Objective: Despite the Global Vaccine Action Plan's goal of at least 90% vaccine coverage for all children, Uganda has made limited progress in vaccination over the past decade. The objective of this study was to examine the subnational trends in the prevalence and inequalities in under-immunisation and zero-dose among children aged 12-23 months in Uganda.
Study Design: A retrospective national cross-sectional study.
Objective: To evaluate construct validity of the contraception-focused "Preference-aligned Fertility Management" (PFM) Index, a new person-centered and rights-based outcome measure, in Nigeria and Uganda.
Study Design: We analyzed survey data from convenience samples of new users of contraception and non-users of contraception in Uganda and users of contraception in Nigeria. PFM Index scores were calculated by combining two indicators: Indicator 1 assessing alignment between desire to use contraception and actual use; Indicator 2 evaluating whether users' current methods are desired.
Introduction: Timely access to emergency obstetric care (EmOC) remains a challenge in sub-Saharan Africa, influenced by poor health care utilization and rapid urbanization. Studies show poor maternal health outcomes in African cities, reflecting weak health systems. Understanding care-seeking pathways is key to improving service delivery and health outcomes.
View Article and Find Full Text PDFBackground: Despite growing literature, few studies have explored the implementation of policy interventions to reduce maternal and perinatal mortality in low- and middle-income countries (LMICs). Even fewer studies explicitly articulate the theoretical approaches used to understand contextual influences on policy implementation. This under-use of theory may account for the limited understanding of the variations in implementation processes and outcomes.
View Article and Find Full Text PDFIntroduction: In people living with HIV, adherence to antiretroviral therapy (ART) is essential for achieving and sustaining viral suppression and reducing mortality. In young people living with HIV, ART adherence and retention remain a challenge with unsatisfactory viral suppression rates despite facility-based intensive adherence counseling that is the standard of care. Few studies have evaluated mHealth adherence interventions among young people living with HIV in resource-limited settings.
View Article and Find Full Text PDFImplementing self-injection (SI) of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) is a key self-care strategy for sexual and reproductive health, but SI uptake remains low, and assertions about the potential of SI to increase women's control over contraceptive use lack evidence. We sought to qualitatively explore how women with diverse contraceptive experiences-including those with and without experience using SI-view the benefits and challenges of SI as compared to other methods. We conducted 241 in-depth interviews with women across four sub-Saharan African countries and found alignment between the perceived and experienced benefits of SI across our diverse sample.
View Article and Find Full Text PDFBackground: Restrictive gender norms exacerbate health inequalities all over the world. More specifically, they prevent women from seeking preventive health services, constrain women's economic empowerment, and are associated with reproductive health decision making. Gender norms, a subset of social norms, are dynamic and change over time.
View Article and Find Full Text PDFObjective: The aim of the research was to explore the barriers to healthcare access for persons with various disabilities in rural Luuka district of Uganda. The findings will assist in appreciating the challenges persons with disabilities face in accessing Healthcare in a rural setting. These insights will contribute to the development of an intervention to improve healthcare access that is affordable, timely and acceptable.
View Article and Find Full Text PDFBackground: Evidence suggests that family-centered care for sick newborns, where parents are co-caregivers in newborn care units, can result in increased breastfeeding frequency, higher weight gain, earlier discharge, and reduced parental anxiety. This study explored healthcare providers' perceptions and experiences of parental participation in care for sick newborns in the newborn care units in two high-volume maternity units in Uganda, with the aim of informing interventions that promote family-centered care for newborns.
Methods: An exploratory qualitative study was conducted between August and December 2023.
Growing evidence suggests that extreme heat events affect both pregnant women and their infants, but few studies are available from sub-Saharan Africa. Using data from 138,015 singleton births in 16 hospitals in Benin, Malawi, Tanzania and Uganda, we investigated the association between extreme heat and early perinatal deaths, including antepartum and intrapartum stillbirths, and deaths within 24 h after birth using a time-stratified case-crossover design. We observed an association between an increase from the 75th to the 99th percentile in mean temperature 1 week (lag 0-6 d) before childbirth and perinatal mortality (odds ratio (OR) = 1.
View Article and Find Full Text PDFAm J Trop Med Hyg
November 2024
Antibiotic use in animals has been identified as a major contributing factor for antibiotic resistance. Given the limited access to veterinary services, the choice of antibiotic and the dosage are determined by the farmers. By analyzing prescription practices and their appropriateness, we can compare performance in antibiotic stewardship across regions to drive change toward national goals and to guide policy interventions.
View Article and Find Full Text PDFUnderstanding and eliminating mental illness stigma is crucial for improving population mental health. In many settings, this stigma is gendered, from the perspectives of both the stigmatized and the stigmatizers. We aimed to find the differences in the level of stigma across different mental disorders while considering the gender of the study participants as well as the gender of the people depicted in the vignettes.
View Article and Find Full Text PDFBackground: Whereas digital payments have been identified as a solution to health payment challenges, evidence on their adoptability among Community Health Workers (CHWs) is limited. Understanding their adoptability is crucial for sustainability. This study assessed the adoptability of digital payments for CHWs in Wakiso district, Uganda.
View Article and Find Full Text PDFBackground: Tuberculosis medication nonadherence is a multi-dimensional public health problem with serious consequences worldwide. There is little information available for medication nonadherence in South Sudan. This study assessed the proportion, reasons, and associated factors for nonadherence among patients with TB in Wau Municipality, South Sudan.
View Article and Find Full Text PDFBackground: In 2015, Uganda joined the Global Financing Facility (GFF), a Global Health Initiative for Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH). Similar initiatives have been found to be powerful entities influencing national policy and priorities in Uganda, but few independent studies have assessed the GFF.
Objective: To understand the policy process and contextual factors in Uganda that influenced the content of the GFF policy documents (Investment Case and Project Appraisal).
Background: The Global Financing Facility (GFF) was launched in 2015 to catalyse increased domestic and external financing for reproductive, maternal, newborn, child, adolescent health, and nutrition. Half of the deaths along this continuum are neonatal deaths, stillbirths or maternal deaths; yet these topics receive the least aid financing across the continuum.
Objectives: To conduct a policy content analysis of maternal and newborn health (MNH), including stillbirths, in GFF country planning documents, and assess the mortality burden related to the investment.
Community Health Workers (CHWs) are a key human resource for health particularly in low- and middle-income countries. In many parts of the world, CHWs are known to have played an instrumental role in controlling the COVID-19 pandemic. This study explored the involvement of CHWs in the COVID-19 response in Uganda.
View Article and Find Full Text PDFBackground: Preterm birth is the leading cause of death in children younger than 5 years worldwide. WHO recommends kangaroo mother care (KMC); however, its effects on mortality in sub-Saharan Africa and its relative costs remain unclear. We aimed to compare the effectiveness, safety, costs, and cost-effectiveness of KMC initiated before clinical stabilisation versus standard care in neonates weighing up to 2000 g.
View Article and Find Full Text PDFIntroduction: 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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