categories experienced work pressure of varying degrees – medical officers (70%), laboratory staff (70%) and clinical officers (60%) were most affected compared to nurses (30%) and midwives (10%). There was perfect number of anesthetists but surplus nursing assistants than needed by the hospital. Amidst shortage, the critical cadres still spent significant time on non-professional activities; medical officers (24%) and midwives (25%). These findings can provide insight into the management of Kuluva hospital to address the current disparities in the health workforce in terms of numbers and skill mix for continuous improvement of health service delivery to the population it serves.
Factors associated with perceived work-life balance among health workers in Gulu District, Northern Uganda: a health facility-based cross-sectional study
(Springer Link, 2024-01-23) Obina, Wilfred Felicity; Ndibazza, Juliet; Kabanda, Richard; Musana, Jonathan; Nanyingi, Miisa
Work-life balance (WLB) plays a significant role in improving career satisfaction and reducing burnout. While health workers’ productivity is considered a key factor in client care, there is limited effort put into examining how health workers perceive the balance of their jobs with family and other societal responsibilities (PWLB), especially in low-income countries where the number of health workers in active patient care is low. The purpose of this study was to assess factors associated with perceived work-life balance (PWLB) among health workers in the rural district of Gulu, Northern Uganda. A health facility-based cross-sectional analytical study was conducted. A simple random sampling technique was used to select 384 study participants from the three main hospitals in Gulu District. Data were collected from health workers using a self-administered semi-structured questionnaire and analyzed using STATA version 15. Factors associated with PWLB were determined at a multivariable level using a modified Poisson regression with robust variance with a 95% confidence level and 5% statistical significance. Adjusted prevalent ratios (APR) were used to report the Factors associated with PWLB. Only 157/384 (40.9%) of the health workers reported a positive perceived work-life balance. Multivariable modified Poisson regression analysis showed positive statistical association with PWLB of a laboratory worker(APR=1.74, 95% CI: 1.10–2.75); a midwife(APR=1.82, 95% CI:1.13–2.93) or a nurse (APR=2.19, 95% CI=1.45– 3.30); working in the inpatient department (APR=1.97, 95% CI: 1.31–2.96) or laboratory (APR=2.09, 95%CI: 1.34–3.28); and having a flexible work schedule (APR=28.32, 95%CI:14.52–55.22); feeling satisfied at work (APR=1.58; 95% CI:1.17–2.10), and belonging to an association in the community (APR=32.71, 95% Cl:11.91–89.88). On the other hand, employment tenure of 1–4 years (APR=0.63,95% CI:0.40–0.99) was negatively associated with perceived work-life balance. Only four in every 10 health workers experienced a positive perceived work-life balance. The type of profession, duty station, flexibility in work schedule, satisfaction with work, and availability of social support systems
Factors associated with perceived worklife balance among health workers in Gulu District, Northern Uganda: a health facility based cross-sectional study
(Springer Link, 2024-01-23) Obina, Wilfred Felicity; Ndibazza, Juliet; Kabanda, Richard; Musana, Jonathan; Nanyingi, Miisa
Work-life balance (WLB) plays a significant role in improving career satisfaction and reducing burnout. While health workers’ productivity is considered a key factor in client care, there is limited effort put into examining how health workers perceive the balance of their jobs with family and other societal responsibilities (PWLB), especially in low-income countries where the number of health workers in active patient care is low. The purpose of this study was to assess factors associated with perceived work-life balance (PWLB) among health workers in the rural district of Gulu, Northern Uganda. A health facility-based cross-sectional analytical study was conducted. A simple random sampling technique was used to select 384 study participants from the three main hospitals in Gulu District. Data were collected from health workers using a self-administered semi-structured questionnaire and analyzed using STATA version 15. Factors associated with PWLB were determined at a multivariable level using a modified Poisson regression with robust variance with a 95% confidence level and 5% statistical significance. Adjusted prevalent ratios (APR) were used to report the Factors associated with PWLB. Only 157/384 (40.9%) of the health workers reported a positive perceived work-life balance. Multivariable modified Poisson regression analysis showed positive statistical association with PWLB of a laboratory worker(APR=1.74, 95% CI: 1.10–2.75); a midwife(APR=1.82, 95% CI:1.13–2.93) or a nurse (APR=2.19, 95% CI=1.45– 3.30); working in the inpatient department (APR=1.97, 95% CI: 1.31–2.96) or laboratory (APR=2.09, 95%CI: 1.34–3.28); and having a flexible work schedule (APR=28.32, 95%CI:14.52–55.22); feeling satisfied at work (APR=1.58; 95% CI:1.17–2.10), and belonging to an association in the community (APR=32.71, 95% Cl:11.91–89.88). On the other hand, employment tenure of 1–4 years (APR=0.63,95% CI:0.40–0.99) was negatively associated with perceived work-life balance. Only four in every 10 health workers experienced a positive perceived work-life balance. The type of profession, duty station, flexibility in work schedule, satisfaction with work, and availability of social support systems, were independent determinants of perceived WLB. Therefore, nurturing a system of reviews of the scheduling of health workers, allowing internal staff rotation, and fostering support systems around the health workers could be beneficial for WLB.
Factors influencing adoption of oral health promotion by antenatal care providers in Moyo district, North-Western Uganda
(PLOS, 2023-04-25) Lulu, Patrick Madrama; Nanyingi, Miisa
Oral health promotion (OHP) during pregnancy is an important global public health and basic human right issue related to quality of life. Several statements and guidelines have been published emphasizing the need for improved oral health care of pregnant mothers, prenatal care providers have missed this critical opportunity. In this study, we assessed factors influencing adoption of oral health promotion by antenatal care providers. A descriptive cross-sectional study design that employed both quantitative and qualitative data collection methods and analysis. 152 samples determined using Yamane’s 1967 and stratified sampling technique was used. Three FGDs and six KI interviews were held. Univariate, bivariate and multivariate analyses were done using SPSS (20.0) and ATLAS Ti for qualitative analysis. Adoption of OHP was low 28% (42). Factors influencing adoption were age of respondents (OR = 0.066, 95%CI = 0.009–0.465, p = 0.006*), level of care of health facility (OR = 0.050, 95%CI = 0.008–0.322, p = 0.002*), good understanding between dentists and ANC providers (OR = 0.283, 95%CI = 0.084–0.958, p = 0.042*), availability of practice guideline for OHP in ANC (OR = 0.323, 95%CI = 0.108–0.958, p = 0.043*), number of years at work (p = 0.084), being knowledgeable (OR = 2.143, 95%CI = 0.864–5.311, p = 0.100), having skills to advance OHP(OR = 0.734, 95%CI = 0.272–1.984, p = 0.542), Management being good at influencing new practices (OR = 00.477.734, 95%CI = 0.227–2.000, p = 0.477). More emphasis on national and local of oral health issues, continuous staff training on oral health, dissemination of National oral health policy (NOHP) were some of key issues that emerged from the qualitative results. Adoption of OHP was low. This was attributed to age, number of years spent at work, level of health facility, having good understanding between dentists and ANC providers, availability of practice guidelines, dissemination of National oral health policy, continuous staff training. We recommend the current NOHP to be reviewed, develop prenatal OHC guidelines, enhance the capacity of ANC providers through training, collaboration with dentists and launch official adoption of OHP.
Factors Influencing Uptake of Sexually Transmitted Infections Screening Among Adolescent Female Sex Workers in Mukono District
(Opast publishing group, 2020-04-29) Nakkazi, Joan; Nanyingi, Miisa
Background Worldwide, more than 1 million Sexually Transmitted Infections (STIs) are acquired every day and female adolescents aged 10 to 19 years are almost twice more susceptible to STIs than boys of the same age. The highest STI prevalence has been reported among key populations such as Female Sex Workers (FSWs) and fisher folk. This study investigated the factors influencing uptake of sexually transmitted infections screening among Adolescent Female sex Workers (AFSWs) in Mukono district, Uganda. Methods In this cross-sectional descriptive and analytical study, a total of 355 AFSWs based on the streets, bars, lodges, hotels, brothels, landing sites and other entertainment places in Mukono district were recruited using snowball sampling. Data was collected using pre-tested semi-structured questionnaires through face to face interviews with the help of trained research assistants. Data collected was entered into Epi- Data and then exported to SPSS for analysis. Analysis was done at three levels; Univariate for descriptive summary, Bivariate to test for possible association between each independent variable and the outcome variable, and Multivariate logistic regression to control for possible confounding effects of the independent variables. Chi square (χ2) test was done and p value 0.05 used to determine the association. Results This study found that uptake of STIs screening among AFSWs was 32.1%. AFSWs who reported that STI screening wasn’t embarrassing were 3 times more likely to take-up STI screening than those who said uptake of STI screening was embarrassing (PR = 3.45, 95%CI = 1.96–6.09, P = < 0.001). AFSWs who reported that STI screening wasn’t painful were 5 times more likely to take-up STI screening than those who said uptake of STI screening was painful (PR = 5.45, 95%CI = 2.78–10.66, P = < 0.001). Conclusion STIs screening rate among AFSWs in Mukono district was at 32.1%. Individual factors (attitude) and health facility factors were found to be the real influencers of uptake of STI screening among AFSWs in Mukono district. We, therefore, recommend that government scales up provision of sexually transmitted infection screening to even cater for high risk and vulnerable groups to facilitate and increase access to STI screening.
Health system factors influencing traditional herbal medicine use during pregnancy amongst women in Mpigi District, Central Uganda
(African Journal of Reproductive Health, 2021) Tumuhaise, Criscent; Kabanda, Richard; Nanyingi, Miisa; Kiconco, Arthur
An estimated 80% of the population in developing countries is dependent on traditional medicine for their health needs, including use during pregnancy despite limited knowledge of potential side effects including teratogenicity. Controlling use of traditional medicines during pregnancy requires understanding the driving factors. This study aimed at determining the health system factors that influence traditional herbal medicine use during pregnancy in a Ugandan setting. A cross-sectional study was conducted among 315 post-partum women obtained by random sampling from post-natal clinics of health facilities in Mpigi District after informed consent. We carried out concurrent triangulation by conducting two focused group discussions of 10 post-natal mothers each, and four Key informant interviews. Quantitative Data analysis involved descriptive statistics and logistic regression analysis. Qualitative data was analyzed by thematic content analysis and presented as narratives. Prevalence of herbal medicine use during pregnancy was 79% (95% Confidence Interval (CI) 68.1% – 86.9%), mainly consumed through oral route (96%). Costly health care adjusted Prevalence Ratio (aPR) 1.61 (95% CI 1.02-2.53), p-value 0.042, and presence and influence of Traditional Birth Attendants aPR 1.21(95% CI 1.05-1.41), p-value 0.011 were significantly associated with use of traditional herbal medicines during pregnancy. Use of traditional herbal medicines is driven by the high costs of quality health care and influence from Traditional Birth Attendants. Innovations in health financing should be promoted and Traditional Birth Attendants should be sensitized and incorporated in the mainstream health care system as community referral agents. (Afr J Reprod Health 2021; 25[6]: 88-98).
Lived Experiences of Prostate Cancer Patients Below 55 Years of Age: A Phenomenological Study of Outpatients Receiving Treatment at the Uganda Cancer Institute
(African Journals Online, 2020-10-06) Nabisubi, Prossy; Nanyingi, Miisa; Okeny, Paul K.
Cancer of the prostate is globally the second commonest cancer among men. Its incidence in Uganda is rising and is currently reported at 5.2%. It is responsible for about 25% of cancer deaths among male Ugandans. The diagnosis and treatment of prostate cancer is associated with massive psychosocial effects on top of the biomedical implications both for the patient and the healthcare system. Understanding these implications from the patients’ perspective may help inform service planning and resource allocation. This study aimed to explore the lived experiences of men below 55 years of age with prostate cancer at Uganda Cancer Institute. The study design was qualitative with a phenomenological approach based on social constructivism theory. Open ended questions were used to conduct in-depth interviews with purposively selected prostate cancer patients at Uganda Cancer Institute (UCI) until theoretical saturation was reached. Their care givers were also interviewed to aid triangulation. Thematic-content analysis of data was performed using Tesch’s eight steps. Twelve patients and eight care givers were interviewed. The recurrent themes were lack of information and unavailability of health workers, altered lives and/or state of doubt, sense of loneliness and lack of support groups. Two marriages were broken as a direct consequence of the experience with prostate cancer. Inconsistent information or complete lack of it and unacceptably long waiting times led to disillusionment and frustration with the health care system. None of the participants received any counseling. The unmet needs from these experiences included psychosocial support, clarity of information and psychosexual support for treatment related side effects. Strengthening a holistic multidisciplinary approach and creation of support groups may help improve the experience with prostate cancer in Uganda.
Maternal Health Care Seeking Behavior of Peri-Urban Women With Disability in Busiro South, Wakiso District, Uganda: a Community Based Study
(Research Square, 2020-08-10) Natukunda, Bonny; Musoke, David; Kiconco, Arthur; Mugambe, Samuel; Atuhairwe, Christine; Taremwa, Ivan Mugisha; Nanyingi, Miisa
In Uganda women with disabilities attend antenatal care (ANC) while pregnant, however, majority of these deliver from the hands of Traditional Birth Attendants (TBAs) due to due to fear of being mistreated by skilled birth attendants. We explored the determinants of the maternal health seeking behavior of women with disability in Busiro health sub district (HSD), Wakiso district, Uganda. A community based cross-sectional study involving quantitative and qualitative methods of data collection was conducted among 182 participants. Quantitative data were collected from disabled women, and qualitative data from six key informants (midwives and in-charges) at selected health facilities in Busiro HSD, Wakiso district. Logistic regression was used to determine the factors influencing the decision to seek maternal health care services (ANC and delivery at health facilities) among women with disability. Qualitative data were analyzed by content analysis. The findings revealed that 82.3% of women with disability attended ANC during pregnancy, and of these, 80.8% delivered their babies at health facilities. Attendance of ANC by the women with disability was influenced by parity (having 1-3 children) (AOR 7.7; 95% CI: 0.249-239.040), mode of delivery-normal delivery verses caesarian section (AOR 2.6, 95%CI: 0.296-22921), place visited during pregnancy TBA visa vie public health facilities (AOR 4.5, 95%CI: 0.922-22.576), and distance to the health facility being less than 5 Kilometres (AOR 2.3 95% CI: 0.695-7.661). There is need to intensify awareness of the use of skilled health workers during pregnancy and child birth to women with disability in the communities so as to improve uptake of maternal health care services.
Missed Opportunity for Neonates to Live: A Cross-sectional study on Utilization of Peri-natal Death Audits to address the Causes of Peri-Natal Mortality in District Hospitals of East–Central Uganda.
(Students journal of health research Africa, 2022-09-10) Waako, Christopher Knox; Nanyingi, Miisa; Katongole, Simon Peter; Atuhairwe, Christine; Konso, Jennipher Mariam; Maniple, Everd
Aim: To assess the utilization of PDAs in addressing the avoidable causes of perinatal mortality in the eastern region of Uganda. Methodology: A cross-section design using a mixed method was conducted between 2014-2015 at Iganga, Bugiri, and Kamuli general hospitals in the East-Central region of Uganda. The interviews involved 115 health workers who included Doctors, Nurses/Midwives, Clinical officers, and Laboratory and Theatre staff. These were drawn from four departments including the Maternity ward, Outpatient department, Theatre, and paediatric ward. Hospital top and departmental managers formed the key informants for this study. Annual reports for the period 2009/10-2012/13 were reviewed. In addition, monthly reports for the calendar year 2013 together with patients’ clinical case notes and patients’ registers were also reviewed to determine the magnitude and causes of perinatal mortality. Factors contributing to perinatal death were assessed and categorized into foetal, maternal, and health facility factors. Results: Results revealed a high and rising perinatal mortality rate of 70/1,000 live births and a decreasing maternal mortality ratio of 363/100,000 live births. Most perinatal deaths were fresh stillbirths 48/88 which occurred during the intrapartum period and the majority of early neonatal death was due to birth asphyxia. None of the health facilities was conducting perinatal death audits and the quality of data used for perinatal death audits was inadequate and was scored poorly. Challenges hindering utilization of perinatal death audits included: lack of staff sensitization and training, work overload, lack of motivation, fear of blame and litigation, political interference, and lack of support from the community. Conclusion: There was a high prevalence of perinatal deaths in east-central Uganda yet none of the hospitals was conducting perinatal death reviews. Recommendations: Health workers should be trained on perinatal death audit tools and guidelines and the records departments are revitalized with tools and personnel for effective data management.
Prevalence and correlates of intimate partner sexual violence among pregnant women in Napak district, North-eastern Uganda
(PLOS, 2024-02-01) Amodoi, Godfrey Patrick; Mugisha Taremwa, Ivan; Nakakande1, Joan; Akugizibwe, Pardon; Mugambe, Samuel; Nanyingi, Miisa
Intimate partner sexual violence (IPSV) during pregnancy is of key reproductive health concern as it is associated with various risks linked to severe intrapartum complications. This study assessed the prevalence and the correlates of intimate partner sexual violence among pregnant women in Napak district, Northeastern Uganda. This was an analytical cross-sectional study conducted among 284 pregnant women who were obtained by systematic sampling in Napak district between November and December 2020. A structured questionnaire was used to collect the data, and this was analyzed using STATA version 15. The correlates of IPSV were determined at a multivariable level using a Poisson regression model with robust variance at the individual, relationship, and societal levels of the socioecological model. The study enrolled 284 pregnant women of whom, 65.5% were aged between 18 and 28 years and 62.0% were not formally educated. Also, 56% of the pregnant women had experienced IPSV during their current pregnancies, the most prevalent form (35.6%) being unwanted sexual advances. Factors of women being in their third or subsequent pregnancies, primiparity, women who rated their communication with their partners as low, being in a relationship for less than five years, lower age of the spouse, and a lower level of education (primary) among women showed a statistical association with IPSV. This study reports a high prevalence of IPSV during pregnancy, and it was associated with individual, relationship, and societal factors. Based on this, concerted efforts through sensitization on the dangers of IPSV are required to avert the practice.
Prevalence and factors associated with sexual and reproductive health literacy among youth living with HIV in Uganda: a cross-sectional study
(Springer Link, 2023-08-07) Mugabi, Benedicto; Nanyingi, Miisa; Kabanda, Richard; Ndibazza; Ndibazza, Juliet; Elyanu, Peter; Asiimwe, John Baptist; Nazziwa, Gorret; Habaasa, Gilbert; Kekitiinwa, Adeodata
Adequate sexual and reproductive health literacy (SRHL) among young people has been linked to informed sexual behaviours. Studies on SRHL have largely been conducted among the general adolescent population. Little is known about youth aged 15-24 years living with human immunodefciency virus (YLHIV). There is a possible lack of SRHL in this population, considering the high rate of teenage pregnancies and unprotected sex reported by YLHIV. This study aimed to assess the prevalence and associated personal and environmental factors for SRHL among YLHIV at a high-volume urban HIV Clinic in Uganda. Through a cross-sectional survey, YLHIV receiving routine HIV care services at Baylor-Uganda HIV Clinic were interviewed using an adapted European Health Literacy Survey (HLS-EU). Using simple random sampling, eligible youth who received HIV care services between August and November 2019 were enrolled in the study. SRHL scores were computed using the HLS-EU index method; and individuals whose scores ranged from 34 to 50 were considered health literate. We used descriptive statistics to determine the prevalence. Potential associated personal and environmental factors (p<0.05) were identifed by performing two-step inferential statistics, bivariate analysis and binary logistic regression. Odds ratios were calculated to estimate the likelihood of youth being health literate on sexual and reproductive health (SRH) issues in comparison with the reference categories, and 95% confdence intervals were determined to establish whether the relationships were statistically signifcant. Of the 267 YLHIV interviewed at Baylor-Uganda HIV Clinic, 167 (62.5%) were female with a mean age of 18.9 years (SD± 2.8), and the majority (242; 90.6%) were vertically infected with HIV. Only 52 (19.5%) were health literate on SRH issues. At the multivariate level, YLHIV who never had difculty accessing SRH information were 0.391 times less likely to be health literate on SRH issues than their counterparts with challenges in accessing SRH information (Adjusted Odds Ratio [AOR] = 0.391, 95% CI =0.178 to 0.860; p= 0.019). YLHIV who did not fnd it easy to access SRH care service points were 2.929 times more likely to be literate in SRH than those who found it easy to access such services (Adjusted Odds Ratio [AOR] = 2.929, 95% CI =1.241 to 6.917; p=0.014). Additionally, YLHIV who did not listen to radio health talks were 2.406 times more likely to be health literate on SRH issues than those who did (AOR = 2.406, 95% CI =1.133 to 5.112; p=0.022). SRHL is an unmet need among YLHIV; only 19.5% were health literate on SRH issues. This could complicate the achievement of the UNAIDS sustainable development goal (SDG) of an HIV/AIDS-free generation by 2030 because low health literacy (HL) skills can afect the efcacy of almost all HIV disease prevention and health promotion eforts. Inaccessible SRH care service points and not listening to radio health talks were positively associated with SRHL, while having access to SRH information was negatively associated with SRHL.
Risk perception and usage of non-occupational post-exposure prophylaxis among fisherfolk in Ggulwe parish on the shores of Lake Victoria in central Uganda
(Frontiers, 2023-11-08) Bahikire1, Daraus; Nanyingi, Miisa; Atuhairwe, Christine; Matama, Catherine; Ninsiima, Lesley Rose; Bbuye, Mudarshiru
The use of non-occupational post-exposure prophylaxis (nPEP) to prevent HIV acquisition among those exposed as an approach to HIV prevention has expanded in Uganda. Although there are increased eorts to avail nPEP services among most at-risk populations, the usage of nPEP medicines remains low. Therefore, this study examined the risk perception and usage of non-occupational post-exposure prophylaxis (nPEP) among fisherfolk in the Ggulwe fishing parish, Bussi sub-county, Wakiso district. A cross-sectional study among adults was carried out from October 2020 to January 2021 in Ggulwe parish, Bussi sub-county, Wakiso district, to examine the usage of nPEP and factors influencing the usage. Data were collected using semi-structured questionnaires, and key informants’ interviews were conducted among healthcare providers and the local leadership. The quantitative data were summarized using bivariate and multivariate logistic regression, while the qualitative data were analyzed thematically to enrich the quantitative results. Overall, 248 fisherfolk encountered an event that required the use of nPEP, and of these, 55/248 (22.2%) were able to use nPEP to prevent them from acquiring HIV. The usage of nPEP among adults in the Bussi sub-county, Wakiso district, was associated with not knowing that HIV can be prevented using nPEP medicines (AOR:0.1, 95% CI 0.03–0.36, p < 0.001), lack of knowledge of the existence of nPEP (AOR: 0.3, 95% CI 0.13–0.76, p = 0.01), the perception that nPEP can eectively prevent HIV infection after exposure (AOR 0.0586, 95% CI: 0.0177–0.1944, p < 0.001), and the community’s opinion aecting the willingness to take nPEP (AOR 0.1924, 95% CI: 0.0380–0.9727, p = 0.0462). The usage of nPEP among fisherfolk was low (22.2%). The low usage of nPEP was associated with a lack of knowledge and awareness about nPEP. This eort to improve the usage of nPEP should include community sensitization and HIV infection prevention using nPEP to raise awareness about HIV infection exposures and the risk of HIV infection during non-occupational exposur
The State of Mortuary and Mortuary Services in Public Health Facilities of South Western Uganda
(International Journal of Public Health Research, 2015-11-10) Kazungu, James; Nanyingi, Miisa; Katongole, Simon Peter; Anguyo, Robert DDM; Wampande, Lillian Nantume
Mortuaries and mortuary services are very crucial support services to healthcare delivery. Information on the status of mortuary services in Uganda is largely missing. This study therefore was carried out to assess the status and factors associated with the prevailing status of mortuary services. A descriptive cross-sectional study that employed both qualitative and quantitative methods of data analysis was carried out in South Western Uganda. Two regional referral hospitals, four district hospitals and 38 public health centre IV’s were studied. Data in these health facilities were obtained through observation, interviewing the managers of the health facilities and personnel directly responsible for the running of mortuary services about the state of and functionality of mortuaries in the facilities they headed. Out of all the health facilities studied, Nineteen (19/44, 43%) did not have mortuaries at all while 21/25 (84%) facilities’ mortuaries, were ranked to be in a fair state. Out of the health facilities with mortuaries, Nineteen (19/25, 76%) were poorly equipped with instruments required in a mortuary.Most mortuaries did not have adequate and trained human resources. As a result, the mortuary and mortuary services are under utilized in the health facilities in the region and are mostly used as dumping and storage centres for corpses that are picked from the streets by police and corpses that are unclaimed for by relatives. The functionality of mortuaries in the area studied and in the whole country as well should be enhanced by the Ministry of health and local governments in the area. When mortuaries are functionalized, the public should be sensitized on the services offered and the need to utilize the mortuaries so as to undo the inefficiencies delineated in this study.
The utility of internet-enabled antibiotic self-medication and Its associated factors among patients attending private clinics in Kawempe Division in Kampala Capital City, Uganda: community-based cross-sectional study
(Taylor and Francis, 2023-04-02) Nakakande, Joan; Taremwa, Ivan Mugisha; Nanyingi, Miisa; Mugambe, Samuel
Introduction: The expanding practice of internet-based antibiotic self-medication raises public health concerns as it increases antibiotic resistance and introduces avoidable risks. This study aims to examine the utility of internet-enabled antibiotic selfmedication and its associated factors among patients attending private clinics in Kawempe division in Kampala Capital City, Uganda. Methods: This was an analytical cross-sectional study that enrolled participants attending private clinics in Kawempe Division’s randomly selected zones. These were interviewed using a structured questionnaire, and the data were analyzed using STATA version 12 software. Logistic regression analysis was used, and variables with p ≤ 0.05 were considered as significantly associated with internet-enabled antibiotic self-medication. Results: Out of the 313 respondents, 246 (79%) reportedly had ever used internet sources to self-medicate with antibiotics. Factors such as being male; single; had knowledge of antibiotics; believed that Internet should be used for antibiotic self-medication; Distance to the nearest medical center/hospital from your residence/workplace of about 5 km and residing near a drug shop/pharmacy that gives antibiotics without a prescription increased internet-enabled antibiotic self-medication. Furthermore, the variables of more than three household members; common practice of antibiotic self-medication in a household; did not agree that one can recover from the illness without a doctor’s prescription and medical workers who did not explain adequately the antibiotics medication given for the illness decreased internet-enabled antibiotic self-medication. Conclusion: This study found that internet-enabled antibiotic self-medication practice is highly utilized and is associated with a variety of individual, household, and healthcare system factors. This necessitates strict adherence to national drug policy regulations governing antibiotic use. Furthermore, community health education is critical in combating such medication practices.