Development of a customized m-Health-based intervention to reduce loss to follow-up among patients undergoing treatment for cervical lesions at a rural referral Hospital, South Western Uganda.

Background: Loss to follow-up (LTFU) in individuals undergoing cervical cancer treatment is a major challenge in many low resource settings. We describe development of a customized and tailored mHealth intervention for reducing LTFU among patients undergoing cervical cancer treatment at Mbarara Regional Referral Hospital (MRRH).

Methods: We interviewed all health care providers (HCPs) at the cervical cancer clinic of MRRH, between April and May 2023.

High Rate of Loss to Follow-Up Among Patients Undergoing Treatment for Premalignant Cervical Lesions at Mbarara Regional Referral Hospital, Southwestern Uganda: A Retrospective Cohort Study.

Background: For a cervical cancer control program to be effective in reducing the incidence of the disease, there should be high compliance to treatment and follow-up of women diagnosed with precursor lesions. Screening programs in low-resource countries such as Uganda are challenged by poor adherence to follow-up following treatment for premalignant cervical lesions. This study sought to describe the burden and factors associated with loss to follow-up among women undergoing treatment for premalignant cervical lesions at a tertiary hospital in southwestern Uganda.

Gaps in vaccine management practices during vaccination outreach sessions in rural settings in southwestern Uganda.

Background: Outreach efforts were developed to bolster people's access to and use of immunization services in underserved populations. However, there have been multiple outbreaks of diseases like measles in Uganda, prompting policy makers and stakeholders to ask many unanswered questions. This research study was created to uncover the discrepancies between vaccine management practices at immunization outreach sessions in rural South Western Uganda compared with existing standards.

Health system strengthening using a : A community case study.

Introduction: Health system strengthening initiatives in low and middle-income countries are commonly hampered by limited implementation readiness. The uses a system "readiness" theory of change to address implementation obstacles. is documented based on field experiences, incorporating best practices, and lessons learned from two decades of maternal, newborn, and child health (MNCH) programming in East Africa.

Evaluation of a comprehensive maternal newborn health intervention in rural Tanzania: single-arm pre-post coverage survey results.

Background: In Tanzania, maternal and newborn deaths can be prevented via quality facility-based antenatal care (ANC), delivery, and postnatal care (PNC). Scalable, integrated, and comprehensive interventions addressing demand and service-side care-seeking barriers are needed.

Objective: Assess coverage survey indicators before and after a comprehensive maternal newborn health (MNH) intervention in Misungwi District, Tanzania.

Dramatic effects of COVID-19 public health measures and mass reverse migration on youth sexual and reproductive health in rural Uganda.

Introduction: Youth (aged 10 to 24 years) comprise nearly one-third of Uganda's population and often face challenges accessing sexual and reproductive health (SRH) services, with a disproportionately high incidence of negative SRH outcomes. Responding to COVID-19, Uganda implemented strict public health measures including broad public transportation, schooling, and business shut-downs, causing mass reverse-migration of youth from urban schools and workplaces back to rural home villages. Our study aimed to qualitatively describe the perceived unintended impacts of COVID-19 health measures on youth SRH in two rural districts.

Five-year retention of volunteer community health workers in rural Uganda: a population-based retrospective cohort.

Community health workers (CHWs) effectively improve maternal, newborn and child health (MNCH) outcomes in low-to-middle-income countries. However, CHW retention remains a challenge. This retrospective registry analysis evaluated medium-term retention of volunteer CHWs in two rural Ugandan districts, trained during a district-wide MNCH initiative.

Context matters in understanding the vulnerability of women: perspectives from southwestern Uganda.

Background: Vulnerability at the individual, family, community or organization level affects access and utilization of health services, and is a key consideration for health equity. Several frameworks have been used to explore the concept of vulnerability and identified demographics including ethnicity, economic class, level of education, and geographical location. While the magnitude of vulnerable populations is not clearly documented and understood, specific indicators, such as extreme poverty, show that vulnerability among women is pervasive.

Prevalence of hypertension in relation to anthropometric indices among secondary adolescents in Mbarara, Southwestern Uganda.

Background: Studies investigating the prevalence of hypertension and its correlation with anthropometric indices among adolescents are still scarce compared to those conducted in adults of greater than 40 years. So far, no other study estimating the prevalence and correlates of hypertension among adolescents in Uganda has been found.

Objective: The purpose of this study, therefore, was to asses the prevalence of hypertension and its correlation with anthropometric indices among adolescents in Mbarara Municipality, southwestern Uganda.

Loss to follow-up and associated maternal factors among HIV-exposed infants at the Mbarara Regional Referral Hospital, Uganda: a retrospective study.

Background: Loss to follow-up (LTFU) deprives HIV-exposed infants the lifesaving care required and results in exposing HIV free infants to virus requisition risk. We aimed to determine the rate of LTFU, postnatal mother-to-child HIV-transmission (MTCT) and to identify maternal factors associated with LTFU among HIV-exposed infants enrolled at Mbarara Regional Referral Hospital PMTCT clinic.

Methods: Study participants were infants born to HIV-positive mothers enrolled in the PMTCT clinic for HIV care at Mbarara Regional Referral Hospital.

Using blood pressure height index to define hypertension among secondary school adolescents in southwestern Uganda.

Hypertension is the number one risk factor for cardiovascular diseases worldwide and yet its diagnosis among adolescents, based on blood pressure percentiles which are age, height, and sex-specific, is complex. Our study intended to determine the suitability of blood pressure height index in defining adolescent hypertension among secondary school adolescents aged 12-17 years in Mbarara municipality, southwestern Uganda. Our study used data of 485 secondary school adolescents of which 173 were boys.

Predictors of sleeping under cost-free mosquito bed nets among children under-five years in Mbarara, Uganda: a household survey.

Background: In 2010, Uganda Malaria Control Programme distributed cost-free mosquito bed nets to households with children under-five years and pregnant women in selected sub-counties. We assessed the factors associated with sleeping under costfree mosquito nets among children under-five years in Nyakayojo sub-county, Mbarara District, Uganda.

Methods: 381 households with at least a child under-five years and benefited from cost-free bed nets in Nyakayojo were randomly selected.

Utilization of Long-Lasting Insecticide Treated Nets and Parasitaemia at 6 Months after a Mass Distribution Exercise among Households in Mbarara Municipality, Uganda: A Cross-Sectional Community Based Study.

Background: Utilization of long-lasting insecticide treated nets (LLINs) after free and mass distribution exercise has not been adequately studied. The objectives of this study were to assess ownership and utilization of LLINs following a mass distribution campaign in a Ugandan urban municipality.

Methods: We conducted a cross-sectional study in western Uganda among households with children under 5 years, at 6 months after a mass LLIN distribution exercise.

Effect of age at initiation of antiretroviral therapy on treatment outcomes; A retrospective cohort study at a large HIV clinic in southwestern Uganda.

Background: The prevalence of HIV infection among older persons is increasing yet older age at initiation of antiretroviral therapy (ART) may be associated with poorer treatment outcomes including mortality. However, majority of these studies have been done in the western world and there is limited data in resource limited settings. Our study used routinely collected health facility data to assess trends in age at initiation of ART, the effect of age at ART initiation on mortality and immunological response at a large urban hospital in south western Uganda.

Supportive supervision and constructive relationships with healthcare workers support CHW performance: Use of a qualitative framework to evaluate CHW programming in Uganda.

Background: While evidence supports community health worker (CHW) capacity to improve maternal and newborn health in less-resourced countries, key implementation gaps remain. Tools for assessing CHW performance and evidence on what programmatic components affect performance are lacking. This study developed and tested a qualitative evaluative framework and tool to assess CHW team performance in a district program in rural Uganda.

The Experience and Impact of Contraceptive Stockouts Among Women, Providers and Policymakers in Two Districts of Uganda.

Context: Little is known about the impact of contraceptive stockouts on women and health care providers, or how policymakers perceive and handle such stockouts.

Methods: In May-July 2015, a qualitative study on experiences of contraceptive stockouts was conducted in two districts of Uganda. It comprised three data collection components: eight focus groups with 50 women, 24 individual in-depth interviews with family planning service providers and facility managers, and 11 in-depth interviews with district-level policymakers and decision makers.

Abundance of megalin and Dab2 is reduced in syncytiotrophoblast during placental malaria, which may contribute to low birth weight.

Placental malaria caused by Plasmodium falciparum contributes to ~200,000 child deaths annually, mainly due to low birth weight (LBW). Parasitized erythrocyte sequestration and consequent inflammation in the placenta are common attributes of placental malaria. The precise molecular details of placental changes leading to LBW are still poorly understood.

Timing of malaria in pregnancy and impact on infant growth and morbidity: a cohort study in Uganda.

Background: Malaria in pregnancy (MiP) is a major cause of fetal growth restriction and low birth weight in endemic areas of sub-Saharan Africa. Understanding of the impact of MiP on infant growth and infant risk of malaria or morbidity is poorly characterized. The objective of this study was to describe the impact of MIP on subsequent infant growth, malaria and morbidity.

Increasing incidence of pregnancy among women receiving HIV care and treatment at a large urban facility in western Uganda.

Background: Antiretroviral treatment restores physical functioning and may have an impact on fertility desires. Counseling is given to HIV positive women to create awareness and to provide information on pregnancy and delivery. The purpose of this study was to determine the incidence of pregnancy and factors that predict pregnancy among women of reproductive age receiving HIV care and treatment at a large urban center in western Uganda.

Potential for revitalisation of the diaphragm for family planning in Uganda: a rapid assessment of the feasibility of introducing the SILCS Diaphragm.

This health systems assessment evaluated the feasibility of introducing a new contraceptive device, the SILCS single-size diaphragm, into the existing family planning method mix in Uganda. A total of 26 focus group discussions with 201 female and 77 male potential users and 98 key informant interviews with policymakers and providers were conducted between June and August 2010. Potential users, providers, and policymakers recognised that the SILCS Diaphragm could fill a gap in the method mix and expressed eagerness to make the SILCS Diaphragm available, particularly because it is nonhormonal and woman initiated.

Consumer perspectives on a pericoital contraceptive pill in India and Uganda.

Context: Studies suggest that women in some countries have adopted emergency contraceptive pills as a routine method of family planning. This practice indicates there may be latent demand for a pericoital contraceptive pill taken only when a woman has sexual intercourse, and labeled and marketed for use as a regular contraceptive method.

Methods: To understand the appeal and potential market for a pericoital contraceptive pill, 39 focus groups and 23 in-depth interviews were conducted with women and men in Lucknow, Uttar Pradesh, India, and Kampala, Uganda.

Stakeholder and provider views regarding pericoital contraceptive pills in India and Uganda.

The development of pericoital contraceptive pills is under consideration to address unmet need for family planning, especially among women who have infrequent sexual intercourse. Pericoital pills, an oral contraceptive taken 24 hours before or after intercourse, would be a potentially desirable contraceptive option because it could provide convenience, discretion, and female control over contraceptive use. To gauge receptivity to pericoital contraception, a total of 49 in-depth interviews and 5 focus group discussions were conducted in India and Uganda with family planning providers and stakeholders.