Publications by authors named "Rornald Muhumuza Kananura"

Background: Preventive nutrition interventions (PNI) are usually implemented without understanding how multilevel factors affect uptake. Undernutrition is defined as inadequate intake of nutritious foods. Pastoral populations in conflict settings are seen to have low uptake.

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Introduction: Owing to the lack of local cost and clinical effectiveness data in sub-Saharan Africa, economic evaluations of the rotavirus vaccine are still limited in the region. In this study, we utilize different data sources, including aggregated routine health information system data to examine the net benefits of the rotavirus vaccine in Uganda. We also present ways in which health facility data can be used to assess subnational vaccination coverage as well as the effect of the vaccine on diarrhoea hospitalization.

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  • The COMONETH project was initiated in rural eastern Uganda from 2017 to 2020 to enhance maternal and newborn care (MNC) and address barriers faced by mothers in accessing health services.
  • The intervention involved training Community Health Workers and providing educational resources, which aimed to improve the uptake of antenatal care (ANC) and postnatal care (PNC) among expectant mothers.
  • Results showed significant increases in the number of ANC visits and PNC service utilization, though no major effects were found on early ANC attendance or facility delivery rates.
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  • The study looks at how various factors make it hard for families in poor areas to get needed healthcare for mothers and young children.* -
  • Researchers talked to mothers who lost newborns and held discussions with parents to understand problems they face when seeking health care in rural Uganda.* -
  • They found that issues like family influence, bad roads, and unhelpful health workers all make it tough for people to get the health services they need.*
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  • In Kampala City, Uganda, a study looked at the quality of health data about deliveries, live births, and maternal deaths in hospitals from 2016 to 2021.
  • The researchers found that only about half of the delivery and live birth data was complete, while information about maternal deaths was very low, with most months showing no deaths reported.
  • They concluded that while the data quality was generally poor, it was somewhat better in facilities that handle emergency childbirth situations.
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Introduction: While urban areas are often perceived to have better access to healthcare services, including modern family planning (FP) services, urban dwellers including those with better socioeconomic status are faced with multidimensional challenges that shape their access to appropriate FP services. In Uganda's urban spaces, there is currently a lack of understanding among service providers, civil society organizations, and individuals/communities regarding the implementation of interventions that promote informed choice and voluntary use of family planning services. This knowledge gap has profound implications for reproductive rights.

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  • The study investigates slum-like household conditions in the Greater Kampala Metropolitan Area using data from Uganda's Demographic and Health Surveys, revealing that 67% of households were classified as slum-like by 2016, with serious implications for residents' health.
  • Key slum-like conditions identified include substandard housing, lack of clean water, overcrowding, unclean cooking fuel, and limited toilet access, which are associated with lower education levels and unprofessional jobs among residents.
  • Children living in slum-like conditions faced higher risks of illnesses like diarrhea, fever, anemia, and stunting, yet those in such conditions were less likely to seek treatment for fever, highlighting the urgent need for health interventions focused
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Background: This study analyses vaccine coverage and equity among children under five years of age in Uganda based on the 2016 Uganda Demographic and Health Survey (UDHS) dataset. Understanding equity in vaccine access and the determinants is crucial for the redress of emerging as well as persistent inequities.

Methods: Applied to the UDHS for 2000, 2006, 2011, and 2016, the Vaccine Economics Research for Sustainability and Equity (VERSE) Equity Toolkit provides a multivariate assessment of immunization coverage and equity by (1) ranking the sample population with a composite direct unfairness index, (2) generating quantitative measure of efficiency (coverage) and equity, and (3) decomposing inequity into its contributing factors.

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Voluntary, rights-based family planning upholds women's right to determine freely the number and spacing of their children. However, low-resource settings like Uganda still face a high unmet need for family planning. And, while urban areas are often indicated to have better access to health services, emerging evidence is revealing intra-urban socio-economic differentials in family planning utilization.

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Anaemia continues to be a burden especially in developing countries that not only affects the physical growth and cognitive development of children but also increases their risk to death. Over the past decade, the prevalence of anaemia among Ugandan children has been unacceptably high. Despite this, spatial variation and attributable risk factors of anaemia are not well explored at national level.

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Despite the widely known preventive interventions, the dyad of acute respiratory infections (ARI) and diarrhoea remain among the top global causes of mortality in under- 5 years. Studies on child morbidity have enormously applied "traditional" statistical techniques that have limitations in handling high dimension data, which leads to the exclusion of some variables. Machine Learning (ML) models appear to perform better on high dimension data (dataset with the number of features p (usually correlated) larger than the number of observations N).

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Introduction: There are concerns about the impact of the COVID-19 pandemic on the continuation of essential health services in sub-Saharan Africa. Through the Countdown to 2030 for Women's, Children's and Adolescents' Health country collaborations, analysts from country and global public health institutions and ministries of health assessed the trends in selected services for maternal, newborn and child health, general service utilisation.

Methods: Monthly routine health facility data by district for the period 2017-2020 were compiled by 12 country teams and adjusted after extensive quality assessments.

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Objective: Teenage pregnancy has become a public health concern in Uganda because of its negative consequences to both the mother and child. The objective of this study was to examine the determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006-2016.

Study Design: A retrospective national cross-sectional study SETTING: Uganda.

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Background: Routine health facility data are a critical source of local monitoring of progress and performance at the subnational level. Uganda has been using district health statistics from facility data for many years. We aimed to systematically assess data quality and examine different methods to obtain plausible subnational estimates of coverage for maternal, newborn and child health interventions.

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Background: The annual collection of fertility, marriage, sexual behaviour, and contraceptive use data in the nationally representative rounds of Performance Monitoring and Accountability (PMA) surveys in sub-Saharan Africa may contribute to the periodic monitoring of adolescent sexual and reproductive health (ASRH). However, we need to understand the reliability of these data in monitoring the ASRH indicators. We assessed the internal and external consistencies in ASRH indicators in five countries.

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Introduction: Uganda'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.

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Objectives: To assess low birth weight's (LBW) mediation role on the factors associated with newborn mortality (NM), including stillbirth and the role of institutional delivery in the association between LBW and NM.

Design And Participants: I used the 2011-2015 event histories health demographic data collected by Iganga-Mayuge Health Demographic and Surveillance Site (HDSS). The dataset consisted of 10 758 registered women whose birth occurred at least 22 weeks of the gestation period and records of newborns' living status 28 days after delivery.

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Introduction: Uganda is in discussions to introduce a national health insurance scheme. However, there is a paucity of information on household preferences and willingness to pay for health insurance attributes that may guide the design of an acceptable health insurance scheme. Our study sought to assess household preferences and willingness to pay for health insurance in Kampala city using a discrete choice experiment.

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Background: Globally, the under-10 years of age mortality has not been comprehensively studied. We applied the life-course perspective in the analysis and interpretation of the event history demographic and verbal autopsy data to examine when and why children die before their 10th birthday.

Methods: We analysed a decade (2005-2015) of event histories data on 22385 and 1815 verbal autopsies data collected by Iganga-Mayuge HDSS in eastern Uganda.

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Background: Electronic data capturing has the potential to improve data quality and user-friendliness compared to manually processed, paper-based documentation systems. The MyChild system uses an innovative approach to process immunization data by employing detachable vouchers integrated into a vaccination booklet which are then scanned and converted into individual-level health data. The aim was to evaluate the MyChild data capturing system by assessing the proportion of correctly processed vouchers and to compare the user-friendliness in term of time spent on documentation and health worker experiences with the standard health information system at health facilities in Uganda.

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Background: There is mixed evidence and lack of consensus on the impact of economic development on stunting, and likewise there is a dearth of empirical studies on this relationship in the case of sub-Saharan Africa. Thus, this paper examines whether economic growth is associated with childhood stunting in low-income and middle-income sub-Saharan African countries.

Methods: We analysed data from 89 Demographic and Health Surveys conducted between 1987 and 2016 available as of October 2018 using multivariable multilevel logistic regression models to show the association between gross domestic product (GDP) per capita and stunting.

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In Uganda, more than 336 out of every 100,000 women die annually during childbirth. Pregnant women, particularly in rural areas, often lack the financial resources and means to access health facilities in a timely manner for quality antenatal, delivery, and post-natal services. For nearly the past decade, the Makerere University School of Public Health researchers, through various projects, have been spearheading innovative interventions, embedded in implementation research, to reduce barriers to access to care.

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Background: The use of participatory monitoring and evaluation (M&E) approaches is important for guiding local decision-making, promoting the implementation of effective interventions and addressing emerging issues in the course of implementation. In this article, we explore how participatory M&E approaches helped to identify key design and implementation issues and how they influenced stakeholders' decision-making in eastern Uganda.

Method: The data for this paper is drawn from a retrospective reflection of various M&E approaches used in a maternal and newborn health project that was implemented in three districts in eastern Uganda.

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Despite its reduction over the last decade, the maternal mortality rate in Uganda remains high, due to in part a lack of access to maternal health care. In an effort to increase access to care, a quasi-experimental trial using vouchers was implemented in Eastern Uganda between 2009 and 2011. Findings from the trial reported a dramatic increase in pregnant women's access to institutional delivery.

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Background: The slow progress in reducing maternal and newborn death in low and middle-income countries is attributed to both demand and supply-side factors. This study assessed the changes in maternal and newborn services in health facilities as well as demand for maternal and newborn health services in Eastern Uganda.

Methods: The health assessment data were collected in August 2013 and September 2015 in the districts of Kamuli, Pallisa, and Kibuku.

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